FNP Board review Questions& Answers
A 24-year old, otherwise healthy college student presents with c/o cough x
6 weeks. She has tried several OTC cough meds with no improvement.
What is the most important information to consider when building your
differential diagnoses?
A) Her age
B) Family hx
C) Ineffectiveness of OTC cough medicines
D) Length of time she has been coughing
(AnsD) Length of time she has been coughing
Why? This information helps you build your ddx
Acute cough < 3 weeks: bronchitis, sinusitis, PND, exacerbation of COPD/asthma, pneumonia, pulmonary embolism Chronic cough (>8 weeks) GERD and Asthma are most common causes,
also consider infection (e.g. pertussis, atypical pneumonia), ACE inhibitors,
chronic bronchitis, bronchiectasis, lung ca)
According to the CDC, what drug class is considered first-line treatment for
pertussis?
A) Sulfonamide
B) Tetracycline
C) Macrolide
D) Beta-lactam
(Ans- C) Macrolide antiobitic (e.g. Azithromycin, clarithromycin
Sulfonamides are second-line
Match the antibiotics with the correct drug class:
- Sulfonamide
- Tetracycline
- Macrolide
- Beta-lactam
A. Doxycyline
B. Azithromycin
C. Penicillins
D.Trimethoprim-Sulfamethoxazole
E. Cephalosporin
F. Clarithromycin
(Ans1. Sulfonamide – D.Trimethoprim-Sulfamethoxazole (Bactrim) - Tetracycline – A. Doxycycline
- Macrolide – B & F, Azithromycin and Clarithromycin
- Beta-lactam – C & E, PCN and cephalosporins
What are the three most common bugs in community-acquired pneumonia?
(AnsStreptococcus pneumoniae
Mycoplasma pneuomiae (atypical pathogen)
Chlamydophila pneumoniae (atypical pathogen)
What is the treatment for CAP caused by Strep pneumo?
(Ans- Respiratory quinolone (e.g. Levofloxacin, moxifloxacin, gemifloxacin)
OR high-dose amoxicillin OR amoxicillin with clavulanate
What antibiotics are avoided in CAP caused by Strep pneumo due to high
rates of resistance?
(Ans- Macrolides
What is the treatment for CAP caused by Mycoplasma pneumoniae?
(Ans- Macrolide OR doxycycline
What antibiotics are avoided in CAP caused by atypical pathogens?
(Ans- Beta-lactams (ineffective)
A 38-year old mother of two teenagers recently recovered from
Mycoplasma pneumonia a couple of weeks ago. She asks if she should get
the “pneumonia shot.” She takes levothyroxine 88 mcg daily for
hypothyroidism, but is otherwise healthy. How do you respond?
A) No, it’s too soon after your infection
B) No, it’s not indicated
C) Yes, you can get it in about a month
D) Yes you can get it today
(Ans- B) No, it’s not indicated
An otherwise healthy adult without immunocompromise or multiple
comorbid conditions is not a “vulnerable population”
The pneumonia vaccine does not prevent mycoplasma pneumonia
According to GOLD, what is required to establish the diagnosis of COPD?
(Ans- Spirometry (FEV1/FVC ratio < 70%)
A 70-year old house painter reports a 4-week history of exertional dyspnea,
chest tightness, and cough for the past 3 months. He has never smoked.
What diagnoses are included in your differential? Select 4.
A) Asthma
B) Angina
C) COPD
D) GERD
E) Pneumonia
F) Tuberculosis
G) Heart Failure
(AnsB) Angina
C) COPD
F) Tuberculosis
G) Heart failure
How do inhaled anticholinergics work to treat shortness of breath in
COPD?
A) They cause bronchodilation in the lungs
B) They block the action of acetylcholine and prevent bronchoconstriction
(AnsB) They block the action of acetylcholine and prevent bronchconstriction
Name a short-acting inhaled anticholinergic: (Ans- Ipratropium (Atrovent)
Name a long-acting inhaled anticholinergic: (Ans- Tiotropium (Spiriva)
How do inhaled betá-agonists work to treat shortness of breath in COPD?
A) They cause bronchodilation in the lungs
B) They block the action of acetylcholine and prevent bronchoconstriction
(AnsA) They cause bronchodilation in the lungs
What are the only 2 inhaled short-acting beta agonists (SABAs):
(Ans- Albuterol and levalbuterol
Name an inhaled long-acting beta agonists (LABAs):
(Ans- Salmeterol (Serevent)
What are the side effects associated with anticholinergic medications?
(Ans- Cognitive impairment, confusion, hallucinations, dry mouth, blurry
vision, urinary retention, constipation, tachycardia, acute angle glaucoma
“Can’t see, can’t pee, can’t spit, can’t shit.”
Name a inhaled combined short-acting anticholinergic/short-acting beta
agonist:
(Ans- Ipratropium/albuterol (Combivent)