Pneumonia NCLEX Questions & Answers: Complete Guide for Nursing Students

 

Question 1: A 68-year-old patient presents with fever, productive cough, and shortness of breath. Chest auscultation reveals crackles in the right lower lobe. Which pathophysiological process is most responsible for the impaired gas exchange?

A. Smooth muscle constriction of bronchioles
B. Alveolar consolidation and fluid accumulation
C. Pleural effusion only
D. Pulmonary embolism

Answer: B
Explanation: In pneumonia, alveoli fill with inflammatory exudate and fluid, impairing gas exchange and causing hypoxemia.

Question 2: A patient with bacterial pneumonia is prescribed antibiotics. Which rationale explains why early antibiotic administration is crucial?

A. Prevents viral infection
B. Reduces alveolar inflammation and prevents complications
C. Increases fluid retention
D. Causes immune suppression

Answer: B
Explanation: Early antibiotic therapy in bacterial pneumonia reduces alveolar inflammation, prevents further lung damage, and improves oxygenation.

Question 3: A nurse is assessing a patient with pneumonia. Which clinical manifestation most directly reflects hypoxemia?

A. Cyanosis
B. Fever
C. Cough
D. Nausea

Answer: A
Explanation: Cyanosis is a direct sign of hypoxemia due to reduced oxygen saturation in the blood.

Question 4: Which nursing intervention best promotes airway clearance in a patient with pneumonia?

A. Strict bed rest
B. Deep breathing and coughing exercises
C. Sedation
D. Limiting fluid intake

Answer: B
Explanation: Deep breathing and coughing exercises help mobilize secretions, prevent atelectasis, and improve ventilation.

Question 5: A patient with a history of aspiration while eating develops pneumonia. Which type of pneumonia should the nurse anticipate?

A. Viral pneumonia
B. Aspiration pneumonia
C. Community-acquired bacterial pneumonia
D. Fungal pneumonia

Answer: B
Explanation: Aspiration pneumonia occurs when food, liquids, or gastric contents enter the lungs, causing localized infection and inflammation.

Question 6: The nurse monitors SpO₂ in a patient with severe pneumonia. Which value indicates the need for supplemental oxygen therapy?

A. 98%
B. 95%
C. 89%
D. 100%

Answer: C
Explanation: SpO₂ below 90% indicates hypoxemia, requiring supplemental oxygen to maintain adequate tissue oxygenation.

Question 7: A patient with pneumonia shows sudden confusion, rapid breathing, and hypotension. What complication should the nurse suspect?

A. Pulmonary embolism
B. Sepsis
C. Pleural effusion
D. Asthma attack

Answer: B
Explanation: Sudden hypotension, confusion, and tachypnea in pneumonia suggest sepsis, a life-threatening systemic infection.

Question 8: Which laboratory finding is most consistent with bacterial pneumonia?

A. Low WBC
B. Elevated WBC with neutrophilia
C. Low CRP
D. Anemia

Answer: B
Explanation: Bacterial pneumonia typically causes leukocytosis with neutrophilic predominance, indicating active infection.

Question 9: A nurse teaches a patient recovering from pneumonia about home care. Which instruction is most important to prevent recurrence?

A. Stop antibiotics early
B. Complete full course of antibiotics and maintain hydration
C. Avoid rest
D. Skip follow-up visits

Answer: B
Explanation: Completing antibiotics, staying hydrated, and attending follow-up visits prevent recurrence and complications.

Question 10: A patient with pneumonia is using an incentive spirometer. What is the primary purpose of this intervention?

A. Prevent atelectasis and promote lung expansion
B. Reduce blood pressure
C. Increase fever
D. Cause sedation

Answer: A
Explanation: Incentive spirometry encourages deep inhalation, preventing atelectasis and promoting lung expansion in pneumonia patients.