NURS 6225 Advanced Health Assessment Exam 2
1. When examining a patient for the apical impulse (PMI), which of the follow-
ing is LEAST important to assess?
A. Location
B. Amplitude
C. Rhythm
D. Diameter Ans: C. Rhythm
Assess location, amplitude, duration, and diameter
2. 5 A's of tobacco cessation Ans:
3. What is tactile fremitus? Ans: palpable vibrations transmitted through the
bron- chopulmonary tree to the chest wall as the patient is speaking "99"
NORMAL= buzzing on hands when patient say "99"
SOLIDS CONDUCT SOUND/VIBRATIONS BETTER THAN AIR
,4. Conditions where tactile fremitus is absent or decreased Ans: Fremitus
is de- creased or absent when the transmission of vibrations is impeded.
Feeling little or no buzzing at all compared to similar lung areas; LARGE POCKETS
OF AIR IN THE LUNGS
thick chest wall
obstructed bronchus
COPD
pleural effusion
fibrosis
pneumo (Air)
infiltrating tumor
fibrosis
emphysema
consolidation
Asthma
5. Causes of asymmetrical fremitus Ans: Decreased
fremitus Unilateral pleural effusion
Pneumo
neoplasm
,Increased fremitus
Unilateral pneumonia
, 6. Causes of increased fremitus Ans: feeling of a strong vibration compared to
similar lung areas
Consolidation of lung tissue
pneumonia
atelectasis
bronchitis
7. Apical Impulse (PMI) Ans: Point of Maximal Impulse (Apex of the heart) Ans:
between 4th to 5th intercostal space, midclavicular
Apex beat is palpable in only 25-40% of healthy adults in supine position and 50%
in left lateral decubitus position—>especially those who are thin
Some hide behind rib cage, despite positioning
8. diaphragmatic excursion Ans: *assesses degree and symmetry of diaphragm
move- ment; percuss from areas of resonance to dullness
* not percussing the diaphragm itself you are identifying the resonant lung tissue and
the duller structures below.
* you can infer the probable location of the diaphragm from the level of dullness
9. during diaphragmatic excursion an "absent decent" means what? Ans:
An ab- normally high level suggests a pleural effusion or an elevated
hemidiaphragm from atelectasis or phrenic nerve paralysis
1. When examining a patient for the apical impulse (PMI), which of the follow-
ing is LEAST important to assess?
A. Location
B. Amplitude
C. Rhythm
D. Diameter Ans: C. Rhythm
Assess location, amplitude, duration, and diameter
2. 5 A's of tobacco cessation Ans:
3. What is tactile fremitus? Ans: palpable vibrations transmitted through the
bron- chopulmonary tree to the chest wall as the patient is speaking "99"
NORMAL= buzzing on hands when patient say "99"
SOLIDS CONDUCT SOUND/VIBRATIONS BETTER THAN AIR
,4. Conditions where tactile fremitus is absent or decreased Ans: Fremitus
is de- creased or absent when the transmission of vibrations is impeded.
Feeling little or no buzzing at all compared to similar lung areas; LARGE POCKETS
OF AIR IN THE LUNGS
thick chest wall
obstructed bronchus
COPD
pleural effusion
fibrosis
pneumo (Air)
infiltrating tumor
fibrosis
emphysema
consolidation
Asthma
5. Causes of asymmetrical fremitus Ans: Decreased
fremitus Unilateral pleural effusion
Pneumo
neoplasm
,Increased fremitus
Unilateral pneumonia
, 6. Causes of increased fremitus Ans: feeling of a strong vibration compared to
similar lung areas
Consolidation of lung tissue
pneumonia
atelectasis
bronchitis
7. Apical Impulse (PMI) Ans: Point of Maximal Impulse (Apex of the heart) Ans:
between 4th to 5th intercostal space, midclavicular
Apex beat is palpable in only 25-40% of healthy adults in supine position and 50%
in left lateral decubitus position—>especially those who are thin
Some hide behind rib cage, despite positioning
8. diaphragmatic excursion Ans: *assesses degree and symmetry of diaphragm
move- ment; percuss from areas of resonance to dullness
* not percussing the diaphragm itself you are identifying the resonant lung tissue and
the duller structures below.
* you can infer the probable location of the diaphragm from the level of dullness
9. during diaphragmatic excursion an "absent decent" means what? Ans:
An ab- normally high level suggests a pleural effusion or an elevated
hemidiaphragm from atelectasis or phrenic nerve paralysis
