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Chapter 16: Asthma and Chronic Obstructive Pulmonary Disease Medications Test Bank

Chapter 16: Asthma and Chronic Obstructive Pulmonary Disease Medications Test Bank

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Chapter 16: Asthma and Chronic Obstructive Pulmonary Disease Medications
Test Bank
MULTIPLE CHOICE
1.   A primary care nurse practitioner (NP) is evaluating a patient with asthma who reports having wheezing and coughing 1 or 2 days each week and awakening from sleep three or four times each month with asthma symptoms. The patient’s forced expiratory volume in 1 second (FEV1) is 80% of the predicted value. The patient’s current medication regimen is an albuterol metered-dose inhaler, 2 puffs every 4 hours as needed. The NP should prescribe:
a.

montelukast (Singulair) po daily.

b.

ipratropium bromide bid with albuterol.

c.

a low-dose inhaled corticosteroid (ICS), 2 puffs bid.

d.

a long-acting â-adrenergic agonist (LABA), 1 puff bid.

2.   A primary care NP sees an adolescent patient for a hospitalization follow-up after an asthma exacerbation. The patient reports having daily symptoms with nighttime awakening 4 or 5 nights per week and misses school several days each month. The patient currently uses a salmeterol/fluticasone LABA twice daily and albuterol as needed. The patient requires a refill of the albuterol prescription once a month. The patient does not have any known allergies. The NP should:
a.

order a high-dose ICS plus a LABA twice daily.

b.

consider adding theophylline to this patient’s regimen.

c.

continue the current regimen and add omalizumab daily.

d.

order a combination product with ipratropium and albuterol.

3.   A 50-year-old patient who recently quit smoking reports a frequent morning cough productive of yellow sputum. A chest x-ray is clear, and the patient’s FEV1 is 80% of predicted. Pulse oximetry reveals an oxygen saturation of 97%. The primary care NP auscultates clear breath sounds. The NP should:
a.

reassure the patient that these symptoms will subside.

b.

prescribe a moderate-dose ICS twice daily.

c.

order a long-acting anticholinergic with albuterol twice daily.

d.

prescribe an albuterol metered-dose-inhaler, 2 puffs every 4 hours as needed.

4.   A primary care NP is evaluating a patient who has COPD. The patient uses a LABA twice daily. The patient reports having increased exertional dyspnea, a frequent cough, and poor sleep. The patient also uses a short-acting â-adrenergic agonist (SABA) five or six times each day. Pulse oximetry reveals an oxygen saturation of 92%. The patient’s FEV1/forced vital capacity is 65, and FEV1 is 55% of predicted. The NP should prescribe a(n):
a.

oral corticosteroid.

b.

long-acting anticholinergic.

c.

long-acting oral theophylline.

d.

combination ICS/LABA inhaler.

5.   A primary care NP sees a child with asthma to evaluate the child’s response to the prescribed therapy. The child uses an ICS twice daily and an albuterol metered-dose inhaler as needed. The child’s symptoms are well controlled. The NP notes slowing of the child’s linear growth on a standardized growth chart. The NP should change this child’s medication regimen to a:
a.

combination ICS/LABA inhaler twice daily.

b.

short-acting â2-agonist (SABA) with oral corticosteroids when symptomatic.

c.

combination ipratropium/albuterol inhaler twice daily.

d.

SABA as needed plus a leukotriene modifier once daily.


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