MN 568 MIDTERM EXAM ACTUAL EXAM
180 QUESTIONS AND CORRECT
DETAILED ANSWERS
You are doing a cerumen extraction and touch the external meatus of your
pt's ear. He winces and starts coughing. What is the name of this reflex? -
✔✔Arnold Reflex
Sam, age 78, presents to the clinic w/respiratory symptoms. His PFTs are
as follows: normal total lung capacity, decreased PaO2, increased PaCO2.
On assessment, you auscultate course crackles and forced expiratory
wheezes. What is your dx? - ✔✔Chronic Bronchitis
George has COPD and an 80% forced expiratory volume in 1 second. How
would you classify the severity of his COPD? - ✔✔Stage 1 mild COPD
African American pt's seems to have a negative reaction to which of the
following asthma meds? - ✔✔Long-term beta-agonist bronchodilators
1
©NINJANERD 2025/2026. YEAR PUBLISHED 2025.
,You are using the CURB-65 clinical prediction tool to decide whether
Mabel, whom you have diagnosed with community-acquired pneumonia
(CAP), should be hospitalized or treated at home. Her score is 3. What
should you do? - ✔✔Hospitalize and consider admitting her to the ICU
Why do you suspect that your pt may have a decreased response to the TB
test? - ✔✔She has been on long-term corticosteroid therapy
Marci has been started on a TB regimen. Because isoniazid (INH) may
cause peripheral neuropathy, you consider ordering which of the following
drugs prophilactically? - ✔✔Pyroxidine
Jolene has breast cancer that has been staged as T1, N0, M0. What might
this mean?
A. The tumor size cannot be evaluated; the cancer has not spread to the
lymph nodes; and the distant spread cannot be evaluated.
B. The cancer is in situ; it is spreading into the lymph nodes but the spread
cannot be evaluated otherwise.
C. The cancer is less than 3 cm in size and has not spread to the lymph
nodes or other parts of the body.
2
©NINJANERD 2025/2026. YEAR PUBLISHED 2025.
,D. The cancer is about 5 cm in size; nearby lymph nodes cannot be
evaluated; and there is no evidence of distant spreading. - ✔✔The cancer
is less than 3cm in size and has not spread to the lymph nodes or other
parts of the body
Nathan, a 32yo policeman, has a 15-pack-year history of smoking and
continues to smoke heavily. During every visit, he gets irate when you try to
talk to him about quitting. What should you do? - ✔✔Continue to ask him at
every visit if he is ready to quit
Your pt has decided to try to quit smoking with Chantix. You are discussing
his quit date and he will begin taking the med tomorrow. When should he
plan to quit smoking? - ✔✔His quit date should be in 1 week
Which info should be included when you are teaching your pt about the use
of nicotine gum? - ✔✔The gum must be correctly chewed to a softened
state and then placed in the buccal mucosa
Cydney presents with a h/o asthma. She has not been treated for a while.
She c/o daily but not continual symptoms, greater than 1 week and at
nighttime. She has been using her rescue inhaler. Her FEV1 is 60-80%
3
©NINJANERD 2025/2026. YEAR PUBLISHED 2025.
, predicted. How would you classify her asthma severity? - ✔✔Moderate
persistent
Joyce is taking a long-acting beta agonist for her asthma. What additional
med should she be taking? - ✔✔Inhaled corticosteroid
Your pt is on theophylline (Therabid) for his asthma. You want to maintain
his serum levels between: - ✔✔5-15mcg/mL
Which of the following statements regarding TST is true? - ✔✔The size of
the TST reaction has nothing to do with erythema but is based solely on
induration
Which obstructive lung disease is classified as reversible? - ✔✔asthma
You have taught Jennifer, age 15, about using a flow meter to assess how
to manage her asthma exacerbations. She calls you today because her
peak expiratory flow rate is 65%. What would you tell her? - ✔✔Use your
rescue inhaler, begin the Rx of PO glucocorticoids you have, and call back
tomorrow."
Which statement about adenocarcinoma of the lung is accurate? - ✔✔It is
the most prevalent carcinoma of the lungs in both sexes and in
nonsmokers, representing 35-40% of all tumors
4
©NINJANERD 2025/2026. YEAR PUBLISHED 2025.
180 QUESTIONS AND CORRECT
DETAILED ANSWERS
You are doing a cerumen extraction and touch the external meatus of your
pt's ear. He winces and starts coughing. What is the name of this reflex? -
✔✔Arnold Reflex
Sam, age 78, presents to the clinic w/respiratory symptoms. His PFTs are
as follows: normal total lung capacity, decreased PaO2, increased PaCO2.
On assessment, you auscultate course crackles and forced expiratory
wheezes. What is your dx? - ✔✔Chronic Bronchitis
George has COPD and an 80% forced expiratory volume in 1 second. How
would you classify the severity of his COPD? - ✔✔Stage 1 mild COPD
African American pt's seems to have a negative reaction to which of the
following asthma meds? - ✔✔Long-term beta-agonist bronchodilators
1
©NINJANERD 2025/2026. YEAR PUBLISHED 2025.
,You are using the CURB-65 clinical prediction tool to decide whether
Mabel, whom you have diagnosed with community-acquired pneumonia
(CAP), should be hospitalized or treated at home. Her score is 3. What
should you do? - ✔✔Hospitalize and consider admitting her to the ICU
Why do you suspect that your pt may have a decreased response to the TB
test? - ✔✔She has been on long-term corticosteroid therapy
Marci has been started on a TB regimen. Because isoniazid (INH) may
cause peripheral neuropathy, you consider ordering which of the following
drugs prophilactically? - ✔✔Pyroxidine
Jolene has breast cancer that has been staged as T1, N0, M0. What might
this mean?
A. The tumor size cannot be evaluated; the cancer has not spread to the
lymph nodes; and the distant spread cannot be evaluated.
B. The cancer is in situ; it is spreading into the lymph nodes but the spread
cannot be evaluated otherwise.
C. The cancer is less than 3 cm in size and has not spread to the lymph
nodes or other parts of the body.
2
©NINJANERD 2025/2026. YEAR PUBLISHED 2025.
,D. The cancer is about 5 cm in size; nearby lymph nodes cannot be
evaluated; and there is no evidence of distant spreading. - ✔✔The cancer
is less than 3cm in size and has not spread to the lymph nodes or other
parts of the body
Nathan, a 32yo policeman, has a 15-pack-year history of smoking and
continues to smoke heavily. During every visit, he gets irate when you try to
talk to him about quitting. What should you do? - ✔✔Continue to ask him at
every visit if he is ready to quit
Your pt has decided to try to quit smoking with Chantix. You are discussing
his quit date and he will begin taking the med tomorrow. When should he
plan to quit smoking? - ✔✔His quit date should be in 1 week
Which info should be included when you are teaching your pt about the use
of nicotine gum? - ✔✔The gum must be correctly chewed to a softened
state and then placed in the buccal mucosa
Cydney presents with a h/o asthma. She has not been treated for a while.
She c/o daily but not continual symptoms, greater than 1 week and at
nighttime. She has been using her rescue inhaler. Her FEV1 is 60-80%
3
©NINJANERD 2025/2026. YEAR PUBLISHED 2025.
, predicted. How would you classify her asthma severity? - ✔✔Moderate
persistent
Joyce is taking a long-acting beta agonist for her asthma. What additional
med should she be taking? - ✔✔Inhaled corticosteroid
Your pt is on theophylline (Therabid) for his asthma. You want to maintain
his serum levels between: - ✔✔5-15mcg/mL
Which of the following statements regarding TST is true? - ✔✔The size of
the TST reaction has nothing to do with erythema but is based solely on
induration
Which obstructive lung disease is classified as reversible? - ✔✔asthma
You have taught Jennifer, age 15, about using a flow meter to assess how
to manage her asthma exacerbations. She calls you today because her
peak expiratory flow rate is 65%. What would you tell her? - ✔✔Use your
rescue inhaler, begin the Rx of PO glucocorticoids you have, and call back
tomorrow."
Which statement about adenocarcinoma of the lung is accurate? - ✔✔It is
the most prevalent carcinoma of the lungs in both sexes and in
nonsmokers, representing 35-40% of all tumors
4
©NINJANERD 2025/2026. YEAR PUBLISHED 2025.
