Deck 32: Asthma and Chronic Obstructive Pulmonary Disease

Question 1

A stepwise approach to the pharmacologic management of asthma:

A)Begins with determining the severity of asthma and assessing asthma control
B)Is used when asthma is severe and requires daily steroids
C)Allows for each provider to determine their personal approach to the care of asthmatic patients
D)Provides a framework for the management of severe asthmatics, but is not as helpful when patients have intermittent asthma

Answer 1

Begins with determining the severity of asthma and assessing asthma control

Question 2

Prior to developing a plan for the treatment of asthma, the patient's asthma should be classified according to the National Heart, Lung, and Blood Institute (NHLBI) Expert Panel 3 guidelines. In adults mild-persistent asthma is classified as asthma symptoms that occur:

A)Daily
B)Daily and limit physical activity
C)Less than twice a week
D)More than twice a week and less than once a day

Answer 2

More than twice a week and less than once a day

Question 3

Pregnant patients with asthma may safely use ________ throughout their pregnancy.

A)Oral terbutaline
B)Prednisone
C)Inhaled corticosteroids (budesonide)
D)Montelukast (Singulair)

Answer 3

Inhaled corticosteroids (budesonide)

Question 4

The first-line therapy for mild-persistent asthma is:

A)High-dose montelukast
B)Theophylline
C)Low-dose inhaled corticosteroids
D)Long-acting beta 2 agonists

Question 5

Asthma exacerbations at home are managed by the patient by:

A)Increasing frequency of beta 2 agonists and contacting their provider
B)Tripling inhaled corticosteroid dose
C)Inhaled beta 2 agonists every 20 minutes for two hours
D)Starting montelukast (Singulair)

Question 6

Medications used in the management of chronic obstructive pulmonary disease (COPD) include:

A)Inhaled beta 2 agonists
B)Inhaled anticholinergics (ipratropium)
C)Inhaled corticosteroids
D)All of the above

Question 7

One goal of asthma management in children is:

A)They can independently manage their asthma.
B)Participation in school and sports activities
C)No exacerbations
D)Minimal use of inhaled corticosteroids

Question 8

Patients with a COPD exacerbation may require:

A)Doubling of inhaled corticosteroid dose
B)Systemic corticosteroid burst
C)Continuous inhaled beta 2 agonists
D)Leukotriene therapy

Question 9

Treatment for mild-intermittent asthma is:

A)Daily inhaled medium-dose corticosteroids
B)Short-acting beta 2 agonists (albuterol) as needed
C)Long-acting beta 2 agonists every morning as a preventative measure
D)Montelukast (Singulair) daily

Question 10

Patients with COPD require monitoring of:

A)Beta 2 agonist use
B)Serum electrolytes
C)Blood pressure
D)Neuropsychiatric effects of montelukast

Question 11

Patients who are at risk of a fatal asthma attack include patients:

A)With moderate-persistent asthma
B)With a history of requiring intubation or intensive care unit (ICU) admission for asthma
C)Who are on daily inhaled corticosteroid therapy
D)Who are pregnant

Question 12

Monitoring a patient with persistent asthma includes:

A)Monitoring how frequently the patient has an upper respiratory infection (URI) during treatment
B)Monthly in-office spirometry testing
C)Determining if the patient has increased use of his or her long-acting beta 2 agonist due to exacerbations
D)Evaluating the patient every 2 to 3 months to determine if the patient needs to step up or down in their therapy

Question 13

One goal of asthma therapy outlined by the NHLBI Expert Panel 3 guidelines is:

A)Control of symptoms using albuterol daily
B)Minimize exacerbations to once a month
C)Keep nighttime symptoms at a maximum of twice a week
D)Require infrequent use of beta 2 agonists (albuterol) for relief of symptoms

Question 14

In children age 5 to 11 years mild-persistent asthma is diagnosed when asthma symptoms occur:

A)At nighttime one to two times a month
B)At nighttime three to four times a month
C)Less than twice a week
D)Daily

Question 15

Education of patients with COPD who use inhaled corticosteroids includes:

A)Doubling the dose at the first sign of a URI
B)Using their inhaled corticosteroid first and then their bronchodilator
C)Rinsing their mouth after inhaler use
D)Abstaining from smoking for at least 30 minutes after using

Question 16

Education for patients who use an inhaled beta agonist and an inhaled corticosteroid includes:

A) Use the inhaled corticosteroid first, followed by the inhaled beta agonist.
B) Use the inhaled beta agonist first, followed by the inhaled corticosteroid.
C) Increase fluid intake to 3 L per day.
D) Avoid use of aspirin or ibuprofen while using inhaled medications.