Name
Purdue University Globle
NU568 FNP I – Primary Care Across the Lifespan
Prof. Name
Date
Respiratory and infectious disorders are common topics in nursing and advanced practice examinations because they frequently occur in clinical practice. Important concepts include appropriate antibiotic selection for sinusitis, the role of inhaled corticosteroids in asthma, recognition of infectious mononucleosis, interpretation of pulmonary function changes with aging, and identification of common pneumonia pathogens. The following NU568 Unit 2 quiz on respiratory conditions and treatments reviews 35 questions covering respiratory, pulmonary, infectious, and ear, nose, and throat (ENT) conditions.
Answer: Levofloxacin
Levofloxacin is a fluoroquinolone antibiotic with activity against a broad range of bacteria, including many gram-negative organisms. It may be considered in selected complicated or resistant sinusitis cases. Antibiotic selection should be based on clinical guidelines, patient-specific factors, and antimicrobial stewardship principles.
Answer: An inhaled corticosteroid (ICS)
A LABA should not be used alone to control asthma. Because asthma involves airway inflammation, an inhaled corticosteroid is needed to reduce inflammation and lower the risk of exacerbations. Combination ICS/LABA therapy is commonly used when an inhaled corticosteroid alone does not provide adequate control.
Answer: Infectious mononucleosis
Infectious mononucleosis is commonly associated with Epstein-Barr virus (EBV). Classic findings include:
Severe pharyngitis
Marked fatigue
Low-grade fever
Posterior cervical lymphadenopathy
The combination of pronounced fatigue and posterior cervical lymph node enlargement can help distinguish mononucleosis from other causes of sore throat.
Answer: Pulmonary function normally declines with age.
Aging produces several physiologic changes in the respiratory system. Lung elasticity decreases, chest wall compliance may be reduced, and respiratory muscle strength can decline. These changes contribute to a gradual age-related reduction in pulmonary function.
Answer: Gram-negative bacteria
Hospital-acquired pneumonia is frequently associated with gram-negative organisms. Important pathogens include:
Pseudomonas aeruginosa
Klebsiella pneumoniae
Acinetobacter species
The specific organisms involved can vary according to the healthcare setting and individual patient risk factors.
Answer: When symptoms persist for more than 12 weeks
Chronic rhinosinusitis involves persistent inflammation of the paranasal sinuses for at least 12 weeks. Symptoms may include nasal obstruction, nasal drainage, facial pressure, and reduced sense of smell.
Answer: Immunoglobulin E (IgE)
IgE plays a central role in immediate hypersensitivity reactions. In allergic rhinitis, exposure to an allergen triggers an IgE-mediated response that activates mast cells and promotes the release of inflammatory mediators such as histamine. This produces symptoms including sneezing, itching, rhinorrhea, and nasal congestion.
Answer: Moderate persistent asthma
The described pattern is consistent with moderate persistent asthma in traditional asthma severity classifications. Typical features include daily symptoms, nighttime awakenings occurring more than once weekly, frequent need for short-acting rescue medication, and an FEV1 between 60% and 80% of predicted.
Current asthma management increasingly emphasizes treatment based on symptom control and exacerbation risk rather than relying only on severity categories.
Answer: Penicillin
Penicillin is a preferred treatment for confirmed Group A Streptococcus pharyngitis because it is effective, narrow-spectrum, generally well tolerated, and inexpensive. Amoxicillin is also commonly used as an alternative first-line option.
Answer: Vincent’s stomatitis
Vincent’s stomatitis, also known as acute necrotizing ulcerative gingivitis, is an inflammatory and infectious condition affecting the oral tissues. It can cause painful ulceration, tissue necrosis, bleeding, and foul-smelling breath and has historically been associated with poor oral hygiene.
Answer: Rhinorrhea
Rhinorrhea is commonly associated with viral upper respiratory infections. Other findings that may suggest a viral cause include:
Cough
Hoarseness
Conjunctivitis
Nasal congestion or discharge
These symptoms are generally less characteristic of uncomplicated Group A Streptococcal pharyngitis.
Answer: Perform a throat culture when indicated.
A throat culture can be used to confirm Group A Streptococcus when a rapid antigen detection test is negative, particularly in children and adolescents when clinical suspicion remains significant. Testing recommendations vary by age and clinical setting.
Answer: Chew the gum until it becomes soft or produces a tingling sensation, then place it between the cheek and gum.
Nicotine gum is used with a “chew and park” technique. The gum is chewed slowly until nicotine is released and then parked between the cheek and gum. This allows nicotine to be absorbed through the oral mucosa while reducing the risk of swallowing excessive nicotine.
Answer: Bladder cancer
Smoking is a major preventable risk factor for bladder cancer. Tobacco exposure is also associated with numerous other malignancies, including cancers of the lung, kidney, pancreas, oral cavity, and larynx.
Answer: Human immunodeficiency virus (HIV) infection
Oral hairy leukoplakia is associated with Epstein-Barr virus and is particularly common in people with significant immunosuppression, including people living with HIV. It typically appears as white, corrugated lesions along the lateral borders of the tongue.
Answer: Allergic or vasomotor rhinitis
Upper-airway conditions can contribute to chronic cough. Allergic rhinitis and nonallergic or vasomotor rhinitis may cause nasal drainage that irritates the throat and triggers coughing. Evaluation should also consider other common causes of chronic cough when appropriate.
Answer: When inflammation persists for an extended period, commonly more than three months, with intermittent or persistent otorrhea.
Chronic otitis media can involve persistent inflammation, recurrent drainage, and abnormalities of the tympanic membrane or middle ear. Persistent symptoms require assessment to identify complications and determine appropriate treatment.
Answer: Continue to assess his readiness to quit at appropriate healthcare visits.
Smoking cessation is a process, and readiness can change over time. Healthcare professionals should continue to provide supportive, nonjudgmental counseling and revisit cessation at future encounters rather than abandoning the discussion after an initial refusal.
Answer: Referral may be appropriate when complications or failure to improve are present.
Examples include:
Vertigo or ataxia
Failure of a perforated tympanic membrane to heal
Worsening symptoms despite several days of appropriate treatment
Recurrent or complicated infections
These findings may indicate complications requiring additional evaluation.
Answer: Captopril
Captopril is an angiotensin-converting enzyme (ACE) inhibitor. ACE inhibitors can cause a persistent, dry cough, partly because they increase bradykinin levels. If the cough becomes problematic, the healthcare provider may consider another antihypertensive class.
Answer: Patients with recurrent, complicated, or treatment-resistant sinusitis may require referral.
Referral may be considered when sinusitis is recurrent, does not respond adequately to appropriate treatment, or is associated with other complicating conditions. Specialist assessment can help identify structural abnormalities, chronic disease, allergies, or alternative diagnoses.
Answer: Hospitalization, with consideration of higher-level care depending on the patient’s overall condition.
A CURB-65 score of 3 indicates a high-risk patient who generally requires hospital-based management. The need for intensive care should be determined using the patient’s overall clinical status, vital signs, oxygenation, laboratory findings, and other severity indicators rather than the score alone.
Answer: A neck circumference of 17 inches
A larger neck circumference is an established risk factor for obstructive sleep apnea because increased soft tissue around the upper airway can contribute to airway narrowing during sleep. Other risk factors include obesity, older age, male sex, and certain craniofacial characteristics.
Answer: Approximately 5–15 mcg/mL
Theophylline has a relatively narrow therapeutic range. Serum concentrations should be monitored because excessive levels can cause serious adverse effects, including nausea, vomiting, tremors, tachycardia, arrhythmias, and seizures.
Answer: On an empty stomach
Some tuberculosis medications are best absorbed when taken without food. However, the exact administration instructions depend on the medication regimen, and gastrointestinal intolerance may affect how treatment is administered. Patients should follow the prescribed regimen carefully.
Answer: Infectious mononucleosis
A diffuse rash following amoxicillin administration in a patient with symptoms such as fever, cervical lymphadenopathy, fatigue, and hepatosplenomegaly strongly suggests an underlying Epstein-Barr virus infection. The rash is a classic clinical clue associated with aminopenicillin exposure during acute mononucleosis.
Answer: At least 15 hours per day
Long-term oxygen therapy can improve survival in appropriately selected patients with severe chronic hypoxemia caused by COPD. For patients who meet established criteria, oxygen is generally prescribed for prolonged daily use, often at least 15 hours per day.
Answer: More than eight weeks in adults
A cough lasting more than eight weeks in an adult is generally considered chronic. Common causes include upper-airway cough syndrome, asthma, gastroesophageal reflux disease, smoking, and medication-related cough such as that caused by ACE inhibitors.
Answer: A viral upper respiratory infection (URI)
Viral respiratory infections can cause inflammation and dysfunction of the Eustachian tube. This may interfere with normal middle-ear ventilation and contribute to the accumulation of fluid behind the tympanic membrane.
Answer: Long-acting beta-agonists (LABAs)
Research has identified differences in response to certain asthma therapies among population groups, including genetic and biologic factors that may influence beta-agonist response. Asthma treatment should therefore be individualized according to clinical response, disease control, and exacerbation risk.
Answer: Immunosuppression, including prolonged corticosteroid therapy
Long-term corticosteroid therapy can suppress immune responses and may result in a false-negative or reduced tuberculin skin test reaction. Other causes of reduced TST response include severe illness, immunodeficiency, and very recent infection.
Answer: African American men
Historically, African American men have experienced the highest lung cancer incidence and mortality rates among major U.S. racial and sex groups. Differences in smoking exposure, occupational and environmental risks, access to healthcare, and other social determinants contribute to disparities in lung cancer outcomes.
Answer: Chronic hyperinflation
Emphysema causes airflow limitation and air trapping. Over time, chronic hyperinflation increases the anteroposterior diameter of the chest, producing the characteristic barrel chest appearance.
Answer: Streptococcus pneumoniae
Streptococcus pneumoniae is a major bacterial cause of community-acquired pneumonia. However, CAP can result from numerous bacterial and viral pathogens, and the causative organism may vary according to patient characteristics, epidemiology, and clinical setting.
Answer: A delayed-type hypersensitivity response to Mycobacterium tuberculosis antigens
The TST evaluates whether a person has developed a cell-mediated immune response to tuberculosis antigens. The result is interpreted by measuring the induration, not the redness, and applying risk-based criteria to determine whether the reaction is considered positive.
When preparing for respiratory and infectious disease questions, focus on recognizing patterns rather than memorizing isolated facts. Important concepts include the role of ICS therapy in asthma, common pneumonia pathogens, chronic cough definitions, tuberculosis testing, smoking-related disease, and characteristic findings of infectious mononucleosis.
High-yield points include:
ICS + LABA: Combination therapy may be used for patients whose asthma is not adequately controlled with an ICS alone.
Infectious mononucleosis: Think severe pharyngitis, fatigue, and posterior cervical lymphadenopathy.
CAP: Streptococcus pneumoniae is a major bacterial cause.
Chronic cough: In adults, a cough lasting more than eight weeks is considered chronic.
Allergic rhinitis: IgE-mediated Type I hypersensitivity is responsible for the allergic response.
Emphysema: Chronic hyperinflation contributes to barrel chest.
ACE inhibitors: Medications such as captopril can cause a persistent dry cough.
TST: Interpret induration according to the patient’s risk category.
Long-term oxygen therapy: Appropriate patients with severe chronic hypoxemia may require prolonged daily oxygen therapy.
Smoking: Cigarette use increases the risk of lung, bladder, kidney, pancreatic, and other cancers.
American Academy of Otolaryngology–Head and Neck Surgery Foundation. (2025). Clinical practice guideline: Adult sinusitis. https://www.entnet.org/quality-practice/quality-products/clinical-practice-guidelines/adult-sinusitis/
Centers for Disease Control and Prevention. (2025). Clinical guidance for group A streptococcal pharyngitis. https://www.cdc.gov/group-a-strep/hcp/clinical-guidance/strep-throat.html
Centers for Disease Control and Prevention. (2025). Clinical testing and diagnosis for tuberculosis. https://www.cdc.gov/tb/hcp/testing-diagnosis/
Global Initiative for Asthma. (2025). Global strategy for asthma management and prevention. https://ginasthma.org/
Global Initiative for Chronic Obstructive Lung Disease. (2025). Global strategy for the prevention, diagnosis and management of COPD. https://goldcopd.org/
National Heart, Lung, and Blood Institute. (2024). Asthma. https://www.nhlbi.nih.gov/health/asthma
National Institute on Deafness and Other Communication Disorders. (2024). Ear infections. https://www.nidcd.nih.gov/health/ear-infections
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Mandell, L. A., & Niederman, M. S. (2019). Aspiration pneumonia. New England Journal of Medicine, 380(7), 651–663. https://doi.org/10.1056/NEJMra1714562
