Below is a summary of Pam’s electronic health record while she is in the hospital. As a doctor you are responsible for examining Pam, ordering tests and diagnosing her condition. Answer the questions below and be prepared to discuss the responses with the rest of Pam’s healthcare team.

1. Review Pam’s VPE: After reviewing Pam’s spirometry test, what do the results show?
   

   A. She is experiencing shortness of breath and she has a mild respiratory condition (COPD).

   B. Her shortness of breath has worsened and she has a moderate respiratory condition (COPD).

   C. Her lung function is starting to decline and she has a severe respiratory condition (COPD).

   D. Her quality of life is impaired and she is considered to have very severe respiratory failure (COPD).



2. Review Pam’s Outpatient EHR: What is her latest SpO₂ reading?
   

   A. 92

   B. 80

   C. 23

   D. 91



3. Internet Research: How is oxygen saturation (SpO₂) measured?
   

   A. Pulse oximeter

   B. Arterial blood gas test

   C. Both A and B



4. Internet Research: Which of the following can cause hypoxemia? Select all that apply.
   

   A. Blocked airway	D. COPD
   B. Mononucleosis	E. Allergies
   C. Asthma	F. Sleep apnea



5. Review Pam’s VPE: You order a pulmonary plethysmography and diffusion capacity (DLCO) test. Using VPE, match the definition to the test.
   

   ____ Diffusion capacity	A. Determines how much air the lungs can hold. After breathing into a mouthpiece, changes in pressure and the amount of air in the room and against the mouthpiece, determines the amount of air in the lungs.
   ____ Pulmonary plethysmography	B. Measures the body’s ability to exchange oxygen and carbon monoxide between the blood and lungs. After inhaling a small amount of carbon monoxide, a blood sample is taken to measure absorption by the lungs.



6. Review Pam’s Outpatient EHR: What does Pam’s plethysmography test results indicate?
   

   A. Emphysema

   B. Asthma

   C. Lung cancer

   D. Bronchitis



7. Review Pam’s VPE: An arterial blood gas (ABG) test is performed to: (Select all that apply)
   

   A. Measure carbon dioxide in the blood

   B. Check how well the lungs move oxygen into the blood

   C. Measure lung air capacity

   D. Check how well the lungs move carbon dioxide from the blood

   E. Measure the temperature of air exhaled from the lungs

Below is a summary of Pam’s electronic health record while she is in the hospital. As a nurse, you are responsible for obtaining and monitoring her vital signs. Answer the following questions and be prepared to discuss the responses with the rest of Pam’s healthcare team.

1. Review Pam’s Outpatient EHR: What is Pam’s latest SpO2 reading?
   

   A. 92

   B. 80

   C. 23

   D. 91



2. Internet Research: How is oxygen saturation (SpO₂) measured?
   

   A. Pulse oximeter

   B. Arterial blood gas test

   C. Both A and B



3. Internet Research: Which of the following can cause hypoxemia? Select all that apply.
   

   A. Blocked airway	D. COPD
   B. Mononucleosis	E. Allergies
   C. Asthma	F. Sleep apnea



4. Review Pam’s VPE: Pam’s physician orders a pulmonary plethysmography and diffusion capacity (DLCO) test. Using VPE, match the definition to the test.
   

   ____ Diffusion capacity	A. Determines how much air the lungs can hold. After breathing into a mouthpiece, changes in pressure and the amount of air in the room and against the mouthpiece, determines the amount of air in the lungs.
   ____ Pulmonary plethysmography	B. Measures the body’s ability to exchange oxygen and carbon monoxide between the blood and lungs. After inhaling a small amount of carbon monoxide, a blood sample is taken to measure absorption by the lungs.



5. Review Pam’s Outpatient EHR: What does Pam’s plethysmography test results indicate?
   

   A. Emphysema

   B. Asthma

   C. Lung cancer

   D. Bronchitis



6. Review Pam’s VPE: An arterial blood gas (ABG) test is performed to: (Select all that apply)
   

   A. Measure carbon dioxide in the blood

   B. Check how well the lungs move oxygen into the blood

   C. Measure lung air capacity

   D. Check how well the lungs move carbon dioxide from the blood

   E. Measure the temperature of air exhaled from the lungs



7. Internet Research: The statements below are the steps a health professional follows when taking a blood sample. Place a number, (1-4) by each statement, identifying the correct order to perform a blood draw for the ABG test.
   

   ____ Insert needle into the artery to draw blood

   ____ Bandage puncture site

   ____ Remove needle

   ____ Clean needle site with alcohol

Below is a summary of Pam’s electronic health record while she is in the hospital. As a technologist, you will perform and collect test results to help identify Pam’s condition. Answer the following questions and be prepared to discuss the responses with the rest of Pam’s healthcare team.

1. Review Pam’s VPE: Pam’s physician orders a pulmonary plethysmography and diffusion capacity (DLCO) test. Using VPE, match the definition to the test.
   

   ____ Diffusion capacity	A. Determines how much air the lungs can hold. After breathing into a mouthpiece, changes in pressure and the amount of air in the room and against the mouthpiece, determines the amount of air in the lungs.
   ____ Pulmonary plethysmography	B. Measures the body’s ability to exchange oxygen and carbon monoxide between the blood and lungs. After inhaling a small amount of carbon monoxide, a blood sample is taken to measure absorption by the lungs.



2. Review Pam’s Outpatient EHR: What does Pam’s plethysmography test results indicate?
   

   A. Emphysema

   B. Asthma

   C. Lung cancer

   D. Bronchitis



3. Review Pam’s VPE: An arterial blood gas (ABG) test is performed to: (Select all that apply)
   

   A. Measure carbon dioxide in the blood

   B. Check how well the lungs move oxygen into the blood

   C. Measure lung air capacity

   D. Check how well the lungs move carbon dioxide from the blood

   E. Measure the temperature of air exhaled from the lungs



4. Review Pam’s VPE: What does Pam’s arterial blood gas (ABG) draw results indicate?
   

   A. She may have heart disease

   B. She may have kidney disease

   C. She may have lung disease

   D. Both B and C



5. Review Pam’s VPE: A sputum analysis has also been ordered for Pam. What is sputum?
   

   A. Saliva

   B. Mucus

   C. Blood

   D. Tears



6. Review Pam’s VPE: TRUE or FALSE: A sputum culture will show if a bacterial infection is present.
   


7. Internet Research: You prepare Pam for the chest X-ray that was ordered. A chest x-ray can show: (Select all that apply)
   

   A. Condition of the lungs

   B. Exact location of a problem in the chest

   C. Size and outline of the heart

   D. Blood clots in the lungs

   E. Blood vessels

   F. Fluid surrounding the lungs

   G. Calcium deposits

Below is a summary of Pam’s electronic health record activity while she is in the hospital. As a pharmacist, your duty is to make sure that Pam receives the correct medications. You will also make sure that Pam’s medications are not harmful to her. Answer the following questions and be prepared to discuss the responses with the rest of Pam’s healthcare team.

1. Review Pam’s Outpatient EHR: According to Pam’s Outpatient EHR, she is allergic to penicillin and codeine. What type of reaction could she experience if she were given any form of these medications?

   A. Swelling of tongue from penicillin; hives and a rash from codeine.

   B. Difficulty breathing from penicillin; hives and a rash from codeine.

   C. Hives and a rash from penicillin; difficulty breathing from codeine.

   D. Hives and a rash from penicillin; swelling of tongue from codeine.



2. Internet Research: As a pharmacist it is important to be aware of the different symptoms associated with drug allergies. Which symptoms below are a type of allergic reaction?
   

   A. Infection

   B. Skin rash / hives

   C. Increase in blood pressure

   D. Wheezing



3. Internet Research: TRUE or FALSE: Pam will NOT have a similar reaction to any form of penicillin.
   
   
4. Internet Research: Albuterol is a short-term bronchodilator. Select the answer that BEST describes how it functions when taken.

A. Slow (extended) release medication that opens up the passages

B. Slow (extended) release medication that relieves chest pains

C. Quick-relief medication that opens up breathing passages

D. Quick-relief medication that relieves chest pains



5. Review Pam’s VPE: Referring to Pam’s VPE (Treatment tab), each statement below is a step to administer a bronchodilator. Put a number (1 – 6) by each statement to show the correct order in using a bronchodilator.
   

   ____ Place inhaler directly into mouth

   ____ Shake inhaler, as directed, and remove cap

   ____ Breathe in slowly, evenly and deeply

   ____ Tilt head back slightly, breathe out slowly

   ____ Hold inhaler upright with mouthpiece at the bottom

   ____ Press inhaler one time and continue to breathe in slowly



6. Internet Research: How does a long-term bronchodilator (LT) differ from a short-term bronchodilator (ST)? Use the corresponding letters to match the type of bronchodilator with each statement.
   

   ____ Quick relief of asthma symptoms

   ____ Long-term control of asthma

   ____ Used twice daily

   ____ Works within minutes after inhalation



7. Internet Research: As part of a nicotine replacement therapy, Pam’s physician prescribes Chantix. Which statement explains how it works in the brain?
   

   A. Blocks dopamine from being released in the brain

   B. Blocks all hormones from being released in the brain

   C. Releases dopamine to prevent withdrawal symptoms

   D. Releases hormones to prevent withdrawal symptoms

Below is a summary of Pam’s electronic health record (EHR) activity while she is in the hospital. As a medical and health services manager, you are ultimately responsible for ensuring that Pam receives the best overall care possible. You are responsible for figuring Pam’s bills – consisting of her tests, procedures, room charges, supplies and medications. Using Pam’s EHRs, Virtual Physical Exam (VPE) and Internet research, complete the bill spreadsheet and be prepared to verify the responses with the rest of Pam’s healthcare team.

To determine the cost of Pam’s PCP and outpatient visits, you will need the following:

• Pam’s EHR–PCP Chart
• MHSM–Bill (which includes both a PCP and outpatient statement)
• MHSM—Bill Reference
• Pam’s EHR–Outpatient Chart (link below)
• Virtual Physical Exam (link below)

1. Use the blank copies of Pam’s PCP and outpatient bills and the Bill Reference to calculate and track her costs. In her EHRs, look for costs in the areas of labs, pathology, medication and diagnostics. You may need to do additional Internet research. Some helpful sites are www.healthcarebluebook.com, www.fairhealthconsumer.org and www.pharmacychecker.com.

Below is a summary of Pam’s electronic health record activity while she is in the hospital. As a health coach, your job is to recommend changes to decrease the need for future care or hospitalization. You will also provide resources Pam needs to understand her diagnosis and what may have caused her condition. Answer the following questions and be prepared to discuss the responses with the rest of Pam’s healthcare team.

1. Review Pam’s VPE: Pam’s physician orders a pulmonary plethysmography and diffusion capacity (DLCO) test. Using VPE, match the definition to the test.
   

   ____ Diffusion capacity	A. Determines how much air the lungs can hold. After breathing into a mouthpiece, changes in pressure and the amount of air in the room and against the mouthpiece, determines the amount of air in the lungs.
   ____ Pulmonary plethysmography	B. Measures the body’s ability to exchange oxygen and carbon monoxide between the blood and lungs. After inhaling a small amount of carbon monoxide, a blood sample is taken to measure absorption by the lungs.



2. Review Pam’s Outpatient EHR: What does Pam’s plethysmography test results indicate?
   

   A. Emphysema

   B. Asthma

   C. Lung cancer

   D. Bronchitis



3. Internet Research: Albuterol is a short-term bronchodilator. Select the answer that BEST describes how it functions when taken.
   

   A. Slow (extended) release medication that opens up breathing passages.

   B. Slow (extended) release medication that relieves chest pains.

   C. Quick-relief medication that opens up breathing passages.

   D. Quick-relief medication that relieves chest pains.



4. Review Pam’s VPE: Referring to Pam’s VPE (Treatment tab), each statement below is a step to administer a bronchodilator. Put a number (1 – 6) by each statement to show the correct order in using a bronchodilator.
   

   ____ Place inhaler directly into mouth

   ____ Shake inhaler, as directed, and remove cap

   ____ Breathe in slowly, evenly and deeply

   ____ Tilt head back slightly, breathe out slowly

   ____ Hold inhaler upright with mouthpiece at the bottom

   ____ Press inhaler one time and continue to breathe in slowly



5. Internet Research: Regardless of her diagnosis, the first thing Pam must do is to stop smoking. Which statements would be good advice for Pam to follow? (Select all that apply)
   

   A. When a tobacco craving hits, eat a lot of food

   B. Get support from family, friends or a support group

   C. It’s okay to have one cigarette, but not more than one

   D. Planning for challenges, such as high-risk places to avoid

   E. Replace smoking with e-cigarettes



6. Internet Research: As part of a nicotine replacement therapy, Pam’s physician prescribes Chantix. Which statement explains how it works in the brain?
   

   A. Blocks dopamine from being released in the brain

   B. Blocks all hormones from being released in the brain

   C. Releases dopamine to prevent withdrawal symptoms

   D. Releases hormones to prevent withdrawal symptoms