NURS 552-1 PRIMARY HEALTH CARE
NURSING ADULT MIDTERM EXAM
COMPLETE GUIDE: QUESTIONS AND
ANSWERS WITH DETAILED SOLUTIONS
NEWLY UPDATED 2026
Question: Which statement most accurately defines the underlying pathology of
asthma? ✔ ✔ Answer: C. Chronic airway inflammation with superimposed
bronchospasm. Asthma is fundamentally an inflammatory disease of the airways
that persists over time. Bronchospasms (the sudden tightening of the muscles
around the airways) occur on top of this existing inflammation, leading to acute
symptoms.
Question: During a physical examination of a patient experiencing an asthma
exacerbation that is stable enough for outpatient care, which finding is most likely?
✔ ✔ Answer: D. Hyperresonance on thoracic percussion. Because an asthma
flare causes air to become trapped in the lungs (air trapping), the chest becomes
over-inflated. When tapping on the chest (percussion), this excess air produces a
lower-pitched, "hollow" sound known as hyperresonance.
Question: A 44-year-old male with well-managed moderate persistent asthma (on
Advair and PRN Albuterol) presents with viral symptoms and increased wheezing.
He has needed Albuterol every 3 hours for the last day with only partial
improvement. What is the most appropriate diagnostic step? ✔ ✔ Answer: C.
Spirometry measurement. In the event of a flare-up, it is essential to objectively
assess the patient's current lung function. Spirometry (specifically measuring
FEV1) provides the necessary data to determine the severity of the obstruction and
guide adjustments to his treatment plan.
,You examine Jane, a 24-year-old woman who has an acute asthma flare following
a 3-day history of upper respiratory tract symptoms (clear nasal drainage, dry
cough, no fever). She has a history of moderate persistent asthma that is in good
control and an acceptable peak expiratory flow (PED). She is using budesonide
(Pulmicort) and albuterol as directed and continues to have difficulty with
coughing and wheezing. At home, her PEF is 55% of personal best. In the office,
her forced expiratory volume at 1 second (FEV1) is 65% of predicted. Her
medication regimen should be adjusted to include:
A. Oral theophylline
B. Inhale salmeterol (Serevent) via MDI
C. Oral prednisone
D. Oral montelukast (Singulair)
For Jane in the previous question, the NP also considers prescribing:
A. A 10-day course of oral amoxicillin
B. A 5-day course of oral azithromycin
C. A 14-day course of levofloxacin
D. No antimicrobial therapy -ANSWER✔✔C. Oral prednisone
D. No antimicrobial therapy
Which of the following describes a PEF meter?
A. Should only be used in the presence of a medical professional
,B. Provides convenient method to check expiratory air flow at home
C. Is as accurate as spirometry
D. Should not be used more than once daily -ANSWER✔✔B. Provides convenient
method to check expiratory air flow at home
Which of the following is most accurate regarding the use of a chest x-ray during
an acute asthma flare?
A. Chest radiograph should be performed with each asthma flare
B. Chest radiograph should be performed during and following resolution of the
flare
C. Chest radiograph should be avoided as it can further exacerbate a flare
D. Chest radiograph should be limited to those with signs of respiratory tract
infection (i.e., fever, congested cough) -ANSWER✔✔D. Chest radiograph should
be limited to those with signs of respiratory tract infection (i.e., fever, congested
cough)
A 36-year-old man with asthma also needs antihypertensive therapy. Which of the
following products should you avoid prescribing?
A. Hydrochlorothiazide
B. Propranolol
C. Amlodipine
D. Enalapril -ANSWER✔✔B. Propranolol
For the next 4 questions, which of the following is consistent with presentation of
asthma that is not well controlled (Yes or No):
, 1. Troublesome nocturnal cough more than two nights per week
2. Need for albuterol to relieve SOB more than twice a week
3. Evidence of consolidation on chest x-ray
4. Two or more exacerbations/year requiring OCSs -ANSWER✔✔1. Yes
2. Yes
3. No
4. Yes
The cornerstone of moderate persistent asthma controller drug therapy is the use
of:
A. Oral theophylline
B. Inhaled mast cell stabilizers
C. Inhaled SABAs
D. ICSs -ANSWER✔✔D. ICSs
Sharon is a 29-year-old woman with moderate persistent asthma. She has a
prescription for an ICS that she does not use, stating, "I'm finding that the albuterol
works better." Currently she uses about two albuterol metered-dose inhalers per
month, "that keeps my cough and wheeze under control." She is requesting a
prescription refill. You consider that:
A. Her asthma is well controlled, and albuterol use can continue
B. Excessive albuterol use is a risk factor for asthma death
C. Her asthma is not well controlled, and salmeterol (Serevent) should be added to
relieve bronchospasm and reduce her albuterol use
NURSING ADULT MIDTERM EXAM
COMPLETE GUIDE: QUESTIONS AND
ANSWERS WITH DETAILED SOLUTIONS
NEWLY UPDATED 2026
Question: Which statement most accurately defines the underlying pathology of
asthma? ✔ ✔ Answer: C. Chronic airway inflammation with superimposed
bronchospasm. Asthma is fundamentally an inflammatory disease of the airways
that persists over time. Bronchospasms (the sudden tightening of the muscles
around the airways) occur on top of this existing inflammation, leading to acute
symptoms.
Question: During a physical examination of a patient experiencing an asthma
exacerbation that is stable enough for outpatient care, which finding is most likely?
✔ ✔ Answer: D. Hyperresonance on thoracic percussion. Because an asthma
flare causes air to become trapped in the lungs (air trapping), the chest becomes
over-inflated. When tapping on the chest (percussion), this excess air produces a
lower-pitched, "hollow" sound known as hyperresonance.
Question: A 44-year-old male with well-managed moderate persistent asthma (on
Advair and PRN Albuterol) presents with viral symptoms and increased wheezing.
He has needed Albuterol every 3 hours for the last day with only partial
improvement. What is the most appropriate diagnostic step? ✔ ✔ Answer: C.
Spirometry measurement. In the event of a flare-up, it is essential to objectively
assess the patient's current lung function. Spirometry (specifically measuring
FEV1) provides the necessary data to determine the severity of the obstruction and
guide adjustments to his treatment plan.
,You examine Jane, a 24-year-old woman who has an acute asthma flare following
a 3-day history of upper respiratory tract symptoms (clear nasal drainage, dry
cough, no fever). She has a history of moderate persistent asthma that is in good
control and an acceptable peak expiratory flow (PED). She is using budesonide
(Pulmicort) and albuterol as directed and continues to have difficulty with
coughing and wheezing. At home, her PEF is 55% of personal best. In the office,
her forced expiratory volume at 1 second (FEV1) is 65% of predicted. Her
medication regimen should be adjusted to include:
A. Oral theophylline
B. Inhale salmeterol (Serevent) via MDI
C. Oral prednisone
D. Oral montelukast (Singulair)
For Jane in the previous question, the NP also considers prescribing:
A. A 10-day course of oral amoxicillin
B. A 5-day course of oral azithromycin
C. A 14-day course of levofloxacin
D. No antimicrobial therapy -ANSWER✔✔C. Oral prednisone
D. No antimicrobial therapy
Which of the following describes a PEF meter?
A. Should only be used in the presence of a medical professional
,B. Provides convenient method to check expiratory air flow at home
C. Is as accurate as spirometry
D. Should not be used more than once daily -ANSWER✔✔B. Provides convenient
method to check expiratory air flow at home
Which of the following is most accurate regarding the use of a chest x-ray during
an acute asthma flare?
A. Chest radiograph should be performed with each asthma flare
B. Chest radiograph should be performed during and following resolution of the
flare
C. Chest radiograph should be avoided as it can further exacerbate a flare
D. Chest radiograph should be limited to those with signs of respiratory tract
infection (i.e., fever, congested cough) -ANSWER✔✔D. Chest radiograph should
be limited to those with signs of respiratory tract infection (i.e., fever, congested
cough)
A 36-year-old man with asthma also needs antihypertensive therapy. Which of the
following products should you avoid prescribing?
A. Hydrochlorothiazide
B. Propranolol
C. Amlodipine
D. Enalapril -ANSWER✔✔B. Propranolol
For the next 4 questions, which of the following is consistent with presentation of
asthma that is not well controlled (Yes or No):
, 1. Troublesome nocturnal cough more than two nights per week
2. Need for albuterol to relieve SOB more than twice a week
3. Evidence of consolidation on chest x-ray
4. Two or more exacerbations/year requiring OCSs -ANSWER✔✔1. Yes
2. Yes
3. No
4. Yes
The cornerstone of moderate persistent asthma controller drug therapy is the use
of:
A. Oral theophylline
B. Inhaled mast cell stabilizers
C. Inhaled SABAs
D. ICSs -ANSWER✔✔D. ICSs
Sharon is a 29-year-old woman with moderate persistent asthma. She has a
prescription for an ICS that she does not use, stating, "I'm finding that the albuterol
works better." Currently she uses about two albuterol metered-dose inhalers per
month, "that keeps my cough and wheeze under control." She is requesting a
prescription refill. You consider that:
A. Her asthma is well controlled, and albuterol use can continue
B. Excessive albuterol use is a risk factor for asthma death
C. Her asthma is not well controlled, and salmeterol (Serevent) should be added to
relieve bronchospasm and reduce her albuterol use
