Thorax and Lungs

Question 1

the manubriosternal angle is

a. the articulation of the manubrium and the body of the sternum
b. a hollow U shaped depression just above the sternum
c. Also known as the breastbone
d. a term synonymous with costochondral junction

Answer 1

A

Question 2

select the correct description of the left lung

a. narrower than the right lung with 3 lobes
b. narrower than the right lung with 2 lobes
c. wider than the right lung with two lobes
d. shorter than the right lung with 3 lobes

Answer 2

B

Question 3

you assess a patient who reports a cough. the characteristic timing of the cough of chronic bronchitis is described as

a. continuous throughout the day
b. productive cough for at least 3 months of the year for 2 consecutive years
c. occurring in the afternoon or evening because of exposure to irritants at work
d. occurring in the early morning

Answer 3

B

Question 4

which of the following assessments best confirms symmetric chest expansion

a. placing hands on the posterolateral chest wall with thumbs at level of t9 or t10 and then sliding the hands up to pinch a small fold of skin between the thumbs
b. inspection of the shape and configuration of the chest wall
c. placing the palmar surface of the fingers of one hand against the chest and having the person repeat the words “ninety-nine”
d. percussion of the posterior chest

Answer 4

A

Question 5

you are auscultating breath sounds on a patient. which of the following best describes how to proceed?

a. hold the bell of the stethoscope against the chest wall, listen to the entire right field and then the entire left field
b. hold the diaphragm of the stethoscope against the chest wall, listen to one full respiration in each location, being sure to do side to side comparisons
c. listen from the apices to the bases of each lung field using the bell of the stethoscope
d. select the bell or diaphragm, depending on the quality of sounds heard, listen for one respiration in each location, moving from side to side

Answer 5

B

Question 6

select the best description of bronchiovesicular breath sounds

a. high-pitched, of longer duration on inspiration than expiration
b. moderate pitched, inspiration equal to expiration
c. low pitched inspiration greater than expiration
d. rustling sound, like the wind in the trees

Answer 6

B

Question 7

apex

Answer 7

3 to 4 cm above the inner third of the clavicles

Question 8

base

Answer 8

rests on the diaphragm

Question 9

lateral left

Answer 9

sixth rib, midclavicular line

Question 10

lateral right

Answer 10

fifth intercostal

Question 11

posterior apex

Answer 11

c7

Question 12

normal chest

Answer 12

elliptic shape with an anteroposterior to transverse diameter in the ratio of 1:2

Question 13

barrel chest

Answer 13

anterioposterior=transverse diameter

Question 14

precuts excavatum

Answer 14

sunken sternum and adjacent cartilages

Question 15

precuts carinatum

Answer 15

forward protrusion of the sternum with ribs sloping back at either side

Question 16

scoliosis

Answer 16

lateral s shaped curvature of the thoracic and lumbar spines

Question 17

kyphosis

Answer 17

exaggerated posterior curvature of thoracic spine

Question 18

on examining a patient’s nails, you note that the angle of the nail base is >160 degrees and that the nail base feels spongy to palpation. these findings are consistent with:

a. acute respiratory distress syndrome
b. normal findings for the nails
c. congenital heart disease and COPD
d. atelectasis

Answer 18

C

Question 19

on auscultating a patient, you note a coarse, low-pitched sound during both inspiration and expiration. this patient reports pain with breathing. these findings are consistent with:

a. fine crackles
b. wheezes
c. atelectatic crackles
d. pleural friction rub

Answer 19

D

Question 20

to use the technique of ego phony, ask the patient to:

a. take several deep breaths and then hold for 5 seconds
b. say ‘eeeeee’ each time the stethoscope is moved
c. repeat the phrase “ninety-nine” each time the stethoscope is moved
d. whisper a phrase as auscultation is performed

Answer 20

B

Question 21

when examining for tactile fremits, it is important to:

a. ask the patient to breathe quickly
b. ask the patient to cough
c. palpate the chest symmetrically
d. use the bell of the stethoscope

Answer 21

C

Question 22

pulse oximetry measures:

a. arterial oxygen stauration of hemoglobin
b. venous oxygen saturation of hemoglobin
c. combined saturation of arterial and venous blood
d. carboxyhemoglobin levels

Answer 22

A

Question 23

a pleural friction rub is best detected by

a. observation
b. palpation
c. auscultation
d. percussion

Answer 23

C

Question 24

a patient has a barrel-shaped chest, characterized by

a. equal anteroposterior transverse diameter and ribs being horizontal
b. anteroposterior transverse diameter of 1:2 and an elliptic shape
c. anteroposterior transverse diameter of 2:1 and ribs being elevated
d. anteroposterior transverse diameter of 3:7 and ribs sloping back

Answer 24

A

Question 25

after examining a patient, you note: fever, increased respiratory rate, chest expansion decreased on eft side, dull to percussion over left lower lobe, breath sounds louder with fine crackles over left lower lobe. these findings are consistent with

a. bronchitis
b. asthma
c. pleural effusion
d. lobar pneumonia

Answer 25

D