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Respiratory Infections and TB Worksheet, 37 min

Total questions: 25

Worksheet time: 38mins

Name
Class
Date
1.

The nurse suspects Legionnaires’ disease in a patient with confusion, diarrhea, fever, and hyponatremia. Which diagnostic test confirms the diagnosis?

a)

Sputum culture

b)

Blood culture

c)

Urine antigen test

d)

Chest x-ray

2.

Which environmental factor increases risk for Legionnaires’ disease?

a)

Standing water in air conditioning systems

b)

Mold growth in bathrooms

c)

Pet birds in the household

d)

Use of humidifiers during winter

3.

Which assessment finding indicates bacterial rather than viral acute bronchitis?

a)

Cough with clear sputum

b)

Fever > 101101^\circ F with purulent sputum

c)

Dry non-productive cough

d)

Wheezing on expiration

4.

Which intervention best relieves airway obstruction in acute bronchitis?

a)

Antitussives at night

b)

Increased oral fluids

c)

Use of cough suppressants during the day

d)

Oxygen therapy

5.

A nurse is preparing to suction airway in a patient admitted for active tuberculosis. What PPE should be worn? Select all that apply

a)

Surgical mask

b)

N95 respirator

c)

gown

d)

gloves

e)

eye protection

6.

Which lab finding indicates effective TB treatment?

a)

2 negative sputum cultures after 2 months

b)

Decreased ESR

c)

Weight gain

d)

Normal chest x-ray after 1 month

e)

Cough improvement

7.

Which medication combination is used for TB therapy?

a)

INH + rifampin + ethambutol

b)

INH + streptomycin + amoxicillin

c)

Rifampin + vancomycin + levofloxacin

d)

INH + clarithromycin + ethambutol

8.

A patient with pleurisy reports sharp chest pain worsening with inspiration. Which intervention provides best relief?

a)

Deep breathing exercises

b)

Side-lying on affected side

c)

Incentive spirometry hourly

d)

Prone positioning

9.

Which assessment finding supports pleurisy rather than cardiac pain?

a)

Pain radiates to left arm

b)

Pain worsens with deep breathing

c)

Pain improves with rest

d)

Pain unrelieved by position

10.

Which postoperative patient is at highest risk for atelectasis?

a)

50-year-old with laparoscopic appendectomy

b)

70-year-old smoker after abdominal surgery

c)

40-year-old with tonsillectomy

d)

25-year-old with knee arthroscopy

11.

A patient with chest tube for pneumothorax suddenly has continuous bubbling in the water-seal chamber. What does this indicate?

a)

Normal finding

b)

Chest tube is kinked

c)

Air leak in the system

d)

Lung fully expanded

12.

Which finding shows resolution of a pneumothorax?

a)

No tidaling in water-seal chamber

b)

Continuous bubbling in suction chamber

c)

Decreased drainage

d)

Increased chest pain

13.

The nurse notes subcutaneous emphysema around a chest tube insertion site. What is the most appropriate action?

a)

Document as expected

b)

Apply pressure dressing

c)

Notify provider immediately

d)

Clamp chest tube

14.

Which patient with pneumonia is at highest risk for poor outcome?

a)

45-year-old with mild fever, productive cough

b)

68-year-old with COPD and diabetes

c)

25-year-old college student with atypical pneumonia

d)

40-year-old with asthma, stable oxygen saturation

15.

A pneumonia patient develops pleuritic chest pain and decreased breath sounds on one side. What complication is most likely?

a)

Atelectasis

b)

Pleural effusion

c)

Bronchospasm

d)

Pulmonary embolism

16.

Which lab indicates hepatotoxicity from TB medications?

a)

AST 90, ALT 105

b)

Sodium 132

c)

WBC 4,500

d)

Hemoglobin 10

17.

Which instruction is most important for a patient starting isoniazid (INH)?

a)

Avoid alcohol

b)

Expect reddish-orange secretions

c)

Wear glasses instead of contact lenses

d)

Take with antacids to prevent GI upset

18.

True or false. Latent tuberculosis has to be treated with antibiotics.

a)

True

b)

False

19.

The nurse prepares to administer isoniazid (INH) to a patient with TB. To reduce the risk of peripheral neuropathy, the provider also prescribes ________.

(a)  

Choose from the below words

Vitamin B9

Vitamin B6

Vitamin B12

Vitamin A

20.

True or false: A patient with pneumonia should be placed on airborne precautions until antibiotics are started.

a)

True

b)

False

21.

Match the disease to its hallmark symptom.

a)

Acid-fast bacillus

1.

Night sweats and low-grade fever

b)

Pneumococcal pneumonia

2.

Tachycardia and tachypnea

c)

Pleural effusion

3.

Diminished breath sounds

d)

Acute bronchitis

4.

Dry persistent cough

22.

Order the steps of sputum collection by matching each step to its correct sequence number.

a)

Have patient cough deeply and expectorate in sterile container

1.

3

b)

Label specimen and send to lab immediately

2.

4

c)

Explain the procedure to the patient

3.

1

d)

Encourage to sit upright

4.

2

23.

The next 3 questions are on the same patient:

A patient is admitted with low-grade fever in the evening, productive cough, and night sweats. The patient is started on isoniazid, rifampin, ethambutol, and pyrazinamide. What is the likely condition?

a)

Latent tuberculosis

b)

Active tuberculosis

c)

Pneumonia

d)

Bronchitis

24.

For the above patient on isoniazid, rifampin, ethambutol, and pyrazinamide, what 2 parameters need to be monitored? Select all that apply.

a)

Liver function

b)

Hearing

c)

Vision changes

d)

Kidney function

25.

A patient is admitted with low-grade fever in the evening, productive cough, and night sweats. The patient is started on isoniazid, rifampin, ethambutol, and pyrazinamide. What 2 actions need to be taken? Select all that apply.

a)

Institute airborne precautions

b)

Educate on adherence

c)

Institute droplet precautions

d)

Administer acetaminophen for low-grade fever