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Respiratory Review/midterm review QUESTIONS AND ANSWERS, Exams of Health sciences

Georgia Highlands CollegeHealth sciences

Respiratory Review/midterm review QUESTIONS AND ANSWERS

Typology: Exams

2021/2022

Available from 05/19/2022

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Respiratory Review
1. A chronic cough lasts longer than:
8 Weeks
2. You are doing a cerumen extraction and touch the external meatus of your pt's ear. He winces and starts
coughing. What is the name of this reflex?
Arnold Reflex
3. Julie has a postnasal drip along with her cough. You assess her for:
Allergic or vasomotor rhinitis
4. A pt with HTN comes in and insists that one of his new meds is causing him to cough. When looking at his
list of meds, you think the cough must be from:
Captopril
5. African American pt's seems to have a negative reaction to which of the following asthma meds?
Long-term beta-agonist bronchodilators
6. Sam, age 78, presents to the clinic w/respiratory symptoms. His PFTs are as follows: normal total lung
capacity, decreased PaO2, increased PaCO2. On assessment, you auscultate course crackles and forced
expiratory wheezes. What is your dx?
Chronic Bronchitis
7. You are using the CURB-65 clinical prediction tool to decide whether Mabel, whom you have diagnosed
with community-acquired pneumonia (CAP), should be hospitalized or treated at home. Her score is 3. What
should you do?
Hospitalize and consider admitting her to ICU
8. Why do you suspect that your pt may have a decreased response to the TB test?
She has been on long-term corticosteroid therapy
9. Marci has been started on a TB regimen. Because isoniazid (INH) may cause peripheral neuropathy, you
consider ordering which of the following drugs prophylactically?
Pyroxidine
10. Jolene has breast cancer that has been staged as T1, N0, M0. What might this mean?
The cancer is less than 2cm in size and has not spread to the lymph nodes or other parts of the body
11. Nathan, a 32yo policeman, has a 15-pack-year history of smoking and continues to smoke heavily.
During every visit, he gets irate when you try to talk to him about quitting. What should you do?
Continue to ask him at every visit if he is ready to quit
12. Your pt has decided to try to quit smoking with Chantix. You are discussing his quit date and he will
begin taking the med tomorrow. When should he plan to quit smoking?
His quit date should be in 1 week
13. Which info should be included when you are teaching your pt about the use of nicotine gum?
The gum must be correctly chewed to a softened state and then placed in the buccal mucosa or “parked”
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Download Respiratory Review/midterm review QUESTIONS AND ANSWERS and more Exams Health sciences in PDF only on Docsity!

Respiratory Review

  1. A chronic cough lasts longer than: 8 Weeks
  2. You are doing a cerumen extraction and touch the external meatus of your pt's ear. He winces and starts coughing. What is the name of this reflex? Arnold Reflex
  3. Julie has a postnasal drip along with her cough. You assess her for: Allergic or vasomotor rhinitis
  4. A pt with HTN comes in and insists that one of his new meds is causing him to cough. When looking at his list of meds, you think the cough must be from: Captopril
  5. African American pt's seems to have a negative reaction to which of the following asthma meds? Long-term beta-agonist bronchodilators
  6. Sam, age 78, presents to the clinic w/respiratory symptoms. His PFTs are as follows: normal total lung capacity, decreased PaO2, increased PaCO2. On assessment, you auscultate course crackles and forced expiratory wheezes. What is your dx? Chronic Bronchitis
  7. You are using the CURB-65 clinical prediction tool to decide whether Mabel, whom you have diagnosed with community-acquired pneumonia (CAP), should be hospitalized or treated at home. Her score is 3. What should you do? Hospitalize and consider admitting her to ICU
  8. Why do you suspect that your pt may have a decreased response to the TB test? She has been on long-term corticosteroid therapy
  9. Marci has been started on a TB regimen. Because isoniazid (INH) may cause peripheral neuropathy, you consider ordering which of the following drugs prophylactically? Pyroxidine
  10. Jolene has breast cancer that has been staged as T1, N0, M0. What might this mean? The cancer is less than 2cm in size and has not spread to the lymph nodes or other parts of the body
  11. Nathan, a 32yo policeman, has a 15-pack-year history of smoking and continues to smoke heavily. During every visit, he gets irate when you try to talk to him about quitting. What should you do? Continue to ask him at every visit if he is ready to quit
  12. Your pt has decided to try to quit smoking with Chantix. You are discussing his quit date and he will begin taking the med tomorrow. When should he plan to quit smoking? His quit date should be in 1 week
  13. Which info should be included when you are teaching your pt about the use of nicotine gum? The gum must be correctly chewed to a softened state and then placed in the buccal mucosa or “parked”
  1. Your pt states he has a strep throat infection. Which of the following symptoms makes you consider a viral etiology instead? Rhinorrhea
  2. What is the first-line recommended treatment against Group A beta-hemolytic streptococci (GABHS), the most common cause of bacterial pharyngitis? PCN
  3. Cydney presents with a h/o asthma. She has not been treated for a while. She c/o daily but not continual symptoms, greater than 1 week and at nighttime. She has been using her rescue inhaler. Her FEV is 60-80% predicted. How would you classify her asthma severity? Moderate Persistent
  4. Joyce is taking a long-acting beta agonist for her asthma. What additional med should she be taking? Inhaled corticosteroid
  5. Your pt is on Therabid (theophylline) for his asthma. You want to maintain his serum levels between: 5-15mcg/mL
  6. George has COPD and an 80% forced expiratory volume in 1 second. How would you classify the severity of his COPD? Stage 1-Mild COPD
  7. Most nosocomial pneumonias are caused by: Gram-negative bacteria
  8. Which of the following statements regarding TST is true? The size of the TST reaction has nothing to do with erythema but is based solely on induration
  9. Which obstructive lung dz is classified as reversible? Asthma
  10. You have taught Jennifer, age 15, about using a flow meter to assess how to manage her asthma exacerbations. She calls you today because her peak expiratory flow rate is 65%. What would you tell her? "Use your rescue inhaler, begin the Rx of PO glucocorticoids you have, and call back tomorrow."
  11. Which statement about adenocarcinoma of the lung is accurate? It is the most prevalent carcinoma of the lungs in both sexes and in nonsmokers, representing 35-40% of all tumors
  12. Jason, age 62, has obstructive sleep apnea. What do you think is one of his contributing factors? His collar size is 17 inches
  13. The forced vital capacity is decreased in: Restrictive Disease
  14. The most common cause of CAP is: Streptococcus pneumoniae

3 hours

  1. The hallmark of an absence seizure is: A blank stare
  2. Jolene has breast cancer that has been staged as T1, N0, M0. What might this mean? The cancer is less than 3 cm in size and has not spread to the lymph nodes or other parts of the body.
  3. Which of the following conditions is associated with cigarette smoking? Bladder cancer
  4. The barrel-chest characteristic of emphysema is a result of: Hyperinflation
  5. Your patient is on theophylline for his asthma. You want to maintain his serum levels between: 5 to 15 mcg/mL
  6. Which ethnic group has the highest lung-cancer incidence and mortality rates? African American men
  7. Marta is taking TB drugs prophylactically. How do you instruct her to take them? Take them on an empty stomach to facilitate absorption.
  8. What is the most common cause of CAP? Streptococcus pneumoniae
  9. Joyce is taking a long-acting beta agonist for her asthma. What additional medication should she be taking? Inhaled corticosteroid
  10. Madeline is a smoker in a primary-care visit with her provider. After her provider asks if she is willing to quit, she says she has decided to quit, has bought nicotine gum, and is interested in hearing about Chantix. Which of the following steps is Madeline in regarding behavioral changes and her attempts at cessation? Preparation
  11. Amy has a history of lung cancer and is experiencing new-onset right side ptosis and miosis and says, “I’m so hot, but I’m not sweating.” Which of the following conditions can be attributed to her new- onset symptoms? Horner’s syndrome
  12. Supplemental oxygen for how many hours per day has been shown to improve the mortality associated with COPD? 15 hours
  1. Sam, age 78, presents to the clinic with respiratory symptoms. His pulmonary function tests are as follows: a normal total lung capacity, a decreased PaO2, and an increased PaCO2. On assessment, you auscultate coarse crackles and forced expiratory wheezes. What is your diagnosis? Chronic bronchitis

Cardiovascular Review

  1. Samuel is going to the dentist for some work and must take endocarditis prophylaxis because of his history of: A prosthetic heart valve
  2. In which patient do premature ventricular contractions NOT need to be treated? Kelly, a 25-year-old female with an allergy to bee stings
  3. Which of the following is abundant in the heart and rapidly rises in the bloodstream in the presence of heart failure, making it a good diagnostic test? Brain natriuretic peptide
  4. There are four stages of heart failure, classified as A to D, that describe the evolution and progression of disease. In which stage are patients hospitalized or treated with specialized interventions or hospice care for refractory symptoms of heart failure despite medical therapy? Stage D
  5. What is the most common form of heart disease in a patient with atrial fibrillation? Coronary artery disease associated with heart failure
  6. What does digitalis compete with at binding sites on the cell membrane? Potassium
  7. A delta wave on the electrocardiogram (ECG) may be present in which condition? Wolff–Parkinson–White syndrome
  8. Data from the Framingham Heart Study suggests that individuals who are normotensive at 55 years of age have how much lifetime risk of developing hypertension? 90%
  9. Which of the following will help a provider determine whether a patient is experiencing paroxysmal supraventricular tachycardia (PSVT) or ventricular tachycardia (VT)? PR Interval
  10. Mary has hypertension and previously had a stroke. Which hypertensive drug has been shown to reduce stroke? Chlorthalidone
  11. If a pulmonary embolus is suspected, which testing should be performed? V/Q scan
  1. A male patient with diabetes asks the clinician why he needs to check his blood sugar at home even when he feels good. Which response by the clinician would be most appropriate? “Control of glucose will help postpone or delay complications.”
  2. A 25-year-old patient presents to the clinic with fatigue, cold intolerance, weight gain, and constipation for the past 3 months. On physical examination, the clinician notices muscular stiffness; coarse, dry hair; and a delay in relaxation in deep tendon reflexes. Which test should be ordered next? Thyroid-stimulating hormone
  3. Which laboratory test result is diagnostic for hypoglycemia? Glucose level 43 mg/dL

Cardiovascular Review

  1. Which group would most benefit from statins? Individuals with clinical arteriosclerotic cardiovascular disease
  2. If chest pain can be alleviated with time, analgesics, and heat applications, what might the differential diagnosis be? Costochondritis
  3. Sandra has palpitations that occur with muscle twitching, paresthesia, and fatigue. What specific diagnostic test might help determine the cause? Serum calcium
  4. A blood pressure (BP) of 150/90 is considered: Normal in healthy older adults
  5. Lifestyle modifications to manage hypertension (HTN) include: Limiting beer intake to 24 ounces per day
  6. Mary has hypertension and previously had a stroke. Which hypertensive drug would you order for her? Angiotensin converting enzyme inhibitor (Lisinopril)
  7. Which high-density lipoprotein (HDL) level is considered cardioprotective? Greater than 60
  8. You are assessing Sigred for metabolic syndrome. Which of her parameters is indicative of this syndrome? Her waist is 36 inches.
  9. Which type of angina do you suspect in Harvey, who complains of chest pain that occurs during sleep and most often in the early morning hours? Variant (Prinzmetal's angina)
  10. Which ECG change is typical of cardiac ischemia? T-wave inversion
  11. In which type of arterioventricular (AV) block does the pulse rate (PR) interval lengthen until a beat is dropped? Second-degree Mobitz I AV block
  1. There are four stages of heart failure, classified as A to D, that describe the evolution and progression of disease. In which stage are patients hospitalized or treated with specialized interventions or hospice care for refractory symptoms of heart failure despite medical therapy? Stage D
  2. Which of the following is abundant in the heart and rapidly rises in the bloodstream in the presence of heart failure, making it a good diagnostic test? B-type natriuretic peptide
  3. Which test has long been considered the gold standard for a diagnosis of venous thromboembolism? Ascending venogram
  4. Statins are approved for which age group? Children over the age of 10
  5. The American College of Cardiology/American Heart Association states which of the following regarding the use of non-statin lipid-lowering agents? There is no sufficient evidence to use non-statin lipid-drugs.
  6. Which of the following medications can cause hyperlipidemia? Diuretics
  7. Jamie, age 55, has just started on a statin after having his liver function tests (LFTs) come back normal. He now asks you how often he has to have the LFTs repeated. What do you tell him? It's no longer necessary for his statin regimen.
  8. In the CHADS2 Index for the stroke risk score for AF, the 'A' stands for: Age
  9. Which murmurs are usually 'watch and wait'? Systolic murmurs
  10. Which of the following statements about dabigatran is true? Anticoagulation cannot be immediately reversed.
  11. What value on the ankle-brachial index diagnoses peripheral artery disease? Less than 0.
  12. Your patient with permanent afib asks when he can discontinue his warfarin. You tell him: You'll probably be on it indefinitely.
  1. You just started Martha on HTN therapy. The Eighth Joint National Committee recommends that if her goal BP is not reached in what length of time, you should increase the initial drug or add a second drug to it? 1 month

Endocrine Review

  1. A pt is 66in in height, weighing 200lbs, and newly diagnosed with T2DM. Her fasting plasma glucose level is 215mg/dL. What is the best initial treatment? Diet and exercise for 6wk trial
  2. The clinician suspects that a client seen in the office has hyperthyroidism. Which of the following tests should the clinician order on the initial visit? High sensitivity thyroid-stimulating hormone (TSH) and free T
  3. A pt whit T2DM asks the clinician why she needs to exercise. In order to answer her, the clinician must understand that exercise has what effect on the pt with T2DM? -Reduces postprandial blood glucose; Reduces triglycerides and increases HDL;-Reduces total cholesterol ******All of the above
  4. A pt with T1DM comes to the clinic c/o feeling nervous and clammy. He states that he took his insulin this morning but was late for work and did not eat breakfast. Which action should the clinician take first. Have him drink 4oz of juice
  5. A pt with T2DM comes to the clinic after reading about metformin in a magazine. Which of the following conditions that the patient also has would be a contraindication to taking metformin? -Ketoacidosis; -Cirrhosis; -Hypoglycemic episodes; ****All of the above
    1. A diabetic pt asks the clinician why he needs to check his blood sugar at home even when he feels good. Which of the following responses would be most appropriate? Control of glucose will help postpone or delay complications; -Regularly checking blood sugar will help establish a routine; -Monitoring glucose will promote a sense of control; -All of the above
  2. How often should the clinician examine the feet of a person with diabetes? Every Visit
  3. The clinician sees a pt who is 5 feet tall and weighs 150lbs. How would the clinician classify this pt? Mild Obesity
  4. Mr. S presents in the clinic with pain, tenderness, erythema, and swelling to his L great toe. The clinician suspects acute gout. Which of the following should the clinician expect in the initial test results for this pt? Elevated uric acid level
  5. Mr. W, 53yo, is seen in the clinic w/concerns about his L foot. He has a 40-yr h/o T1DM w/"fairly good" control on twice-daily insulin. He denies injury but states that he tripped a few months ago and his foot is sore when he walks. Physical exam reveals an edematous, erythemic, and warm foot. There is a superficial ulcer on the plantar surface. Which of the following is the most likely dx? Charcot Joint
  6. Which of the following tests should you order to confirm Mr. W's dx? X-ray of foot
    1. A vegetarian pt w/gout asks the clinician about food he should avoid. The clinician should advise the pt to avoid which of the following foods? Spinach
  8. The clinician should question the pt w/suspected gout about use of which medication? -Low-dose ASA; -Thiazide diuretics; -Ethambutol; -All of the above
  9. The clinician finds numerous nodules on the thyroid of a 65yo woman. The clinician suspects thyroid cancer. Which of the following data would be most significant for this pt? A h/o tonsillectomy in the 1940's
  10. Which of the following is essential for diagnosing thyroid cancer? Fine needle aspiration
  1. Which of the following are common signs of T2DM? Recurrent Yeast infections
  2. Which of the following meds can cause hyperglycemia? Prednisone
  3. Which of the following is diagnostic for DM? Random glucose of 200mg/dL on 2 occasions
  4. Which of the following meds for T2DM should not be prescribed during pregnancy? Glucotrol
  5. A 35yo woman presents w/symptoms of hypoglycemia. There is no h/o DM. Which of the following should be included in the differential dx? Pheochromocytoma
  6. Metformin is the first line of pharm treatment for T2DM. True
  7. Fruit juice with added sugar is the tx of choice for anyone experiencing hypoglycemia. False
  8. Lifestyle modification is the tx of choice for metabolic syndrome. True
  9. A BMI of 29 is considered obesity. False
  10. Urine-free cortisol is one of four diagnostic tests recommended for Cushing's syndrome. True If you are going to give TPA Need to get head CT for sure A link in the delay for stroke treatment Calling Primary care instead of 911 A patient with carotid bruit may also have hx of Peripheral Vascular Occlusive Disease Use licorice in caution with HTN BORG Scale 0= rest; 1=really easy; 2=easy; 3=moderate; 4 sort-of hard; 5/6=hard; 7/8=really hard; 9=really really hard; 10=maximal-just like my hardest race 30-year-old African American coughing up blood Mitral Stenosis Not the best choice in African American Long term beta agonist bronchodilators

Dabigatrin (Pradaxa) Anticoagulation cannot be immediately reversed; Must give antidote=idarucizumab (Praxbind) Apixaban (Eliquis) does not necessitate dose titration Ankle brachial index of <0.9 can indicate PAD Apixaban does not necessitate Dose titration; antidote JNC-8 guideline If blood pressure control is not reached in 1 month then increase initial drug or add a second drug Good first line choice for HTN HCTZ (chlorthalidone) Non-pharmaceutical ways to reduce HTN DIET, EXERCISE, WEIGHT LOSS is the greatest Appropriate for Post- MI with HTN Lisinopril Right axis deviation (lead 1) Right axis deviation occurs with the QRS axis and is between + and +180 degrees. CAUSES: Normal variant; Right BBB, RVH, Right ventricular hypertrophy Left posterior fascicular block Dextrocardia; Ventricular rhythms (accelerated idioventricular or ventricular tachycardia); Lateral wall myocardial infarction; Wolff- Parkinson-White syndrome; Acute right heart strain/pressure overload — also known as McGinn-White Sign Distended neck veins Male patients with HTN PVC and young Don’t need treatment Diabetes Diet, Exercise, Metformin TSH, T

Renal Review

  1. A patient is seen in the clinic with a chief complaint of hematuria. To make a differential diagnosis, which of the following questions should be asked? b. "What medications are you currently taking?" The result of the patient's 24-hour urine for protein was 4.2 g/day. The clinician should take which of the following actions? b. Refer to a nephrologist.
  2. A patient is seen complaining of "leaking urine when I sneeze." Which of the following actions should the clinician take first? c. Instruct the patient on Kegel exercises.
  1. A patient is seen in the clinic with hematuria confirmed on microscopic examination. The clinician should inquire about the ingestion of which of these substances that might be the cause of hematuria? a. NSAIDs
  2. A 27-year-old female presents with a chief complaint of burning and pain on urination. She has no previous history of urinary tract infection (UTI). What are some additional symptoms consistent with a diagnosis of lower UTI? c. Blood in urine and frequency
  3. A 30-year-old patient presents with pain on urination. The urine microscopy of unspun urine shows greater than 10 leukocytes/mL, and a dipstick is positive for nitrites. What is the probable diagnosis? a. Lower urinary tract infection
  4. A patient presents with CVA tenderness and a several-day history of high fever, chills, and dysuria. Which of the following diagnoses is most likely given the above information? a. Pyelonephritis
  5. Which of the following information is essential before prescribing Bactrim DS to a 24-year-old woman with a UTI? d. All of the above (last menstrual period, method of birth control, last unprotected sexual contact)
  6. A patient is seen in the office complaining of severe flank pain. The clinician should assess this patient for which risk factor for kidney stones? a. Hypertension
  7. A patient is diagnosed with urge incontinence. Before prescribing Detrol XL, the provider should question the patient about which of these contraindications to this medication? c. Closed-angle glaucoma
  8. A patient is diagnosed with overactive bladder. Which of the following instructions should be given to this woman? b. "Eliminate caffeine from your diet."
  9. A 34-year-old patient was treated for a UTI and has not responded to antibiotic therapy. Which of the following actions should be taken next? a. Send a urine specimen for microscopy and evaluate for fungal colonies.

c."Your cancer has spread to other organs."

  1. The patient is diagnosed with acute renal failure (ARF). Which of the following data obtained from the history should alert the provider that this is a case of prerenal azotemia? a. Recent heat stroke
  2. The patient is diagnosed with ARF. Which of the following conditions is the most common cause? b. Acute tubular necrosis
  3. An 82-year-old woman with renal failure is seen in the clinic. The provider should question the patient about the intake of which of these substances that can cause renal toxicity? d.All of the above (Ibuprofen, Captopril, Losartan)
  4. Which of the following clinical manifestations are consistent with a patient in ARF? a.Pruritis
  5. Which of the following examination findings should be expected in a patient with chronic renal failure (CRF)? b.Auscultatory crackles
  6. Which of the following tests is most useful in determining renal function in a patient suspected of CRF? c. Creatinine clearance
  7. The urine osmolality is greater than 500 mOsm/L in patients with postrenal ARF. False
  8. Cigarette smoking is a risk factor for CRF. True A protein loss of more than 3.0 to 3.5 g every 24 hours indicate? Proteinuria – Glomerular lesion

A 24-hour urine test is the best way to measure proteinuria. A protein loss of more than 3.0 to 3.5 g every 24 hours indicates a glomerular lesion, whereas lesser amounts in the urine are more indicative of an interstitial disorder.

  1. Which of the following foods should be limited in a patient with CRF? d.All of the above (Milk, bananas, soy sauce) Stages of AKI Prerenal - Any condition that leads to an overall decrease in renal perfusion: hypovolemia, renovascular disease, decreased cardiac output, systemic vasodilation, renal vasoconstriction Intrarenal referes to disorders that affect the renal parenchyma itself like ATN, interstitial nephritis and tubular obstruction. Postrenal azotemia any etiology that might lead to an obstruction of flow of urine from the kidneys, ureteral, bladder neck, such as BPH, prostate or bladder cancer and metastatic disease affecting the UT.

More Renal Review

A patient is seen in the clinic with a chief complaint of hematuria. To make a differential diagnosis, which of the following questions should be asked? B. "What medications are you currently taking?" The result of the patient's 24-hour urine for protein was 4.2 g/day. The clinician should take which of the following actions? B. Refer to a nephrologist. The clinician is speaking with Bernadette, who has recently been diagnosed with urinary incontinence. She has had this condition for a number of years, she is 5 feet 5 inches, and she weighs 140 pounds. Which of the following should the health-care provider be aware of? D. Bernadette may be suffering from depression and may need a psychiatric consult. A patient is seen in the clinic with hematuria confirmed on microscopic examination. The clinician should inquire about the ingestion of which of these substances that might be the cause of hematuria? A. NSAIDs