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Adult asthma: Diagnosis and treatment

doi: 10.1097/01.NPR.0000526792.03604.61
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INSTRUCTIONS Adult asthma: Diagnosis and treatment


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Lippincott Professional Development will award 1.5 contact hours for this continuing nursing education activity.

Lippincott Professional Development 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 1.5 contact hours. Lippincott Professional Development is also an approved provider of continuing nursing education by the District of Columbia, Georgia, and Florida CE Broker #50–1223.

This activity has been assigned 1.0 pharmacology credits.

Adult asthma: Diagnosis and treatment

General Purpose: To provide an overview of the epidemiology, pathophysiology, diagnosis, and management of adults with asthma. Learning Objectives/Outcomes: After completing this continuing education activity, you should be able to: 1. Recall the pathophysiology of asthma and factors considered in the diagnostic process. 2. Outline evidence-based, systematic approaches to managing asthma in adult patients.

  1. Asthma is differentiated from other respiratory conditions in that
    1. airway obstruction is generally reversible.
    2. exacerbations are infrequent.
    3. there is chronic airway inflammation.
  2. Which statement concerning asthma incidence is accurate?
    1. Males are more likely to be diagnosed with asthma over age 18.
    2. White adults are hospitalized more frequently than Black adults.
    3. The prevalence of asthma in females increases with age.
  3. Asthma mortality
    1. decreases with age.
    2. rates have increased since 2001.
    3. increases with age.
  4. What is the primary underlying physiologic change associated with asthma?
    1. inflammation
    2. edema
    3. bronchoconstriction
  5. Presenting symptoms of asthma
    1. differ markedly from upper respiratory infection symptoms.
    2. often occur concurrently with respiratory infections.
    3. are typically worse during the day.
  6. The greatest decline in lung function is associated with
    1. cardioselective beta-blockers.
    2. nonselective beta-blockers.
    3. angiotensin II receptor blockers.
  7. Which physical finding signals imminent respiratory failure?
    1. prolonged expiratory phase
    2. absence of wheezing
    3. accessory muscle use
  8. In which diagnostic test is a SABA used to demonstrate reversibility?
    1. bronchial provocation test
    2. peak expiratory flow monitoring
    3. spirometry
  9. A positive bronchial provocation test
    1. can signify asthma when spirometry is normal.
    2. rules out asthma as a diagnosis.
    3. has high specificity for the diagnosis of asthma.
  10. Which statement is not accurate concerning allergy testing?
    1. Allergy testing reveals sensitivity to certain triggers.
    2. Allergy testing determines which triggers cause asthma.
    3. Allergy testing is not a recommended routine assessment tool for diagnosing asthma.
  11. Under which condition may peak expiratory flow meters be used diagnostically?
    1. if limited or no access to PFT/spirometry
    2. for the ex-smoker population
    3. following a positive bronchial provocation test
  12. Control-based asthma management
    1. is initiated before prevention measures fail.
    2. is based on the severity of presenting symptoms.
    3. treats patients for comorbid conditions.
  13. Which statement concerning albuterol administration is correct?
    1. MDIs deliver the dose better using a spacer.
    2. Levalbuterol NEB treatments provide better airway response when compared with albuterol.
    3. During exacerbations, symptoms will not be relieved with higher doses.
  14. Which is considered outpatient primary care treatment for a patient with persistent dyspnea following inhaled SABA?
    1. immediate referral to the ED for I.V. corticosteroids
    2. short-term early treatment with a systemic corticosteroid burst
    3. administration of salmeterol
  15. LABAs
    1. are the drugs of choice for controlling inflammation related to asthma.
    2. should be used in place of an ICS.
    3. provide an increased risk of severe asthma exacerbations and death.
  16. Which LTRA has advantages for use in primary care?
    1. montelukast
    2. zafirlukast
    3. zileuton
  17. In the stepwise approach to severe asthma from the 2017 GINA guidelines, tiotropium is indicated
    1. in step 2 or 3.
    2. for severe asthma uncontrolled despite multiple controllers.
    3. for patients taking low-dose ICS.
  18. Which is an advantage of a DPI over an MDI with spacer?
    1. reduced pharyngeal deposition of medication
    2. reduced risk of contamination
    3. known number of remaining doses


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