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Nurse Practitioner:
doi: 10.1097/01.NPR.0000453113.19133.f5
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Primary care of chronic dyspnea in adults

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INSTRUCTIONS Primary care of chronic dyspnea in adults

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Primary care of chronic dyspnea in adults

General Purpose: To provide information on the management of chronic dyspnea in adults. Learning Objectives: After reading the preceding article and taking this test, you should be able to: 1. Examine the etiology and assessment of a patient with dyspnea. 2. Outline the treatment of patients with dyspnea.

  1. Some patients with dyspnea have reported increased shortness of breath when providers tell them that they
    1. have asthma.
    2. will need to start taking medication.
    3. should calm down.
    4. need pulmonary rehabilitation.
  2. Chronic dyspnea is defined as the presence of shortness of breath for at least
    1. 4 weeks.
    2. 6 weeks.
    3. 8 weeks.
    4. 10 weeks.
  3. Dyspnea accompanied by chest tightness is highly suggestive of
    1. HF.
    2. bronchoconstriction.
    3. interstitial lung disease.
    4. COPD.
  4. A patient experiencing worsening dyspnea after recently starting treatment with a nonselective beta-blocker may have undiagnosed
    1. asthma.
    2. postnasal drainage.
    3. HF.
    4. chronic pulmonary embolism.
  5. Which medication has been implicated in causing dyspnea?
    1. inhaled corticosteroids
    2. anticholinergic drugs
    3. aspirin
    4. albuterol
  6. Which skin condition may be present in a patient with allergies and asthma?
    1. impetigo
    2. psoriasis
    3. seborrheic dermatitis
    4. eczema
  7. Which of the following statements is true?
    1. Normal pulse oximetry rules out a pulmonary cause.
    2. Chronic postnasal drainage often presents with a chief complaint of chronic dyspnea.
    3. Patients with asthma often have a worsening of symptoms in the morning.
    4. Wheezing and/or cough may be present in the patient with HF.
  8. Patients with left-sided HF may have associated
    1. weight gain.
    2. fatigue and orthopnea.
    3. frequent urination.
    4. liver enlargement.
  9. Elevations of BNP are suggestive of
    1. interstitial lung disease.
    2. chronic pulmonary emboli.
    3. gastroesophageal reflux disease.
    4. HF.
  10. What can help to determine which disorder is causing dyspnea in the patient with HF and COPD?
    1. pulse oximetry
    2. serum lipids
    3. cardiopulmonary exercise testing
    4. spirometry
  11. The majority of patients with asthma will require
    1. inhaled corticosteroids.
    2. oxygen therapy.
    3. long-acting beta2-agonists.
    4. pulmonary rehabilitation.
  12. The newest class of drugs to treat patients with COPD is
    1. inhaled corticosteroids.
    2. beta2-agonists.
    3. phosphodiesterase-4 inhibitors.
    4. anticholinergic drugs.
  13. Which drug has been shown to improve FEV1 in patients using long-acting bronchodilator therapy?
    1. roflumilast
    2. albuterol
    3. theophylline
    4. salmeterol
  14. According to the American Thoracic Society, pulmonary rehabilitation for patients with COPD should continue for a minimum of
    1. 4 weeks.
    2. 6 weeks.
    3. 8 weeks.
    4. 10 weeks.
  15. The AHA guideline recommends that all patients with HF should be treated initially with any of the following beta-blockersexcept
    1. bisoprolol.
    2. propranolol.
    3. carvedilol.
    4. sustained release metoprolol succinate.
  16. After standard drug therapy, further drug choice for patients with HF depends on all of the followingexcept
    1. if the patient is Black.
    2. the presence of volume overload.
    3. if they are physically deconditioned.
    4. renal function.
  17. Which statement about the AHA-recommended treatment of patients with AF is true?
    1. The resting heart rate should be controlled to less than 70 beats/minute.
    2. Aspirin 650 mg is recommended for patients who have contraindications to oral anticoagulants.
    3. Oral anticoagulants are no longer required for patients with artificial heart valves.
    4. All patients with AF should receive antithrombotic therapy except those with “lone” AF.
  18. Patients with anxiety that presents as chronic dyspnea generally complain of dyspnea
    1. at rest that improves with exertion.
    2. with wheezing.
    3. that gets worse when the weather changes.
    4. along with a productive cough.
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