Question 1

A respiratory therapist is examining a patient in respiratory distress. She observes that the patient has a barrel chest, is using his accessory muscles of inspiration even when sitting at rest, and has a prolonged expiratory phase with pursed-lip breathing. This finding is most consistent with:

Accepted Answer

The symptoms described, such as barrel chest, use of accessory muscles, prolonged expiratory phase, and pursed-lip breathing, are characteristic of severe Chronic Obstructive Pulmonary Disease (COPD).

Question 2

In patients with severe COPD and hyperinflation, the low, flat diaphragm causes inward movement of the lateral chest walls with inspiration. What is this called?

Accepted Answer

The Hoover sign is the inward movement of the lateral chest walls during inspiration, often seen in patients with severe COPD and hyperinflation due to the low, flat diaphragm.

Question 3

Which of the following clinical disorders will cause decreased resonance to percussion?

Accepted Answer

Pneumonia causes lung consolidation, leading to decreased resonance to percussion due to the presence of fluid or solid tissue in the lungs.

Question 4

Which of the following clinical conditions is associated with central cyanosis?

Accepted Answer

Central cyanosis is typically associated with respiratory failure due to inadequate oxygenation of the blood in the lungs.

Question 5

Which of the following techniques is most useful for application of the bell portion of the stethoscope?

Accepted Answer

The bell of the stethoscope is designed to pick up low-frequency sounds, and pressing it lightly against the chest wall helps to achieve this by minimizing distortion of the skin and underlying tissues.

Question 6

The diaphragm portion of the stethoscope is used to listen for:

Accepted Answer

The diaphragm of the stethoscope is designed to pick up higher-pitched sounds, which include most lung sounds.

Question 7

What clinical disorder will cause a unilateral decrease in thoracic expansion?

Accepted Answer

Lobar pneumonia can cause a unilateral decrease in thoracic expansion due to consolidation in one lung, restricting its movement.

Question 8

Which of the following will cause a decrease in vocal fremitus upon palpation?

Accepted Answer

Pneumothorax causes a decrease in vocal fremitus because the presence of air in the pleural space disrupts the transmission of vibrations from the lung to the chest wall.

Question 9

The muscles of inspiration include all which of the following?
1) The diaphragm
2) The sternocleidomastoids
3) The scalene muscles
4) The rectus abdominus muscle

Accepted Answer

The diaphragm, sternocleidomastoids, and scalene muscles are all involved in the process of inspiration. The rectus abdominus muscle is primarily involved in expiration.

Question 10

Which of the following characteristics apply to normal tracheal breath sounds?
1) Loud
2) Low pitched
3) High pitched
4) Fairly equal inspiratory and expiratory components

Accepted Answer

The answer of Which of the following characteristics apply to...

Question 11

Where is the best anatomic place to begin auscultation in most patients?

Accepted Answer

Auscultation should begin in the dependent regions, as this is where abnormal breath sounds, such as crackles, are most likely to be heard due to gravity-dependent fluid accumulation.

Question 12

The bell portion of the stethoscope is best designed to listen to _____-pitched _____ sounds.

Accepted Answer

The bell portion of the stethoscope is best designed to listen to low-pitched heart sounds.

Question 13

Which of the following will cause an increase in vocal fremitus upon palpation?

Accepted Answer

Pneumonia causes lung consolidation, which increases the transmission of vibrations through lung tissue, leading to increased vocal fremitus.

Question 14

Which of the following breathing patterns is most typically associated with fatigue of the diaphragm?

Accepted Answer

Abdominal paradox is a breathing pattern where the abdomen moves inward during inspiration instead of outward, indicating diaphragm fatigue or dysfunction.

Question 15

Which of the following are characteristics of breath sounds that should be evaluated whenever chest auscultation is performed?
1) The respiratory rate
2) The pitch (vibration frequency)
3) The amplitude or intensity (loudness)
4) The duration of inspiration versus expiration

Accepted Answer

The pitch, amplitude, and duration of inspiration versus expiration are key characteristics of breath sounds that are evaluated during chest auscultation to assess lung function and detect abnormalities.

Question 16

A respiratory therapist (RT) examining a patient notes that on assessment of chest expansion with palpation, the right lower chest is found to lag behind the left lower chest. With which of the following problems is this finding consistent?

Accepted Answer

Right lower lobe pneumonia can cause decreased movement or lagging of the right lower chest due to consolidation and reduced lung expansion in that area.

Question 17

Which of the following terms describes the sinking inward of the skin overlying the rib cage with each inspiratory effort?

Accepted Answer

Retractions refer to the inward movement of the skin and muscles around the ribs during breathing, often seen in respiratory distress.

Question 18

A therapist examining a patient encounters an area of skin along the right midaxillary line, which, when palpated, produces a crackling sound and sensation. This is an indication of ______________ in this patient.

Accepted Answer

The crackling sound and sensation upon palpation is indicative of subcutaneous emphysema, which occurs when air becomes trapped under the skin.

Question 19

Which of the following clinical disorders will cause increased resonance to percussion?

Accepted Answer

Pneumothorax causes increased resonance to percussion due to the presence of air in the pleural space, which increases the air content and decreases the density of the lung tissue.

Question 20

Retractions and bulging are observed:

Accepted Answer

The answer of Retractions and bulging are observed:
...

Quiz 5: Fundamentals of Physical Examination