N580 ADVANCED PRACTICE I EXAM QUESTIONS WITH CORRECT ANSWERS LATEST UPDATE 2026

N580 ADVANCED PRACTICE I EXAM QUESTIONS WITH CORRECT ANSWERS LATEST UPDATE 2026 Common Cold Features Onset Fever Body Aches Fatigue - Answers Gradual onset Low/No fever; Mild body aches; Mild fatigue Flu Features Onset Fever Body Aches Fatigue - Answers Sudden onset High fever Severe body aches Severe fatigue Upper Respiratory Infection characteristics - Answers Usually viral - do NOT require antibiotics Transmission: hands - face Post viral cough can last 6-8 weeks Epiglottitis S/S, Tx, & Contraindication - Answers S/S: odynophagia (pain on swallowing), drooling, dyspnea, stridor, tripod position Tx: Secure airway + IV ABX + IV steroids (dexamethasone) CI: DO NOT EXAMINE THROAT; to ER or OR while sitting up to secure airway STAT Name 2 Lower Respiratory Infections - Answers Bronchitis & Bronchiolitis (RSV) Name 2 URIs - Answers Common Cold & Influenza Name an upper respiratory airway emergency? - Answers Epiglottitis often seen in kids Acute bronchitis - Answers Usually viral Cough sputum No antibiotics Supportive care Bronchiolitis - Answers RSV Common in kids Wheezing, retractions Supportive unless severe Typical Pneumonia s/s - Answers High fever Productive cough Lobar consolidation MCC: Streptococcus pneumoniae Atypical Pneumonia s/s - Answers Low fever Dry cough Interstitial pattern Mycoplasma, chlamydia TB s/s - Answers Chronic cough Night sweats Weight loss Hemoptysis TB Tx & SE of Tx - Answers Active TB = RIPE 2 months: Rifampin (red orange urine) Isoniazid (INH) (neuropathy) Pyrazinamide (painful joints) Ethambutol (eye issues) Then 4 months: INH + Rifampin **Hepatotoxic drugs Resistent TB (MDR-TB & XDR-TB) - Answers Based on antimicrobial sensitivity Treatment for 18 months or longer High mortality rate Pregnancy TB Tx - Answers Treat TB (disease worse untreated) Use INH + RIF ± EMB No streptomycin PZA controversial in US Breastfeeding OK TB Tx for HIV + patients - Answers Rifabutin instead of rifampin Treat longer (9 months) DOT (directly observed tx) essential TB Treatment Monitoring: - Answers Before treatment: CBC CMP Vision test (for EMB) Uric acid (for PZA) During treatment: Monthly symptom check Sputum cultures monthly until negative Watch for hepatotoxicity Latent TB Tx - Answers INH 6-9 months Rifampin 4 months INH + rifapentine weekly x 12 weeks When to Treat Latent TB - Answers HIV Close contacts Fibrotic CXR changes Recent converters Diabetes, ESRD, immunosuppression Recent immigrants Nursing home, prison, shelter residents Directly Observed Therapy (DOT) - Answers Gold standard Prevents resistance Required for many public health cases MCC of CAP - Answers Streptococcus pneumoniae Which TB drug affects vision? - Answers Ethambutol Most common pneumonia complication causing death? - Answers Sepsis How long is standard TB treatment? - Answers 6 months What TB drug needs B6? - Answers Isoniazid MDR-TB means resistant to which 2 drugs? - Answers Isoniazid & Rifampin What population must get LTBI treatment? - Answers HIV + Diabetes, ESRD, immunosuppression Recent immigrants Nursing home, prison, shelter residents What pneumonia pattern suggests atypical organisms? - Answers Interstitial pattern on CXR laryngitis - Answers hoarseness, aphonia Usually viral Tx: voice rest, steam, cough suppressants croup - Answers barking cough + stridor Tx: racemic epi + dexamethasone Bacterial tracheitis - Answers toxic, purulent → IV antibiotics + admit When to consider ABX in respiratory disorders - Answers Sinusitis 10 days Pneumonia Otitis media Strep throat Supportive care in respiratory illness - Answers Rest, fluids Antipyretics Decongestants (pseudoephedrine - avoid HTN) Afrin/Neo-Synephrine: max 3 days (rebound congestion) Ipratropium nasal spray for rhinorrhea Saline rinses Flu Antivirals - Answers Oseltamivir (Tamiflu)--PO--Start within 48 hrs Zanamivir--Inhaled-- Avoid asthma/COPD Peramivir--IV--ED single dose Respiratory Illness Prevention - Answers Annual flu vaccine for everyone ≥ 6 months No vaccine for common cold Hand washing = best prevention High-risk: Elderly Chronic lung/heart disease Pregnant Immunocompromised Who must get antivirals for flu? - Answers Severe disease Hospitalized High-risk patients (immunocompromised, elderly, & young children) Pregnant patients What is cystic fibrosis - Answers Lifelong, autosomal recessive disease affecting exocrine glands. Affects multiple systems: lungs, pancreas, sweat glands, reproductive tract. Progressive lung disease = major morbidity & mortality CF Clinical Presentation - Answers Subjective Chronic nasal congestion, sinus disease, headaches, postnasal drip Cough: chronic, productive GI: steatorrhea, bulky/foul stools, poor weight gain Reproductive: male infertility (95%), reduced female fertility Bone: increased fractures, kyphoscoliosis Objective Respiratory: wheezing, dyspnea, tachypnea, hyperinflation on CXR, PFTs show obstruction Digital clubbing in advanced disease GI: meconium ileus in 10-20% infants, DIOS in adults (~15%) Other: venous thrombosis, anemia, nephrolithiasis CF Dx: - Answers Newborn screen: immunoreactive trypsinogen (IRT) ± DNA testing Confirmatory: sweat chloride test 29 mmol/L = normal 30-59 mmol/L = intermediate ≥60 mmol/L = positive What confirms Dx of CF? - Answers Sweat chloride ≥60 mmol/L confirms diagnosis CF Tx: - Answers Airway Clearance Techniques (ACTs): 2-3 hours/day Adjuncts: bronchodilators, mucolytics, inhaled antibiotics Pulmonary exacerbations (PEx): IV antibiotics based on culture for ≥2 weeks Common: aminoglycosides, vancomycin, ciprofloxacin, colistin Goal: prevent permanent FEV1 loss CFTR Modulators Treat underlying CFTR defect, not just symptoms Genotype testing required Examples: Ivacaftor: ≥6 mo Lumacaftor/Ivacaftor: 2-5 yr Tezacaftor/Ivacaftor: 6-11 yr Elexacaftor/Tezacaftor/Ivacaftor: ≥12 yr