You are seeing a 45 year old paramedic who reports with a mild fever, malaise, a productive cough, and dyspnea

You are seeing a 45 year old paramedic who reports with a mild fever, malaise, a productive cough, and dyspnea. She reports on going symptoms for over 3 weeks. She is frustrated that she is having to wear panty liners because she is coughing so much she is wetting herself. She has been doing albuterol treatments in the back of the ambulance about every 4 hours trying to get some relief. The treatments don’t seem to be effective as they were a week ago. You take a CXR and you note bilateral infilrates. Which of the following antibiotics is best as the first line anti- microbial agent for community acquired pneumonia on an outpatient basis: Cipro Keflex Amoxicillin Azithromycin 2. Your 69 year old male patient with COPD, who continues to smoke, complains to you that his ipratropium bromide (Atrovent) is just not working. He is short of breath even using his Atrovent 2 puffs QID for the last few months. Understanding that current guidelines for the treatment of COPD you recommend? Continue his Atrovert and add 02 per nasal cannula B. Add a corticosteroid inhaler C. Add 2 puffs of albuterol (Ventolin) to his Atrovent regimen D. Recommend the addition of a Himalayan salt inhaler 3. Mom brings in her 2 year old child describing symptoms over the last couple weeks of an increased cough at night and audible wheeze almost daily with relief for a short period of time from use of a short acting betea2 agonist. Treatment of these moderate persistent asthma symptoms in this child would include: A. Adding an oral antihistamine for the cough daily B. Adding an Advair 100/50 (fluticasone/salmeterol diskus BID C. Adding 1.0mg Pulmicort respules (budesonide) via nebulizer BID D. Adding Atrovent 2.0% (ipratropium bromide) solution via nebulizer TID 4. A 20 year old female comes into the clinic today and tells you she took a home pregnancy test this morning and it was positive. She has a history of intermittent asthma that is controlled by Albuterol. As her primary care NP which of the following instructions do you provide as a part of your treatment plan? Answer: A. Maintain your current asthma management during the pregnancy 5. A patient reports that despite the use of albuterol inhaler she is still experiencing some troubles breathing and has a lot of mucus. A spirometry test performed last week indicated an FEV/EVC = 70% and her FEV1 = 39% of expected. Based on these findings you know that she is in Stage I (moderate) COPD. Which of the following medications is best added next to her short acting

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