Question 1

Ms. Rudman, age 74 years, has no known health problems or diseases. You are doing a preventive healthcare history and examination. Which symptom is associated with intrathoracic infection?

Accepted Answer

Intrathoracic infections may make the breath malodorous.

Question 2

As you take vital signs on Mr. Barrow, age 78 years, you note that his respirations are 40 breaths/min. He has been resting, and his mucosa is pink. In regard to Mr. Barrow's respirations, you would:

Accepted Answer

The normal adult respiratory rate is 12 to 20 breaths/min, and the ratio of breaths to heartbeats is 1:4. A respiratory rate of 40 breaths/min is not within the normal range and should be documented as above average.

Question 3

Which site of chest wall retractions indicates a more severe obstruction in the asthmatic patient?

Accepted Answer

Asthma usually causes retractions of the lower chest. The more severe the obstruction, the greater the negative pressure produced in the chest during inspiration, and retractions are manifested in the upper thorax.

Question 4

A 44-year-old male patient who complains of a cough has presented to the emergency department. He admits to smoking one pack per day. During your inspection of his chest, the most appropriate lighting source to highlight chest movement is:

Accepted Answer

Bright tangential light is best for visualizing chest movements.

Question 5

With consolidation in the lung tissue, the breath sounds are louder and easier to hear, whereas healthy lung tissue produces softer sounds. This is because:

Accepted Answer

Air is a poor conductor of sound. Denser consolidation promotes louder sounds and is a better conductor of sound. Consolidation is a better conductor of sound than air. Breath sounds are easier to hear when the lungs are consolidated; the mass surrounding the tube of the respiratory tree promotes sound transmission better than air-filled alveoli.

Question 6

You would expect to document the presence of a pleural friction rub for a patient being treated for:

Accepted Answer

A pleural friction rub is caused by inflammation of the pleural surfaces and would be expected to be auscultated with pleurisy.

Question 7

In which patient situation would you expect to assess tachypnea?

Accepted Answer

In metabolic acidosis, the body compensates by increasing the respiratory rate to blow off the excess carbon dioxide. A patient who is depressed, abuses narcotics, or has myasthenia gravis would have respiratory depression.

Question 8

Which finding suggests a minor structural variation?

Accepted Answer

Pectus carinatum (pigeon chest) is a minor structural variation. Barrel chest, clubbing of the fingers, and chest wall retractions result from compromised respirations.

Question 9

To count the ribs and the intercostal spaces, you begin by palpating the reference point of the:

Accepted Answer

The angle of Louis, the junction of the manubrium and the sternum, corresponds to the second rib, the reference point for counting ribs and intercostal spaces.

Question 10

The best time to observe and count respirations is while:

Accepted Answer

Counting respirations while you palpate the pulse does not make the patient self-conscious because the patient expects you to be counting the pulse. Respiratory patterns change as the patient speaks. Attempting to count during weighing would make the patient self-conscious and affect the respiratory rate. Respiratory patterns change as the patient sleeps.

Question 11

An Apgar score of __________ is given to the infant who demonstrates irregular respiratory effort.

Accepted Answer

The answer of An Apgar score of __________ is given...

Question 12

When auscultating the apex of the lung, you should listen at a point:

Accepted Answer

The apex of the lung is 4 cm above the first rib.

Question 13

Which type of apnea requires immediate action?

Accepted Answer

Secondary apnea is a grave condition, and unless resuscitative measures are instituted immediately, breathing will not resume spontaneously. Primary apnea is self-limiting. Sleep apnea should be evaluated but does not require immediate action. Periodic apnea of the newborn is a normal condition.

Question 14

Which lung sounds are associated with atelectasis? (Select all that apply.)

Accepted Answer

Wheezes, ronchi, and crackles in varying amounts are associated with atelectasis.

Question 15

Mr. Curtis is a 44-year-old patient who has presented to the emergency department with shortness of breath. During the history, the patient describes shortness of breath that gets worse when he sits up. To document this, you will use the term:

Accepted Answer

Dyspnea that increases in the upright posture is called platypnea. Orthopnea is dyspnea that worsens when the person lies down. Tachypnea is an increased respiratory rate. Bradypnea is a decreased respiratory rate.

Quiz 14: Chest and Lungs