NU568 Unit 2 Quiz on Respiratory Conditions and Treatments

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Purdue University Globle 

NU568 FNP I – Primary Care Across the Lifespan

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Quiz on Respiratory Conditions and Treatments

Acute and chronic respiratory conditions are frequently assessed in nursing and advanced practice examinations because they are common in clinical practice. Key evidence-based concepts include using levofloxacin in selected cases of suspected gram-negative sinusitis, combining inhaled corticosteroids (ICS) with long-acting beta agonists (LABAs) for asthma management, recognizing mononucleosis as a cause of severe sore throat with posterior cervical lymphadenopathy, and identifying Streptococcus pneumoniae as the leading cause of community-acquired pneumonia (CAP). This question-and-answer guide provides concise, clinically relevant information to improve understanding of respiratory, infectious, and pulmonary disorders while supporting exam preparation for nursing students and healthcare professionals.

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 that provides broad-spectrum coverage against many gram-negative organisms. It may be considered in selected cases of complicated or resistant sinusitis; however, antimicrobial stewardship principles should always guide antibiotic selection to minimize resistance.

2. Joyce is taking a long-acting beta agonist (LABA) for her asthma. What additional medication should she be taking?
Answer: An inhaled corticosteroid (ICS).

LABAs should not be used alone in asthma management because they do not treat airway inflammation. Combining a LABA with an ICS improves symptom control and decreases the risk of asthma exacerbations.

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: Infectious mononucleosis.

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

• Severe sore throat

• Significant 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.

Pulmonary function naturally decreases with age due to reduced lung elasticity and diminished respiratory muscle strength.

5. Most nosocomial pneumonias are caused by which organisms?
Answer: Gram-negative bacteria.

Common pathogens include:

• Pseudomonas aeruginosa

• Klebsiella pneumoniae

• Acinetobacter species

6. When is sinusitis considered chronic?
Answer: When symptoms persist for more than 12 weeks.

Chronic sinusitis is characterized by prolonged inflammation of the paranasal sinuses and may result from recurrent infections or unresolved acute sinusitis.

7. Which immunoglobulin mediates the Type I hypersensitivity reaction involved in allergic rhinitis?
Answer: Immunoglobulin E (IgE).

IgE activates mast cells and triggers the release of histamine, causing symptoms such as sneezing, itching, and nasal congestion.

Asthma and Pulmonary Conditions

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

Characteristics of moderate persistent asthma include:

• Daily symptoms

• Nighttime awakenings more than once per week

• FEV1 between 60% and 80%

• Frequent 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 because of its effectiveness, safety, and affordability.

10. Which type of stomatitis causes necrotic ulceration of the oral mucous membranes?
Answer: Vincent’s stomatitis.

Also known as acute necrotizing ulcerative gingivitis, Vincent’s stomatitis is commonly associated with poor oral hygiene and bacterial infection.

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

Symptoms commonly associated with viral pharyngitis include:

• Rhinorrhea

• 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.

A throat culture remains the gold standard for confirming Group A Streptococcus when rapid antigen tests are negative or inconclusive.

13. What should patients know about using nicotine gum?
Answer: Nicotine gum should be chewed until softened and then placed between the cheek and gum.

This “chew and park” method improves nicotine absorption and helps reduce adverse effects.

14. Which condition is associated with cigarette smoking?
Answer: Bladder cancer.

Smoking significantly increases the risk of several cancers, including:

• Lung cancer

• Bladder cancer

• Kidney cancer

• Pancreatic cancer

15. Hairy leukoplakia in a patient without other symptoms of immunosuppression strongly suggests which infection?
Answer: Human Immunodeficiency Virus (HIV).

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

16. Julie has a postnasal drip along with her cough. What should be assessed?
Answer: Allergic or vasomotor rhinitis.

Postnasal drip is a common cause of chronic cough and should prompt evaluation for rhinitis-related conditions.

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 otorrhea.

18. Nathan, a heavy smoker, becomes upset when smoking cessation is discussed. What should you do?
Answer: Continue asking at every healthcare visit whether he is ready to quit.

Repeated counseling interventions have been shown to improve smoking cessation rates over time.

19. When should patients with acute otitis media be referred to a specialist?
Answer: Referral is indicated when any of the following are present:

• Concurrent vertigo or ataxia

• Failure of a ruptured tympanic membrane to heal

• Worsening symptoms after 3–4 days of treatment

20. Which antihypertensive medication commonly causes a persistent cough?
Answer: Captopril.

ACE inhibitors can cause a dry, persistent cough because of increased bradykinin levels.

21. Which sinusitis cases warrant specialist referral?
Answer: Patients with the following conditions should be referred:

• Recurrent sinusitis

• Allergic sinusitis

• Sinusitis that is 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: Hospitalization with consideration for intensive care unit (ICU) admission.

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

23. Jason, age 62, has obstructive sleep apnea. Which factor contributes to his condition?
Answer: A neck circumference of 17 inches.

An increased neck circumference is a well-established 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 serum theophylline levels helps maximize therapeutic benefits while minimizing toxicity.

25. How should tuberculosis (TB) prophylactic medications be taken?
Answer: On an empty stomach.

Taking TB medications without food generally improves absorption unless gastrointestinal intolerance necessitates administration with meals.

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

The development of a diffuse rash following amoxicillin administration is strongly associated with Epstein-Barr virus infection.

27. How many hours of supplemental oxygen daily improve mortality in patients with COPD?
Answer: Fifteen to eighteen hours per day.

Long-term oxygen therapy has been shown to improve survival in patients with severe COPD and chronic hypoxemia.

28. How long must a cough persist to be considered chronic?
Answer: More than eight 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.

Treatment responses may vary among individuals, emphasizing the importance of personalized asthma management.

31. Why might a patient have a decreased response to the tuberculin skin test (TST)?
Answer: Long-term corticosteroid therapy.

Immunosuppression associated with prolonged corticosteroid use can produce false-negative TST results.

32. Which population 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 leads to enlargement of the thoracic cavity and the classic barrel chest appearance.

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

Streptococcus pneumoniae remains the leading bacterial cause of CAP worldwide.

35. Which statement regarding the tuberculin skin test (TST) is true?
Answer: The TST identifies delayed hypersensitivity to Mycobacterium tuberculosis antigens and should be interpreted according to patient risk factors and the size of induration.

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). Group A Streptococcal (GAS) disease. https://www.cdc.gov/groupastrep

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

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

NU568 Unit 2 Quiz on Respiratory Conditions and Treatments

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

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

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