Respiratory Infections Practice Questions

25 multiple-choice questions on Respiratory infections for paramedic and EMT students, from Chapter 27 (Infectious Diseases). Read each question, pick your answer, then tap Show answer to check it and read the explanation.

25 practice questions

1. Tuberculosis is caused by:

   1. A. Mycobacterium tuberculosis
   2. B. Streptococcus pneumoniae
   3. C. Influenza virus
   4. D. Haemophilus influenzae type b
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   Answer: A. Mycobacterium tuberculosis

   TB is a slow-growing bacterium that mainly affects the lungs.

2. A patient on treatment for tuberculosis is worried because his urine and tears are orange. This is most likely:

   1. A. A sign of TB spreading to the kidneys
   2. B. Bleeding from the bladder
   3. C. Acute liver failure
   4. D. An expected effect of rifampin
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   Answer: D. An expected effect of rifampin

   Rifampin, a standard TB drug, turns urine, sweat, and tears orange-red. It is harmless, but it also stains contact lenses. Jaundice, not orange urine, would suggest liver injury.

3. Latent TB infection means the patient:

   1. A. Has active, contagious disease
   2. B. Is infected but not contagious
   3. C. Has never been exposed
   4. D. Is immune to TB
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   Answer: B. Is infected but not contagious

   About 5% to 10% of people with latent TB develop active disease, especially if immunosuppressed.

4. Multidrug-resistant TB is resistant to:

   1. A. Isoniazid and rifampin
   2. B. Ethambutol and pyrazinamide
   3. C. Isoniazid and ethambutol
   4. D. Streptomycin
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   Answer: A. Isoniazid and rifampin

   MDR-TB requires prolonged treatment with second-line drugs. MDR-TB is defined by resistance to both isoniazid and rifampin, the two most important first-line drugs. Other combinations of resistance do not define it.

5. Which group is at highest risk of TB?

   1. A. Office workers in large cities
   2. B. Healthy teenage students
   3. C. Homeless and incarcerated people
   4. D. Professional and college athletes
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   Answer: C. Homeless and incarcerated people

   Crowded living conditions, HIV, and immigration from endemic areas raise risk.

6. Antiviral drugs such as oseltamivir work best for influenza when they are started:

   1. A. After the fever has lasted for a full week
   2. B. Within 48 hours of symptom onset
   3. C. Once pneumonia develops
   4. D. After a blood culture has come back positive
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   Answer: B. Within 48 hours of symptom onset

   Influenza antivirals shorten illness most when started within 48 hours, though they are still given to hospitalized and high-risk patients later. Mention when symptoms began in your handoff.

7. Influenza typically causes:

   1. A. Sudden fever, aches, and cough
   2. B. A gradual rash and joint pain
   3. C. Painless jaundice and itching
   4. D. Bloody diarrhea and cramps
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   Answer: A. Sudden fever, aches, and cough

   Onset is abrupt. Complications include pneumonia and exacerbation of chronic disease.

8. Which group is at highest risk of severe influenza?

   1. A. Healthy young adults
   2. B. School-age children
   3. C. Vaccinated health care workers
   4. D. Elderly and pregnant patients
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   Answer: D. Elderly and pregnant patients

   Patients with chronic illness and young children are also at risk.

9. An older man was improving from influenza, but on day 6 he has a new high fever, productive cough, and worsening dyspnea. You should suspect:

   1. A. The normal final stage of the flu
   2. B. A second infection with the same flu strain
   3. C. A secondary bacterial pneumonia
   4. D. A delayed allergy to his recent flu vaccine
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   Answer: C. A secondary bacterial pneumonia

   Bacterial pneumonia, often from S. aureus or pneumococcus, can follow influenza and typically appears as a relapse after initial improvement. It is a major cause of flu deaths and needs prompt care.

10. COVID-19 is caused by:

    1. A. Influenza A
    2. B. RSV
    3. C. Rhinovirus
    4. D. SARS-CoV-2
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    Answer: D. SARS-CoV-2

    It spreads by respiratory droplets and aerosols.

11. A unique early symptom associated with COVID-19 has been:

    1. A. A barking cough
    2. B. A slapped-cheek rash
    3. C. Loss of taste or smell
    4. D. A sudden high fever with chills
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    Answer: C. Loss of taste or smell

    Other symptoms include fever, cough, dyspnea, and fatigue. A barking cough suggests croup, a slapped-cheek rash suggests fifth disease, and sudden fever with chills is common in many viral illnesses, so it is not unique to COVID-19.

12. Silent hypoxia in COVID-19 refers to:

    1. A. Low SpO2 without distress
    2. B. Hypoxia only during sleep
    3. C. Hypoxia with loud wheezing
    4. D. Normal SpO2 with distress
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    Answer: A. Low SpO2 without distress

    Patients may appear comfortable despite very low oxygen saturation.

13. A 40-year-old has had 3 weeks of coughing fits that end in vomiting, with normal breathing between fits. Childhood vaccines do not rule out:

    1. A. An acute asthma attack
    2. B. Pertussis (whooping cough)
    3. C. Seasonal allergic rhinitis
    4. D. Viral bronchiolitis
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    Answer: B. Pertussis (whooping cough)

    Pertussis immunity wanes, so adults get it and often lack the whoop; long coughing fits with vomiting and normal breathing between them are typical. Adults spread it to infants, so use droplet precautions.

14. RSV vaccination is now recommended for which group because RSV can cause severe pneumonia in them?

    1. A. Healthy teenage athletes
    2. B. Adults age 75 and older
    3. C. Adults age 20 to 40
    4. D. School-age children
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    Answer: B. Adults age 75 and older

    RSV is a major cause of hospitalization in older adults. ACIP recommends a single RSV vaccine for everyone 75 and older and for adults 60 to 74 at higher risk. Infants are protected by a maternal vaccine or nirsevimab.

15. An adult has severe throat pain and pain with swallowing, a muffled voice, and drooling, but the throat looks almost normal. You should suspect:

    1. A. Adult epiglottitis
    2. B. Simple viral sore throat
    3. C. Acid reflux irritation
    4. D. Seasonal allergy symptoms
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    Answer: A. Adult epiglottitis

    In adults, epiglottitis causes throat pain and painful swallowing out of proportion to what you see in the mouth, because the swelling is below view. Drooling and a muffled voice warn of airway threat. Keep the patient upright and calm and transport.

16. A dairy farm worker has red, irritated eyes and a mild cough during an H5N1 bird flu outbreak in local cattle. You should:

    1. A. Assume it is a routine pinkeye
    2. B. Treat it as seasonal allergies
    3. C. Use PPE and report the exposure
    4. D. Advise him to milk with bare hands
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    Answer: C. Use PPE and report the exposure

    In the 2024 outbreak, most human H5N1 cases were dairy or poultry workers, and conjunctivitis was the most common symptom. Use an N95, eye protection, gloves, and a gown, and tell the hospital about the exposure so testing and antivirals can be considered.

17. A 19-year-old college student has had a dry cough, low fever, and fatigue for 2 weeks but is walking around and attending classes. A common cause is:

    1. A. Active pulmonary tuberculosis
    2. B. Legionnaires disease from a hot tub
    3. C. Pneumocystis jirovecii pneumonia
    4. D. Mycoplasma 'walking' pneumonia
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    Answer: D. Mycoplasma 'walking' pneumonia

    Mycoplasma pneumoniae causes milder 'walking' pneumonia in young adults, often in dorms or schools, with dry cough and gradual onset. TB is unlikely without risk factors, Legionella usually makes patients quite ill, and Pneumocystis affects the immunocompromised.

18. Community-acquired pneumonia is most often caused by:

    1. A. Staphylococcus aureus
    2. B. Klebsiella pneumoniae
    3. C. Haemophilus influenzae type b
    4. D. Streptococcus pneumoniae
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    Answer: D. Streptococcus pneumoniae

    Patients have fever, productive cough, pleuritic chest pain, and crackles. S. aureus and Klebsiella cause pneumonia less often, mainly after influenza or in heavy drinkers, and type b Haemophilus is now rare in vaccinated populations.

19. A heavy drinker who had a recent blackout has fever and foul-smelling sputum. A likely cause is:

    1. A. An aspiration lung abscess
    2. B. Viral bronchiolitis
    3. C. A pulmonary embolism
    4. D. Acid reflux with heartburn
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    Answer: A. An aspiration lung abscess

    Loss of consciousness from alcohol lets mouth bacteria be aspirated into the lungs, where they can form an abscess with foul, putrid sputum. It needs hospital care and long antibiotic treatment.

20. Hantavirus is transmitted by:

    1. A. Mosquito bites
    2. B. Rodent droppings
    3. C. Contaminated blood
    4. D. Respiratory droplets
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    Answer: B. Rodent droppings

    It causes a severe pulmonary syndrome with rapid respiratory failure.

21. In the week after a confirmed influenza infection, a patient's risk of which event is several times higher than normal?

    1. A. Kidney stones
    2. B. Appendicitis
    3. C. Heart attack
    4. D. Migraine
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    Answer: C. Heart attack

    Studies show the risk of acute MI rises about sixfold in the week after laboratory-confirmed influenza, from inflammation and stress on the heart. Take chest pain seriously in patients with recent flu; vaccination lowers the risk.

22. The common cold is most often caused by:

    1. A. Streptococcus
    2. B. Influenza B
    3. C. Rhinovirus
    4. D. Staphylococcus
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    Answer: C. Rhinovirus

    Colds are self-limited and do not respond to antibiotics.

23. A patient being treated for active TB stopped his medicines after 1 month because he felt better. The main risk is:

    1. A. Relapse with drug-resistant TB
    2. B. A cure that is already complete
    3. C. An allergy to the TB drugs
    4. D. Rapid spread of hepatitis A
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    Answer: A. Relapse with drug-resistant TB

    TB needs at least 4 to 6 months of treatment. Stopping early allows surviving bacteria to regrow and select for resistance, which is why public health uses directly observed therapy. Feeling better does not mean cure.

24. Bird flu (avian influenza) is a concern because it can:

    1. A. Stay confined to wild and domestic birds
    2. B. Cause severe disease and pandemics
    3. C. Be cured with standard antibiotics
    4. D. Spread mainly through blood contact
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    Answer: B. Cause severe disease and pandemics

    Some strains have high mortality in humans.

25. SARS and MERS are caused by:

    1. A. Gram-positive bacteria
    2. B. Fungi
    3. C. Prions
    4. D. Coronaviruses
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    Answer: D. Coronaviruses

    They cause severe respiratory illness with high mortality.