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620 ADULT - RESPIRATORY SYSTEM NP
CERTIFICATION, FITZGERALD 4TH ED
QUESTIONS AND ANSWERS, Exams of Nursing
2026 Graded A+| Validate Pass
a. penicillin - ANSWER -the antibiotic choice for the tx of Streptococcus pneumoniae infection is: a. penicillin b. dicloxacillin c. erythromycin d. ampicillin clavulanate d. sudden infant death syndrome (SIDS) - ANSWER -what is the most common cause of sudden and unexpected death in infants, accting for 80% of postneonatal infant mortality with a peak incidence at 6 months? a. choking b. shaken baby syndrome c. infantile pneumonia d. sudden infant death syndrome (SIDS) d. the Mantoux test shows a raised injected or red area without induration - ANSWER -the dx of TB does NOT need to be reported when: a. the client's Mantoux test shows an induration of 15mm b. a case of TB is only suspected c. an asymptomatic clt has a positive chest x-ray for pulmonary TB
d. the Mantoux test shows a raised injected or red area without induration c. cockroaches - ANSWER -in inner-city children, an important cause of asthma-related illness and hospitalizations is: a. heredity and genetics b. vitamin deficiencies c. cockroaches d. playing on asphalt playgrounds b. vocal cord dysfunction - ANSWER -when asthma does not respond to traditional therapy, it may be due to another syndrome that mimics asthma, such as: a. lower airway obstruction b. vocal cord dysfunction c. COPD d. bronchitis b.. tapered symmetric subglottic narrowing on x-ray - ANSWER - approximately 50% of children with viral croup have a(n): a. aspirated foreign body b. tapered symmetric subglottic narrowing on x-ray c. concurrent epiglottitis d. hx of allergic rhinitis
b. lung abscess c. cystic fibrosis d. TB c. you will want to use it every night, all night long - ANSWER - Henry has severe obstructive sleep apnea and has just been ordered a continuous positive airway pressure (CPAP) machine. What do you tell him about it? a. you put it on at night after you have woken up several times b. you must use it at least 5 night during the week c. you will want to use it every night, all night long d. we will discontinue it if you develop nasal dryness or rhinitis a. antibiotic exposure and a hospital stay of more than 1 week. - ANSWER -the well established risk factor(s) for a nosocomial pneumonia caused by a multidrug resistant organism is(are) a. antibiotic exposure and a hospital stay of more than 1 week. b. age greater than 65 and having COPD c. having outpatient surgery d. having allergies to multiple antibiotics a. streptococci and staphylococci - ANSWER -the two most predominant organisms constituting the normal flora of the oropharynx are: a. streptococci and staphylococci b. streptococci and moraxella catarrhalis c. staphylococci and candida albicans
d. various protozoa and staphylococci b. post-infection - ANSWER -the most common reason for a chronic cough in children is: a. asthma b. post-infection c. postnasal drip d. an irritant a. emphysema - ANSWER -hyperresonance on percussion of the chest occurs with: a. emphysema b. pneumonia c. pleural effusion d. lung tumor a. chronic bronchitis - ANSWER -a pulmonary function test, such as a spirometry is helpful in the dx of: a. chronic bronchitis b. lung cancer c. pneumonia d. TB c. presents with adventitious sounds, wheezing and rhonchi, and a normal percussion note. - ANSWER -in trying to differentiate between chronic bronchitis and emphysema, you know that chronic bronchitis:
c. use of accessory muscles d. a cough c. engaging in moderate to high levels of physical activity - ANSWER -other than smoking cessation, which of the following slows the progression of COPD in smokers? a. making sure the environment is free of all pollutants b. eliminating all pets from the environment c. engaging in moderate to high levels of physical activity d. remaining indoors with air conditioning as much as possible b. yes, she might recognize early sign of deterioration - ANSWER - Sarah, age 49, has had asthma for several years but has never used a peak expiratory flowmeter. Should you now recommend it? a. no, she has been managing fine without it b. yes, she might recognize early sign of deterioration c. present the options and let Sarah decide d. no, at her age it is not recommended a. the prevalence of COPD is directly related to increasing age. - ANSWER -which statement about COPD is true? a. the prevalence of COPD is directly related to increasing age. b. the incidence of COPD is about equal in men and in women c. cigar or pipe smoking does not increase the risk of developing COPD d. environmental factors such as smoke do not affect the potential for COPD
a. racial and ethnic minorities - ANSWER -which grp is at the highest risk for TB? a. racial and ethnic minorities b. foreign-born individuals c. substance abusers d. nursing home residents b. Legionnaires' disease - ANSWER -Michael, age 52, has a GRADUAL onset of dry cough, dyspnea, chills, fever, general malaise, headache, confusion, anorexia, diarrhea, myalgias, and arthralgias. Which dx do you suspect? a. bronchopneumonia b. Legionnaires' disease primary atypical pneumonia d. Pneumocystis jirovecii pneumonia a. respiratory rate - ANSWER -the CURB-65 criteria may be used to help assess whether a pt needs to be tx in the hospital or can be effectively treated at home. The "R" stands for a. respiratory rate b. rapid pulse rate c. Raynaud's syndrome present d. region of the country where the clt lives d. Cystic fibrosis - ANSWER -which of the following differential dx should be considered with a chronic cough in children ages 1- yrs after the more common causes have been r/o?
c. Jerry, who has lymphoid leukemia - ANSWER -which of the following individuals most likely will have a false-negative rx to the Mantoux test? a. Marvin, age 57 b. Jane who is on a short course of corticosteroid therapy for an acute exacerbation of asthma c. Jerry, who has lymphoid leukemia d. Mary, who recently was exposed to someone coughing c. 6-9 months - ANSWER -Tina, age 49, is on multiple drug therapy for TB. She asks you how long she needs to take the drugs. You respond: a. 6 wks to 2 months b. 4-6 months c. 6-9 months d. one year c. beta-2 agonist - ANSWER -Which sympathomimetic agents are the drugs of choice for asthma? a. alpha agonists b. beta-1 agonist c. beta-2 agonist d. alpha antagonists c. PZA - pyrazinamide - ANSWER -which of the following medications commonly prescribed for TB cannot be taken by pregnant women?
a. INH - isoniazid b. RIF - rifampin c. PZA - pyrazinamide d. EMB - ethambutol sudden infant death - ANSWER -an infant who has periodic breathing with persistent or prolonged apnea (> than 20 seconds) may have an increased risk of a. 7-10 - ANSWER -what would be the 1 min APGAR score for a newborn in good condition who needs only suctioning of the nose and mouth and otherwise routine care? a. 7- b. 6- c. 3- d. 0- d. nosocomial pneumonia - ANSWER -increased severity of underlying illness, presence of an indwelling urethral catheter, and use of broad-spectrum antibiotics are risk factors predisposing clts to the development of: a. TB b. decreased mobility c. pressure ulcers d. nosocomial pneumonia
d. concurrent COPD c. hoarseness - ANSWER -which is the most notable clinical manifestation of glottis (tongue) cancer? a. earache b. halitosis c. hoarseness d. frequent swallowing d. whenever the clt needs it, at any time and at any step - ANSWER -when should a rescue course of prednisolone be initiated for an attack of asthma? a. when the clt is in step 1 (intermitten stage) b. when the clt is in step 2 (mild persistent stage) c. when the clt is in step 4 (severe persistent stage) d. whenever the clt needs it, at any time and at any step b. discard the gum after 30 min - ANSWER -when teaching smokers about using nicotine gum to aid in smoking cessation, tell them to: a. chew the gum like regular gum b. discard the gum after 30 min c. drink a cup of coffee before chewing the gum because it assists in the nicotine absorption d. chew 6-9 pieces daily to help prevent nicotine withdrawal
a. newborn and infant - ANSWER -in which age grp does respiratory retraction occur more often? a. newborn and infant b. school-age child c. young adult d. older adult c. 15 hrs per day - ANSWER -Mary, age 69 has COPD. her o2 sat is less than 85%. She is to start on O2 therapy to relieve her symptoms. How often must she be on oxygen therapy to actually improve her O2 sat? a. on an as-needed basis b. continuously c. 15 hrs per day d. 24 hrs per day b. the amt of gas left in the lung after exhaling all that is physically possible - ANSWER -what is the definition of the spirometric assessment of residual volume? a. the sum of the vital capacity and the residual volume b. the amt of gas left in the lung after exhaling all that is physically possible c. the volume that can be maximally exhaled after a passive exhalation d. the measure of the maximum flow rate achieved during the forced vital capacity maneuver
measure gross changes in peak expiratory flow. Which zone would rate her expiratory compliance as 50-80% of her personal best? a. white zone b. green zone c. yellow zone d. red zone c. moderate persistent - ANSWER -Jill, age 49 has daily sxs of asthma. She uses her inhaled SABA daily. Her exacerbations affect her activities and they occur at least twice weekly and may last for days. She is affected more than once weekly during the night with an exacerbation. Which category of asthma severity is Jill in? a. mild intermittent b. mild persistent c. moderate persistent d. severe persistent c. use this ONCE per day - ANSWER -what do you include in your teaching about Spiriva (tiotropium) when you initially prescribe it for your clt with COPD? a. use it every time you use your beta-2 agonist b. stop taking all your other COPD medications c. use this ONCE per day d. stop taking Spiriva if you develop the adverse effect of dry mouth
b. lobar pneumonia - ANSWER -increased tactile fremitus occurs with: a. pleural effusion b. lobar pneumonia c. pneumothorax d. emphysema assessment of digital clubbing of the fingers - ANSWER -what is a Schamroth sign? b. Hamman's sign - ANSWER -what is the term describing an auscultation sound at the mediastinum in the presence of a mediastinal "crunch" that coincides with cardiac systole and diastole? a. Homan's sign b. Hamman's sign c. Manubrium's sign d. Louis sign d. cigarette smoking - ANSWER -which of the following is the most frequent contributor to the incidence of carcinoma of the lung? a. chronic pneumonia b. exposure to materials such as asbestos, uranium, and radon c. chronic interstial lung disease d. cigarette smoking
b. respiratory alkalosis - ANSWER -what early acid-base disturbance occurs in a teenager admitted for an aspirin overdose? a. respiratory acidosis b. respiratory alkalosis c. metabolic acidosis d. metabolic alkalosis d. night sweats are often noted as a manifestation of fever - ANSWER -which of the following statements is true regarding pulmonary TB? a. manifestations are usually confined to the respiratory system b. dyspnea is usually present in the early stages c. crackles and bronchial breath sound are usually present in all phases of the disease d. night sweats are often noted as a manifestation of fever c. ACEi (prils) - ANSWER -during the hx portion of a respiratory assessment, it is particularly important to ask if the clt takes which of the following drugs? a. beta-2 agonists b. calcium channel blockers c. ACEi (prils) d. birth control pills b. 85% - ANSWER -persons requiring home O2 will have an O2 sat below: a. 90%
b. 85% c. 80% d. 75% a. the thoracic cage may appear wider - ANSWER -which of the following statements regarding the respiratory status of the pregnant women is true? a. the thoracic cage may appear wider b. the costal angle may feel narrower c. respiration may be shallow d. Oxygenation is decreased d. begin tx with corticosteroids - ANSWER -Jessica, age 9 months, is brought into the clinic by her mother. She has a low-grade fever, stridor with agitation, some retractions, and a cough, but no drooling. You dx viral croup. Your next step would be to: a. hospital Jessica b. start antibiotic therapy c. order supportive treatment d. begin tx with corticosteroids a. bronchodilator - ANSWER -Theophylline when given for COPD acts as a: a. bronchodilator b. by decreasing and strengthening respirations c.to impede mucociliary clearance d. with a negative inotropic effect
