Albany State University | NURS 5410 Feedback Davis Edge #6 Score: 25 / 25 | 2025/2026

Questions 1 to 25 of 25  1  Feedback Davis Edge #6 Score: 25 / 25 Feedback Report Question 1. Barrel chest occurs with: Rationales [Page Reference: 479] Course Topic: Respiratory Problems | Area of Practice: Adult-Gerontology Primary Care, Family Practice | APN Knowledge Area: Health Assessment | Testing Domain: Assess | Cognitive Level: Comprehension [Understanding] Question 2. Which of the following medications prescribed for asthma prevents binding of IgE receptors on basophils and mast cells? Rationales [Page Reference: 474]   1. Emphysema. 2. Pneumonia. 3. Pleural effusion. 4. Lung tumor. Option 1: The hyperinflation of emphysematous lung may produce the “barrel chest” that is less often associated with chronic bronchitis. Option 2: A dull sound on percussion indicates an abnormal density in the lungs, such as occurs with pneumonia, pleural effusion, a lung tumor, or atelectasis. Option 3: A dull sound on percussion indicates an abnormal density in the lungs, such as occurs with pneumonia, pleural effusion, a lung tumor, or atelectasis. Option 4: A dull sound on percussion indicates an abnormal density in the lungs, such as occurs with pneumonia, pleural effusion, a lung tumor, or atelectasis.  1. Anti-inflammatory agents 2. Bronchodilators 3. Mast cell stabilizers  4. Immunomodulators Option 1: Anti-inflammatory agents calm inflammation. Option 2: Bronchodilators dilate the bronchi. Option 3: Mast cell stabilizers stabilize mast cells and interfere with chloride channel function. Option 4: Immunomodulators such as omalizumab (Xolair), a monoclonal antibody, prevent binding of IgE receptors on basophils and mast cells. 3/19/25, 10:44 AM Feedback Pharmacological Therapy and Polypharmacy | Testing Domain: Plan | Cognitive Level: Comprehension [Understanding] Question 3. A 23-year-old college student presents to your primary care clinic complaining of the following symptoms: fever for 4 days that is controlled with Tylenol, nonproductive cough, general malaise and fatigue, and minimal rhinorrhea. The patient did not get a flu shot this year and states his girlfriend was diagnosed with the flu 3 days ago. His rapid influenza test is positive. What is the best treatment? Rationales [Page Reference: 435] Course Topic: Respiratory Problems | Area of Practice: Adult-Gerontology Acute Care, Family Practice, Adult-Gerontology Primary Care | APN Knowledge Area: Disease Management | Testing Domain: Plan | Cognitive Level: Application [Applying] Question 4. Mary, age 69, has chronic obstructive pulmonary disease (COPD). Her oxygen saturation is less than 85%. She is to start on oxygen therapy to relieve her symptoms. How often must she be on oxygen therapy to actually improve her oxygen saturation? Rationales [Page Reference: 483]   1. Rest and hydration 2. Oseltamivir 3. Inpatient hospitalization for supportive care 4. Azithromycin Option 1: This is the treatment of choice for influenza. At this point, the patient's symptoms have been present too long to give him Tamiflu. Option 2: This can be given as treatment for the flu within the first 48 hours of symptoms only. Option 3: In patients with chronic obstructive pulmonary disease (COPD) or other significant medical comorbidities, hospitalization can be considered. Option 4: The patient has the flu, which is a viral infection.  1. On an as-needed basis 2. 6 to 12 hours per day  3. 15 hours per day 4. 24 hours per day Option 1: Because Mary's oxygen saturation is less than 85%, oxygen must be used at least 15 hours per day to be of more than symptomatic benefit. Option 2: Because Mary's oxygen saturation is less than 85%, oxygen must be used at least 15 hours per day to be of more than symptomatic benefit. Option 3: To decrease mortality in patients with COPD whose oxygen saturations are less than 85%, oxygen must be used at least 15 hours per day to be of more than symptomatic benefit. The oxygen can be either a specific concentration delivered by mask or a flow rate administered through a nasal cannula. It is needed to maintain adequate oxygenation levels during both activity and rest. The goal of therapy is a Pao2 of 60 mm Hg or Sao2 of 90%. Option 4: Because Mary's oxygen saturation is less than 85%, oxygen must be used at least 15 hours per day to be of more than symptomatic benefit. 3/19/25, 10:44 AM Feedback Disease Management | Testing Domain: Plan | Cognitive Level: Application [Applying] Question 5. Which of the following conditions is characterized by intermittent episodes of airway obstruction caused by bronchospasm, excessive bronchial secretions, or edema of bronchial mucosa? Rationales [Page Reference: 466] Course Topic: Respiratory Problems | Area of Practice: Family Practice, Pediatrics, Adult-Gerontology Primary Care | APN Knowledge Area: Pathophysiology | Testing Domain: Assess | Cognitive Level: Comprehension [Understanding] Question 6. A 55-year-old man in your primary care clinic complains of a cough for 3 months. He has diabetes and is currently taking lisinopril, atorvastatin, and metformin. He denies dyspnea, chest pain, and productive cough. He was recently diagnosed with diabetes and has started all 3 of these medications within the last 4 months. The patient's vital signs are within normal limits, and his chest x-ray is negative. What is the etiology of the patient's cough? Rationales [Page Reference: 417]   1. Asthma 2. Atelectasis 3. Acute bronchitis 4. Emphysema Option 1: Asthma is characterized by intermittent episodes of airway obstruction caused by bronchospasm, excessive bronchial secretions, or edema of bronchial mucosa. Option 2: Atelectasis is a collapse of alveolar lung tissue, and findings reflect the presence of a small, airless lung. It is caused by complete obstruction of a draining bronchus by a tumor, thick secretions, or an aspirated foreign body. Option 3: Acute bronchitis is an inflammation of the bronchial tree characterized by partial bronchial obstruction and secretions or constrictions. It results in abnormally deflated portions of the lung. Option 4: Emphysema is a permanent hyperinflation of lung beyond the terminal bronchioles with destruction of the alveolar walls.  1. Upper respiratory infection (URI) 2. Walking pneumonia  3. Lisinopril 4. Sinus infection Option 1: The patient's symptoms have been present for 3 months; this is not the course taken by a viral URI. Option 2: The patient has no fever or productive cough and has a normal chest x-ray. Option 3: The patient has had a chronic cough for approximately as long as he has been taking his angiotensin-converting enzyme (ACE) inhibitor, so it is likely a side effect of this medication. Option 4: The patient doesn't have facial pain or congestion. 3/19/25, 10:44 AM Feedback Practice | APN Knowledge Area: Pharmacological Therapy and Polypharmacy | Testing Domain: Diagnose | Cognitive Level: Analysis [Analyzing] Question 7. Keaton, age 6, comes to the clinic with his mother for a 3-month follow-up visit for his asthma. His mother reports he has symptoms 2 days a week but not more than once each day, he has had only 1 episode of nighttime awakening because of his asthma, he is able to play soccer without provoking an attack, and his peak flow personal best is 80% or higher. His current treatment includes a short-acting beta agonist and a leukotriene receptor antagonist. Based on the level of control, your plan for adjusting therapy includes: Rationales [Page Reference: 470] Course Topic: Respiratory Problems | Area of Practice: Pediatrics, Family Practice | APN Knowledge Area: Disease Management | Testing Domain: Evaluate | Cognitive Level: Evaluation [Evaluating] Question 8. You are teaching Holly, age 14, who has asthma, to use a home peak expiratory flow meter daily to measure gross changes in peak expiratory flow. Which zone would rate her expiratory compliance as 50% to 80% of her personal best? Rationales  1. Considering a short course of oral systemic corticosteroids. 2. Stepping up 1 step. 3. Stepping up 2 steps.  4. Maintaining the current step. Option 1: For very poorly controlled asthma, recommendations include considering a short course of oral systemic corticosteroids and stepping up 1 to 2 steps. Option 2: For asthma that is not well controlled, step up at least 1 step and consider 1 to 2 steps in patients aged 12 and older. Option 3: For asthma that is not well controlled, step up at least 1 step and consider 1 to 2 steps in patients aged 12 and older. Option 4: Keaton's asthma symptoms are well controlled, and he is at step 2. Recommendations for well-controlled asthma include maintaining the current step, following up every 1 to 6 months, and considering a step down if the asthma is well controlled for at least 3 months.  1. White zone 2. Green zone  3. Yellow zone 4. Red zone Option 1: There is no white zone. Option 2: A green zone (80%–100% of her personal best) indicates no asthma symptoms are present and she should continue with her normal medication regimen. Option 3: Holly should perform a peak expiratory flow meter reading daily during a 2-week period when she feels well. The highest number recorded during this period is her personal best. A yellow zone (50%–80% of her personal best) indicates asthma symptoms may be starting, and signals caution. Option 4: A red zone (below 50% of her personal best) indicates that an asthma attack is occurring and that Holly should take her inhaled beta-2 agonist and repeat the peak flow assessment. 3/19/25, 10:44 AM Feedback Course Topic: Respiratory Problems | Area of Practice: Family Practice, Pediatrics, Adult-Gerontology Primary Care | APN Knowledge Area: Differential Diagnosis Clinical Decision Making | Testing Domain: Diagnose | Cognitive Level: Analysis [Analyzing] Question 9. What do you include in your teaching about tiotropium (Spiriva) when you initially prescribe it for your patient with chronic obstructive pulmonary disease (COPD)? Rationales [Page Reference: 481] Course Topic: Respiratory Problems | Area of Practice: Adult-Gerontology Primary Care, Family Practice | APN Knowledge Area: Pharmacological Therapy and Polypharmacy | Testing Domain: Plan | Cognitive Level: Application [Applying] Question 10. Sherri, age 49, has had asthma for several years but has never used a peak expiratory flow (PEF) meter. Should you now recommend it? Rationales [Page Reference: 469]  1. “Use it every time you use your beta-2 agonist.” 2. “Stop taking all your other COPD medications.”  3. “Use it once per day.” 4. “Stop taking Spiriva if you develop the adverse effect of dry mouth.” Option 1: The patient may use a beta-2 agonist several times per day, as tiotropium is not for the relief of acute symptoms. Option 2: The patient should certainly not stop taking other medications until the clinician sees the effectiveness of tiotropium. Option 3: Tiotropium (Spiriva) is a once-daily, long-acting anticholinergic. It results in improved lung function and reduction in both COPD exacerbations and the use of rescue medication. Option 4: The most frequently reported adverse side effect is dry mouth, which is easily remedied with increased hydration.  1. No, she has been managing fine without it.  2. Yes, she might recognize early signs of a potential respiratory problem. 3. Present the options and let Sherri decide. 4. No, at her age it is not recommended. Option 1: Daily peak flow monitoring has long been recommended for patients with asthma. Daily PEF monitoring could help Sherri recognize early signs of deterioration in airway function so that corrective steps can be initiated. Option 2: Daily peak flow monitoring has long been recommended for patients with asthma. Guidelines from the National Asthma Education and Prevention Program of the National Heart, Lung, and Blood Institute increase the flexibility of this recommendation and suggest that the use of peak flow measurements be individualized. The guidelines recommend that all patients with persistent asthma assess peak flow each morning. Subsequent assessments are necessary during the day when the morning measurement is less than 80% of the patient's personal best PEF measurement. The goal of daily PEF monitoring is to recognize early signs of deterioration in airway function so that corrective steps can be initiated. Option 3: Daily peak flow monitoring has long been recommended for patients with asthma. Option 4: Daily peak flow monitoring has long been recommended for patients with asthma. 3/19/25, 10:44 AM Feedback Health Promotion and Patient Education | Testing Domain: Plan | Cognitive Level: Application [Applying] | IsInstructorOnly: Yes Question 11. Dennis, age 54, has chronic obstructive pulmonary disease (COPD). He has recently been having difficulty in breathing. His arterial blood gas reveals pH 7.3, Pao 57 mm Hg, Paco 54 mm Hg, and oxygen saturation 84%. Dennis has: Rationales [Page Reference: 479] Course Topic: Respiratory Problems | Area of Practice: Adult-Gerontology Acute Care, Adult-Gerontology Primary Care, Family Practice | APN Knowledge Area: Diagnostic Tests and Therapeutic Procedures | Testing Domain: Diagnose | Cognitive Level: Analysis [Analyzing] Question 12. Marci, age 15, has been given a diagnosis of step 1 (intermittent) asthma. What long-term control therapy is indicated? Rationales [Page Reference: 470] Course Topic: Respiratory Problems | Area of Practice: Pediatrics, Family Practice | APN Knowledge Area: Pharmacological Therapy and Polypharmacy | Testing Domain: Plan | Cognitive Level: Application [Applying] 2 2   1. Respiratory acidosis. 2. Respiratory alkalosis. 3. Metabolic acidosis. 4. Metabolic alkalosis. Option 1: Respiratory acidosis results when the serum Paco is more than 45 mm Hg and the serum pH is lower than 7.35. It occurs when there is a reduction in the rate of alveolar ventilation in relation to the rate of carbon dioxide production. The result is an accumulation of dissolved carbon dioxide, or carbonic acid. Dennis's COPD leads to alveolar hypoventilation with an acute retention of carbon dioxide, resulting in acute respiratory acidosis. 2 Option 2: With respiratory alkalosis, hyperventilation is usually evident, the Paco2 is less than 35 mm Hg, and the pH is higher than 7.45. Option 3: In metabolic acidosis, the Hco3 is less than 22 mEq/L and the pH is lower than 7.35. Option 4: In metabolic alkalosis, the Hco3 is more than 26 mEq/L and the pH is higher than 7.45.   1. None 2. A single agent with anti-inflammatory activity 3. An inhaled corticosteroid with the addition of a long-acting bronchodilator if needed 4. Multiple long-term control medications with oral corticosteroids if needed Option 1: No long-term control therapy is indicated for patients with step 1 (intermittent) asthma, be they children, adolescents, or adults. Patients with step 1 asthma require only quick relief with a beta-2 agonist as needed. Option 2: There is no indication for long-term control until patients approach step 2 (mild persistent) asthma. Option 3: There is no indication for long-term control until patients approach step 2 (mild persistent) asthma. Option 4: There is no indication for long-term control until patients approach step 2 (mild persistent) asthma. 3/19/25, 10:44 AM Feedback pulmonary disease (COPD)? Rationales [Page Reference: 476] Course Topic: Respiratory Problems | Area of Practice: Adult-Gerontology Acute Care, Adult-Gerontology Primary Care, Family Practice | APN Knowledge Area: Population Health and Epidemiology | Testing Domain: Assess | Cognitive Level: Knowledge [Remembering] Question 14. Jill, age 49, has daily symptoms of asthma. She uses her inhaled shortacting beta-2 agonist daily. Her exacerbations affect her activities, and they occur at least twice weekly and may last for days. She is affected more than once weekly during the night with an exacerbation. Which category of asthma severity is Jill in? Rationales [Page Reference: 468] Course Topic: Respiratory Problems | Area of Practice: Adult-Gerontology Primary Care, Family Practice | APN Knowledge Area: Differential Diagnosis Clinical Decision Making | Testing Domain: Diagnose | Cognitive Level: Analysis [Analyzing] Question 15. Which of the following is not a risk factor for the development of asthma?   1. Cigarette smoking 2. Air pollution 3. Work exposure 4. Asthma Option 1: Smoking is responsible for 80% to 90% of COPD cases. Option 2: This increases risk of COPD but not as much as smoking. Option 3: Exposure to certain chemicals and gases in work environments increases risk of COPD but not as much as smoking. Option 4: Asthma doesn't increase the risk of COPD.  1. Intermittent 2. Mild persistent  3. Moderate persistent 4. Severe persistent Option 1: In step 1 (intermittent) asthma, daily symptoms are no more frequent than twice weekly and nocturnal symptoms are no more frequent than twice monthly. Option 2: In step 2 (mild persistent) asthma, daily symptoms are more frequent than twice weekly but less than once a day, exacerbations may affect activity, and nocturnal symptoms occur more than twice monthly. Option 3: Jill is in the step 3 (moderate persistent) category of asthma severity. This is because she has daily symptoms, with exacerbations affecting her activity, and nocturnal symptoms that occur more than once weekly. Option 4: In step 4 (severe persistent) asthma, the patient has continuous symptoms, with limited physical activity, frequent exacerbations, and frequent nocturnal symptoms.  1. Younger age 3/19/25, 10:44 AM Feedback [Page Reference: 465] Course Topic: Respiratory Problems | Area of Practice: Pediatrics, Adult-Gerontology Acute Care, Adult-Gerontology Primary Care, Family Practice | APN Knowledge Area: Population Health and Epidemiology | Testing Domain: Assess | Cognitive Level: Knowledge [Remembering] Question 16. What is a common inhaled allergen in allergic asthma (extrinsic asthma)? Rationales [Page Reference: 466] Course Topic: Respiratory Problems | Area of Practice: Pediatrics, Family Practice, Adult-Gerontology Primary Care | APN Knowledge Area: Pathophysiology | Testing Domain: Assess | Cognitive Level: Comprehension [Understanding] Question 17. When you suspect a diagnosis of asthma, which test is the most appropriate to order to confirm the diagnosis? Rationales 2. African American race 3. Female gender  4. Obesity Option 1: People ages 5 to 17 have the highest risk of asthma. Option 2: African Americans have a 47% increased risk of asthma compared with other races. Option 3: Women have a higher risk of developing asthma than men. Option 4: Obesity has no bearing on asthma development.  1. Smoke 2. Cold air 3. Strong smells  4. Pet dander Option 1: Smoke is a nonallergic asthma trigger. Option 2: Cold air is a nonallergic asthma trigger. Option 3: Strong smells are a nonallergic asthma trigger. Option 4: Allergic asthma (extrinsic asthma) is a chronic inflammatory disorder of the airways. The symptoms of allergic and nonallergic asthma are the same, but the triggers are not. Allergic asthma is triggered by exposure to inhaled allergens. The most common of these are dust mites, pet dander, pollen, mold, grass, and ragweed. Nonallergic asthma triggers generally do not cause inflammation but can aggravate airways, especially if they are already inflamed. Nonallergic triggers include smoke, exercise, cold air, strong smells like chemicals and perfume, air pollutants, and intense emotions.  1. Chest x-ray  2. Spirometry 3. Bronchoprovocation 4. Bronchoscopy Option 1: This is normal in most people with asthma. 3/19/25, 10:44 AM Feedback Course Topic: Respiratory Problems | Area of Practice: Pediatrics, Adult-Gerontology Acute Care, Family Practice, Adult-Gerontology Primary Care | APN Knowledge Area: Diagnostic Tests and Therapeutic Procedures | Testing Domain: Diagnose | Cognitive Level: Knowledge [Remembering] Question 18. What is the gold standard for the diagnosis of asthma? Rationales [Page Reference: 467] Course Topic: Respiratory Problems | Area of Practice: Family Practice, Pediatrics, Adult-Gerontology Primary Care | APN Knowledge Area: Diagnostic Tests and Therapeutic Procedures | Testing Domain: Diagnose | Cognitive Level: Comprehension [Understanding] Question 19. You have been counseling your patient about her asthma. You realize she does not understand your suggestions when she tells you she will do which of the following? Rationales Option 2: This is the best way to diagnose asthma. Option 3: This is best used when spirometry is nondiagnostic. Option 4: This is the procedure of choice for infectious or oncological pathology testing.  1. Validated quality-of-life questionnaire 2. Patient's perception of clogged airways  3. Spirometry 4. Bronchoscopy Option 1: Routine use of validated quality-of-life questionnaires may detect impairment and severity of the disease. Option 2: The patient's perception may be greatly exaggerated. Option 3: Spirometry remains the gold standard for the diagnosis of asthma as well as for periodic monitoring of the condition. Option 4: A bronchoscopy may be necessary to diagnose several conditions, including a chronic cough or infection. If a patient is not having an asthma attack, the airways may not appear constricted.  1. Cover the mattress and pillows in airtight, dustproof covers. 2. Wash the bedding weekly and dry it on a hot setting for 20 minutes. 3. Avoid sleeping on natural fibers such as wool or down.  4. Avoid onions and garlic in her diet. Option 1: This is a recommended measure to control dust mites, a common asthma trigger. Option 2: This is a recommended measure to control dust mites, a common asthma trigger. Option 3: This is a recommended measure to control dust mites, a common asthma trigger. Option 4: Onions and garlic have demonstrated some protection against allergic responses and may be beneficial; at the very least they are not to be avoided. 3/19/25, 10:44 AM Feedback Course Topic: Respiratory Problems | Area of Practice: Pediatrics, Family Practice, Adult-Gerontology Primary Care | APN Knowledge Area: Health Promotion and Patient Education | Testing Domain: Plan | Cognitive Level: Application [Applying] Question 20. In trying to differentiate between chronic bronchitis and emphysema, you know that chronic bronchitis: Rationales [Page Reference: 478] Course Topic: Respiratory Problems | Area of Practice: Adult-Gerontology Primary Care, Family Practice | APN Knowledge Area: Differential Diagnosis Clinical Decision Making | Testing Domain: Diagnose | Cognitive Level: Comprehension [Understanding] Question 21. Cough and congestion result when breathing: Rationales [Page Reference: 417] Course Topic: Respiratory Problems | Area of Practice: Pediatrics, Family Practice, Adult-Gerontology Primary Care |  1. Usually occurs after age 50 and has insidious progressive dyspnea. 2. Usually presents with a cough that is mild and with scant, clear sputum, if any.  3. Presents with adventitious sounds, wheezing and rhonchi, and a normal percussion note. 4. Results in an increased total lung capacity with a markedly increased residual volume. Option 1: In a patient with emphysema, the onset is usually after age 50. Option 2: In a patient with emphysema, there is an insidious progressive dyspnea, and the cough is usually absent or mild with scant, clear sputum, if any. There are also distant or diminished breath sounds and a hyperresonant percussion note. With chronic bronchitis, there is usually copious mucopurulent sputum. Option 3: In trying to differentiate between chronic bronchitis and emphysema, remember that chronic bronchitis presents with adventitious sounds, wheezing and rhonchi, and a normal percussion note. Chronic bronchitis usually occurs after age 35, with recurrent respiratory infections. There is usually a persistent cough productive of copious mucopurulent sputum, and pulmonary function studies show normal or decreased total lung capacity with a moderately increased residual volume. Option 4: In a patient with emphysema, pulmonary function studies show an increased total lung capacity with a markedly increased residual volume.  1. Carbon monoxide.  2. Industrial dust. 3. Tear gas. 4. Carbon dioxide. Option 1: Carbon monoxide produces dizziness, headache, and fatigue. Option 2: Cough and congestion result from breathing irritants from the environment such as air pollution, industrial dust, and secondhand smoke. Option 3: Tear gas irritates the conjunctivae and produces a flow of tears. Option 4: Carbon dioxide produces sleepiness. 3/19/25, 10:44 AM Feedback Question 22. Jamie, age 16, has had her asthma well controlled by using only a beta-2 adrenergic metered-dose inhaler. Lately, however, she has had difficulty breathing during the night, and her sleep has been interrupted about 3 times a week. What do you do? Rationales [Page Reference: 470] Course Topic: Respiratory Problems | Area of Practice: Pediatrics, Adult-Gerontology Primary Care, Family Practice | APN Knowledge Area: Pharmacological Therapy and Polypharmacy | Testing Domain: Plan | Cognitive Level: Application [Applying] Question 23. You have completed a physical exam on Sandra, age 32, who presented to the clinic for a cough that is particularly worse at night. She has had episodes of recurrent tightness in the chest with wheezing. She tells you that exercise and changes in the weather make her symptoms occur or worsen. Which test is performed to diagnose asthma? Rationales [Page Reference: 467] Course Topic: Respiratory Problems | Area of Practice: Adult-Gerontology Primary Care, Family Practice | APN Knowledge Area: Diagnostic Tests and Therapeutic Procedures | Testing Domain: Diagnose | Cognitive Level: Analysis [Analyzing]  1. Prescribe a short course of steroid therapy.  2. Prescribe an inhaled steroid. 3. Prescribe a longer-acting bronchodilator. 4. Prescribe oral theophylline. Option 1: If the asthma worsens, then a short course of oral steroids may be tried. Option 2: If a patient develops moderate asthma, defined as more than 2 episodes per week, an inhaled steroid should be prescribed and used in conjunction with the beta-2 adrenergic metered-dose inhaler. Option 3: With no improvement, a longer-acting bronchodilator, such as salmeterol xinafoate (Serevent), may be added. Option 4: Theophylline is no longer used except in extremely resistant cases.  1. Bronchoprovocation with methacholine, histamine, cold air, or exercise challenge 2. Peak expiratory flow meter monitoring  3. Spirometry testing 4. Chest x-ray Option 1: A positive bronchoprovocation test is diagnostic of airway hyperresponsiveness, which may also be present in other conditions. Option 2: Peak flow meters are used for monitoring asthma. Option 3: Spirometry tests are done to diagnose asthma in patients who are 5 years of age and older. Measurements should include forced expiratory volume in the first second of expiration (FEV ), forced expiratory volume in 6 seconds (FEV ), forced vital capacity (FVC), and FEV /FVC. These measurements should be performed before and after the patient inhales a short-acting bronchodilator. Bronchoprovocation is done when asthma is suspected but the spirometry testing is normal. 1 6 1 Option 4: A chest x-ray is performed to exclude other diseases. 3/19/25, 10:44 AM Feedback Question 24. When you teach patients about using steroid inhalers for asthma or chronic obstructive pulmonary disease (COPD), what information is essential? Rationales [Page Reference: 472] Course Topic: Respiratory Problems | Area of Practice: Pediatrics, Adult-Gerontology Primary Care, Family Practice | APN Knowledge Area: Health Promotion and Patient Education | Testing Domain: Plan | Cognitive Level: Application [Applying] Question 25. Sarah, age 25, has allergic rhinitis and is currently bothered by nasal congestion. Which of the following medications for allergic rhinitis would be most appropriate? Rationales [Page Reference: 357] Course Topic: Respiratory Problems | Area of Practice: Adult-Gerontology Primary Care, Family Practice | APN Knowledge Area: Pharmacological Therapy and Polypharmacy | Testing Domain: Plan | Cognitive Level: Application [Applying]  1. Keep the inhaler in the refrigerator. 2. Do not use another inhaler for 10 minutes after the steroid inhaler.  3. Rinse your mouth after using the inhaler. 4. Be careful not to shake the container before using. Option 1: The inhaler should be stored at room temperature. Option 2: If the patient is also taking a beta-2 agonist, tell him or her to take that first, because that will open the airway, allowing more of the steroid medication to be administered. It's necessary to wait only 1 to 2 minutes between inhalers. Option 3: After using a steroid inhaler, the patient should always rinse the mouth to prevent oral candidiasis (thrush). Brushing the teeth will get rid of any bad taste. Option 4: The inhaler or Diskus should be shaken first.   1. A decongestant nasal spray 2. An antihistamine nasal spray 3. Ipratropium bromide (Atrovent) 4. Omalizumab (Xolair) Option 1: For Sarah, who has allergic rhinitis and nasal congestion, a decongestant nasal spray would be indicated. Option 2: For rhinorrhea, an antihistamine nasal spray or ipratropium bromide (Atrovent) would be indicated. Option 3: For rhinorrhea, an antihistamine nasal spray or ipratropium bromide (Atrovent) would be indicated. Option 4: Omalizumab (Xolair) may be necessary for grade 4 allergic rhinitis (severe persistent). 3/19/25, 10:44 AM Feedback