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Once the headphone is confirmed to be functioning properly, the remainder of the tutorial is left to the discretion of the examinee. The diagnostic workup would also include a complete blood count, arthrocentesis with relevant synovial fluid studies (cell count, crystals, and bacterial culture), an antinuclear antibody assay, and an erythrocyte sedimentation rate or C-reactive protein test. It would be suboptimal to order anything unnecessary that would waste time, even if the test or procedure were not invasive or risky (eg, lung scan). A rheumatoid factor test or a cyclic citrullinated peptide antibody (Anti-CCP) test would support the diagnosis of rheumatoid arthritis. The characteristic feature of persistent asthma … Cardiovascular examination reveals a prominent and sustained apical impulse, and an indistinct S2 with S4 audible at the apex, and a grade 2/6 diastolic decrescendo murmur heard best at the right sternal border. In this acute presentation, timing is critically important. Practice materials updated September 2019, Practice materials updated November 2020 Practice Sessions are available, for a fee, for registered examinees who want the opportunity to become familiar with the Prometric test center environment. 8.3, Copyright © 2009- the National Board of Medical Examiners. As to the materials that are owned and copyrighted by the NBME and FSMB: Copyright © 1998- the Federation of State Medical Asthma is inflammation and narrowing of the airways (bronchi), and during an attack the … Admitting the patient to the inpatient ward or intensive care unit, Changing the location to the outpatient office or sending the patient home, Administrative rights - Control Panel > User Accounts > Change account type, Control Panel > Appearance and Personalization >, Control Panel > Appearance and Personalization > Display >, Control Panel > Clock, Language, Region > Region and Location >, File sharing software must be disabled (e.g., uTorrent, drop box, google drive), Double click on downloaded file to extract installation file, Double click on installation file and follow prompts. An autoimmune disease. Examples of additional tests, treatments, or actions that could be ordered but would be neither useful nor harmful to the patient include: Examples of suboptimal or poor management would include failure to examine the chest, admission before treatment, failure to order a chest x-ray after inserting the chest tube and/or needle thoracostomy, delay in treatment to reexpand the lung, or absence of treatment. An optimal, efficient diagnostic approach would include quickly performing a targeted physical examination that includes chest/lung and cardiovascular examination, cardiac monitoring, and assessing oxygen saturation by pulse oximetry. An optimal approach would include completing the above diagnostic and management actions as quickly as possible (ie, during the first hour of simulated time). This NCLEX review will discuss asthma. The patient is anxious, diaphoretic, and in severe distress from chest pain. In this acute presentation, timing is important. Other physical findings are unremarkable. The remainder of the physical examination is unremarkable. The pain is excruciating, sharp, and increases with respiration. Elderly b. Take the quiz > Behavioral Science. from Versant Corporation, Copyright © 1996. Severe persistent asthma is defined as having either continuous daytime symptoms or frequent nighttime symptoms. Abdominal examination shows a gravid uterus with a fundal height of 37 cm. (M1.PL.13.91) A 12-year-old female presents to her pediatrician with an asthma exacerbation. Examples of invasive and noninvasive actions that would subject the patient to unnecessary discomfort or risk, or would add no useful information to that available through safer or less invasive means, include: In this case, a 31-year-old woman is brought to the emergency department by her roommate because of lethargy, nausea, and vomiting. Continued monitoring of the patient’s serum glucose, electrolytes, particularly potassium, and arterial blood pH after treatment is also important. There is no time limit. Optimal treatment would include a combination of a nonsteroidal anti-inflammatory drug (NSAID) or corticosteroid with a disease-modifying antirheumatic drug (DMARD) for comprehensive therapeutic treatment. Examples of invasive tests that would subject the patient to unnecessary discomfort or risk and add no useful information include: While many case scenarios run for a relatively short period of simulated time, a matter of hours or days, this scenario runs for a longer period of time, weeks. Most of these questions are the same as those you can install on your computer from the USMLE website. The comprehensive history, however, narrows the differential. Asthma questionnaire is a compilation of questions which is used to diagnose people, especially small children with asthma. You can view the answer right after you answer each question. The patient appears pale and in marked respiratory distress. HEENT/neck examination shows grade II arteriovenous nicking on funduscopic examination. Xanthines such as aminophylline, magnesium sulfate via an IV, as well as Heliox. Bronchial Asthma 3. An optimal approach would include completing the above diagnostic and management actions as quickly as possible. Then, let us know what you think by taking our brief survey. and the National Board of Medical Examiners. A review of the pathophysiology, presentation, diagnosis, and treatment of asthma for medical students and those learning clinical medicine. Quiz: Which Anime Character Are You Most Like? Optimal medical therapy would include stabilizing the patient with intravenous (IV) medications to lower both blood pressure and heart rate. Don't forget to take the asthma … 10 item question in Asthma. In adult patients, an optimal approach to treatment would focus on relieving pain, decreasing inflammation, preventing or slowing joint damage, and improving function. Physical examination shows hypertension and tachycardia with bounding central and peripheral pulses. The patient's cardiovascular status should be monitored with a cardiac monitor or by ordering repeat vital signs. She has a history of hypertension for the past 5 years that is being appropriately treated with medication. The fetus is cephalic by palpation with a fetal heart rate of 144 beats/min. What are some special medications used for asthma… Serum creatinine or urea nitrogen measurements (basic metabolic profile or complete metabolic profile) to assess kidney function are indicated. With the availability of effective treatment for rheumatoid arthritis and concerns about opioid addiction, narcotic analgesics should have a limited role in treatment. What is asthma exactly? An optimal, efficient approach would include performing a targeted physical examination (including HEENT/neck, chest/lung, cardiovascular, and abdominal examinations) and addressing oxygen status by ordering pulse oximetry or oxygen therapy. Suboptimal management of this case would include administering a bronchodilator by a suboptimal route (such as intramuscular or oral); or administering a suboptimal bronchodilator (such as atropine or aminophylline); monitoring the patient by ordering arterial blood gas analysis instead of a chest/lung examination after treatment; failing to counsel the patient/family; or a delay in diagnosis or treatment. She has a history of type 1 diabetes mellitus, for which she normally takes insulin multiple times daily. The first step in management is to involve your health care provider. Primum® Computer-based Case Simulation Software Version Chest/lung examination reveals bilateral, mild, intercostal retractions, and bilateral expiratory wheezes with prolonged expiratory phase, and no crackles. Some measure of the patient’s urine output is also indicated. practice by individuals who are registered to take the examinations, and further reproduction, distribution, transmission, or other uses These type of questions may be found on NCLEX and definitely on nursing lecture exams. Asthma free copy 100 mcqs 1. www.pharmaqz.com INTRODUCTION TO MULTIPLE CHOICE MCQS Multiple choice questions each have a number of options for the correct answer, with … Questions and Answers . Do you know what triggers your asthma? Take the quiz > Biostatistics. The characteristic feature of persistent asthma is: Simple instrument to roughly determine lung function is a: Which of the following tests cannot detect airway inflammation? The patient’s blood pressure and respiratory rate should be closely monitored until the patient’s condition has stabilized. The cervix is dilated to 1 cm and 50% effaced. He is moaning and holding his hands over the right side of his chest. Removing question excerpt is a premium feature. An NSAID or corticosteroid relieves pain and decreases inflammation essential to provide interim symptom relief while the selected DMARD takes effect. The pain began abruptly 45 minutes before the patient came to the emergency department. National Board of Medical Examiners or owned and copyrighted by the Federation of State Medical Boards and the National Board of Medical These also appear at the end of the practice cases. Please view the announcement regarding upcoming Step 2 CK content changes. Therefore, ordering a rheumatology consult or additional monitoring is appropriate but optional during the time frame of this simulation. Therefore, it is not feasible to list every action that might affect an examinee's score. She has had a severe headache for the past 3 days, and her feet have appeared swollen during the past 2 to 3 weeks. Examples of invasive and noninvasive actions that would subject the patient to unnecessary discomfort or risk include: In this case, a 4-year-old boy is brought to the office because of increasing shortness of breath during the past 3 days. 10 item question in Asthma. • Download the Step 3 tutorial and practice items, which includes practice CCS cases. USMLE Content Outline Anti-asthma medications include quick relief and long-term medications. 2. The patient had an acute onset of right-sided chest pain 10 minutes before the ambulance arrived. This is a practice mode. The following descriptions are meant to serve as examples of actions that would add to, subtract from, or have no effect on an examinee's score for this case. Upon physical examination, the physician notes the finding shown in Figure A. Physical examination shows bilateral swollen, warm, and tender wrist, proximal metacarpophalangeal, and knee joints, and bilateral knee effusions. Genital examination reveals an edematous vulva. Treatment options for asthma are dependent on the patient’s asthma stage: Intermittent: Requires short-acting β2 agonists as needed, which is a part of the treatment for all levels of asthma. Other examples of treatments that would waste time, subject the patient to unnecessary discomfort or risk, and add no real benefit to this patient include: In this case, a 32-year-old woman comes to the office because of knee pain and swelling. Delaying diagnosis or treatment and pursuing alternative diagnoses with tests such as a lung scan will waste valuable time and could be harmful or even fatal to the patient. Treatment should be initiated immediately before the patient’s condition worsens. • Read the Primum CCS FAQs (PDF) to learn more about the Primum experience. Treatment with salicylates would also be considered suboptimal management in this case. The practice package includes proprietary information and materials that are licensed by the The FEV1 here tends to be less than 60%. C. An atopic disease. The patient has been experiencing nausea and vomiting for the past 24 hours and has been unable to eat during that time. Pneumonia Unfortunately he is the 10th patient in 2 days who has required similar … HEENT/neck examination shows pale, boggy, edematous nasal mucosa without nasal flaring. The remainder of the physical examination is unremarkable. 1 Asthma Maintenance | Alabama Pharmacy Association | www.aparx.org Multiple Choice Assessment Questions . Children c. Adult d. All are equal . If you still experience issues after following the instructions above, please contact us. In this case, a 65-year-old man is brought to the emergency department by ambulance because of acute chest pain and respiratory distress. An optimal, efficient approach would include performing a targeted physical examination (including chest/lung, cardiovascular, abdominal, and neurologic/psychiatric examinations), and ordering a serum glucose test using a glucometer and a urinalysis or complete blood count (CBC) to check for signs of infection. World's Hardest Science Quiz You'll Ever Take! Skin examination reveals poor turgor. reversibility test: Bronchoprovocation tests usually use histamine to challenge the Deep tendon reflexes are 4+ with bilateral clonus at the ankles. There is a grade 2/6 systolic ejection murmur at the left sternal border without radiation. Overview. The patient also has a history of allergy to pollen and atopic dermatitis. From the chief complaints, the differential diagnosis is broad and includes the many causes of acutely altered mental status. Cardiovascular examination shows thready central and peripheral pulses. Pharmacology makes up 15–22% of the Step 1 exam. The patient appears drowsy, lethargic, and acutely ill. From the chief complaint, the differential diagnosis is broad; however, the comprehensive history narrows the differential. You can view the answer right after you answer each question. Are you preparing for USMLE Step 1? The patient’s roommate says that the patient experienced some chills yesterday. In addition, joint x-rays would provide a baseline assessment. Suboptimal treatment would include other antihypertensive agents. Permission to use this software and the other materials installed with it is limited to exam preparation or This presentation is a common side effect of which of the following pharmacologic agents used in the treatment of asthma? The patient's illness, at this point, seems most consistent with an intrathoracic process. The United States Medical Licensing Examination is a joint program of the … The patient has experienced increasing fatigue and generalized weakness during the past 4 months. Examples of additional tests and treatments that could be ordered but would be neither useful nor harmful to the patient include: Examples of suboptimal management of this case would include delay in diagnosis or treatment, or treatment with NSAIDS or corticosteroids alone. Skin examination reveals dry, scaly patches in the antecubital areas. Take the quiz > Microbiology. Examples of poor management would include failure to order any physical examination or failure to treat rheumatoid arthritis. It includes osteoarthritis, infectious arthritis, rheumatoid arthritis, systemic lupus erythematosus (SLE), gout, and psoriatic arthritis. The remainder of the physical examination is unremarkable. Pneumonia Examples of poor management would include failure to order any physical examination, failure to order an imaging study that would reveal the dissection, failure to administer an antihypertensive agent, or failure to order surgical intervention. Environmental risk factors for the development of asthma … The computer-based case simulation database contains thousands of possible tests and treatments. This is carried out by doctors, pediatricians and hospitals to find out the severity … Start studying NUR 317 NCLEX questions for ASTHMA and COPD med surg I. D. A malignant disease. In this case, the increased coughing and wheezing, as well as the history of frequent respiratory and ear infections, are highly suggestive of the diagnosis of asthma. Can You Pass This Basic World History Quiz? Examples of invasive and noninvasive actions that would subject the patient to unnecessary discomfort or risk or would add no useful information to that available through safer or less invasive means include: In this case, a 25-year-old woman at 38 weeks’ gestation comes to the emergency department after suffering a seizure with loss of consciousness about 10 minutes earlier. Once the patient’s condition is stabilized, it is imperative to deliver the fetus either by stimulating contractions using optimal uterotonics, by performing a cesarean delivery, or by consulting obstetrics/gynecology. In this case, a 65-year-old woman comes to the emergency department because of chest pain. The fetal heart rate should be watched until delivery by ordering a fetal monitor. • ONE BOOK for (First aid book + USMLE World qbank + high … HEENT/neck examination shows dry mucous membranes. Optimal management should also include counseling the patient/family about asthma care and the side effects of medication. Click here to check on the status of your test center. Vital signs show tachypnea, tachycardia, and low blood pressure. If you do not find the answer you need, please fill out our contact form. Asthma is common and should be evaluated.

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