NU568 Unit 2 – Quiz on Respiratory Conditions and Treatments

NU568 Unit 2 – Quiz on Respiratory Conditions and Treatments

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Purdue University Global

NU568 FNP I – Primary Care Across the Lifespan

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NU568 Unit 2 – Quiz on Respiratory Conditions and Treatments

Acute and chronic respiratory conditions such as sinusitis, asthma, pneumonia, pharyngitis, and chronic obstructive pulmonary disease (COPD) are commonly tested in nursing and advanced practice examinations. Key evidence-based answers include levofloxacin for suspected gram-negative sinusitis, inhaled corticosteroids with long-acting beta agonists (LABAs), mononucleosis as a cause of severe sore throat with posterior cervical lymphadenopathy, and Streptococcus pneumoniae as the leading cause of community-acquired pneumonia (CAP). The following question-and-answer guide provides concise, clinically relevant information based on current practice recommendations.

Respiratory and Infectious Disease Questions

1. Which antibiotic provides the best coverage in acute or chronic sinusitis when gram-negative organisms are suspected?

Answer: Levofloxacin.

Levofloxacin is a fluoroquinolone with broad-spectrum activity against many gram-negative pathogens and is considered in selected cases of complicated or resistant sinus infections. However, antimicrobial stewardship principles should be followed to minimize resistance.

2. Joyce is taking a long-acting beta agonist for her asthma. What additional medication should she be taking?

Answer: An inhaled corticosteroid (ICS).

LABAs should not be used as monotherapy in asthma because they do not address airway inflammation. Combining a LABA with an ICS improves asthma control and reduces exacerbation risk.

3. A patient presents with gradual onset of low-grade fever, marked fatigue, severe sore throat, and posterior cervical lymphadenopathy. What is the most likely diagnosis?

Answer: Mononucleosis.

Epstein-Barr virus (EBV)-associated infectious mononucleosis commonly presents with:

• Severe sore throat

• Fatigue

• Low-grade fever

• Posterior cervical lymphadenopathy

4. What is true regarding pulmonary function?

Answer: There is a normal age-related decline in pulmonary function.

Lung elasticity and respiratory muscle strength gradually decrease with age, leading to measurable reductions in pulmonary function tests.

5. Most nosocomial pneumonias are caused by?

Answer: Gram-negative bacteria.

Common organisms include Pseudomonas aeruginosa, Klebsiella pneumoniae, and Acinetobacter species.

6. When is sinusitis considered chronic?

Answer: When symptoms persist for more than 12 weeks.

Chronic sinusitis is characterized by prolonged inflammation, often resulting from recurrent or inadequately treated acute infections.

7. Which immunoglobulin mediates the Type I hypersensitivity reaction involved in allergic rhinitis?

Answer: IgE.

Immunoglobulin E triggers mast cell degranulation, leading to symptoms such as sneezing, nasal congestion, and itching.

Asthma and Pulmonary Conditions

8. Cydney has daily asthma symptoms, nighttime awakenings more than once weekly, uses a rescue inhaler, and has an FEV1 of 60–80% predicted. How is her asthma classified?

Answer: Moderate persistent asthma.

Moderate persistent asthma typically includes:

• Daily symptoms

• Nighttime symptoms more than once per week

• FEV1 between 60% and 80%

• Increased use of rescue medications

9. What is the first-line treatment for Group A beta-hemolytic streptococcal (GABHS) pharyngitis?

Answer: Penicillin.

Penicillin remains the preferred treatment due to its effectiveness, safety profile, and low cost.

10. Which type of stomatitis causes necrotic ulceration of the oral mucous membranes?

Answer: Vincent’s stomatitis.

Also known as acute necrotizing ulcerative gingivitis, this condition is associated with poor oral hygiene and bacterial infection.

11. Which symptom suggests a viral rather than bacterial cause of sore throat?

Answer: Rhinorrhea.

Symptoms suggestive of viral pharyngitis include:

• Runny nose

• Cough

• Hoarseness

• Conjunctivitis

12. What should be done if a rapid strep test is negative but clinical suspicion remains high?

Answer: Perform a throat culture.

Throat cultures remain the gold standard for confirming Group A Streptococcus when rapid antigen testing is inconclusive.

13. What should patients know about using nicotine gum?

Answer: The gum should be chewed until softened and then placed in the buccal mucosa.

This “chew and park” technique improves nicotine absorption and reduces adverse effects.

14. Which condition is associated with cigarette smoking?

Answer: Bladder cancer.

Smoking is a major risk factor for multiple cancers, including:

• Lung cancer

• Bladder cancer

• Kidney cancer

• Pancreatic cancer

15. Hairy leukoplakia in a person without other symptoms of immune suppression strongly suggests which infection?

Answer: HIV.

Oral hairy leukoplakia is frequently associated with Epstein-Barr virus in immunocompromised individuals, particularly those with HIV infection.

16. Julie has a postnasal drip along with her cough. What should be assessed?

Answer: Allergic or vasomotor rhinitis.

Postnasal drip is among the most common causes of chronic cough.

Ear, Nose, and Throat (ENT) Disorders

17. When is otitis media considered chronic?

Answer: When inflammation persists for more than three months with intermittent or persistent ear discharge.

18. Nathan, a heavy smoker, becomes upset when smoking cessation is discussed. What should you do?

Answer: Continue asking at every visit whether he is ready to quit.

Brief, repeated counseling increases smoking cessation success rates over time.

19. When should patients with acute otitis media be referred to a specialist?

Answer: Referral is appropriate when any of the following occur:

• Concurrent vertigo or ataxia

• Failure of a ruptured tympanic membrane to heal

• Symptoms worsen after 3–4 days of treatment

20. Which antihypertensive medication commonly causes a cough?

Answer: Captopril.

ACE inhibitors can produce a persistent, dry cough due to increased bradykinin levels.

21. Which sinusitis cases warrant specialist referral?

Answer:

• Recurrent sinusitis

• Allergic sinusitis

• Sinusitis refractory to antibiotic therapy

Pneumonia, Sleep Disorders, and Tuberculosis

22. Mabel has a CURB-65 score of 3 for community-acquired pneumonia. What is the appropriate management?

Answer: Hospitalize the patient and consider intensive care unit (ICU) admission.

A CURB-65 score of 3 indicates severe pneumonia with increased mortality risk.

23. Jason, age 62, has obstructive sleep apnea. Which factor contributes to his condition?

Answer: A collar size of 17 inches.

Large neck circumference is a recognized risk factor for obstructive sleep apnea.

24. A patient taking Therabid (theophylline) for asthma should maintain what serum level?

Answer: 5–15 mcg/mL.

Monitoring therapeutic levels helps optimize efficacy while reducing toxicity.

25. How should TB prophylactic medications be taken?

Answer: On an empty stomach.

Taking tuberculosis medications without food improves absorption unless gastrointestinal intolerance occurs.

26. A patient treated with amoxicillin for strep throat develops fever, diffuse rash, hepatomegaly, and cervical adenopathy. What should be suspected?

Answer: Concurrent mononucleosis with streptococcal infection.

A diffuse rash following amoxicillin administration is strongly associated with infectious mononucleosis.

27. How many hours of supplemental oxygen daily improve mortality in COPD?

Answer: 15–18 hours per day.

Long-term oxygen therapy has demonstrated survival benefits in patients with severe COPD and chronic hypoxemia.

28. How long must a cough persist to be considered chronic?

Answer: More than 8 weeks.

Additional Pulmonary and Infectious Disease Questions

29. What is the most significant precipitating event leading to otitis media with effusion?

Answer: Viral upper respiratory infection (URI).

30. Which asthma medication class may have reduced effectiveness in some African American patients?

Answer: Long-term beta-agonist bronchodilators.

Clinical responses may vary among populations, highlighting the importance of individualized treatment.

31. Why might a patient have a decreased response to the tuberculin skin test (TST)?

Answer: Long-term corticosteroid therapy.

Immunosuppression can result in false-negative TST findings.

32. Which ethnic group has the highest lung cancer incidence and mortality rates in the United States?

Answer: African American men.

33. The barrel chest characteristic of emphysema is caused by what?

Answer: Hyperinflation.

Air trapping causes expansion of the thoracic cavity, producing the classic barrel chest appearance.

34. What is the most common cause of community-acquired pneumonia (CAP)?

Answer: Streptococcus pneumoniae.

S. pneumoniae remains the leading bacterial cause of CAP worldwide.

35. Which statement regarding the tuberculin skin test (TST) is true?

Answer: The tuberculin skin test detects delayed hypersensitivity to Mycobacterium tuberculosis antigens and must be interpreted based on patient-specific risk factors and induration size.

References

American Academy of Otolaryngology–Head and Neck Surgery. (2024). Clinical practice guideline: Adult sinusitis. https://www.entnet.org

Centers for Disease Control and Prevention. (2025). Tuberculosis (TB): Testing and diagnosis. https://www.cdc.gov/tb

Centers for Disease Control and Prevention. (2025). Group A Streptococcal (GAS) disease. https://www.cdc.gov/groupastrep

Global Initiative for Asthma. (2025). Global strategy for asthma management and prevention. https://ginasthma.org

Global Initiative for Chronic Obstructive Lung Disease. (2025). Global strategy for the diagnosis, management, and prevention of COPD. https://goldcopd.org

National Heart, Lung, and Blood Institute. (2024). Asthma. https://www.nhlbi.nih.gov/health/asthma

National Institute on Deafness and Other Communication Disorders. (2024). Ear infections in children and adults. https://www.nidcd.nih.gov

Mandell, L. A., & Niederman, M. S. (2019). Aspiration pneumonia. New England Journal of Medicine, 380(7), 651–663. https://doi.org/10.1056/NEJMra1714562

Metlay, J. P., Waterer, G. W., Long, A. C., et al. (2019). Diagnosis and treatment of adults with community-acquired pneumonia. American Journal of Respiratory and Critical Care Medicine, 200(7), e45–e67. https://doi.org/10.1164/rccm.201908-1581ST