Nur 634- Exam #2 Questions With
Correct Detailed Answers
Which lobes of the lung will be heard anteriorly? - ANSWER- -Right Upper Lung
-Right Middle Lung
-Right Lower Lung
-Left Upper Lung
-Left Lower Lung
Which lobes of the lung will be heard posteriorly? - ANSWER- -Right Upper Lung
-Right Lower Lung
-Left Upper Lung
-Left Lower Lung
Which lobes of the lung will be heard laterally - right? - ANSWER- -Right Upper Lung
-Right Middle Lung
-Right Lower Lung
Which lobes of the lung will be heard laterally - left? - ANSWER- -Left Upper Lung
-Left Lower Lung
Possible causes of chest pain? - ANSWER- -Anxiety/panic disorders
-Costochondritis
Cardiovascular:
-Heart attack
-Pericarditis or myocarditis
Respiratory:
-Bronchitis
-Pneumonia
Abdominal:
-GERD
Chest S/S that indicate a cardiovascular problem - ANSWER- -Exertional chest pain
-Orthopnea (SOB when supine) / paroxysmal nocturnal dyspnea (relieved by sitting up)
-Palpitations
-Edema
,How to assess for dyspnea? - ANSWER- Ask the patient "Have you had difficulty
breathing?"
How to assess for degree of severity of dyspnea? - ANSWER- Determine its effect on
patient's ADLs
Possible causes of shortness of breath? - ANSWER- -Anxiety
-Activity
Possible causes of cough? - ANSWER- -Irritating stimuli (ex. mucus, allergens, dust,
foreign bodies)
-Inflammation
-Compression of bronchioles from tumor, enlarged lymph nodes, or pulmonary edema
-Left-sided heart failure
Specific possible causes of chronic cough - ANSWER- -GERD
-Postnasal drip
-Bronchiectasis
Bronchiectasis (define) - ANSWER- Reversible dilatation of the bronchi where the
elastic and muscular tissue is destroyed by inflammation and infection. This damage
impairs the natural drainage of bronchial secretions which can become chronically
infected
Possible causes of hemoptysis - ANSWER- -Bronchitis
-Cystic fibrosis
-Bronchiectasis
-Malignancy
How to differentiate if coughed up blood is coming from the stomach or the respiratory
tract? - ANSWER- Blood from the stomach is usually darker than blood from the
respiratory tract
Most common cause of acute cough - ANSWER- **Viral upper respiratory infection**
~Acute = < 3 weeks~
Acute coronary syndromes (S/S) - ANSWER- -Chest pain
-Dyspnea / orthopnea
Pneumonia (S/S) - ANSWER- -Fever
-Productive cough
How to differentiate between bacterial and viral infections in pneumonia? - ANSWER-
**Bacterial pneumonia = purulent sputum (yellow or green)
,**Viral infections = mucoid sputum (translucent, white)
^this type of sputum also present in cystic fibrosis
Five As framework - ANSWER- -Ask about tobacco use
-Advise to quit
-Assess willingness to make a quit attempt
-Assist in quit attempt
-Arrange follow-up
What type of prevention is screening? - ANSWER- Secondary prevention
^interventions to detect disease early
Primary prevention (define) - ANSWER- Preventative measures that come before the
onset of disease (ex. immunization)q
Timing for flu vaccine - ANSWER- Late fall & winter (peaking in February)
Nasal spray flu vaccine is/was recommended for what age group? - ANSWER-
**Healthy people 2-49 years old**
Timing for pneumonia vaccine - ANSWER- **Prevnar**
*Under 2 years old:
-2 mnths, 4 mnths, 6 mnths, & 15 mnths
*Greater than 65 years old:
-First, PCV13
-Then PPSV23 6-12 months later
*If already received PPSV23, give PCV13 one year after most recent PPSV23
vaccination
Special groups who should be immunized with PCV13 & PPSV23 - ANSWER- *Pts >2
years old who are immunocompromised & those with chronic illnesses associated with
increased risk for pneumococcal infection (sickle cell disease, diabetes, alcoholism,
etc.)
*Pts >19 years old who smoke or have asthma
*Residents of nursing homes or long-term care facilities
Order for respiratory assessment - ANSWER- 1) Inspect
2) Palpate
, 3) Percuss
4) Auscultate
Where are you most likely to hear abnormal wheezes or crackles? - ANSWER- The
dependent side
^ventilation is greater in dependent lung
Signs of respiratory distress - ANSWER- -Tachypnea (>25 breaths/min)
-Cyanosis or pallor
-Clubbing of fingers
-Audible signs of breathing
-Contraction of accessory muscles
Stridor (define) - ANSWER- Audible high-pitched inspiratory whistling; sign of upper
airway obstruction
Stridor (causes) - ANSWER- -Epiglottitis
-Foreign body
-Anaphylaxis
-Tracheal stenosis from intubation
-Airway edema after device removal
AP (anteroposterior) diameter - ANSWER- A measure of the shape and symmetry of
the chest; Normally, the ratio of AP diameter to lateral chest diameter = 0.7-0.9
~A barrel-shaped chest (anteroposterior diameter = transverse diameter) characterized
aging and chronic lung disease
Asymmetric expansion/unilateral delay in chest expansion occurs in what conditions? -
ANSWER- -Pleural effusions
-Pleural disease (from asbestosis or silicosis)
-Lobar pneumonia
-Unilateral bronchial obstruction
Crepitus (define) - ANSWER- Crackling or grinding sound over bones, joints, or skin
(with or without pain) due to air in subcutaneous tissue
-Possible causes:
~Arthritis joints
~Overt fractures
Fremitus (define) - ANSWER- The palpable vibrations that are transmitted through the
lungs to the chest wall as the patient speaks
Correct Detailed Answers
Which lobes of the lung will be heard anteriorly? - ANSWER- -Right Upper Lung
-Right Middle Lung
-Right Lower Lung
-Left Upper Lung
-Left Lower Lung
Which lobes of the lung will be heard posteriorly? - ANSWER- -Right Upper Lung
-Right Lower Lung
-Left Upper Lung
-Left Lower Lung
Which lobes of the lung will be heard laterally - right? - ANSWER- -Right Upper Lung
-Right Middle Lung
-Right Lower Lung
Which lobes of the lung will be heard laterally - left? - ANSWER- -Left Upper Lung
-Left Lower Lung
Possible causes of chest pain? - ANSWER- -Anxiety/panic disorders
-Costochondritis
Cardiovascular:
-Heart attack
-Pericarditis or myocarditis
Respiratory:
-Bronchitis
-Pneumonia
Abdominal:
-GERD
Chest S/S that indicate a cardiovascular problem - ANSWER- -Exertional chest pain
-Orthopnea (SOB when supine) / paroxysmal nocturnal dyspnea (relieved by sitting up)
-Palpitations
-Edema
,How to assess for dyspnea? - ANSWER- Ask the patient "Have you had difficulty
breathing?"
How to assess for degree of severity of dyspnea? - ANSWER- Determine its effect on
patient's ADLs
Possible causes of shortness of breath? - ANSWER- -Anxiety
-Activity
Possible causes of cough? - ANSWER- -Irritating stimuli (ex. mucus, allergens, dust,
foreign bodies)
-Inflammation
-Compression of bronchioles from tumor, enlarged lymph nodes, or pulmonary edema
-Left-sided heart failure
Specific possible causes of chronic cough - ANSWER- -GERD
-Postnasal drip
-Bronchiectasis
Bronchiectasis (define) - ANSWER- Reversible dilatation of the bronchi where the
elastic and muscular tissue is destroyed by inflammation and infection. This damage
impairs the natural drainage of bronchial secretions which can become chronically
infected
Possible causes of hemoptysis - ANSWER- -Bronchitis
-Cystic fibrosis
-Bronchiectasis
-Malignancy
How to differentiate if coughed up blood is coming from the stomach or the respiratory
tract? - ANSWER- Blood from the stomach is usually darker than blood from the
respiratory tract
Most common cause of acute cough - ANSWER- **Viral upper respiratory infection**
~Acute = < 3 weeks~
Acute coronary syndromes (S/S) - ANSWER- -Chest pain
-Dyspnea / orthopnea
Pneumonia (S/S) - ANSWER- -Fever
-Productive cough
How to differentiate between bacterial and viral infections in pneumonia? - ANSWER-
**Bacterial pneumonia = purulent sputum (yellow or green)
,**Viral infections = mucoid sputum (translucent, white)
^this type of sputum also present in cystic fibrosis
Five As framework - ANSWER- -Ask about tobacco use
-Advise to quit
-Assess willingness to make a quit attempt
-Assist in quit attempt
-Arrange follow-up
What type of prevention is screening? - ANSWER- Secondary prevention
^interventions to detect disease early
Primary prevention (define) - ANSWER- Preventative measures that come before the
onset of disease (ex. immunization)q
Timing for flu vaccine - ANSWER- Late fall & winter (peaking in February)
Nasal spray flu vaccine is/was recommended for what age group? - ANSWER-
**Healthy people 2-49 years old**
Timing for pneumonia vaccine - ANSWER- **Prevnar**
*Under 2 years old:
-2 mnths, 4 mnths, 6 mnths, & 15 mnths
*Greater than 65 years old:
-First, PCV13
-Then PPSV23 6-12 months later
*If already received PPSV23, give PCV13 one year after most recent PPSV23
vaccination
Special groups who should be immunized with PCV13 & PPSV23 - ANSWER- *Pts >2
years old who are immunocompromised & those with chronic illnesses associated with
increased risk for pneumococcal infection (sickle cell disease, diabetes, alcoholism,
etc.)
*Pts >19 years old who smoke or have asthma
*Residents of nursing homes or long-term care facilities
Order for respiratory assessment - ANSWER- 1) Inspect
2) Palpate
, 3) Percuss
4) Auscultate
Where are you most likely to hear abnormal wheezes or crackles? - ANSWER- The
dependent side
^ventilation is greater in dependent lung
Signs of respiratory distress - ANSWER- -Tachypnea (>25 breaths/min)
-Cyanosis or pallor
-Clubbing of fingers
-Audible signs of breathing
-Contraction of accessory muscles
Stridor (define) - ANSWER- Audible high-pitched inspiratory whistling; sign of upper
airway obstruction
Stridor (causes) - ANSWER- -Epiglottitis
-Foreign body
-Anaphylaxis
-Tracheal stenosis from intubation
-Airway edema after device removal
AP (anteroposterior) diameter - ANSWER- A measure of the shape and symmetry of
the chest; Normally, the ratio of AP diameter to lateral chest diameter = 0.7-0.9
~A barrel-shaped chest (anteroposterior diameter = transverse diameter) characterized
aging and chronic lung disease
Asymmetric expansion/unilateral delay in chest expansion occurs in what conditions? -
ANSWER- -Pleural effusions
-Pleural disease (from asbestosis or silicosis)
-Lobar pneumonia
-Unilateral bronchial obstruction
Crepitus (define) - ANSWER- Crackling or grinding sound over bones, joints, or skin
(with or without pain) due to air in subcutaneous tissue
-Possible causes:
~Arthritis joints
~Overt fractures
Fremitus (define) - ANSWER- The palpable vibrations that are transmitted through the
lungs to the chest wall as the patient speaks
