Patient Case Questions: Transitions – Dr. Wheeler
1. SJ is currently not well. He awoke with a fever and chills and is feeling very
short of breath. He currently is in the Red zone of his COPD action plan. All of
the following are appropriate actions to take EXCEPT:
a. Call 911 or seek immediate medical care
b. Start an oral corticosteroid such as prednisone
c. Begin albuterol via nebulizer continuously until EMTs arrive
d. Use albuterol MDI – 8 puffs every 20 minutes until arrival at ED
2. RP was recently hospitalized for a COPD exacerbation. During his stay, two of
his home medications, pantoprazole 40mg and rosuvastatin 10mg were changed
to omeprazole 40mg and atorvastatin 20mg. Which of the following is TRUE
regarding RP’s risk of therapeutic duplication.
a. RP is at an increased risk of therapeutic duplication.
b. RP is a decreased risk of therapeutic duplication.
3. Which of the following therapies can reduce the number of exacerbations and
hospitalizations for a patient with COPD?
a. Vaccination
b. Smoking cessation
c. Proper inhaler technique
d. Phosphodiesterase-4 inhibitors
e. All may reduce the number of exacerbations
4. TK has recently been prescribed a steroid inhaler. Which of the following
statements is an important counseling point?
a. Rinse and spit with an alcohol containing mouthwash to prevent oral
thrush after using steroid inhalers
b. Antibiotics will prevent thrush because oral thrush is a bacterial infection
c. Gargle and rinse the mouth with water after each use of steroid inhalers,
but do not swallow the water!
d. Gargle and rinse the mouth with water after each use of steroid inhalers;
swallowing the water afterwards is not a problem
5. PT is experiencing the following symptoms: an increase shortness of breath as
well as in quantity and thickness of phlegm, her ankles are more swollen than
usual and she has been sleeping poorly due to her symptoms keeping her awake.
She is able to go about her activities of daily living. Which COPD action plan
colors is best described by these symptoms?
a. Green
b. Yellow
c. Red
6. RK has been recently been admitted to the hospital for a COPD exacerbation. At
discharge, she was provided an action plan for her COPD. A meta-analysis has
shown that action plans have demonstrated which of the following?
a. Mortality benefit
b. Improved symptom scores
c. Improvement in quality of life
d. Earlier initiation of antibiotics and steroids
7. You are meeting with RK prior to her discharge from the hospital. As part of the
services you provide her, you compare a list of her hospital medications and her
home medication list with her newly written discharge medication list. This
comparison to ensure accuracy and identification of medication related problems
is an example of which of the following?
a. Medication counseling
b. Medication reconciliation
c. Medication therapy management
8. True or False: There is no need to facilitate communication of updated therapeutic
strategies to all providers and the patient.
a. True
b. False
9. All of the following are cardinal symptoms of a COPD exacerbation EXCEPT:
a. Increased sputum purulence
b. Increased sputum production
c. Increased shortness of breath
d. Increase in sleep disturbances due to symptoms
10. PT’s symptoms currently place her in the Green of her COPD action plan. Which
of the following best describe the actions to take.
a. Take all medications as prescribed
b. Start an oral corticosteroid
c. Begin an oral antibiotic
d. Call 911