Np Test 1: Chest Disorders (Respiratory)

66 Questions | Total Attempts: 3191

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Np Test 1: Chest Disorders (Respiratory)

NP review questions


Questions and Answers
  • 1. 
    Compared with short-acting beta 2 agonists, long-acting beta 2 agonists:
    • A. 

      Should be added to therapy only when ICS use does not provide adequate asthma control.

    • B. 

      Have a rapid onset of action across the drug class.

    • C. 

      Have a significantly different pharmacodynamic profile.

    • D. 

      Are recommended as a first-line therapy in mild persistent asthma.

  • 2. 
    All of the following are consistent with the GOLD COPD recommendation for pulmonary rehabilitation except:
    • A. 

      Indicated in all COPD stages

    • B. 

      Goals include improvement in overall well-being

    • C. 

      An underused therapeutic option

    • D. 

      Components aimed at reducing the deconditioning common in COPD.

  • 3. 
    Clinical presentation of progressive primary TB most commonly includes all of the following except:
    • A. 

      Malaise

    • B. 

      Fever

    • C. 

      Dry cough

    • D. 

      Frank hemoptysis

  • 4. 
    The mechanism of transmission of Legionella species is primarily via 
    • A. 

      Respiratory droplet

    • B. 

      Inhalation of contaminated water

    • C. 

      Contact with contaminated surface

    • D. 

      Hematogenous spread

  • 5. 
    Risk factors for infection with DRSP include all of the following except:
    • A. 

      Systemic antimicrobial therapy in the previous 3 months

    • B. 

      Exposure to children in day care

    • C. 

      Age older than 65

    • D. 

      Use of inhaled corticosteroids

  • 6. 
    Risk factors for development of infection reactivation in patients with latent TB infection include all of the following except:
    • A. 

      Diabetes Mellitus

    • B. 

      Immunocompromise

    • C. 

      Long-term oral corticosteroid therapy

    • D. 

      Male gender

  • 7. 
    Which of the following best describes the role of theophylline in COPD treatment?
    • A. 

      Indicated in moderate to very severe COPD

    • B. 

      Use limited by narrow therapeutic profile and drug-drug interaction potential

    • C. 

      A potent bronchodilator

    • D. 

      Available only in parenteral form.

  • 8. 
    Which of the following is true regarding the use of systemic corticosteroids?
    • A. 

      Parenteral therapy is preferred over the oral route

    • B. 

      Tapering down the dosage is required if used for 5-7 days as is typical in an asthma flare

    • C. 

      These medications provide action against the formation of various inflammatory mediators.

    • D. 

      The adult dose to treat an asthma flare should not exceed the equivalent of prednisone 40 mg daily.

  • 9. 
    Which of the following is the therapeutic objective of using inhaled ipratroprium bromide in the treatment of acute asthma exacerbation?
    • A. 

      A recommendation for use with short-acting beta2 agonists in the hospital.

    • B. 

      An increase in vagal tone in the airway

    • C. 

      Inhibition of muscarinic cholinergic receptors

    • D. 

      An increase in salivary and mucous secretions

  • 10. 
    With a COPD exacerbation, a CXR should be obtained:
    • A. 

      Routinely in all patients

    • B. 

      When attempting to rule out a concomitant pneumonia

    • C. 

      If sputum is increased

    • D. 

      When work of breathing is increased.

  • 11. 
    Compared with TST, potential advantages of the QuantiFERON-TB Gold test (QTF-G) include all of the following except 
    • A. 

      Ability to have entire testing process complete with one clinical visit

    • B. 

      Results are available within 24 hours

    • C. 

      Interpretation of test is not subject to reader bias

    • D. 

      Provides a prediction as to who is at greatest risk for disease development

  • 12. 
    While seeing a 62-year-old who is hospitalized with CAP, the NP considers that:
    • A. 

      Antipneumococcal vaccine should be given when antimicrobial therapy has completed.

    • B. 

      Antipneumococcal vaccine can be given today, and influenza vaccine can be given in 2 weeks.

    • C. 

      Influenza vaccine can be given today and antipneumococcal vaccine can be given in 2 weeks.

    • D. 

      Influenza and antipneumococcal vaccines should be given today.

  • 13. 
    You are caring for a 52-year-old man who is currently smoking 1.5 PPD and has a 40-pack-year cigarette smoking history and has CAP. It is the third day of his antimicrobial therapy, and he is without fever, is well hydrated and is feeling less short of breath. His initial CXR revealed a right lower lobe infiltrate. Physical exam today reveals peak inspiratory crackles with increased tactile fremitus in the right posterior thorax. Which of the following represents the most appropriate next step in this patient's care?
    • A. 

      His current plan of care should continue because he is improving by clinical assessment

    • B. 

      A CXR should be taken today to confirm resolution of pneumonia

    • C. 

      Given the persistence of abnormal thoracic findings, his antimicrobial therapy should be changed.

    • D. 

      A computed tomography scan of the thorax is needed today to image better any potential thoracic abnormalities.

  • 14. 
    A 33-year-old woman works in a small office with a man recently diagnosed with active pulmonary TB. Which of the following would be the best plan of care for this woman?
    • A. 

      She should receive TB chemoprophylaxis if her TST result is 5 mm or more in induration.

    • B. 

      Because of her age, TB chemoprophylaxis is contraindicated even in the presence of a positive TST result.

    • C. 

      If the TST result is positive, but the CXR is normal, no further evaluation or treatment

    • D. 

      Further evaluation is needed only if the TST result is 15 mm or more in induration.

  • 15. 
    You examine a 28-year-old woman who has emigrated from a country where TB is endemic. She has documentation of receiving bacille Calmette-Guerin (BCG) as a child. With this information you consider that:
    • A. 

      She will always have a positive TST result

    • B. 

      Biannual CXR are needed to assess her health status accurately.

    • C. 

      A TST finding of 10 mm or more induration should be considered a positive result.

    • D. 

      Isoniazid therapy should be given for 6 months before TST is undertaken.

  • 16. 
    You see a 67-year-old man with stage IV (very severe) COPD who asks, "When should I use my home oxygen?" You respond:
    • A. 

      As needed when SOB

    • B. 

      Primarily during sleep hours

    • C. 

      Preferably during waking hours

    • D. 

      For at least 15 hours a day

  • 17. 
    An organism often associated with COPD exacerbation in a person with advanced disease and repeated exacerbations is
    • A. 

      Pseudomonas aeruginosa

    • B. 

      Chlamydophila (Chlamydia) pneumoniae

    • C. 

      Streptococcus pneumoniae

    • D. 

      Haemophilus influenzae

  • 18. 
    What is the most appropriate choice for abx therapy for a severe COPD exacerbation in a 52-year-old man?
    • A. 

      Azithromycin

    • B. 

      Amoxicillin

    • C. 

      Trimethoprim-sulfamethoxazole

    • D. 

      Fosfomycin

  • 19. 
    Regarding the use of long-acting beta2 agonists (LABA), which of the following is true?
    • A. 

      LABAs enhance the anti-inflammatory action of the corticosteroids

    • B. 

      Use of LABAs is associated with a small increase in risk of asthma-related death.

    • C. 

      LABAs reduce asthma exacerbations

    • D. 

      LABAs can be tried before ICS to relieve bronchospasm.

  • 20. 
    Which of the following best describes the mechanism of action of short-acting beta2 agonists?
    • A. 

      Reducer of inflammation

    • B. 

      Inhibition of secretions

    • C. 

      Modification of leukotrienes

    • D. 

      Smooth muscle relaxation

  • 21. 
    Which of the following represents findings in an acceptable sputum specimen for Gram staining?
    • A. 

      Many squamous epithelial cells and few WBCs

    • B. 

      Three or more stained organisms

    • C. 

      Few squamous epithelial cells and many WBCs

    • D. 

      Motile bacteria with monocytes

  • 22. 
    Findings of increased tactile fremitus and dullness to percussion at the right lung base in the person with CAP likely indicate an area of:
    • A. 

      Atelectasis

    • B. 

      Pneumothorax

    • C. 

      Consolidation

    • D. 

      Cavitation

  • 23. 
    All of the following antimicrobial strategies help facilitate the development of resistant pathogens except:
    • A. 

      Longer course of therapy

    • B. 

      Lower antimicrobial dosage

    • C. 

      Higher antimicrobial dosage

    • D. 

      Prescribing a broader spectrum agent

  • 24. 
    Risk factors for death resulting from pneumonia include:
    • A. 

      Viral origin

    • B. 

      History of allergy

    • C. 

      Renal insufficiency

    • D. 

      Polycythemia

  • 25. 
    Which is the most appropriate choice for therapy of mild acute COPD exacerbation in a 42-year-old man?
    • A. 

      Levofloxacin

    • B. 

      Daptomycin

    • C. 

      Linezolid

    • D. 

      ABX therapy is usually not indicated

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