Advanced Practice NP Respiratory Care Test
Bank – 150-Item Mastery Review Answers And
Rationale Included.
2025/2026
1. A 55-year-old patient with COPD presents with increased dyspnea
and productive cough. Which initial treatment adjustment is most
appropriate?
A) Start oral corticosteroids
B) Increase short-acting bronchodilator use
C) Start inhaled antibiotics
D) Begin long-term oxygen therapy
Answer: B) Increase short-acting bronchodilator use
Rationale: Short-acting bronchodilators are first-line for acute symptom
exacerbation in COPD to provide rapid relief of bronchoconstriction.
Oral corticosteroids are reserved for moderate to severe exacerbations
not responding to bronchodilators.
2. Which of the following is the most common cause of community-
acquired pneumonia (CAP) in adults?
A) Haemophilus influenzae
B) Mycoplasma pneumoniae
C) Streptococcus pneumoniae
D) Staphylococcus aureus
Answer: C) Streptococcus pneumoniae
Rationale: Streptococcus pneumoniae is the most frequent bacterial
cause of CAP in adults, accounting for approximately 30-50% of cases.
,3. A patient with asthma presents with nocturnal symptoms twice a
week and uses a rescue inhaler daily. How is their asthma classified?
A) Intermittent
B) Mild persistent
C) Moderate persistent
D) Severe persistent
Answer: C) Moderate persistent
Rationale: Asthma classification is based on symptom frequency,
nighttime awakenings, and rescue inhaler use. Daily use and nocturnal
symptoms more than once a week correspond to moderate persistent
asthma.
4. Which test is the gold standard for diagnosing pulmonary embolism
(PE)?
A) Chest X-ray
B) Ventilation-perfusion (V/Q) scan
C) CT pulmonary angiography
D) D-dimer assay
Answer: C) CT pulmonary angiography
Rationale: CT pulmonary angiography is the most accurate and widely
used test to confirm PE due to its high sensitivity and specificity.
5. Which long-term controller medication is indicated for a patient with
persistent asthma not controlled with inhaled corticosteroids alone?
A) Short-acting beta-agonists
B) Leukotriene receptor antagonists
C) Long-acting beta-agonists
D) Oral antibiotics
Answer: C) Long-acting beta-agonists
Rationale: Long-acting beta-agonists (LABAs) are added to inhaled
,corticosteroids for patients with persistent asthma uncontrolled on ICS
monotherapy to improve symptom control.
6. In acute exacerbation of COPD, what is the main indication for
systemic corticosteroid therapy?
A) Mild dyspnea
B) Acute respiratory failure
C) Chronic oxygen therapy
D) Stable lung function
Answer: B) Acute respiratory failure
Rationale: Systemic corticosteroids are used in moderate to severe
COPD exacerbations, particularly when patients show signs of increased
work of breathing, hypoxemia, or impending respiratory failure.
7. Which of the following vaccines is recommended annually for
patients with chronic respiratory disease?
A) MMR vaccine
B) Tdap vaccine
C) Influenza vaccine
D) Varicella vaccine
Answer: C) Influenza vaccine
Rationale: Annual influenza vaccination is strongly recommended for
patients with chronic respiratory illnesses, including COPD and asthma,
to prevent respiratory infections.
8. A 30-year-old patient with asthma has daily symptoms and nighttime
awakenings 4 nights per month. Their current treatment includes low-
dose inhaled corticosteroid. What is the next step?
A) Maintain current therapy
B) Step up to medium-dose ICS
, C) Add oral corticosteroid
D) Add leukotriene receptor antagonist
Answer: B) Step up to medium-dose ICS
Rationale: Guidelines recommend increasing inhaled corticosteroid dose
or adding a long-acting beta-agonist for asthma not well controlled on
low-dose ICS.
9. Which of the following is the first-line therapy for acute bronchitis in
otherwise healthy adults?
A) Amoxicillin
B) Azithromycin
C) Supportive care
D) Levofloxacin
Answer: C) Supportive care
Rationale: Acute bronchitis is usually viral; antibiotics are generally not
indicated unless bacterial infection is suspected.
10. A 65-year-old patient with COPD presents with worsening hypoxia
(SpO₂ 88%). What is the most appropriate initial oxygen therapy?
A) High-flow oxygen at 15 L/min
B) Low-flow oxygen at 1-2 L/min
C) Non-rebreather mask at 15 L/min
D) Mechanical ventilation
Answer: B) Low-flow oxygen at 1-2 L/min
Rationale: COPD patients are at risk of hypercapnia with high-flow
oxygen. Low-flow oxygen titrated to maintain SpO₂ 88–92% is safest.
11. Which class of medications is preferred for long-term maintenance
therapy in COPD?
A) Short-acting beta-agonists
B) Inhaled corticosteroids
Bank – 150-Item Mastery Review Answers And
Rationale Included.
2025/2026
1. A 55-year-old patient with COPD presents with increased dyspnea
and productive cough. Which initial treatment adjustment is most
appropriate?
A) Start oral corticosteroids
B) Increase short-acting bronchodilator use
C) Start inhaled antibiotics
D) Begin long-term oxygen therapy
Answer: B) Increase short-acting bronchodilator use
Rationale: Short-acting bronchodilators are first-line for acute symptom
exacerbation in COPD to provide rapid relief of bronchoconstriction.
Oral corticosteroids are reserved for moderate to severe exacerbations
not responding to bronchodilators.
2. Which of the following is the most common cause of community-
acquired pneumonia (CAP) in adults?
A) Haemophilus influenzae
B) Mycoplasma pneumoniae
C) Streptococcus pneumoniae
D) Staphylococcus aureus
Answer: C) Streptococcus pneumoniae
Rationale: Streptococcus pneumoniae is the most frequent bacterial
cause of CAP in adults, accounting for approximately 30-50% of cases.
,3. A patient with asthma presents with nocturnal symptoms twice a
week and uses a rescue inhaler daily. How is their asthma classified?
A) Intermittent
B) Mild persistent
C) Moderate persistent
D) Severe persistent
Answer: C) Moderate persistent
Rationale: Asthma classification is based on symptom frequency,
nighttime awakenings, and rescue inhaler use. Daily use and nocturnal
symptoms more than once a week correspond to moderate persistent
asthma.
4. Which test is the gold standard for diagnosing pulmonary embolism
(PE)?
A) Chest X-ray
B) Ventilation-perfusion (V/Q) scan
C) CT pulmonary angiography
D) D-dimer assay
Answer: C) CT pulmonary angiography
Rationale: CT pulmonary angiography is the most accurate and widely
used test to confirm PE due to its high sensitivity and specificity.
5. Which long-term controller medication is indicated for a patient with
persistent asthma not controlled with inhaled corticosteroids alone?
A) Short-acting beta-agonists
B) Leukotriene receptor antagonists
C) Long-acting beta-agonists
D) Oral antibiotics
Answer: C) Long-acting beta-agonists
Rationale: Long-acting beta-agonists (LABAs) are added to inhaled
,corticosteroids for patients with persistent asthma uncontrolled on ICS
monotherapy to improve symptom control.
6. In acute exacerbation of COPD, what is the main indication for
systemic corticosteroid therapy?
A) Mild dyspnea
B) Acute respiratory failure
C) Chronic oxygen therapy
D) Stable lung function
Answer: B) Acute respiratory failure
Rationale: Systemic corticosteroids are used in moderate to severe
COPD exacerbations, particularly when patients show signs of increased
work of breathing, hypoxemia, or impending respiratory failure.
7. Which of the following vaccines is recommended annually for
patients with chronic respiratory disease?
A) MMR vaccine
B) Tdap vaccine
C) Influenza vaccine
D) Varicella vaccine
Answer: C) Influenza vaccine
Rationale: Annual influenza vaccination is strongly recommended for
patients with chronic respiratory illnesses, including COPD and asthma,
to prevent respiratory infections.
8. A 30-year-old patient with asthma has daily symptoms and nighttime
awakenings 4 nights per month. Their current treatment includes low-
dose inhaled corticosteroid. What is the next step?
A) Maintain current therapy
B) Step up to medium-dose ICS
, C) Add oral corticosteroid
D) Add leukotriene receptor antagonist
Answer: B) Step up to medium-dose ICS
Rationale: Guidelines recommend increasing inhaled corticosteroid dose
or adding a long-acting beta-agonist for asthma not well controlled on
low-dose ICS.
9. Which of the following is the first-line therapy for acute bronchitis in
otherwise healthy adults?
A) Amoxicillin
B) Azithromycin
C) Supportive care
D) Levofloxacin
Answer: C) Supportive care
Rationale: Acute bronchitis is usually viral; antibiotics are generally not
indicated unless bacterial infection is suspected.
10. A 65-year-old patient with COPD presents with worsening hypoxia
(SpO₂ 88%). What is the most appropriate initial oxygen therapy?
A) High-flow oxygen at 15 L/min
B) Low-flow oxygen at 1-2 L/min
C) Non-rebreather mask at 15 L/min
D) Mechanical ventilation
Answer: B) Low-flow oxygen at 1-2 L/min
Rationale: COPD patients are at risk of hypercapnia with high-flow
oxygen. Low-flow oxygen titrated to maintain SpO₂ 88–92% is safest.
11. Which class of medications is preferred for long-term maintenance
therapy in COPD?
A) Short-acting beta-agonists
B) Inhaled corticosteroids
