Deck 3: Asthma

Question 1

Which of the following contribute to the increase in the work of breathing associated with an asthma attack?

A)Mucus plugging
B)Bronchospasm
C)Air trapping
D)All the above

Answer 1

D

Question 2

How many weeks must pass during which time the asthma patient does not need an increase in medications to control her/his asthma for the patient to be considered stable?

A)2 weeks
B)4 weeks
C)8 weeks
D)12 weeks

Answer 2

B

Question 3

Which of the following indicate(s)that your patient who is having a severe asthma attack is at a greater risk for respiratory failure and needs mechanical ventilation?

A)History of prior intubation
B)Steroid dependence
C)History of allergic reactions
D)A and B only

Answer 3

D

Question 4

How soon after the first small volume nebulizer treatment with Albuterol can you safely give another one to the same patient?

A)20 minutes
B)60 minutes
C)120 minutes
D)180 minutes

Question 5

Which of the following ventilator settings or measurements is most concerning to you during mechanical ventilation of a patient with acute asthma?

A)Plateau pressure of 45 cm H₂O
B)Inspiratory flow of 80 L/min
C)Tidal volume set at 6-8 mL/kg of ideal body weight
D)Mechanical rate of 10/min

Question 6

Which of the following conditions is least likely to mimic the symptoms of an asthma attack?

A)Congestive heart failure
B)Bronchitis
C)Acute respiratory distress syndrome
D)Acute upper airway obstruction

Question 7

Which of the following physical examination findings is least associated with an asthma attack?

A)Prolonged inspiratory time
B)Polyphonic wheezing
C)Heavy use of accessory muscles
D)Retractions

Question 8

What complication is common when mechanical ventilation is used to treat the patient with severe asthma?

A)Pneumonia
B)Auto-PEEP
C)Circulatory failure
D)Pulmonary embolism

Question 9

Which of the following medications is NOT recommended for the treatment of an acute asthma attack?

A)Atrovent
B)Prednisone
C)Aminophylline
D)Salmeterol

Question 10

What strategy during mechanical ventilation is often used to prevent barotraumas?

A)High-frequency jet ventilation
B)Permissive hypercapnia
C)Inverse ratio ventilation
D)CPAP

Question 11

Which of the following medications has recently been developed and has been shown to decrease the incidence of exacerbations in asthmatics but is expensive?

A)Atrovent
B)Xolair
C)Albuterol
D)Methylprednisolone

Question 12

What instrument should the asthma patient have at home to monitor his/her status and to help indicate when to call the doctor?

A)Pulse oximeter
B)Densitometer
C)Peak flow meter
D)Blood pressure cuff

Question 13

Inhaled bronchodilators are most often used instead of oral bronchodilators to treat asthma patients.Which of the following explain(s)the use of aerosolized bronchodilators?

A)Fewer side effects
B)Better protection of the airways
C)More rapid onset
D)All the above

Question 14

What can be said about the incidence of asthma and the death rate from asthma in the past decade or so?

A)Both are on the decrease
B)Both are on the increase
C)Incidence is up,but death rate is down
D)Incidence is down,but death rate is up

Question 15

Which of the following pulmonary function tests is most useful during an acute attack?

A)Peak flow
B)Vital capacity
C)Total lung capacity
D)Terminal flow

Question 16

Mr.Smith is having a routine asthma attack.Which of the following assessment techniques is least useful for assessment of Mr.Smith?

A)Auscultation
B)Vital signs
C)SpO₂
D)Chest x-ray

Question 17

Adult patients with chronic asthma are at greater risk for developing what condition?

A)ARDS
B)Pulmonary fibrosis
C)COPD
D)Lung cancer

Question 18

Patient A is having an asthma attack with loud wheezing,paradoxical pulse,and normal sensorium.Patient B is also having an asthma attack but has no audible wheezing,no paradoxical pulse,but is confused and slow to respond.Which patient(s)should be treated most aggressively?

A)Patient A
B)Patient B
C)Both patients
D)Neither patient

Question 19

Your patient has been having a severe asthma attack for the past several hours.Which of the following blood gas findings suggests that the patient may be experiencing respiratory muscle fatigue?

A)PaO₂ 55 mmHg
B)SaO₂ 78%
C)PaCO₂ 44 mmHg
D)pH 7.36

Question 20

Which of the following is NOT associated with provoking an asthma attack?

A)Aspirin use
B)Exercise
C)Viral respiratory infection
D)Use of Atropine to increase heart rate

Question 21

Your patient is having a severe asthma attack.What treatment should be avoided at this time?

A)Dense aerosols
B)Sedatives
C)Acetylcysteine
D)All the above

Question 22

What is indicated by a paradoxical breathing pattern during an acute asthma attack?

A)Severe hypoxia
B)Severe hypercapnia
C)Diaphragm fatigue
D)Pneumothorax

Question 23

How soon after I.V.steroids are given should you see an improvement in the asthma patient having an attack?

A)30-45 minutes
B)60-90 minutes
C)4-6 hours
D)6-8 hours