PULM Exam Questions with Correct Answers Latest Version 2025 Graded A+
A 45 year-old male presents with sudden onset of pleuritic chest pain, productive cough and fever for 1
day. He relates having symptoms of a "cold" for the past week that suddenly became worse yesterday.
Which of the following findings will most likely be seen on physical examination of this patient? -
Answers spoken "ee" heard as "ay" (bacterial pneumonia with consolidation)
Which of the following is a common symptom associated with laryngotracheobronchitis (viral croup)? -
Answers barking cough
A foreign body lodged in the trachea that is causing partial obstruction will most likely produce what
physical examination finding? - Answers stridor
On physical examination you note diminished breath sounds over the right lower lobe with decreased
tactile fremitus and dullness to percussion. Which of the following is the most likely cause? - Answers
pleural effusion
Which of the following is essential to make a diagnosis of cystic fibrosis? - Answers Elevated sweat
chloride
An adult patient who is HIV positive receives a PPD. He develops an area of induration that measures 8
mm after 48 hours. Which of the following is the most appropriate interpretation of this test result? -
Answers positive
A 23 year-old female with history of asthma for the past 5 years presents with complaints of increasing
shortness of breath for 2 days. Her asthma has been well controlled until 2 days ago and since yesterday
she has been using her albuterol inhaler every 4-6 hours. She is normally very active, however yesterday
she did not complete her 30 minutes exercise routine due to increasing dyspnea. She denies any cough,
fever, recent surgeries or use of oral contraceptives. On examination, you note the presence of
prolonged expiration and diffuse wheezing. The remainder of the exam is unremarkable. Which of the
following is the most appropriate initial diagnostic evaluation prior to initiation of treatment? - Answers
peak flow
A patient presents with a history of progressive worsening of dyspnea over the past several years. He
gives a history of having worked as a ship builder for over 50 years. He denies any alcohol or tobacco
use. On examination you note clubbing and inspiratory crackles. Which of the following chest x-ray
findings support your suspected diagnosis? - Answers interstitial fibrosis and pleural thickening
(abestosis)
You are called to the nursery to see a male infant, born by uncomplicated vaginal delivery. He weighs
2,600 grams and has one deep crease on the anterior third of each foot. Respirations are 88
breaths/minute with expiratory grunting and intercostals retractions. He is cyanotic on room air and
becomes pink when placed in 60% oxygen. Chest x-ray shows atelectasis with air bronchograms. Which
of the following is the most likely diagnosis? - Answers hyaline membrane disease
,A 15 year-old male presents with a 1 week history of hacking non-productive cough, low grade fever,
malaise and myalgias. Examination is unremarkable except for a few scattered rhonchi and rales upon
auscultation of the chest. The chest x-ray reveals interstitial infiltrates and a cold agglutinin titer was
negative. Which of the following is the most likely diagnosis? - Answers viral pneumonia
A 32 year-old African American female presents with complaints of a gradual worsening of exertional
dyspnea associated with a mild dry cough. She has tried various cough preparations on her own without
any significant relief. Her examination is essentially unremarkable. A chest x-ray reveals the presence of
bilateral hilar adenopathy. Which of the following is the most likely diagnosis? - Answers sarcoidosis
A 53 year-old female status post abdominal hysterectomy 3 days ago suddenly develops pleuritic chest
pain and dyspnea. On exam she is tachycardic and tachypneic with rales in the left lower lobe. A chest x-
ray is unremarkable and an EKG reveals tachycardia. Which of the following is the most likely diagnosis?
- Answers pulmonary embolism
A 17 year-old male who is trying out for the track team notes excessive coughing with chest tightness
when running. Which of the following is the most appropriate preventive agent for this patient? -
Answers Albuterol inhaler (Proventil)
A 62 year-old female is admitted to a nursing home during an outbreak of influenza. In review of her
records, you note that she did not receive the flu vaccine this year. Which of the following is the most
appropriate drug of choice for influenza prophylaxis in this patient? - Answers Zanamivir (Relenza)
Which of the following is an independent risk factor for development of a mesothelioma? - Answers
Asbestos exposure
A 3 month-old male presents with a hoarse cough and thick purulent rhinorrhea for the past 2 days. The
mother noted that yesterday he appeared to get worse and seemed to have increasing problems
breathing and trouble feeding. Examination reveals a temperature of 100.2 degrees F and respiratory
rate of 80/minute with nasal flaring and retractions. Lung examination reveals a prolonged expiratory
phase with inspiratory rales. He is tachycardic. Pulse oximetry reveals oxygen saturation of 89%. Chest x-
ray reveals hyperinflation with diffuse interstitial infiltrates. Which of the following is the most
appropriate intervention? - Answers hospitalization (bronchiolitis)
A 62 year-old male presents with a history of dyspnea on exertion and chronic cough worse with arising
in the mornings. He has a 40-year-pack history of cigarette use. On examination there is increased AP
diameter and decreased breath sounds with a prolonged expiratory phase. Pulse oximetry reveals an
oxygen saturation of 93% on room air. In addition to smoking cessation, which of the following is an
appropriate intervention at this time? - Answers Recommend influenza and pneumococcal vaccines
A 21 year-old male presents to the ED with increasing dyspnea and pleuritic chest pain of sudden onset
after getting hit in the left side of the chest during a bar fight. Examination reveals moderate respiratory
distress with absence of breath sounds and hyperresonance to percussion on the left, with tracheal
, deviation to the right. Which of the following is the most appropriate next step? - Answers insert large
bore needle into left 2nd ICS stat (tension pneumothorax)
Which of the following is a major contraindication to curative surgical resection of a lung tumor? -
Answers Liver metastases
A 36 year-old male developed a sore throat and was treated with IM penicillin. Within 20 minutes, he
felt faint, became dyspneic, and had diarrhea. Upon entry to the emergency department, he was pale
and apprehensive. He had a thready pulse, and systolic blood pressure was 40 mmHg. Which of the
following is the most appropriate initial agent to use? - Answers Epinephrine
A 22 year-old female with a history of asthma presents with complaints of increasing "asthma" attacks.
The patient states she has been well controlled on albuterol inhaler until one month ago. Since that time
she notices that she has had to use her inhaler 3-4 times a week and also has had increasing nighttime
use averaging about three episodes in the past month. Spirometry reveals > 85% predicted value. Which
of the following is the most appropriate intervention at this time? - Answers Beclomethasone inhaler
A 42 year-old male with unremarkable past medical history is admitted to the general medical ward with
community-acquired pneumonia. He has a 20 pack-year history of cigarette smoking. He is empirically
started on ceftriaxone (Rocephin). Which of the following antibiotics would be most appropriate to add
to his empiric treatment regimen? - Answers Azithromycin
A 40 year-old alcoholic male presents with sudden onset of severe chills, fever, dyspnea and cough
productive of red mucoid sticky sputum. He appears ill looking with cyanosis. Examination reveals vital
signs: Temp - 102 degrees F; Pulse - 120 /minute and regular; 89 RR - 28/min; BP 90/62 mm Hg. Lungs
reveal minimal rales and dullness in the right upper lobe with decreased breath sounds. Chest x-ray
reveals right upper lobe consolidation with a bulging fissure. Gram stain reveals many white blood cells
and many gram- negative rods. Which of the following is the most appropriate drug of choice? - Answers
Cefotaxime (pneumonia caused by klebsiella)
Which of the following is the greatest risk factor for the development of drug resistance in the
treatment of tuberculosis? - Answers Non-adherence to prescribed drug regimen
Which of the following has been found to be an important reservoir in the transmission of pertussis? -
Answers Adult humans
Which of the following best describes the pathophysiology of emphysema? - Answers Alveoli
enlargement and loss of septa
Which of the following mechanisms leads to a primary pneumothorax? - Answers Rupture of subpleural
apical blebs due to high negative intrapleural pressures
A 3 year-old girl is diagnosed with atopic dermatitis. Which of the following disorders is this child at risk
for in the future? - Answers Asthma
A 45 year-old male presents with sudden onset of pleuritic chest pain, productive cough and fever for 1
day. He relates having symptoms of a "cold" for the past week that suddenly became worse yesterday.
Which of the following findings will most likely be seen on physical examination of this patient? -
Answers spoken "ee" heard as "ay" (bacterial pneumonia with consolidation)
Which of the following is a common symptom associated with laryngotracheobronchitis (viral croup)? -
Answers barking cough
A foreign body lodged in the trachea that is causing partial obstruction will most likely produce what
physical examination finding? - Answers stridor
On physical examination you note diminished breath sounds over the right lower lobe with decreased
tactile fremitus and dullness to percussion. Which of the following is the most likely cause? - Answers
pleural effusion
Which of the following is essential to make a diagnosis of cystic fibrosis? - Answers Elevated sweat
chloride
An adult patient who is HIV positive receives a PPD. He develops an area of induration that measures 8
mm after 48 hours. Which of the following is the most appropriate interpretation of this test result? -
Answers positive
A 23 year-old female with history of asthma for the past 5 years presents with complaints of increasing
shortness of breath for 2 days. Her asthma has been well controlled until 2 days ago and since yesterday
she has been using her albuterol inhaler every 4-6 hours. She is normally very active, however yesterday
she did not complete her 30 minutes exercise routine due to increasing dyspnea. She denies any cough,
fever, recent surgeries or use of oral contraceptives. On examination, you note the presence of
prolonged expiration and diffuse wheezing. The remainder of the exam is unremarkable. Which of the
following is the most appropriate initial diagnostic evaluation prior to initiation of treatment? - Answers
peak flow
A patient presents with a history of progressive worsening of dyspnea over the past several years. He
gives a history of having worked as a ship builder for over 50 years. He denies any alcohol or tobacco
use. On examination you note clubbing and inspiratory crackles. Which of the following chest x-ray
findings support your suspected diagnosis? - Answers interstitial fibrosis and pleural thickening
(abestosis)
You are called to the nursery to see a male infant, born by uncomplicated vaginal delivery. He weighs
2,600 grams and has one deep crease on the anterior third of each foot. Respirations are 88
breaths/minute with expiratory grunting and intercostals retractions. He is cyanotic on room air and
becomes pink when placed in 60% oxygen. Chest x-ray shows atelectasis with air bronchograms. Which
of the following is the most likely diagnosis? - Answers hyaline membrane disease
,A 15 year-old male presents with a 1 week history of hacking non-productive cough, low grade fever,
malaise and myalgias. Examination is unremarkable except for a few scattered rhonchi and rales upon
auscultation of the chest. The chest x-ray reveals interstitial infiltrates and a cold agglutinin titer was
negative. Which of the following is the most likely diagnosis? - Answers viral pneumonia
A 32 year-old African American female presents with complaints of a gradual worsening of exertional
dyspnea associated with a mild dry cough. She has tried various cough preparations on her own without
any significant relief. Her examination is essentially unremarkable. A chest x-ray reveals the presence of
bilateral hilar adenopathy. Which of the following is the most likely diagnosis? - Answers sarcoidosis
A 53 year-old female status post abdominal hysterectomy 3 days ago suddenly develops pleuritic chest
pain and dyspnea. On exam she is tachycardic and tachypneic with rales in the left lower lobe. A chest x-
ray is unremarkable and an EKG reveals tachycardia. Which of the following is the most likely diagnosis?
- Answers pulmonary embolism
A 17 year-old male who is trying out for the track team notes excessive coughing with chest tightness
when running. Which of the following is the most appropriate preventive agent for this patient? -
Answers Albuterol inhaler (Proventil)
A 62 year-old female is admitted to a nursing home during an outbreak of influenza. In review of her
records, you note that she did not receive the flu vaccine this year. Which of the following is the most
appropriate drug of choice for influenza prophylaxis in this patient? - Answers Zanamivir (Relenza)
Which of the following is an independent risk factor for development of a mesothelioma? - Answers
Asbestos exposure
A 3 month-old male presents with a hoarse cough and thick purulent rhinorrhea for the past 2 days. The
mother noted that yesterday he appeared to get worse and seemed to have increasing problems
breathing and trouble feeding. Examination reveals a temperature of 100.2 degrees F and respiratory
rate of 80/minute with nasal flaring and retractions. Lung examination reveals a prolonged expiratory
phase with inspiratory rales. He is tachycardic. Pulse oximetry reveals oxygen saturation of 89%. Chest x-
ray reveals hyperinflation with diffuse interstitial infiltrates. Which of the following is the most
appropriate intervention? - Answers hospitalization (bronchiolitis)
A 62 year-old male presents with a history of dyspnea on exertion and chronic cough worse with arising
in the mornings. He has a 40-year-pack history of cigarette use. On examination there is increased AP
diameter and decreased breath sounds with a prolonged expiratory phase. Pulse oximetry reveals an
oxygen saturation of 93% on room air. In addition to smoking cessation, which of the following is an
appropriate intervention at this time? - Answers Recommend influenza and pneumococcal vaccines
A 21 year-old male presents to the ED with increasing dyspnea and pleuritic chest pain of sudden onset
after getting hit in the left side of the chest during a bar fight. Examination reveals moderate respiratory
distress with absence of breath sounds and hyperresonance to percussion on the left, with tracheal
, deviation to the right. Which of the following is the most appropriate next step? - Answers insert large
bore needle into left 2nd ICS stat (tension pneumothorax)
Which of the following is a major contraindication to curative surgical resection of a lung tumor? -
Answers Liver metastases
A 36 year-old male developed a sore throat and was treated with IM penicillin. Within 20 minutes, he
felt faint, became dyspneic, and had diarrhea. Upon entry to the emergency department, he was pale
and apprehensive. He had a thready pulse, and systolic blood pressure was 40 mmHg. Which of the
following is the most appropriate initial agent to use? - Answers Epinephrine
A 22 year-old female with a history of asthma presents with complaints of increasing "asthma" attacks.
The patient states she has been well controlled on albuterol inhaler until one month ago. Since that time
she notices that she has had to use her inhaler 3-4 times a week and also has had increasing nighttime
use averaging about three episodes in the past month. Spirometry reveals > 85% predicted value. Which
of the following is the most appropriate intervention at this time? - Answers Beclomethasone inhaler
A 42 year-old male with unremarkable past medical history is admitted to the general medical ward with
community-acquired pneumonia. He has a 20 pack-year history of cigarette smoking. He is empirically
started on ceftriaxone (Rocephin). Which of the following antibiotics would be most appropriate to add
to his empiric treatment regimen? - Answers Azithromycin
A 40 year-old alcoholic male presents with sudden onset of severe chills, fever, dyspnea and cough
productive of red mucoid sticky sputum. He appears ill looking with cyanosis. Examination reveals vital
signs: Temp - 102 degrees F; Pulse - 120 /minute and regular; 89 RR - 28/min; BP 90/62 mm Hg. Lungs
reveal minimal rales and dullness in the right upper lobe with decreased breath sounds. Chest x-ray
reveals right upper lobe consolidation with a bulging fissure. Gram stain reveals many white blood cells
and many gram- negative rods. Which of the following is the most appropriate drug of choice? - Answers
Cefotaxime (pneumonia caused by klebsiella)
Which of the following is the greatest risk factor for the development of drug resistance in the
treatment of tuberculosis? - Answers Non-adherence to prescribed drug regimen
Which of the following has been found to be an important reservoir in the transmission of pertussis? -
Answers Adult humans
Which of the following best describes the pathophysiology of emphysema? - Answers Alveoli
enlargement and loss of septa
Which of the following mechanisms leads to a primary pneumothorax? - Answers Rupture of subpleural
apical blebs due to high negative intrapleural pressures
A 3 year-old girl is diagnosed with atopic dermatitis. Which of the following disorders is this child at risk
for in the future? - Answers Asthma
