MGRADES EXAMS
NURS 5461 M4 Pulmonary UPDATED
ACTUAL Exam Questions and CORRECT
Answers
cough - CORRECT ANSWER - take a thorough HX. DDX: rx drugs*postnasal
drip*COPD*asthma*post infection*GERD*chf*Interstital lung disease*
RX for Cough - CORRECT ANSWER - Treat underling Disease*smoking cessation*
medications--ipratropiaum, cromolyn, atrovent, dextromethorphan, antihistamines/decongestant,
benzonatate(Tessalon), codeine is last resort. see eppocrates guideline
Dyspnea - CORRECT ANSWER - good eaxm-s3,s4? murmurs? edema? check peak flow on
spriometry
DDX:asthma, COPD, Pneumonia,CHF, IHD, Anemia, panic.
Hemoptysis - CORRECT ANSWER - 85% inflammatory (bronchitis, TB, pneumonia),
otherwise likely neoplasia
--Treat underlying cause
URI - CORRECT ANSWER - Only 25% are bacterial, otherwise viral (cold, flu)
Laryngitis - CORRECT ANSWER - parainfluenza, RSV, or flu are common etiologies
Acute Bronchitis - CORRECT ANSWER - self limited inflammation of trachea and major
bronchi, 3rd most common reason HCP visit.
+cough-lasting up to 3w w/wo phlegm+dyspnea+/- wheezing+/-pleurisy
usually viral-corona, flu, rhinovirus
DDX:cold, asthma,pertussis,pneumona
BUT--Cough w/nl VS, absence of Tachypnea, tachycardia, rales, egophany ('e' to 'a') *suggest
acute bronchitis*
, MGRADES EXAMS
Acute Bronchitis RX: - CORRECT ANSWER - SABA (Albuterol,ventolin Proair) is DOC
(whz, cough for up to two weeks) also antitussives, Phenergan DM incr. fluids and rest ATBX
not justified, no evidence that mucolytics (mucinex)are helpful
Chronic Bronchitis - CORRECT ANSWER - cough+sputum production x3m for 2y. Infl of
cells lining bronchial walls=hyperplasia=narrowing-most common w/COPD.
Etiologies, H. Influenzae, S pneumoniae, Moraxella, catarrhalis, or viral (flu, etc)
Chronic Bronchitis RX - CORRECT ANSWER - 1st line severe exacerbation>Augmentin
875 bid, or Doxy 100mg bid, or Bactrim 1(DS) BID, OR cefuroxime 500MG Bid for 7 days or
Zpak 500mg day one then 250mg x 4 days
**Cipro 500-750bid only if pseudomonas
SABA(Albuterol, Ventolin Proair), and prednisone 3-40 qd x7d. **no need to taper id <14d Rx
CAP - CORRECT ANSWER - non hosp acquired pneumonia (bacteria, fungua, virus,
parasite) consolidation on CXR.
Healthy pt <60 suspect legoinella
*S. Pneumoniae is predominate organism
Pneumococcal PNA clinical features (CAP) - CORRECT ANSWER - S pneumoniae (gram
+), abrupt onset, prod. cough, rusty sputum, fever, chills, pleuritic CP
*MORE SUBTLE IN OLDER PTS: altered mental status and weakness, fever blunted
cough/ fatigus may last 3-4w
atypical PNA (CAP) - CORRECT ANSWER - *Most Common in <40, mycoplasma,
legionella, chlamydia (atypical pahtogens)
present w. headache, dry cough ~6w, myalgia, but may be indistinguishable from pneumococcal
chlamydia presents w/ severe pharyngitis, laryngitis, fever, cough, may improve then worsen
NURS 5461 M4 Pulmonary UPDATED
ACTUAL Exam Questions and CORRECT
Answers
cough - CORRECT ANSWER - take a thorough HX. DDX: rx drugs*postnasal
drip*COPD*asthma*post infection*GERD*chf*Interstital lung disease*
RX for Cough - CORRECT ANSWER - Treat underling Disease*smoking cessation*
medications--ipratropiaum, cromolyn, atrovent, dextromethorphan, antihistamines/decongestant,
benzonatate(Tessalon), codeine is last resort. see eppocrates guideline
Dyspnea - CORRECT ANSWER - good eaxm-s3,s4? murmurs? edema? check peak flow on
spriometry
DDX:asthma, COPD, Pneumonia,CHF, IHD, Anemia, panic.
Hemoptysis - CORRECT ANSWER - 85% inflammatory (bronchitis, TB, pneumonia),
otherwise likely neoplasia
--Treat underlying cause
URI - CORRECT ANSWER - Only 25% are bacterial, otherwise viral (cold, flu)
Laryngitis - CORRECT ANSWER - parainfluenza, RSV, or flu are common etiologies
Acute Bronchitis - CORRECT ANSWER - self limited inflammation of trachea and major
bronchi, 3rd most common reason HCP visit.
+cough-lasting up to 3w w/wo phlegm+dyspnea+/- wheezing+/-pleurisy
usually viral-corona, flu, rhinovirus
DDX:cold, asthma,pertussis,pneumona
BUT--Cough w/nl VS, absence of Tachypnea, tachycardia, rales, egophany ('e' to 'a') *suggest
acute bronchitis*
, MGRADES EXAMS
Acute Bronchitis RX: - CORRECT ANSWER - SABA (Albuterol,ventolin Proair) is DOC
(whz, cough for up to two weeks) also antitussives, Phenergan DM incr. fluids and rest ATBX
not justified, no evidence that mucolytics (mucinex)are helpful
Chronic Bronchitis - CORRECT ANSWER - cough+sputum production x3m for 2y. Infl of
cells lining bronchial walls=hyperplasia=narrowing-most common w/COPD.
Etiologies, H. Influenzae, S pneumoniae, Moraxella, catarrhalis, or viral (flu, etc)
Chronic Bronchitis RX - CORRECT ANSWER - 1st line severe exacerbation>Augmentin
875 bid, or Doxy 100mg bid, or Bactrim 1(DS) BID, OR cefuroxime 500MG Bid for 7 days or
Zpak 500mg day one then 250mg x 4 days
**Cipro 500-750bid only if pseudomonas
SABA(Albuterol, Ventolin Proair), and prednisone 3-40 qd x7d. **no need to taper id <14d Rx
CAP - CORRECT ANSWER - non hosp acquired pneumonia (bacteria, fungua, virus,
parasite) consolidation on CXR.
Healthy pt <60 suspect legoinella
*S. Pneumoniae is predominate organism
Pneumococcal PNA clinical features (CAP) - CORRECT ANSWER - S pneumoniae (gram
+), abrupt onset, prod. cough, rusty sputum, fever, chills, pleuritic CP
*MORE SUBTLE IN OLDER PTS: altered mental status and weakness, fever blunted
cough/ fatigus may last 3-4w
atypical PNA (CAP) - CORRECT ANSWER - *Most Common in <40, mycoplasma,
legionella, chlamydia (atypical pahtogens)
present w. headache, dry cough ~6w, myalgia, but may be indistinguishable from pneumococcal
chlamydia presents w/ severe pharyngitis, laryngitis, fever, cough, may improve then worsen
