1. COPD Tutoring – Part 2
By Alaina Darby

2. Which of the following medications contains a long-acting beta-2 agonist? (Select ALL that apply.)    A. Spiriva Respimat B. Advair HFA C. Symbicort D. Seebri E. Tudorza

3. GB has COPD. What is the test used to diagnose COPD. A. Spirometry B
GB has COPD. What is the test used to diagnose COPD?   A. Spirometry B. Listening to lung sounds with a stethoscope C. Chest X-ray D. Bronchoscopy E. V/Q scan

4. Which drugs require patients to rinse their mouth with water after use and spit? (Select ALL that apply.)   A. Advair Diskus B. Breo Ellipta C. Atrovent HFA D. Symbicort E. Spiriva HandiHaler

5. Breo Ellipta should be discarded how long after the removal of the device from the foil tray if not used sooner?   A. 4 weeks B. 6 weeks C. 2 months D. 3 months E. 4 months

6. Glycopyrrolate is a: A. Short-acting beta-2 agonist B
Glycopyrrolate is a:   A. Short-acting beta-2 agonist B. Long-acting beta-2 agonist C. Long-acting anticholinergic D. Inhaled corticosteroid E. Mucolytic

7. Which patient counseling point is incorrect in regards to cleaning the inhalation devices?   A. Atrovent HFA does not require routine cleaning. B. Combivent Respimat should be cleaned weekly. C. Spiriva Handihaler should be cleaned as needed. D. Tudorza Pressair should not be cleaned with water. E. Breo Ellipta does not require routine cleaning.

8. What are patient counseling points regarding the use of Combivent Respimat? (Select ALL that apply.)   A. The most common side effect is dry mouth. B. To take an inhalation, turn the base, open the cap, and press the dose-release button. C. Shake the inhaler prior to taking an inhalation. D. It does not need to be primed prior to its initial use. E. Take two inhalations BID.

9. Which of the following patient counseling points is false regarding Atrovent HFA?   A. To prime, spray twice away from the face. Prime again if it has been over 3 days since last use. B. Breathe in quickly through the mouth while pressing the top of the canister to inhale the medication. C. Hold breath for as long as possible, preferably 10 seconds. D. If another inhalation is needed, wait at least 15 seconds in between inhalations. E. Rinse Atrovent HFA mouthpiece weekly and let air dry.

10. A patient is started on Combivent Respimat
A patient is started on Combivent Respimat. What are the ingredients in Combivent?   A. Albuterol + aclidinium B. Ipratropium + formoterol C. Tiotropium + salmeterol D. Albuterol + ipratropium E. Fluticasone + albuterol

11. Advair is a: A. Long-acting anticholinergic, inhaled corticosteroid B
Advair is a:   A. Long-acting anticholinergic, inhaled corticosteroid B. Long-acting beta-2 agonist, inhaled corticosteroid C. Long-acting anticholinergic, short-acting beta-2 agonist D. Long-acting anticholinergic, long-acting beta-2 agonist E. Long-acting beta-2 agonist, short-acting anticholinergic

12. A patient is prescribed Advair Diskus 250/50
A patient is prescribed Advair Diskus 250/50. Which of the following statements is correct statements regarding Advair Diskus? A. Advair Diskus is not indicated for COPD. B. Advair Diskus improves lung function in COPD patients. C. Advair Diskus does not have a dose counter. D. Advair Diskus contains flunisolide and salmeterol. E. Advair Diskus should be used with a spacer device to decrease the risk of thrush.

13. SD is a COPD patient at the clinic
SD is a COPD patient at the clinic. He is currently taking Perforomist for his symptoms.  Which of the following statements is correct regarding his regimen? A. This medication contains a long-acting anticholinergic. B. This medication should not be used as monotherapy in this patient due to the risk of asthma-related death. C. This medication should be taken twice daily. D. This medication is formulated as a dry powder inhaler. E. SD should be instructed to rinse his mouth after use to avoid thrush.

14. What is the most likely side effect from the use of Spiriva. A
What is the most likely side effect from the use of Spiriva? A. Urinary retention B. Depression C. Dry mouth D. Constipation E. Blurry vision

15. Case History of Present Illness: DK, a 67 year-old male, is hospitalized on 11/15 for an acute exacerbation of his COPD. He is intubated and has been in the ICU for 1 day. Allergies: NKDA   Past Medical History: COPD (hospitalized months ago) Tobacco user (1 ppd) GERD  
Medications: Albuterol neb Q4H PRN Piperacillin/Tazobactam 4.5 g
IV Q8H Ciprofloxacin 400 mg IV Q12H Pantoprazole 40 mg IV daily

16. Which of the following interventions will provide the most benefit in slowing the progression of DK's COPD?   A. Managing the mucus production B. Treating the infection in the lungs C. Switching from a SABA to a LABA D. Provide pulmonary rehabilitation E. Smoking cessation

17. Which of the following medications should be added to DK's regimen. A
Which of the following medications should be added to DK's regimen?   A. Acetylcysteine B. Ranitidine C. Warfarin D. Prednisone E. Theophylline

18. Which vaccines should DK receive before discharge (if no contraindications are present)?   A. Influenza, meningococcal B. Influenza, pneumococcal C. Pneumococcal, meningococcal D. Pneumococcal, varicella E. Hepatitis, meningococcal

19. FS is a patient newly diagnosed with COPD
FS is a patient newly diagnosed with COPD. In order to determine appropriate therapy, what factors are considered in assessing the severity of his COPD? (Select ALL that apply.) A. Current symptoms B. Age C. Degree of airflow limitation D. Exacerbation history E. Race

20. Which of the following medications come as a dry powder inhaler
Which of the following medications come as a dry powder inhaler? (Select ALL that apply.)   A. Combivent Respimat B. Symbicort C. Arcapta D. Advair Diskus E. Bevespi Aerosphere

21. Which of the following medications are in Symbicort. A
Which of the following medications are in Symbicort?   A. Mometasone + formoterol B. Fluticasone + salmeterol C. Budesonide + formoterol D. Budesonide + salmeterol E. Beclomethasone + formoterol

22. Which of the following statements are correct regarding Roflumilast (Daliresp)? (Select ALL that apply.)   A. It is used for mild COPD due to modest benefit. B. It is a phosphodiesterase-4 inhibitor. C. It can cause diarrhea and weight loss. D. It is contraindicated in severe liver impairment. E. It is contraindicated in severe renal impairment.

23. Some COPD medications are formulated as a capsule, which is then inserted into a device for inhalation. Patients need to be counseled that these capsules are not meant to be taken by mouth, but inhaled. Select the COPD medications which come as a capsule meant for inhalation:   A. Spiriva HandiHaler B. Combivent Respimat C. Tudorza Pressair D. Anoro Ellipta E. Arcapta Neohaler

24. Which inhaler has a window that turns from green to red to indicate a dose was given?   A. Anoro Ellipta B. Striverdi Respimat C. Spiriva HandiHaler D. Tudorza Pressair E. Utibron Neohaler

25. What is the generic name for Arcapta. A. Olodaterol B. Arformoterol C
What is the generic name for Arcapta?   A. Olodaterol B. Arformoterol C. Aclidinum D. Indacaterol E. Tiotropium

26. Glycopyrrolate is an active ingredient in: A. Bevespi B. Brovana C
Glycopyrrolate is an active ingredient in:   A. Bevespi B. Brovana C. Striverdi D. Anoro E. Stiolto

27. What is the major risk factor for developing COPD. A
What is the major risk factor for developing COPD? A. Alpha-1 antitrypsin deficiency B. Smoking C. Occupational chemical exposure D. Indoor air pollution from cooking fumes E. Outdoor air pollution

28. Which medications have been shown to be most effective in treating COPD when used on a regular basis?   A. Short-acting inhaled bronchodilators B. Long-acting inhaled bronchodilators C. Oral corticosteroids D. Theophylline E. PDE-4 inhibitors

29. PD is a 72 year-old male who has COPD with chronic bronchitis and emphysema. He was a long-term smoker (1.5 packs per day for 35 years), but has not smoked for years. Fortunately, he does not require oxygen therapy. He is having trouble managing his many medications, including the four-time daily dose of Atrovent. The physician has switched his Atrovent to Spiriva. Choose the correct statement regarding Spiriva:   A. Spiriva is available as a DPI and an MDI formulation. B. Spiriva contains ipratropium; an anticholinergic medication. C. Spiriva is a long-acting beta-2 agonist. D. Spiriva is only indicated for COPD. E. Spiriva is dosed 1 puff twice per day after breakfast and dinner.

30. Note: Content adapted from RxPrep
Questions?
Note: Content adapted from RxPrep