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CMN 568 practice questions and answers fully solved
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CMN 568 practice questions
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CMN 568 practice questionsA thin patient w/ a slight build present with constant difficulty breathing and clear mucus.
A physical exam also indicates an increased chest anteroposterior diameter and
hyperresonance on percussion. Given the most likely diagnosis, which class of
medications is best suited for long-term tx? - answer anticholinergics
Which of these manifestations is LEAST likely to present with the onset of asthma?
A. Plugging the airways by thick mucus
B. Hypertrophy of the mucus glands
C. Thinning of the epithelial basement membrane
D. Hypertrophy of smooth muscle - answerC
Your patient was seen by a pulmonologist 2 months ago and diagnosed with asthma.
The pulmonologist ordered a short acting beta-2 agonist for initial symptom relief.
However, on today's visit to your office, the patient states, "I don't think this stuff is really
working because I'm still short of breath." You refer the patient back to the
pulmonologist. Which of the following would you anticipate being the next step in the
patient's management following the latest national guidelines? - answeran inhaled
corticosteroid (ICS)
Jackie, a 25-yo female, comes to the clinic experiencing respiratory distress and
difficulty speaking. Her lungs are hyperresonant and show hyperinflation on the x-ray.
Which result would most strongly indicate that Jackie should be admitted to a hospital?
A. Forced expiratory volume is below 30%
B. Respiratory rate is 25 breaths/minute
C. Pulsus paradoxus of 8 mmHg
D. Pulse is 112 bpm - answerA
Which of these is NOT a common indoor trigger for asthma?
Cockroaches
Dust mites
Exercise
Termites - answertermites
Upon examination, you notice that Alex, an obese 63yo male, has moderate dyspnea
and purulent sputum. His lungs are normal upon percussion. Laboratory results reveal
an increased hematocrit level. Given the most likely diagnosis, which of the following
drugs would you be LEAST likely to prescribe for the patient's condition?
A. Ipratropium bromide
B. Albuterol
C. Budesonide
D. Montelukast - answerD. montelukast
,Which of the following medications is considered to be the mainstay of treatment for
chronic obstructive pulmonary disease?
A. Budesonide
B. Ipratropium bromide
C. Salmeterol
D. Triamcinolone - answerB
Victor, a stocky 40yo male, presents to the clinic with complaints of difficulty breathing
and "endless amounts of gunk whenever he coughs." During the visit, he coughs up a
substantial amount of yellow phlegm. A blood test reveals an increased hematocrit
level, and a physical exam detects lungs that are normal upon percussion. You order a
pulmonary lab for the patient. Given the most likely condition, which of the following
findings would you LEAST expect?
A. Increased forced expiratory volume in 1 second
B. Increased total lung capacity
C. Increased functional residual capacity
D. Increased residual volume - answerA. (this is an indication of healthy lung
functioning)
Winston, a 42yo male, is an HIV-positive patient whose TB skin test returns with an
elevation of 5mm. After confirming a diagnosis of TB, you prescribe a traditional drug
regimen. For what minimum period of time is Winston expected to continue his
regimen? - answer9 months
Common symptoms of COPD are: - answercough, dyspnea, sputum production
Is a chest x-ray needed to diagnose COPD? - answerNo. Chest x-ray may show
hyperinflation, but PFTs are the standard for diagnosis. PFT may be able to diagnose
prior to the presentation of symptoms.
What is the PFT result need for diagnosis of COPD? - answerFEV1 <0.7
Does every patient with asthma need a SABA? - answeryes
30yo patient with persistent asthma, what are the essential components of their care
plan? (select all that apply)
A. Asthma action plan
B. Flu and pneumonia vaccine
C. Rescue inhaler
D. LABA - answerA, B, C
T or F: Asthma patients and COPD pts both need rescue inhalers? - answertrue
Most common side effects of long-term inhaled steroid use? - answerBone
demineralization (osteopenia) and cataracts
, A 12yo patient presents to the clinic with wheezing, SOB, a feeling of tightness in the
chest. He is afebrile. Which of the following would be the best test to confirm diagnosis?
- answerPFT
T or F: USPSTF recommends screening with low-dose helical CT scans for lung
cancer? - answertrue (small vs large cell carcinoma)
T or F: Women are more likely to be diagnosed with mesothelioma? - answerfalse
What are symptoms of TB? - answerCough (3+ weeks), hemoptysis, chest pain, sputum
production, weight loss, anorexia, fatigue
TB interpretation of the Mantoux test: What are some patient populations that a >10mm
induration would be classified as positive? - answerAt risk peds, lab workers, healthcare
workers, IV drug users
Can you do a TST test on a pregnant woman; and when would you do it? - answerYes,
high risk group or showing signs / symptoms
Can IGRAs be used to differentiate between TB and LTBI? - answerAnswer: No, IGRAs
cannot differentiate between the two
How long after infection can LTBI be detected by TST or IGRAs? - answer2-8 weeks
T or F: Direct Observed Therapy is recommended for only high-risk populations. -
answerFalse, it is recommended for ALL
What TB regimen is recommended for pregnant women? What should the NP do if the
patient is unable to take regimen? - answer9 months of INH daily or twice weekly, give
with vitamin B6; if unable to take, consult TB expert
What is the strongest predictor of asthma? - answeratopy
Due to severely restricted air flow, severe asthma may present with what breathe
sounds? - answerAbsent wheezing, decreased breath sounds
How should you diagnose a 3yo with asthma? Does this process change with a 9yo
being diagnosed? How? - answer3yo is based on s/s and exam; unable to cooperate
with PFT; 9yo diagnosed based on s/s, exam, and PFT
When a patient has been diagnosed with asthma, the NP may refer them out for what
additional testing? - answerallergy
Increasing use of SABA greater than how many days/weeks for sx relief generally
indicates inadequate control and a need to step up treatment? - answer>2
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