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Question 1

What layers make up the mucosal blanket that covers the airways?

  1. Gel and Sol
  2. Mucus glands and globet cells
  3. Alveolar type I and II cells
  4. Clara cells and cilia

 

Question 2

Corticosteroids are described as which of the following?

  1. Bronchodilators
  2. Smooth muscle dilators
  3. Antiinflammatory agents
  4. Lipid soluble agents

 

Question 3

Cromolyn sodium is indicated in all but which of the following conditions?

  1. Acute asthma
  2. Asthma prophylaxis
  3. Exercise induced asthma
  4. Allergic rhinitis

 

Question 4

Patients with mild asthma are often treated with Xolair injections.

  1. TRUE
  2. FALSE

 

Question 5

Antileukotriene drugs are beneficial in the treatment of aspirin-induced asthma.

  1. TRUE
  2. FALSE

 

Question 6

All BUT WHICH of the following are complications that may occur with the use of exogenous surfactant?

  1. Desaturation
  2. Tachycardia
  3. Hyperoxyenation
  4. Overventilation

 

Question 7

Which of the following disease are characterized by hypersecretion of mucus?

  1. Congestive heart failure
  2. Chronic bronchitis
  3. Asthma
  4. Cystic fibrosis

 

Question 8

Which of the following would occur if it is determined that an alveolus has a surface tension of 40 dynes and a radius of 4 centimeters?

  1. 20 cmH2O would be required to inflate alveolus; patient’s WOB woudl decrease
  2. 40 cmH2O would be required to inflate alveolus; patient’s WOB would decrease
  3. 20 cmH2O would be required to inflate alveolus; pateint’s WOB would increase
  4. 40 cmH2O would be required to inflate alveolus; patient’s WOB would increase

 

Question 9

A patient receiving both Azmacort and Proventil questions the practitioner about why both drugs are needed. The best answer is:

  1. “Azmacort treats wheezing and Proventil prevents future asthma attacks
  2. Proventil works quickly to relax your airways and Azmacort helps reduce the inflammation
  3. The doctor ordered both to be taken once every night
  4. Azmacort usually causes bronchospasm, so we are giving you Proventil to treat this side effect

 

Question 10

The same patient using combination Steroid and Bronchodilator is discharged from a hospital. The patient is sent home with orders for both Azmacort and Proventil MDIs. What is most critical that the patient understand?

  1. That use of the MDIs may elicit a cough
  2. That Proventil is also available in a nebulization solution
  3. That Azmacort is a controller and not to be used during an acute attack
  4. That Azmacort should be discontinued after wheezing stops

 

Question 11

If a patient experiences an asthma attack as a result of exposure to cats, the asthma would be categorized as which of the following?

  1. Intrinsic
  2. Extrinsic
  3. Autoimmune
  4. Intangible

 

Question 12

Side effects of aerosolized Mucomyst may include:

  1. Bronchospasm, acute airway obstruction, and nausea
  2. Bronchodilation, oropharyngeal irritation, and acute airway obstruction
  3. Fluid overload, bronchospasm, and oropharyngeal irritation
  4. Liver damage, bronchospasm, and corrosion of metal dental work

 

Question 13

Which of the following should be stressed when instructing a new patient in the use of aerosolized steroids?

  1. Use the MDI steroids only when symptoms are severe
  2. Taper steroid use gradually under a physician’s supervision
  3. Adjust dosage and frequency according to how it “feels”
  4. Alternate MDI steroids with other antiasthmatic drugs

 

Question 14

What is the mode of action of Acetylcysteine in promoting mucolysis?

  1. Disruption of plasma proteins
  2. Increase of mucus alkalinity
  3. Hygroscopic properties
  4. Disruption of disulfide bonds

 

Question 15

Allergic and nonallergic rhinitis would be treated with which of the following forms of corticosteroids?

  1. Pill
  2. Nasal spray
  3. Aerosol
  4. Injection

 

Question 16

Which of the following would be recommended to properly administer Survanta to a 1200 gram infant?

  1. Administer 4 doses of Survanta 1.2 ml via the ET tube
  2. Rotate infant twice during administration of the drug
  3. Administer 2 doses of Survanta 3 ml via the ET tube
  4. Rotate infant four times during administration of the drug
  5. Provide positive pressure ventilation for 30 to 4545 seconds after each
    administration
  6. Suction infant immediately after administration to clear airway

 

Question 17

When administering corticosteroids by the aerosol route, local side effects to monitor include:

  1. Appearance of nasal polyps
  2. Cough
  3. Appearance of thrush
  4. HPA suppression

 

Question 18

All but which of the following are possible side effects seen with systemic administration of corticosteroids?

  1. HPA suppression
  2. Slow growth in children
  3. Diuresis
  4. Osteoporosis

 

Question 19

Cromolyn sodium accomplishes which of the following?

  1. Stabilizes leukotrienes
  2. Stabilizes mast cells
  3. Prevents histamine release
  4. Prevents eosinophil degranulation

 

Question 20

Which of the following does not appropriately describe Cromolyn sodium?

  1. Bronchodilator
  2. Mast cell stabilizer
  3. Controller drug
  4. Antiinflammatory

Question 21

Which of the following reactions may occur when using aerosolized corticosteroids for a local effect?

  1. Oral fungal infections
  2. Pulmonary aspergillosis
  3. Delayed healing
  4. Adult-onset diabetes

 

Question 22

Corticosteroids are naturally secreted by which of the following?

  1. Thymal cortex – outer zone
  2. Adrenal cortex – outer zone
  3. Adrenal cortex – inner zone
  4. Thymal cortex – inner zone

 

Question 23

Glucocorticoids inhibit all but which of the following cells of inflammation?

  1. Red blood cells
  2. Macrophages
  3. Lymphocytes
  4. Mast cells

 

Question 24

Which of the following minimizes local side effects associated with use of inhaled corticosteroids?

  1. Use a spacer device
  2. Rinse mouth after each treatment
  3. Prescribe the lowest effective dose

 

Question 25

Which surfactant preparation is derived from the lung of a calf?

  1. Survanta
  2. Curosurf
  3. Dornase Alfa
  4. Formoterol

 

Question 26

Aerosol therapy via ultrasonic nebulization has been ordered for the purpose of sputum induction. The patient has thick, copious secretions with frequent mucous plugging. Given that the patient is also asthmatic, what modification of the order should the CRT recommend?

  1. Discontinue the ultrasonic order
  2. Add Mucomyst to the ultrasonic nebulizer
  3. Add a bronchodilator to the ultrasonic nebulizer
  4. Use a small-volume nebulizer with a bronchodilator and Mucomyst

 

Question 27

A pediatric pulmonologist prescribes Singulair to a 10-year-old female with asthma. What recommendations would you give to this child and her parents?

  1. Take a 4 mg tablet every morning
  2. Take a 10 mg tablet daily
  3. Take a 5 mg tablet daily
  4. Take a 4 mg packet of granules every evening

 

Question 28

Mucomyst should not be aerosolized with which of the following due to incompatibility?

  1. Penicillin
  2. Tetracycline
  3. Erythromycin
  4. Amphotericin B

 

Question 29

Which of the following statements concerning Mucomyst is NOT correct?

  1. It is a mucolytic
  2. It can be used to treat Advil overdose
  3. It can be administered directly into an endotracheal tube
  4. It has a bad odor.

 

Question 30

Which of the following should not be recommended for treating severe asthma?

  1. Cromolyn Sodium
  2. Nasalcrom
  3. Vanceril
  4. Albuterol

 

Question 31

The equation describing the relationship between the internal pressure of a bubble, its surface tension, and the radius is:

  1. Fick’s Law
  2. Starling’s Law
  3. Venturi’s principle
  4. Laplace’s Law

 

Question 32

An asthmatic patient is about to be discharged from the hospital. What information must the CRT give the patient before the patient leaves the hospital?

  1. How to avoid asthma triggers
  2. How to use metered-dose inhalers (MDI)
  3. How to determine which peak flow meter test is best
  4. How to taper oral corticosteroids

 

Question 33

Which of the following are indications for exogenous surfactant therapy

  1. Prevention of sudden infant death syndrome in premature infants
  2. Prevention of RDS in low birth weight infants
  3. Rescue treatment for bronchodpulmonary hyperplasia
  4. Rescue treatment for RDS

 

Question 34

Acetylcysteine may be delivered by which of the following routes?

  1. Oral
  2. Aerosol
  3. Topical (direct instillation)
  4. All of the above

 

Question 35

All but which of the following slow the rate of mucociliary transport?

  1. Cigarette smoking
  2. Beta agonists
  3. COPD
  4. Hypoxia

 

Question 36

Which of the following occur during an asthma attack?

  1. Bronchospasm
  2. Release of epinephrine
  3. Mucosal edema
  4. Increased secretions

 

Question 37

Which of the following are methods of producing natuaral surfactants?

  1. Cloing
  2. Use of aminotic fluid
  3. Alveolar wash

 

Question 38

Which of the following drugs breaks down the DNA of infected secretions in patients with cystic fibrosis?

  1. Acetylcysteine
  2. Pancreatic dornase
  3. Dornalse alfa
  4. Fenoterol

 

Question 39

When administring Survanta as a prevention therapy to RDS, a premature infant less than 1250 grams should be given the drug _____________________.

  1. 15 minutes after birth
  2. 1 hour after birth
  3. 6 hours after birth
  4. 48 hours after birth

1. Adrenergic bronchodilators mimic the actions of:

A. Acetylcholine

B. Penicillin

C. Epinephrine

D. norepinephrine

2. Relaxation of smooth airway muscle in the presence of reversible airflow obstruction is a general indication for the use of:

A. adrenergic bronchodilators

B. anti-infective agents

C. steroids

D. mucolytics

3. Disease states that could benefit from the use of adrenergic bronchodilators include which of the following?
     I. asthma
     II. bronchitis
     III. emphysema
     IV. bronchiectasis
     V. pleural effusion

A. II, IV, and V only

B. I, II, II, and IV only

C. I, II, III, IV, and V

D. I and III only 

4. Short-acting B2 agonists are indicated for:

A. relief of acute reversible airflow obstruction

B. maintenance of bronchodilation

C. thinning of secretions

D. reduction of airway edema 

5. Your patient is diagnosed with persistent asthma. Which type of drug would you recommend for maintenance bronchodilation and control of bronchospasm?

A. long-acting adrenergic agent

B. alpha-adrenergic agent

C. mucolytic agent

D. short-acting adrenergic agent

6. Your patient presents with postextubation stridor. You recommend racemic epinephrine for its:

A. short-acting B2-adrenergic effect

B. long-acting B2-adrenergic effect

C. B1-adrenergic effect

D. alpha-adrenergic vasoconstricting effect

7. You enter the room of a 2-year-old patient who presents with the characteristic “barking cough” found with croup. Once the diagnosis is confirmed, you may recommend which of the following medications to help provide relief from subglottic swelling?

A. terbutaline

B. racemic epinephrine

C. salmeterol

D. albuterol 

8. In a patient who is receiving large doses of catecholamines, you may expect to see all of the following side effects except:

A. relaxation of bronchial smooth muscle

B. diuresis

C. tachycardia

D. increase blood pressure 

9. Levalbuterol is:

A. the single (R)-isomer of albuterol

B. an equal mixture of (R)- and (S)-isomers

C. the same as racemic epinephrine

D. the same as albuterol.

10. Epinephrine stimulates which sites?
     I. Alpha
     II. B1
     III. B2
     IV. Cholinergic

A. IV only

B. I, II, and III only

C. II, III, and IV only

D. II only

11. Epinephrine would be indicated for all of the following except:

A. systemic hypersensitivity reactions

B. acute asthma episodes

C. cardiac stimulation

D. treatment of infections 

12. Racemic epinephrine comes in what percent solution?

A. 1.25%

B. 2.25%

C. 5.0%

D. 0.05% 

13. The keyhole theory indicates that the larger the side-chain attachment to a catechol base, the:

A. more easily it is metabolized

B. more easily it is broken down by COMT

C. greater B2 specificity

D. shorter the duration of action

14. Catecholamines are inactivated by:

A. COMT

B. epinephrine

C. ATP

D. ACTH

15. Catecholamines should not be given by which of the following routes:

A. subcutaneous

B. oral

C. injection

D. inhalation

16. Albuterol is available in which of the following forms?
     I. syrup
     II. nebulizer solution
     III. MDI
     IV. oral tablets
     V. DPI

A. I, II, and V only

B. III, IV, and V only

C. I, II, III, IV and V

D. II and III only

17. Salmeterol is:

A. another name for albuterol

B. available in nebulizer solution only

C. a long-acting B-adrenergic

D. indicated for acute asthma attacks

18. Long-acting B2 agonists are indicated for:

A. mucus reduction

B. treating infections

C. maintenance therapy for asthmatics

D. acute asthma attacks

19. The bronchodilating action of adrenergic drugs is due to stimulation of:

A. cholinergic receptors

B. B1 receptors

C. B2 receptors

D. alpha receptors

20. B1 receptor stimulation will:

A. provide upper airway decongestion

B. increase heart rate and contractile force

C. relax bronchiole smooth muscles

D. cause vasoconstriction

21. Smooth muscle relaxation most likely occurs as a result of:

A. an increase in intracellular cAMP

B. an incr in ATP

C. a decr in ATP

D. a decr in intracellular cAMP

22. Inhalation is the preferred route of administering catecholamines for which of the following reasons?
     I. rapid onset of action
     II. smaller dosage used
     III. reduced side effects
     IV. drug is delivered to target organ
     V. safe and painless route

A. III and IV only

B. I, III, and V only

C. I, II, III, IV, and V

D. I and II only 

23. Continuous nebulization of inhaled B agonists has been used for:

A. pneumonia

B. cystic fibrosis

C. emphysema

D. severe asthma 

24. The dosage recommended by NAEPP EPR 2 for continuous nebulization of adrenergic agents is:

A. 8 to 12 mg/hr

B. 10-15 mg/hr

C. 20-30 mg/hr

D. 5 to 8 mg/hr 

25. Your patient is receiving her third continuous nebulizer of albuterol (15 mg/hr). Which potential complications should you be on the look out for?
     I. hypokalemia
     II. cardiac arrhythmias
     III. hyperglycemia
     IV. PVCs
     V. tremor

A. I, II, and V only

B. I, II, IV, and V only

C. I, II, III, IV, and IV

D. II and IV only 

26. All of the following are side effects that should be monitored in you patient when using sympathomimetic aerosol except:

A. muscle tremor

B. bradycardia

C. tachycardia

D. insomnia 

27. You are ordered to extubate a mechanically ventilated patient who has recently undergone open heart surgery. On post-extubation assessment, you note that the patient has stridor with mild retractions. Pharmacologically, you would recommend:

A. alpha adrenergic

B. anticholinergic

C. sympatholytic

D. B2 adrenergic 

28. Which is the only B-agonist formulation that is a single isomer and is approved by the FDA for aerosol deliver?

A. albuterol

B. levalbuterol

C. tiotropium

D. epinephrine

29. What is the rationale for using the single-isomer agent levalbuterol instead of racemic albuterol?

A. the (S)-isomer is a weak bronchodilator

B. The (R)-isomer is thought to cause tachycardia

C. The (R)-isomer is thought to cause tremors

D. the (S)-isomer is thought to promote bronchoconstriction

30. What is the main difference between salmeterol and formoterol?

A. formoterol has slower onset and peak effect compared with salmeterol

B. formoterol is more B2 specific than salmeterol

C. formoterol has a quicker onset and peak effect than salmeterol

D. formoterol is a short-acting; salmeterol is long-acting

31. What is the indication for use of a short-acing B agonist in asthma?

A. rescue therapy in reversible airflow obstruction

B. antiinflammatory agent in reversible airflow obstruction

C. antiinfective agent in respiratory infections

D. maintenance therapy in reversible airflow obstruction 

32. Is it appropriate to use formoterol as a rescue B-agonist bronchodilator?

a. yes

b. no 

33. Which procedure would tell you that a patient has reversible airway obstruction?

A. pre- and postpulmonary function tests

B. pulse oximetry

C. wheezing on auscultation

D. inspection: patient SOB when walking < 25 ft 34. You receive an order to administer 5 ml of albuterol by SVN.

34. You receive an order to administer 5 ml of albuterol by SVN. You would: 

A. have your supervisor administer the treatment

B. call the physician to confirm the medication dose

C. give 0.5 ml of medication because that is probably what the doctor meant to write

D. confirm the order on the chart and administer as directed 

35. You are administering an aerosolized bronchodilator to your patient. Her pretreatment pulse was 85 bpm. You would stop the treatment if her pulse reached: 

A. 100

B. 110 

C. 120 

D. 90

36. A 7-yr-old boy has been given multiple aerosolized albuterol treatments over the last several days. You enter the room and his father tells you that every time a therapist administers a treatment, a few minutes later the saturation falls. You explain to the father: 

A. that this is abnormal and you will try to change the med to levalbuterol B. that this is normal because of

B. that this is normal because of increase perfusion to poorly ventilated areas

C. that this is abnormal and call the physician 

37. A patient with glottic edema is in mild distress. Which of the following medications would be of benefit in this situation? 

A. ipratropium bromide

B. racemic epinephrine

C. theophylline 

D. albuterol

38. The only anticholinergic that is approved by the FDA for aerosolization is: 

A. albuterol sulfate 

B. glycopyrrolate 

C. atropine 

D. ipratropium bromide

39. Ipratropium bromide can be delivered by which of the following methods? I. tablet II. nebulizer III. injection IV. MDI V. nasal spray 

A. I, III, and IV only

B. I, II, and IV only 

C. II, IV, and V only 

D. II only

40. Atrovent is approved for:

A. thinning of dried secretions

B. acute bronchoconstriction 

C. maintenance treatment of airflow obstruction in COPD 

D. exacerbation of COPD

41. Combivent is a combination drug including which agents? 

A. serevent and atrovent 

B. albuterol and atrovent 

C. maxair and atrovent 

D. albuterol and serevent 

42. Cholinergic stimulation will produce which of the following effects? I. bronchoconstrictionn II. incr mucus secretion III. miosis IV. decr heart rate V. salivation

A. I, III, and V only

B. II, III, and IV only 

C. I, II, III, IV, and V 

D. IV only 

43. Mucociliary slowing, bronchodilation, and increased heart rate are all a result of: 

A. adrenergic agents

B. anticholinergic agents 

C. parasympathetic agents

D. cholinergic agents 

44. Quaternary ammonium compounds such as ipratropium: 

A. do not cross lipid membranes easily 

B. are distributed quickly throught the body when inhaled 

C. have no role in respiratory care 

D. are not effective as inhaled agents 

45. Ipratropium agents may be indicated to treat: 

a. allergic rhinitis

b. common cold 

c. nonallergic rhinitis 

d. all of the above

46. Quaternary ammonium compounds cause bronchodilation by: 

A. stimulating cholinergic sites

B. blocking adrenergic sites 

C. stimulating adrenergic sites 

D. blocking cholinergic sites 

47. Patients using ipratropium aerosols should be instructed to avoid allowing the aerosol in contact with their: 

A. nose

B. eye 

C. ear 

D. hair 

48. Activating an Atrovent inhaler in the eye may cause: 

A. pupil dilation

B. pupil constriction 

C. scarring of the cornea 

D. blindness 

49. Cardiac effects of aerosolized apratropium bromide include: 

A. increase blood pressure

B. increase heart muscle contractility 

C. little or no effect 

D. increase heart rate 

50. Drugs that competitively block the action of acetylcholine at parasympathetic postganglionic effector cell receptors are called: 

A. adrenergic agents 

B. antimuscarinic agents 

C. cholinergic agents

D. musarinic agents 

51. The most common side effect of anticholinergic bronchodilators is: 

A. incr heart rate 

B. wheezing 

C. delirium 

D. dry mouth 

52. Possible side effects of aerosolized atrovent include which of the following? I. flulike symptoms II. pharyngitits III. cardiac arrest IV. dry mouth V. dyspnea

A. I, II, and IV only

B. I, II, IV, and V only 

C. I, II, III, IV, and V 

D. I, II, and III only

53. Results of your patient’s PFT show that the peak flow rate increased the most when she inhaled an aerosolized sympathomimetic agent and an aerosolized parasympatholytic agent. You would recommend that she be given:

A. serevent DPI

B. combivent MDI 

C. foradil DPI 

D. ventolin MDI 

54. What is the only once-a-day anticholinergic on the market? 

A. ipratropium bromide

B. glycopyrrolate 

C. tiotropium bromide 

D. atropine

55. All of the following are true about piratropium, except: 

A. It can be combined with a B-agonist for maintenance bronchodilation in COPD.

B. It is added to B-agonist in severe asthma episodes that do not respond to B-agonists alone.

C. It is a leukotriene modifier used to treat step 3 asthma.

D. It is a first-line choice of bronchodilator for COPD. 

 

Question 1

10 ml of a drug contains 25 mg of active ingredient. How many ml are needed for a 5 mg dose?

  1. 7 mL
  2. 2 mL
  3. 5 mL
  4. 4 mL

 

Question 2

A COPD patient is receiving a beta 2 agonist via a SVN. The RCP notes that the patient’s heart rate has increased from 75 bpm to 105 bpm during the treatment. What should the RCP do?

  1. Continue the treatment and monitor the patient
  2. Terminate the treatment and notify the physician
  3. Have the patient use a MDI instead of the SVN
  4. Switch to a different beta 2 agonist

 

Question 3

A confused, combative resident of a skilled nursing facility was administered an excessive dose of Diazepam (Valium). After administration of the drug, the patient cannot be awakened. Which of the following drugs is indicated in this situation?

  1. Triazolam (Halcion)
  2. Edrophonium (Tensilon)
  3. Flumazenil (Romazicon)
  4. Naloxone (Narcan)

 

Question 4

A mechanically ventilated patient who has been paralyzed with a neuromuscular blocking agent should be given a sedative agent for what reason?

  1. To relieve the patient’s anxiety
  2. To control pain
  3. To keep patient synchronized with the ventilator
  4. To sustain the paralysis

 

Question 5

A mechanically ventilated premature neonate (gestational age 31 weeks) is receiving Beracant (Survanta) for treatment of RDS. After administration of the drug, the neonate’s work of breathing decreases and chest x-ray improves. Which of the following should the RCP recommend?

  1. Increase the FiO2 on the mechanical ventilator
  2. Wait 24 hours, and administer Ribavirin via the SPAG II
  3. Suggest that ventilation via the oscillator be initiated
  4. Decrease the PIP on the mechanical ventilator

 

Question 6

A neonate is to be discharged with apnea monitoring in the home. Which of the following drugs would be prescribed to treat this condition?

  1. Beractant (Survanta)
  2. Nitric Oxide
  3. Montelukast (Singulair)
  4. Caffeine citrate (Cafcit)

 

Question 7

A patient had a bronchoscopy procedure and biopsy taken of a suspected lung tumor. After the biopsy, uncontrolled bleeding occurs. What should be given to control the bleeding?

  1. Instill epinephring through the bronchoscope at the site of the bleeding.
  2. Administer nebulized Albuterol by small volume nebulizer.
  3. Administer heparin if intravenous line.
  4. Administer lidocaine (Xylocaine) by an intravenous line

 

Question 8

A patient is admitted to the pulmonary floor with the diagnosis of Penumocystis carinnii pneumonia. After evaluating the patient, the RCP should suggest which of the following drugs to nebulizer for this patient?

  1. Gentamicin
  2. Pentamidine Isethionate
  3. Amphotericin B
  4. Penicllin G

 

Question 9

A patient is being resuscitated after a cardiac arrest. The resuscitation effort has been in progress for an extended time. The patient might benefit from which of the following at this time?

  1. Administration of a continuous lidocaine drip
  2. Administration of Morphine sulfate
  3. Administration of three defibrillation efforts at 300 joules
  4. Administration of sodium bicarbonate

 

Question 10

A patient presents to the ER after numerous bee stings. The patient is severely hypotensive and is determined to have anaphylaxis. Which of the following drugs would you recommend to treat this patient?

  1. Lidocaine
  2. Dopamine hydrochloride (Intropin)
  3. Sodium bicarbonate
  4. Nitroprusside (Nipride)
  5. Norephinephrine (Levophed)

 

Question 11

A patient presents to the ER with hypotension, episodes of syncope and a heart rate of 42 beats/min. Which of the following drugs would you recommend to treat this patient?

  1. Atropine
  2. Propranolol
  3. Digoxin
  4. Lidocaine

 

Question 12

A patient presents to the ER with severe dyspnea, rales in the lung bases, dry cough, and pitting edema. A chest x-ray reveals enlarged heart with moderate pleural effusion. Which of the following is indicated at this time?

  1. Administration of Lasix
  2. Administration of oxygen
  3. Administration of IV fluids
  4. Administration of Xopenex
  5. STAT electrolyte panel

 

Question 13

A patient receiving both Azmacort and Proventil is sent home with orders for both Azmacort and Proventil MDIs. What is most critical that the patient understand?

  1. That Proventil is also available in a nebulization solution
  2. That use of the MDIs may elicit a cough
  3. That Azmacort should be discontinued after wheezing stops
  4. That Azmacort will not help in acute attack

 

Question 14

A patient receiving both Azmacort and Proventil questions the practitioner about why both drugs are needed. The best answer is:

  1. The doctor ordered both to be taken once every night
  2. Proventil works quickly to relax your airways and Azmacort helps reduce the inflammation
  3. Azmacort usually causes bronchospasm, so we are giving you Proventil to treat this side effect
  4. “Azmacort treats wheezing and Proventil prevents future asthma attacks

 

Question 15

A patient whose cholinergic activity (suppression of the PNS) in the lungs was blocked would be expected to experience which response?

  1. Decreased pulmonary blood flow
  2. Bronchoconstriction
  3. Hypersecretion of the globlet cells
  4. Bronchodilation

 

Question 16

A physician has ordered a 0.20 ml dose of Isuprel (1:200) to be given. How many mg of active ingredient is this?

  1. 1 mg
  2. 1.5 mg
  3. .05 mg
  4. 2 mg

 

Question 17

A physician orders 3 mg of dexamethasone. If it is available in a solution of 4mg/ml, how many milliliters should you give?

  1. 0.75 ml
  2. 3 ml
  3. 0.85 ml
  4. 8.5 ml

 

Question 18

A stock bottle of racemic epinephrine has a concentration of 2.25%. How much of this solution is needed in order to obtain 10 mg of active ingredient?

  1. 0.22 ml
  2. 0.75 ml
  3. 0.44 ml
  4. 0.33 ml

 

Question 19

Aerosol racemic epinephrine is helpful in laryngeal edema and bleeding because it stimulates which of the following receptors?

  1. Beta 1
  2. Alpha
  3. All of the above
  4. Beta 2

Question 20

An adult male asthmatic is receiving 1.25 mg of a.5% solution of Proventil with 3 cc of normal saline via a SVN QID. His wheezing diminishes but does not completely clear following the treatment. What should the RCP recommend in this situation?

  1. Increase the dose of Proventil to 2.5 mg
  2. Increase the frequency of the therapy to Q2 hours
  3. Change to a 1% solution of Proventil
  4. Change to Alupent via a MDI

 

Question 21

An asthmatic patient is about to be discharged from the hospital. What information must the CRT give the patient before the patient leaves the hospital?

  1. How to avoid asthma triggers
  2. How to use metered-dose inhalers (MDI)
  3. How to determine which peak flow meter test is best
  4. How to taper oral corticosteroids

 

Question 22

During therapeutic bronchoscopy for removal of secretions, the pulmonologist is having difficulty aspirating secretions because of their extremely thick, tenacious character. To aid in removal you would recommend?

  1. Epinephrine
  2. Acetylcysteine
  3. Xylocaine
  4. Albuterol

 

Question 23

If nebulized Mucomyst is ordered for an asthmatic patient, what other mediation(s) should be simultaneously administered?

  1. Neo-Synephrine
  2. Cromolyn sodium
  3. Antihistamine
  4. Levalbuterol

 

Question 24

In ACLS, which of the following drugs can be safely and effectively administered via the endotracheal tube?

  1. Atropine
  2. Propranolol
  3. Lidocaine
  4. Dopamine
  5. Epinephrine

 

Question 25

In order to facilitate endotracheal inbuation, a patient is paralyzed with Pavulon. Following intubation, you wish to reverse the paralysis. You would administer:

  1. Succinylcholine chloride
  2. Any of the above
  3. Atropine
  4. Neostigmine bromide (Prostigmin)

 

Question 26

In which of the following anticholinergic bronchodilators would the RCP give instructions to patient for proper DPI use?

  1. Spiriva
  2. DuoNeb
  3. Atrovent
  4. Combivent

 

Question 27

Positive inotrophic drugs have which of the following effects?

  1. Increased strength of cardiac contraction
  2. Decreased electrical conductivity of the heart
  3. Decreased heart rate
  4. Decreased strength of cardiac contraction

 

Question 28

Naloxone (Narcan) would be an affective antagonist for which of the following?

  1. Morphine
  2. Valium
  3. Heroin
  4. Pentobarbital sodium (Nembutal)
  5. Codeine

 

Question 29

Of the following sedative agents, which are considered barbituates?

  1. Chloral hydrate (Noctec)
  2. Pentobarbital sodium (Nembutal)
  3. Diazepam (Valium)
  4. Phenobarbital (Luminol)
  5. Thiopental sodium (Pentothal)

 

Question 30

Sputum induction has been ordered for a newly admitted patient with tuberculosis. The patient is a 37-year-old male in no acute distress. Which of the following techniques should the RCP attempt first to collect the sputum?

  1. Use 6 cc of 20% mucomyst and SVN
  2. Use a nasal trumpet and NT suction the patient
  3. Use a bronchodilator and encourage vigorous coughing
  4. Use a hypertonic saline solution and SVN

 

Question 31

The physician has just determined airway responsiveness to bronchodilator therapy in a COPD patient. He asks the RCP to recommend a bronchodilator for long-term use. Which of the following bronchodilators should the RCP recommend at this time?

  1. Ipratropium bromide
  2. Bitolteral sulfate
  3. Metaproterenol sulfate
  4. Albuterol sulfate

 

Question 32

Which disease state is consistently treated with aerosolized antibiotics such as TOBI?

  1. Acute bronchitis
  2. Asthma
  3. Cystic fibrosis
  4. COPD

 

Question 33

Which of the following adrenergic bronchodilators is available in both a SVN and MDI formulation?

  1. Levalbuterol
  2. Raceminc epinephrine
  3. Albuterol
  4. Serevent
  5. Epinephrine

 

Question 34

Which of the following are considered effective antituberculosis drugs?

  1. Gentamicin
  2. Isoniazid
  3. Streptomycin
  4. Ethambutal
  5. Rifampin

 

Question 35

Which of the following best describes Cromolyn sodium (Intal)?

  1. Available as MDI and SVN
  2. Should be recommended to used in acute asthma attacks
  3. SVN solution is available as a 20 mg vial
  4. Is considered an asthma controller drug

 

Question 36

Which of the following best describes Dornase alfa?

  1. Trade name is Pulmozyme
  2. Available as a MDI
  3. Available as a SVN solution in a 2.5 mg ampule
  4. Is indicated as a mucolytic for patients with cystic fibrosis

 

Question 37

Which of the following can be used to decrease the viscosity of secretions?

  1. Potassium iodide
  2. Acetylcysteine
  3. Dornase alfa
  4. Normal saline

 

Question 38

Which of the following corticosteroids are available in a MDI formulation?

  1. Ziletuon (Zyflo)
  2. Beclomethasone (Qvar)
  3. Nedocromil sodium (Tilade)
  4. Triamcinolone acetonide (Azmacort)
  5. Fluticasone propionate (Flovent)

 

Question 39

Which of the following is an inotropic agent useful in the treatment of hypotensive patients who have organic heart disease (heart failure)?

  1. Procainamide
  2. Atropine sulfate
  3. Dobutamine hydrochloride (Dobutrex)
  4. Nitroglycerin

 

Question 40

Which of the following is indicated for a patient in hypertensive crisis?

  1. Dopamine hydrochloride (Intropin)
  2. Dobutamine hydrochloride (Dobutrex)
  3. Nitroprusside (Nipride)
  4. Sodium bicarbonate

 

Question 41

Which of the following is the most appropriate first-line pharmacologic agent for a COPD patient with severe hypoxemia?

  1. Furosemide
  2. Xopenex
  3. Mannitol
  4. Oxygen

 

Question 42

Which of the following is true regarding Morphine sulfate?

  1. his drug can lead to respiratory depression if high doses are given
  2. This drug is used to treat pain associated with a MI
  3. This drug causes vasoconstriction and should not be given to patients with pulmonary edema
  4. This drug cannot be reversed and should be avoided in COPD patients

 

Question 43

Which of the following is true regarding the nondepolarizing blocker Pancuronium bromide (Pavulon)?

  1. This drug has a long duration of action
  2. This drug can produce a cardiac arrhythmia
  3. This drug last for approximately 15 minutes
  4. This drug can be reversed with Neostigmine bromide (Prostigmin)
  5. This drug removes patient’s perception of pain

 

Question 44

Which of the following osmotic diuretics are indicated to reduce cerebral edema?

  1. Chlorothiazide (Diuril)
  2. Mannitol (Osmitrol)
  3. Furosemide (Lasix)
  4. Sterile urea (Ureaphil)

 

Question 45

Which of the following pharmacologic agents is indicated in the treatment of a patient with status asthmaticus?

  1. Acetylcysteine
  2. Cromolyn sodium
  3. Levalbuterol
  4. Aminophylline
  5. Methylpredinisolone (Solu-Medrol)

 

Question 46

Which of the following reactions may occur when using aerosolized corticosteroids for a local effect?

  1. Adult-onset diabetes
  2. Pulmonary aspergillosis
  3. Oral fungal infections
  4. Delayed healing

 

Question 47

Which of the following should be stressed when instructing a patient on systemic corticosteroids in the use of aerosolized steroids?

  1. Use the MDI steroids only when symptoms are severe
  2. Taper systemic steroid use gradually under a physician’s supervision
  3. Alternate MDI steroids with other antiasthmatic drugs
  4. Adjust dosage and frequency according to how it “feels”

 

Question 48

While recording the results of an aerosolized Beta 2 agonist treatment, the RCP erroneously wrote the trade name of the wrong Beta 2 agonist. What should the RCP do in this situation?

  1. Use correction fluid on the wrong trade name and write in the name of the correct medication
  2. Leave the trade name written, because it is also classified as a Beta 2 agonist
  3. Erase the wrong trade name and write in the correct drug
  4. Draw a horizontal line through the incorrect trade name, print “error” above it, and continue charting

Question 49

You are called to the ER to intubate a MVA victim with numerous injuries including chest wall trauma. The patient is very combative. Which of the following drugs would be helpful in performing the intubation?

  1. Succinylcholine chloride (Anectine)
  2. Diazepam (Valium)
  3. Midazolam (Versed)
  4. Furosemide (Lasix)
  5. Nedocromil sodium (Tilade)

 

Question 50

You receive an order to administer a sympathomimetic bronchodilator to a patient with pneumonia. The patient has never needed prior bronchodilator therapy. Common side effects to be aware of include:

  1. Nervousness
  2. Trembling hands
  3. Headache
  4. Decreased heart rate
Question 1

A 78-year-old female patient with a history of CHF has lab work performed with the following results: BUN 22 mg/ml and Creatine level of 2.2 mg/dl. This patient is most likely suffering from:

  1. Pulmonary edema
  2. Kidney failure
  3. Acute MI
  4. Severe dehydration

 

Question 2

The main clinical use of Succinylcholine (Anectine) is to relax muscles during:

  1. Surgery
  2. Laryngeal spasm
  3. Intubation
  4. Exercise

 

Question 3

The only depolarizing drug is which of the following?

  1. Tubocurarine
  2. Doxacurium
  3. Pancuronium
  4. Succinylcholine

 

Question 4

Which of the following barbiturates would be used to control seizures?

  1. Methohexital
  2. Pentobarbital
  3. Phenobarbital
  4. Thiopental

 

Question 5

Which of the following would be considered a toxic level of alcohol in the blood?

  1. 100 mg/dl
  2. 200 mg/dl
  3. 300 mg/dl
  4. 400 mg/dl

 

Question 6

Neuromuscular blocking agents are clinically used for all but which of the following?

  1. Relieve severe pain
  2. Muscle paralysis during surgery
  3. To facilitate mechanical ventilation
  4. Endotracheal intubation

 

Question 7

In a 70-kg person, how much of the total cardiac output flows through the kidney?

  1. 50%
  2. 40%
  3. 37%
  4. 21%

 

Question 8

Which of the following therapeutic procedures are needed for patients receiving prolonged neuromuscular blockade?

  1. Frequent turning
  2. Range of Motion exercises
  3. Suctioning only every 4 hours
  4. Lubrication of the eyes
  5. Ventilator apnea alarms set at 45 seconds

 

Question 9

Which of the following describes the mode of action of local anesthetics?

  1. Produce nerve conduction block by blocking sodium channels
  2. Block transmission of pain signals to the brain
  3. Produce nerve conduction block by increasing calcium ions
  4. Provide transmitters that attach to nerves and block signals

 

Question 10

Hypochloremia and hypoalkemia result in which acid base disorder?

  1. Metabolic alkalosis
  2. Metabolic acidosis
  3. Respiratory acidosis
  4. Mixed respiratory and metabolic alkalsosi

 

Question 11

The functional unit of the kidney is which of the following?

  1. Glomerulus
  2. Tubule
  3. Bladder
  4. Nephron

 

Question 12

The kidney is which of the following?

  1. Active organ
  2. Passive filter organ
  3. High oxygen consuming organ

 

Question 13

The preferred route of administration for neuromuscular blocking agents is which of the following?

  1. IM
  2. Oral
  3. Aerosol
  4. IV

 

Question 14

Diuretics are used to treat heart failure and lower blood pressure by:

  1. Reducing the plasma volume
  2. Maintaining blood volume
  3. Causing vasoconstriction
  4. Increase the number of RBCs

 

Question 15

Patients receiving loop diuretics should have their __________ levels monitored.

  1. Magnesium
  2. Potassium
  3. Bleeding time
  4. Bicarbonate

 

Question 16

All but which of the following statements are true about diuretics?

  1. Diuretics increase urine output
  2. Diuretics act directly on the kidney
  3. Diuretics eliminate excess fluid from the body
  4. Diuretics are all alike in their mode of action

 

Question 17

Muscle paralysis caused by nondepolarizing blocking agents can be reversed by which of the following?

  1. Spironolactone
  2. Edroponium
  3. Neostigmine
  4. Pavulon

 

Question 18

Which of the following describes Succinylcholine (Anectine):

  1. Is long lasting
  2. Cannot be reversed
  3. Decreases sodium potassium levels
  4. Is contraindicated for patients with head trauma

 

Question 19

Which approach is usually more effective in pain management?

  1. Using maximum doses of pain relievers
  2. Estimating a patient’s level of pain while he is sleeping
  3. Using a combination of pain medications
  4. Always using a narcotic pain reliever

 

Question 20

Carbonic anhydrase inhibitors can be used to stimulate respirations by creating which of the following acid-base disorders?

  1. Metabolic acidosis
  2. Metabolic alkalosis
  3. Respiratory acidosis
  4. Respiratory alkalosis

Question 21

Which of the following drugs are used as reversal agents for Opioid drugs?

  1. Propranolol (Inderal)
  2. Methylxanthine
  3. Propofol (Diprivan)
  4. Naloxone (Narcan)

 

Question 22

Which of the following are components of the kidney?

  1. Nephron
  2. Bladder
  3. Loop of Henle
  4. Distal tubule

 

Question 23

Which of the following are uses of Barbiturates?

  1. Used as a hyotonic to induce sleep
  2. Used to relieve pain
  3. Used to stimulate respirations
  4. Used to treat anxiety

 

Question 24

A patient is scheduled to have a FOB (Fiberoptic bronchoscopy) due to hemoptysis. The patient is given Versed prior to the procedure. Which of the following should be monitored during the procedure?

  1. Pulse oximetry
  2. Endotracheal tube placement
  3. Blood pressure
  4. Continuous ECG monitoring

 

Question 25

Which group of diuretics are the most potent?

  1. Osmotic diuretics
  2. Loop diuretics
  3. Carbonic anhydrase inhibitors
  4. Thiazide diuretics

 

Question 26

About 10% of the glomurular filtrate is exerted as urine.

  1. TRUE
  2. FALSE

 

Question 27

You are caring for a patient who has sustained a severe closed head injury. The ICP monitor reads a pressure of 38 mmHg. To reduce the cerebral edema and lower the ICP, you would recommend which diuretic?

  1. Amiloride
  2. Lasix
  3. Metolazone
  4. Mannitol

 

Question 28

CNS and respiratory stimulant drugs are used to trea

  1. Anxiety
  2. Narcolepsy
  3. Obesity
  4. Depression

 

Question 29

A patient is scheduled for a surgery that will require a neuromuscular blocking drug to be given. Upon examination, you find that the patient has bilateral expiratory wheezing, has increased expiratory time, and has small amounts of mucoid secretions. What neuromuscular drug would you NOT recommend for this patient?

  1. Norcuron
  2. D-tubocurarine
  3. Anectine
  4. Valium

 

Question 30

All of the following are considered to be therapeutic uses for narcotic analgesic EXCEPT:

  1. Muscular paralysis
  2. Pain relief
  3. Sedation
  4. Relief of dyspnea caused by advanced respiratory failure

 

Question 31

Which of the following lab values would indicate that a 49-year-old male patient is dehydrated?

  1. BUN of 12 mg/ml
  2. Creatine level of .8 mg/dl
  3. BUN of 26 mg/ml
  4. Creatine level of 2.38 mg/dl

 

Question 32

Muscle contraction occurs with which of the following phases?

  1. Apolarization
  2. Depolarization
  3. Repolarization
  4. Myelination

 

Question 33

Which of the following applies to narcotic analgesics (Opioid analgesics)?

  1. Used to treat severe pain
  2. Can depress the medullary respiratory center
  3. Can be administered by IV only

 

Question 34

Which of the following agents will reverse the effects of a benzodiazepine such as Valium?

  1. Amitriptyline (Elavil)
  2. Alteplase (Activase)
  3. Flumazenil (Romazicon)
  4. Atropine

 

Question 35

What acid-base imbalance would be seen in a person who has overdosed on barbiturates?

  1. Respiratory alkalosis
  2. Respiratory acidosis
  3. Metabolic acidosis
  4. Metabolic alkalosis

 

Question 36

Nonsteroidal anti-inflammatory drugs (NSAID) should be used cautiously in patient’s with:

  1. A history of cardiac arrhythmias
  2. A history of gastric ulcers
  3. A history of alcohol abuse
  4. A history of CVA

 

Question 37

The first priority in treating a patient who has just overdosed on Barbiturates is:

  1. Provide circulatory support
  2. Drug elimination
  3. Provide ventilatory support
  4. Prevent dehydration