Question 1.1. 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:

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?

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:

Loratadine

Diphenhydramine

Ipratropium

Albuterol

Question 4. 4. One goal of asthma therapy outlined by the NHLBI Expert Panel 3 guidelines is:

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:

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:

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:

High-dose montelukast

Theophylline

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:

Ciprofloxacin

Azithromycin

Amoxicillin

Doxycycline

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:

Levofloxacin

Amoxicillin

Ciprofloxacin

Cephalexin

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

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:

Levofloxacin

Amoxicillin

Erythromycin

Cephalexin

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?

Ceftriaxone

Azithromycin

Cephalexin

Levofloxacin

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?

Ceftriaxone

Azithromycin

Ciprofloxacin

Levofloxacin

Question 14. 14. If prescribing bupropion (Zyban) for tobacco cessation, the instructions to the patient include:

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:

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:

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:

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:

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?

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:

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