Exam 2 Questions

Question 1

Which of the following is the normal percussion note over the peripheral lung fields?

Answer 1

Resonance

Question 2

A 70 year old male presents to the clinic for an annual with a history of smoking 1 pack of cigarettes a day for 50 years. How many pack years is that? (50). When examining his chest you note an increase in his AP diameter. What is the name for a patient with an increased AP diameter?

Answer 2

Barrel chest

Question 3

Expected assessment findings in the normal lung are

Answer 3

muffled voice sounds and symmetrical tactile fremitus

Question 4

The trachea bifurcates anteriorly at

Answer 4

the manubrial sternal angle or the angle of Louis - this is also the top of the heart and where the 2nd rib is

Question 5

Unequal chest expansion will occur when

Answer 5

part of the lung is obstructed or collapsed

Question 6

When auscultating the lungs of an adult patient, you note that over the posterior lower lobes you hear low-pitched soft breath sounds with inspiration being longer than expiration. Those are

Answer 6

normal and vesicular

Question 7

Broncophony on auscultation is associated with

Answer 7

pulmonary consolidation as in pneumonia

Question 8

Percussion over an area of atelecisis in the lungs would reveal

Answer 8

dullness

Question 9

When auscultating a patient’s lungs you ask them to say “EEE” and you hear a clear “AAA”, you note this as E to A changes and know that it is consistent with

Answer 9

pulmonary consolidation like lobular pneumonia

Question 10

A physical finding consistent with emphysema is

Answer 10

hyper-resonance

Question 11

Name the following condition: an allergic hypersensitivity to certain inhaled allergens, irritants, microorganisms stress or and exercise that’s characterized by bronchopasm

Answer 11

Asthma

Question 12

The following condition is an inflammatory condition of the lung, affecting primarily the alveoli, caused by infection with either a virus, a bacteria or other microorganism, and the alveoli become consolidated

Answer 12

pneumonia

Question 13

We don’t see retraction phenomenon in

Answer 13

a benign condition

Question 14

Exam of the male breast includes

Answer 14

inspection and palpation

Question 15

The 4 lymph nodes in the axilla:

Answer 15

central, pectoral, sub scapular and lateral. Epitrochlear is not part of the axilla

Question 16

Mrs. R reports a recent breast inflammation and you would expect ____ axillary node enlargement

Answer 16

ipsilateral

Question 17

Which 2 heart chambers are most anterior in the chest?

Answer 17

Right atrium and ventricle. Remember that the heart is twisted in the body, and there’s very little of the left ventricle anterior and there’s no left atrium.

Question 18

In the inspection of a normal adult, where would you expect to palpate the apical impulse?

Answer 18

At the 5th ICS at the mid-clavicular line

Question 19

Systole coincides with the

Answer 19

carotid artery pulse (S1)

Question 20

What is heard louder at the base of the heart?

Answer 20

S2

Question 21

What is closure of the mitral and tricuspid valves?

Answer 21

S1

Question 22

Closure of the pulmonic and aortic valves?

Answer 22

S2

Question 23

In cardiovascular assessment, a thrill is

Answer 23

A murmur that is palpable. (level 4,5,6) - turbulent blood flow which is palpable feeling through the chest wall

Question 24

Afterload is

Answer 24

the resistance against which the ventricle must pump blood. (or the opposing pressure the ventricle must generate to open the aortic valve against the pressure in the aorta)

Question 25

Preload

Answer 25

the volume of blood in the ventricle at the end of diastole

Question 26

the findings from your assessment of a 70 y/o male include swelling in his ankles and jugular venous pulsations 7cm above the sternal angle. Is this normal? No. What’s wrong with him?

Answer 26

When you have increased pressure in the right side of the heart, you’re going to have visible pulsations and edema in the feet.

Question 27

When the left side of the heart has too much pressure, there will be

Answer 27

buildup of fluid in the lungs

Question 28

An S4 heart sound is

Answer 28

a rumbling sound heard because the ventricle is resistant to blood filling from the atrial contraction or atrial kick.

Question 29

S3 and S4 are both

Answer 29

ventricular filling sounds

Question 30

S3 is at beginning of

Answer 30

rapid filling during diastole

Question 31

S4 is at the end of

Answer 31

diastole with atrial contraction/atrial kick

Question 32

S4 is called an ___ gallop

Answer 32

atrial

Question 33

S3 is called a ____ gallop

Answer 33

ventricular

Question 34

S3 and S4 combined are called a ____ gallop

Answer 34

summation

Question 35

John doe has a murmur heard after S1 but before S2. This murmur is classified as

Answer 35

Mitral regurgitation, systolic (it could also be aortic stenosis)

Question 36

Which of the following would cause a person to be at the highest risk for peripheral vascular disease of the venous system:

Answer 36

Prolonged standing without moving the muscles of your legs

Question 37

When does peripheral vascular pressure fall to the lowest point?

Answer 37

During diastole

Question 38

Posterior tibial pulse can be found behind the

Answer 38

medial malleolus

Question 39

To assess the dorsalis pedis artery, it’s lateral to the

Answer 39

extensor tendon of the great toe

Question 40

WP is a 35 year old with infection in left foot. Which of the following would you expect to find:

Answer 40

Enlarged and tender inguinal nodes.

Question 41

Heard louder at the apex of the heart?

Answer 41

S1

Question 42

What sound heard over the abdominal aorta would suggest either an aneurism, stenosis, or other problem in the main vessels of the abdomen?

Answer 42

Bruit

Question 43

Which of the following is not normally palpable in the adult?

Answer 43

Gallbladder

Question 44

main reason we do auscultation before percussion and palpation is to

Answer 44

prevent the distortion of bowel sounds.

Question 45

More than 95% of aortic aneurisms are located

Answer 45

ABOVE the umbilicus

Question 46

The normal liver span at the mid-clavicular line is

Answer 46

6-12

Question 47

Mrs. T is complaining of tenderness along the posterior costovertebral angels, this is most indicative of a

Answer 47

kidney inflammation

Question 48

Your patient complains of an inability to void. What finding on exam makes you think his bladder is full?

Answer 48

Subprapubic dullness to percussion.

Question 49

You suspect that Mrs. W has appendicitis. Which of the following procedures would not be an expected finding?

Answer 49

The Murphy’s sign

Question 50

While hooking your fingers under the ribs on the right side, you ask the patient to take a deep breath and they are unable to complete the breath?

Answer 50

Cholecystitis which is inflammation of the gallbladder

Question 51

Jane Doe has a diastolic murmur, which are possible?

Answer 51

Aortic regurgitation and mitral stenosis

Question 52

Patient complains of sore on lower leg that doesn’t seem to be getting better. You suspect venous insufficiency. Which of the findings below reflects venous insufficiency?

Answer 52

All of them (soreness in legs, hyper pigmentation, ulcerations present usually on medial side, leg will be warm to the touch)

Question 53

Patient complains of severe pain in right foot and you suspect arterial insufficiency. Findings include:

Answer 53

Pallor of the foot on elevation

Question 54

If you note the presence of a large right epitrochlear lymph node, you want to

Answer 54

examine the areas that feed into that. Hand