NU 650 EXAM COMPREHENSIVE
QUESTION SET WITH CORRECT
ANSWERS AND DETAILED
RATIONALES FOR TOP GRADES
A young toddler is brought to the emergency room by his parents. The
mother states that the child was playing on the floor with toys and
suddenly began to wheeze. The mother reports no recent illnesses. The
nurse suspects that the most likely cause of the wheezing is:
A increased secretions
B exercise induced asthma
C a severe cold
D foreign body obstruction - ANSWER>>D
The nurse documents vesicular lung sounds upon auscultation. The nurse
heard what type of sound?
A. short silence between inspiration and expiration
B. sound heard throughout inspiration and two thirds of expiration
C. expiratory sounds lasting longer than inspiratory
D. inspiratory and expiratory sounds equal in length - ANSWER>>B
A patient appears in the clinic with a cough that began 24 hours prior to
coming to this visit. The nurse evaluates the patient based on the most
common cause of an acute cough, which is
A. chronic bronchitis
B. asthma
C. viral respiratory infection
,D. pneumonia - ANSWER>>C
A 21-year-old college senior presents to your clinic, complaining of SOB and
a nonproductive nocturnal cough. She states she used to feel this way only
with extreme exercise, but lately she has felt this way continuously. She
denies any other upper respiratory symptoms, CP, GI symptoms, or urinary
tract symptoms. PMH significant only for seasonal allergies. On exam she is
in no acute distress; temp is 98.6, BP is 120/80, her pulse is 80, and her RR
is 20. On auscultation of her chest, there is decreased air movement and a
high-pitched whistling on expiration in all lobes. Percussion reveals
resonant lungs. Which disorder of the thorax or lung does this best
describe?
A) Spontaneous pneumothorax
B) Chronic obstructive pulmonary disease (COPD)
C) Asthma
D) Pneumonia - ANSWER>>C
A 47-year-old receptionist comes to your office, complaining of fever,
shortness of breath, and a productive cough with golden sputum. She says
she had a cold last week and her symptoms have only gotten worse,
despite using over-the-counter cold remedies. She looks ill, temp is
elevated, at 101; BP and pulse unremarkable. Edema of the nasal
turbinates. On auscultation she has decreased air movement, and coarse
crackles are heard over LLL. There is dullness on percussion, increased
fremitus during palpation, and egophony and whispered pectoriloquy on
auscultation. What disorder of the thorax or lung best describes her
symptoms?
A) Spontaneous pneumothorax
,B) Chronic obstructive pulmonary disease (COPD)
C) Asthma
D) Pneumonia - ANSWER>>D
A 17-year-old high school senior presents to your clinic in acute respiratory
distress. Between shallow breaths he states he was at home finishing his
homework when he suddenly began having right-sided chest pain and
severe SOB. Denies any recent traumas or illnesses. PMH unremarkable. On
examination you see a tall, thin young man in obvious distress. He is
diaphoretic and RR 35. On auscultation you hear no breath sounds on the
right side of his superior chest wall. On percussion he is hyperresonant over
RUL. Palpation: absent fremitus over the RUL.
What disorder of the thorax or lung best describes his symptoms?
A) Spontaneous pneumothorax
B) Chronic obstructive pulmonary disease (COPD)
C) Asthma
D) Pneumonia - ANSWER>>A
A 62-year-old construction worker presents to your clinic, complaining of
almost a year of chronic cough and occasional shortness of breath.
Although he has had worsening of symptoms occasionally with a cold, his
symptoms have stayed about the same. The cough has occasional mucous
drainage but never any blood. He denies any chest pain. PMH significant for
high BP and arthritis. 2 pack/day smoker x45 years packs a day for the past
45 years. On examination you see a man looking slightly older than his
stated age. His BP is 130/80, pulse 88. He is breathing comfortably -RR 12.
On examination of his chest, the diameter seems enlarged. Breath sounds
are decreased throughout all lobes. Rhonchi are heard over all lung fields.
, There is no area of dullness and no increased or decreased fremitus. What
thorax or lung disorder is most likely causing his symptoms?
A) Spontaneous pneumothorax
B) Chronic obstructive pulmonary disea - ANSWER>>B
A 36-year-old teacher presents to your clinic, complaining of sharp,
knifelike pain on the left side of her chest x2 days. Breathing and lying
down make the pain worse, while sitting forward helps her pain. Tylenol
and ibuprofen have not helped. Her pain does not radiate to any other
area. She denies any upper respiratory or gastrointestinal symptoms. PMH
systemic lupus. On examination you find her to be distressed, leaning over
and holding her left arm and hand to her left chest. BP 130/70, RR 12, and
pulse 90. On auscultation her lung fields have normal breath sounds. A
scratching noise is heard at the lower left sternal border, coincident with
systole; leaning forward relieves some of her pain. What disorder of the
chest best describes this disorder?
A) Angina pectoris
B) Pericarditis
C) Dissecting aortic aneurysm
D) Pleural pain - ANSWER>>B
A 68-year-old retired postman presents to your clinic, complaining of dull,
intermittent left-sided chest pain over the last few weeks. The pain occurs
after he mows his lawn or chops wood. Pain radiates to the left side of his
jaw but nowhere else. He has felt light-headed and nauseated with the pain
but has had no other symptoms. He states when he sits down for several
minutes the pain goes away. Ibuprofen, Tylenol, and antacids have not
improved his
QUESTION SET WITH CORRECT
ANSWERS AND DETAILED
RATIONALES FOR TOP GRADES
A young toddler is brought to the emergency room by his parents. The
mother states that the child was playing on the floor with toys and
suddenly began to wheeze. The mother reports no recent illnesses. The
nurse suspects that the most likely cause of the wheezing is:
A increased secretions
B exercise induced asthma
C a severe cold
D foreign body obstruction - ANSWER>>D
The nurse documents vesicular lung sounds upon auscultation. The nurse
heard what type of sound?
A. short silence between inspiration and expiration
B. sound heard throughout inspiration and two thirds of expiration
C. expiratory sounds lasting longer than inspiratory
D. inspiratory and expiratory sounds equal in length - ANSWER>>B
A patient appears in the clinic with a cough that began 24 hours prior to
coming to this visit. The nurse evaluates the patient based on the most
common cause of an acute cough, which is
A. chronic bronchitis
B. asthma
C. viral respiratory infection
,D. pneumonia - ANSWER>>C
A 21-year-old college senior presents to your clinic, complaining of SOB and
a nonproductive nocturnal cough. She states she used to feel this way only
with extreme exercise, but lately she has felt this way continuously. She
denies any other upper respiratory symptoms, CP, GI symptoms, or urinary
tract symptoms. PMH significant only for seasonal allergies. On exam she is
in no acute distress; temp is 98.6, BP is 120/80, her pulse is 80, and her RR
is 20. On auscultation of her chest, there is decreased air movement and a
high-pitched whistling on expiration in all lobes. Percussion reveals
resonant lungs. Which disorder of the thorax or lung does this best
describe?
A) Spontaneous pneumothorax
B) Chronic obstructive pulmonary disease (COPD)
C) Asthma
D) Pneumonia - ANSWER>>C
A 47-year-old receptionist comes to your office, complaining of fever,
shortness of breath, and a productive cough with golden sputum. She says
she had a cold last week and her symptoms have only gotten worse,
despite using over-the-counter cold remedies. She looks ill, temp is
elevated, at 101; BP and pulse unremarkable. Edema of the nasal
turbinates. On auscultation she has decreased air movement, and coarse
crackles are heard over LLL. There is dullness on percussion, increased
fremitus during palpation, and egophony and whispered pectoriloquy on
auscultation. What disorder of the thorax or lung best describes her
symptoms?
A) Spontaneous pneumothorax
,B) Chronic obstructive pulmonary disease (COPD)
C) Asthma
D) Pneumonia - ANSWER>>D
A 17-year-old high school senior presents to your clinic in acute respiratory
distress. Between shallow breaths he states he was at home finishing his
homework when he suddenly began having right-sided chest pain and
severe SOB. Denies any recent traumas or illnesses. PMH unremarkable. On
examination you see a tall, thin young man in obvious distress. He is
diaphoretic and RR 35. On auscultation you hear no breath sounds on the
right side of his superior chest wall. On percussion he is hyperresonant over
RUL. Palpation: absent fremitus over the RUL.
What disorder of the thorax or lung best describes his symptoms?
A) Spontaneous pneumothorax
B) Chronic obstructive pulmonary disease (COPD)
C) Asthma
D) Pneumonia - ANSWER>>A
A 62-year-old construction worker presents to your clinic, complaining of
almost a year of chronic cough and occasional shortness of breath.
Although he has had worsening of symptoms occasionally with a cold, his
symptoms have stayed about the same. The cough has occasional mucous
drainage but never any blood. He denies any chest pain. PMH significant for
high BP and arthritis. 2 pack/day smoker x45 years packs a day for the past
45 years. On examination you see a man looking slightly older than his
stated age. His BP is 130/80, pulse 88. He is breathing comfortably -RR 12.
On examination of his chest, the diameter seems enlarged. Breath sounds
are decreased throughout all lobes. Rhonchi are heard over all lung fields.
, There is no area of dullness and no increased or decreased fremitus. What
thorax or lung disorder is most likely causing his symptoms?
A) Spontaneous pneumothorax
B) Chronic obstructive pulmonary disea - ANSWER>>B
A 36-year-old teacher presents to your clinic, complaining of sharp,
knifelike pain on the left side of her chest x2 days. Breathing and lying
down make the pain worse, while sitting forward helps her pain. Tylenol
and ibuprofen have not helped. Her pain does not radiate to any other
area. She denies any upper respiratory or gastrointestinal symptoms. PMH
systemic lupus. On examination you find her to be distressed, leaning over
and holding her left arm and hand to her left chest. BP 130/70, RR 12, and
pulse 90. On auscultation her lung fields have normal breath sounds. A
scratching noise is heard at the lower left sternal border, coincident with
systole; leaning forward relieves some of her pain. What disorder of the
chest best describes this disorder?
A) Angina pectoris
B) Pericarditis
C) Dissecting aortic aneurysm
D) Pleural pain - ANSWER>>B
A 68-year-old retired postman presents to your clinic, complaining of dull,
intermittent left-sided chest pain over the last few weeks. The pain occurs
after he mows his lawn or chops wood. Pain radiates to the left side of his
jaw but nowhere else. He has felt light-headed and nauseated with the pain
but has had no other symptoms. He states when he sits down for several
minutes the pain goes away. Ibuprofen, Tylenol, and antacids have not
improved his
