MN 568 MIDTERM EXAM ACTUAL EXAM
180 QUESTIONS AND CORRECT
DETAILED 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? - Answer-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? - Answer-
Chronic Bronchitis
/.George has COPD and an 80% forced expiratory volume in 1 second. How would you
classify the severity of his COPD? - Answer-Stage 1 mild COPD
/.African American pt's seems to have a negative reaction to which of the following
asthma meds? - Answer-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? - Answer-Hospitalize and
consider admitting her to the ICU
/.Why do you suspect that your pt may have a decreased response to the TB test? -
Answer-She has been on long-term corticosteroid therapy
/.Marci has been started on a TB regimen. Because isoniazid (INH) may cause
peripheral neuropathy, you consider ordering which of the following drugs
prophilactically? - Answer-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. - Answer-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? - Answer-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?
- Answer-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? - Answer-The gum must be correctly chewed to a softened state and then placed
in the buccal mucosa
/.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? - Answer-Moderate persistent
/.Joyce is taking a long-acting beta agonist for her asthma. What additional med should
she be taking? - Answer-Inhaled corticosteroid
/.Your pt is on theophylline (Therabid) for his asthma. You want to maintain his serum
levels between: - Answer-5-15mcg/mL
/.Which of the following statements regarding TST is true? - Answer-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? - Answer-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? - Answer-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? - Answer-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? - Answer-His collar size is 17in
/.The forced vital capacity is decreased in:
a. Asthma
b. Chronic bronchitis
c. Emphysema
d. Restrictive disease - Answer-restrictive disease
, /.The most common cause of CAP is: - Answer-Streptococcus pneumoniae
/.Which of the following pt's would you expect to have a decreased response to TST? -
Answer-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 - Answer-insulin resistance
/.Which of the following conditions is associated with cigarette smoking?
a. Glaucoma
b. Increased sperm quality
c. Bladder cancer
d. Eczema - Answer-Bladder cancer
/.Marta is taking TB drugs prophylactically. How do you instruct her to take them? -
Answer-Take them on an empty stomach to facilitate absorption
/.Which of the following statements regarding pulmonary function is true?
a. Cigarette smoking accelerates the decline in pulmonary function tenfold
b. Smoking cessation can reverse most pathological changes
c. Cigarette smoking decreases mucus production
d. There is a normal age-related decline in pulmonary function - Answer-There is a
normal age-related decline in pulmonary function
/.Supplemental oxygen for how many hours per day has been shown to improve the
mortality associated with COPD? - Answer-15-18 hours
/.The barrel chest characteristic of emphysema is a result of: - Answer-hyperinflation
/.Which ethnic group has the highest lung cancer incidence and mortality rates? -
Answer-African American men
/.A pt is 66in in height, weighing 200lbs, and newly diagnosed with T2DM. Her fasting
plasma glucose level is 215mg/dL. What is the best initial treatment? - Answer-Diet and
exercise for 6 week trial
/.The clinician suspects that a client seen in the office has hyperthyroidism. Which of the
following tests should the clinician order on the initial visit?
180 QUESTIONS AND CORRECT
DETAILED 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? - Answer-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? - Answer-
Chronic Bronchitis
/.George has COPD and an 80% forced expiratory volume in 1 second. How would you
classify the severity of his COPD? - Answer-Stage 1 mild COPD
/.African American pt's seems to have a negative reaction to which of the following
asthma meds? - Answer-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? - Answer-Hospitalize and
consider admitting her to the ICU
/.Why do you suspect that your pt may have a decreased response to the TB test? -
Answer-She has been on long-term corticosteroid therapy
/.Marci has been started on a TB regimen. Because isoniazid (INH) may cause
peripheral neuropathy, you consider ordering which of the following drugs
prophilactically? - Answer-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. - Answer-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? - Answer-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?
- Answer-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? - Answer-The gum must be correctly chewed to a softened state and then placed
in the buccal mucosa
/.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? - Answer-Moderate persistent
/.Joyce is taking a long-acting beta agonist for her asthma. What additional med should
she be taking? - Answer-Inhaled corticosteroid
/.Your pt is on theophylline (Therabid) for his asthma. You want to maintain his serum
levels between: - Answer-5-15mcg/mL
/.Which of the following statements regarding TST is true? - Answer-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? - Answer-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? - Answer-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? - Answer-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? - Answer-His collar size is 17in
/.The forced vital capacity is decreased in:
a. Asthma
b. Chronic bronchitis
c. Emphysema
d. Restrictive disease - Answer-restrictive disease
, /.The most common cause of CAP is: - Answer-Streptococcus pneumoniae
/.Which of the following pt's would you expect to have a decreased response to TST? -
Answer-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 - Answer-insulin resistance
/.Which of the following conditions is associated with cigarette smoking?
a. Glaucoma
b. Increased sperm quality
c. Bladder cancer
d. Eczema - Answer-Bladder cancer
/.Marta is taking TB drugs prophylactically. How do you instruct her to take them? -
Answer-Take them on an empty stomach to facilitate absorption
/.Which of the following statements regarding pulmonary function is true?
a. Cigarette smoking accelerates the decline in pulmonary function tenfold
b. Smoking cessation can reverse most pathological changes
c. Cigarette smoking decreases mucus production
d. There is a normal age-related decline in pulmonary function - Answer-There is a
normal age-related decline in pulmonary function
/.Supplemental oxygen for how many hours per day has been shown to improve the
mortality associated with COPD? - Answer-15-18 hours
/.The barrel chest characteristic of emphysema is a result of: - Answer-hyperinflation
/.Which ethnic group has the highest lung cancer incidence and mortality rates? -
Answer-African American men
/.A pt is 66in in height, weighing 200lbs, and newly diagnosed with T2DM. Her fasting
plasma glucose level is 215mg/dL. What is the best initial treatment? - Answer-Diet and
exercise for 6 week trial
/.The clinician suspects that a client seen in the office has hyperthyroidism. Which of the
following tests should the clinician order on the initial visit?
