Ch 15 Thorax & Lungs Bates Final
Exam Questions and All Correct
Answers 2025-2026 Updated.
A patient reports chest pain/discomfort and uses a clenched fist over their sternum to indicate
this; what does this suggest is the underlying cause? - Answer Angina pectoris
A patient reports chest pain/discomfort and uses a finger to point to a tender spot on the chest
wall; what does this suggest is the underlying cause? - Answer Musculoskeletal pain
A patient reports chest pain/discomfort and uses a hand moving from the neck to the
epigastrium; what does this suggest is the underlying cause? - Answer Heartburn
Sources of chest pain w/ related causes: - Answer
What is the "triangle of safety"? - Answer Anatomical region in the midaxillary line formed
by the lateral border of the pectoralis major muscle anteriorly, lateral border of the latissimus
dorsi posteriorly, and nipple line (4th or 5th intercostal space) inferiorly. This triangle represents
a "safe position" for chest tube insertion.
Aspiration pneumonia is more common in which lung? Why? - Answer More common in the
right middle and lower (RML & RLL) lobes because the right main bronchus is more vertical.
for this same reason, if an ETT is advanced too far during intubation, it will more likely enter the
right main-stem bronchus
visceral pleura - Answer covers the outer surface of the lungs
lacks sensory nerves
parietal pleura - Answer Lines the pleural cavity along the inner rib cage and the upper
surface of the diaphragm.
, A 13-year-old girl is brought by her mother to the clinic one day before the start of eighth grade
because of a 3-day history of episodes of shortness of breath. When she gets the shortness of
breath, she also notices tingling around her lips. She has no fever, cough, sputum production, or
chest pain. She has no history of serious illness and takes no medications. Vital signs are within
normal limits. Cardiac, lung, and extremity examinations show no abnormalities. Which of the
following is the most likely diagnosis?
A. Anxiety
B. Asthma
C. Pneumonia
D. Aspiration of a foreign body
E. Left-sided heart failure - Answer A. Anxiety
Tingling around the lips can be a symptom of anxiety. The start of a new school year can be
anxiety provoking for children. The normal lung examination is consistent with anxiety.
Aspiration of a foreign body is incorrect. She does not have a cough. Putting a foreign body in
her mouth and aspirating it would be unusual at her age. Asthma is incorrect. Asthma is a
possible cause of shortness of breath but is less likely in this girl because of the tingling around
her lips and lack of cough or chest tightness, in addition to the lack of wheezing on examination.
Left-sided heart failure is incorrect. Left-sided heart failure is uncommon in children. She also
has no other symptoms of heart failure, such as orthopnea or paroxysmal nocturnal dyspnea.
She has no history of heart disease, high blood pressure, or other conditions that could put at
an increased risk of heart disease. She also has no crackles on lung auscultation, which can be
heard in left-sided heart failure. Pneumonia is incorrect. Pneumonia is less likely than anxiety
because of the lack of other characteristic symptoms of pneumonia (fever, cough, sputum
production, and chest pain) and the normal lung examination.
Reference: Bickley, Lynn S.Bates'Guide to Physical Examination and History Taking,13th ed.,
Philadelphia: Wolters Kluwer, Chapter 15: The Thorax and Lungs.
A 14-year-old high school student comes to the clinic for a 3-month history of periodic dyspnea
when playing basketball. It resolves shortly after resting. He has not had fever, chills, cough,
sputum production, or chest pain. He has no history of serious illness. Based on the boy's
history, asthma is suspected. Which of the following sounds heard on expiration during lung
auscultation would be most suggestive of asthma?
A. Stridor
B. Wheezes
Exam Questions and All Correct
Answers 2025-2026 Updated.
A patient reports chest pain/discomfort and uses a clenched fist over their sternum to indicate
this; what does this suggest is the underlying cause? - Answer Angina pectoris
A patient reports chest pain/discomfort and uses a finger to point to a tender spot on the chest
wall; what does this suggest is the underlying cause? - Answer Musculoskeletal pain
A patient reports chest pain/discomfort and uses a hand moving from the neck to the
epigastrium; what does this suggest is the underlying cause? - Answer Heartburn
Sources of chest pain w/ related causes: - Answer
What is the "triangle of safety"? - Answer Anatomical region in the midaxillary line formed
by the lateral border of the pectoralis major muscle anteriorly, lateral border of the latissimus
dorsi posteriorly, and nipple line (4th or 5th intercostal space) inferiorly. This triangle represents
a "safe position" for chest tube insertion.
Aspiration pneumonia is more common in which lung? Why? - Answer More common in the
right middle and lower (RML & RLL) lobes because the right main bronchus is more vertical.
for this same reason, if an ETT is advanced too far during intubation, it will more likely enter the
right main-stem bronchus
visceral pleura - Answer covers the outer surface of the lungs
lacks sensory nerves
parietal pleura - Answer Lines the pleural cavity along the inner rib cage and the upper
surface of the diaphragm.
, A 13-year-old girl is brought by her mother to the clinic one day before the start of eighth grade
because of a 3-day history of episodes of shortness of breath. When she gets the shortness of
breath, she also notices tingling around her lips. She has no fever, cough, sputum production, or
chest pain. She has no history of serious illness and takes no medications. Vital signs are within
normal limits. Cardiac, lung, and extremity examinations show no abnormalities. Which of the
following is the most likely diagnosis?
A. Anxiety
B. Asthma
C. Pneumonia
D. Aspiration of a foreign body
E. Left-sided heart failure - Answer A. Anxiety
Tingling around the lips can be a symptom of anxiety. The start of a new school year can be
anxiety provoking for children. The normal lung examination is consistent with anxiety.
Aspiration of a foreign body is incorrect. She does not have a cough. Putting a foreign body in
her mouth and aspirating it would be unusual at her age. Asthma is incorrect. Asthma is a
possible cause of shortness of breath but is less likely in this girl because of the tingling around
her lips and lack of cough or chest tightness, in addition to the lack of wheezing on examination.
Left-sided heart failure is incorrect. Left-sided heart failure is uncommon in children. She also
has no other symptoms of heart failure, such as orthopnea or paroxysmal nocturnal dyspnea.
She has no history of heart disease, high blood pressure, or other conditions that could put at
an increased risk of heart disease. She also has no crackles on lung auscultation, which can be
heard in left-sided heart failure. Pneumonia is incorrect. Pneumonia is less likely than anxiety
because of the lack of other characteristic symptoms of pneumonia (fever, cough, sputum
production, and chest pain) and the normal lung examination.
Reference: Bickley, Lynn S.Bates'Guide to Physical Examination and History Taking,13th ed.,
Philadelphia: Wolters Kluwer, Chapter 15: The Thorax and Lungs.
A 14-year-old high school student comes to the clinic for a 3-month history of periodic dyspnea
when playing basketball. It resolves shortly after resting. He has not had fever, chills, cough,
sputum production, or chest pain. He has no history of serious illness. Based on the boy's
history, asthma is suspected. Which of the following sounds heard on expiration during lung
auscultation would be most suggestive of asthma?
A. Stridor
B. Wheezes
