QUESTIONS AND CORRECT ANSWERS.
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? - ANS Arnold Reflex
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? - ANS Chronic Bronchitis
George has COPD and an 80% forced expiratory volume in 1 second. How would you classify the
severity of his COPD? - ANS Stage 1 mild COPD
African American pt's seems to have a negative reaction to which of the following asthma
meds? - ANS Long-term beta-agonist bronchodilators
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? - ANS Hospitalize and consider admitting her to
the ICU
Why do you suspect that your pt may have a decreased response to the TB test? - ANS She
has been on long-term corticosteroid therapy
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,Marci has been started on a TB regimen. Because isoniazid (INH) may cause peripheral
neuropathy, you consider ordering which of the following drugs prophilactically? -
ANS Pyroxidine
Jolene has breast cancer that has been staged as T1, N0, M0. What might this mean?
A. The tumor size cannot be evaluated; the cancer has not spread to the lymph nodes; and the
distant spread cannot be evaluated.
B. The cancer is in situ; it is spreading into the lymph nodes but the spread cannot be evaluated
otherwise.
C. The cancer is less than 3 cm in size and has not spread to the lymph nodes or other parts of
the body.
D. The cancer is about 5 cm in size; nearby lymph nodes cannot be evaluated; and there is no
evidence of distant spreading. - ANS The cancer is less than 3cm in size and has not spread to
the lymph nodes or other parts of the body
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? - ANS Continue to ask him at every visit if he is ready to quit
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? - ANS His quit
date should be in 1 week
Which info should be included when you are teaching your pt about the use of nicotine gum? -
ANS The gum must be correctly chewed to a softened state and then placed in the buccal
mucosa
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,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? -
ANS Moderate persistent
Joyce is taking a long-acting beta agonist for her asthma. What additional med should she be
taking? - ANS Inhaled corticosteroid
Your pt is on theophylline (Therabid) for his asthma. You want to maintain his serum levels
between: - ANS 5-15mcg/mL
Which of the following statements regarding TST is true? - ANS The size of the TST reaction
has nothing to do with erythema but is based solely on induration
Which obstructive lung disease is classified as reversible? - ANS asthma
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? - ANS Use your rescue inhaler, begin the Rx of PO glucocorticoids you have, and
call back tomorrow."
Which statement about adenocarcinoma of the lung is accurate? - ANS It is the most
prevalent carcinoma of the lungs in both sexes and in nonsmokers, representing 35-40% of all
tumors
Jason, age 62, has obstructive sleep apnea. What do you think is one of his contributing factors?
- ANS His collar size is 17in
The forced vital capacity is decreased in:
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, a. Asthma
b. Chronic bronchitis
c. Emphysema
d. Restrictive disease - ANS restrictive disease
The most common cause of CAP is: - ANS Streptococcus pneumoniae
Which of the following pt's would you expect to have a decreased response to TST? -
ANS Sandy, a 40yo pt who recently survived a fire that left 40% of her total body surface
covered in burns
Which of the following is a possible consequence of sleep apnea?
a. Asthma
b. Increased WBC
c. Insulin resistance
d. Hyperactivity - ANS insulin resistance
Which of the following conditions is associated with cigarette smoking?
a. Glaucoma
b. Increased sperm quality
c. Bladder cancer
d. Eczema - ANS Bladder cancer
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