Question 1.1. Li takes theophylline for his persistent asthma and calls the office with a complaint of nausea, vomiting, and headache. The best advice for him would be to:
Reassure him this is probably a viral infection and should be better soon
Have him seen the same day for an assessment and theophylline level
Schedule him for an appointment in 2 to 3 days, which he can cancel if he is better
Order a theophylline level at the lab for him
Question 2. 2. Harold, a 42-year-old African American, has moderate persistent asthma. Which of the following asthma medications should be used cautiously, if at all?
Betamethasone, an inhaled corticosteroid
Salmeterol, an inhaled long-acting beta-agonist
Albuterol, a short-acting beta-agonist
Montelukast, a leukotriene modifier
Question 3. 3. Digoxin levels need to be monitored closely when the following medication is started:
Loratadine
Diphenhydramine
Ipratropium
Albuterol
Question 4. 4. One goal of asthma therapy outlined by the NHLBI Expert Panel 3 guidelines is:
Ability to use albuterol daily to control symptoms
Minimize exacerbations to once a month
Keep nighttime symptoms at a maximum of twice a week
Require infrequent use of beta 2 agonists (albuterol) for relief of symptoms
Question 5. 5. A stepwise approach to the pharmacologic management of asthma:
Begins with determining the severity of asthma and assessing asthma control
Is used when asthma is severe and requires daily steroids
Allows for each provider to determine their personal approach to the care of asthmatic patients
Provides a framework for the management of severe asthmatics, but is not as helpful when patients have intermittent asthma
Question 6. 6. Treatment for mild intermittent asthma is:
Daily inhaled medium dose corticosteroids
Short-acting beta-2-agonists (albuterol) as needed
Long-acting beta-2-agonists every morning as a preventative
Montelukast (Singulair) daily
Question 7. 7. The first-line therapy for mild-persistent asthma is:
High-dose montelukast
Theophylline
Low-dose inhaled corticosteroids
Long-acting beta-2-agonists
Question 8. 8. The first-line drug choice for a previously healthy adult patient diagnosed with community acquired pneumonia would be:
Ciprofloxacin
Azithromycin
Amoxicillin
Doxycycline
Question 9. 9. The first-line antibiotic choice for a patient with comorbidities or who is immunosuppressed who has pneumonia and can be treated as an outpatient would be:
Levofloxacin
Amoxicillin
Ciprofloxacin
Cephalexin
Question 10. 10. Adults with pneumonia who are responding to antimicrobial therapy should show improvement in their clinical status in:
12 to 24 hours
24 to 36 hours
48 to 72 hours
4 or 5 days
Question 11. 11. John is a 4-week-old infant who has been diagnosed with chlamydial pneumonia. The appropriate treatment for his pneumonia would be:
Levofloxacin
Amoxicillin
Erythromycin
Cephalexin
Question 12. 12. Wing-Sing is a 4 year old who has a suspected bacterial pneumonia. He has a temperature of 102°F, oxygen saturation level of 95%, and is taking fluids adequately. What would be appropriate initial treatment for his pneumonia?
Ceftriaxone
Azithromycin
Cephalexin
Levofloxacin
Question 13. 13. Giselle is a 14-year-old who presents to clinic with symptoms consistent with mycoplasma pneumonia. What is the treatment for suspected mycoplasma pneumonia in an adolescent?
Ceftriaxone
Azithromycin
Ciprofloxacin
Levofloxacin
Question 14. 14. If prescribing bupropion (Zyban) for tobacco cessation, the instructions to the patient include:
Bupropion (Zyban) is started 1 to 2 weeks before the quit date
Nicotine replacement products should not be used with bupropion
If they smoke when taking bupropion they may have increased anxiety and insomnia
Since they are not using bupropion as an antidepressant, they do not need to worry about increased suicide ideation when starting therapy
Question 15. 15. Instructions for the use of nicotine gum include:
Chew the gum quickly to get a peak effect
The gum should be "parked" in the buccal space between chewing
Acidic drinks such as coffee help with the absorption of the nicotine
The highest abstinence rates occur if the patient chews the gum when he or she is having cravings
Question 16. 16. Patients who choose the nicotine lozenge to assist in quitting tobacco should be instructed:
Chew the lozenge well
Drink at least 8 ounces of water after the lozenge dissolves
Use one lozenge every 1 to 2 hours (at least nine per day with a maximum of twenty per day)
A tingling sensation in the mouth should be reported to the provider
Question 17. 17. Isabella has confirmed tuberculosis and is placed on a 6-month treatment regimen. The 6-month regimen consists of:
2 months of four drug therapy (INH, rifampin, pyrazinamide, and ethambutol) followed by 4 months of INH and rifampin
6 months of INH with daily pyridoxine throughout therapy
6 months of INH, rifampin, pyrazinamide, and ethambutol
Any of the above
Question 18. 18. Goals of treatment when treating tuberculosis include:
Completion of recommended therapy
Negative PPD at the end of therapy
Completely normal chest x-ray
All of the above
Question 19. 19. Alyssa is a 15-month-old who has been on amoxicillin for 2 days for acute otitis media. She is still febrile and there is no change in her tympanic membrane examination. What would be the plan of care for her?
Continue the amoxicillin for the full 10 days.
Change the antibiotic to azithromycin.
Change the antibiotic to amoxicillin/clavulanate.
Change the antibiotic to trimethoprim/sulfamethoxazole.
Question 20. 20. A child that may warrant "watchful waiting" instead of prescribing an antibiotic for acute otitis media includes patients who:
Are low risk with temperature less than 39°C or 102.2°F
Have reliable parents with transportation
Are older than age 2 years
All of the above