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, and 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
PFT
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, and 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
PFT
