Deck 15: Clinical Evaluation and Assessment of the Cardiovascular and Pulmonary Systems

Question 1

Which area of the chest will assist the therapist in auscultation of the tricuspid valve?

A) Second intercostal space at the right sternal border
B) Second intercostal space at the left sternal border
C) Fourth and fifth intercostal space at the left sternal border
D) Cardiac apex, fifth intercostal space, and midclavicular line

Answer 1

C
Four auscultation areas are defined as the following: aortic-second intercostal space (ICS)at the right sternal border (RSB); pulmonic-second ICS at the left sternal border (LSB); tricuspid-fourth and fifth ICS at the LSB; mitral-cardiac apex,fifth ICS,and midclavicular line.

Question 2

Which structural chest deformity describes a depressed lower sternum that usually causes restriction only when it is severe?

A) Flail chest
B) Pigeon chest
C) Pectus carinatum
D) Pectus excavatum

Answer 2

D
Structural defects of the anterior chest may include pectus excavatum,or funnel chest (a depressed lower sternum that usually causes restriction only when it is severe),pectus carinatum,or pigeon chest (a prominent upper sternum that does not restrict chest wall movement,and flail chest (the chest wall moves inward with inspiration,such as with multiple rib fractures).

Question 3

Which of the following may cause tracheal deviation?

A) A pneumothorax
B) Atelectasis
C) A tumor
D) All of the above

Answer 3

D
An equal distance between the clavicle and the trachea should exist bilaterally.Tracheal deviation may be caused by a pneumothorax,atelectasis,or a tumor.Whether the deviation is ipsilateral or contralateral depends on the underlying cause.

Question 4

Which kind of question is likely to give the most valuable information?

A) A yes/no question directed toward a patient
B) An open-ended question directed toward a patient
C) A yes/no question directed toward a patient's family
D) An open-ended question directed toward a patient's family

Question 5

Which breath sounds are described as high pitched and are distinguished by a pause that exists between the inspiratory and expiratory phases that are heard?

A) Bronchial
B) Bronchovesicular
C) Vesicular
D) Adventitious

Question 6

What is the normal respiratory rate for newborns?

A) 14 to 20 breaths/min
B) 15 to 25 breaths/min
C) 20 to 40 breaths/min
D) 30 to 60 breaths/min

Question 7

Which of the following may be present if crepitus is palpated over the chest wall?

A) An air leak from a chest-tube site
B) Pleural rub
C) Friction rub
D) All of the above

Question 8

Which voice sound phenomenon distorts the "e" sound so that an "aaa" sound is heard over the peripheral lung area?

A) Bronchophony
B) Egophony
C) Whispered pectoriloquy
D) Wheezing

Question 9

Which heart sound is normal in children and young adults but abnormal in individuals older than age 40 years?

A) S1
B) S2
C) S3
D) S4

Question 10

Which of the following is an imaginary topographic line on a lateral view of the thorax?

A) Midsternal line
B) Anterior axillary line
C) Midclavicular line
D) Midscapular line

Question 11

When should discharge planning begin in the acute-care setting?

A) The first day of treatment
B) The second day of treatment
C) The second week of treatment
D) The second-to-last day of treatment

Question 12

What amount of chest wall excursion is normal in young adults between 20 and 30 years of age?

A) 1.25 inches
B) 3.25 inches
C) 4.5 inches
D) 8.5 inches

Question 13

Which heart sound signifies the closing of the atrioventricular valves?

A) S1
B) S2
C) S3
D) S4

Question 14

Which tone derived from mediate percussion describes a high-pitched,medium-duration tone heard over hollow structures such as the stomach?

A) Tympanic
B) Flat
C) Dull
D) Resonant

Question 15

Which adventitious breath sounds are described as discontinuous,low-pitched sounds?

A) Crackles
B) Rhonchi
C) Wheezes
D) Whistles

Question 16

What will likely be observed during inspection of a patient's skin when oxygen saturation is less than 80%?

A) Cyanosis
B) Ecchymosis
C) Edema
D) Unusually prominent bony landmarks

Question 17

Which breathing pattern exists when respiration is slowed to less than 12 breaths/min?

A) Tachypnea
B) Bradypnea
C) Eupnea
D) Kussmaul breathing

Question 18

Which of the following describes hyperresonant tones derived from mediate percussion?

A) High-pitched, medium-duration sounds
B) Low-amplitude, medium- to high-pitched, short-duration sounds
C) High-pitched, short-duration sounds
D) Very-low-pitched, prolonged-duration sounds

Question 19

During evaluation of thoracic expansion,a symmetrical decrease in chest wall motion occurs in which condition?

A) Lobar pneumonia
B) Scoliosis
C) Surgical incision
D) COPD

Question 20

Which topographic landmarks designate the location of the left ventricular apex?

A) The midclavicular line and fifth intercostal space
B) The midclavicular line and second intercostal space
C) The left sternal border and second intercostal space
D) The right sternal border and second intercostal space