MN568 MIDTERM REVIEW EXAM Review
Respiratory QUESTIONS AND ANSWERS
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?
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Respiratory QUESTIONS AND ANSWERS
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?
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