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NURS 552-1 Primary Health Care Nursing Adult Midterm Exam Questions All Answered Scored A+.

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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. Chronic airway inflammation with superimposed bronchospasm The patient you are evaluating is having an asthma flare. You have assessed that his condition is appropriate for office treatment. You expect to find the following on physical exam: A. Tripod posture B. Inspiratory crackles C. Increased vocal fremitus D. Hyperresonance on thoracic percussion - Answer D. Hyperresonance on thoracic percussion 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 one to two times a week as needed for wheezing. Three days ago, he developed a sore throat, clear nasal discharge, body aches, and a cough with a small amount of white sputum production. 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 WBCs - Answer C. Spirometry measurement 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 drainage, dry cough, no fever). She has a history of moderate persistent asthma that is in good control and an acceptable peak expiratory flow (PED). She is using budesonide (Pulmicort) and albuterol as directed and continues to have difficulty with coughing and wheezing. At home, her PEF is 55% of personal

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NURS 552-1 Primary Health Care
Nursing Adult Midterm Exam Questions
All Answered Scored A+.
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. Chronic airway inflammation with
superimposed bronchospasm



The patient you are evaluating is having an asthma flare. You have assessed that his condition is
appropriate for office treatment. You expect to find the following on physical exam:



A. Tripod posture

B. Inspiratory crackles

C. Increased vocal fremitus

D. Hyperresonance on thoracic percussion - Answer D. Hyperresonance on thoracic percussion



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 one to two times a week as needed for wheezing. Three days
ago, he developed a sore throat, clear nasal discharge, body aches, and a cough with a small
amount of white sputum production. 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 WBCs - Answer C. Spirometry measurement

,best. In the office, her forced expiratory volume at 1 second (FEV1) is 65% of predicted. Her
medication regimen should be adjusted to include:



A. Oral theophylline

B. Inhale salmeterol (Serevent) via MDI

C. Oral prednisone

D. Oral montelukast (Singulair)




For Jane in the previous question, the NP also considers prescribing:



A. A 10-day course of oral amoxicillin

B. A 5-day course of oral azithromycin

C. A 14-day course of levofloxacin

D. No antimicrobial therapy - Answer C. Oral prednisone



D. No antimicrobial therapy



Which of the following describes a PEF meter?



A. Should only be used in the presence of a medical professional

B. Provides convenient method to check expiratory air flow at home

C. Is as accurate as spirometry

D. Should not be used more than once daily - Answer B. Provides convenient method to check
expiratory air flow at home



Which of the following is most accurate regarding the use of a chest x-ray during an acute
asthma flare?



A. Chest radiograph should be performed with each asthma flare

B. Chest radiograph should be performed during and following resolution of the flare

, 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. Propranolol



For the next 4 questions, which of the following is consistent with presentation of asthma that is
not well controlled (Yes or No):



1. Troublesome nocturnal cough more than two nights per week

2. Need for albuterol to relieve SOB more than twice a week

3. Evidence of consolidation on chest x-ray

4. Two or more exacerbations/year requiring OCSs - Answer 1. Yes

2. Yes

3. No

4. Yes



The cornerstone of moderate persistent asthma controller drug therapy is the use of:



A. Oral theophylline

B. Inhaled mast cell stabilizers

C. Inhaled SABAs

D. ICSs - Answer D. ICSs



Sharon is a 29-year-old woman with moderate persistent asthma. She has a prescription for an
ICS that she does not use, stating, "I'm finding that the albuterol works better." Currently she
uses about two albuterol metered-dose inhalers per month, "that keeps my cough and wheeze
under control." She is requesting a prescription refill. You consider that:




A. Her asthma is well controlled, and albuterol use can continue

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