NCLEX Questions: Pneumonia

A male client with pneumococcal pneumonia is admitted to an acute care facility. The client in
the next roomis being treated for mycoplasmal pneumonia. Despite the different causes of the
various types of pneumonia, all of them share which feature?
1. Inflamed lung tissue
2. Sudden onset
3. Responsiveness to penicillin.
4. Elevated white blood cell (WBC) count
Answer 1. The common feature of all types of pneumonia is an inflammatory pulmonary
response to the offending organism or agent. Although most types of pneumonia have a
sudden onset, a few (such as anaerobic bacterial pneumonia and mycoplasmal pneumonia)
have an insidious onset. Antibiotic therapy is the primary treatment for most types of
pneumonia; however, the antibiotic must be specific for the causative agent, which may not be
responsive to penicillin. A few types of pneumonia, such as viral pneumonia, aren’t treated with
antibiotics. Although pneumonia usually causes an elevated WBC count, some types, such as
mycoplasmal pneumonia, don’t.

A client with bacterial pneumonia is to be started on I.V. antibiotics. Which of the following
diagnostic tests must be completed before antibiotic therapy begins?
1. Urinalysis.
2. Sputum culture.
3. Chest radiograph.
4. Red blood cell count.

Answer 2. A sputum specimen is obtained for culture to determine the causative organism.
After the organism is identified, an appropriate antibiotic can be prescribed. Beginning antibiotic
therapy before obtaining the sputum specimen may alter the results of the test. Neither a urinalysis, a chest
radiograph, nor a red blood cell count needs to be obtained before initiation of antibiotic
therapy for pneumonia

Which of the following would be priority assessment data to gather from a client who has been
diagnosed with pneumonia? Select all that apply.

1. Auscultation of breath sounds

2. Auscultation of bowel sounds
3. Presence of chest pain.
4. Presence of peripheral edema
5. Color of nail beds

Answer: 1, 3, 5.
A respiratory assessment, which includes auscultation of breath sounds and assessing the color
of the nail beds, is apriority for clients with pneumonia. Assessing for the presence of chest pain
is also an important respiratory assessment as chest pain can interfere with the client’s ability
to breathe deeply. Auscultating bowel sounds and assessing for peripheral edema may be appropriate
assessments, but these are not priority assessments for the patient with pneumonia.

Which of the following pathophysiological mechanisms that occurs in the lung

parenchyma allows pneumonia to develop?
1. Atelectasis
2. Bronchiectasis
3. Effusion
4. Inflammation

Answer 4. The most common feature of all types of pneumonia is an inflammatory pulmonary
response to the offending organism or agent. Atelectasis and brochiectasis indicate a collapse
of a portion of the airway that doesn’t occur with pneumonia. An effusion is an accumulation of
excess pleural fluid in the pleural space, which may be a secondary response to pneumonia.