ne
sh
NSG6420 QUIZ 3
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1 Question :
la Susan P., a 60-year-old woman with a 30 pack year history, presents to
tz
. your primary care practice for evaluation of a persistent, daily cough
sh
Sp
with increased sputum production, worse in the morning, occurring over
the past three months. She tells you, “I have the same thing, year after
ne year.” Which of the following choices would you consider strongly in
la
your critical thinking process?
sh
Student
Sp
Answer: Seasonal allergies
ne
Acute bronchitis
la
tz
Bronchial asthma
sh
Sp
Chronic bronchitis
ne
Instructor The pulmonary component includes an abnormal inflammatory response to noxious
Explanation: stimuli, principally tobacco, but also occupational and environmental pollutants. The
la
hallmark of chronic bronchitis is a daily chronic cough with increased sputum
production lasting for at least 3 consecutive months in at least 2 consecutive years,
sh
usually worse on awakening; this may or may not be
Sp
associated with COPD (GOLD, 2011). Emphysema is characterized by
ne
obstruction to airflow caused by abnormal airspace enlargement distal to terminal
bronchioles.
la
tz
Kennedy-Malone, Laurie, Kathleen Fletcher, Lori Martin-Plank. Advanced Practice
sh
Sp
Nursing in the Care of Older Adults. F.A. Davis Company, 2014-01-14. VitalBook file.
(page 206)
ne
la
&
sh
Goolsby, Mary J., Laurie Grubbs. Advanced Assessment Interpreting Findings and
Sp
Formulating Differential Diagnoses, 3rd Edition. F.A. Davis Company,
ne
11/2014. VitalBook file. (page 213)
la
tz
sh
Sp
Points Received: 2 of 2
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Comments:
la
sh
Question Question :
Sp
A patient presents complaining of a 5 day history of upper respiratory
2.
ne
symptoms including nasal congestion and drainage. On the day the
symptoms began he had a low-grade fever that has now resolved. His
a
nasal congestion persisted and he has had yellow nasal drainage for
tz
three days associated with mild headaches. On exam he is afebrile and
l
sh
in no distress. Examination of his tympanic membranes and throat are
Sp
normal. Examination of his nose is unremarkable although a slight
ne
yellowish-clear drainage is noted. There is tenderness when you lightly
percuss his maxillary sinus. What would your treatment plan for this
la
patient be?
sh
Sp
la
Sp
, ne
sh
ne
Student Answer:
la Observation and reassurance
tz
Treatment with an antibiotic such as amoxicillin
sh
Sp
Treatment with an antibiotic such as a fluoroquinoline or
ne amoxicillin-clavulanate
Combination of a low dose inhaled corticosteroid and a long
la
acting beta2 agonist inhaler.
Instructor MedU Card #4. According to the American Academy of Ortolaryngology—Head
sh
Sp
Explanation: and Neck Surgery Foundation guidelines (2007) on sinusitis, making the
ne
distinction between a lingering viral upper respiratory infection that affects the
nose and sinuses (viral rhinosinusitis) or early acute bacterial sinusitis can be
la
difficult. It is more likely to be a viral rhinosinusitis if the duration of symptoms is
tz
less than ten days and they are not worsening. In this case, you can continue to
sh
observe the patient and reassure him that antibiotics are not necessary at this
Sp
time.
ne
la
Points Received: 2 of 2
sh
Sp
Comments:
ne
la
Question Question :
tz
Emphysematous changes in the lungs produce the following
3.
sh
characteristic in COPD patients?
Sp
ne
Student
Asymmetric chest expansion
la
Answer:
Increased lateral diameter
sh
Sp
Increased anterior-posterior diameter
ne
Pectus excavatum
la
Instructor In COPD, patients commonly develop a barrel-shaped chest due to
tz
Explanation: emphysematous changes in the lungs. A barrel shape is due to an increased
sh
anterior-posterior (AP) diameter. In emphysema, there is a 1:1 ratio of AP to lateral
Sp
diameter; AP diameter equals the lateral diameter. Normally the AP diameter is
ne
twice the lateral diameter.
la
Goolsby, Mary J., Laurie Grubbs. Advanced Assessment Interpreting Findings and
Formulating Differential Diagnoses, 3rd Edition. F.A. Davis Company, 11/2014.
sh
Sp
VitalBook file( page 213-214)
ne
&
a
tz
Kennedy-Malone, Laurie, Kathleen Fletcher, Lori Martin-Plank. Advanced Practice
l
sh
Nursing in the Care of Older Adults. F.A. Davis Company, 2014-01-14. VitalBook
Sp
file. (page 206)
ne
la
sh
Sp
la
Sp
sh
NSG6420 QUIZ 3
ne
1 Question :
la Susan P., a 60-year-old woman with a 30 pack year history, presents to
tz
. your primary care practice for evaluation of a persistent, daily cough
sh
Sp
with increased sputum production, worse in the morning, occurring over
the past three months. She tells you, “I have the same thing, year after
ne year.” Which of the following choices would you consider strongly in
la
your critical thinking process?
sh
Student
Sp
Answer: Seasonal allergies
ne
Acute bronchitis
la
tz
Bronchial asthma
sh
Sp
Chronic bronchitis
ne
Instructor The pulmonary component includes an abnormal inflammatory response to noxious
Explanation: stimuli, principally tobacco, but also occupational and environmental pollutants. The
la
hallmark of chronic bronchitis is a daily chronic cough with increased sputum
production lasting for at least 3 consecutive months in at least 2 consecutive years,
sh
usually worse on awakening; this may or may not be
Sp
associated with COPD (GOLD, 2011). Emphysema is characterized by
ne
obstruction to airflow caused by abnormal airspace enlargement distal to terminal
bronchioles.
la
tz
Kennedy-Malone, Laurie, Kathleen Fletcher, Lori Martin-Plank. Advanced Practice
sh
Sp
Nursing in the Care of Older Adults. F.A. Davis Company, 2014-01-14. VitalBook file.
(page 206)
ne
la
&
sh
Goolsby, Mary J., Laurie Grubbs. Advanced Assessment Interpreting Findings and
Sp
Formulating Differential Diagnoses, 3rd Edition. F.A. Davis Company,
ne
11/2014. VitalBook file. (page 213)
la
tz
sh
Sp
Points Received: 2 of 2
ne
Comments:
la
sh
Question Question :
Sp
A patient presents complaining of a 5 day history of upper respiratory
2.
ne
symptoms including nasal congestion and drainage. On the day the
symptoms began he had a low-grade fever that has now resolved. His
a
nasal congestion persisted and he has had yellow nasal drainage for
tz
three days associated with mild headaches. On exam he is afebrile and
l
sh
in no distress. Examination of his tympanic membranes and throat are
Sp
normal. Examination of his nose is unremarkable although a slight
ne
yellowish-clear drainage is noted. There is tenderness when you lightly
percuss his maxillary sinus. What would your treatment plan for this
la
patient be?
sh
Sp
la
Sp
, ne
sh
ne
Student Answer:
la Observation and reassurance
tz
Treatment with an antibiotic such as amoxicillin
sh
Sp
Treatment with an antibiotic such as a fluoroquinoline or
ne amoxicillin-clavulanate
Combination of a low dose inhaled corticosteroid and a long
la
acting beta2 agonist inhaler.
Instructor MedU Card #4. According to the American Academy of Ortolaryngology—Head
sh
Sp
Explanation: and Neck Surgery Foundation guidelines (2007) on sinusitis, making the
ne
distinction between a lingering viral upper respiratory infection that affects the
nose and sinuses (viral rhinosinusitis) or early acute bacterial sinusitis can be
la
difficult. It is more likely to be a viral rhinosinusitis if the duration of symptoms is
tz
less than ten days and they are not worsening. In this case, you can continue to
sh
observe the patient and reassure him that antibiotics are not necessary at this
Sp
time.
ne
la
Points Received: 2 of 2
sh
Sp
Comments:
ne
la
Question Question :
tz
Emphysematous changes in the lungs produce the following
3.
sh
characteristic in COPD patients?
Sp
ne
Student
Asymmetric chest expansion
la
Answer:
Increased lateral diameter
sh
Sp
Increased anterior-posterior diameter
ne
Pectus excavatum
la
Instructor In COPD, patients commonly develop a barrel-shaped chest due to
tz
Explanation: emphysematous changes in the lungs. A barrel shape is due to an increased
sh
anterior-posterior (AP) diameter. In emphysema, there is a 1:1 ratio of AP to lateral
Sp
diameter; AP diameter equals the lateral diameter. Normally the AP diameter is
ne
twice the lateral diameter.
la
Goolsby, Mary J., Laurie Grubbs. Advanced Assessment Interpreting Findings and
Formulating Differential Diagnoses, 3rd Edition. F.A. Davis Company, 11/2014.
sh
Sp
VitalBook file( page 213-214)
ne
&
a
tz
Kennedy-Malone, Laurie, Kathleen Fletcher, Lori Martin-Plank. Advanced Practice
l
sh
Nursing in the Care of Older Adults. F.A. Davis Company, 2014-01-14. VitalBook
Sp
file. (page 206)
ne
la
sh
Sp
la
Sp
