NURS 5461 Final Exam - Questions With Fully
Explained Solutions
Cough Treatment Right Ans - Treat primary cause
Get rid of the source, the cough goes away
Soothe cough
Dextromethorophan
Inhaled meds- Ipratropium
Benzonatate
Codeine-last resort
Hemoptysis most common causes Right Ans - inflammatory—bronchitis,
bronchiectasis, pneumonia, TB
A cough can last how long sometimes after a URI? Right Ans - up to 8 weeks
Acute bronchitis Right Ans - a temporary inflammation of the mucous
membranes that line the trachea and bronchial passageways; causes a cough
that may produce mucus
5th most common cause of to see a HCP
Pneumonia symptoms Right Ans - -coughing
-fatigue
-pleuritic pain
-fever
-increased WBC
-rust colored sputum
-crackles
-tachypnea
CURB-65 Right Ans - 1) Confusion
2) BUN>19
3) RR>30
4) BP<90/60
5) 65yo
One or less indicates patient can be treated outpatient, >1 =hospitalization
Single Pulmonary Nodule Right Ans - "Coin lesion"
, A single parenchymal lung lesion smaller than 3cm W/O PNA , atelectasis, or
lymphadenopathy
Pure subsolid SPN < 5mm require no follow-up
if SPN < 8mm follow Fleischner Society guidelines on intervals for repeat CT
If SPN >8mm refer specialist
Sleep apnea Right Ans - a sleep disorder characterized by temporary
cessations of breathing during sleep and repeated momentary awakenings
Central apneas—absent airflow and respiratory efforts-Neurological diseases
Obstructive apneas [OSA]-Tongue and soft palate fall backward
What is the definitive test for sleep apnea Right Ans - Overnight
Polysomnogram
Age Related Pulmonary Changes Right Ans - • Reduced airway size
•Shallow alveolar sacs
•Decline in chest wall compliance
• Intercostal muscle atrophy
• Reduction in diaphragmatic strength by 25%
Who or when should you consider silent aspiration Right Ans - Consider
possibility of silent aspiration, especially in those with frequent pneumonias,
neurologic deficits, or residence in extended-care facilities
Initial Therapies for Asthma and COPD Right Ans - Asthma: never use LABA
without ICS
COPD: start treatment with LABA and/or LAMA, without ICS
What recommendation does GINA make for controllers? Right Ans - GINA
recommends treatment with low-dose ICS for most patients with asthma,
even those with infrequent symptoms, to reduce the risk of serious
exacerbations.
GINA stepwise approach for Asthma Right Ans - 1. Consider low dose ICS,
PRN SABA
2. Low dose ICS or LTRA, PRN SABA
3. Low dose ICS/LABA, PRN SABA or ICS/Formoterol
4. Med/High dose ICS/LABA, same
Explained Solutions
Cough Treatment Right Ans - Treat primary cause
Get rid of the source, the cough goes away
Soothe cough
Dextromethorophan
Inhaled meds- Ipratropium
Benzonatate
Codeine-last resort
Hemoptysis most common causes Right Ans - inflammatory—bronchitis,
bronchiectasis, pneumonia, TB
A cough can last how long sometimes after a URI? Right Ans - up to 8 weeks
Acute bronchitis Right Ans - a temporary inflammation of the mucous
membranes that line the trachea and bronchial passageways; causes a cough
that may produce mucus
5th most common cause of to see a HCP
Pneumonia symptoms Right Ans - -coughing
-fatigue
-pleuritic pain
-fever
-increased WBC
-rust colored sputum
-crackles
-tachypnea
CURB-65 Right Ans - 1) Confusion
2) BUN>19
3) RR>30
4) BP<90/60
5) 65yo
One or less indicates patient can be treated outpatient, >1 =hospitalization
Single Pulmonary Nodule Right Ans - "Coin lesion"
, A single parenchymal lung lesion smaller than 3cm W/O PNA , atelectasis, or
lymphadenopathy
Pure subsolid SPN < 5mm require no follow-up
if SPN < 8mm follow Fleischner Society guidelines on intervals for repeat CT
If SPN >8mm refer specialist
Sleep apnea Right Ans - a sleep disorder characterized by temporary
cessations of breathing during sleep and repeated momentary awakenings
Central apneas—absent airflow and respiratory efforts-Neurological diseases
Obstructive apneas [OSA]-Tongue and soft palate fall backward
What is the definitive test for sleep apnea Right Ans - Overnight
Polysomnogram
Age Related Pulmonary Changes Right Ans - • Reduced airway size
•Shallow alveolar sacs
•Decline in chest wall compliance
• Intercostal muscle atrophy
• Reduction in diaphragmatic strength by 25%
Who or when should you consider silent aspiration Right Ans - Consider
possibility of silent aspiration, especially in those with frequent pneumonias,
neurologic deficits, or residence in extended-care facilities
Initial Therapies for Asthma and COPD Right Ans - Asthma: never use LABA
without ICS
COPD: start treatment with LABA and/or LAMA, without ICS
What recommendation does GINA make for controllers? Right Ans - GINA
recommends treatment with low-dose ICS for most patients with asthma,
even those with infrequent symptoms, to reduce the risk of serious
exacerbations.
GINA stepwise approach for Asthma Right Ans - 1. Consider low dose ICS,
PRN SABA
2. Low dose ICS or LTRA, PRN SABA
3. Low dose ICS/LABA, PRN SABA or ICS/Formoterol
4. Med/High dose ICS/LABA, same
