REVIEWER IN OXY AND FLUIDS a.

Aspergillus
RESPIRATORY        c. Parainfluenza B18. Pneumonia is considered hospital acquired if the
A1. Which is the most common organism causing b. Histoplasma diagnosis is confirmed after how many hours’ after
community acquired pneumonia? d. Influenza admission?
 a) pneumococcus  a. 24 hrs. c.72 hrs.
 b) hemophilic influenza A10. Respiratory acidosis occurs as a result of which of  b. 48 hrs. d. none of the above
 c) viral the following?
 d) mycoplasma    a. Lung disease, causing increased retention of CO2
b. Kidney disease, causing increased retention of B19. When pneumonia is caused by aspiration of
B2. Which of the list below is not the cause of an bicarbonate endogenous or exogenous substances, it called
exudative pleural effusion?  c. Lung disease, causing increased exhalation of CO2  a. pulmonary edema
a) viral pneumonia d. Kidney disease, causing increased excretion of c. viral pneumonia
c) TB bicarbonate  b. aspiration pneumonia
 b) malignancy                  d.  influenza
d) pancreatitis  A11. Besides treating bacterial pneumonia with
antibiotics, it might also be necessary to: A20. In your understanding of ventilation perfusion
B3. Asthma is caused by: a. Use a ventilator ratio, perfusion refers to:
a. sensitivity to specific allergens c. Administer cardio protective agents  a. the amount of blood that flows to the alveolar
c. emotional stress b. Perform neurosurgery capillaries
b. severe respiratory tract infection d. Perform a liver transplant  b. the amount of blood that flows to the systemic circulation.
d. fatigue  c. the amount of blood that is oxygenated
B12. Hyperventilating as a result of anxiety. What is the  d. the amount of blood that remains in the alveoli
D4. Tuberculosis is transmitted through: best course of treatment for hyperventilation?
a. fecal –oral route  a. Oxygen supplements
c. contact with urine c. Diaphragmatic breathing
b. contact with food  b. Breathing into a paper bag
d. inhalation of infected droplets d. Steroidal inhalers

B5. Pneumococcal resistance to βlactams can be D13. The three causes of pneumonia are bacteria, fungi,
overcome by increasing βlactam doses except for: and _____.
a.  sinusitis  a. parasites
c.  bacteremia c. poison
b.  meningitis b. contaminated food
d.  pneumonia d. a virus
FLUIDS
A6. All of the following are risk factors for community- D15. In regards to pneumonia, which of the following 1. Which of the following is a clinical manifestation of
acquired pneumonia, EXCEPT: statements is NOT correct? hypokalemia?
a. female gender a. Pneumonia involves the lungs irritability
b. smoking history c. pneumonia may cause over hydration. soft flabby muscles
c. occupational dust exposure b. Pneumonia may cause chills and a fever abdominal cramping
d. history of childhood pneumonia d. Pneumonia may cause a cough. oliguria
2. Which of the following is a clinical manifestation of
B7. All of the following are common symptoms of B16. Which respiratory disease causes the walls of the hyperkalemia?
community-acquired pneumonia in adults, except: alveoli to deteriorate? irritability
a. fever  a. bronchitis        soft flabby muscles
c. sputum production c. asthma abdominal cramping
b. bradycardia   b. emphysema oliguria
d. signs of consolidation d. tuberculosis 3. A patient with small-cell carcinoma of the lungs which
is causing a syndrome of inappropriate anti-diuretic
D8. The primary preventive strategy for community- D17. You are in the process of educating several hormone(SIADH). which of the following would the
acquired pneumonia is members of the community about pneumonia on nurse expect the patient to manifest?
a. antibiotic therapy. children. All of the following are conditions when to call
b. good hand hygiene. a doctor immediately except? weight loss
c. adherence to healthy lifestyle behaviors.   a. child is having trouble breathing or is breathing too fast decreased serum sodium level
d. immunization with pneumococcal and influenza   b. child is bluish or gray fingernails or lips increased urinary output
vaccines.   c. child has fever above 100.4°F (38°C) in babies younger peripheral and pulmonary edema
than 3 months’ old 4. A patient is receiving normal saline solution at 100
D9. The most common cause of viral pneumonia is:   d. child is asking too much of bottle feeding cc/hr.; has a nasogastric tube connected to a low
pressure suction and is on NPO. Which of the following increased secretion of progesterone 20.  In your understanding of renal filtration, protein is
assessment findings would alert the nurse to a major 12. The hormones aldosterone and ADH both have an normally excreted by the kidneys
fluid and electrolyte problem? important function in:
true
weight gain fluid balance in the body false
a decreasing level of consciousness regulation of acid concentration in the body
flushed moist skin stimulation of a conscious desire for water
a serum sodium level of 138 mmol/dL the activity of buffer system
5. Which is the most reliable index of volume status 13. Which of the following may be possible cause edema
when caring for a patient with fluid imbalance? in the tissues.
skin turgor
presence of edema decreased blood pressure
hourly urine output decreased level of proteins in the plasma
daily weight gain the ingestion of large amount of
6. When monitoring fluid and electrolyte status of an carbohydrates
older adult, impairment of the thirst mechanism may reduced temperature at the skin surface
lead to?  14. Ninety percent of the cations in the extracellular fluid
consist of:
hyper osmolality
cellular edema hydroxyl ions
isotonic fluid deficit Calcium ions
decreased production of ADH sodium ions
7. All of the following are important electrolytes of the bicarbonate ions
body except:
15. Pre-renal failure results from:
potassium ions
carbon ions bilateral obstruction of urine flow
chloride ions conditions that diminish blood flow to
sodium ions the kidneys
damage to the filtering systems itself
8. Aldosterone is a steroid hormone secreted from 16. Excessive amount of potassium in the body may
which of the following organs? lead to:

hypothalamus arrhythmia of the heart

pituitary poor muscle contraction
adrenal cortex accumulation of acid in the body
adrenal medulla fibrillation of the heart
9. Water leaves the body by all of the following 17. Renal failure is presented with the following signs
mechanisms except: except:

through air expired from the lungs increased BUN

through metabolic reactions taking place in Increased creatinine
the cells Uremia
through sweat given off from the skin arrhythmia
from feces eliminated from the intestines 18. To differentiate nephritic syndrome from nephrotic
10. When the concentration of solutes is the same on syndrome, nephritic syndrome has:
both inside and outside cells, the:
hematuria
water leaves the cells massive proteinuria
water rushes into the cells edema
water flows out of the cells into the hypoalbuminemia
transcellular environment 19. To differentiate nephrotic syndrome from nephritic
the osmotic pressure is zero syndrome, nephrotic syndrome has:
11.  The osmoreceptors detect a decreased blood
volume and increased concentration sodium of blood hematuria
and these will stimulate: massive proteinuria
increased kidney activity oliguria
increased salivary secretions azotemia
thirst
1. A patient is presenting with mild symptoms of
pneumonia. The doctor diagnoses the patient with
"walking pneumonia". From your nursing knowledge,
you know this type of pneumonia is caused by what
type of infectious agent?
A. Fungi
B. Streptococcus pneumonia
C. Mycoplasma pneumonia
D. Influenza
2. A patient was admitted to the intensive care unit 48 hours
ago for treatment of a gunshot wound. The patient has
recently developed a productive cough and a fever of 104.3
'F. The patient is breathing on their own and doesn't require
mechanical ventilation. On assessment, you note coarse
crackles in the right lower lobe. A chest x-ray shows
infiltrates with consolidation in the right lower lobe. Based on
this specific patient scenario, this is known as what type of
pneumonia?
E. Aspiration pneumonia
F. Ventilator acquired pneumonia
G. Hospital-acquired pneumonia
H. Community-acquired pneumonia
3. Which of the following patients are MOST at risk for
developing pneumonia? Select-all-that-apply:
i. A 53-year-old female recovering from abdominal
surgery.
ii. A 69-year-old patient who recently received the
pneumococcal conjugate vaccine
iii. A 42-year-old male with COPD and is on
continuous oxygen via nasal cannula.
iv. A 8 month old with RSV (respiratory syncytial virus)
infection.
4. You're caring for a patient with pneumonia. The patient
has just started treatment for pneumonia and is still
experiencing hypoxemia. You know that respiratory
acidosis is very common with patients with pneumonia.
Which arterial blood gas readings below represent
respiratory acidosis that is NOT compensated?
i. pH 7.29, PaCO2 55, HCO3 23, PO2 85
ii. pH 7.48, PaCO2 35, HCO3 22, PO2 85
iii. pH 7.20, PaCO2 20, HCO3 28, PO2 85
iv. pH 7.55, PaCO 63, HCO3 19, PO2 85
5. Which of the following are typical signs and symptoms
of pneumonia? Select-all-that-apply:
A. Stridor
B. Coarse crackles
C. Oxygen saturation less than 90%
D. Non-productive, nagging cough
E. Elevated white blood cells
F. Low PCO2 of less than 35
G. Tachypnea
6. You're educating a patient with pneumonia on how to
deep breath by using an incentive spirometer. Which of
the following is the correct way to use this device?
A. Encourage the patient to use it twice a day.
B. The patient exhales into the device rapidly and then
coughs.
C. The patient inhales slowly from the device until no E. Penicillin
longer able, and then holds breath for 6 seconds and
exhales. 12. A patient is admitted with rupture of the Achilles
D. The patient rapidly inhales 10 times from the device tendon. The patient was recently treated with
and then exhales for 6 seconds. antibiotics for pneumonia. Which of the following
7. A 72-year-old male patient who is diagnosed with medications below can cause this adverse effect?
bilateral lower lobe pneumonia is admitted to your unit. a. Penicillin
The patient has a history of systolic heart failure and b. Fluoroquinolones
arthritis. On assessment, you note the patient has a c. Tetracycline
respiratory rate of 21, oxygen saturation 93% on 2L d. Macrolides
nasal cannula, is alert & oriented, and has a productive 13. A patient is being discharged home on
cough with green/yellowish sputum. Which of the Doxycycline for treatment of pneumonia. Which
following nursing interventions will you provide to this statement by the patient indicates they understood
patient based on your assessment findings and the your education material?
patient's diagnosis? Select-all-that-apply: a. "I will wear sunscreen when outdoors."
A. Keep head-of-the-bed less than 30 degrees at all b. "I will avoid green leafy vegetables while
times taking this medication."
B. Collect sputum cultures. c. "I will monitor my blood glucose
C. Encourage 3L of fluids a day to keep secretions regularly due to the side effects of
thin. hypoglycemia."
D. Encourage incentive spirometer usage d. "I will take this medication with a full
E. Provide education about receiving the Pneumovax glass of milk."
vaccine every 5 years. 14. You are about to hang a bag of intravenous
8. You’re providing discharge teaching to a patient who Vancomycin for a patient who has severe
was admitted for pneumonia. You are discussing pneumonia. Which statement by the patient
measures the patient can take to prevent pneumonia. causes you to hold the bag of Vancomycin and
Which of the following statements by the patient notify the doctor immediately?
indicates they did NOT understand your education a. "I'm seeing yellow halos around the
material? light."
i. "I’ll use hand sanitizer regularly while I'm out in b. "My mouth tastes like metal."
public.” c. "My head hurts."
ii. "It is important I don’t receive the Pneumovax d. "I have this constant ringing in my ears."
vaccine since I'm already immune to pneumonia."
iii. "I will try to avoid large crowds of people during the
peak of flu season."
iv. "It is important I try to quit smoking."
9. A patient is admitted with pneumonia. Sputum cultures
show that the patient is infected with a gram positive
bacterium. The patient is allergic to Penicillin. Which
medication would the patient most likely be prescribed?
A. Macrolide
B. Cephalosporin
C. Penicillin G
D. Tamiflu
10. A 25-year-old female patient with pneumonia is
prescribed Doxycycline. What question is important to
ask the patient prior to administration of this
medication?
i. "Do you take birth control pills?"
ii. "Are you allergic to Penicillin?"
iii. "Are you allergic to eggs?"
iv. "Do you have a history of diabetes?"
11. Select all the medications used to treat pneumonia that
are narrow-spectrum?
B. Macrolides
C. Tamiflu
D. Fluoroquinolones