Deck 13: Pharmacologic Management of Obstructive Pulmonary Disease: Asthma, chronic Bronchitis, and Emphysema

Question 1

Of the following medications,which would you recommend during an asthmatic episode to provide the quickest relief?

A)Aminophylline
B)Epinephrine
C)Ipratropium bromide
D)Levalbuterol

Answer 1

Levalbuterol

Question 2

All of the following are present with asthma except:

A)Increased eosinophils.
B)Cough at night and in the early morning.
C)Loss of elastic recoil in the lung.
D)Inflammation of the airways.

Answer 2

Loss of elastic recoil in the lung.

Question 3

Which of the following characteristics of obstructive pulmonary diseases distinguish asthma from COPD?

A)Inflammation involving cellular and chemical mediators
B)Airway narrowing and reversibility
C)The presence of airway hyperreactivity
D)Ongoing wheezing,breathlessness,and cough

Answer 3

Inflammation involving cellular and chemical mediators

Question 4

A physician has asked for your recommendation in setting up a drug regimen for an adolescent patient with chronic allergic asthma.Which of the following agents would be beneficial for long-term effects in controlling this patient's asthma? I.Cromolyn sodium
II)Ipratropium bromide
III)Salmeterol

A)I and II
B)II and III
C)I and III
D)I,II,and III

Question 5

You are evaluating an asthmatic patient in a hospital clinic.When asked how often her symptoms occur,she explains that her attacks occur every day and prevent her from walking to work and school.She adds that some nights,her sleep is disrupted because she is having difficulty breathing.How would you classify the severity of her asthma?

A)Mild intermittent
B)Mild persistent
C)Moderate persistent
D)Severe persistent

Question 6

Benefits of nicotine replacement therapy (NRT)include all except which of the following?

A)Carcinogens are not being delivered to the lungs.
B)NRT can be adjusted to substitute partially for inhaled nicotine.
C)NRT decreases the cravings when the smoker's blood levels of nicotine drop.
D)Blood levels of nicotine from NRT are not as consistent as with smoking.

Question 7

Of the following,which products combine LABAs and corticosteroids? I.Combivent
II)Advair
III)Symbicort

A)I and II
B)I and III
C)II and III
D)I,II,and III

Question 8

Which of the following is true of inhaled corticosteroids?

A)They are most effective for quick relief of asthma.
B)They are effective bronchodilators.
C)They require mouth rinsing after inhalation.
D)They are absorbed more than systemic corticosteroids.

Question 9

A patient with COPD who was admitted to the hospital 2 days ago in acute exacerbation is ordered a pulmonary function test.Upon performing the test,you record his results as an FEV₁/FVC of 60% and an FEV₁ of 39% of predicted value.This patient is in which of the following stages of COPD?

A)Stage I
B)Stage II
C)Stage III
D)Stage IV

Question 10

According to the NAEPP guidelines,all patients with asthma should know how to do all except which of the following?

A)Use a quick-relief medication
B)Use long-term medication daily
C)Take personal peak-flow meter measurements
D)Recognize symptoms of an attack

Question 11

Which of the following corticosteroids can cause osteoporosis,hypertension,or cataracts?

A)Methylprednisolone
B)Fluticasone
C)Flunisolide
D)Budesonide

Question 12

Which of the following clinical presentations are typical for emphysema? I.Cyanosis
II)Exhaling through pursed lips
III)Marked weight loss

A)I and II
B)II and III
C)I and III
D)I,II,and III

Question 13

Patients with exercise-induced asthma should do which of the following to prevent an asthma attack from occurring?

A)Avoid exercise
B)Consider immunotherapy
C)Monitor PEFR during exercise
D)Use a short- or long-acting bronchodilator prior to exercise

Question 14

You are called to the emergency room to treat a patient experiencing an acute exacerbation of COPD.Which of the following drugs would be the best choice?

A)Albuterol
B)Atrovent
C)Cromolyn sodium
D)Theophylline

Question 15

Which of the following drugs used for nicotine addiction does not provide nicotine replacement?

A)Commit lozenge
B)Nicotrol
C)Nicorette
D)Zyban

Question 16

Which of the following is a diagnostic marker used to confirm a diagnosis of COPD due to emphysema?

A)A cough,typically in the evening
B)Increased eosinophilia
C)Episodic attacks brought on by exposure to allergens
D)A history of smoking

Question 17

A COPD patient who presents with an FEV₁/FVC of less than 70% and an FEV₁ greater than 80% of predicted value would be classified as:

A)Being at risk for COPD.
B)Having mild COPD.
C)Having moderate COPD.
D)Having severe COPD.

Question 18

While reviewing a patient's history and physical examination for diagnostic markers that indicate the presence of asthma,your findings should include all except which of the following?

A)Variable peak expiratory flow rates
B)Triggers to irritants or allergens
C)Increased A-P chest diameter
D)Improvement with corticosteroid use

Question 19

To reduce attacks caused by viral infections,asthmatic patients should do all except which of the following?

A)Consider specific immunotherapy
B)Be vaccinated for influenza yearly
C)Be aware of good hand-washing techniques
D)Avoid exposure that would increase viral transmission

Question 20

Which of the following describes asthma?

A)Presence of productive cough during 3 months of the year for 2 consecutive years
B)Episodes of reversible airway hyperreactivity and inflammation
C)Destruction of alveolar walls and loss of elastic recoil in the lung
D)Chronic sputum production and associated cough

Question 21

______ 10.COPD patients respond better to anticholinergic agents than do asthmatic patients.
FILL-IN-THE-BLANK
Write the word or phrase that best completes each statement.

Question 22

Which of the following patients is likely to present with a hyperinflated barrel chest? I.A patient with asthma
II)A patient with chronic bronchitis
III)A patient with emphysema

A)I and II
B)II and III
C)I and III
D)I,II,and III

Question 23

______ 7.An increase in the anterior-posterior diameter of the chest is typically seen only in patients with emphysema.

Question 24

Inhaled corticosteroids should always be administered with a ________________.

Question 25

________________ is a reversible obstructive disease,and ________________ is progressive and not fully reversible.

Question 26

A patient with COPD who has just progressed into stage III COPD and has repeated exacerbations should now be treated with the addition of which of the following medications?

A)A short-acting bronchodilator
B)A long-acting bronchodilator
C)Inhaled corticosteroids
D)Oxygen

Question 27

______ 2.The National Asthma Education and Prevention Program (NAEPP)recommends that asthmatics maintain normal exercise and physical activity.

Question 28

Of the following clinical features,which most likely indicates chronic bronchitis?

A)Hyperinflated barrel chest
B)Cough and copious secretions
C)Exhalation through pursed lips
D)Labored or difficulty breathing TRUE/FALSE
Write 'T' if the statement is true and 'F' if the statement is false.

Question 29

Patients with all categories of ________________ asthma should be on anti-inflammatory medication to prevent their symptoms from occurring.

Question 30

______ 6.Most patients with COPD have features of both emphysema and chronic bronchitis.

Question 31

______ 1.Obstructive pulmonary disease is the fourth leading cause of death in the United States.

Question 32

______ 9.A score of 6 or higher on the Fagerstrom Test for Nicotine Dependence (FTND)indicates a high level of nicotine addiction.

Question 33

The most effective agents for long-term control of asthma are ______________.

Question 34

______ 5.The death rate of women from COPD has increased dramatically since 1980 due to the increased number of women who smoke.

Question 35

________________ is the most common chronic disease among children and young adults.

Question 36

______ 4.Agents that are most effective for long-term control of asthma are methylxanthines.

Question 37

______ 3.Asthma that occurs two times or less per week and can be controlled is considered mild persistent asthma.

Question 38

The primary cause of COPD includes which of the following conditions?

A)Exposure to tobacco
B)Alpha₁-antitrypsin deficiency
C)Environmental pollution
D)Exposure to allergens

Question 39

Patients with COPD who require a sympathomimetic and anticholinergic bronchodilator should be prescribed:

A)Brethaire.
B)Combivent.
C)Maxair.
D)Spiriva.

Question 40

______ 8.Zafirlukast reduces bronchospasm by blocking IgE from activating mast cells in patients with severe allergic asthma.

Question 41

The pharmacologic agent _____________ is recommended for patients who are severely limited by their COPD to improve their activities of daily living.

Question 42

Describe the clinical presentation of a patient with emphysema that you suspect is due to a deficiency of alpha₁-antitrypsin.

Question 43

The major causative factor in chronic bronchitis is ________________.

Question 44

Emphysemic patients exhale through ______________ to maintain airway pressure and prevent airway collapse.

Question 45

The primary cause of COPD is ________________.

Question 46

Describe the meanings of the terms "pink puffer" and "blue bloater."

Question 47

Discuss the use of aminophylline in the treatment of asthmatic episodes.

Question 48

Alpha₁-antitrypsin augmentation therapy is administered on a ________________ basis.

Question 49

Leukotriene inhibitors have no established use in patients with

Question 50

In addition to treatment with nicotine replacement,patients who wish to quit smoking should be encouraged to ________________.

Question 51

According to the NAEPP guidelines,what must a respiratory therapist remember when using the treatment algorithm in the management of asthma?

Question 52

________________ is a drug that blocks IgE from activating mast cells in patients with severe allergic asthma.

Question 53

Why is it recommended to use nicotine replacements with Zyban?

Question 54

In asthmatic patients whose symptoms are enough to require emergency room treatment,_______________ corticosteroids should be administered.

Question 55

Emphysema can be caused by a genetic deficiency of ________________.