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Quiz Session - Attempts With Random Questions

AANPCB FNP Exam Questions

Page 9 of 50

161.

You are examining a 32-year-old female patient diagnosed with lupus erythematosus. The patient is presenting with fatigue, headaches, and decreased exercise tolerance. You would expect diagnostic test findings to reveal which type of anemia?

  • Normocytic, normochromic anemia with normal red blood cell distribution width (RDW)

  • Microcytic hypochromic anemia with elevated red blood cell distribution width (RDW)

  • Microcytic hypochromic anemia with normal red blood cell distribution width (RDW)

  • Drug-induced macrocytosis

Correct answer: Normocytic, normochromic anemia, with normal red blood cell distribution width (RDW)

The most common etiologies for this type of anemia are anemia related to chronic disease (ACD) or anemia due to acute blood loss. ACD is largely a diagnosis of exclusion, where other causes of normocytic, normochromic anemia have been eliminated by history, clinical presentation, and diagnostics. If ACD is suspected, serum iron, transferring reticulocyte count, and serum ferritin should be measured to check if Iron Deficiency Anemia (IDA) is also present. 

Microcytic hypochromic anemia with elevated RDW is most commonly associated with iron deficiency. The most common etiology for microcytic hypochromic anemia with normal RDW is alpha or beta thalassemia minor. Drug-induced macrocytosis is associated with the use of medications, including, in part, carbamazepine (Tegretol, Carbatrol, Epitol), zidovudine (Retrovir), valproic acid (Depakote, Depakene, Stavzor), and phenytoin (Dilantin, Phenytek, Cerebyx). Drug-induced macrocytosis is also associated with alcohol use.

162.

The 57-year-old postmenopausal patient for whom you are performing a well-woman examination informs you that she needs a refill on her hormone therapy (HT). You review her chart and find she has been prescribed transdermal 17-estradiol patch 0.1 mg applied twice weekly and medroxyprogesterone acetate 5 mg orally for 12 days each month. The patient informs you that she does not need the oral tablet prescribed, as she did not feel it helped with her menopausal symptoms, and she has not been using it for the last 10 months.

You know your patient is at risk for which of the following?

  • Endometrial cancer

  • Post-menopausal bleeding

  • Breast cancer

  • Thromboembolic event

Correct answer: Endometrial cancer

Post-menopausal women who have retained their uterus and require HT should not be treated with unopposed estrogen due to the considerable risk of endometrial cancer. A progestin should be prescribed in addition to the estrogen to minimize this risk; dosing forms and plans may vary based on the type of progestogen chosen.

The use of Hormone Therapy (HT) carries with it the risk of adverse effects. Use of HT should be limited to the lowest dose possible to relieve symptoms and used for the shortest time possible. An increased risk of breast cancer is found in women using HT. Transdermal estrogen is preferred over oral forms due to the lower risk of thromboembolic events.

163.

A 77-year-old male presents to the clinic with complaints of a painful, swollen mass on the back of his neck and feeling generally unwell. He states he first noted the mass approximately 1 month ago and states it has increased in size and has become more painful. You examine the area and note a 3-cm erythematous mass on the patient's posterior neck and further note the patient appears somewhat unkempt and dirty and has a low-grade fever but otherwise appears well.

You diagnose the patient with a carbuncle and plan to treat the patient how?

  • By performing an incision and drainage (I&D) of the area and ordering oral antibiotics

  • By recommending the patient apply hot packs at home 3 to 4 times per day and return to the clinic in one week for re-evaluation

  • With cephalexin (Keflex) 500 mg administered orally four times per day for 7 days

  • With amoxicillin/clavulanic acid (Augmentin) 875 mg/125 mg administered orally two times per day for 10 days

Correct answer: By performing an incision and drainage (I&D) of the area and ordering oral antibiotics

A carbuncle is a collection of boils, or furuncles, that occur in one area and may measure up to 4 inches across. They affect males more often than females, occur more frequently in men with poor health or a weakened immune system, and affect those living in unhygienic circumstances. Fever and general malaise may accompany a carbuncle. Carbuncles occur more frequently on the back of the neck, the thighs, and on the back.

Treatment of a carbuncle in an individual who does not present with systemic symptoms includes I&D of the area followed by oral antibiotics. Usage of a broad-spectrum antibiotic, such as amoxicillin/clavulanic acid (Augmentin), should be limited to those patients who are immunocompromised or who present with complications of the skin or soft tissue infection. Typically, carbuncles are caused by S. aureus and respond well to second-generation cephalosporins, not first-generation cephalosporins, such as cephalexin (Keflex).

Hot packs applied to the area should only be recommended in those patients who have been experiencing symptoms for 2 weeks or fewer and who are not experiencing other symptoms consistent with infection, such as fever, inflammation, and pain.

164.

An elderly male patient presents to the emergency department because of an acute exacerbation of chronic obstructive pulmonary disease (COPD). Which of the following interventions should be included as a component of the treatment plan?

  • Oral systemic corticosteroid therapy daily for 5 to 10 days if forced expiratory volume is < 60% of predicted.

  • A chest X-ray is indicated related to patient's age.

  • Oral systemic corticosteroid therapy daily for 14 days if forced expiratory volume is < 60% of predicted.

  • A prescription for azithromycin (Zithromax, Zmax, Z-Pak)

Correct answer: Oral systemic corticosteroid therapy daily for 5 to 10 days if forced expiratory volume is < 60% of predicted.

Although a 10-day course of systemic corticosteroid therapy has been advised in the past, recent research supports the efficacy and safety of a shorter, 5-day course.

A 5- to 10-day course, not a 14-day course of oral systemic corticosteroids is recommended (such as prednisone 40 mg daily for 5 to 7 days). Fever and/or an unusually low oxygen saturation, rather than patient age, are indications for a chest X-ray due to the possibility of concomitant pneumonia. Antimicrobial therapy is not always needed as part of the treatment of an exacerbation of COPD, as the cause can be non-bacterial in origin (such as environmental factors or a viral infection). 

165.

You are providing care for an adolescent with acne vulgaris for whom you have prescribed isotretinoin. Which symptoms indicate the need to discontinue this medication?

  • Difficulty sleeping, back pain, or stiff joints

  • Epistaxis and cracks in the corners of the mouth

  • Dry lips, dry mouth, and minor swelling of the eyelids

  • Cracking or peeling skin, itching, or a rash

Correct answer: Difficulty sleeping, back pain, or stiff joints

Isotretinoin (Claravis, Sotret, Myorisan, and discontinued brand: Accutane) is effective in treating cystic acne that does not respond to conventional therapy. Although most patients who take it have adverse effects related only to dry skin, the prescriber and patient need to be well aware of potentially serious problems associated with its use.

Serious side effects include:

  • Depressed mood, trouble concentrating, sleep problems, crying spells, aggression or agitation, changes in behavior, hallucinations, thoughts of suicide
  • Sudden numbness or weakness, especially on one side of the body
  • Blurred vision, sudden and severe headache or pain behind the eyes, sometimes with vomiting
  • Hearing problems, hearing loss, or tinnitus
  • Seizure
  • Severe stomach pain radiating to the back; nausea and vomiting
  • Fast heart rate
  • Loss of appetite; dark urine; clay-colored stools; severe diarrhea; rectal bleeding; black, bloody, or tarry stools
  • Jaundice
  • Fever, chills, body aches, flu symptoms, urticaria, easy bruising or bleeding
  • Severe blistering, peeling, and red skin rash
  • Joint stiffness, bone pain, or fracture

Epistaxis, cracking in the corners of the mouth, dry lips and mouth, minor swelling of the eyelids, cracking or peeling skin, itching or rash are common side effects that would not indicate the need for discontinuation of isotretinoin treatment.

166.

A 24-year-old patient with irritable bowel syndrome (IBS) causing constipation reports severe anal pain with every bowel movement, which sometimes persists for hours afterward. What is your rationale for including intra-anal applications of nitroglycerin (NTG) as a component of the plan of care?

  • NTG will relax the internal sphincter and increase blood flow to the anal mucosa

  • NTG will relieve spasms of the anal sphincter for up to three months

  • NTG will provide pain relief without the potential for adverse effects

  • NTG will help lubricate the stool and render defecation more comfortable

Correct answer: NTG will relax the internal sphincter and increase blood flow to the anal mucosa

The symptoms described are consistent with anal fissure. For severe cases of anal fissure, intra-anal applications of 0.4% nitroglycerin (NTG) can be applied directly to the internal sphincter. NTG is believed to relax the internal sphincter, increasing blood flow to the anal mucosa, which will assist with pain relief and hasten the healing process. 

Botulinum injections, not NTG, provide relief of anal spasms for approximately three months. Adverse effects of intra-anal NTG are identical to what is reported with other NTG forms, and include headache and dizziness, which significantly limits the use of the product. Mineral oil, not NTG, helps lubricate the stool and renders defecation more comfortable.

167.

You are caring for an elderly male patient who has presented to the emergency department with complaints of general fatigue and feeling lightheaded. He has a history of coronary artery disease (CAD) and chronic stable angina and is currently taking the following medications: lisinopril 10 mg orally once per day, metoprolol 100 mg orally twice per day, and isosorbide mononitrate 30 mg orally once per day. You complete the patient's examination, noting a slow pulse, and obtain an electrocardiogram (EKG).

You identify a sinus rhythm and Mobitz II. All the following characterize a Mobitz II heart block except:

  • There is a gradual increase in the PR interval until one of the P waves is not conducted to the ventricles.

  • It is a disease affecting the His-Purkinje system.

  • The PR interval is constant but prolonged with occasional impulses being blocked.

  • It is an infranodal block.

Correct answer:  There is a gradual increase in the PR interval until one of the P waves is not conducted to the ventricles.

Mobitz II is a type of second-degree heart block that typically occurs in older individuals and often results from arteriosclerotic heart disease. It may also occur as a result of a defect in the cardiac conduction system, degenerative diseases, or tumors. This infranodal block may occur either within the bundle of His or in both of the bundle branches, affecting the His-Purkinje system. It is characterized by a constant but prolonged PR interval with occasional impulses being blocked, resulting in non-conduction of P waves to the ventricles and subsequent absence of the QRS complex on ECG tracing. Mobitz II typically requires treatment with either medications or pacemaker implantation, as it may progress to complete heart block.

Mobitz I is characterized by a gradual increase in the PR interval until ultimately a P wave is not conducted to the ventricles, and the QRS complex is then absent from the ECG tracing.

168.

A patient's lab results reveal a need for dose adjustment in their levothyroxine (Synthroid, Levothroid, Levoxyl). At which time interval will you plan to recheck the patient's thyroid-stimulating hormone (TSH) level? 

  • 6 to 8 weeks

  • 4 weeks 

  • 10 to 12 weeks 

  • 2 weeks

Correct answer: 6 to 8 weeks

Because this drug has a long half-life, the effects of a dosage adjustment would not cause a change in TSH levels for approximately 5 to 6 drug half-lives. Therefore, the recommended testing interval post-adjustment of levothyroxine (Synthroid, Levothroid, Levoxyl) is 6 to 8 weeks and should be rechecked in this fashion until TSH is normalized (TSH <5.0 mU/L). When under control (within normal limits), check TSH every 12 months. 

169.

When providing care for a patient presenting with joint pain and stiffness associated with use of the joint, which of the following statements is consistent with a diagnosis of osteoarthritis?

  • Symptoms become worse as the day progresses.

  • A positive family history is likely the most common personal risk factor.

  • Morning stiffness is usually the most problematic.

  • The most commonly affected joints are the hip and knee.

Correct answer: Symptoms become worse as the day progresses.

With osteoarthritis, discomfort typically increases as the day progresses, and there is minimal morning stiffness. Symptoms become more severe with use of the joint, so joint pain typically becomes worse as the day progresses. In contrast, with Rheumatoid Arthritis (RA), morning stiffness is usually the most problematic. 

Obesity, rather than a positive family history, is likely the most common personal risk factor. The worst symptoms are reported with use of the joints. As a result, discomfort typically increases as the day progresses, and there is minimal morning stiffness. Although the most problematic joint involvement is in the hip and knee, the distal interphalangeal joint is the most commonly affected site.

170.

The 35-year-old patient who experiences migraine headaches only during the premenstrual week may benefit from treatment with which of the following?

  • Combined oral contraceptives (COCs)

  • Opiods

  • Triptans

  • Ergotamines

Correct answer: Combined oral contraceptives (COCs)

Women who experience migraine headaches only during the premenstrual week are likely experiencing symptoms due to the drop in estrogen that takes place during that time of the cycle. Using hormonal contraception such as COCs adds an exogenous source of estrogen, supplementing the natural decline of endogenous estrogen, thus preventing the migraine. 

If a patient does not require contraception or does not wish to take a daily medication to prevent migraines that occur only during one week of the month, low-dose estradiol patches may also be considered for use only during the premenstrual week.

171.

When performing a routine annual well-woman examination of a 62-year-old patient of Scandinavian ancestry, you recognize all the following as factors associated with an increased risk for osteoporosis except:

  • Obesity

  • Estrogen deficiency

  • Prolonged use of thyroid hormones

  • Prior history of broken bones

Correct answer: Obesity

Obesity appears to minimize rather than increase osteoporosis risk, in part because of high endogenous estrogen production by fatty tissue and increased bone weight-bearing.

Estrogen deficiency is a potent risk factor for osteoporosis; the condition is most common in small-framed women of Asian and European ancestry who usually have lower bone density in adulthood. Prolonged therapy with certain medications, including some anticonvulsants, thyroid hormones, and systematic corticosteroids contributes to risk. Additional risk factors include (but are not limited to) a family history of osteoporosis, heavy alcohol use, cigarette smoking, and a prior history of broken bones.

172.

A school-aged child who presented to the family medicine office with symptoms of purulent discharge from his left eye that had been present for the last 48 hours and irritation and erythema of the eye was diagnosed with bacterial conjunctivitis and started on antibiotic ophthalmic drops. Which of the following antibiotic ophthalmic drops should be avoided when treating bacterial conjunctivitis due to concerns about bacterial resistance?

  • Tobramycin

  • Levofloxacin

  • Azithromycin

  • Polymixin B plus trimethoprim

Correct answer: Tobramycin

While the majority of cases of conjunctivitis ("pink eye") are caused by a viral source (most often, adenovirus), bacterial conjunctivitis predominates in the pediatric-aged population, contributing to approximately 70% of cases of conjunctivitis. Mucopurulent or purulent discharge from the affected eye is highly suspicious for conjunctivitis of a bacterial nature and is most often caused by S. pneumoniae, S. aureus, and H. influenzae, with S. pneumoniae and H. influenzae being the most common cause in the pediatric-aged patient. Moraxella is also frequently implicated as the cause of bacterial conjunctivitis in pediatric patients. 

Most cases of bacterial conjunctivitis resolve without intervention; however, due to the highly contagious nature of the disease and the apparent ease with which it spreads, topical ophthalmic drops should be prescribed as first-line treatment. The FNP should choose an antibiotic that will provide coverage for the three most common bacterial strains that cause conjunctivitis while avoiding the use of antibiotics that have been implicated in bacterial resistance. Tobramycin and gentamycin are most likely to provide incomplete resolution of bacterial conjunctivitis due to the resistance of microorganisms to these antibiotics. 

173.

A patient comes to the medical clinic due to a persistent cough over the past two weeks. Which of the following factors would confirm a diagnosis of acute bronchitis versus other respiratory illness?

  • A self-limited infection persisting for approximately 3 weeks

  • The presence of fever, tachypnea, and tachycardia

  • A history of a chronic airway disease

  • The presence of nasal congestion and rhinorrhea lasting 7 to 10 days

Correct answer: A self-limited infection persisting for approximately 3 weeks

Acute bronchitis, presenting with a chronic cough, is a self-limited infection that typically persists about 3 weeks, although it may occasionally last up to 4 to 6 weeks.

The presence of fever, tachypnea, and tachycardia is associated with pneumonia. The diagnosis of acute bronchitis is usually limited to those without a history of a chronic airway disease. The presence of nasal congestion and rhinorrhea lasting 7 to 10 days indicates the common cold.

174.

You are providing care for a 52-year-old African American post-menopausal female who is complaining of worsening vasomotor symptoms. She is requesting pharmacologic treatment for her symptoms and has a history of deep vein thrombosis (DVT) experienced at age 41 after an unexpected pregnancy.

You discuss the possible use of which of the following medications to treat her vasomotor symptoms?

  • Paroxetine (Paxil, Brisdelle)

  • Oral conjugated estrogen (Premarin)

  • Transdermal 17-estradiol (Vivelle-Dot, Minivelle)

  • Vitamin E 800 international units (IU) per day

Correct answer: Paroxetine (Paxil, Brisdelle)

Postmenopausal usage of Hormone Therapy (HT) has contraindications and cautions for certain groups of women. HT usage is absolutely contraindicated in women who have:

  • unexplained vaginal bleeding
  • acute liver disease
  • chronic impaired liver function
  • thrombotic disease
  • neuro-ophthalmic vascular disease

Use of HT in women who have a history of endometrial cancer or breast cancer is controversial; short-term usage for treatment of severe menopausal symptoms may be acceptable. 

HT should be used cautiously in women who have:

  • seizure disorder
  • dyslipidemia, particularly triglyceridemia

Women who are unable to use HT should still be offered pharmacologic treatment of bothersome vasomotor symptoms. Certain selective serotonin reuptake inhibitors (SSRIs), such as paroxetine (Paxil, Brisdelle) and sertraline (Zoloft) as well as certain selective serotonin and norepinephrine reuptake inhibitors (SNRI) such as venlafaxine (Effexor) can reduce the frequency and severity of vasomotor symptoms by 35% (i.e., hot flashes). 

High-dose vitamin E (800 IU per day) has been tested in women with a history of breast cancer and has been found to have a modest effect on reducing the number of hot flashes; however, this is not an example of pharmacologic therapy (rather, this is nonpharmacologic therapy).

175.

Your treatment plan for a patient with signs and symptoms of subscapular bursitis includes the application of ice for 15 minutes at least four times a day, taking nonsteroidal anti-inflammatory medications and minimizing causative activity. If symptoms persist, at what time interval will you plan to consider intrabursal corticosteroid injections?

  • 4 to 8 weeks

  • 6 to 12 weeks

  • 3 to 4 weeks

  • 1 to 2 weeks

Correct answer: 4 to 8 weeks

First-line therapy for subscapular bursitis includes minimizing or eliminating the offending activity, applying ice to the affected area for 15 minutes at least four times per day, and taking nonsteroidal anti-inflammatory drugs. If these conservative measures have not worked after approximately 4 to 8 weeks, intrabursal corticosteroid injection should be considered.

176.

A concerned mother brings her 9-year-old daughter to the clinic due to concern about a small cluster of warts located on the girl's hand. Which of the following statements made by the primary care provider regarding the treatment of warts is appropriate?

  • "These warts should clear on their own in 12 months or so. Let's watch and see what happens to them before we decide to do anything."

  • "We can apply liquid nitrogen to the warts today in the office. This is the best course of action for warts of this type, and the treatment is relatively painless."

  • "I'm going to send a prescription for imiquimod to your pharmacy. I would like you to apply the cream to the warts 3 times a week for the next 16 weeks. This will permanently get rid of them."

  • "I can easily remove those warts with a scalpel here in the office; I'll give your daughter a small injection to numb the area first, and then I'll take off the warts. Would you like me to do that today, or would you rather come back next week?"

Correct answer: "These warts should clear on their own in 12 months or so. Let's watch and see what happens to them before we decide to do anything."

There are several strains of the human papillomavirus (HPV) that are responsible for causing harmless warts among the general population. HPV-3 and HPV-10 cause flat cutaneous warts, HPV-2 and HPV-7 cause common warts, and HPV-1, HPV-2, and HPV-4 cause plantar warts. The wart-causing virus typically gains entry into the body through a cut or scrape on the hands or feet (hangnail on the finger, splinter in the sole) or from damage to the fingertips from biting the nails. These warts are harmless and typically resolve without treatment in 12 to 24 months, making a watch-and-wait method of management appropriate for most patients affected by warts. 

If warts are painful or are impairing daily function, such as in large, painful plantar warts, removal may be indicated. Surgical excision of the warts is rarely indicated anymore due to the many effective pharmaceutical methods of treatment that are available. If removal of the wart is indicated, liquid nitrogen may be applied in the office but may cause pain; the patient may need to return to the office for subsequent treatments to eliminate the wart. Keratolic agents may be applied to larger, thickened warts (usually plantar warts) in the office and reapplied at home after 5 days. 

Imiquimod is indicated for the treatment of genital warts. 

177.

You are preparing to insert a levonorgestrel (LNG) 52 mg intrauterine device (IUD) into a parous 32-year-old female who desires long-term hormonal contraception. Prior to inserting the device, you must confirm the uterine length is appropriate to place the device.

What uterine length is necessary for placement of the 52 mg LNG IUD?

  • Between 6 to 10 cm

  • Less than 5 cm 

  • Greater than 4 cm

  • Greater than 8 cm

Correct answer: Between 6 to 10 cm

Insertion of IUDs requires that the uterine length meet certain criteria prior to the actual insertion. Both the copper IUD and the 52 mg LNG IUDs require the length of the uterus to be between 6 to 10 cm.

The 13.5 mg LNG IUD, which has a shorter, more narrow profile, may be inserted in a uterus that sounds to a depth of at least 5 cm.

178.

You have diagnosed your patient with gonococcal proctitis. Your patient is male, has sex with men (MSM), and has no known drug allergies. Your treatment plan for him includes:

  • Ceftriaxone (Rocephin) 250 mg intramuscular (IM) plus azithromycin (Zithromax) 1 gram by mouth, both as a single dose

  • Gentamicin 240 mg intramuscular (IM) as a single dose in combination with azithromycin (Zithromax) 2 grams by mouth as a single dose

  • Levofloxacin 500 mg by mouth once a day for 7 days

  • Cefixime 400 mg by mouth daily for 10 days

Correct answer: Ceftriaxone (Rocephin) 250 mg intramuscular (IM) plus azithromycin (Zithromax) 1 gram by mouth, both as a single dose

Among anal receptive partners in Men who have Sex with Men (MSM), rectal infection leading to proctitis is often seen when one of the partners is infected with gonorrhea. Gonorrhea has a short incubation period, 1-5 days, and the highest percentage of total gonorrhoea cases occurs in MSM at approximately 45%.

In the absence of allergy to penicillins, the Centers for Disease Control (CDC) recommends treatment for Neisseria gonorrhoeae infection using a single dose of both ceftriaxone 250 mg IntraMuscular (IM) and azithromycin (Zithromax) 1 gram by mouth.

Gentamicin 240 mg IntraMuscular (IM) as a single dose in combination with azithromycin (Zithromax) 2 grams by mouth as a single dose is recommended for treating gonorrhea in penicillin-allergic individuals.

Non-gonococcal urethritis is treated using levofloxacin 500 mg by mouth once a day for 7 days.

Oral cephalosporins such as cefixime are no longer recommended for treatment of gonococcal infections due to resistance.

179.

You are providing care for a patient with a diagnosis of gastroesophageal reflux disease (GERD). Which of the following statements will guide the development of a treatment plan for this patient?

  • An 8-week course of a proton pump inhibitor is the therapy of choice for symptom relief and healing of erosive esophagitis.

  • Proton pump inhibitor therapy should be initiated with twice-a-day dosing after meals.

  • Routine global elimination of food that can trigger reflux is recommended in the treatment of gastroesophageal reflux disease.

  • There are major differences in efficacy between the different proton pump inhibitors. 

Correct answer: An 8-week course of a proton pump inhibitor is the therapy of choice for symptom relief and healing of erosive esophagitis.

An 8-week course of Proton Pump Inhibitor (PPI) therapy is usually adequate to heal acute esophageal inflammation noted with ongoing GERD. If symptoms do not resolve with this PPI course, referral to gastroenterology for further evaluation, including upper G.I. endoscopy, is warranted.

Proton pump inhibitor therapy should be initiated once daily, rather than twice-a-day dosing, before the first meal of the day. Tailored therapy with adjustment of dose timing and/or twice-daily dosing should be considered for patients with partial response to once-daily therapy. This can also be considered in patients with night-time symptoms, variable schedules, and/or sleep disturbances. Switching to another PPI is also an option, though there are no major differences in efficacy between the different PPIs. Routine global elimination of foods that can trigger reflux (including chocolate, caffeine, alcohol, acidic foods) is not recommended in the treatment of GERD. At the same time, foods that are known to trigger symptoms should be eliminated or minimized.

180.

You are re-evaluating a patient who has been diagnosed with a work-related respiratory disease after exposure to inhaled dust. An office spirometer can be used for this patient to provide an accurate assessment of:

  • The relationship between chronic respiratory symptoms and decreased ventilatory capacity

  • A decrease in baseline pulmonary function of a patient being newly diagnosed with a pulmonary disorder

  • The patient's functional residual capacity (FRC)

  • The relationship between acute respiratory symptoms and decreased ventilatory capacity

Correct answer: The relationship between chronic respiratory symptoms and decreased ventilatory capacity

Office spirometry is the most commonly used pulmonary function test (PFT) and can be used for providing many measures. In evaluating patients who have been affected by a work-related respiratory disease after exposure to inhaled dusts, powders, solvents, gases, or fumes, office spirometry can provide the nurse practitioner with an accurate assessment in evaluating the relationship between chronic respiratory symptoms and decreased ventilatory capacity. 

Without already having baseline spirometry test results of a patient on file, spirometry cannot determine the baseline pulmonary function of a patient being newly diagnosed with a pulmonary disorder.

Spirometry does not measure functional residual capacity (FRC).

In this scenario, the nurse practitioner is re-evaluating a patient who has been diagnosed with a chronic pulmonary disorder, not an acute respiratory illness.

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