Deck 3: Advanced Patient Assessment: Inspection, Palpation, and Percussion

Question 1

What chest wall abnormality is commonly associated with chronic lung disease due to air trapping and a loss in lung compliance and is commonly associated with COPD?

A)Kyphosis
B)Pectus excavatum
C)Barrel chest
D)Kyphoscoliosis

Answer 1

Barrel chest

Question 2

Where is (are)the midaxillary line(s)located?

A)It is an imaginary line on the lateral chest extending downward from the posterior junction of the arm.
B)It is a line on the anterior chest descending vertically from the junction of the arm and torso (at the front of the armpit).
C)They are imaginary lines on the posterior chest bisecting the shoulder blades and descending vertically.
D)It is an imaginary line on the lateral chest extending downward from the center of the armpit.

Answer 2

It is an imaginary line on the lateral chest extending downward from the center of the armpit.

Question 3

What type of skeletal abnormality has an anterior-to-posterior curvature of the upper spine and a lateral curvature that causes the vertebrae in the affected area to rotate,flattening the rib cage anteriorly?

A)Kyphosis
B)Lordosis
C)Scoliosis
D)Kyphoscoliosis

Answer 3

Kyphoscoliosis

Question 4

Where is (are)the midclavicular line(s)located?

A)It is an imaginary line on the anterior chest dividing the sternum vertically in half.It is a line descending from the center of the sternum to the umbilicus (navel).
B)They are two vertical lines on the anterior chest bisecting the collarbones.Each of these lines pass just medial to the nipples.
C)It is a line on the anterior chest descending vertically from the junction of the arm and torso (at the front of the armpit).
D)They are imaginary lines on the posterior chest bisecting the shoulder blades and descending vertically.

Question 5

What is the normal diaphragmatic excursion?

A)1:2
B)Between the 2nd and 4th ribs
C)Between the MCL and the MAL
D)Approximately 8 cm

Question 6

Which type of breathing pattern is characterized by the diaphragm descending and the ribs moving up and out anteriorly and laterally and is the result of discoordinated motion of various parts of the chest wall and/or abdomen?

A)Kussmaul's respirations
B)Cheyne-Stokes respirations
C)Biot's respirations
D)Paradoxical breathing

Question 7

Upon reviewing a patient's admission notes,the history states the patient has a long-standing history of emphysema.What type of percussion note would you expect over the patient's chest?

A)Resonance
B)Dullness
C)Flatness
D)Hyperresonance

Question 8

What is defined as vibration felt on the palpation of the chest during phonation,or speech?

A)Pectus carinatum
B)Subcutaneous emphysema
C)Tactile fremitus
D)Hyperresonance

Question 9

A patient had a respiratory rate of 16/minute with an I:E ratio of 1:2.How would you record this in the patient's chart?

A)Normocapnia
B)Eupnea
C)Hyperpnea
D)Normopnea

Question 10

In diabetic acidosis,a condition termed metabolic acidosis is produced.What type of breathing pattern is produced to compensate for this condition?

A)Kussmaul's respiration
B)Cheyne-Stokes respiration
C)Biot's respiration
D)Paradoxical breathing

Question 11

What is an increase in the depth of respirations to greater than normal?

A)Hyperventilation
B)Hypopnea
C)Hyperpnea
D)Hypercapnia

Question 12

Resonance is the sound heard in percussing normal lung tissue.Which of the following best describes this percussion note?

A)It is a low-pitched sound of long duration.
B)It is a loud,low-pitched sound of long duration.
C)It is a sound of medium intensity and pitch with a short duration.
D)It is a sound of low amplitude and pitch.

Question 13

Where is (are)the midscapulae line(s)located?

A)They are imaginary lines on the posterior chest bisecting the shoulder blades and descending vertically.
B)They are vertical lines on the anterior chest bisecting the clavicles.Each of these lines pass just medial to the nipples.
C)It is an imaginary line on the lateral chest extending downward from the center of the armpit.
D)It is an imaginary line on the posterior chest descending along the vertebral column.

Question 14

What is defined as the presence of air beneath the skin in the subcutaneous tissues?

A)Tension pneumothorax
B)Subcutaneous emphysema
C)Pleural effusion
D)Fibrosis

Question 15

Which way would the trachea shift if the patient had a tension pneumothorax on the right side?

A)Toward the right
B)Away from the right side
C)Away from the left side
D)Superiorly on the left side

Question 16

What breathing pattern is periodic in nature,with a gradual increase in depth and respiratory rate followed by a tapering of rate and depth with periods of apnea or as a waxing and waning of respirations?

A)Kussmaul's respirations
B)Cheyne-Stokes respirations
C)Biot's respirations
D)Paradoxical breathing

Question 17

What is normal I:E ratio?

A)1:2
B)1:4
C)1:6
D)1:8

Question 18

Immediately lateral to the sternal angle is (are)the _________________.

A)fourth rib.
B)clavicles.
C)manubrium.
D)second rib.

Question 19

The sternal notch is located where the clavicles join at the top of the sternum-the manubrium.The manubrium joins the body of the sternum at a horizontal ridge.What is this ridge called?

A)Sternal angle
B)Clavicle
C)Suprasternal notch
D)Fourth rib

Question 20

What is a congenital deformity of the sternum characterized by a depression in the sternum at the level of the lower body and xyphoid process?

A)Lordosis
B)Pectus excavatum
C)Kyphoscoliosis
D)Pectus carinatum

Question 21

A patient's chest radiograph indicates a pleural effusion in the left side of the chest.Which of the following percussion notes may be heard over the effusion?
I.Dullness
II.Flatness
III.Hyperresonance
IV.Resonance

A)I,II,III
B)III and IV
C)I and II
D)IV only

Question 22

A patient with severe COPD arrives in the clinic.What findings would you expect upon evaluating this patient's chest and breathing pattern?

Question 23

Which of the following would cause a tracheal shift toward the affected side of the chest?
I.Pleural effusion
II.Atelectasis
III.Pulmonary fibrosis
IV.Tension pneumothorax

A)III and IV
B)II only
C)I only
D)II and III

Question 24

What is (are)the bony prominence(s)on the posterior chest?
I.Vertebrae
II.Sternum
III.Scapulae
IV.Clavicles

A)I and III
B)II and IV
C)I only
D)II,III,IV

Question 25

Which of the following CANNOT be determined with detailed inspection of the chest?

A)The patient's breathing pattern
B)Assess the patient's work of breathing
C)Determination of the type of lung disease
D)Identification of skeletal abnormalities

Question 26

Which of the following statements is FALSE concerning digital clubbing or how chronic lung disease causes digital clubbing?

A)Hypoxemia (insufficient oxygen in the blood)results in the formation of arterial-venous anastomoses in the terminal digits.
B)Looking at the digits from above,the terminal portion decreases in diameter.
C)In clubbing,the angle between the nailbed and finger becomes increased.
D)The circulatory changes result in dramatic changes in the terminal portions of the digits (both fingers and toes).

Question 27

A patient is admitted to the hospital with an infiltrate on the chest x-ray in the left lower lobe.Explain what should be expected upon inspecting,percussing,and palpating this patient's chest wall.

Question 28

Upon percussing the patient's chest,a dull percussion note is heard over the left lower lobe.What other findings would be expected to be found over the left lower lobe?