NURS8026 DD exam 2 Questions with 100%
Correct Answers
According to Wells Clinical Predication rule-out for PE, what RF/signs/symptoms are
associated with PE?
SOB, pleuritic chest pain, tachypnea, low grade fever, recent surgery, CA Dx
if D-Dimer is negative
not a PE
33 y/o woman (- PMH, on OC's, recent flight from China) presents to ER w/ acute SOB.
what test do you order first to rule out your top DD?
pulmonary angiography
D-dimer
VQ Scan
Venous doppler ultrasound
D-Dimer
on chest Xray: dilation of pulmonary vessels proximal to embolus along with collapse of
distal vessels with sharp cut off
westermark sign
crunching, rasping sound, synchronous with heartbeat
Hamman's sign
,Upon auscultation of the lungs, you hear Hamman's sign: crunching, rasping sound,
synchronous with heartbeat. This is pathognomonic for
spontaneous pneumothorax
Of the following patients presenting w/ SOB, which has the greatest risk of spontaneous
pneumothorax?
5'8" 60yo male, nonsmoker, BMI 32
5'8" 60yo male, smoker, BMI 32
6'0" 21yo female, nonsmoker, BMI 19
6'4" 21yo male, smoker, BMI 19
6'4" 21-year male, smoker, BMI 19
A 17-year-old high school senior presents to your clinic in acute respiratory distress.
Between shallow breaths, he states that he was at home finishing his homework when he
suddenly began having right-sided chest pain and severe shortness of breath. He denies
any recent traumas or illnesses. His past medical history is unremarkable. He doesn't
smoke but drinks several beers on the weekend. He has tried marijuana several times
but denies any other illegal drugs. He is an honors student and is on the basketball
team. His parents are both in good health. He denies any recent weight gain, weight loss,
fever, or night sweats. On exam, you see a tall, thin young man in obvious distress. He is
diaphoretic and is breathing at a rate of 35 breaths per minute. On auscultation, you
hear no breath sounds on the right side of his superior chest wall. On percussion, he is
hyperresonant over the right upper lobe. With palpation, h
spontaneous pneumothorax
Foreign Body Aspiration is at the top of your list of differentials for a pt. presenting w/
SOB. Which is the most common type of FB aspirated?
, metallic objects
balloons
vegetable matter
plastic objects
vegetable matter
which COPD diagnosis has normal PFT's
chronic bronchitis
PFTs for Emphysema (COPD)
^lung capacity
FEV1/FVC decreased
FEV1 classifies severity
^ residual volume
70 y/o male w/ 30 pack yr smoking Hx presents for f/u after hosp. d/c from emphysema.
PFT shows FEV1/FVC 60% & FEV1 35%. This is:
mild COPD
moderate COPD
severe COPD
very severe COPD
severe COPD (30-50%)
CHF Classes (NYHA)
Class 1 - no limitation
Class 2 - slight limitation w/ ordinary activity
Correct Answers
According to Wells Clinical Predication rule-out for PE, what RF/signs/symptoms are
associated with PE?
SOB, pleuritic chest pain, tachypnea, low grade fever, recent surgery, CA Dx
if D-Dimer is negative
not a PE
33 y/o woman (- PMH, on OC's, recent flight from China) presents to ER w/ acute SOB.
what test do you order first to rule out your top DD?
pulmonary angiography
D-dimer
VQ Scan
Venous doppler ultrasound
D-Dimer
on chest Xray: dilation of pulmonary vessels proximal to embolus along with collapse of
distal vessels with sharp cut off
westermark sign
crunching, rasping sound, synchronous with heartbeat
Hamman's sign
,Upon auscultation of the lungs, you hear Hamman's sign: crunching, rasping sound,
synchronous with heartbeat. This is pathognomonic for
spontaneous pneumothorax
Of the following patients presenting w/ SOB, which has the greatest risk of spontaneous
pneumothorax?
5'8" 60yo male, nonsmoker, BMI 32
5'8" 60yo male, smoker, BMI 32
6'0" 21yo female, nonsmoker, BMI 19
6'4" 21yo male, smoker, BMI 19
6'4" 21-year male, smoker, BMI 19
A 17-year-old high school senior presents to your clinic in acute respiratory distress.
Between shallow breaths, he states that he was at home finishing his homework when he
suddenly began having right-sided chest pain and severe shortness of breath. He denies
any recent traumas or illnesses. His past medical history is unremarkable. He doesn't
smoke but drinks several beers on the weekend. He has tried marijuana several times
but denies any other illegal drugs. He is an honors student and is on the basketball
team. His parents are both in good health. He denies any recent weight gain, weight loss,
fever, or night sweats. On exam, you see a tall, thin young man in obvious distress. He is
diaphoretic and is breathing at a rate of 35 breaths per minute. On auscultation, you
hear no breath sounds on the right side of his superior chest wall. On percussion, he is
hyperresonant over the right upper lobe. With palpation, h
spontaneous pneumothorax
Foreign Body Aspiration is at the top of your list of differentials for a pt. presenting w/
SOB. Which is the most common type of FB aspirated?
, metallic objects
balloons
vegetable matter
plastic objects
vegetable matter
which COPD diagnosis has normal PFT's
chronic bronchitis
PFTs for Emphysema (COPD)
^lung capacity
FEV1/FVC decreased
FEV1 classifies severity
^ residual volume
70 y/o male w/ 30 pack yr smoking Hx presents for f/u after hosp. d/c from emphysema.
PFT shows FEV1/FVC 60% & FEV1 35%. This is:
mild COPD
moderate COPD
severe COPD
very severe COPD
severe COPD (30-50%)
CHF Classes (NYHA)
Class 1 - no limitation
Class 2 - slight limitation w/ ordinary activity
