NURS 536 Pulmonary exam questions with correct answers,

NURS 536 Pulmonary exam questions with
|\ |\ |\ |\ |\ |\




correct answers |\




COPD, Group B first choice pharm for stable disease - CORRECT
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\



ANSWERS ✔✔LA anticholinergic (triotropium) or
|\ |\ |\ |\ |\




LA B2 agonist (salmeterol)
|\ |\ |\




COPD, Group B second choice pharm for stable disease - CORRECT
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\



ANSWERS ✔✔LA anticholinergic and LA B2 agonist
|\ |\ |\ |\ |\ |\ |\




COPD, Group B alternate choice pharm for stable disease -
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\



CORRECT ANSWERS ✔✔SA B2 agonist and/or SA anticholinergic
|\ |\ |\ |\ |\ |\ |\




COPD, Group C first choice pharm for stable disease - CORRECT
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\



ANSWERS ✔✔ICS plus LA B2 agonist (salmeterol) or
|\ |\ |\ |\ |\ |\ |\ |\




LA anticholinergic (tiotropium)
|\ |\




COPD, Group C second choice pharm for stable disease - CORRECT
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\



ANSWERS ✔✔LA anticholinergic (tiotropium) and LA B2 agonist
|\ |\ |\ |\ |\ |\ |\ |\




SA anticholinergic - CORRECT ANSWERS ✔✔ipratropium;
|\ |\ |\ |\ |\ |\



bronchospasm relief |\




SA B2 agonist (SABA) - CORRECT ANSWERS ✔✔albuterol;
|\ |\ |\ |\ |\ |\ |\ |\



bronchospasm relief |\

,LA anticholinergic (LAMA) - CORRECT ANSWERS ✔✔tiotropium;
|\ |\ |\ |\ |\ |\ |\



protracted duration bronchodilation, reduces risk of exacerbation
|\ |\ |\ |\ |\ |\




LA B2 agonist (LABA) - CORRECT ANSWERS ✔✔salmeterol;
|\ |\ |\ |\ |\ |\ |\ |\



protracted duration bronchodilation |\ |\




PDE4 inhibitor - CORRECT ANSWERS ✔✔roflumilast; minimizes risk
|\ |\ |\ |\ |\ |\ |\



of exacerbation
|\ |\




Roflumilast cannot be used with - CORRECT ANSWERS
|\ |\ |\ |\ |\ |\ |\ |\



✔✔theophylline; bronchodilator |\




COPD Group C alternate choice pharm for stable disease -
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\



CORRECT ANSWERS ✔✔PDE-4 inhibitor, SA B2 agonist and/or SA
|\ |\ |\ |\ |\ |\ |\ |\ |\



anticholinergic, theophylline |\




COPD Group D first choice pharm, stable disease - CORRECT
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\



ANSWERS ✔✔ISC, LA B2 agonist or LA anticholinergic
|\ |\ |\ |\ |\ |\ |\




COPD Group D second choice pharm, stable disease - CORRECT
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\



ANSWERS ✔✔ISC & LA anticholinergic, ICS plus LA B2 agonist and
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\



PD4 inhibitor, LA anticholinergic and LA B2 agonist, LA
|\ |\ |\ |\ |\ |\ |\ |\ |\



anticholinergic and PDE-4 |\ |\




Causative pathogens COPD exacerbation - CORRECT ANSWERS
|\ |\ |\ |\ |\ |\ |\



✔✔H. Flu, Haemophilus, Strep pneumonaie, moraxella
|\ |\ |\ |\ |\

,Abx for mild-mod COPD/bronchitis exacerbation - CORRECT
|\ |\ |\ |\ |\ |\ |\



ANSWERS ✔✔None or if indicated, amoxicillian, doxy, TMP-SMX
|\ |\ |\ |\ |\ |\ |\




Abx for severe COPD/bronchitis exacerbation - CORRECT
|\ |\ |\ |\ |\ |\ |\



ANSWERS ✔✔Amox-clav, cephalosporin (cefdinir, cefpodoxime|\ |\ |\ |\ |\



etc), Azithro, clarithromycin, Fluoroquinolone x 5-7 days
|\ |\ |\ |\ |\ |\




COPD diagnosis, post bronchodilator FEV1/FVC of ______ confirms
|\ |\ |\ |\ |\ |\ |\ |\



the presence of persistent airflow limitation. - CORRECT ANSWERS
|\ |\ |\ |\ |\ |\ |\ |\ |\



✔✔<0.70 of predicted |\ |\




Goals of COPD treatment - CORRECT ANSWERS ✔✔Symptom
|\ |\ |\ |\ |\ |\ |\ |\



relief, reduce impact of symptoms & exacerbations
|\ |\ |\ |\ |\ |\




COPD risk factors - CORRECT ANSWERS ✔✔Irritants, family history,
|\ |\ |\ |\ |\ |\ |\ |\



advancing age
|\ |\




COPD diagnosis considered in patients with risk factors above age
|\ |\ |\ |\ |\ |\ |\ |\ |\



- CORRECT ANSWERS ✔✔40
|\ |\ |\ |\




Population at highest risk of COPD exacerbation & death - |\ |\ |\ |\ |\ |\ |\ |\ |\ |\



CORRECT ANSWERS ✔✔COPD diagnosis and >= 2 exacerbations
|\ |\ |\ |\ |\ |\ |\ |\



in last year, FEV1 < 50% of predicted, hospitalization for COPD in
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\



past year |\




Diagnosis of end stage COPD - spirometry - CORRECT ANSWERS
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\



✔✔FEV1 < 50% |\ |\

, Steps of COPD diagnosis - CORRECT ANSWERS ✔✔1. Spirometry,
|\ |\ |\ |\ |\ |\ |\ |\ |\



2. Symptom assessment, 3. Assessment of exacerbation risk, 4.
|\ |\ |\ |\ |\ |\ |\ |\ |\



Assess comorbidities |\




Gold 1 - CORRECT ANSWERS ✔✔Mild disease, FEV1 >80%
|\ |\ |\ |\ |\ |\ |\ |\ |\



predicted


Gold 2 - CORRECT ANSWERS ✔✔Moderate disease, FEV1 50-80%
|\ |\ |\ |\ |\ |\ |\ |\ |\



predicted


Gold 3 - CORRECT ANSWERS ✔✔Severe disease, FEV1 30- <50%
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\



predicted


Gold 4 - CORRECT ANSWERS ✔✔Very severe disease, FEV < 30%
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\



predicted


COPD assessment test (CAT) scoring - CORRECT ANSWERS ✔✔Max
|\ |\ |\ |\ |\ |\ |\ |\



score 40, lower is better
|\ |\ |\ |\ |\




COPD exacerbation risk - CORRECT ANSWERS ✔✔2 or more in last
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\



year - high risk, 1 or more in last year high risk
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\




Alpha-1 Antitrypsin Deficiency Screening considered - CORRECT
|\ |\ |\ |\ |\ |\ |\



ANSWERS ✔✔COPD in patients of caucasian descent < 45 y/o or
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\



strong family history
|\ |\