1
NR 603 Week 2 Case Discussion Pulmonary
Part One Chamberlain University Actual
Exam 2026/2027 Complete Exam-Style
Questions with Detailed Rationales | 100%
Verified | Pass Guaranteed – A+ Graded
Patient: Marcus Webb, a 58-year-old male auto mechanic
Chief Complaint: "I can't seem to shake this cough and it's
getting harder to breathe, especially when I'm working under
cars or when it's cold outside."
Setting: Primary care office — established patient, hasn't been
seen in 18 months
Part I: Pulmonary Case Presentation & Subjective Data
(Questions 1-8)
Q1: Mr. Webb presents with a progressive cough and increasing
shortness of breath over the past 3 weeks. When using the
OLDCARTS mnemonic to characterize his chief complaint
during the history of present illness (HPI), which component is
being assessed by asking, "Does anything make your breathing
better or worse—like rest, sitting up, or using your inhaler?"
,2
A. Onset
B. Aggravating and Alleviating factors
C. Timing
D. Associated symptoms
Correct Answer: B
Rationale: The best answer is B because the "A" in OLDCARTS
stands for Aggravating and Alleviating factors—this is exactly
what you're asking about when you want to know what makes
symptoms better or worse. Onset (A) covers when it started.
Timing (C) covers duration, frequency, and pattern. Associated
symptoms (D) covers other symptoms occurring alongside the
chief complaint. Using OLDCARTS systematically ensures you
don't miss critical HPI elements that shape your differential
diagnosis.
Q2: Mr. Webb reports his cough is productive of "thick yellow-
green stuff" most mornings, and he's wheezing "pretty often"
especially with exertion or exposure to exhaust fumes at work.
He denies fever, chills, night sweats, chest pain, hemoptysis, or
leg swelling. He mentions he's gone through two albuterol
inhalers in the past 6 weeks but they don't seem to help as much
as they used to. Based on this subjective information so far,
,3
which finding is MOST concerning for possible COPD rather
than uncomplicated asthma?
A. Productive morning cough with thick sputum
B. Wheezing triggered by exhaust fumes
C. Increasing albuterol use with diminishing response
D. Absence of fever and hemoptysis
Correct Answer: A
Rationale: This choice is correct because a chronic productive
cough, especially with morning sputum production, is a
hallmark feature of COPD—particularly chronic bronchitis—
whereas asthma typically presents with a dry or minimally
productive cough unless there's an acute exacerbation or
comorbid condition. While options B and C can occur in both
asthma and COPD, the quality and chronicity of productive
cough strongly points toward chronic airway inflammation and
mucus hypersecretion seen in COPD. Option D is actually a
reassuring negative finding that makes pneumonia or
malignancy less likely.
Q3: When exploring Mr. Webb's past medical history, he reveals
he was "told I had asthma as a kid" but hasn't regularly seen a
doctor for it since his early 20s. He was hospitalized once at age
, 4
32 for "breathing trouble" but doesn't remember details. Which
additional past history element is MOST critical to elicit at this
point?
A. History of previous intubation or ICU admission for
respiratory failure
B. Childhood immunization history
C. Previous surgeries unrelated to respiratory system
D. Family travel history
Correct Answer: A
Rationale: The best answer is A because knowing whether Mr.
Webb has ever required intubation, mechanical ventilation, or
ICU admission for respiratory failure dramatically changes your
risk stratification and management approach—a history of near-
fatal asthma or previous respiratory failure places him in a much
higher acuity category and influences referral decisions,
medication intensity, and action planning. While childhood
immunizations (B), other surgeries (C), and travel history (D)
have their place in a complete history, none carry the same
immediate clinical weight for a patient presenting with
progressive respiratory symptoms and a history of prior
hospitalization for breathing problems.
NR 603 Week 2 Case Discussion Pulmonary
Part One Chamberlain University Actual
Exam 2026/2027 Complete Exam-Style
Questions with Detailed Rationales | 100%
Verified | Pass Guaranteed – A+ Graded
Patient: Marcus Webb, a 58-year-old male auto mechanic
Chief Complaint: "I can't seem to shake this cough and it's
getting harder to breathe, especially when I'm working under
cars or when it's cold outside."
Setting: Primary care office — established patient, hasn't been
seen in 18 months
Part I: Pulmonary Case Presentation & Subjective Data
(Questions 1-8)
Q1: Mr. Webb presents with a progressive cough and increasing
shortness of breath over the past 3 weeks. When using the
OLDCARTS mnemonic to characterize his chief complaint
during the history of present illness (HPI), which component is
being assessed by asking, "Does anything make your breathing
better or worse—like rest, sitting up, or using your inhaler?"
,2
A. Onset
B. Aggravating and Alleviating factors
C. Timing
D. Associated symptoms
Correct Answer: B
Rationale: The best answer is B because the "A" in OLDCARTS
stands for Aggravating and Alleviating factors—this is exactly
what you're asking about when you want to know what makes
symptoms better or worse. Onset (A) covers when it started.
Timing (C) covers duration, frequency, and pattern. Associated
symptoms (D) covers other symptoms occurring alongside the
chief complaint. Using OLDCARTS systematically ensures you
don't miss critical HPI elements that shape your differential
diagnosis.
Q2: Mr. Webb reports his cough is productive of "thick yellow-
green stuff" most mornings, and he's wheezing "pretty often"
especially with exertion or exposure to exhaust fumes at work.
He denies fever, chills, night sweats, chest pain, hemoptysis, or
leg swelling. He mentions he's gone through two albuterol
inhalers in the past 6 weeks but they don't seem to help as much
as they used to. Based on this subjective information so far,
,3
which finding is MOST concerning for possible COPD rather
than uncomplicated asthma?
A. Productive morning cough with thick sputum
B. Wheezing triggered by exhaust fumes
C. Increasing albuterol use with diminishing response
D. Absence of fever and hemoptysis
Correct Answer: A
Rationale: This choice is correct because a chronic productive
cough, especially with morning sputum production, is a
hallmark feature of COPD—particularly chronic bronchitis—
whereas asthma typically presents with a dry or minimally
productive cough unless there's an acute exacerbation or
comorbid condition. While options B and C can occur in both
asthma and COPD, the quality and chronicity of productive
cough strongly points toward chronic airway inflammation and
mucus hypersecretion seen in COPD. Option D is actually a
reassuring negative finding that makes pneumonia or
malignancy less likely.
Q3: When exploring Mr. Webb's past medical history, he reveals
he was "told I had asthma as a kid" but hasn't regularly seen a
doctor for it since his early 20s. He was hospitalized once at age
, 4
32 for "breathing trouble" but doesn't remember details. Which
additional past history element is MOST critical to elicit at this
point?
A. History of previous intubation or ICU admission for
respiratory failure
B. Childhood immunization history
C. Previous surgeries unrelated to respiratory system
D. Family travel history
Correct Answer: A
Rationale: The best answer is A because knowing whether Mr.
Webb has ever required intubation, mechanical ventilation, or
ICU admission for respiratory failure dramatically changes your
risk stratification and management approach—a history of near-
fatal asthma or previous respiratory failure places him in a much
higher acuity category and influences referral decisions,
medication intensity, and action planning. While childhood
immunizations (B), other surgeries (C), and travel history (D)
have their place in a complete history, none carry the same
immediate clinical weight for a patient presenting with
progressive respiratory symptoms and a history of prior
hospitalization for breathing problems.
