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MN 568 Midterm Study Guide Questions with Answers

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Respiratory Review 1. A chronic cough lasts longer than: 8 Weeks 2. You are doing a cerumen extraction and touch the external meatus of your pt's ear. He winces and starts coughing. What is the name of this reflex? Arnold Reflex 3. Julie has a postnasal drip along with her cough. You assess her for: Allergic or vasomotor rhinitis 4. A pt with HTN comes in and insists that one of his new meds is causing him to cough. When looking at his list of meds, you think the cough must be from: Captopril 5. African American pt's seems to have a negative reaction to which of the following asthma meds? Long-term beta-agonist bronchodilators 6. Sam, age 78, presents to the clinic w/respiratory symptoms. His PFTs are as follows: normal total lung capacity, decreased PaO2, increased PaCO2. On assessment, you auscultate course crackles and forced expiratory wheezes. What is your dx? Chronic Bronchitis 7. You are using the CURB-65 clinical prediction tool to decide whether Mabel, whom you have diagnosed with community-acquired pneumonia (CAP), should be hospitalized or treated at home. Her score is 3. What should you do? Hospitalize and consider admitting her to ICU 8. Why do you suspect that your pt may have a decreased response to the TB test? She has been on long-term corticosteroid therapy 9. Marci has been started on a TB regimen. Because isoniazid (INH) may cause peripheral neuropathy, you consider ordering which of the following drugs prophylactically? Pyroxidine 10. Jolene has breast cancer that has been staged as T1, N0, M0. What might this mean? The cancer is less than 2cm in size and has not spread to the lymph nodes or other parts of the body 11. Nathan, a 32yo policeman, has a 15-pack-year history of smoking and continues to smoke heavily. During every visit, he gets irate when you try to talk to him about quitting. What should you do? Continue to ask him at every visit if he is ready to quit 12. Your pt has decided to try to quit smoking with Chantix. You are discussing his quit date and he will begin taking the med tomorrow. When should he plan to quit smoking? His quit date should be in 1 week 13. Which info should be included when you are teaching your pt about the use of nicotine gum? The gum must be correctly chewed to a softened state and then placed in the buccal mucosa or “parked” 14. Your pt states he has a strep throat infection. Which of the following symptoms makes you consider a viral etiology instead? Rhinorrhea 15. What is the first-line recommended treatment against Group A beta-hemolytic streptococci (GABHS), the most common cause of bacterial pharyngitis? PCN 16. Cydney presents with a h/o asthma. She has not been treated for a while. She c/o daily but not continual symptoms, greater than 1 week and at nighttime. She has been using her rescue inhaler. Her FEV1 is 60-80% predicted. How would you classify her asthma severity? Moderate Persistent 17. Joyce is taking a long-acting beta agonist for her asthma. What additional med should she be taking? Inhaled corticosteroid 18. Your pt is on Therabid (theophylline) for his asthma. You want to maintain his serum levels between: 5-15mcg/mL 19. George has COPD and an 80% forced expiratory volume in 1 second. How would you classify the severity of his COPD? Stage 1-Mild COPD 20. Most nosocomial pneumonias are caused by: Gram-negative bacteria 21. Which of the following statements regarding TST is true? The size of the TST reaction has nothing to do with erythema but is based solely on induration 22. Which obstructive lung dz is classified as reversible? Asthma 23. You have taught Jennifer, age 15, about using a flow meter to assess how to manage her asthma exacerbations. She calls you today because her peak expiratory flow rate is 65%. What would you tell her? "Use your rescue inhaler, begin the Rx of PO glucocorticoids you have, and call back tomorrow." 24. Which statement about adenocarcinoma of the lung is accurate? It is the most prevalent carcinoma of the lungs in both sexes and in nonsmokers, representing 35-40% of all tumors 25. Jason, age 62, has obstructive sleep apnea. What do you think is one of his contributing factors? His collar size is 17 inches 26. The forced vital capacity is decreased in: Restrictive Disease 27. The most common cause of CAP is: Streptococcus pneumoniae 28. Which of the following pt's would you expect to have a decreased response to TST? Sandy, a 40yo pt who recently survived a fire that left 40% of her total body surface covered in burns 29. Which of the following is a possible consequence of sleep apnea? Insulin Resistance 30. Which of the following conditions is associated with cigarette smoking? Bladder cancer 31. Marta is taking TB drugs prophylactically. How do you instruct her to take them? Take them on an empty stomach to facilitate absorption 32. Which of the following statements regarding pulmonary function is true? There is a normal age-related decline in pulmonary function 33. The barrel chest characteristic of emphysema is a result of: Hyperinflation 34. Supplemental oxygen for how many hours per day has been shown to improve the mortality associated with COPD? 15-18 Hours 36. Gabby, aged 22, has Bell’s palsy on the right side of her face. Her mouth is distorted, and she is concerned about permanent paralysis and pain. What do you tell her? Most patients have complete recovery in 3 to 6 months. 37. Sondra’s peripheral vestibular disease causes dizziness and vertigo. Which of the following medications will help to decrease edema in the labyrinth of the ear? Diamox 38. Which of the following should be started promptly if viral encephalitis is suspected? IV acyclovir 39. When a patient has a carotid bruit, which of the following should the PCP gather from the patient history? History of

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Respiratory Review
1. A chronic cough lasts longer than:
8 Weeks
2. You are doing a cerumen extraction and touch the external meatus of your pt's ear. He winces and
starts coughing. What is the name of this reflex?
Arnold Reflex
3. Julie has a postnasal drip along with her cough. You assess her for:
Allergic or vasomotor rhinitis
4. A pt with HTN comes in and insists that one of his new meds is causing him to cough. When looking at
his list of meds, you think the cough must be from:
Captopril
5. African American pt's seems to have a negative reaction to which of the following asthma
meds? Long-term beta-agonist bronchodilators
6. Sam, age 78, presents to the clinic w/respiratory symptoms. His PFTs are as follows: normal total
lung capacity, decreased PaO2, increased PaCO2. On assessment, you auscultate course crackles and
forced expiratory wheezes. What is your dx?
Chronic Bronchitis
7. You are using the CURB-65 clinical prediction tool to decide whether Mabel, whom you have diagnosed
with community-acquired pneumonia (CAP), should be hospitalized or treated at home. Her score is 3.
What should you do?
Hospitalize and consider admitting her to ICU
8. Why do you suspect that your pt may have a decreased response to the TB
test? She has been on long-term corticosteroid therapy
9. Marci has been started on a TB regimen. Because isoniazid (INH) may cause peripheral neuropathy,
you consider ordering which of the following drugs prophylactically?
Pyroxidine
10. Jolene has breast cancer that has been staged as T1, N0, M0. What might this mean?
The cancer is less than 2cm in size and has not spread to the lymph nodes or other parts of the body
11. Nathan, a 32yo policeman, has a 15-pack-year history of smoking and continues to smoke
heavily. During every visit, he gets irate when you try to talk to him about quitting. What should you
do? Continue to ask him at every visit if he is ready to quit
12. Your pt has decided to try to quit smoking with Chantix. You are discussing his quit date and he
will begin taking the med tomorrow. When should he plan to quit smoking?
His quit date should be in 1 week
13. Which info should be included when you are teaching your pt about the use of nicotine gum?
The gum must be correctly chewed to a softened state and then placed in the buccal mucosa or “parked”

1

,14. Your pt states he has a strep throat infection. Which of the following symptoms makes you consider
a viral etiology instead?
Rhinorrhea
15. What is the first-line recommended treatment against Group A beta-hemolytic streptococci
(GABHS), the most common cause of bacterial pharyngitis?
PCN
16. Cydney presents with a h/o asthma. She has not been treated for a while. She c/o daily but not
continual symptoms, greater than 1 week and at nighttime. She has been using her rescue inhaler. Her
FEV1 is 60-80% predicted. How would you classify her asthma severity?
Moderate Persistent
17. Joyce is taking a long-acting beta agonist for her asthma. What additional med should she be
taking? Inhaled corticosteroid
18. Your pt is on Therabid (theophylline) for his asthma. You want to maintain his serum levels
between: 5-15mcg/mL
19. George has COPD and an 80% forced expiratory volume in 1 second. How would you classify the
severity of his COPD?
Stage 1-Mild COPD
20. Most nosocomial pneumonias are caused by:
Gram-negative bacteria
21. Which of the following statements regarding TST is true?
The size of the TST reaction has nothing to do with erythema but is based solely on induration
22. Which obstructive lung dz is classified as
reversible? Asthma
23. You have taught Jennifer, age 15, about using a flow meter to assess how to manage her asthma
exacerbations. She calls you today because her peak expiratory flow rate is 65%. What would you tell
her? "Use your rescue inhaler, begin the Rx of PO glucocorticoids you have, and call back tomorrow."
24. Which statement about adenocarcinoma of the lung is accurate?
It is the most prevalent carcinoma of the lungs in both sexes and in nonsmokers, representing 35-40% of all
tumors
25. Jason, age 62, has obstructive sleep apnea. What do you think is one of his contributing
factors? His collar size is 17 inches
26. The forced vital capacity is decreased
in: Restrictive Disease
27. The most common cause of CAP
is: Streptococcus pneumoniae


2

,28. Which of the following pt's would you expect to have a decreased response to TST?
Sandy, a 40yo pt who recently survived a fire that left 40% of her total body surface covered in burns
29. Which of the following is a possible consequence of sleep
apnea? Insulin Resistance
30. Which of the following conditions is associated with cigarette
smoking? Bladder cancer
31. Marta is taking TB drugs prophylactically. How do you instruct her to take
them? Take them on an empty stomach to facilitate absorption
32. Which of the following statements regarding pulmonary function is
true? There is a normal age-related decline in pulmonary function
33. The barrel chest characteristic of emphysema is a result
of: Hyperinflation
34. Supplemental oxygen for how many hours per day has been shown to improve the mortality
associated with COPD?
15-18 Hours
36. Gabby, aged 22, has Bell’s palsy on the right side of her face. Her mouth is distorted, and she is
concerned about permanent paralysis and pain. What do you tell her?
Most patients have complete recovery in 3 to 6 months.

37. Sondra’s peripheral vestibular disease causes dizziness and vertigo. Which of the following
medications will help to decrease edema in the labyrinth of the ear?
Diamox

38. Which of the following should be started promptly if viral encephalitis is suspected?
IV acyclovir

39. When a patient has a carotid bruit, which of the following should the PCP gather from the patient
history?
History of peripheral vascular occlusive disease

40. Which patient is most likely to have myasthenia gravis (MG)?
A 31-year-old Hispanic woman

41. Which patient is most likely to be diagnosed with Guillain-Barré syndrome?
A 72-year-old woman

42. Julie has relapsing-remitting muscular sclerosis. She has not had a good response to interferon.
Which medication might help given IV once a month?
Natalizumab

43. IV thrombolytic therapy following an ischemic CVA should be given within how many hours of
symptom onset?
3

, 3 hours


44. The hallmark of an absence seizure is:
A blank stare

45. Jolene has breast cancer that has been staged as T1, N0, M0. What might this mean?
The cancer is less than 3 cm in size and has not spread to the lymph nodes or other parts of the body.

46. Which of the following conditions is associated with cigarette smoking?
Bladder cancer

47. The barrel-chest characteristic of emphysema is a result of:
Hyperinflation

48. Your patient is on theophylline for his asthma. You want to maintain his serum levels between:
5 to 15 mcg/mL

49. Which ethnic group has the highest lung-cancer incidence and mortality rates?
African American men


50. Marta is taking TB drugs prophylactically. How do you instruct her to take them?
Take them on an empty stomach to facilitate absorption.

51. What is the most common cause of CAP?
Streptococcus pneumoniae

52. Joyce is taking a long-acting beta agonist for her asthma. What additional medication should she be
taking?
Inhaled corticosteroid

53. Madeline is a smoker in a primary-care visit with her provider. After her provider asks if she is willing
to quit, she says she has decided to quit, has bought nicotine gum, and is interested in hearing about
Chantix. Which of the following steps is Madeline in regarding behavioral changes and her attempts
at cessation?
Preparation

54. Amy has a history of lung cancer and is experiencing new-onset right side ptosis and miosis and says,
“I’m so hot, but I’m not sweating.” Which of the following conditions can be attributed to her new-
onset symptoms?
Horner’s syndrome

55. Supplemental oxygen for how many hours per day has been shown to improve the mortality
associated with COPD?
15 hours

4

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