Chapter 14: Chest and Lungs
Ball: Seidel’s Guide to Physical Examination, 9th Edition
MULTIPLE CHOICE
1. A 44-year-old male patient who complains of a cough has presented to the emergency
department. He admits to smoking one pack
per day. During your inspection of his chest, the most appropriate lighting source to highlight
chest movement is:
a. bright tangential lighting.
b. daylight from a window.
c. flashlight in a dark room.
d. fluorescent ceiling lights.
ANS: A
Bright tangential light is best for visualizing chest movements.
DIF: Cognitive Level: Applying (Application)
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
2. When auscultating the apex of the lung, you should listen at a point:
a. even with the second rib.
b. 4 cm above the first rib.
c. higher on the right side.
d. on the convex diaphragm surface.
ANS: B
The apex of the lung is 4 cm above the first rib.
DIF: Cognitive Level: Analyzing (Analysis)
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
3. To count the ribs and the intercostal spaces, you begin by palpating the reference point of the:
a. distal point of the xiphoid.
b. manubriosternal junction.
c. suprasternal notch.
d. acromion process.
ANS: B
The angle of Louis, the junction of the manubrium and the sternum, corresponds to the second
rib, the reference point for counting ribs and intercostal spaces.
DIF: Cognitive Level: Applying (Application)
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
4. Mr. Curtis is a 44-year-old patient who has presented to the emergency department with
shortness of breath. During the history, the patient describes shortness of breath that gets worse
when he sits up. To document this, you will use the term:
a. platypnea.
, b. orthopnea.
c. tachypnea.
d. bradypnea.
ANS: A
Dyspnea that increases in the upright posture is called platypnea. Orthopnea is dyspnea that
worsens when the person lies down.
Tachypnea is an increased respiratory rate. Bradypnea is a decreased respiratory rate.
DIF: Cognitive Level: Understanding (Comprehension)
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
5. Which finding suggests a minor structural variation?
a. Barrel chest
b. Clubbed fingers
c. Pectus carinatum
d. Chest wall retractions
ANS: C
Pectus carinatum (pigeon chest) is a minor structural variation. Barrel chest, clubbing of the
fingers, and chest wall retractions result from compromised respirations.
DIF: Cognitive Level: Applying (Application)
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
6. Ms. Rudman, age 74 years, has no known health problems or diseases. You are doing a
preventive healthcare history and examination. Which symptom is associated with intrathoracic
infection?
a. Barrel chest
b. Cor pulmonale
c. Funnel chest
d. Malodorous breath
ANS: D
Intrathoracic infections may make the breath malodorous.
DIF: Cognitive Level: Understanding (Comprehension)
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
7. The best time to observe and count respirations is while:
a. the patient is answering questions.
b. weighing the patient.
c. palpating the pulse.
d. the patient is sleeping.
ANS: C
Counting respirations while you palpate the pulse does not make the patient self-conscious
because the patient expects you to be counting the pulse. Respiratory patterns change as the
patient speaks. Attempting to count during weighing would make the patient self-conscious and
affect the respiratory rate. Respiratory patterns change as the patient sleeps.
DIF: Cognitive Level: Applying (Application)
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
Ball: Seidel’s Guide to Physical Examination, 9th Edition
MULTIPLE CHOICE
1. A 44-year-old male patient who complains of a cough has presented to the emergency
department. He admits to smoking one pack
per day. During your inspection of his chest, the most appropriate lighting source to highlight
chest movement is:
a. bright tangential lighting.
b. daylight from a window.
c. flashlight in a dark room.
d. fluorescent ceiling lights.
ANS: A
Bright tangential light is best for visualizing chest movements.
DIF: Cognitive Level: Applying (Application)
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
2. When auscultating the apex of the lung, you should listen at a point:
a. even with the second rib.
b. 4 cm above the first rib.
c. higher on the right side.
d. on the convex diaphragm surface.
ANS: B
The apex of the lung is 4 cm above the first rib.
DIF: Cognitive Level: Analyzing (Analysis)
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
3. To count the ribs and the intercostal spaces, you begin by palpating the reference point of the:
a. distal point of the xiphoid.
b. manubriosternal junction.
c. suprasternal notch.
d. acromion process.
ANS: B
The angle of Louis, the junction of the manubrium and the sternum, corresponds to the second
rib, the reference point for counting ribs and intercostal spaces.
DIF: Cognitive Level: Applying (Application)
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
4. Mr. Curtis is a 44-year-old patient who has presented to the emergency department with
shortness of breath. During the history, the patient describes shortness of breath that gets worse
when he sits up. To document this, you will use the term:
a. platypnea.
, b. orthopnea.
c. tachypnea.
d. bradypnea.
ANS: A
Dyspnea that increases in the upright posture is called platypnea. Orthopnea is dyspnea that
worsens when the person lies down.
Tachypnea is an increased respiratory rate. Bradypnea is a decreased respiratory rate.
DIF: Cognitive Level: Understanding (Comprehension)
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
5. Which finding suggests a minor structural variation?
a. Barrel chest
b. Clubbed fingers
c. Pectus carinatum
d. Chest wall retractions
ANS: C
Pectus carinatum (pigeon chest) is a minor structural variation. Barrel chest, clubbing of the
fingers, and chest wall retractions result from compromised respirations.
DIF: Cognitive Level: Applying (Application)
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
6. Ms. Rudman, age 74 years, has no known health problems or diseases. You are doing a
preventive healthcare history and examination. Which symptom is associated with intrathoracic
infection?
a. Barrel chest
b. Cor pulmonale
c. Funnel chest
d. Malodorous breath
ANS: D
Intrathoracic infections may make the breath malodorous.
DIF: Cognitive Level: Understanding (Comprehension)
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
7. The best time to observe and count respirations is while:
a. the patient is answering questions.
b. weighing the patient.
c. palpating the pulse.
d. the patient is sleeping.
ANS: C
Counting respirations while you palpate the pulse does not make the patient self-conscious
because the patient expects you to be counting the pulse. Respiratory patterns change as the
patient speaks. Attempting to count during weighing would make the patient self-conscious and
affect the respiratory rate. Respiratory patterns change as the patient sleeps.
DIF: Cognitive Level: Applying (Application)
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
