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 soon
       Have him seen the same day for an assessment and theophylline level
       Schedule him for an appointment in 2 to 3 days, which he can cancel if he is better
       Order a theophylline level at the lab for him

  Question 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 corticosteroid
       Salmeterol, an inhaled long-acting beta-agonist
       Albuterol, a short-acting beta-agonist
       Montelukast, a leukotriene modifier

  Question 3. 3. Digoxin levels need to be monitored closely when the following medication is started: (Points : 1)


  Question 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 symptoms
       Minimize exacerbations to once a month
       Keep nighttime symptoms at a maximum of twice a week
       Require infrequent use of beta 2 agonists (albuterol) for relief of symptoms

  Question 5. 5. A stepwise approach to the pharmacologic management of asthma: (Points : 1)

       Begins with determining the severity of asthma and assessing asthma control
       Is used when asthma is severe and requires daily steroids
       Allows for each provider to determine their personal approach to the care of asthmatic patients
       Provides a framework for the management of severe asthmatics, but is not as helpful when patients have intermittent asthma

  Question 6. 6. Treatment for mild intermittent asthma is: (Points : 1)

       Daily inhaled medium dose corticosteroids
       Short-acting beta-2-agonists (albuterol) as needed
       Long-acting beta-2-agonists every morning as a preventative
       Montelukast (Singulair) daily

  Question 7. 7. The first-line therapy for mild-persistent asthma is: (Points : 1)

       High-dose montelukast
       Low-dose inhaled corticosteroids
       Long-acting beta-2-agonists

  Question 8. 8. The first-line drug choice for a previously healthy adult patient diagnosed with community acquired pneumonia would be: (Points : 1)


  Question 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)


  Question 10. 10. Adults with pneumonia who are responding to antimicrobial therapy should show improvement in their clinical status in: (Points : 1)

       12 to 24 hours
       24 to 36 hours
       48 to 72 hours
       4 or 5 days

  Question 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)


  Question 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)


  Question 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)


  Question 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 date
       Nicotine replacement products should not be used with bupropion
       If they smoke when taking bupropion they may have increased anxiety and insomnia
       Since they are not using bupropion as an antidepressant, they do not need to worry about increased suicide ideation when starting therapy

  Question 15. 15. Instructions for the use of nicotine gum include: (Points : 1)

       Chew the gum quickly to get a peak effect
       The gum should be “parked” in the buccal space between chewing
       Acidic drinks such as coffee help with the absorption of the nicotine
       The highest abstinence rates occur if the patient chews the gum when he or she is having cravings

  Question 16. 16. Patients who choose the nicotine lozenge to assist in quitting tobacco should be instructed: (Points : 1)

       Chew the lozenge well
       Drink at least 8 ounces of water after the lozenge dissolves
       Use 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 provider

  Question 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 rifampin
       6 months of INH with daily pyridoxine throughout therapy
       6 months of INH, rifampin, pyrazinamide, and ethambutol
       Any of the above

  Question 18. 18. Goals of treatment when treating tuberculosis include: (Points : 1)

       Completion of recommended therapy
       Negative PPD at the end of therapy
       Completely normal chest x-ray
       All of the above

  Question 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°F
       Have reliable parents with transportation
       Are older than age 2 years
       All of the above


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