620 ADULT - RESPIRATORY SYSTEM NP
CERTIFICATION, FITZGERALD. EXAM
2025 QUESTIONS AND ANSWERS
C. chronic airway inflammation with superimposed bronchospasm - ANS which of the
following best describes asthma?
a. intermitten 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
d. hyperresonance on thoracic percussion - ANS the patient you are evaluating is having a
severe asthma flare. You have assessed that his condition is appropriate for office tx. You
expect to find the following on physical examination:
a. tripod posture
b. inspiratory crackles
c. increased vocal fremitus
d. hyperresonance on thoracic percussion
c. spirometry measurement - ANS a 44 y/o man has a long-standing hx of moderate
persistent asthma that is normally well controlled by fluticasone with salmeterol (Advair) via
metered-dose inhaler, one puff bid, nad the use of albuterol 1-2 times a week prn for wheezing.
Three days ago, he developed a sorethroat, clear nasal discharge, body aches, and a dry cough.
In the past 24 hrs, he has had intermittent wheezing that necessitated the use of albuterol, two
puffs every 3 hrs, which produced partial relief. Your next most appropriate action is to obtain
a:
1 Copyright ©2025 SIRJOEL ALL RIGHTS RESERVED
,a. chest x-ray
b. measurement of oxygen saturation (SaO2)
c. spirometry measurement
d. sputum smear for WBCs
c. prednisone - ANS You examine Jane, a 24 y/o female who has an acute asthma flare
following a 3 day hx of UPR sxs (clear nasal discharge, dry cough, no fever). She has a hx of
moderate persistent asthma that is in good control and an acceptable peak expiratory flow
(PEF). 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 best. In the office,
her forced expiratory volume at 1 sec (FEV1) is 65% of predicted. Her medication regime should
be adjusted to include:
a. theophylline
b. salmeterol (Serevent)
c. prednisone
d. montelukast (Singulair)
b. provide a convenient method to check lung function at home - ANS 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
a. hyperinflation - ANS which of the following is most likely to appear on a chest x-ray of a
person during an acute severe asthma attack?
a. hyperinflation
b. atelectasis
c. consolidation
d. Kerley B signs
2 Copyright ©2025 SIRJOEL ALL RIGHTS RESERVED
, b. propranolol (beta-blocker) - ANS a 36- y/o male with asthma also need antihypertensive
therapy. Which of the following products should you try to avoid?
a. hydrochlorothiazide (thiazide)
b. propranolol (beta-blocker)
c. amlodipine (calcium channel blocker)
d. enalapril (ACEi)
c. morning sputum production - ANS which of the following is INCONSISTENT with the
presentation of asthma that is not well controlled?
a. troublesome nocturnal cough at least 2 nights per week
b. need for albuterol to relieve SOB at least twice a week
c. morning sputum production
d. two or more exacerbations/year requiring oral corticosteroids
d. inhaled corticosteroids - ANS the cornerstone of moderate persistent asthma drug therapy
is the use of:
a. oral theophylline
b. mast cell stabilizers
c. short-acting beta2 agonist (SABA)
d. inhaled corticosteroids
b. controllers to inhibit inflammatory responses - ANS in the tx of asthma, leukotriene
receptor antagonist should be used as:
a. controllers to prevent bronchospasm
b. controllers to inhibit inflammatory responses
c. relievers to tx acute bronchospasm
d. relievers to tx bronchospasm and inflammation
3 Copyright ©2025 SIRJOEL ALL RIGHTS RESERVED
CERTIFICATION, FITZGERALD. EXAM
2025 QUESTIONS AND ANSWERS
C. chronic airway inflammation with superimposed bronchospasm - ANS which of the
following best describes asthma?
a. intermitten 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
d. hyperresonance on thoracic percussion - ANS the patient you are evaluating is having a
severe asthma flare. You have assessed that his condition is appropriate for office tx. You
expect to find the following on physical examination:
a. tripod posture
b. inspiratory crackles
c. increased vocal fremitus
d. hyperresonance on thoracic percussion
c. spirometry measurement - ANS a 44 y/o man has a long-standing hx of moderate
persistent asthma that is normally well controlled by fluticasone with salmeterol (Advair) via
metered-dose inhaler, one puff bid, nad the use of albuterol 1-2 times a week prn for wheezing.
Three days ago, he developed a sorethroat, clear nasal discharge, body aches, and a dry cough.
In the past 24 hrs, he has had intermittent wheezing that necessitated the use of albuterol, two
puffs every 3 hrs, which produced partial relief. Your next most appropriate action is to obtain
a:
1 Copyright ©2025 SIRJOEL ALL RIGHTS RESERVED
,a. chest x-ray
b. measurement of oxygen saturation (SaO2)
c. spirometry measurement
d. sputum smear for WBCs
c. prednisone - ANS You examine Jane, a 24 y/o female who has an acute asthma flare
following a 3 day hx of UPR sxs (clear nasal discharge, dry cough, no fever). She has a hx of
moderate persistent asthma that is in good control and an acceptable peak expiratory flow
(PEF). 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 best. In the office,
her forced expiratory volume at 1 sec (FEV1) is 65% of predicted. Her medication regime should
be adjusted to include:
a. theophylline
b. salmeterol (Serevent)
c. prednisone
d. montelukast (Singulair)
b. provide a convenient method to check lung function at home - ANS 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
a. hyperinflation - ANS which of the following is most likely to appear on a chest x-ray of a
person during an acute severe asthma attack?
a. hyperinflation
b. atelectasis
c. consolidation
d. Kerley B signs
2 Copyright ©2025 SIRJOEL ALL RIGHTS RESERVED
, b. propranolol (beta-blocker) - ANS a 36- y/o male with asthma also need antihypertensive
therapy. Which of the following products should you try to avoid?
a. hydrochlorothiazide (thiazide)
b. propranolol (beta-blocker)
c. amlodipine (calcium channel blocker)
d. enalapril (ACEi)
c. morning sputum production - ANS which of the following is INCONSISTENT with the
presentation of asthma that is not well controlled?
a. troublesome nocturnal cough at least 2 nights per week
b. need for albuterol to relieve SOB at least twice a week
c. morning sputum production
d. two or more exacerbations/year requiring oral corticosteroids
d. inhaled corticosteroids - ANS the cornerstone of moderate persistent asthma drug therapy
is the use of:
a. oral theophylline
b. mast cell stabilizers
c. short-acting beta2 agonist (SABA)
d. inhaled corticosteroids
b. controllers to inhibit inflammatory responses - ANS in the tx of asthma, leukotriene
receptor antagonist should be used as:
a. controllers to prevent bronchospasm
b. controllers to inhibit inflammatory responses
c. relievers to tx acute bronchospasm
d. relievers to tx bronchospasm and inflammation
3 Copyright ©2025 SIRJOEL ALL RIGHTS RESERVED
