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Evidence-based diagnosis and management of acute bronchitis

doi: 10.1097/01.NPR.0000453812.05509.98
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INSTRUCTIONS Evidence-based diagnosis and management of acute bronchitis


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Lippincott Williams & Wilkins, publisher of The Nurse Practitioner journal, will award 2.0 contact hours for this continuing nursing education activity.

Lippincott Williams & Wilkins is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation.

This activity is also provider approved by the California Board of Registered Nursing, Provider Number CEP 11749 for 2.0 contact hours. Lippincott Williams & Wilkins is also an approved provider of continuing nursing education by the District of Columbia and Florida #50-1223.

Your certificate is valid in all states. This activity has been assigned 1.0 pharmacology credits.

Evidence-based diagnosis and management of acute bronchitis

GENERAL PURPOSE: The purpose of this learning activity is to provide information about the current evidence-based recommendations for the diagnosis and management of acute bronchitis in adults. Learning Objectives: After reading this article and taking this test, you will be able to: 1. Identify the current evidence-based recommendations for the diagnosis of acute bronchitis in adults. 2. Select current evidence-based recommendations for the management of acute bronchitis in adults.

  1. Acute bronchitis is characterized by the primary symptom of
    1. a productive cough lasting 2 weeks.
    2. a productive cough and fever lasting 3 weeks.
    3. a cough lasting less than 3 weeks.
    4. intermittent coughing accompanied by dyspnea lasting 10-15 days.
  2. Acute bronchitis occurs most commonly
    1. in people over age 70.
    2. during the fall and winter months.
    3. during the late summer and fall.
    4. during the winter and spring.
  3. National surveys indicate that the most frequent clinical symptom for which individuals seek care from outpatient providers is
    1. coughing.
    2. dyspnea.
    3. congestion.
    4. wheezing.
  4. Acute bronchitis stems from
    1. a thinning of the bronchial mucosa.
    2. desquamation of the tracheal mucosa.
    3. thickening of the airway's basement membrane.
    4. inflammation of the bronchial epithelium.
  5. The mean duration of cough in cough illness in adults is
    1. 10.8 days.
    2. 14 days.
    3. 17.8 days.
    4. 22.4 days.
  6. The presence of purulent sputum in acute bronchitis
    1. indicates the need to obtain a chest X-ray.
    2. is not indicative of a bacterial infection.
    3. is symptomatic of Mycoplasma pneumoniae.
    4. is uncommon in acute bronchitis.
  7. Which symptom is typically absent in acute bronchitis?
    1. runny nose
    2. sore throat
    3. dyspnea
    4. nasal congestion
  8. On physical examination, which sign might be expected in acute bronchitis?
    1. egophony
    2. increased fremitus
    3. wheezes
    4. dullness to percussion
  9. As a serum biomarker in acute bronchitis, the level of procalcitonin
    1. increases in response to viral infections.
    2. shows promise for distinguishing bacterial from viral etiologies.
    3. increases in the presence of lung tissue inflammation.
    4. decreases in the presence of bacterial infections.
  10. Which may be the least reliable parameter for ruling out pneumonia in patients over age 75?
    1. respirations over 24/minute
    2. decreased oxygen saturation
    3. absence of fever
    4. decreased mental status
  11. Which statement about the reliability of chest X-ray for diagnosing pneumonia is accurate?
    1. Dehydrated patients may have a false-negative result.
    2. They are reliable in 97% of cases.
    3. 15% of patients have a false-negative result.
    4. They can reliably supersede clinical judgment.
  12. An important consideration in the diagnosis of influenza is that
    1. its symptoms are nonspecific.
    2. its peak season occurs before December.
    3. accompanying body aches last 1-2 weeks while the cough often lasts 7-10 days.
    4. rapid diagnostic tests should be used as the first step in diagnosis.
  13. Which statement about pertussis is correct?
    1. Diagnosis of this viral infection is based on the characteristic “whoop” cough.
    2. Among its severe complications are dehydration and rib fractures.
    3. Its incidence has decreased in older adults.
    4. It should be considered when cough lasts more than 1 week without apparent cause.
  14. The evidence-based recommended management of acute bronchitis is
    1. amoxicillin for 14 days.
    2. antitussive prescription medication for 10 days.
    3. primarily supportive.
    4. expectorants and codeine.
  15. The 2012 Cochrane review of over-the-counter medications for acute cough
    1. reported mixed results.
    2. reported the antihistamine/decongestant combinations were the most effective.
    3. recommended antitussives for 10 days.
    4. reported terfenadine as the most effective expectorant.
  16. Which of the following statements about cough suppression is correct?
    1. Codeine is the research-supported gold standard for cough suppression.
    2. Hydrocodone is effective in suppressing coughs.
    3. Tramadol is more effective than placebo in suppressing cough in acute bronchitis.
    4. Little evidence supports using codeine and hydrocodone for treating acute cough.
  17. Which treatment is being researched for suppressing the cough reflex?
    1. bromhexine
    2. P. sidoides
    3. guaifenesin with benzonatate
    4. nebulized lidocaine


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