NUR 524 Exam Questions and Answers| New Update with 100% Correct Answers
What percentage of cases of bronchitis are viral? 90%
If your patient presenting with bronchitis symptoms has an elevated WBC and CRP, what would
your new diagnosis be? CAP
Treatment for bronchitis cough suppressants before bed to promote sleep, antihistamines
Mucoterm-46kinetics only if pt expectorating
Corticosteroids NOT recommended
Acute bronchitis s/s Cough with or without sputum
Wheezes, ronchi/coarse rales
Reduced FEV1 that improves with bronchodilator
Treatment parameters for Covid-19 Pt > 50 and unvaccinated
Any pt > 65
Any patient at high risk for severe disease (Cormibidities)
How soon should treatment for Covid-19 begin? within 48 hours of symptoms
Treatment options for Covid-19 Paxlovid: Outpatient, for mild to moderate symptoms; Has
many interactions; Possibility for rebound symptoms within 5-14 days of stopping; Renal
adjustment needed
Inpatient: Remdesivir, dexamethasone, bronchodilators/ICS, ASA
What is the #1 causative agent of PNA? Strep Pneumoniae
,What are the common PNA pathogens for COPD patients? H. Flu, P. Aeruginosa, Legionella,
S. pneumoniae, Maraxella Catarrhalis (MCAT), Chlamydophila Pneumoniae
What are the common PNA pathogens for ETOH users? S. Pneumoniae, Oral anaerobes
(Aspiration), Acinetobacter, Mycobacterium TB
What are the common PNA pathogens that form abcesses? Myobacterium TB, MRSA,
endemic fungi, atypical mycobacterium
What PNA pathogens would you find in someone who resides in or recently visited the
Southwest US? Coccidiodes species
What symptoms are more likely with atypical PNA's? HA and sore throat
What are your first line drugs of choice for treatment of CAP in a patient without PCN allergy?
No comorbids: Amoxicillin
With comorbids: Augmentin
A 65-year-old man is evaluated for a 2-year history of dyspnea on exertion. He reports dyspnea
and occasional wheezing mainly with increased exertion like climbing stairs or walking briskly
up an incline. He reports no chest pain. He has a 15-year history of well-controlled hypertension
and hyperlipidemia treated with amlodipine and atorvastatin. He has a 30 pack-year history of
smoking. On physical examination, his vital signs are normal. His lungs are clear to auscultation.
His laboratory work reveals a normal complete blood count and chemistry panel. Spirometry
shows a postbronchodilator FEV1 of 80% and FEV1/FVC ratio of 0.65. A chest radiograph and
electrocardiogram are both normal. What is the most appropriate initial treatment for this
patient?
A Inhaled corticosteroid and long-acting beta-agonist
B Long-acting beta-agonist
C Long-acting muscarinic antagonist
D Short-acting beta-agonist D
, A 54-year-old man with a 40 pack-year smoking history presents to the primary care office for a
follow-up for chronic cough that began 2 years ago. His recent spirometry testing revealed a
postbronchodilator FEV1/FVC ratio of 0.6 and an FEV1 of 75% of predicted normal. His oxygen
saturation is 92%. What is the most appropriate initial pharmacologic therapy for this patient?
A Budesonide nebulizer 2 mg four times daily
B Ipratropium bromide 2 inhalations four times dailyCorrect Answer
C Long-term supplemental oxygen therapy
D Theophylline 300 mg three times daily B
A 67-year-old man presents to the clinic for a routine follow-up visit. He was diagnosed with
GOLD category B chronic obstructive pulmonary disease three years ago. He has had one mild
exacerbation in the past year but no hospitalizations. His initial presenting symptoms of
dyspnea and productive cough have improved significantly with daily use of inhaled tiotropium.
SpO2 with ambulation is 94%. The patient stopped smoking five years ago and carries a 35-year
pack history. He received pneumococcal conjugate vaccine one year ago. Which of the
following is the most appropriate additional step in management?
A Advise that pulmonary rehabilitation is ineffective
B Order pneumococcal polysaccharide vaccine
C Prescribe oxygen 2L/NC for use with ambulation
D Repeat dose of pneumococcal conjugate vaccine B
A 14-month-old girl presents to the office with a three-day history of rhinorrhea and low-grade
temperature. Today the patient has developed a cough and parents note some changes in her
breathing. She has no history of asthma or any other pulmonary problems. On examination,
there is diffuse wheezing, mild substernal retractions, and mild tachypnea. Which of the
following is the most likely diagnosis?
A Acute bronchiolitis
B Asthma exacerbation
C Bacterial pneumonia
D Croup A
What percentage of cases of bronchitis are viral? 90%
If your patient presenting with bronchitis symptoms has an elevated WBC and CRP, what would
your new diagnosis be? CAP
Treatment for bronchitis cough suppressants before bed to promote sleep, antihistamines
Mucoterm-46kinetics only if pt expectorating
Corticosteroids NOT recommended
Acute bronchitis s/s Cough with or without sputum
Wheezes, ronchi/coarse rales
Reduced FEV1 that improves with bronchodilator
Treatment parameters for Covid-19 Pt > 50 and unvaccinated
Any pt > 65
Any patient at high risk for severe disease (Cormibidities)
How soon should treatment for Covid-19 begin? within 48 hours of symptoms
Treatment options for Covid-19 Paxlovid: Outpatient, for mild to moderate symptoms; Has
many interactions; Possibility for rebound symptoms within 5-14 days of stopping; Renal
adjustment needed
Inpatient: Remdesivir, dexamethasone, bronchodilators/ICS, ASA
What is the #1 causative agent of PNA? Strep Pneumoniae
,What are the common PNA pathogens for COPD patients? H. Flu, P. Aeruginosa, Legionella,
S. pneumoniae, Maraxella Catarrhalis (MCAT), Chlamydophila Pneumoniae
What are the common PNA pathogens for ETOH users? S. Pneumoniae, Oral anaerobes
(Aspiration), Acinetobacter, Mycobacterium TB
What are the common PNA pathogens that form abcesses? Myobacterium TB, MRSA,
endemic fungi, atypical mycobacterium
What PNA pathogens would you find in someone who resides in or recently visited the
Southwest US? Coccidiodes species
What symptoms are more likely with atypical PNA's? HA and sore throat
What are your first line drugs of choice for treatment of CAP in a patient without PCN allergy?
No comorbids: Amoxicillin
With comorbids: Augmentin
A 65-year-old man is evaluated for a 2-year history of dyspnea on exertion. He reports dyspnea
and occasional wheezing mainly with increased exertion like climbing stairs or walking briskly
up an incline. He reports no chest pain. He has a 15-year history of well-controlled hypertension
and hyperlipidemia treated with amlodipine and atorvastatin. He has a 30 pack-year history of
smoking. On physical examination, his vital signs are normal. His lungs are clear to auscultation.
His laboratory work reveals a normal complete blood count and chemistry panel. Spirometry
shows a postbronchodilator FEV1 of 80% and FEV1/FVC ratio of 0.65. A chest radiograph and
electrocardiogram are both normal. What is the most appropriate initial treatment for this
patient?
A Inhaled corticosteroid and long-acting beta-agonist
B Long-acting beta-agonist
C Long-acting muscarinic antagonist
D Short-acting beta-agonist D
, A 54-year-old man with a 40 pack-year smoking history presents to the primary care office for a
follow-up for chronic cough that began 2 years ago. His recent spirometry testing revealed a
postbronchodilator FEV1/FVC ratio of 0.6 and an FEV1 of 75% of predicted normal. His oxygen
saturation is 92%. What is the most appropriate initial pharmacologic therapy for this patient?
A Budesonide nebulizer 2 mg four times daily
B Ipratropium bromide 2 inhalations four times dailyCorrect Answer
C Long-term supplemental oxygen therapy
D Theophylline 300 mg three times daily B
A 67-year-old man presents to the clinic for a routine follow-up visit. He was diagnosed with
GOLD category B chronic obstructive pulmonary disease three years ago. He has had one mild
exacerbation in the past year but no hospitalizations. His initial presenting symptoms of
dyspnea and productive cough have improved significantly with daily use of inhaled tiotropium.
SpO2 with ambulation is 94%. The patient stopped smoking five years ago and carries a 35-year
pack history. He received pneumococcal conjugate vaccine one year ago. Which of the
following is the most appropriate additional step in management?
A Advise that pulmonary rehabilitation is ineffective
B Order pneumococcal polysaccharide vaccine
C Prescribe oxygen 2L/NC for use with ambulation
D Repeat dose of pneumococcal conjugate vaccine B
A 14-month-old girl presents to the office with a three-day history of rhinorrhea and low-grade
temperature. Today the patient has developed a cough and parents note some changes in her
breathing. She has no history of asthma or any other pulmonary problems. On examination,
there is diffuse wheezing, mild substernal retractions, and mild tachypnea. Which of the
following is the most likely diagnosis?
A Acute bronchiolitis
B Asthma exacerbation
C Bacterial pneumonia
D Croup A
