Question 1

Which of the following heart sounds when heard early in diastole is a diagnostic sign of congestive heart failure?

Accepted Answer

A third heart sound (S3)occurs early in diastole while the ventricle is rapidly filling (immediately following S2).It is a key diagnostic sign for congestive heart failure.

Question 2

Auscultation at the lower left sternal border,approximately the fourth to fifth intercostal spaces,describes the area where which of the following heart sounds is heard?

Accepted Answer

The tricuspid area is located at the lower left sterna border,approximately the fourth to fifth intercostals space.

Question 3

Which of the following is considered an abnormal blood pressure response to an exercise activity in which the workload is gradually being increased?

Accepted Answer

Systolic blood pressure normally increases with increasing levels of exertion and diastolic blood pressure normally increases or decreases within 10 mm Hg.However,in a trained athlete,a normal progressive decline in diastolic blood pressure may occur.If a patient is on beta-adrenergic antagonists,a blunted response with systolic BP is considered normal.Answer D describes an abnormal response termed exertional systolic hypotension.

Question 4

A 68-year-old female patient reports shortness of breath during the activity evaluation at her first visit in the physical therapy clinic.She has a history of obesity,diabetes,and hypertension.Which of the following clinical signs or symptoms MOST likely indicates an angina equivalent?

Accepted Answer

The fact that this patient's shortness of breath eases with rest sitting in a chair not with active recovery indicates the shortness of breath may be suspicious of an angina equivalent.She also has coronary disease risk factors--obesity,diabetes,and hypertension.Active recovery and a reported history of a sedentary lifestyle indicate deconditioning and esophageal reflux and asthma may indicate other medical conditions that might elicit shortness of breath with exertion.

Question 5

When measuring blood pressure on a patient who is performing an activity such as walking,using an automatic blood pressure cuff is easier but does not provide the same accuracy as manual blood pressure measurement.

Accepted Answer

Portable automatic blood pressure cuffs are often used in the hospital.This equipment is not always accurate with multiple uses or with activity.Accuracy in measurement is critical to the correct interpretation of the blood pressure.

Question 6

Egophony is BEST described by which of the following in a patient with emphysema?

Accepted Answer

Egophony is having the patient say "E" and what is auscultated is "A." In an emphysema patient the auscultated "A" is much more softer than normal due to hyperinflation from emphysema disease.

Question 7

A patient with chronic obstructive lung disease who appears to have a barrel chest will have which of the following signs on examination of the chest area?

Accepted Answer

Mediate percussion used to measure diaphragmatic excursion is normally 3 to 5 cm.A patient with COPD and a barrel chest or hyperinflation will be noted to have a diminished diaphragmatic excursion.

Question 8

Which of the palpation techniques assists in the confirmation of consolidation in an area of the lung?

Accepted Answer

Fremitus is defined as the vibration that is produced by the voice or by the presence of secretions in the airways and is transmitted to the chest wall and palpated by the hand.When fremitus is increased,the suspicion of consolidation is supported.

Question 9

Which of the following conditions would transmission of lung sound increase?

Accepted Answer

A pathological condition in the lungs can change the transmission of the sounds.An increase in lung tissue density causes increased sound transmission.

Question 10

Lung sounds auscultated in the latter half of inspiration that are commonly associated with pulmonary edema are BEST described as which of the following?

Accepted Answer

Crackles are discontinuous adventitious lung sounds that sound like a brief burst of popping bubbles.Peripheral airways can collapse owing to atelectasis,pulmonary edema,fibrosis,or compression from pleural effusion,and often crackles auscultated with these pathological conditions in the latter half of inspiration.

Quiz 16: Examination and Assessment Procedures