Exam 1

Question 1

What should be included in the history of present illness during a cardiopulmonary assessment?

Answer 1

Onset of symptoms, nature of symptoms (e.g., dyspnea, chest pain), factors that aggravate or relieve symptoms, and progression of the illness.

Question 2

What are critical components of PMH and PSH in a cardiopulmonary assessment?

Answer 2

Previous diagnoses (e.g., COPD, hypertension), past surgeries (e.g., CABG, thoracotomy), and comorbid conditions.

Question 3

Why is social history important in a cardiopulmonary assessment?

Answer 3

provides context for the patient’s lifestyle, living situation, occupation, and social support, which can influence treatment planning.

Question 4

What should be observed in a systems review during a cardiopulmonary assessment?

Answer 4

Patient’s overall appearance, facial expression, body type (e.g., cachectic, obese), and breathing pattern.

Question 5

What are the common abnormal chest shapes seen in cardiopulmonary conditions?

Answer 5

Barrel chest (common in COPD), pectus excavatum, and pectus carinatum.

Question 6

What does the presence of JVD indicate?

Answer 6

Right-sided heart failure, as it suggests increased central venous pressure.

Question 7

What does digital clubbing indicate in a patient?

Answer 7

Chronic hypoxemia, often seen in patients with chronic pulmonary diseases like COPD or cystic fibrosis.

Question 8

What are the key vital signs to monitor during a cardiopulmonary assessment?

Answer 8

Heart rate, blood pressure, respiratory rate, and oxygen saturation.

Question 9

What does the S1 heart sound represent?

Answer 9

The closure of the atrioventricular valves (mitral and tricuspid) at the start of systole, often described as “Lub.”

Question 10

What does the S2 heart sound represent?

Answer 10

The closure of the semilunar valves (aortic and pulmonic) at the end of systole, often described as “Dub.”

Question 11

What does the presence of an S3 heart sound indicate?

Answer 11

It suggests heart failure and is often heard as a “Lub-Dub-pah” sound during early diastole.

Question 12

What does the presence of an S4 heart sound indicate?

Answer 12

It indicates stiff ventricles, often associated with systemic hypertension or left ventricular hypertrophy (LVH).

Question 13

What are the three types of normal breath sounds?

Answer 13

Bronchial, bronchovesicular, and vesicular breath sounds.

Question 14

What are the types of adventitious breath sounds?

Answer 14

Crackles, rhonchi, wheezes, pleural rub, and stridor.

Question 15

What do crackles in the lungs indicate?

Answer 15

presence of fluid in the alveoli, commonly associated with pneumonia or heart failure.

Question 16

What does the presence of rhonchi indicate?

Answer 16

consolidation or secretions in the larger airways, often described as a snoring sound.

Question 17

What does the presence of wheezes indicate?

Answer 17

It indicates airway narrowing, often due to bronchospasm or secretions, commonly seen in asthma.

Question 18

What does a pleural rub sound indicate?

Answer 18

It suggests inflammation or neoplasm of the pleura, heard as a grating sound.

Question 19

What does the presence of stridor indicate?

Answer 19

It indicates a blockage or inflammation in the trachea, often heard as a high-pitched sound during inspiration.

Question 20

What does a positive egophony finding indicate?

Answer 20

It suggests lung consolidation, where the “E” sound changes to an “A” sound during auscultation.

Question 21

What are the key components of a cardiopulmonary assessment?

Answer 21

History, Systems Review, and Tests and Measures.

Question 22

Where can you obtain a patient’s history during a cardiopulmonary assessment?

Answer 22

Patient chart, medical team (nurse, MD, PA, NP, social work), and patient interview.

Question 23

What should be assessed during the functional mobility part of a systems review?

Answer 23

Transfers (supine to sit, sit to stand), ambulation, and stairs. Monitor vital signs with position change.

Question 24

What is cachexia and in which patients is it commonly observed?

Answer 24

Cachexia is muscle loss or wasting, with or without loss of fat, often seen in patients with chronic, progressive diseases.

Question 25

What does cyanosis indicate during a cardiopulmonary assessment?

Answer 25

Cyanosis indicates poor oxygenation, with central cyanosis suggesting hypoxemia and peripheral cyanosis suggesting decreased cardiac output.

Question 26

How is pain level assessed during a cardiopulmonary systems review?

Answer 26

Using a pain scale (0-10), observing facial grimacing, and evaluating pain quality (sharp, dull, burning, or ache).

Question 27

How do you assess a patient’s respiratory rate?

Answer 27

By observing the rise and fall of the chest and counting breaths per minute, with normal adult values being 12-20 breaths per minute.

Question 28

What does an ABI measurement indicate?

Answer 28

ABI compares blood pressure at the ankle and arm to assess arterial narrowing and decreased blood flow, with values less than 0.9 indicative of peripheral artery disease (PAD).

Question 29

What is mediate percussion used for in a cardiopulmonary assessment?

Answer 29

To assess the density of underlying tissues, producing sounds like resonant, dull, flat, tympanic, or hyperresonant.

Question 30

What does increased tactile fremitus indicate during palpation?

Answer 30

Increased tactile fremitus suggests lung consolidation, while decreased fremitus may indicate air trapping or pleural effusion.

Question 31

What conditions can cause tracheal deviation?

Answer 31

Conditions like tension pneumothorax, pleural effusion, atelectasis, or pneumonectomy can cause tracheal deviation.

Question 32

When are systolic murmurs heard and what might they indicate?

Answer 32

Systolic murmurs are heard between S1 and S2 and may indicate conditions like aortic stenosis or mitral regurgitation.

Question 33

When are diastolic murmurs heard and what might they indicate?

Answer 33

Diastolic murmurs are heard between S2 and S1 and may indicate conditions like aortic regurgitation or mitral stenosis.

Question 34

What is the purpose of incentive spirometry in a cardiopulmonary assessment?

Answer 34

To increase lung volume and reverse atelectasis, often used post-surgically or in patients with pulmonary conditions.

Question 35

What differentiates normal breath sounds from abnormal breath sounds?

Answer 35

Normal breath sounds include bronchial, bronchovesicular, and vesicular sounds, while abnormal sounds include adventitious sounds like crackles, rhonchi, and wheezes.

Question 36

What does a positive bronchophony finding indicate?

Answer 36

A positive bronchophony, where voice sounds are clearly transmitted, indicates increased lung density, often due to consolidation.

Question 37

What does assessing chest excursion involve?

Answer 37

Measuring the movement of the chest wall during breathing, with normal chest wall excursion being approximately 3 inches.

Question 38

What does the presence of crepitus during palpation indicate?

Answer 38

Crepitus indicates an air leak from the respiratory system, often associated with chest tubes or pneumothorax.

Question 39

What is apnea, and how is it detected?

Answer 39

Apnea is the absence of breathing, detected by observing a lack of chest movement and no detectable breath sounds.

Question 40

What does tripod breathing indicate?

Answer 40

It indicates respiratory distress, where the patient leans forward with elbows on the knees to recruit accessory muscles for breathing.

Question 41

What are common signs of respiratory distress?

Answer 41

Use of accessory muscles, tachypnea, cyanosis, pursed-lip breathing, nasal flaring, and changes in mental status.

Question 42

What are the normal parameters for blood pressure?

Answer 42

Systolic: 90-120 mmHg; Diastolic: 60-80 mmHg.

Question 43

In which patients is an S3 heart sound considered normal?

Answer 43

S3 can be normal in children and young adults but is often pathological in adults over 40, indicating heart failure.

Question 44

How is pitting edema graded?

Answer 44

By the time it takes for the skin to rebound:
1+: slight depression
2+: <15 seconds
3+: 15-30 seconds
4+: >30 seconds