CMN 568 Practice Questions And Correct
Answers
A 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 o...
A 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 - answer✔✔C
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? - answer✔✔an 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 - answer✔✔A
Which of these is NOT a common indoor trigger for asthma?
Cockroaches
Termites - answer✔✔termites
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 - answer✔✔D. 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 - answer✔✔B
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 - answer✔✔A. (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? - answer✔✔9 months
Common symptoms of COPD are: - answer✔✔cough, dyspnea, sputum production
Is a chest x-ray needed to diagnose COPD? - answer✔✔No. 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? - answer✔✔FEV1 <0.7
Does every patient with asthma need a SABA? - answer✔✔yes
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 - answer✔✔A, B, C
T or F: Asthma patients and COPD pts both need rescue inhalers? - answer✔✔true
Most common side effects of long-term inhaled steroid use? - answer✔✔Bone 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? - answer✔✔PFT
T or F: USPSTF recommends screening with low-dose helical CT scans for lung cancer? -
answer✔✔true (small vs large cell carcinoma)
T or F: Women are more likely to be diagnosed with mesothelioma? - answer✔✔false
What are symptoms of TB? - answer✔✔Cough (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? - answer✔✔At 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? - answer✔✔Yes, high
risk group or showing signs / symptoms
Can IGRAs be used to differentiate between TB and LTBI? - answer✔✔Answer: No, IGRAs
cannot differentiate between the two
How long after infection can LTBI be detected by TST or IGRAs? - answer✔✔2-8 weeks
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