Upper and Lower Respiratory Tract Disorders Flashcards
Question 1 of 10
Carol, age 68, was brought to the emergency department by her husband when she was having difficulty breathing. She had also developed a cough and fever, and her husband noticed that her symptoms seemed to occur suddenly.
Based on the information available, you assess Carol for pneumonia. Which of the following assessment results would indicate Carol may have pneumonia? Select all that apply.
Hyperresonance of some lung fields with percussion
Crackles
Whispered sounds clear and distinct over some lung fields
Increased tactile fremitus
Lack of accessory muscle involvement in breathing.
Crackles
Whispered sounds clear and distinct over some lung fields
Increased tactile fremitus
Crackles or rales are the characteristic symptom of pneumonia, indicating the alveoli are opening and closing against fluid. Whispered sounds and tactile fremitus are heard and felt, respectively, more clearly when pneumonia is present. Hyperresonance of lung fields occurs in emphysema, not pneumonia. As Carol is struggling to breathe, she would have increased used of accessory muscles, not less.
Question 2 of 10
On hearing your assessment results, the physician decides to order follow-up tests to confirm the potential diagnosis of pneumonia for Carol. Which of the following tests and findings would indicate pneumonia? Select all that apply. Echocardiogram Chest X-ray Sputum culture Ghon focus Blood test
Chest X-ray
Sputum culture
Chest X-rays and sputum cultures are standard diagnostic procedures in pneumonia. Consolidation on a chest X-ray is indicative of pneumonia, while a Ghon focus is seen in cases of tuberculosis. An echocardiogram evaluates the heart and not the lungs.
Question 3 of 10
Carol has not been hospitalized recently, so you believe that Carol has community-acquired pneumonia. Which organisms is the most likely cause of Carol’s pneumonia? Streptococcus pneumoniae Mycobacterium tuberculosis Bordetella pertussis Legionella pneumophilia
Streptococcus pneumoniae
Streptococcus pneumoniae is the most common cause of community-acquired pneumonia. The other organisms may cause respiratory infections but are not usually the main cause of community pneumonia.
Question 4 of 10
You continue to document Carol’s health history and find several risk factors that may have played a role in Carol’s infection. Which of the following may be risk factors for Carol’s pneumonia? Select all that apply.
Carol smokes one pack of cigarettes per day.
Carol has received the pneumococcal vaccine.
Carol was recently infected with influenza but did not seek medical treatment.
Carol is female.
Carol is of normal weight for her height.
Carol smokes one pack of cigarettes per day.
Carol was recently infected with influenza but did not seek medical treatment.
Smoking is a known risk factor for pneumonia, as is recent infection with influenza. Pneumococcal vaccination would decrease Carol’s risk for community-acquired pneumonia, not increase. The fact that Carol is female and of normal weight are not significant risk factors for pneumonia.
Question 5 of 10
Carol wonders how her pneumonia will be treated. Which of the following may the physician consider for Carol? Select all that apply.
Prescription for antibiotics
Recommendations that Carol begin to exercise to “clear her lungs”
Assessment of Carol with PSI (Pneumonia Severity Index)
Assessment of Carol’s SaO2 and PaO2 levels
Prescription for bronchodilators
Prescription for antibiotics
Assessment of Carol with PSI (Pneumonia Severity Index)
Assessment of Carol’s SaO2 and PaO2 levels
Prescription for bronchodilators
As Carol’s pneumonia is likely bacterial in nature, antibiotics are a primary component of treatment. Carol’s status can be assessed with the PSI to determine whether hospitalization is necessary. Carol’s oxygen levels should be evaluated to see if she should receive oxygen therapy. Given Carol’s illness and difficulty breathing, an exercise program is not recommended. Carol may benefit from bronchodilators.
Question 6 of 10
Manuel is seeking clinical information about a medical test he was given before starting his new job in a health care setting. The test required Manuel’s forearm skin to be pricked and then evaluated 48 hours later.
Which test was performed on Manuel? CBC test IGRA test PFT test Mantoux test
Mantoux test
The Mantoux test requires intradermal injection of purified protein derivative of TB. The area injected is evaluated 48 hours later. The interferon gamma release assay (IGRA) and complete blood cell count (CBC) are blood tests, not intradermal injections. Pulmonary function tests (PFTs) measure pulmonary function.
Question 7 of 10
Manuel is informed that he has a positive test result. What does this mean?
Manuel has had prior exposure and sensitization to M. tuberculosis.
Manuel has an overreactive immune system indicating presence of autoimmune disease.
Manuel had no response to the injected substance.
Manuel has active TB.
Manuel has had prior exposure and sensitization to M. tuberculosis.
The Mantoux test shows exposure and sensitization to the organism that causes TB but does not differentiate active TB. A positive Mantoux test shows Manuel had a response to the injected substance.
Question 8 of 10
What follow-up test will Manuel require based on his positive test result? Echocardiogram CBC Chest X-ray examination V-Q scan
Chest X-ray examination
Following a positive Mantoux test, a chest X-ray is used to determine if active TB is present.
Question 9 of 10
What diagnostic test results may a clinician look for to determine if Manuel has been infected with TB? Select all that apply.
Tubercles on chest X-ray
Gram-positive stain result in sputum sample
Ranke complex
Acid-fast positive stain result in sputum sample
Ghon focus on chest X-ray
Tubercles on chest X-ray
Ranke complex
Acid-fast positive stain result in sputum sample
Ghon focus on chest X-ray
Tubercles, Ghon focus, and Ranke complex can all appear on chest X-ray with TB infection. M. tuberculosis is an acid-fast positive organism that may be present in the sputum of individuals with active TB. A gram-positive stain is not a differential indicator for tuberculosis.
Question 10 of 10
Manuel wonders why he had a positive Mantoux test if his chest X-ray does not indicate tuberculosis. The clinician asks Manuel if he has ever been vaccinated for TB. Which of the following is a vaccine for TB that Manuel may have received? PCP BCG IgRA Xpert MTB
BCG
The BCG vaccine, bacille Calmette-Guérin, protects against tuberculosis. Some countries in Europe, Middle East, Africa, and Asia provide this vaccine. If vaccinated with BCG, Manuel will have a positive Mantoux test.
Q uestion 1 of 5
A patient complains of nasal congestion and nasal discharge and is diagnosed with the common cold. Which virus could be responsible for this illness?
Rhinovirus
Epstein-Barr virus
Streptococcus pneumoniae
Mycobacterium tuberculosis
Rhinovirus
Question 2 of 5
A patient is diagnosed with “strep throat.” Which microorganism causes this condition?
Streptococcus aureus
Streptococcus pyogenes
Haemophilus influenza
Mycobacterium tuberculosis
Streptococcus pyogenes
Question 3 of 5
Fluid accumulation in the alveoli occurs in _________________.
pneumonia
tonsillitis
epiglottitis
bronchitis
Pneumonia
Question 4 of 5
Which of the following are means by which pneumonia may be acquired? Select all that apply.
Secondary infection Community Hospital Genetics Ventilator
Community
Secondary infection
Hospital
Ventilator
Question 5 of 5
The most common infectious disease worldwide is caused by _____________.
Mycobacterium tuberculosis
Clostridium botulinum
Epstein-Barr virus
Staphylococcus aureus
Mycobacterium tuberculosis
