NURS 5461 FINAL ACTUAL EXAM
100% CORRECT ANSWERS
A cough can last how long sometimes after a URI? - answer- up to 8 weeks
Acute bronchitis - answer- a temporary inflammation of the mucous membranes that line
the trachea and bronchial passageways; causes a cough that may produce mucus
5th most common cause of to see a HCP
Cough Treatment - answer- Treat primary cause
Get rid of the source, the cough goes away
Soothe cough
Dextromethorophan
Inhaled meds- Ipratropium
Benzonatate
Codeine-last resort
Hemoptysis most common causes - answer- inflammatory—bronchitis, bronchiectasis,
pneumonia, TB
Pneumonia symptoms - answer- -coughing
-fatigue
-pleuritic pain
-fever
-increased WBC
,-rust colored sputum
-crackles
-tachypnea
CURB-65 - answer- 1) Confusion
2) BUN>19
3) RR>30
4) BP<90/60
5) 65yo
One or less indicates patient can be treated outpatient, >1 =hospitalization
Single Pulmonary Nodule - answer- "Coin lesion"
A single parenchymal lung lesion smaller than 3cm W/O PNA , atelectasis, or lymphadenopathy
Pure subsolid SPN < 5mm require no follow-up
if SPN < 8mm follow Fleischner Society guidelines on intervals for repeat CT
If SPN >8mm refer specialist
Sleep apnea - answer- a sleep disorder characterized by temporary cessations of
breathing during sleep and repeated momentary awakenings
Central apneas—absent airflow and respiratory efforts-Neurological diseases
Obstructive apneas [OSA]-Tongue and soft palate fall backward
What is the definitive test for sleep apnea - answer- Overnight Polysomnogram
Age Related Pulmonary Changes - answer- • Reduced airway size
, •Shallow alveolar sacs
•Decline in chest wall compliance
• Intercostal muscle atrophy
• Reduction in diaphragmatic strength by 25%
Who or when should you consider silent aspiration - answer- Consider possibility of silent
aspiration, especially in those with frequent pneumonias, neurologic deficits, or residence in
extended-care facilities
Initial Therapies for Asthma and COPD - answer- Asthma: never use LABA without ICS
COPD: start treatment with LABA and/or LAMA, without ICS
What recommendation does GINA make for controllers? - answer- GINA recommends
treatment with low-dose ICS for most patients with asthma, even those with infrequent
symptoms, to reduce the risk of serious exacerbations.
GINA stepwise approach for Asthma - answer- 1. Consider low dose ICS, PRN SABA
2. Low dose ICS or LTRA, PRN SABA
3. Low dose ICS/LABA, PRN SABA or ICS/Formoterol
4. Med/High dose ICS/LABA, same
5. Refer to asthma specialist for add on therapy
Asthma Symptoms are caused by? - answer- Symptoms are associated with variable
expiratory airflow, i.e. difficulty breathing air out of the lungs due to
Bronchoconstriction
Airway wall thickening
Increased mucus
100% CORRECT ANSWERS
A cough can last how long sometimes after a URI? - answer- up to 8 weeks
Acute bronchitis - answer- a temporary inflammation of the mucous membranes that line
the trachea and bronchial passageways; causes a cough that may produce mucus
5th most common cause of to see a HCP
Cough Treatment - answer- Treat primary cause
Get rid of the source, the cough goes away
Soothe cough
Dextromethorophan
Inhaled meds- Ipratropium
Benzonatate
Codeine-last resort
Hemoptysis most common causes - answer- inflammatory—bronchitis, bronchiectasis,
pneumonia, TB
Pneumonia symptoms - answer- -coughing
-fatigue
-pleuritic pain
-fever
-increased WBC
,-rust colored sputum
-crackles
-tachypnea
CURB-65 - answer- 1) Confusion
2) BUN>19
3) RR>30
4) BP<90/60
5) 65yo
One or less indicates patient can be treated outpatient, >1 =hospitalization
Single Pulmonary Nodule - answer- "Coin lesion"
A single parenchymal lung lesion smaller than 3cm W/O PNA , atelectasis, or lymphadenopathy
Pure subsolid SPN < 5mm require no follow-up
if SPN < 8mm follow Fleischner Society guidelines on intervals for repeat CT
If SPN >8mm refer specialist
Sleep apnea - answer- a sleep disorder characterized by temporary cessations of
breathing during sleep and repeated momentary awakenings
Central apneas—absent airflow and respiratory efforts-Neurological diseases
Obstructive apneas [OSA]-Tongue and soft palate fall backward
What is the definitive test for sleep apnea - answer- Overnight Polysomnogram
Age Related Pulmonary Changes - answer- • Reduced airway size
, •Shallow alveolar sacs
•Decline in chest wall compliance
• Intercostal muscle atrophy
• Reduction in diaphragmatic strength by 25%
Who or when should you consider silent aspiration - answer- Consider possibility of silent
aspiration, especially in those with frequent pneumonias, neurologic deficits, or residence in
extended-care facilities
Initial Therapies for Asthma and COPD - answer- Asthma: never use LABA without ICS
COPD: start treatment with LABA and/or LAMA, without ICS
What recommendation does GINA make for controllers? - answer- GINA recommends
treatment with low-dose ICS for most patients with asthma, even those with infrequent
symptoms, to reduce the risk of serious exacerbations.
GINA stepwise approach for Asthma - answer- 1. Consider low dose ICS, PRN SABA
2. Low dose ICS or LTRA, PRN SABA
3. Low dose ICS/LABA, PRN SABA or ICS/Formoterol
4. Med/High dose ICS/LABA, same
5. Refer to asthma specialist for add on therapy
Asthma Symptoms are caused by? - answer- Symptoms are associated with variable
expiratory airflow, i.e. difficulty breathing air out of the lungs due to
Bronchoconstriction
Airway wall thickening
Increased mucus
