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NR 511 Week 4 Midterm Question Bank (Newest), Differential Diagnosis and Primary Care Practicum, 100 % VERIFIED ANSWERS. Secure HIGHSCORE
NR 511 Week 4 Midterm Question Bank Q bank questions Respiratory An adult has upper respiratory symptoms and cough for the past 14 days. What should be consi...
NR511 Midterm Exam Question
Bank
NR 511 Differential Diagnosis and
Primary Care, Chamberlain
,NR511_Midterm-Question Bank
Respiratory
An adult has upper respiratory symptoms and cough for the past 14
days. What should be considered? (Pertussis)
Pertussis should always be considered in adults who present with acute
cough of greater than 5 days’ duration. The incubation period for
pertussis is about 7-10 days. Patients present with URI symptoms for 1-2
weeks. The classic paroxysmal cough usually begins in the second week
of the illness. The duration of symptoms and cough are about 3 months
even when treated with antibiotics. This is highly infectious and is a
reportable disease.
Mycoplasma pneumoniae is: (a disease with extrapulmonary
manifestations)
Mycoplasma is an atypical pathogen and produces atypical pneumonia.
It can be difficult to diagnose because symptoms can be varied and
involve multiple body systems (extrapulmonary manifestations).
Infection with Mycoplasma may present with a normal white blood cell
count, maculopapular rash, GI symptoms, tender joints and aches, and,
though rare, cardiac rhythm disturbances. Respiratory symptoms may
not be pronounced. On chest X-ray there are some unique findings
(peribronchial pattern) with Mycoplasma. These include thickened
bronchial shadow, streaks of interstitial infiltration, and atelectasis.
These are more likely to occur in the lower lobes.
Which medication below is contraindicated in an asthma patient
because it may increase risk of sudden death if used alone? (Long-
acting bronchodilator)
,A long-acting bronchodilator can be used to treat asthma when it is used
in combination with an inhaled steroid. Otherwise, using a long-acting
bronchodilator like salmeterol is contraindicated. There is an increased
risk of sudden death with asthma exacerbations when this class is used
solo to treat asthma. The other choices can be used to treat asthma.
Choices vary depending on the patient.
A 75-year-old female with emphysema who has been treated with
inhaled steroids for many years should: (should be screened for
osteoporosis)
Older females are at higher risk than others for osteoporosis. This female
patient, who has used inhaled steroids and smokes, has multiple risk
factors for osteoporosis. Additionally, she probably has emphysema
because she smoked (or still smokes). If she is Asian or Caucasian, she
has still another risk factor. Screening for osteoporosis should be
considered when managing patients with multiple risk factors.
A patient received the pneumonia immunization at age 60 years. He
is 65 years old and presents to your clinic today. What
recommendation should be made about the pneumococcal
immunization? (He should receive another one today)
This patient should receive another one today because he is 65 years old
and at least 5 years has elapsed since his last one. The CDC does not
recommend immunizing this patient every 5 years. Two immunizations
are available, PCV13 and PPSV23. He needs both, but PCV13 should be
administered today. PPSV23 should be administered at least 1 year later.
Which of the following medications should be used cautiously in a
patient who has asthma? (Timolol ophthalmic drops)
Timolol is a beta blocker. This class of medications can precipitate
bronchoconstriction in patients who have asthma. Even though timolol is
being administered in the eye, it is absorbed through mucous membranes
and can exert systemic effects. Beta blockers should be avoided in
, patients with asthma and used cautiously in patients with COPD. The
other medications listed have no specific contraindications for patients
with asthma.
The most common symptom associated with acute bronchitis is:
(Cough)
Fever (temp > 101°F) is an unusual symptom associated with acute
bronchitis. Cough is the most common symptom associated with acute
bronchitis. Purulent sputum is identified in more than 50% of patients
with acute bronchitis. The color imparted to the sputum is usually due to
sloughing of epithelial cells, not bacterial infection. Concurrent upper
respiratory symptoms are typical of acute bronchitis. Pharyngitis is
common.
Mild persistent asthma is characterized by: (symptoms occurring
more than twice weekly)
Mild persistent asthma is characterized by symptoms that occur more
than twice weekly but not daily; or 3-4 nocturnal awakenings per month
due to asthma. It is treated with an inhaled steroid daily, and a
bronchodilator PRN for exacerbations. If symptoms occur more than
twice weekly, therapy should be stepped up. Generally, a long-acting
bronchodilator is added to the steroid when therapy is stepped up.
The chest circumference of a 12 month-old is: (equal to head
circumference)
The chest circumference is not routinely measured at well-child visits,
but is assessed if there is concern about the circumference of either the
head or the chest. An exception to this observation can occur in
premature infants where the head grows very rapidly. Normally, the
head exceeds the chest circumference by 1-2 cm from birth until 6
months. Between 6 and 24 months the head and chest circumference
should be about equal and by 2 years of age the chest should be larger
than the head. The chest circumference is measured at the nipple line.
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