Patient Assessment Part 2 - Test Review

Question 1

What are the 4 techniques that are performed during a chest physical examination?

Answer 1

Inspection (observation), palpation, percussion, auscultation

Question 2

What can be assessed by the technique “Inspection”?

Answer 2

What you can see or observe about a patient

Question 3

What can be assessed by the technique “Palpation”?

Answer 3

Areas of tenderness, symmetry of excursion, tracheal position, capillary refill, tactile
fremitus

Question 4

What signs could the patient exhibit if they had an increased work of breathing
(WOB)?

Answer 4

Accessory muscle use, JVD, pursed lip breathing, nasal flaring, intercostal
retractions, diaphoresis (diaphoretic) at rest, sitting in tripod position, unable to
speak in complete sentences

Question 5

hemoptysis

Answer 5

coughing up blood

Question 6

diaphoresis

Answer 6

sweating

Question 7

pneumothorax

Answer 7

air in pleural space

Question 8

atelectasis

Answer 8

collapsed lung

Question 9

sensorium

Answer 9

refers to level of consciousness of pt.

Question 10

dypsnea

Answer 10

difficulty breathing as observed by
the patient

Question 11

anterior

Answer 11

front

Question 12

posterior

Answer 12

back

Question 13

lateral

Answer 13

side down

Question 14

orthopnea

Answer 14

difficulty breathing when lying

Question 15

dysphagia

Answer 15

difficulty swallowing

Question 16

erythema

Answer 16

redness of skin

Question 17

pedal edema

Answer 17

swelling of ankles-feet

Question 18

peripheral edema

Answer 18

swelling of extremities

Question 19

What is cyanosis and what is it caused by?

Answer 19

Blue or blue gray discoloration of skin and mucous membranes caused by
desaturated hemoglobin in blood- indicates inadequate tissue perfusion

Question 20

What type of breathing pattern is associated with a diabetic ketoacidosis?

Answer 20

Kussmauls

Question 21

Biot’s

Answer 21

irregular rate & depth with irregular periods of apnea

Question 22

Kussmaul’s

Answer 22

increase in rate and depth with no pauses- diabetic ketoacidosis

Question 23

Cheyne Stokes

Answer 23

gradual increase then gradual decrease in depth and rate of
breathing followed by periods apnea

Question 24

Eupnea

Answer 24

normal breathing pattern 12-20 bpm

Question 25

Hyperpnea

Answer 25

increase in depth- deeper breathing- increase Tidal volume (Vt)

Question 26

Hypopnea

Answer 26

decrease in depth-shallow breathing- decreased tidal volume (Vt)

Question 27

Apnea

Answer 27

absence of breathing

Question 28

Bradypnea

Answer 28

slow than normal RR <12 bpm

Question 29

Tachypnea

Answer 29

faster than normal RR > 20 bpm

Question 30

Hyperventilation

Answer 30

decreased PaC02 levels- caused by an increase in ventilation

Question 31

What is paradoxical breathing?

Answer 31

An Area of the Chest wall moves in with inhalation and out with exhalation- opposite of what is normal-typically seen with chest wall trauma- broken ribs

Question 32

What is Flail Chest?

Answer 32

An Area of the Chest wall moves in with inhalation and out with exhalation- opposite of what is normal- typically seen with chest wall trauma- broken ribs

Question 33

If a patient has an increased A-P (anterioposterior) diameter this is called what & what causes this?

Answer 33

Barrel chest caused by chronic COPD- air trapping

Question 34

What is it called when the patient has a lateral curvature of the spine?

Answer 34

scoliosis

Question 35

What is it called when the patient has a curvature of the upper spine (anteroposterior spine)?

Answer 35

kyphosis

Question 36

What is it called when the patient has a lateral & anteroposterior curve of the spine?

Answer 36

kyphoscoliosis

Question 37

What is pectus excavatum & what is another name for this?

Answer 37

Inward curvature of sternum- Funnel chest

Question 38

What is pectus carinatum & what is another name for this?

Answer 38

Outward projection of sternum- pigeon chest

Question 39

What is lordosis?

Answer 39

Swayback- inward curvature of lumbar spine

Question 40

Describe digital clubbing & what causes this?

Answer 40

Abnormal thickening of ends of fingers- angle between nailbed & skin decreases Caused by chronic hypoxemia

Question 41

How do you check capillary refill & what does it assess?

Answer 41

Compress or pinch the tip of the patients finger until color disappears, then release and count the number of seconds it takes for the color to return- normal return of color should be less than 5 seconds Assesses perfusion to extremities

Question 42

How is symmetrical chest movement determined?

Answer 42

Place hands on patient chest wall with thumbs touching- have patient take a deep breath- observe movement of thumbs- look for equal movement in your hands- thumbs

Question 43

What could cause asymmetrical chest movement?

Answer 43

Consolidation (pneumonia), pleural effusion, atelectasis, pneumothorax

Question 44

What is tactile fremitus?

Answer 44

Feel for vibrations on patient chest wall when they say 99

Question 45

What could cause tactile fremitus to increase & decrease?

Answer 45

Increased with secretions, fluid, atelectasis Decreased with pneumothorax, COPD- extra air, pleural effusion

Question 46

What is subcutaneous emphysema?

Answer 46

Air felt under the skin- crepitus crackling sensation

Question 47

What could cause the trachea to shift away from an affected side?

Answer 47

Problem outside the patient’s lung- pneumothorax, pleural effusion

Question 48

What could cause the trachea to shift toward an affected side?

Answer 48

Problem inside the lung- atelectasis

Question 49

What is an objective term and give some examples:

Answer 49

Something healthcare worker measures or observe- vital signs, lab values, Breathsounds, x-rays, etc.

Question 50

What is a subjective term and give some examples:

Answer 50

Something the patient tells you- I’m nauseous, chest pain, etc.

Question 51

Resonance

Answer 51

Normal lung tissue

Question 52

Hyperresonance

Answer 52

Over areas containing trapped air- COPD, pneumothorax

Question 53

Dullness

Answer 53

Over areas of the lung that has a greater portion of tissue or fluid than air- pneumonia, consolidation, atelectasis

Question 54

Flatness

Answer 54

Same as Dullness

Question 55

Tympany

Answer 55

Air filled stomach- tension pneumothorax

Question 56

What are the four critical life functions?

Answer 56

Oxygenation, ventilation, circulation, perfusion

Question 57

How is perfusion assessed?

Answer 57

BP, sensorium, temperature, urine output, hemodynamics

Question 58

How is circulation assessed?

Answer 58

HR & strength of heartbeat, cardiac output

Question 59

How is oxygenation assessed?

Answer 59

HR, color, sensorium

Question 60

How is ventilation assessed?

Answer 60

RR, Vt, chest movement, breathsounds

Question 61

What will a decreased peripheral perfusion affect?

Answer 61

Urinary output-decreased output, sensorium- confused, peripheral pulses- patient feels cold and clammy, decreased 02 to tissues- cyanosis

Question 62

List the life functions in order of priority during an emergency:

Answer 62

1- Ventilation 2- Oxygenation 3- Circulation 4- perfusion

Question 63

What information is important to obtain when interviewing patient?

Answer 63

Signs & symptoms, past medical history, allergies, smoking history, family history

Question 64

Be able to calculate smoking history in pack years? Example: patient has smoked for 25 years and smokes 2 ½ packs a day.

Answer 64

#years smoked x packs per day EX: 25 X 2.5 = 62.5 pk yr smoking history

Question 65

When describing a sputum sample what should be included?

Answer 65

Color, odor, quantity (amount), consistency (thick, loose, etc), presence of blood

Question 66

AFB test

Answer 66

tuberculosis

Question 67

Gram stain test

Answer 67

Type of microorganism- Gram – or Gram +

Question 68

C/S- Culture & sensitivity test

Answer 68

Which antibiotic will treat the infection

Question 69

Prone

Answer 69

laying on stomach- face down UPWARD

Question 70

supine

Answer 70

laying on back- face

Question 71

fowler’s

Answer 71

sitting position

Question 72

semi-fowler’s

Answer 72

sitting position

Question 73

Trendelenburg

Answer 73

head down, feet up