ABFM + KSA Asthma Exam
Test Bank
(Latest 2025 Update)
Verified Qs & As | Grade A|
100% Correct
(Verified Answers)
,A 26-year-old male with asthma is seen in the emergency department. He is short of breath to a degree
that makes it difficult to speak in sentences and he appears tired. On examination you note diminished
breath sounds with an occasional wheeze. His FEV1 is 15% of predicted and his pCO2 is 45 mm Hg. He is
given albuterol (Proventil, Ventolin) over the next hour but he has a poor response. He is not able to
repeat the spirometry and he now appears drowsy. Which one of the following would be consistent with
imminent respiratory failure?
E. The absence of wheezes
Which one of the following is true regarding leukotriene modifiers for treatment of asthma in adults?
D. They are less effective than inhaled corticosteroids (ICSs)
Chronic low- to medium-dose inhaled corticosteroid use in children is associated with
E. no long-term adverse effects
An 18-year-old female presents to your office with a history of wheezing, coughing, and year-round
symptoms of rhinitis. She reports that her symptoms occur several times a week but rarely more than
once a day, except in the last year, when she has had to intermittently use albuterol (Proventil, Ventolin)
every day for a week at a time. She wakes up with nighttime coughing weekly, with no fever or other
symptoms, and tells you that the coughing is severe enough to make her cat jump off the bed. Albuterol
helps her symptoms temporarily. She has been treated with oral corticosteroids on three occasions this
past year, most recently 6 weeks ago. Her Asthma Control Test score is 17. Pre- and postbronchodilator
spirometry results are shown below.
Initial testing
FVC............2.0 L (80% of predicted)
FEV1............1.4 L (70% of predicted)
FEF 25-75............1.5 L/sec (89% of predicted)
15 minutes post bronchodilator administration
FVC............2.3 L (105% of predicted)
,FEV1............2.0 L (100% of predicted)
FEF 25-75............1.9 L/sec (100% of predicted)
Which one of the following would be most appropriate to add at this time?
A. Budesonide/formoterol (Symbicort), with an increase in dosage for exacerbations
A 22-year-old female presents to your office with an acute asthma attack that developed 2 days after
the onset of a viral upper respiratory infection. Her asthma is usually well controlled, with a personal
best peak expiratory flow (PEF) of 380 L/min. On initial evaluation by the nurse she has a pulse rate of
120 beats/min, a respiratory rate of 32/min, and an oxygen saturation of 92% on room air. On
examination she is very dyspneic with diffuse inspiratory and expiratory wheezing and she is using
accessory muscles to breathe. Her PEF is 150 L/min. Inhaled β-agonists and systemic corticosteroids are
administered and she is reevaluated 1 hour later. Which one of the following would provide the most
reassurance that she is responding to therapy?
C. A PEF of 310 L/min
You are counseling a patient with moderate persistent asthma about the value of following a written
asthma action plan. To encourage her to use an asthma action plan you share the results of studies that
document their benefit in optimizing asthma control and reducing future risk.
Which one of the following is an accurate statement regarding asthma action plans?
D. The lack of a written asthma action plan is a risk factor for death from asthma
A 28-year-old female presents with progressively worsening asthma after a recent viral upper
respiratory infection. When you enter the room, she appears in distress and is only able to talk in words,
not sentences. Her respiratory rate is 34/min and her heart rate is 126 beats/min. Her oxygen saturation
before oxygen was administered was 89%. You begin treatment with a nebulized short-acting β-agonist
(SABA) plus ipratropium and give an initial dose of oral prednisone. After one hour her symptoms are
not responsive to initial treatment efforts.
Which one of the following should you consider as a possible adjunctive treatment?
C. Intravenous magnesium sulfate
, Which one of the following is true regarding regular use of inhaled corticosteroids (ICSs) in patients with
persistent asthma?
A. Oral candidiasis is a potential side effect of ICS use
You have recently opened a new practice in western North Carolina. In your first week of seeing
patients, a 17-year-old male reports that his asthma is usually worse in the early spring.
Which one of the following is most likely triggering his symptoms at that time of year?
A. Tree Pollen
A 14-year-old female presents with a recent history of cough and shortness of breath with exercise.
Baseline pulmonary function testing reveals an FEV1 of 3.1 L and a peak expiratory flow of 600 L/min.
Exercise testing is scheduled.
If measured within 30 minutes of exercise, which one of the following FEV1 values would support a
diagnosis of mild exercise-induced bronchospasm in this patient?
B. 2.8L
A 14-year-old female with a history of asthma presents to your office for follow-up. Her mother reports
that the patient has become increasingly agitated during the day and has frequent nightmares, which
she never had before. When asking about any other changes to her routine, family stressors, or
medication changes you learn that she was seen by an allergy specialist 2 months ago and was given a
new prescription to help with her asthma management. Her mother cannot recall the name of this new
medication and it is not in your electronic medical record.
Which one of the following asthma medications is most likely to have precipitated these symptoms?
D. Montelukast (Singulair)
A 35-year-old male who was admitted to the intensive-care unit with a severe asthma exacerbation has
failed to improve with aggressive bronchodilator therapy and systemic corticosteroid therapy. For the
past 10 minutes he has appeared more fatigued, but less wheezing is heard and his pulsus paradoxus,
which had been 30 mm Hg, is <10 mm Hg. His pO2 is 75 mm Hg and his pCO2 is 48 mm Hg on 6 L/min of
oxygen.
Test Bank
(Latest 2025 Update)
Verified Qs & As | Grade A|
100% Correct
(Verified Answers)
,A 26-year-old male with asthma is seen in the emergency department. He is short of breath to a degree
that makes it difficult to speak in sentences and he appears tired. On examination you note diminished
breath sounds with an occasional wheeze. His FEV1 is 15% of predicted and his pCO2 is 45 mm Hg. He is
given albuterol (Proventil, Ventolin) over the next hour but he has a poor response. He is not able to
repeat the spirometry and he now appears drowsy. Which one of the following would be consistent with
imminent respiratory failure?
E. The absence of wheezes
Which one of the following is true regarding leukotriene modifiers for treatment of asthma in adults?
D. They are less effective than inhaled corticosteroids (ICSs)
Chronic low- to medium-dose inhaled corticosteroid use in children is associated with
E. no long-term adverse effects
An 18-year-old female presents to your office with a history of wheezing, coughing, and year-round
symptoms of rhinitis. She reports that her symptoms occur several times a week but rarely more than
once a day, except in the last year, when she has had to intermittently use albuterol (Proventil, Ventolin)
every day for a week at a time. She wakes up with nighttime coughing weekly, with no fever or other
symptoms, and tells you that the coughing is severe enough to make her cat jump off the bed. Albuterol
helps her symptoms temporarily. She has been treated with oral corticosteroids on three occasions this
past year, most recently 6 weeks ago. Her Asthma Control Test score is 17. Pre- and postbronchodilator
spirometry results are shown below.
Initial testing
FVC............2.0 L (80% of predicted)
FEV1............1.4 L (70% of predicted)
FEF 25-75............1.5 L/sec (89% of predicted)
15 minutes post bronchodilator administration
FVC............2.3 L (105% of predicted)
,FEV1............2.0 L (100% of predicted)
FEF 25-75............1.9 L/sec (100% of predicted)
Which one of the following would be most appropriate to add at this time?
A. Budesonide/formoterol (Symbicort), with an increase in dosage for exacerbations
A 22-year-old female presents to your office with an acute asthma attack that developed 2 days after
the onset of a viral upper respiratory infection. Her asthma is usually well controlled, with a personal
best peak expiratory flow (PEF) of 380 L/min. On initial evaluation by the nurse she has a pulse rate of
120 beats/min, a respiratory rate of 32/min, and an oxygen saturation of 92% on room air. On
examination she is very dyspneic with diffuse inspiratory and expiratory wheezing and she is using
accessory muscles to breathe. Her PEF is 150 L/min. Inhaled β-agonists and systemic corticosteroids are
administered and she is reevaluated 1 hour later. Which one of the following would provide the most
reassurance that she is responding to therapy?
C. A PEF of 310 L/min
You are counseling a patient with moderate persistent asthma about the value of following a written
asthma action plan. To encourage her to use an asthma action plan you share the results of studies that
document their benefit in optimizing asthma control and reducing future risk.
Which one of the following is an accurate statement regarding asthma action plans?
D. The lack of a written asthma action plan is a risk factor for death from asthma
A 28-year-old female presents with progressively worsening asthma after a recent viral upper
respiratory infection. When you enter the room, she appears in distress and is only able to talk in words,
not sentences. Her respiratory rate is 34/min and her heart rate is 126 beats/min. Her oxygen saturation
before oxygen was administered was 89%. You begin treatment with a nebulized short-acting β-agonist
(SABA) plus ipratropium and give an initial dose of oral prednisone. After one hour her symptoms are
not responsive to initial treatment efforts.
Which one of the following should you consider as a possible adjunctive treatment?
C. Intravenous magnesium sulfate
, Which one of the following is true regarding regular use of inhaled corticosteroids (ICSs) in patients with
persistent asthma?
A. Oral candidiasis is a potential side effect of ICS use
You have recently opened a new practice in western North Carolina. In your first week of seeing
patients, a 17-year-old male reports that his asthma is usually worse in the early spring.
Which one of the following is most likely triggering his symptoms at that time of year?
A. Tree Pollen
A 14-year-old female presents with a recent history of cough and shortness of breath with exercise.
Baseline pulmonary function testing reveals an FEV1 of 3.1 L and a peak expiratory flow of 600 L/min.
Exercise testing is scheduled.
If measured within 30 minutes of exercise, which one of the following FEV1 values would support a
diagnosis of mild exercise-induced bronchospasm in this patient?
B. 2.8L
A 14-year-old female with a history of asthma presents to your office for follow-up. Her mother reports
that the patient has become increasingly agitated during the day and has frequent nightmares, which
she never had before. When asking about any other changes to her routine, family stressors, or
medication changes you learn that she was seen by an allergy specialist 2 months ago and was given a
new prescription to help with her asthma management. Her mother cannot recall the name of this new
medication and it is not in your electronic medical record.
Which one of the following asthma medications is most likely to have precipitated these symptoms?
D. Montelukast (Singulair)
A 35-year-old male who was admitted to the intensive-care unit with a severe asthma exacerbation has
failed to improve with aggressive bronchodilator therapy and systemic corticosteroid therapy. For the
past 10 minutes he has appeared more fatigued, but less wheezing is heard and his pulsus paradoxus,
which had been 30 mm Hg, is <10 mm Hg. His pO2 is 75 mm Hg and his pCO2 is 48 mm Hg on 6 L/min of
oxygen.
