Respiratory NCLEX Questions with Rationale 1-9

Here is another 5-item Respiratory NCLEX Questions with Rationale. These questions will challenge your knowledge about the concepts behind Tuberculosis, Pulmonary Sarcoidosis, COPD and many more.
 1. A client who is human immunodeficiency virus (HIV)– positive has had a tuberculin skin test (TST). The nurse notes a 7-mm area of induration at the site of the skin test and interprets the result as which finding?

a) Positive
b) Negative
c) Inconclusive
d) Need for repeat testing

2. A client with acquired immunodeficiency syndrome (AIDS) has histoplasmosis. The nurse should assess the client for which expected finding?

a) Dyspnea
b) Headache
c) Weight gain
d) Hypothermia

3. Respiratory NCLEX Questions with Rationale about the nurse who is giving discharge instructions to a client with pulmonary sarcoidosis. The nurse concludes that the client understands the information if the client indicates to report which early sign of exacerbation?

a) Fever
b) Fatigue
c) Weight loss
d) Shortness of breath

4. The nurse is taking the history of a client with occupational lung disease (silicosis). The nurse should assess whether the client wears which item during periods of exposure to silica particles?

a) Mask
b) Gown
c) Gloves
d) Eye protection

5. An oxygen delivery system is prescribed for a client with chronic obstructive pulmonary disease to deliver a precise oxygen concentration. Which oxygen delivery system would the nurse anticipate to be prescribed?

a) Face tent
b) Venturi mask
c) Aerosol mask
d) Tracheostomy collar

6. Respiratory NCLEX Questions with Rationale about the nurse who is instructing a hospitalized client with a diagnosis of emphysema about measures that will enhance the effectiveness of breathing during dyspneic periods. Which position should the nurse instruct the client to assume?

a) Sitting up in bed
b) Side-lying in bed
c) Sitting in a recliner chair
d) Sitting on the side of the bed and leaning on an overbed table

7. The community health nurse is conducting an educational session with community members regarding the symptoms associated with tuberculosis. Which is one of the first manifestations associated with tuberculosis?

a) Dyspnea
b) Chest pain
c) A bloody, productive cough
d) A cough with the expectoration of mucoid sputum

8. The nurse performs an admission assessment on a client with a diagnosis of tuberculosis. The nurse should check the results of which diagnostic test that will confirm this diagnosis?

a) Chest x-ray
b) Bronchoscopy
c) Sputum culture
d) Tuberculin skin test

9. The low-pressure alarm sounds on a ventilator. The nurse assesses the client and then attempts to determine the cause of the alarm. If unsuccessful in determining the cause of the alarm, the nurse should take what initial action?

a) Administer oxygen
b) Check the client’s vital signs
c) Ventilate the client manually
d) Start cardiopulmonary resuscitation




Respiratory NCLEX Questions with Rationale

1) A
- Rationale: The client with human immunodeficiency virus (HIV) infection is considered to have positive results on tuberculin skin testing with an area of induration larger than 5 mm. The client without HIV is positive with an induration larger than 10 mm. The client with HIV is immunosuppressed, making a smaller area of induration positive for this type of client. It is possible for the client infected with HIV to have false-negative readings because of the immunosuppression factor. Options B, C, and D are incorrect interpretations.

- Test-Taking Strategy: Eliminate options C and D first because they are comparable or alike. From the remaining options, recalling that the client with HIV is immunosuppressed will assist in determining the interpretation of the area of induration.

2) A
- Respiratory NCLEX Questions with Rationale: Histoplasmosis is an opportunistic fungal infection that can occur in the client with acquired immunodeficiency syndrome (AIDS). The infection begins as a respiratory infection and can progress to disseminated infection. Typical signs and symptoms include fever, dyspnea, cough, and weight loss. Enlargement of the client’s lymph nodes, liver, and spleen may occur as well.

- Test-Taking Strategy: Focus on the subject, manifestations of histoplasmosis. Recalling that histoplasmosis is an infectious process will help you eliminate option 4. Because the client has AIDS and another infection, weight gain is an unlikely symptom and can be eliminated next. Knowing that histoplasmosis begins as a respiratory infection helps you choose dyspnea over headache as the correct option.

3) D
- Respiratory NCLEX Questions with Rationale: Dry cough and dyspnea are typical early manifestations of pulmonary sarcoidosis. Later manifestations include night sweats, fever, weight loss, and skin nodules.

- Test-Taking Strategy: Note the strategic word early. Because sarcoidosis is a pulmonary problem, eliminate options A and C first. Select the correct option over option B because the shortness of breath (and impaired ventilation) appears first and would cause the fatigue as a secondary symptom.

4) A
- Rationale: Silicosis results from chronic, excessive inhalation of particles of free crystalline silica dust. The client should wear a mask to limit inhalation of this substance, which can cause restrictive lung disease after years of exposure. Options B, C, and D are not necessary.

- Test-Taking Strategy: Focus on the subject, prevention of silicosis. Recalling that exposure to silica dust causes the illness and that the dust is inhaled into the respiratory tract will direct you to the correct option.

5) B
-Respiratory NCLEX Questions with Rationale: The Venturi mask delivers the most accurate oxygen concentration. It is the best oxygen delivery system for the client with chronic airflow limitation because it delivers a precise oxygen concentration. The face tent, aerosol mask, and tracheostomy collar are also high-flow oxygen delivery systems but most often are used to administer high humidity.

- Test-Taking Strategy: Focus on the subject, delivery of a precise oxygen concentration. Eliminate options A, C, and D because they are comparable or alike in that they are used to provide high humidity.

6) D
- Rationale: Positions that will assist the client with emphysema with breathing include sitting up and leaning on an overbed table, sitting up and resting the elbows on the knees, and standing and leaning against the wall.

- Test-Taking Strategy: Eliminate options A and C first because they are comparable or alike. Next, eliminate option B because this position will not enhance breathing.

7) D
- Respiratory NCLEX Questions with Rationale: One of the first pulmonary manifestations of tuberculosis is a slight cough with the expectoration of mucoid sputum. Options A, B, and C are late manifestations and signify cavitation and extensive lung involvement.

- Test-Taking Strategy: Note the strategic word first in the question. Next, focusing on the diagnosis should direct you to the correct option.

8) C
- Rationale: Tuberculosis is definitively diagnosed through culture and isolation of Mycobacterium tuberculosis. A presumptive diagnosis is made based on a tuberculin skin test, a sputum smear that is positive for acid-fast bacteria, a chest x-ray, and histological evidence of granulomatous disease on biopsy.

- Test-Taking Strategy: Focus on the subject, confirming the diagnosis of tuberculosis. Confirmation is made by identifying M. tuberculosis.

9) C
- Rationale: If at any time an alarm is sounding and the nurse cannot quickly ascertain the problem, the client is disconnected from the ventilator and manual resuscitation is used to support respirations until the problem can be corrected. No reason is given to begin cardiopulmonary resuscitation. Checking vital signs is not the initial action. Although oxygen is helpful, it will not provide ventilation to the client.

- Test-Taking Strategy: Note the strategic word, initial, and note that the subject relates to adequate ventilation of the client. Also note that the nurse is unsuccessful in determining the cause of the alarm. This will direct you to the correct option.


Proceed to the next set of questions:

Respiratory NCLEX Questions with Rationale 10-15