RESPIRATORY PRACTICE QUESTIONS
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 - ANSWER-C
The patient you are evaluating is having a severe asthma flare. You have assessed that his condition is
appropriate for office treatment. You expect to find the following on physical examination:
A. tripod posture
B. inspiratory crackles
C. increased vocal fremitus
D. hyperresonance on thoracic percussion - ANSWER-D
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 1 to 2 times a week as needed for wheezing. Three days ago, he developed a sore
throat, clear nasal discharge, body aches, and a dry cough. 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 white blood cells (WBCs). - ANSWER-C
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 discharge, dry cough, no fever). She has a history of
moderate persistent asthma that is in good control and an acceptable PEF. She is using budesonide
(Pulmicort) and albuterol as directed and continues to have difficulty with coughing and wheezing. At
home, her peak expiratory flow (PEF) is 55% of personal best. In the office, her FEV1 is 65% of
predicted. Her medication regimen should be adjusted to include:
A. theophylline.
B. salmeterol (Serevent).
C. prednisone.
D. montelukast (Singulair). - ANSWER-C
For Jane in the above question, you also prescribe:
A. amoxicillin.
B. azithromycin.
C. levofloxacin.
D. no antimicrobial therapy. - ANSWER-D
Peak expiratory flow meters:
, A. should only be used in the presence of a medical professional.
B. provide a convenient method to check lung function at home.
C. are as accurate as spirometry.
D. should not be used more than once daily. - ANSWER-B
Which of the following is most likely to appear on a chest radiograph of a person during an acute
severe asthma attack?
A. hyperinflation
B. atelectasis
C. consolidation
D. Kerley B signs - ANSWER-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
Which of the following is inconsistent with the presentation of asthma that is not well controlled?
A. a troublesome nocturnal cough at least 2 nights per week
B. need for albuterol to relieve shortness of breath at least twice a week
C. morning sputum production
D. two or more exacerbations/year requiring oral corticosteroids - ANSWER-C
The cornerstone of moderate persistent asthma drug therapy is the use of:
A. oral theophylline.
B. mast cell stabilizers.
C. short-acting beta2-agonists.
D. inhaled corticosteroids. - ANSWER-D
Sharon is a 29-year-old woman with moderate persistent asthma. She is not using prescribed inhaled
corticosteroids, but is using albuterol PRN to relieve her cough and wheeze with reported satisfactory
clinical effect. Currently she uses about two albuterol metered-dose inhalers per month and 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 inhaled corticosteroids. - ANSWER-B
In the treatment of asthma, leukotriene receptor antagonists should be used as:
A. controllers to prevent bronchospasm.
B. controllers to inhibit inflammatory responses.
C. relievers to treat acute bronchospasm.
D. relievers to treat bronchospasm and inflammation. - ANSWER-B
According to the National Asthma Education and Prevention Program Expert Panel Report-3 (NAEPP
EPR-3) guidelines, which of the following is not a risk for asthma death?
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 - ANSWER-C
The patient you are evaluating is having a severe asthma flare. You have assessed that his condition is
appropriate for office treatment. You expect to find the following on physical examination:
A. tripod posture
B. inspiratory crackles
C. increased vocal fremitus
D. hyperresonance on thoracic percussion - ANSWER-D
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 1 to 2 times a week as needed for wheezing. Three days ago, he developed a sore
throat, clear nasal discharge, body aches, and a dry cough. 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 white blood cells (WBCs). - ANSWER-C
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 discharge, dry cough, no fever). She has a history of
moderate persistent asthma that is in good control and an acceptable PEF. She is using budesonide
(Pulmicort) and albuterol as directed and continues to have difficulty with coughing and wheezing. At
home, her peak expiratory flow (PEF) is 55% of personal best. In the office, her FEV1 is 65% of
predicted. Her medication regimen should be adjusted to include:
A. theophylline.
B. salmeterol (Serevent).
C. prednisone.
D. montelukast (Singulair). - ANSWER-C
For Jane in the above question, you also prescribe:
A. amoxicillin.
B. azithromycin.
C. levofloxacin.
D. no antimicrobial therapy. - ANSWER-D
Peak expiratory flow meters:
, A. should only be used in the presence of a medical professional.
B. provide a convenient method to check lung function at home.
C. are as accurate as spirometry.
D. should not be used more than once daily. - ANSWER-B
Which of the following is most likely to appear on a chest radiograph of a person during an acute
severe asthma attack?
A. hyperinflation
B. atelectasis
C. consolidation
D. Kerley B signs - ANSWER-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
Which of the following is inconsistent with the presentation of asthma that is not well controlled?
A. a troublesome nocturnal cough at least 2 nights per week
B. need for albuterol to relieve shortness of breath at least twice a week
C. morning sputum production
D. two or more exacerbations/year requiring oral corticosteroids - ANSWER-C
The cornerstone of moderate persistent asthma drug therapy is the use of:
A. oral theophylline.
B. mast cell stabilizers.
C. short-acting beta2-agonists.
D. inhaled corticosteroids. - ANSWER-D
Sharon is a 29-year-old woman with moderate persistent asthma. She is not using prescribed inhaled
corticosteroids, but is using albuterol PRN to relieve her cough and wheeze with reported satisfactory
clinical effect. Currently she uses about two albuterol metered-dose inhalers per month and 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 inhaled corticosteroids. - ANSWER-B
In the treatment of asthma, leukotriene receptor antagonists should be used as:
A. controllers to prevent bronchospasm.
B. controllers to inhibit inflammatory responses.
C. relievers to treat acute bronchospasm.
D. relievers to treat bronchospasm and inflammation. - ANSWER-B
According to the National Asthma Education and Prevention Program Expert Panel Report-3 (NAEPP
EPR-3) guidelines, which of the following is not a risk for asthma death?
