MSNCB Respiratory Care 5

Question 1

A nurse is preparing to administer ipratropium bromide to a patient with COPD. Which assessment finding is a contraindication for this medication?

Accepted Answer

History of narrow-angle glaucoma

Answer

Ipratropium, an anticholinergic, can increase intraocular pressure and is contraindicated in narrow-angle glaucoma; closed-angle glaucoma crisis can result from systemic or inhaled anticholinergics.

Question 2

Which clinical indicator most reliably signals that weaning from mechanical ventilation should proceed?

Accepted Answer

Rapid shallow breathing index (RSBI) of 80 or less with hemodynamic stability

Answer

An RSBI (respiratory rate / tidal volume in liters) ≤105, especially ≤80, combined with hemodynamic stability and adequate oxygenation, predicts successful extubation.

Question 3

A patient with community-acquired pneumonia has a CURB-65 score of 3. This score indicates the patient should receive care in which setting?

Accepted Answer

ICU-level or inpatient with close monitoring

Answer

A CURB-65 score of 3–5 indicates severe pneumonia with high 30-day mortality risk, requiring hospitalization and consideration of ICU-level care.

Question 4

A patient receiving high-flow nasal cannula (HFNC) therapy develops increasing work of breathing and SpO2 of 86% despite FiO2 of 0.80 at 50 L/min. The nurse's priority action is:

Accepted Answer

Notify the physician immediately for escalation of respiratory support

Answer

Failure to maintain oxygenation on maximum HFNC settings indicates the need for immediate physician notification and escalation to non-invasive or invasive ventilation.

Question 5

A nurse is educating a patient newly diagnosed with tuberculosis (TB) about respiratory precautions at home. Which statement by the patient indicates understanding?

Accepted Answer

I should wear a surgical mask in common areas and sleep in a well-ventilated separate room until non-infectious.

Answer

Active TB requires airborne precautions including wearing a mask in shared spaces and sleeping separately in a well-ventilated room until sputum cultures are negative on three consecutive tests.

(MSNCB) Medical-Surgical Nursing Certification Board Practice Test

(MSNCB) Medical-Surgical Nursing Certification Board Practice Test

MSNCB Respiratory Care 5