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ACNP Certification Review: Pulmonary – Questions With Solutions (100% Correct)
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ACNP Certification Review: Pulmonary – Questions With Solutions (100% Correct)
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ACNP Certification Review: Pulmonary – QuestionsWith Solutions (100% Correct)
Bleating and goatlike sound produced by a patient's voice when heard over
the chest is known as:
A. Normal breath sounds
B. Broncophony
C. Egophony
D. Pectoriloquy Right Ans - C- Egophony
Which breath sounds may be heard over pleural effusions?
A. Vesicular
B. Bronchial
C. Absent
D. All of the above Right Ans - D- All
Which medication is used to treat side effects of isoniazid (INH) and rifampin?
A. Vit B12
B. Vit B6
C Magnesium oxide
D. Calcium Right Ans - B- Vit B6
Salmeterol (Serevent) Right Ans - Long-acting beta agonist
DPI= 1 puff (50 mcg) BID
Formoterol (Foradil) Right Ans - Long-acting beta agonst
DPI= 1 puff (12 mcg) BID
Budesonide/formoterol (Symbicort) Right Ans - inhaled corticosteroid +
LABA
Asthma and COPD maintenance
Dosage forms: 80/4.5, 160/4.5 mcg
COPD- use 160/4.5 mcg ( max 640/18/day)
Fluticasone/Salmeterol (Advair) Right Ans - ICS +LABA
DPI= 1 puff BID
, Albuterol/ipratropium (Combivent, DuoNeb) Right Ans - Short-acting beta
agonist + short-acting anticholinergic
MDI= 2 puffs QID
Tiotropium (Spiriva) Right Ans - Long-acting anticholinergic
DPI= 1 puff Daily
Ipratropium (Atrovent) Right Ans - Short-acting anticholinergic
MDI= 2 puffs q4-6hr
Pirbuterol (Maxair) Right Ans - SABA
MDI: 2 puffs q4-6hr
Levalbuerol (Xopenex) Right Ans - SABA
MDI: 2 puffs q4-6hr
Albuterol Right Ans - SABA
MDI: 2 puffs q4-6hr
Why does hypercapnia develop in severe COPD? Right Ans - Hypercarbia
can be avoided for some time through hyperventilation. Eventually, work of
breathing is too much. Over time, chemoreceptors reset, allowing for a higher
PaCO2.
Why is the unregulated use of O2 in severe COPD/chronic hypercapnia
detrimental? Right Ans - Excessive supplemental O2 causes further
increases in PaCO2 due to increased dead space ventilation (V:Q >1). This is
excessive ventilation relative to capillary blood flow (no gas exchange is
occuring).
What conditions increase physiologic dead space? Right Ans - Alveolar-
capillary interface destruction (emphysema); decreased blood flow (low CO);
overdistended alveoli (positive-pressure ventilation)
Haldane Effect Right Ans - States that deoxygenated hemoglobin picks up
more CO2 while oxygenated blood has reduced capacity for CO2. Thus,
increased uptake of CO2 in venous blood is caused by oxyhemoglobin
desaturation.
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