Comprehensive Respiratory
Assessment & Management: NP
Exam Questions 1–150,Answers And
Rationales.
2025/2026
1. A 55-year-old patient with COPD presents with increased
shortness of breath and productive cough. Which is the first-line
therapy for an acute exacerbation?
A. Oral corticosteroids alone
B. Inhaled corticosteroids
C. Short-acting bronchodilators with systemic corticosteroids
D. Long-acting beta-agonists
Rationale: Short-acting bronchodilators relieve acute bronchospasm,
and systemic corticosteroids reduce inflammation during
exacerbations.
2. Which of the following is the most sensitive test for diagnosing
pulmonary embolism in a hemodynamically stable patient?
A. Chest X-ray
B. Ventilation-perfusion scan
C. CT pulmonary angiography
D. D-dimer alone
Rationale: CT pulmonary angiography provides direct visualization of
pulmonary arteries and is the preferred diagnostic tool in stable
patients.
, 3. A patient with asthma has symptoms 3 nights per month and uses
a rescue inhaler twice weekly. What is the classification of asthma
severity?
A. Moderate persistent
B. Severe persistent
C. Intermittent
D. Mild persistent
Rationale: Mild persistent asthma is characterized by symptoms more
than twice a week but less than daily and nighttime awakenings 3–4
times per month.
4. Which of the following is the most common cause of community-
acquired pneumonia?
A. Streptococcus pneumoniae
B. Haemophilus influenzae
C. Mycoplasma pneumoniae
D. Legionella pneumophila
Rationale: Streptococcus pneumoniae is the leading bacterial cause of
community-acquired pneumonia in adults.
5. In a patient with suspected obstructive sleep apnea, the gold
standard diagnostic test is:
A. Polysomnography
B. Home oximetry
C. Pulmonary function test
D. In-lab overnight polysomnography
Rationale: Full in-lab polysomnography is the gold standard as it
measures multiple physiologic parameters during sleep.
6. A 60-year-old male with COPD presents with chronic productive
cough for 3 months each year for 2 consecutive years. What is the
, likely diagnosis?
A. Asthma
B. Chronic bronchitis
C. Emphysema
D. Bronchiectasis
Rationale: Chronic bronchitis is defined by chronic productive cough
for at least 3 months in 2 consecutive years.
7. Which medication is first-line for long-term control in persistent
asthma?
A. Short-acting beta-agonist
B. Oral corticosteroids
C. Inhaled corticosteroids
D. Leukotriene receptor antagonists
Rationale: Inhaled corticosteroids are the most effective long-term
controller therapy for persistent asthma.
8. Which of the following is the most effective vaccination to reduce
exacerbations in patients with COPD?
A. Tetanus
B. Hepatitis B
C. Influenza and pneumococcal vaccines
D. Varicella
Rationale: Influenza and pneumococcal vaccines reduce infection risk
and exacerbations in COPD patients.
9. A patient presents with sudden-onset dyspnea, pleuritic chest
pain, and hemoptysis. Which condition should be considered
first?
A. Pneumothorax
B. Pulmonary embolism
, C. Asthma exacerbation
D. COPD exacerbation
Rationale: The classic triad of pulmonary embolism includes sudden
dyspnea, pleuritic chest pain, and hemoptysis.
10. In COPD, which of the following changes is expected on
pulmonary function testing?
A. Reduced FEV1/FVC ratio
B. Normal FEV1/FVC ratio
C. Increased FEV1/FVC ratio
D. Increased TLC with normal RV
Rationale: Obstructive lung disease, like COPD, reduces the FEV1/FVC
ratio due to airflow limitation.
11. Which bronchodilator class is preferred for rapid relief of
acute asthma symptoms?
A. Long-acting beta-agonist
B. Short-acting beta-agonist
C. Leukotriene receptor antagonist
D. Inhaled corticosteroid
Rationale: Short-acting beta-agonists act quickly to relieve
bronchospasm during acute asthma attacks.
12. Which of the following is a hallmark of restrictive lung
disease?
A. Reduced total lung capacity (TLC)
B. Increased residual volume
C. Reduced FEV1/FVC ratio
D. Normal lung volumes
Rationale: Restrictive lung diseases decrease TLC due to stiff lungs or
chest wall abnormalities.
Assessment & Management: NP
Exam Questions 1–150,Answers And
Rationales.
2025/2026
1. A 55-year-old patient with COPD presents with increased
shortness of breath and productive cough. Which is the first-line
therapy for an acute exacerbation?
A. Oral corticosteroids alone
B. Inhaled corticosteroids
C. Short-acting bronchodilators with systemic corticosteroids
D. Long-acting beta-agonists
Rationale: Short-acting bronchodilators relieve acute bronchospasm,
and systemic corticosteroids reduce inflammation during
exacerbations.
2. Which of the following is the most sensitive test for diagnosing
pulmonary embolism in a hemodynamically stable patient?
A. Chest X-ray
B. Ventilation-perfusion scan
C. CT pulmonary angiography
D. D-dimer alone
Rationale: CT pulmonary angiography provides direct visualization of
pulmonary arteries and is the preferred diagnostic tool in stable
patients.
, 3. A patient with asthma has symptoms 3 nights per month and uses
a rescue inhaler twice weekly. What is the classification of asthma
severity?
A. Moderate persistent
B. Severe persistent
C. Intermittent
D. Mild persistent
Rationale: Mild persistent asthma is characterized by symptoms more
than twice a week but less than daily and nighttime awakenings 3–4
times per month.
4. Which of the following is the most common cause of community-
acquired pneumonia?
A. Streptococcus pneumoniae
B. Haemophilus influenzae
C. Mycoplasma pneumoniae
D. Legionella pneumophila
Rationale: Streptococcus pneumoniae is the leading bacterial cause of
community-acquired pneumonia in adults.
5. In a patient with suspected obstructive sleep apnea, the gold
standard diagnostic test is:
A. Polysomnography
B. Home oximetry
C. Pulmonary function test
D. In-lab overnight polysomnography
Rationale: Full in-lab polysomnography is the gold standard as it
measures multiple physiologic parameters during sleep.
6. A 60-year-old male with COPD presents with chronic productive
cough for 3 months each year for 2 consecutive years. What is the
, likely diagnosis?
A. Asthma
B. Chronic bronchitis
C. Emphysema
D. Bronchiectasis
Rationale: Chronic bronchitis is defined by chronic productive cough
for at least 3 months in 2 consecutive years.
7. Which medication is first-line for long-term control in persistent
asthma?
A. Short-acting beta-agonist
B. Oral corticosteroids
C. Inhaled corticosteroids
D. Leukotriene receptor antagonists
Rationale: Inhaled corticosteroids are the most effective long-term
controller therapy for persistent asthma.
8. Which of the following is the most effective vaccination to reduce
exacerbations in patients with COPD?
A. Tetanus
B. Hepatitis B
C. Influenza and pneumococcal vaccines
D. Varicella
Rationale: Influenza and pneumococcal vaccines reduce infection risk
and exacerbations in COPD patients.
9. A patient presents with sudden-onset dyspnea, pleuritic chest
pain, and hemoptysis. Which condition should be considered
first?
A. Pneumothorax
B. Pulmonary embolism
, C. Asthma exacerbation
D. COPD exacerbation
Rationale: The classic triad of pulmonary embolism includes sudden
dyspnea, pleuritic chest pain, and hemoptysis.
10. In COPD, which of the following changes is expected on
pulmonary function testing?
A. Reduced FEV1/FVC ratio
B. Normal FEV1/FVC ratio
C. Increased FEV1/FVC ratio
D. Increased TLC with normal RV
Rationale: Obstructive lung disease, like COPD, reduces the FEV1/FVC
ratio due to airflow limitation.
11. Which bronchodilator class is preferred for rapid relief of
acute asthma symptoms?
A. Long-acting beta-agonist
B. Short-acting beta-agonist
C. Leukotriene receptor antagonist
D. Inhaled corticosteroid
Rationale: Short-acting beta-agonists act quickly to relieve
bronchospasm during acute asthma attacks.
12. Which of the following is a hallmark of restrictive lung
disease?
A. Reduced total lung capacity (TLC)
B. Increased residual volume
C. Reduced FEV1/FVC ratio
D. Normal lung volumes
Rationale: Restrictive lung diseases decrease TLC due to stiff lungs or
chest wall abnormalities.
