NR601 MIDTERM EXAM 2026 COMPLETE
QUESTIONS AND SOLUTIONS GRADED A PLUS
ADVANCED PRIMARY CARE PRACTICE GUIDE
◉ What is FEV1?
Answer: Forced Expiratory Volume in 1 second (80-120%)
◉ What is FVC?
Answer: Forced Vital Capacity (80-120%)
◉ What is normal FEV1/FVC ratio?
Answer: <0.7 (70%)
◉ What is GOLD 1 criteria?
Answer: Mild
FEV1 >/= 80% predicted
◉ What is GOLD 2 criteria?
Answer: Moderate
FEV1 50-79% predicted
,◉ What is GOLD 3 criteria?
Answer: Severe
FEV1 30-49% predicted
◉ What is GOLD 4 criteria?
Answer: Very severe
FEV1 <30% predicted
◉ What are the signal symptoms of COPD?
Answer: Dyspnea
Chronic cough w/sputum
Decreased activity tolerance
Wheezing
◉ What are characteristics of COPD?
Answer: Common, preventable, treatable.
Characterized by persistent airflow limitation.
Usually progressive, associated with enhanced chronic inflammatory
response in airways and lungs to noxious particles/gases
,Airway fibrosis, luminal plugs, airway inflammation, increased
airway resistance, small airway dz.
Decreased elastic recoil of alveoli.
◉ What are risk factors for COPD?
Answer: Smoking (increasing w/number of pack years)
Second hand smoke
Environmental pollution (endotoxins, coal dust, mineral dust)
◉ What is seen on phys exam in COPD?
Answer: May be normal in early states
As severity progresses: lung hyperinflation, decreased breath
sounds, wheezes at bases, distant heart tones (b/c of hyperinflation,
so S1/S2 sounds off in distance), accessory muscle use, pursed lip
breathing, increased expiratory phase, neck vein distention.
◉ How is COPD diagnosed?
Answer: Spirometry is gold standard (pre and post bronchodilator).
Irreversible airflow limitation is hallmark.
◉ How is COPD treated?
, Answer: Bronchodilators: beta agonists (long/short),
anticholinergics (long/short), or combo.
◉ What is the MOA of beta agonists?
Answer: Stimulates beta-2-adrenergic receptors, increasing cyclic
AMP, resulting in relaxing airways.
◉ What is the MOA of anticholinergics?
Answer: Block the effect of acetylcholine on muscarinic type 3
receptors, resulting in bronchodilation.
◉ Why are long-acting beta agonists prescribed for COPD?
Answer: They are for moderate airflow limitation.
They relieve symptoms, increase exercise tolerance, reduce number
of exacerbations, improve QOL.
◉ What are some non pulmonary diagnoses that result in COPD-
type symptoms?
Answer: CHF
Hyperventilation syndrome
Panic attacks
Vocal cord dysfunction
QUESTIONS AND SOLUTIONS GRADED A PLUS
ADVANCED PRIMARY CARE PRACTICE GUIDE
◉ What is FEV1?
Answer: Forced Expiratory Volume in 1 second (80-120%)
◉ What is FVC?
Answer: Forced Vital Capacity (80-120%)
◉ What is normal FEV1/FVC ratio?
Answer: <0.7 (70%)
◉ What is GOLD 1 criteria?
Answer: Mild
FEV1 >/= 80% predicted
◉ What is GOLD 2 criteria?
Answer: Moderate
FEV1 50-79% predicted
,◉ What is GOLD 3 criteria?
Answer: Severe
FEV1 30-49% predicted
◉ What is GOLD 4 criteria?
Answer: Very severe
FEV1 <30% predicted
◉ What are the signal symptoms of COPD?
Answer: Dyspnea
Chronic cough w/sputum
Decreased activity tolerance
Wheezing
◉ What are characteristics of COPD?
Answer: Common, preventable, treatable.
Characterized by persistent airflow limitation.
Usually progressive, associated with enhanced chronic inflammatory
response in airways and lungs to noxious particles/gases
,Airway fibrosis, luminal plugs, airway inflammation, increased
airway resistance, small airway dz.
Decreased elastic recoil of alveoli.
◉ What are risk factors for COPD?
Answer: Smoking (increasing w/number of pack years)
Second hand smoke
Environmental pollution (endotoxins, coal dust, mineral dust)
◉ What is seen on phys exam in COPD?
Answer: May be normal in early states
As severity progresses: lung hyperinflation, decreased breath
sounds, wheezes at bases, distant heart tones (b/c of hyperinflation,
so S1/S2 sounds off in distance), accessory muscle use, pursed lip
breathing, increased expiratory phase, neck vein distention.
◉ How is COPD diagnosed?
Answer: Spirometry is gold standard (pre and post bronchodilator).
Irreversible airflow limitation is hallmark.
◉ How is COPD treated?
, Answer: Bronchodilators: beta agonists (long/short),
anticholinergics (long/short), or combo.
◉ What is the MOA of beta agonists?
Answer: Stimulates beta-2-adrenergic receptors, increasing cyclic
AMP, resulting in relaxing airways.
◉ What is the MOA of anticholinergics?
Answer: Block the effect of acetylcholine on muscarinic type 3
receptors, resulting in bronchodilation.
◉ Why are long-acting beta agonists prescribed for COPD?
Answer: They are for moderate airflow limitation.
They relieve symptoms, increase exercise tolerance, reduce number
of exacerbations, improve QOL.
◉ What are some non pulmonary diagnoses that result in COPD-
type symptoms?
Answer: CHF
Hyperventilation syndrome
Panic attacks
Vocal cord dysfunction
