Ch7 The Respiratory System Complete Test Bank

CHAPTER 7: ADVANCED HEALTH ASSESSMENT OF THE RESPIRATORY SYSTEM

1. The clinician is assessing a patient, whose breastbone is raised, pushing upward and outward. The clinician determines this condition to be:

a. Funnel chest

b. Pigeon chest

c. Kyphosis

d. Barrel chest

2. A 65-year-old patient with a recent heart bypass surgery develops cough and difficulty in breathing with rapid shallow breaths. The patient has no history of asthma or chronic obstructive lung disease. Chest x-ray shows reduction in the volume of gas in the right upper lung lobe. Which percussion note will be heard over the affected lung area?

a. Dull

b. Flat

c. Resonant

d. Hyperresonant

3. The chest x-ray of a patient shows a clear visceral pleural edge as a very thin, sharp white line. No lung markings are seen peripheral to this line, and the peripheral space is radiolucent as compared to the other lung. Which of the following findings is expected while examining this patient?

a. A dull percussion note

b. Decreased to absent breath sounds

c. Increased tactile fremitus

d. Coarse crackles

4. A clinician is examining a 15-year-old patient with complaints of cough, shortness of breath, runny nose, and lethargy for the last 3 days. The patient has had several such episodes in the past 2 years with increasing severity. Auscultation reveals continuous, relatively high-pitched breath sounds with a hissing shrill quality. The clinician determines these breath sounds to be:

a. Coarse crackles

b. Rhonchi

c. Wheeze

d. Fine crackles

5. A clinician is auscultating a patient with lobar pneumonia. Which of the following voice sounds are expected?

a. Vesicular breath sounds

b. Egophony

c. Muffled indistinct voice sounds

d. Bronchial sounds

6. A clinician is educating a patient who has recently been diagnosed with chronic obstructive pulmonary disease (COPD). The clinician should counsel the patient to: (Select all that apply.)

a. Stop smoking

b. Avoid exposure to smoke, chemicals, and occupational dusts

c. Avoid exercise

d. Learn breathing techniques

e. Get vaccinated for flu

7. A patient reports to the ED of a hospital complaining of cough and high- grade fever for the last 3 days. In the past 24 hours, the patient has developed shortness of breath and a sharp pain in the chest especially on breathing in deeply. What findings are expected on examination? Select all that apply.

a. Dullness

b. Hyperresonance

c. A tympanitic sound

d. Pleural rub

8. A 30-year-old patient reports in the ED of a hospital with history of fever with chills and cough for the last 1 week, along with an episode of sputum streaked with blood and slight discomfort in the chest. The examination reveals a resonant percussion note with dull gurgling sounds over airways. The clinician asks the patient to cough and examines again. The gurgling sounds now diminish significantly. There is no history of chronic obstructive pulmonary disease (COPD) or asthma. The clinician concludes this to be:

a. Pneumonia

b. Asthma

c. Acute bronchitis

d. Allergy

9. Which of the following indicates an emergency and demands immediate attention?

a. Rhonchi

b. Stridor

c. Pleural rub

d. Mediastinal crunch

sounds over airways caused by fluid in large- and medium-sized airways. Pleural rub is an abnormal lung sound caused by inflamed pleural layers of the lungs rubbing together. Rhonchi and pleural rub do not indicate an emergency (unless the patient is in severe respiratory distress).

10. The epithelial tissue present on the inner surface of bronchioles is:

a. Squamous

b. Ciliated

c. Glandular

d. Cuboidal

11. A 5-year-old patient is admitted to the hospital with respiratory distress. The patient has a history of fever, chills, cough, and dehydration for the last 7 days. Immunizations are up-to-date, and there is no history of asthma. Examination reveals an alert child, with nasal flaring and mild chest retractions. The lung sounds have some rales with no air movement in the right lung base. The chest is dull to percussion on the right. The clinician concludes this to be:

a. Acute bronchiolitis

b. Epiglottitis

c. Pneumonia

d. Croup

12. The clinician is examining a patient with emphysema. What findings are expected on the examination? Select all that apply.

a. Barrel chest

b. Hyperresonance

c. Wheeze

d. Bronchial breath sounds

13. Explain egophony.

14. Briefly describe normal breath sounds.

15. While examining a patient with complaints of fever, cough, and respiratory distress, the clinician notices a dull percussion note over the right lung area. What does this indicate and what other tests can be done to confirm this finding?

Bronchophony (Bronchiloquy)—Conducted to assess abnormal transmission of sound through secretions or consolidation. The patient is asked to repeat the word ninety-nine, while auscultating a suspected area of consolidation. Any area of increased sound transmission, suggests consolidation.

Egophony—While auscultating an area of suspected consolidation, the patient is asked to say “E.” If the sound is heard as “A”, it indicates an area of consolidation.

Whispered pectoriloquy—While auscultating an area of suspected consolidation, the patient is asked to whisper numbers 1, 2, and 3. Any areas of increased sound transmission, suggest consolidation.

16. A 14-year-old patient is brought to the ED complaining of shortness of breath. The patient has had a cough with mild fever for the last 1 week. The patient has had several such episodes in the past year, though not this severe. Examination reveals a normal resonant percussion note with a clearly audible wheeze. What should the clinician suspect?

17. A 45-year-old patient is brought to the ED of a hospital with shortness of breath and a sharp pain on the right side of the chest. The patient is unable to speak, and the pain increases on breathing. What should the clinician suspect and what should be the further course of action?

18. A 70-year-old patient reported to a hospital with complains of progressive dyspnoea for the last 3 weeks. On examination, the clinician noted that the anteroposterior diameter of the chest is increased. What is this condition known as and is this significant?

19. The respiratory system can be divided into the conducting and the respiratory zones. Briefly describe the respiratory zone.

20. A clinician is assessing tactile fremitus in a patient with pneumonia. Explain how tactile fremitus is assessed and what finding the clinician should expect in this patient.

21. A clinician is examining a patient with suspected bronchiectasis. Describe the findings expected on auscultation in this patient.