A 68-year-old patient is admitted to the hospital with a diagnosis of pneumonia. The nurse assesses the patient and notes crackles in the lower lung fields, increased respiratory rate, and a temperature of 101.5°F (38.6°C). The patient reports a productive cough with yellow-green sputum. What action should the nurse prioritize?
A. Administer a bronchodilator
B. Initiate a high-flow oxygen therapy
C. Administer an antipyretic
D. Encourage increased fluid intake
E. Prepare for chest tube insertion
Rationale:
In pneumonia, impaired gas exchange is a significant concern due to inflammation and consolidation of lung tissue. Initiation of high-flow oxygen therapy helps improve oxygenation and supports respiratory function. This intervention is crucial for patients experiencing hypoxia, as seen in this case with crackles, increased respiratory rate, and an elevated temperature. Correct Answer: B. Initiate a high-flow oxygen therapy
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Understanding Pneumonia: NCLEX Priority Questions
A 45-year-old male is diagnosed with community-acquired pneumonia and is prescribed antibiotics. Which statement by the patient indicates the need for further education?
A. “I will take the antibiotics with a glass of milk.”
B. “I should complete the entire course of antibiotics.”
C. “I will skip a dose if I start feeling better before finishing the medication.”
D. “I will monitor for any allergic reactions, such as rash or difficulty breathing.”
E. “I should report any worsening of symptoms or persistent fever to my healthcare provider.”
Rationale:
Completing the entire course of antibiotics is essential to ensure eradication of the infectious agent and prevent the development of antibiotic resistance. Skipping doses or discontinuing the medication prematurely may lead to incomplete treatment, increasing the risk of recurrence or antibiotic resistance.
Understanding the Pneumonia: NCLEX Delegation Questions
A 50-year-old female with pneumonia is receiving intravenous antibiotics. The nurse notes the patient’s temperature has increased despite antibiotic therapy. What is the nurse’s initial action?
A. Administer an additional dose of the antibiotic
B. Apply a cooling blanket to the patient
C. Increase the rate of the intravenous fluids
D. Obtain blood cultures for further analysis
E. Administer an antipyretic medication
Rationale:
Persistent or increasing fever despite antibiotic therapy may indicate an inadequate response to the current treatment or the presence of a resistant organism. Obtaining blood cultures allows for identification of the specific pathogen and adjustment of antibiotic therapy based on culture and sensitivity results.*
Understanding Pneumonia: Causes and Symptoms
A 70-year-old patient is admitted with pneumonia. The nurse assesses the patient’s breath sounds and notes decreased air entry on the right side. The patient complains of sharp chest pain exacerbated by deep breathing and coughing. What is the nurse’s priority action?
A. Administer a bronchodilator
B. Prepare for chest physiotherapy
C. Administer an antipyretic
D. Encourage incentive spirometry use
E. Initiate high-flow oxygen therapy
Rationale: The patient’s symptoms, including decreased air entry and sharp chest pain with deep breathing, suggest possible pleuritic involvement. Incentive spirometry helps prevent atelectasis by encouraging deep breathing and optimal lung expansion, promoting better gas exchange and reducing chest pain.*
NCLEX Practice Questions: Understanding Pneumonia Causes and Symptoms
A 55-year-old patient is diagnosed with pneumonia and is prescribed levofloxacin. The patient mention s taking antacids for indigestion. What nursing intervention is most appropriate?
A. Administer the levofloxacin with an antacid to enhance absorption
B. Monitor for signs of antibiotic toxicity
C. Instruct the patient to stop taking antacids during antibiotic therapy
D. Increase the dose of levofloxacin to counteract antacid interference
E. Switch to a different class of antibiotics
Rationale: Antacids containing aluminum, magnesium, or calcium can chelate with fluoroquinolone antibiotics, reducing their absorption. Instructing the patient to separate the administration of antacids and antibiotics by at least 2 hours helps ensure optimal antibiotic absorption and effectiveness.*
NCLEX Questions: Focus on Medications for Pneumonia
A 60-year-old patient with pneumonia is receiving oxygen therapy via nasal cannula. The nurse notes that the patient’s oxygen saturation (SpO2) has dropped below the target range. What action should the nurse take first?
A. Increase the oxygen flow rate
B. Administer a bronchodilator
C. Assess lung sounds and respiratory effort
D. Encourage the patient to take deep breaths
E. Notify the healthcare provider for a respiratory therapy consult
Rationale: The first step in addressing decreased oxygen saturation is to assess the patient’s respiratory status. Lung sounds and respiratory effort provide valuable information about potential airway obstruction, secretion retention, or worsening pneumonia. The nurse should identify and address the underlying cause before considering adjustments to the oxygen therapy.
NCLEX Focus Exploring Pneumonia: Causes and Diagnosis
A 30-year-old patient is admitted with a diagnosis of pneumonia. The nurse notes that the patient’s skin is cool and moist, and the respiratory rate is elevated. The patient reports feeling lightheaded and dizzy. What should the nurse prioritize in the care of this patient?
A. Administer an antipyretic
B. Increase the room temperature
C. Administer a bronchodilator
D. Encourage increased fluid intake
E. Initiate high-flow oxygen therapy
Rationale:
The patient’s cool, moist skin and symptoms of lightheadedness and dizziness suggest inadequate oxygenation. Initiating high-flow oxygen therapy is essential to improve oxygen saturation and address hypoxia, a common complication in pneumonia.*
NCLEX Review: Pneumonia Treatments
A 40-year-old patient with pneumonia is prescribed azithromycin. The patient asks the nurse if it’s necessary to take the medication with food. How should the nurse respond?
A. “Yes, take it with a full meal to enhance absorption.”
B. “No, you can take it on an empty stomach for better effectiveness.”
C. “Take it with a small snack to prevent gastrointestinal upset.”
D. “It doesn’t matter; take it whenever convenient for you.”
E. “Avoid food for at least 2 hours after taking the medication.”
Rationale:
Azithromycin is best absorbed with food, but taking it with a small snack can help prevent gastrointestinal upset commonly associated with macrolide antibiotics.
NCLEX Questions Critical Thinking: Pneumonia Symptoms
A 50-year-old patient is admitted with pneumonia. The nurse observes the patient leaning forward while sitting in bed, with hands on knees, in an attempt to breathe more comfortably. What term is used to describe this characteristic posture associated with respiratory distress?
A. Orthopnea
B. Tripod position
C. Fowlers position
D. Sims position
E. Trendelenburg position
Rationale:
The tripod position, characterized by leaning forward with hands on knees or another surface, is a classic sign of respiratory distress. This posture helps improve respiratory mechanics by allowing better use of accessory muscles and increasing lung expansion.
A 60-year-old patient with pneumonia has a persistent cough with thick, yellow-green sputum. The nurse notes decreased breath sounds in the left lower lung field. What intervention is a priority for this patient?
A. Administer an antipyretic
B. Encourage increased fluid intake
C. Initiate high-flow oxygen therapy
D. Administer a mucolytic medication
E. Position the patient in a side-lying position with affected lung down
Rationale:
Positioning the patient with the affected lung down can help optimize ventilation-perfusion matching and improve drainage of secretions, aiding in the resolution of pneumonia. This intervention is particularly important when breath sounds are diminished in a specific lung field.
