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APEA 6440 Respiratory Q BANK with actual
answers
APEA 6440 RESPIRATORY
QBANK
Mr. Smith has smoked for 45 years. Which of the following medications may worsen
one of his diseases? propranolol
An 80 y/o has Stage 3 COPD. He is most likely to have concomitant:
anxiety or depression
Breath sounds auscultated over the periphery of the lung fields are quiet and wispy
during the inspiratory phase followed by a short, almost silent expiratory phase.
These breath sounds are considered:
Vesicular
A 6 yr old child who has moderate persistent asthma is diagnosed with pneumonia
after chest x-ray and lab studies. He developed a sudden onset of fever with chills.
He is in no distress. What is the preferred treatment for him?
Amoxicillin
An 18-month-old child is diagnosed with bronchiolitis. His respiratory rate is 28
breaths per minute. Which choice below is most appropriate for patient
management?
Antipyretics
- d. ramipril^ which drug may be associated with a cough? a. dextromethorphan b. guaifenesin c. albuterol d. ramipril
- d. obesity^ which of the following is NOT part of the differential for a pt who complains of cough? a. heart failure b. reflux disease c. asthma d. obesity
- c. cause atypical pneumonia^ M. pneumoniae and C. pneumoniae are respiratory pathogens that: a. are spread via direct contact b. associated with immunosuppression c. cause atypical pneumonia d. transmitted via direct contact
- d. expiratory flow^ what does a peak flow meter measure? a. exercise capacity b. oxygen saturation
APEA 6440 Respiratory Q BANK with actual
answers
c. peak flow capacity d. expiratory flow
- b. a 65 y/o with emphysema^ which pt might be expected to have the worst FEV1?
APEA 6440 Respiratory Q BANK with actual answers
- via respiratory droplet^ How is mycoplasma pneumoniae transmitted?
- a. S. pneumoniae^ the most common cause of pneumonia in people of ALL ages is: a. S. pneumoniae b. Group A strept. c. S. aureus d. mycoplasma sp.
- b. S. pneumoniae^ what is the most common cause of CAP world-wide? a. Group A strept. b. S. pneumoniae c. S. aureus d. mycoplasma sp.
- immunocompetent^ Group A strept can cause a fulminant pneumonia even in pts who are
- post-influenza in the very young and very old
Staphylococcus pneumonia is more common
- a. cough^ a pt has cough, pharyngitis, nasal discharge, and fever. Which sx is most common in a pt with acute bronchitis? a. cough b. pharyngitis c. nasal discharge d. fever
- b. continue the original plan
- c. decongestant and antitussive
a pt with acute bronchitis and cough for 5 days calls to report that his cough is productive of discolored sputum. He has no other new sxs. How should the NP manage this? a. consider pneumonia; prescribe a macrolide antibiotic b. continue the original plan c. encourage the pt to return to the clinic for a recheck d. order a chest x-ray and tx accordingly a pt with acute bronchitis was dx at an urgent care center 10 days ago. He reports he was given an anti-tussive for nighttime cough, a steroid injection and oral steroids, an antibiotic, and a nasal decongestant. Which of these interventions was actually indicated for acute bronchitis? a. steroid injection and oral steroids b. antibiotic c. decongestant and antitussive d. antibiotic and steroids
- b. once weekly^ "Good control" of asthma is measured by the number of times weekly a pt uses a rescue inhaler. What choice below indicates "good control"? a. six times monthly at nighttime b. once weekly c. not more than three times weekly d. not more than once daily and once nightly
APEA 6440 Respiratory Q BANK with actual answers
- c. increase the dose of the inhaled steroid, refill the albuterol
- twice weekly during daytime OR twice monthly at nighttime
a pt with asthma uses one puff twice daily of an inhaled steroid and has an albuterol inhaler for PRN use. He requests a refill on his albuterol inhaler. His last prescription was filled 5 weeks ago. What action by the NP is appropriate? a. refill the albuterol only b. prescribe a longer acting bronchodilator, continue the steroid c. increase the dose of the inhaled steroid, refill the albuterol d. prescribe a long acting bronchodilator and increase the steroid Good asthma management is characterized by using short- acting bronchodilators (rescue inhaler) no more than
- a. timolol opthalmic drops^ which of the following medications should be avoided in a pt who has asthma? a. timolol opthalmic drops b. naproxen c. lisinopril d. amlodipine 26 d. Pertussis^ an adult has upper respiratory sxs and cough for the past 14 days. . What should be considered? a. H. influenza b. S. pneumoniae c. Viral agents d. Pertussis 27 c. COPD^ a 60 y/o pt reports chronic cough and sputum production. He has .
28 b. it decreases parasympathetic tone and
. produces bronchodilation
a long hx of exposure to second hand cigarette smoke from his wife. What dx is most likely? a. lung cancer b. emphysema c. COPD d. allergic cough Ipratropium is very widely used in the tx of COPD. Which of the following statements about ipratropium is correct? a. it slows the progression of COPD b. it decreases parasympathetic tone and produces bronchodilation c. it has anti-inflammatory actions and reduces bronchoconstriction d. it is more effective than a beta agonist in producing bronchodilation 29 c. Pulmonary function tests^ which of the following may be used to dx COPD?
. a. chest x-ray b. CT scan of the chest c. Pulmonary function tests d. arterial blood gases
APEA 6440 Respiratory Q BANK with actual
answers
41 uncomplicated pneumonia in outpatients
. who are otherwise healthy and have not had recent antibiotic exposure
choice for tx for him? a. erythromycin b. levofloxacin c. clarithromycin d. amoxicillin macrolides like azithromycin or clarithromycin or a tetracylinc like doxycyline is used for initial tx of
42 co-morbidities and/or those who have^ fluoroquinolones are commonly used first line for patients with
. suspected macrolide resistant strains of Streptococcus
43 b. add a long acting beta agonist
. he is using it too frequently, should be used only a few times weekly because if it used to frequently it will lose its effectiveness over time
a pt with COPD has been using albuterol with good relief for SOB. He is using it 3-4 times daily over the past 4 weeks. How should the NP manage this? a. encourage its use b. add a long acting beta agonist c. tell him to use it only once daily d. add an oral steroid
44 a. levalbuterol
. other examples are: albuterol, pirbuterol, or bitolterol
an example of a short-acting beta agonist is: a. levalbuterol b. salmeterol c. mometasone d. beclomethasone
45 c. guafenesin^ an older adult has a cold. She calls your office to ask for advice
. for an agent to help her runny nose and congestion. She has hypertension, COPD, and glaucoma. What agent is safe to use? a. pseudoephedrine b. oxymetazoline nasal spray c. guafenesin d. diphenhydramine
47 a. lymphocytosis and atypical lymphocytes^ in a pt with monoucleosis, which laboratory abnormality is most
. common? a. lymphocytosis and atypical lymphocytes b. elevated monocytes c. a decreased total white count d. elevated liver enzymes
48 a. infiltrates the Gold Standard for dxing pneumonia on chest x-ray is the
. presence of: a. infiltrates b. interstitial fluid c. cavitation d. "pooling"
APEA 6440 Respiratory Q BANK with actual
answers
49 Yes^ can pts with pneumonia have some GI sxs like nausea, vomiting,
. and diarrhea? Yes
APEA 6440 Respiratory Q BANK with actual
answers
c. he has an infection of unknown origin d. he does not have an infection
57 a. asthma exacerbation^ a pt is found to have eosinophilia. An expected finding is:
APEA 6440 Respiratory Q BANK with actual answers
. a. asthma exacerbation b. bronchitis c. hepatitis d. osteoporosis 58 c. pertussis^ a 24 y/o presents with fever, rhinorrhea, and paroxysmal, high-pitched . whooping cough. This is: a. bronchiolitis b. croup c. pertussis d. epiglottitis 59 a. cigarette smoking^ a 74 y/o pt has peripheral artery disease. Which item listed below is . the most important risk factor for PAD? a. cigarette smoking b. hyperlipidemia c. diabetes d. alcohol consumption 60 b. cough^ the most common sx associated with acute bronchitis is: .
61 b. levofloxacin - a respiratory
. quinolone
a. fever b. cough c. pharyngitis d. purulent sputum an 83 y/o healthy adult is dx with pneumonia. he is febrile but in no distress. Wha tis the preferred tx for him? a. supportive measures, it is probably viral b. levofloxacin c. azithromycin d. doxycycline 62 c. stop azithromycin and initiate a
. respiratory QUINOLONE this pt should have improved within 24-48 hrs
a 26 y/o being tx for CAP has been taking azithromycin in therapeutic doses for 72 hrs. His temperature has gone from 102F to 101F. What should be done? a. continue the same dose and monitor his status b. increase the dose to high dose azithromycin c. stop azithromycin and initiate a penicillin d. this is probably viral, stop the antibiotic 63 b. leukocytosis^ the major laboratory abnormality noted in pts with pneumonia is:
. a. eosinophila b. leukocytosis c. Gram stain positive d. leukopenia 64 c. azithromycin^ a 44 y/o nonsmoker is dx with pneumonia. He is otherwise healthy . and does not need hospitalization at this time. Which antibiotic can be used for empirical tx according to the 2007 Infectious Diseases Society of America/american Thoracic Society Guidelines? a. erythromycin b. levofloxacin
APEA 6440 Respiratory Q BANK with actual
answers
d. tachyarrhythmias
72 b. a TB skin test^ how should a 20 y/o college age student who presents with cough, night
. sweats, and weight loss be screened for TB? a. a chest x-ray b. a TB skin test c. a sputum specimen d. questionnaire about sxs
73 b. chest x-ray^ what laboratory test could help differentiate acute bronchitis from .
74 d. she does not need the
. immunization
pneumonia in a patient with a productive cough? a. CBC b. chest x-ray c. sputum specimen d. pulmonary function tests a 72 y/o pt presents an immunization record that reflects having received the PCV13 immunization when she was 65 y/o. She received the PPSV23 immunization one year later. Which statement below reflects the current standard of practice recommended by ACIP and CDC for this pt? a. she should be revaccinated today b. she should receive the immunization every 5 years c. she can elect to receive it today if she has COPD d. she does not need the immunization
75 a. he should be revaccinated
. today the recommendation are pneumococcal immunization once at age 65 years, regardless of other disease present. However, if the initial immunization was given prior to age 65 and 5 years has elapsed since the initial one, he should be revaccinated
a 67 y/o pt presents an immunization record that reflects having received the pneumococcal immunization when he was 60 y/o. Which statement below reflects the current standard of practice recommended by ACIP and CDC for this pt? a. he should be revaccinated today b. he should receive the immunization every 5 years c. he can elect to receive it today if she has COPD d. he does not need the immunization
76 b. all exhibit cough^ pts with cough variant asthma:
. a. all exhibit wheezing b. all exhibit cough c. may exhibit cough or wheeze d. have dyspnea
