NURS 552-1 PRIMARY HEALTH CARE
NURSING ADULT MIDTERM EXAM
QUESTIONS & ACCURATE PASSED
ANSWERS 100%
Which of the following best describes asthma?
A. Intermittent airway inflammation with occasional bronchospasm
B. A disease of bronchospasm that leads to airway inflammation
C. Chronic airway inflammation with superimposed bronchospasm
D. Relatively fixed airway constriction - Correct Answer ✔✔ C. Chronic airway
inflammation with superimposed bronchospasm
The patient you are evaluating is having an asthma flare. You have assessed that his
condition is appropriate for office treatment. You expect to find the following on physical
exam:
A. Tripod posture
B. Inspiratory crackles
C. Increased vocal fremitus
D. Hyperresonance on thoracic percussion - Correct Answer ✔✔ D. Hyperresonance on
thoracic percussion
A 44-year-old man has a long-standing history of moderate persistent asthma that is
normally well controlled by fluticasone with salmeterol (Advair) via metered-dose
inhaler, one puff twice a day, and the use of albuterol one to two times a week as
needed for wheezing. Three days ago, he developed a sore throat, clear nasal
discharge, body aches, and a cough with a small amount of white sputum production. In
the past 24 hours, he has had intermittent wheezing that necessitated the use of
albuterol, two puffs, every 3 hours, which produced partial relief. Your next most
appropriate action is to obtain a:
A. Chest radiograph
B. Measurement of oxygen saturation (SaO2)
C. Spirometry measurement
D. Sputum smear for WBCs - Correct Answer ✔✔ C. Spirometry measurement
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 - Correct 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 - Correct 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) - Correct 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 - Correct 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 - Correct 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 - Correct 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
D. Her asthma has better control with albuterol than ICSs - Correct Answer ✔✔ B.
Excessive albuterol use is a risk factor for asthma death
In the treatment of asthma, an LTM should be used as a:
A. Controller to prevent bronchospasm
B. Controller to inhibit inflammatory responses
C. Reliever to treat acute bronchospasm
D. Reliever to treat inflammation - Correct Answer ✔✔ B. Controller to inhibit
inflammatory responses
Which of the following is not a risk for asthma death?
A. Hospitalization or an emergency department visit for asthma in the past month
B. Current use of systemic corticosteroids or recent withdrawal from systemic
corticosteroids
C. Difficulty perceiving airflow obstruction or its severity
NURSING ADULT MIDTERM EXAM
QUESTIONS & ACCURATE PASSED
ANSWERS 100%
Which of the following best describes asthma?
A. Intermittent airway inflammation with occasional bronchospasm
B. A disease of bronchospasm that leads to airway inflammation
C. Chronic airway inflammation with superimposed bronchospasm
D. Relatively fixed airway constriction - Correct Answer ✔✔ C. Chronic airway
inflammation with superimposed bronchospasm
The patient you are evaluating is having an asthma flare. You have assessed that his
condition is appropriate for office treatment. You expect to find the following on physical
exam:
A. Tripod posture
B. Inspiratory crackles
C. Increased vocal fremitus
D. Hyperresonance on thoracic percussion - Correct Answer ✔✔ D. Hyperresonance on
thoracic percussion
A 44-year-old man has a long-standing history of moderate persistent asthma that is
normally well controlled by fluticasone with salmeterol (Advair) via metered-dose
inhaler, one puff twice a day, and the use of albuterol one to two times a week as
needed for wheezing. Three days ago, he developed a sore throat, clear nasal
discharge, body aches, and a cough with a small amount of white sputum production. In
the past 24 hours, he has had intermittent wheezing that necessitated the use of
albuterol, two puffs, every 3 hours, which produced partial relief. Your next most
appropriate action is to obtain a:
A. Chest radiograph
B. Measurement of oxygen saturation (SaO2)
C. Spirometry measurement
D. Sputum smear for WBCs - Correct Answer ✔✔ C. Spirometry measurement
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 - Correct 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 - Correct 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) - Correct 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 - Correct 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 - Correct 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 - Correct 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
D. Her asthma has better control with albuterol than ICSs - Correct Answer ✔✔ B.
Excessive albuterol use is a risk factor for asthma death
In the treatment of asthma, an LTM should be used as a:
A. Controller to prevent bronchospasm
B. Controller to inhibit inflammatory responses
C. Reliever to treat acute bronchospasm
D. Reliever to treat inflammation - Correct Answer ✔✔ B. Controller to inhibit
inflammatory responses
Which of the following is not a risk for asthma death?
A. Hospitalization or an emergency department visit for asthma in the past month
B. Current use of systemic corticosteroids or recent withdrawal from systemic
corticosteroids
C. Difficulty perceiving airflow obstruction or its severity
