Question 1

The therapist is asked to explain to a 10-year-old how to use a corticosteroid inhaler.Which of the following side effects should the therapist mention to the patient and caregiver?

Accepted Answer

A) Headache 
B) Blurred vision 
C) Changes in pupillary size 
D) Oral candidiasis 
A) Headache 
B) Blurred vision 
C) Changes in pupillary size 
D) Oral candidiasis D

Question 2

Which of the following spirometric measurements is sensitive to small changes in airway caliber and decreases in value with increasing obstructive disease?

Accepted Answer

A) Forced vital capacity (FV
C)  
B) Forced expiratory flow between 200 and 1200 mL of the FVC (FEF200-1200) 
C) Mean forced expiratory flow during the middle half of the FVC (FEF25-75) 
D) Forced expiratory volume in 1 second (FEV₁) 
A) Forced vital capacity (FV
C)  
B) Forced expiratory flow between 200 and 1200 mL of the FVC (FEF200-1200) 
C) Mean forced expiratory flow during the middle half of the FVC (FEF25-75) 
D) Forced expiratory volume in 1 second (FEV₁) C

Question 3

The therapist has been asked to check the FENO on a patient with asthma.The level is < 15 ppb.How should the therapist interpret this data?

Accepted Answer

A) The asthma is well controlled. 
B) The patient is less likely to respond to corticosteroids. 
C) The patient is likely to require immunotherapy. 
D) The patient has a neutrophilic phenotype of asthma. 
A) The asthma is well controlled. 
B) The patient is less likely to respond to corticosteroids. 
C) The patient is likely to require immunotherapy. 
D) The patient has a neutrophilic phenotype of asthma. B

Question 4

Which of the following spirometric criteria are used to determine the presence of airway obstruction?

Accepted Answer

A) FEV₁ less than 80% of predicted and FEV₁/FVC less than 80% 
B) FEV₁ less than 60% of predicted and FEV₁/FVC less than 60% 
C) FEV₁ less than 80% of predicted and FEV₁/FVC less than 65% 
D) FEV₁ less than 65% of predicted and FEV₁/FVC less than 80% 
A) FEV₁ less than 80% of predicted and FEV₁/FVC less than 80% 
B) FEV₁ less than 60% of predicted and FEV₁/FVC less than 60% 
C) FEV₁ less than 80% of predicted and FEV₁/FVC less than 65% 
D) FEV₁ less than 65% of predicted and FEV₁/FVC less than 80%

Question 5

Which of the following events occurs during the first phase of airway inflammation?

Accepted Answer

A) Release of preformed mediators 
B) Antigen-antibody reactions on the surface of mast cells 
C) Inhalation of offending antigen 
D) Bronchial mucosal edema 
A) Release of preformed mediators 
B) Antigen-antibody reactions on the surface of mast cells 
C) Inhalation of offending antigen 
D) Bronchial mucosal edema

Question 6

The therapist is asked to recommend a quick-onset,long-acting beta-2 agonist to be added to the inhaled corticosteroid for a patient with asthma.Which of the following medications should the therapist recommend?

Accepted Answer

A) Formoterol 
B) Salmeterol 
C) Tiotropium bromide 
D) Albuterol 
A) Formoterol 
B) Salmeterol 
C) Tiotropium bromide 
D) Albuterol

Question 7

Which of the following types of cells play a role in the pathophysiology of asthma?
I.Mast cells
II.Eosinophils
III.Neutrophils
IV.Basophils

Accepted Answer

A) I and III only 
B) II and IV only 
C) I,II,and III only 
D) II,III,and IV only 
A) I and III only 
B) II and IV only 
C) I,II,and III only 
D) II,III,and IV only

Question 8

Which of the following immunoglobulins has been identified as a key molecule in mediating allergic asthma and should be measured in serum?

Accepted Answer

A) IgA 
B) IgE 
C) IgM 
D) IgD 
A) IgA 
B) IgE 
C) IgM 
D) IgD

Question 9

On the basis of the National Asthma Education and Prevention Program (NAEPP)guidelines,when a diagnosis of asthma is being made,which of the following criteria are recommended?
I.That the patient be free of any comorbidity
II.That a physical examination be performed
III.That spirometry is conducted to determine the presence of reversible disease
IV.That a detailed medical history be conducted

Accepted Answer

A) I and III only 
B) I,II,and III only 
C) I,III,and IV only 
D) II,III,and IV only 
A) I and III only 
B) I,II,and III only 
C) I,III,and IV only 
D) II,III,and IV only

Question 10

A 2-year-old child diagnosed with asthma has a family history of frequent respiratory infections.What is the most common respiratory virus isolated from infants who wheeze?

Accepted Answer

A) Adenovirus 
B) Parainfluenza virus 
C) Respiratory syncytial virus (RSV) 
D) Coxsackievirus 
A) Adenovirus 
B) Parainfluenza virus 
C) Respiratory syncytial virus (RSV) 
D) Coxsackievirus

Question 11

In order to establish the personal best peak flow,which instructions should the asthma educator give the patient?
I.Record peak flows when free of symptoms
II.Record peak flows once a week for 2 to 3 weeks
III.Record peak flows preferably in early afternoon
IV.Maintain peak flow values within 80% of the best peak flow

Accepted Answer

A) I,III,and IV only 
B) II and IV only 
C) I,II,and III only 
D) I,III,and IV only. 
A) I,III,and IV only 
B) II and IV only 
C) I,II,and III only 
D) I,III,and IV only.

Question 12

The respiratory therapist is assisting the pulmonologist on a methacholine challenge.After inhalation of the fourth concentration of methacholine,the FEV₁ decreases 12%.What should the therapist suggest at this time?

Accepted Answer

A) Stop the challenge because a drop in the FEV₁ is consistent with a positive test 
B) Stop the challenge because only four concentrations are delivered 
C) Administer one more concentration to confirm that FEV₁ drop is in fact 12% 
D) Continue administering methacholine until FEV₁ decreases 20% 
A) Stop the challenge because a drop in the FEV₁ is consistent with a positive test 
B) Stop the challenge because only four concentrations are delivered 
C) Administer one more concentration to confirm that FEV₁ drop is in fact 12% 
D) Continue administering methacholine until FEV₁ decreases 20%

Question 13

When endotracheal intubation and mechanical ventilation are indicated for a pediatric patient with asthma,which of the following ventilator setting adjustments should the therapist consider making?

Accepted Answer

A) 25% inspiratory pause 
B) Tidal volume 10 mL/kg 
C) Low to moderate positive end-expiratory pressure (PEEP) 
D) Low Fio₂ 
A) 25% inspiratory pause 
B) Tidal volume 10 mL/kg 
C) Low to moderate positive end-expiratory pressure (PEEP) 
D) Low Fio₂

Question 14

Which of the following medications is indicated for a 15-year-old patient with moderate asthma who is not controlled with inhaled corticosteroids and exhibits the following signs: (1)a positive skin test or positive in vitro test for aeroallergens and (2)an IgE level of 500 IU/L?

Accepted Answer

A) Zileuton 
B) Salmeterol 
C) Xopenex 
D) Omalizumab 
A) Zileuton 
B) Salmeterol 
C) Xopenex 
D) Omalizumab

Question 15

Persistent inflammation in asthma leads to a remodeling phase that is characterized by which of the following processes?

Accepted Answer

A) Bronchoconstriction 
B) Mucous hyporsecretion 
C) Airway smooth muscle hypertrophy 
D) Ciliary paralysis 
A) Bronchoconstriction 
B) Mucous hyporsecretion 
C) Airway smooth muscle hypertrophy 
D) Ciliary paralysis

Question 16

What is typically the first pharmacologic intervention instituted by the therapist to treat a patient who enters the emergency room with an asthmatic episode?

Accepted Answer

A) Three 20-minute administrations of salmeterol via a small-volume nebulizer in the first hour 
B) Three treatments with albuterol given every 20 to 30 minutes by nebulization 
C) Intravenous administration of corticosteroids 
D) Combination therapy with a short-acting agonist and an anticholinergic bronchodilator via a metered dose inhaler (MDI) 
A) Three 20-minute administrations of salmeterol via a small-volume nebulizer in the first hour 
B) Three treatments with albuterol given every 20 to 30 minutes by nebulization 
C) Intravenous administration of corticosteroids 
D) Combination therapy with a short-acting agonist and an anticholinergic bronchodilator via a metered dose inhaler (MDI)

Question 17

Which of the following medications are considered the first line of chronic treatment for patients with asthma?

Accepted Answer

A) Short-acting beta-2 adrenergic agonists 
B) Leukotriene modifiers 
C) Methylxanthines 
D) Inhaled corticosteroids 
A) Short-acting beta-2 adrenergic agonists 
B) Leukotriene modifiers 
C) Methylxanthines 
D) Inhaled corticosteroids

Question 18

Which of the following pharmacologic agents may be used for bronchoprovocation challenge testing?

Accepted Answer

A) Albuterol 
B) Ipratropium bromide 
C) Heparin 
D) Histamine 
A) Albuterol 
B) Ipratropium bromide 
C) Heparin 
D) Histamine

Question 19

What appears to be the strongest identifiable predisposing factor for developing asthma?

Accepted Answer

A) Atopy 
B) Genetics 
C) Socioeconomic status 
D) Race 
A) Atopy 
B) Genetics 
C) Socioeconomic status 
D) Race

Question 20

How is significant clinical airflow limitation determined from pre- and postbronchodilator spirometry?

Accepted Answer

A) When the patient's FEF25-7% increases by 12% and 200 mL/second 
B) When the patient's FEV₁ increases by 12% and 200 mL 
C) When the FVC increases by 20% and 200 mL 
D) When the FEV₁/FVC ratio increases by 25% 
A) When the patient's FEF25-7% increases by 12% and 200 mL/second 
B) When the patient's FEV₁ increases by 12% and 200 mL 
C) When the FVC increases by 20% and 200 mL 
D) When the FEV₁/FVC ratio increases by 25%

Exam 27: Asthma

The therapist is asked to explain to a 10-year-old how to use a corticosteroid inhaler.Which of the following side effects should the therapist mention to the patient and caregiver?

Which of the following spirometric measurements is sensitive to small changes in airway caliber and decreases in value with increasing obstructive disease?

The therapist has been asked to check the FENO on a patient with asthma.The level is < 15 ppb.How should the therapist interpret this data?

Which of the following spirometric criteria are used to determine the presence of airway obstruction?

Which of the following events occurs during the first phase of airway inflammation?

The therapist is asked to recommend a quick-onset,long-acting beta-2 agonist to be added to the inhaled corticosteroid for a patient with asthma.Which of the following medications should the therapist recommend?

Which of the following types of cells play a role in the pathophysiology of asthma? I.Mast cells II.Eosinophils III.Neutrophils IV.Basophils

Which of the following immunoglobulins has been identified as a key molecule in mediating allergic asthma and should be measured in serum?

A 2-year-old child diagnosed with asthma has a family history of frequent respiratory infections.What is the most common respiratory virus isolated from infants who wheeze?

The respiratory therapist is assisting the pulmonologist on a methacholine challenge.After inhalation of the fourth concentration of methacholine,the FEV₁ decreases 12%.What should the therapist suggest at this time?

When endotracheal intubation and mechanical ventilation are indicated for a pediatric patient with asthma,which of the following ventilator setting adjustments should the therapist consider making?

Which of the following medications is indicated for a 15-year-old patient with moderate asthma who is not controlled with inhaled corticosteroids and exhibits the following signs: (1)a positive skin test or positive in vitro test for aeroallergens and (2)an IgE level of 500 IU/L?

Persistent inflammation in asthma leads to a remodeling phase that is characterized by which of the following processes?

What is typically the first pharmacologic intervention instituted by the therapist to treat a patient who enters the emergency room with an asthmatic episode?

Which of the following medications are considered the first line of chronic treatment for patients with asthma?

Which of the following pharmacologic agents may be used for bronchoprovocation challenge testing?

What appears to be the strongest identifiable predisposing factor for developing asthma?

How is significant clinical airflow limitation determined from pre- and postbronchodilator spirometry?

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