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NURS 552-1 Primary Health Care Nursing Adult Midterm Exam with correct answers
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NURS 552-1 Primary Health CareNursing Adult Midterm Exam with
correct answers
Which of the following best describes asthma?
A. Intermittent airway inflammation with occasional bronchospasm
B. A disease of bronchospasm that leads to airway inflammation
C. Chronic airway inflammation with superimposed bronchospasm
D. Relatively fixed airway constriction - ANSWER -C. Chronic airway inflammation with superimposed bronchospasm
The patient you are evaluating is having an asthma flare. You have assessed that his condition is appropriate for
office treatment. You expect to find the following on physical exam:
A. Tripod posture
B. Inspiratory crackles
C. Increased vocal fremitus
D. Hyperresonance on thoracic percussion - ANSWER -D. Hyperresonance on thoracic percussion
A 44-year-old man has a long-standing history of moderate persistent asthma that is normally well controlled by
fluticasone with salmeterol (Advair) via metered-dose inhaler, one puff twice a day, and the use of albuterol one to
two times a week as needed for wheezing. Three days ago, he developed a sore throat, clear nasal discharge, body
aches, and a cough with a small amount of white sputum production. In the past 24 hours, he has had intermittent
wheezing that necessitated the use of albuterol, two puffs, every 3 hours, which produced partial relief. Your next
most appropriate action is to obtain a:
A. Chest radiograph
B. Measurement of oxygen saturation (SaO2)
C. Spirometry measurement
D. Sputum smear for WBCs - ANSWER -C. Spirometry measurement
NURS 552-1 Primary Health Care
Nursing Adult Midterm Exam with
correct answers
,You examine Jane, a 24-year-old woman who has an acute asthma flare following a 3-day history of upper
respiratory tract symptoms (clear nasal drainage, dry cough, no fever). She has a history of moderate persistent
asthma that is in good control and an acceptable peak expiratory flow (PED). She is using budesonide (Pulmicort)
and albuterol as directed and continues to have difficulty with coughing and wheezing. At home, her PEF is 55% of
personal best. In the office, her forced expiratory volume at 1 second (FEV1) is 65% of predicted. Her medication
regimen should be adjusted to include:
A. Oral theophylline
B. Inhale salmeterol (Serevent) via MDI
C. Oral prednisone
D. Oral montelukast (Singulair)
For Jane in the previous question, the NP also considers prescribing:
A. A 10-day course of oral amoxicillin
B. A 5-day course of oral azithromycin
C. A 14-day course of levofloxacin
D. No antimicrobial therapy - ANSWER -C. Oral prednisone
D. No antimicrobial therapy
Which of the following describes a PEF meter?
A. Should only be used in the presence of a medical professional
B. Provides convenient method to check expiratory air flow at home
C. Is as accurate as spirometry
D. Should not be used more than once daily - ANSWER -B. Provides convenient method to check expiratory air flow
at home
NURS 552-1 Primary Health Care
Nursing Adult Midterm Exam with
correct answers
,Which of the following is most accurate regarding the use of a chest x-ray during an acute asthma flare?
A. Chest radiograph should be performed with each asthma flare
B. Chest radiograph should be performed during and following resolution of the flare
C. Chest radiograph should be avoided as it can further exacerbate a flare
D. Chest radiograph should be limited to those with signs of respiratory tract infection (i.e., fever, congested cough) -
ANSWER -D. Chest radiograph should be limited to those with signs of respiratory tract infection (i.e., fever,
congested cough)
A 36-year-old man with asthma also needs antihypertensive therapy. Which of the following products should you
avoid prescribing?
A. Hydrochlorothiazide
B. Propranolol
C. Amlodipine
D. Enalapril - ANSWER -B. Propranolol
For the next 4 questions, which of the following is consistent with presentation of asthma that is not well controlled
(Yes or No):
1. Troublesome nocturnal cough more than two nights per week
2. Need for albuterol to relieve SOB more than twice a week
3. Evidence of consolidation on chest x-ray
4. Two or more exacerbations/year requiring OCSs - ANSWER -1. Yes
2. Yes
3. No
4. Yes
The cornerstone of moderate persistent asthma controller drug therapy is the use of:
NURS 552-1 Primary Health Care
Nursing Adult Midterm Exam with
correct answers
, A. Oral theophylline
B. Inhaled mast cell stabilizers
C. Inhaled SABAs
D. ICSs - ANSWER -D. ICSs
Sharon is a 29-year-old woman with moderate persistent asthma. She has a prescription for an ICS that she does not
use, stating, "I'm finding that the albuterol works better." Currently she uses about two albuterol metered-dose
inhalers per month, "that keeps my cough and wheeze under control." She is requesting a prescription refill. You
consider that:
A. Her asthma is well controlled, and albuterol use can continue
B. Excessive albuterol use is a risk factor for asthma death
C. Her asthma is not well controlled, and salmeterol (Serevent) should be added to relieve bronchospasm and
reduce her albuterol use
D. Her asthma has better control with albuterol than ICSs - ANSWER -B. Excessive albuterol use is a risk factor for
asthma death
In the treatment of asthma, an LTM should be used as a:
A. Controller to prevent bronchospasm
B. Controller to inhibit inflammatory responses
C. Reliever to treat acute bronchospasm
D. Reliever to treat inflammation - ANSWER -B. Controller to inhibit inflammatory responses
Which of the following is not a risk for asthma death?
A. Hospitalization or an emergency department visit for asthma in the past month
B. Current use of systemic corticosteroids or recent withdrawal from systemic corticosteroids
C. Difficulty perceiving airflow obstruction or its severity
D. Rural residence - ANSWER -D. Rural residence
NURS 552-1 Primary Health Care
Nursing Adult Midterm Exam with
correct answers
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