CMN 568 Intro to Family NP
Final Exam Practice
Complete Guide with Questions and Verified Answers
1. Your patient was seen by a pulmonologist 2 months ago and diagnosed with
asthma. The pulmonologist ordered a short acting beta-2 agonist for initial
symptom relief. However, on today's visit to your office, the patient states, "I
don't think this stuff is really working because I'm still short of breath." You
refer the patient back to the pulmonologist. Which of the following would you
anticipate being the next step in the patient's management following the latest
national guidelines?
Answer
an inhaled corticosteroid (ICS)
2. Jackie, a 25-yo female, comes to the clinic experiencing respiratory distress
and difficulty speaking. Her lungs are hyperresonant and show hyperinflation
on the x-ray. Which result would most strongly indicate that Jackie should be
admitted to a hospital?
A. Forced expiratory volume is below 30%
B. Respiratory rate is 25 breaths/minute
C. Pulsus paradoxus of 8 mmHg
D. Pulse is 112 bpm
Answer A
3. Which of these is NOT a common indoor trigger for asthma?
Cockroaches
Dust mites
Exercise
Termites
,Answer
termites
4. Upon examination, you notice that Alex, an obese 63yo male, has moderate
dyspnea and purulent sputum. His lungs are normal upon percussion. Labo-
ratory results reveal an increased hematocrit level. Given the most likely di-
agnosis, which of the following drugs would you be LEAST likely to prescribe
for the patient's condition?
A. Ipratropium bromide
B. Albuterol
C. Budesonide
D. Montelukast
Answer
D. montelukast
5. Which of the following medications is considered to be the mainstay of
treatment for chronic obstructive pulmonary disease?
A. Budesonide
B. Ipratropium bromide
C. Salmeterol
D. Triamcinolone
Answer B
6. Victor, a stocky 40yo male, presents to the clinic with complaints of difficulty
breathing and "endless amounts of gunk whenever he coughs." During the
visit, he coughs up a substantial amount of yellow phlegm. A blood test
reveals an increased hematocrit level,2 /and
15
a physical exam detects lungs that
are normal upon percussion. You order a pulmonary lab for the patient. Given
the most likely condition, which of the following findings would you LEAST
expect?
A. Increased forced expiratory volume in 1 second
B. Increased total lung capacity
C. Increased functional residual capacity
D. Increased residual volume
, Answer
A. (this is an indication of healthy lung functioning)
7. A thin patient w/ a slight build present with constant difficulty breathing
and clear mucus. A physical exam also indicates an increased chest antero-
posterior diameter and hyperresonance on percussion. Given the most likely
diagnosis, which class of medications is best suited for long-term tx?
Answer
anti- cholinergics
8. Which of these manifestations is LEAST likely to present with the onset of
asthma?
A. Plugging the airways by thick mucus
B. Hypertrophy of the mucus glands
C. Thinning of the epithelial basement membrane
D. Hypertrophy of smooth muscle
Answer C
9. Winston, a 42yo male, is an HIV-positive patient whose TB skin test returns
with an elevation of 5mm. After confirming a diagnosis of TB, you prescribe
a traditional drug regimen. For what minimum period of time is Winston
expected to continue his regimen?
Answer
9 months
10. Common symptoms of COPD are
Answer
cough, dyspnea, sputum production
11. Is a chest x-ray needed to diagnose COPD?
Answer
No. Chest x-ray may show hyperinflation, but PFTs are the standard for diagnosis.
, PFT may be able to diagnose prior to the presentation of symptoms.
12. What is the PFT result need for diagnosis of COPD?
Answer
FEV1 <0.7
13. Does every patient with asthma need a SABA?
Answer
yes
14. 30yo patient with persistent asthma, what are the essential components of
their care plan? (select all that apply)
A. Asthma action plan
B. Flu and pneumonia vaccine
C. Rescue inhaler
D. LABA
Answer
A, B, C
15. T or F. Asthma patients and COPD pts both need rescue inhalers?
Answer
true
16. Most common side effects of long-term inhaled steroid use?
Answer
Bone dem- ineralization (osteopenia) and cataracts
17. A 12yo patient presents to the clinic with wheezing, SOB, a feeling of
tightness in the chest. He is afebrile. Which of the following would be the best
test to confirm diagnosis?
Answer
Final Exam Practice
Complete Guide with Questions and Verified Answers
1. Your patient was seen by a pulmonologist 2 months ago and diagnosed with
asthma. The pulmonologist ordered a short acting beta-2 agonist for initial
symptom relief. However, on today's visit to your office, the patient states, "I
don't think this stuff is really working because I'm still short of breath." You
refer the patient back to the pulmonologist. Which of the following would you
anticipate being the next step in the patient's management following the latest
national guidelines?
Answer
an inhaled corticosteroid (ICS)
2. Jackie, a 25-yo female, comes to the clinic experiencing respiratory distress
and difficulty speaking. Her lungs are hyperresonant and show hyperinflation
on the x-ray. Which result would most strongly indicate that Jackie should be
admitted to a hospital?
A. Forced expiratory volume is below 30%
B. Respiratory rate is 25 breaths/minute
C. Pulsus paradoxus of 8 mmHg
D. Pulse is 112 bpm
Answer A
3. Which of these is NOT a common indoor trigger for asthma?
Cockroaches
Dust mites
Exercise
Termites
,Answer
termites
4. Upon examination, you notice that Alex, an obese 63yo male, has moderate
dyspnea and purulent sputum. His lungs are normal upon percussion. Labo-
ratory results reveal an increased hematocrit level. Given the most likely di-
agnosis, which of the following drugs would you be LEAST likely to prescribe
for the patient's condition?
A. Ipratropium bromide
B. Albuterol
C. Budesonide
D. Montelukast
Answer
D. montelukast
5. Which of the following medications is considered to be the mainstay of
treatment for chronic obstructive pulmonary disease?
A. Budesonide
B. Ipratropium bromide
C. Salmeterol
D. Triamcinolone
Answer B
6. Victor, a stocky 40yo male, presents to the clinic with complaints of difficulty
breathing and "endless amounts of gunk whenever he coughs." During the
visit, he coughs up a substantial amount of yellow phlegm. A blood test
reveals an increased hematocrit level,2 /and
15
a physical exam detects lungs that
are normal upon percussion. You order a pulmonary lab for the patient. Given
the most likely condition, which of the following findings would you LEAST
expect?
A. Increased forced expiratory volume in 1 second
B. Increased total lung capacity
C. Increased functional residual capacity
D. Increased residual volume
, Answer
A. (this is an indication of healthy lung functioning)
7. A thin patient w/ a slight build present with constant difficulty breathing
and clear mucus. A physical exam also indicates an increased chest antero-
posterior diameter and hyperresonance on percussion. Given the most likely
diagnosis, which class of medications is best suited for long-term tx?
Answer
anti- cholinergics
8. Which of these manifestations is LEAST likely to present with the onset of
asthma?
A. Plugging the airways by thick mucus
B. Hypertrophy of the mucus glands
C. Thinning of the epithelial basement membrane
D. Hypertrophy of smooth muscle
Answer C
9. Winston, a 42yo male, is an HIV-positive patient whose TB skin test returns
with an elevation of 5mm. After confirming a diagnosis of TB, you prescribe
a traditional drug regimen. For what minimum period of time is Winston
expected to continue his regimen?
Answer
9 months
10. Common symptoms of COPD are
Answer
cough, dyspnea, sputum production
11. Is a chest x-ray needed to diagnose COPD?
Answer
No. Chest x-ray may show hyperinflation, but PFTs are the standard for diagnosis.
, PFT may be able to diagnose prior to the presentation of symptoms.
12. What is the PFT result need for diagnosis of COPD?
Answer
FEV1 <0.7
13. Does every patient with asthma need a SABA?
Answer
yes
14. 30yo patient with persistent asthma, what are the essential components of
their care plan? (select all that apply)
A. Asthma action plan
B. Flu and pneumonia vaccine
C. Rescue inhaler
D. LABA
Answer
A, B, C
15. T or F. Asthma patients and COPD pts both need rescue inhalers?
Answer
true
16. Most common side effects of long-term inhaled steroid use?
Answer
Bone dem- ineralization (osteopenia) and cataracts
17. A 12yo patient presents to the clinic with wheezing, SOB, a feeling of
tightness in the chest. He is afebrile. Which of the following would be the best
test to confirm diagnosis?
Answer
