When asthma is suspected, which of the following is NOT useful in ...

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When asthma is suspected, which of the following is NOT useful in making a diagnosis?
 
  A. Decreased FEV1/FVC ratio
  B. Decreased FEV1
  C. Some reversibility with administration of bronchodilator
  D. Peak flow meter reading

Question 2

The following criterion is considered a positive finding when determining whether a patient with asthma can be safely monitored and treated at home:
 
  A. Age over 40
  B. Fever greater than 101
  C. Tachypnea greater than 30 breaths/minute
  D. Productive cough

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Answer to Question 1

ANS: D
Pulmonary function tests or spirometry provide diagnosis of asthma; diminished forced expiratory volume in 1 second (FEV1)/forced vital capacity (FVC) ratio with diminished FEV1 If they are the same, please choose one and use throughout to indicate obstructed outflow. Some degree of reversibility occurs with administration of bronchodilators. Chest films are generally within normal limits unless there is significant air trapping. Peak flow meters should not be used as diagnostic tools. They are appropriate for monitoring ongoing symptoms and determining the response to therapy, particularly once a patient's personal best is determined.

Answer to Question 2

ANS: C
Decision Rule: CURB-65 provides framework for determining whether the patient diagnosed with community-acquired pneumonia can be safely monitored and treated at home. One point is awarded for each of the following factors present:
 Confusion of new onset
 BUN greater than 20mg/dL
 Respiratory rate of  30 breaths/minute
 Blood pressure is less than 90 mmHg systolic or diastolic  60 mm Hg
 Age 65 or older
Patients scoring 3 to 5 typically require hospitalization for observation and therapy. Scores of 0 to 1 indicate likelihood that outpatient management is appropriate. A score of 2 is inconclusive.