Deck 9: Respiratory Problems

Question 1

Cydney presents with a history of asthma.She has not been treated for a while.She complains of daily but not continual symptoms, greater than 1 week and at nighttime.She has been using her rescue inhaler.Her FEV₁ is 60% to 80% predicted.How would you classify her asthma severity?

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

Answer 1

Moderate persistent

Question 2

Nathan, a 32-year-old policeman, has a 15-pack-a-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?

A)Hand him literature about smoking cessation at every visit.
B)Wait until he is ready to talk to you about quitting.
C)Document in the record that he is not ready to quit.
D)Continue to ask him at every visit if he is ready to quit.

Answer 2

Continue to ask him at every visit if he is ready to quit.

Question 3

Your patient is on Therabid for his asthma.You want to maintain his serum levels between:

A)0 to 5 mcg/mL
B)5 to 10 mcg/mL
C)5 to 15 mcg/mL
D)10 to 20 mcg/mL

Answer 3

5 to 15 mcg/mL

Question 4

Most nosocomial pneumonias are caused by:

A)Fungi
B)Viruses
C)Gram-negative bacteria
D)Pneumococcal pneumonia

Question 5

Marci has been started on a tuberculosis (TB) regimen.Because isoniazid (INH) may cause peripheral neuropathy, you consider ordering which of the following drugs prophylactically?

A)Pyridoxine
B)Thiamine
C)Probiotic
D)Phytonadione

Question 6

Jolene has breast cancer that has been staged as T1, N0, M0.What might this mean?

A)The tumor size cannot be evaluated; the cancer has not spread to the lymph nodes; and the distant spread cannot be evaluated.
B)The cancer is in situ; it is spreading into the lymph nodes, but the spread cannot be evaluated otherwise.
C)The cancer is less than 2 cm in size and has not spread to the lymph nodes or other parts of the body.
D)The cancer is about 5 cm in size; nearby lymph nodes cannot be evaluated; and there is no evidence of distant spreading.

Question 7

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?

A)Asthma
B)Emphysema
C)Chronic bronchitis
D)Influenza

Question 8

A chronic cough lasts longer than:

A)3 weeks
B)1 month
C)6 months
D)1 year

Question 9

Joyce is taking a long-acting beta agonist for her asthma.What additional medication should she be taking?

A)Inhaled corticosteroid
B)Leukotriene receptor antagonist
C)Systemic corticosteroid
D)Methyl xanthenes

Question 10

Your patient has decided to try to quit smoking with Chantix.You are discussing his quit date, and he will begin taking the medicine tomorrow.When should he plan to quit smoking?

A)He should stop smoking today.
B)He should stop smoking tomorrow.
C)His quit date should be in 1 week.
D)He will be ready to quit after the first 30 days.

Question 11

Your patient states he has a strep throat infection.Which of the following symptoms makes you consider a viral etiology instead?

A)Fever
B)Headache
C)Exudative pharyngitis
D)Rhinorrhea

Question 12

Which information should be included when you are teaching your patient about the use of nicotine gum?

A)The gum must be correctly chewed to a softened state and then placed in the buccal mucosa.
B)Patients should not eat for 30 minutes prior to or during the use of the gum.
C)Initially, one piece is chewed every 30 minutes while awake.
D)Acidic foods and beverages should be encouraged during nicotine therapy.

Question 13

George has chronic obstructive pulmonary disease (COPD) and an 80% forced expiratory volume in 1 second.How would you classify the severity of his COPD?

A)Stage 1 mild COPD
B)Stage 2 moderate COPD
C)Stage 3 severe COPD
D)Stage 5 very severe COPD

Question 14

What is the first-line recommended treatment against Group A β-hemolytic streptococci (GABHS), the most common cause of bacterial pharyngitis?

A)Penicillin
B)Quinolone
C)Cephalosporin
D)Macrolide

Question 15

Why do you suspect that your patient may have a decreased response to the tuberculin skin test (TBT)?

A)She is on a high-protein diet.
B)She is an adolescent.
C)She has been on long-term corticosteroid therapy.
D)She just got over a cold.

Question 16

You are doing a cerumen extraction and touch the external meatus of your patient's ear.He winces and starts coughing.What is the name of this reflex?

A)Baker phenomenon
B)Arnold reflex
C)Cough reflex
D)Tragus reflex

Question 17

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?

A)Consider home treatment.
B)Plan for a short inpatient hospitalization.
C)Closely supervise her outpatient treatment.
D)Hospitalize and consider admitting her to the intensive care unit.

Question 18

Julie has a postnasal drip along with her cough.You assess her for:

A)Asthma
B)Sinusitis
C)Allergic or vasomotor rhinitis
D)Influenza

Question 19

A patient with hypertension comes in and insists that one of his new medications is causing him to cough.When looking at his list of medications, you think the cough must be from:

A)Metoprolol
B)Clopidogrel
C)Tadalafil
D)Captopril

Question 20

African American patients seem to have a negative reaction to which of the following asthma medications?

A)Inhaled corticosteroids
B)Long-term beta-agonist bronchodilators
C)Leukotriene receptor agonists
D)Oral corticosteroids

Question 21

Which of the following statements regarding pulmonary function is true?

A)Cigarette smoking accelerates the decline in pulmonary function tenfold.
B)Smoking cessation can reverse most pathological changes.
C)Cigarette smoking decreases mucus production.
D)There is a normal age-related decline in pulmonary function.

Question 22

The most common cause of CAP is?

A)Streptococcus pneumoniae
B)Klebsiella pneumoniae
C)Legionella pneumoniae
D)Pseudomonas aeruginosa

Question 23

Which of the following statements regarding TST is true?

A)Tests should be read 48 hours after the injection.
B)The size of the TST reaction has nothing to do with erythema but is based solely on induration.
C)It is a type V T cell-mediated immune response.
D)The diameter of the induration is measured in centimeters.

Question 24

Jason, age 62, has obstructive sleep apnea.What do you think is one of his contributing factors?

A)He is a recovering alcoholic of 6 years.
B)His collar size is 17 inches.
C)He is the only person in his family who has this.
D)He is extremely thin.

Question 25

Which of the following is a possible consequence of sleep apnea?

A)Asthma
B)Increased white blood cells
C)Insulin resistance
D)Hyperactivity

Question 26

Which obstructive lung disease is classified as reversible?

A)Asthma
B)Chronic bronchitis
C)Emphysema
D)COPD

Question 27

The forced vital capacity is decreased in:

A)Asthma
B)Chronic bronchitis
C)Emphysema
D)Restrictive disease

Question 28

Which of the following conditions is associated with cigarette smoking?

A)Glaucoma
B)Increased sperm quality
C)Bladder cancer
D)Eczema

Question 29

Supplemental oxygen for how many hours per day has been shown to improve the mortality associated with COPD?

A)3 to 5 hours
B)6 to 10 hours
C)11 to 14 hours
D)15 to 18 hours

Question 30

Which statement about adenocarcinoma of the lung is accurate?

A)It is the least common type of lung cancer, representing approximately 5% to 10% of cases.
B)It is the most prevalent carcinoma of the lungs in both sexes and in nonsmokers, representing 35% to 40% of all tumors.
C)It is more common in men than in women and occurs almost entirely in cigarette smokers.
D)It is aggressive, with rapid growth and early local and distant metastases via the lymphatic and blood vessels.

Question 31

The barrel chest characteristic of emphysema is a result of:

A)Chronic coughing
B)Hyperinflation
C)Polycythemia
D)Pulmonary hypertension

Question 32

Which of the following patients would you expect to have a decreased response to TST?

A)Julie, a 50-year-old postal worker
B)Sandy, a 40-year-old patient who recently survived a fire that left 40% of her total body surface covered in burns
C)Jill, a 16-year-old cheerleader
D)Mark, a 29-year-old tennis player

Question 33

Marta is taking TB drugs prophylactically.How do you instruct her to take them?

A)Take them on an empty stomach to facilitate absorption.
B)Take them with aspirin (ASA) to prevent flushing.
C)Take them with ibuprofen to prevent a headache.
D)Take them with food to prevent nausea.

Question 34

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?

A)"Take your short-acting beta-2 agonist, remain quiet, and call back tomorrow."
B)"Use your rescue inhaler, begin the prescription of oral glucocorticoids you have, and call back tomorrow."
C)"Drive to the emergency room now."
D)"Call 911."

Question 35

Which ethnic group has the highest lung cancer incidence and mortality rates?

A)African American men
B)Scandinavian men and women
C)Caucasian women
D)Asian men .