1. Li takes theophylline for his persistent asthma and calls the office with a complaint of nausea, vomiting, and headache. The best advice for him would be to: (Points : 1)Reassure him this is probably a viral infection and should be better soonHave him seen the same day for an assessment and theophylline levelSchedule him for an appointment in 2 to 3 days, which he can cancel if he is betterOrder a theophylline level at the lab for himQuestion 2. 2. Harold, a 42-year-old African American, has moderate persistent asthma. Which of the following asthma medications should be used cautiously, if at all? (Points : 1)Betamethasone, an inhaled corticosteroidSalmeterol, an inhaled long-acting beta-agonistAlbuterol, a short-acting beta-agonistMontelukast, a leukotriene modifierQuestion 3. 3. Digoxin levels need to be monitored closely when the following medication is started: (Points : 1)LoratadineDiphenhydramineIpratropiumAlbuterolQuestion 4. 4. One goal of asthma therapy outlined by the NHLBI Expert Panel 3 guidelines is: (Points : 1)Ability to use albuterol daily to control symptomsMinimize exacerbations to once a monthKeep nighttime symptoms at a maximum of twice a weekRequire infrequent use of beta 2 agonists (albuterol) for relief of symptomsQuestion 5. 5. A stepwise approach to the pharmacologic management of asthma: (Points : 1)Begins with determining the severity of asthma and assessing asthma controlIs used when asthma is severe and requires daily steroidsAllows for each provider to determine their personal approach to the care of asthmatic patientsProvides a framework for the management of severe asthmatics, but is not as helpful when patients have intermittent asthmaQuestion 6. 6. Treatment for mild intermittent asthma is: (Points : 1)Daily inhaled medium dose corticosteroidsShort-acting beta-2-agonists (albuterol) as neededLong-acting beta-2-agonists every morning as a preventativeMontelukast (Singulair) dailyQuestion 7. 7. The first-line therapy for mild-persistent asthma is: (Points : 1)High-dose montelukastTheophyllineLow-dose inhaled corticosteroidsLong-acting beta-2-agonistsQuestion 8. 8. The first-line drug choice for a previously healthy adult patient diagnosed with community acquired pneumonia would be: (Points : 1)CiprofloxacinAzithromycinAmoxicillinDoxycyclineQuestion 9. 9. The first-line antibiotic choice for a patient with comorbidities or who is immunosuppressed who has pneumonia and can be treated as an outpatient would be: (Points : 1)LevofloxacinAmoxicillinCiprofloxacinCephalexinQuestion 10. 10. Adults with pneumonia who are responding to antimicrobial therapy should show improvement in their clinical status in: (Points : 1)12 to 24 hours24 to 36 hours48 to 72 hours4 or 5 daysQuestion 11. 11. John is a 4-week-old infant who has been diagnosed with chlamydial pneumonia. The appropriate treatment for his pneumonia would be: (Points : 1)LevofloxacinAmoxicillinErythromycinCephalexinQuestion 12. 12. Wing-Sing is a 4 year old who has a suspected bacterial pneumonia. He has a temperature of 102°F, oxygen saturation level of 95%, and is taking fluids adequately. What would be appropriate initial treatment for his pneumonia? (Points : 1)CeftriaxoneAzithromycinCephalexinLevofloxacinQuestion 13. 13. Giselle is a 14-year-old who presents to clinic with symptoms consistent with mycoplasma pneumonia. What is the treatment for suspected mycoplasma pneumonia in an adolescent? (Points : 1)CeftriaxoneAzithromycinCiprofloxacinLevofloxacinQuestion 14. 14. If prescribing bupropion (Zyban) for tobacco cessation, the instructions to the patient include: (Points : 1)Bupropion (Zyban) is started 1 to 2 weeks before the quit dateNicotine replacement products should not be used with bupropionIf they smoke when taking bupropion they may have increased anxiety and insomniaSince they are not using bupropion as an antidepressant, they do not need to worry about increased suicide ideation when starting therapyQuestion 15. 15. Instructions for the use of nicotine gum include: (Points : 1)Chew the gum quickly to get a peak effectThe gum should be “parked” in the buccal space between chewingAcidic drinks such as coffee help with the absorption of the nicotineThe highest abstinence rates occur if the patient chews the gum when he or she is having cravingsQuestion 16. 16. Patients who choose the nicotine lozenge to assist in quitting tobacco should be instructed: (Points : 1)Chew the lozenge wellDrink at least 8 ounces of water after the lozenge dissolvesUse one lozenge every 1 to 2 hours (at least nine per day with a maximum of twenty per day)A tingling sensation in the mouth should be reported to the providerQuestion 17. 17. Isabella has confirmed tuberculosis and is placed on a 6-month treatment regimen. The 6-month regimen consists of: (Points : 1)2 months of four drug therapy (INH, rifampin, pyrazinamide, and ethambutol) followed by 4 months of INH and rifampin6 months of INH with daily pyridoxine throughout therapy6 months of INH, rifampin, pyrazinamide, and ethambutolAny of the aboveQuestion 18. 18. Goals of treatment when treating tuberculosis include: (Points : 1)Completion of recommended therapyNegative PPD at the end of therapyCompletely normal chest x-rayAll of the aboveQuestion 19. 19. Alyssa is a 15-month-old who has been on amoxicillin for 2 days for acute otitis media. She is still febrile and there is no change in her tympanic membrane examination. What would be the plan of care for her? (Points : 1)Continue the amoxicillin for the full 10 days.Change the antibiotic to azithromycin.Change the antibiotic to amoxicillin/clavulanate.Change the antibiotic to trimethoprim/sulfamethoxazole.Question 20. 20. A child that may warrant “watchful waiting” instead of prescribing an antibiotic for acute otitis media includes patients who: (Points : 1)Are low risk with temperature less than 39°C or 102.2°FHave reliable parents with transportationAre older than age 2 yearsAll of the above

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