Chapter 14: Chest and Lungs

Question 1

1. 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
   a. bright tangential lighting.
   b. daylight from a window.
   c. flashlight in a dark room.
   d. fluorescent ceiling lights.

Answer 1

a. bright tangential lighting.

Question 2

2. When auscultating the apex of the lung, you should listen at a point
   a. even with the second rib.
   b. 4 cm above the first rib.
   c. higher on the right side.
   d. on the convex diaphragm surface.

Answer 2

b. 4 cm above the first rib.

Question 3

3. To count the ribs and the intercostal spaces, you begin by palpating the reference point of the
   a. distal point of the xiphoid.
   b. manubriosternal junction.
   c. suprasternal notch.
   d. acromion process

Answer 3

b. manubriosternal junction.

Question 4

4. 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
   a. platypnea.
   b. orthopnea.
   c. tachypnea.
   d. bradypnea.

Answer 4

a. platypnea.

Question 5

5. Which finding suggests a minor structural variation?
   a. Barrel chest
   b. Clubbed fingers
   c. Pectus carinatum
   d. Chest wall retractions

Answer 5

c. Pectus carinatum

Question 6

6. 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?
   a. Barrel chest
   b. Cor pulmonale
   c. Funnel chest
   d. Malodorous breath

Answer 6

d. Malodorous breath

Question 7

7. The best time to observe and count respirations is while
   a. the patient is answering questions.
   b. weighing the patient.
   c. palpating the pulse.
   d. the patient is sleeping.

Answer 7

c. palpating the pulse

Question 8

8. 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
   a. document his rate as normal.
   b. do nothing because his color is pink.
   c. note that his rate is below normal.
   d. report that he has an above-average rate.

Answer 8

d. report that he has an above-average rate.

Question 9

9. In which patient situation would you expect to assess tachypnea?
   a. Patient who is depressed
   b. Patient who abuses narcotics
   c. Patient with metabolic acidosis
   d. Patient with myasthenia gravis

Answer 9

c. Patient with metabolic acidosis

Question 10

10. Which site of chest wall retractions indicates a more severe obstruction in the asthmatic patient?
    a. Lower chest
    b. Along the anterior axillary line
    c. Above the clavicles
    d. At the nipple line

Answer 10

c. Above the clavicles

Question 11

11. You would expect to document the presence of a pleural friction rub for a patient being treated for
    a. pneumonia.
    b. atelectasis.
    c. pleurisy.
    d. emphysema.

Answer 11

c. pleurisy.

Question 12

12. Which type of apnea requires immediate action?
    a. Primary apnea
    b. Secondary apnea
    c. Sleep apnea
    d. Periodic apnea of the newborn

Answer 12

b. Secondary apnea

Question 13

13. 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
    a. consolidation echoes in the chest.
    b. consolidation is a poor conductor of sound.
    c. air-filled lung sounds are from smaller spaces.
    d. air-filled lung tissue is an insulator of sound.

Answer 13

d. air-filled lung tissue is an insulator of sound.

Question 14

1. Which lung sounds are associated with atelectasis? (Select all that apply.)
   a. Wheezes
   b. Ronchi
   c. Crackles
   d. Crepitus
   e. Rales

Answer 14

a. Wheezes
b. Ronchi
c. Crackles