QUESTION #1
You’re providing discharge teaching to a patient who was admitted for pneumonia. You
are discussing measures the patient can take to prevent pneumonia. Which of the following
statements by the patient indicates they did NOT understand your education material?
A. "I’ll use hand sanitizer regularly while I'm out in public."
B. "It is important I don’t receive the Pneumovax vaccine since I'm already immune to
pneumonia."
C. "I will try to avoid large crowds of people during the peak of flu season."
D. "It is important I try to quit smoking."
RATIONALE: The answer is B. All the other options are correct statements
regarding the prevention of pneumonia. However, option B is incorrect because
although the patient has had pneumonia they should still receive the Pneumovax
vaccine to prevent other forms of pneumonia.
QUESTION #2
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?*
A. "Do you take birth control pills?"
B. "Are you allergic to Penicillin?"
C. "Are you allergic to eggs?"
D. "Do you have a history of diabetes?"
RATIONALE: The answer is A. Doxycycline is part of the Tetracycline antibiotic
family. This medication can decrease the effectiveness of birth control pills. Since
the patient is female and within child-bearing age, the question should be asked if
she is taking birth control pills so you can educate her on using another form of
birth control to prevent pregnancy.
QUESTION #3
You're educating a patient with pneumonia on how to deep breathe 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 longer able, and then holds breath for 6
seconds and exhales.
D. The patient rapidly inhales 10 times from the device and then exhales for 6 seconds.
RATIONALE: The answer is C. The patient will inhale slowly from the device until
no longer able, and then hold breath for 6 seconds and exhale. The patient should
use the device at least 10 times every 1-2 hours while awake. The other options are
incorrect ways to use the device
Question # 4
A patient is admitted with rupture of the Achilles tendon. The patient was recently treated
with antibiotics for pneumonia. Which of the following medications below can cause this
adverse effect?
A. Penicillin
B. Fluroquinolones
C. Tetracyclines
D. Macrolides
RATIONALE: The answer is B. Fluroquinolones can cause tendon rupture along with
c.diff infection and cardiac arrhythmia such as prolonged QT interval.
Question #5
A patient is being discharged home on Doxycyline for treatment of pneumonia. Which
statement by the patient indicates they understood your education material?
A. "I will wear sunscreen when outdoors."
B. "I will avoid green leafy vegetables while taking this medication."
C. "I will monitor my blood glucose regularly due to the side effects of hypoglycemia."
D. "I will take this medication with a full glass of milk."
RATIONALE: The answer is A. Doxycycline increases the skin's sensitivity to the sun, so
the patient should wear sunscreen when outdoors. Also, the patient should not take this
medication with antacids or milk products because this affects the absorption of the
medication. Options B and C are incorrect statements.
Question #6
You are about to hang a bag of intravenous Vancomycin for a patient who has severe
pneumonia. Which statement by the patient causes you to hold the bag of Vancomycin and
notify the doctor immediately?
A. "I'm seeing yellow halos around the light."
B. "My mouth tastes like metal."
C. "My head hurts."
D. "I have this constant ringing in my ears."
RATIONALE: The answer is D. Vancomycin can cause ototoxicity. Roaring or ringing in
the ears are a possible sign/symptom of this adverse effect. Option A happens with Digoxin
toxicity. Options B and C are vague and are not a common adverse reaction to
Vancomycin.
Question #7
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. Cephalosporins
C. Pencillin G
D. Tamiflu
RATIONALE: The answer is A. Marcolides are used to treat gram-positive bacterial
infections and are used in patients with penicillin allergies. Penicillin G is a penicillin
antibiotic and would not be used because of the patient's allergy. In addition, usually if a
patient is allergic to penicillin there is an increased chance they are allergic to
cephalosporin....therefore it would not be used as well.
Question#8
Select all the medications used to treat pneumonia that are narrow-spectrum?*
A. Macrolides
B. Tamiflu
C. Fluroquinolones
D. Penicillins
RATIONALE: The answers are A and D. These are the only options that are considered
narrow spectrum antibiotics which means they target specific family of bacteria.
*We can do this one in a true/false format. For example, true or false, Macrolides and Penicillins are
narrow-spectrum meds. Used for pneumonia?
Question #9
Which of the following patients are the LEAST at risk for developing pneumonia?
A. A 53 year old female recovering from abdominal surgery.
B. A 69 year old patient who recently received the pneumococcal conjugate vaccine.
C. A 42 year old male with COPD and is on continuous oxygen via nasal cannula.
D. A 8 month old with RSV (respiratory syncytial virus) infection.
RATIONALE: The answer is B. Risks factors for pneumonia include: recent surgery, lung
disorder (ex: COPD), and viral infection (ex: RSV). Option B is a preventive measure in
preventing pneumonia.
QUESTION #10 BONUS QUESTION DOUBLE POINTS!!!
Picture! True or false, for this kind of lung drainage, would we want to position
the patient in high fowlers?
ANS=FALSE!!!
Pt. Should be placed in prone, trendelenburg position to allow the drainage to clear from
basal region and move closer to the bronchi.
ALL QUESTIONS EXCEPT FOR BONUS WERE TAKEN FROM
https://www.registerednursern.com/pneumonia-nclex-questions/
Extra Question:
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?*
A. pH 7.29, PaCO2 55, HCO3 23, PO2 85
B. pH 7.48, PaCO2 35, HCO3 22, PO2 85
C. pH 7.20, PaCO2 20, HCO3 28, PO2 85
D. pH 7.55, PaCO 63, HCO3 19, PO2 85
Rationale: The answer is A. This is the only ABG result that represents respiratory acidosis
Normal Ranges:
PH 7.35 - 7.45
PaCO2 35 - 45
HCO3 22-26
Med Math Question:
A health care provider prescribes an intramuscular (IM) dose of 250,000 units of
penicillin G benzathine (Bicillin). The label on the 10-mL ampule sent from the
pharmacy reads penicillin G benzathine 300,000 units/mL. How much medication
will the nurse prepare to administer the correct dose? Fill in the blank. Record
your answer to one decimal place.
Answer: 0.8 mL
Rationale: 250,000 units divided by 300,000 units/mL equals 0.8 mL