BSN assessment and pathophysiology final

BSN assessment and pathophysiology final Respiratory assessment is a very important component of the physical assessment process because: - All of the above (including) - Other system dysfunction may be identified. - Potential problems caused by genetic predisposition may be identified - Early dysfunction of the respiratory system may be identified. Pulmonary ventilation is the exchange of oxygen and carbon dioxide: - Between the lungs and the atmosphere through the Naso and oropharynx Which structure covers the lung? - Visceral pleura The functional unit of the lung where oxygen and carbon dioxide gas exchange occurs is the: - Alveoli The likely outcome of hypo ventilation caused by pneumonia is: - Respiratory acidosis For a person with normal respiratory function, which chemical has the greatest impact on respiration? - Carbon dioxide When suctioning a newborn, which area should be suctioned first? - Nose Infant respiratory rhythm is often irregular with brief periods of apnea. Further evaluation of the infants respiratory status is indicated if: - The apnea exceeds 15 seconds On auscultation, a patient's breath sounds include high pitched wheezing, interior and posterior, in the upper lobes. Sibilant wheezing is caused by: - Narrowed airways Which of the following assessments of sputum would be of most concern in a 40 year old smoker who reports a 20 year history of smoking ? - Thin rust Paroxysmal nocturnal dyspnea (PND) usually indicates which of the following conditions? - Congestive Heart Failure Which of the following respiratory disorders may be genetically linked? - Emphysema Which of the following situations may explain why a patient who has recently emigrated to the United states tests positive for tuberculosis without any indication of active infection? - Vaccination with bacilli Calmette -Guerin (BCG) The best position to place the patient in to assess the lungs is: - Fowler's A respiratory rate of 18 with a tidal volume of 450 may be termed: - Eupnea Which definition best describes Kussmaul's breathing, seen in diabetic ketoacidosis or lactic acidosis? - Rapid deep respirations Pursed lip breathing is most often seen in patients with which disease process? - COPD Clubbing of the nails may indicate - Polycythemia A patient's chest excursion should be measured to assess for: - All of the above (including) Complete or partial airway obstruction Pleural effusion Pneumothorax On auscultation of the patient's lung fields, crackles that do not clear with coughing are heard bilaterally at the bases. This assessment is indicative of: - All of the above (including) Collapsed alveoli popping open Fluid in the lungs Rales auscultated at the bases Upon palpation of the patient's rib cage, the nurse notes a crackling sensation like crumpling cellophane. This indicates: - Air leaking into the surrounding tissue. The nurse asks a patient to repeat saying the number 99 several times as the rib cage is lightly palpated. The nurse is assessing for: - Fremitus A major risk factor for developing atelectasis postoperatively is: - smoking Which of the following is not a warning sign of lung cancer? - Recurring pleural effusion John Green, age 53, is admitted to the hospital with an acute exacerbation of COPD. Mr. Green admits dyspnea on exertion (DOE), cough, weight gain, and swollen ankles. Which of these findings is most frequently associated with respiratory disorders? - Cough Upon inspection, the nurse ones that Mr. Green has a barrel chest. What is the normal anteroposterior (AP) to lateral chest ratio? - 1:2 Inspection of Mr. Green's chest also reveals a wider costal angle. What is the costal angle for a healthy adult? - 90 degrees The nurse observes that Mr. Green is using his intercostal muscles for breathing. Adult males normally use which muscles for breathing? - Abdominal Considering Mr. Green's diagnosis of COPD, the nurse assesses for signs and symptoms of hypoxia. What may alert the nurse to early signs and symptoms of hypoxia? - Changes in mental status While palpating Mr. Green's chest, the nurse assesses his respiratory excursion. What does this technique assess? - Chest movement The nurse then assesses for tactile fremitus. Which statement best defines tactile fremitus? - Palpable vibrations Percussion over healthy lung tissue normally elicits which sound? - Resonance Percussion over Mr. Green's lungs is likely to produce which sound? - Hyper resonance Stanley Walters, age 74 is admitted to the hospital with aspiration pneumonia of the right middle lobe. Which approaches will best facilitate assessment of the right middle lobe of the lung? - Anterior and lateral When assessing for cyanotic changes, central cyanosis may be distinguished from peripheral cyanosis. Central cyanosis is best assessed: - In the mucous membranes The nurse detects crackles when auscultating Mr. Walter's chest. Which statement accurately characterizes crackles? - Crackles are more predominate on inspiration The nurse also notes scattered rhonchi when auscultating Mr. Walter's chest. How do rhonchi differ from crackles? - Rhonchi result from a narrowing of the airways Because Mr. Walters has pneumonia, the nurse assesses for abnormal voice sounds. Mr. Walters has clearer transmission of spoken voice sounds. This is an example of which type of voice sound? - Bronchophony Considering that Mr. Walters has consolidation pneumonia, what type of breath sounds would you expect to auscultate over the affected area? - Bronchial What type of breath sound would you expect to auscultate over most of the lung fields in a healthy patient? - Vesicular Robert Howe, age 67, is admitted with the diagnosis of pleuritic. Auscultation of Mr. Howe's thorax reveals a pleural friction rub. How can the nurse differentiate this sound from other abnormal breath sounds? - Rubs occur during inspiration and expiration and are unaffected by coughing. Mr. Howe develops a pleural effusion, so a chest tube is inserted. The nurse detects crepitus at the insertion site. Crepitus is indicative of: - Air leakage into subcutaneous tissue Which physical assessment technique would be used to determine AP: lateral ratio? - Inspection Which physical assessment technique would be used to identify tactile fremitus? - Palpation Which physical assessment technique would be used to identify wheezing? - Auscultation Which physical assessment technique would best determine chest expansion? - Palpation Which physical assessment technique would be used to identify egophony? - Auscultation Which physical assessment technique would be used to identify dullness? - Percussion Which physical assessment technique would be used to identify rales? - Auscultation Which physical assessment technique would be used to identify a friction rub? - Auscultation Which physical assessment technique would be used to identify rhonchi? - Auscultation Which physical assessment technique would be used to identify resonance? - Percussion Which physical assessment technique would be used to identify sternal retraction? - Inspection The respiratory assessment is approached from all of the following standard views except: - Superior A cough always indicates respiratory dysfunction - False Egophany is an "e" to an "a" change over the affected area - True Bronchovesicular breath sounds are normally auscultated in the periphery of the lungs - False The inspiratory and expiratory phases are equal with vesicular sounds - False The largest health problem in the United States today is: - Cardiovascular disease The largest volume of blood in the ventricles occurs at - The end of diastole Stroke colume responds to changes in: - Contractility of the heart, preload and afterload. (all of the above was the answer) A patient becomes agitated with his wife on the phone. His heart rate increases from 80 to 100 beats per minute (BPM). What effect does this have on his cardiac output? - It increases