NURS 602 Week 5 iHuman Case 3 - 200
Question Test Bank - Verified Answers &
Rationales (Paisley Ward & Gonzalez)
latest update 2026/2027
1. what is the most likely primary diagnosis for Paisley Ward, a 16-year-old presenting with a 3-
week history of non-productive cough and shortness of breath?
A) Acute Bronchitis
B) Acute Asthma Exacerbation
C) Viral Pneumonia
D) Panic Disorder
Answer: B
Rationale: Paisley presents with classic symptoms of asthma, including a cough that worsens
at night, shortness of breath on exertion, and a history of reactive airway disease and eczema,
which are common comorbidities in asthma patients.
2. During the history taking, Paisley mentions her shortness of breath is triggered by which of the
following?
A) Eating spicy food
B) Cold weather
C) Walking to class at school
D) Lying flat on her back
Answer: C
Rationale: Paisley specifically reports shortness of breath when walking to class, which is
relieved by resting for a minute, indicating exercise-induced bronchospasm as part of her
asthma presentation.
3. Which environmental risk factor is documented in Paisley's social history?
A) Household pets
B) Mold in the basement
C) Exposure to secondhand smoke
D) Use of illegal vaping products
Answer: C
, Rationale: Paisley reports that her father smokes and her neighbors smoke inside their
building, leading to constant secondhand smoke exposure, a known trigger for asthma.
4. What respiratory rate (RR) is recorded for Paisley, and how is it classified?
A) RR 16 (Normal)
B) RR 20 (High Normal)
C) RR 26 (Tachypnea)
D) RR 32 (Severe Tachypnea)
Answer: C
Rationale: A respiratory rate of 26 breaths per minute in a 16-year-old is elevated (tachypnea)
and indicates increased work of breathing during her exacerbation.
5. Upon physical examination of Paisley’s chest, what is the most significant finding?
A) Inspiratory crackles at the bases
B) Bilateral expiratory wheezing
C) Friction rub on the left side
D) Dullness to percussion
Answer: B
Rationale: Expiratory wheezing is the hallmark physical exam finding for asthma
exacerbations, representing narrowed airways and air trapping.
6. Which medication is the most appropriate first-line treatment for Paisley’s acute symptoms?
A) Oral Prednisone
B) Albuterol HFA MDI
C) Fluticasone (ICS)
D) Azithromycin
Answer: B
Rationale: Albuterol is a short-acting beta-agonist (SABA) used as a rescue inhaler to provide
rapid bronchodilation during an acute exacerbation.
7. What is the diagnostic significance of Paisley’s history of eczema?
A) It suggests a bacterial etiology.
B) It is part of the atopic triad associated with asthma.
C) It indicates poor hygiene.
D) It is unrelated to her respiratory symptoms.
Answer: B
Rationale: Eczema (atopic dermatitis), allergic rhinitis, and asthma form the "atopic triad,"
significantly increasing the likelihood of an asthma diagnosis in patients with chronic cough.
8. Which finding on a chest X-ray would be consistent with Paisley's asthma exacerbation?
A) Lobar consolidation
B) Pulmonary hyperinflation
C) Pleural effusion
D) Enlarged cardiac silhouette
Answer: B
Rationale: Hyperinflation on a chest X-ray is a common finding in asthma due to air trapping
in the distal airways during an exacerbation.
, 9. In teaching Paisley about her new Albuterol inhaler, what is the recommended frequency for
"rescue" use?
A) 2 puffs every hour until symptoms stop
B) 2 puffs every 4 to 6 hours as needed for wheezing
C) 1 puff every morning before school
D) 4 puffs only if she loses consciousness
Answer: B
Rationale: The standard rescue dose for Albuterol in an acute exacerbation is 2 puffs every 4-6
hours as needed for symptoms like SOB or wheezing.
10. What is the goal of assessing Paisley's Peak Expiratory Flow Rate (PEFR)?
A) To measure her oxygen saturation
B) To check for lung infections
C) To objectively measure the severity of airflow obstruction
D) To determine her heart rate
Answer: C
Rationale: PEFR provides an objective measurement of how well air is moving out of the lungs;
a significant drop from baseline or predicted values indicates airway narrowing.
Part 2: Case 3 - Jose Gonzalez (Infectious Diarrhea)
11. Jose Gonzalez, a 42-year-old male, presents with which primary chief complaint?
A) Chronic constipation
B) Diarrhea and abdominal pain for 3 days
C) Severe chest pain radiating to the jaw
D) Jaundice and itchy skin
Answer: B
Rationale: Jose's primary reason for the encounter is a 3-day history of frequent diarrhea and
associated abdominal soreness.
12. Which vital sign finding is indicative of Jose’s state of hydration?
A) Temperature of 98.6 F
B) Positive orthostatic hypotension
C) Respiratory rate of 18
D) Blood pressure of 140/90
Answer: B
Rationale: Jose has a blood pressure drop from 112/62 (lying) to 92/50 (standing), which is a
classic sign of dehydration and fluid loss due to diarrhea.
13. What recent event in Jose's history is a significant clue to the etiology of his symptoms?
A) He recently started a keto diet.
B) He traveled to Chicago for business meetings.
C) He began taking a new daily multivitamin.
D) He recently joined a local gym.
Answer: B
Question Test Bank - Verified Answers &
Rationales (Paisley Ward & Gonzalez)
latest update 2026/2027
1. what is the most likely primary diagnosis for Paisley Ward, a 16-year-old presenting with a 3-
week history of non-productive cough and shortness of breath?
A) Acute Bronchitis
B) Acute Asthma Exacerbation
C) Viral Pneumonia
D) Panic Disorder
Answer: B
Rationale: Paisley presents with classic symptoms of asthma, including a cough that worsens
at night, shortness of breath on exertion, and a history of reactive airway disease and eczema,
which are common comorbidities in asthma patients.
2. During the history taking, Paisley mentions her shortness of breath is triggered by which of the
following?
A) Eating spicy food
B) Cold weather
C) Walking to class at school
D) Lying flat on her back
Answer: C
Rationale: Paisley specifically reports shortness of breath when walking to class, which is
relieved by resting for a minute, indicating exercise-induced bronchospasm as part of her
asthma presentation.
3. Which environmental risk factor is documented in Paisley's social history?
A) Household pets
B) Mold in the basement
C) Exposure to secondhand smoke
D) Use of illegal vaping products
Answer: C
, Rationale: Paisley reports that her father smokes and her neighbors smoke inside their
building, leading to constant secondhand smoke exposure, a known trigger for asthma.
4. What respiratory rate (RR) is recorded for Paisley, and how is it classified?
A) RR 16 (Normal)
B) RR 20 (High Normal)
C) RR 26 (Tachypnea)
D) RR 32 (Severe Tachypnea)
Answer: C
Rationale: A respiratory rate of 26 breaths per minute in a 16-year-old is elevated (tachypnea)
and indicates increased work of breathing during her exacerbation.
5. Upon physical examination of Paisley’s chest, what is the most significant finding?
A) Inspiratory crackles at the bases
B) Bilateral expiratory wheezing
C) Friction rub on the left side
D) Dullness to percussion
Answer: B
Rationale: Expiratory wheezing is the hallmark physical exam finding for asthma
exacerbations, representing narrowed airways and air trapping.
6. Which medication is the most appropriate first-line treatment for Paisley’s acute symptoms?
A) Oral Prednisone
B) Albuterol HFA MDI
C) Fluticasone (ICS)
D) Azithromycin
Answer: B
Rationale: Albuterol is a short-acting beta-agonist (SABA) used as a rescue inhaler to provide
rapid bronchodilation during an acute exacerbation.
7. What is the diagnostic significance of Paisley’s history of eczema?
A) It suggests a bacterial etiology.
B) It is part of the atopic triad associated with asthma.
C) It indicates poor hygiene.
D) It is unrelated to her respiratory symptoms.
Answer: B
Rationale: Eczema (atopic dermatitis), allergic rhinitis, and asthma form the "atopic triad,"
significantly increasing the likelihood of an asthma diagnosis in patients with chronic cough.
8. Which finding on a chest X-ray would be consistent with Paisley's asthma exacerbation?
A) Lobar consolidation
B) Pulmonary hyperinflation
C) Pleural effusion
D) Enlarged cardiac silhouette
Answer: B
Rationale: Hyperinflation on a chest X-ray is a common finding in asthma due to air trapping
in the distal airways during an exacerbation.
, 9. In teaching Paisley about her new Albuterol inhaler, what is the recommended frequency for
"rescue" use?
A) 2 puffs every hour until symptoms stop
B) 2 puffs every 4 to 6 hours as needed for wheezing
C) 1 puff every morning before school
D) 4 puffs only if she loses consciousness
Answer: B
Rationale: The standard rescue dose for Albuterol in an acute exacerbation is 2 puffs every 4-6
hours as needed for symptoms like SOB or wheezing.
10. What is the goal of assessing Paisley's Peak Expiratory Flow Rate (PEFR)?
A) To measure her oxygen saturation
B) To check for lung infections
C) To objectively measure the severity of airflow obstruction
D) To determine her heart rate
Answer: C
Rationale: PEFR provides an objective measurement of how well air is moving out of the lungs;
a significant drop from baseline or predicted values indicates airway narrowing.
Part 2: Case 3 - Jose Gonzalez (Infectious Diarrhea)
11. Jose Gonzalez, a 42-year-old male, presents with which primary chief complaint?
A) Chronic constipation
B) Diarrhea and abdominal pain for 3 days
C) Severe chest pain radiating to the jaw
D) Jaundice and itchy skin
Answer: B
Rationale: Jose's primary reason for the encounter is a 3-day history of frequent diarrhea and
associated abdominal soreness.
12. Which vital sign finding is indicative of Jose’s state of hydration?
A) Temperature of 98.6 F
B) Positive orthostatic hypotension
C) Respiratory rate of 18
D) Blood pressure of 140/90
Answer: B
Rationale: Jose has a blood pressure drop from 112/62 (lying) to 92/50 (standing), which is a
classic sign of dehydration and fluid loss due to diarrhea.
13. What recent event in Jose's history is a significant clue to the etiology of his symptoms?
A) He recently started a keto diet.
B) He traveled to Chicago for business meetings.
C) He began taking a new daily multivitamin.
D) He recently joined a local gym.
Answer: B
