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Questions and Answers

During a physical examination, a patient's tactile fremitus is decreased, and percussion reveals hyperresonance. Auscultation is likely to reveal:

Adventitious sounds such as crackles, suggesting fluid in the small airways.
Diminished breath sounds, potentially indicating extra air in the pleural space. (correct)
Bronchial breath sounds, indicating fluid-filled alveoli.
Increased breath sounds, suggesting lung consolidation.

A patient presents with suspected pneumonia in the lower lobe of the right lung. Which combination of findings would most strongly support the diagnosis of lobar consolidation?

Decreased tactile fremitus, hyperresonant percussion, diminished breath sounds.
Absent tactile fremitus, stony dull percussion, absent breath sounds.
Normal tactile fremitus, resonant percussion, vesicular breath sounds.
Increased tactile fremitus, dull percussion, bronchial breath sounds. (correct)

In the context of lung auscultation, how would you differentiate between egophony and whispered pectoriloquy, and what underlying lung condition do both typically indicate?

Egophony is a coarse, grating sound; whispered pectoriloquy is a fine, crackling sound; both indicate airway constriction.
Egophony is a clear, whispered sound; whispered pectoriloquy is 'ee' heard as 'ay'; both indicate pneumothorax.
Egophony is a low-pitched wheeze; whispered pectoriloquy is a high-pitched crackle; both indicate pleural effusion.
Egophony is 'ee' heard as 'ay'; whispered pectoriloquy is a clear, whispered sound; both indicate lung consolidation. (correct)

A patient is suspected of having a moderate pleural effusion. Which set of findings would be most consistent with this condition upon physical examination of the chest?

Decreased tactile fremitus, dull percussion, and decreased breath sounds. (B) Signup and view all the answers

During auscultation, a nurse detects high-pitched, continuous musical sounds primarily during expiration. Which of the following pathophysiological mechanisms is most likely responsible for these adventitious sounds?

Airflow through narrowed airways, creating a vibratory effect. (D) Signup and view all the answers

In the context of a respiratory examination, what does the assessment of 'Tactile Fremitus' primarily evaluate?

The presence of consolidation or other abnormalities affecting the transmission of vibrations through the lung tissue. (D) Signup and view all the answers

During pulmonary auscultation, which of the following findings would most strongly suggest the presence of a pleural effusion?

Reduced or absent breath sounds with possible presence of a pleural friction rub. (A) Signup and view all the answers

What underlying physiological principle is used to assess lung conditions through percussion?

The vibration characteristics based on lung tissue density. (D) Signup and view all the answers

A patient presents with suspected pneumonia. Which combination of findings from inspection, palpation, percussion, and auscultation would most strongly support this diagnosis?

Asymmetrical chest expansion, increased tactile fremitus, dullness on percussion, and bronchial breath sounds with crackles. (B) Signup and view all the answers

What is the rationale behind assessing voice sounds (e.g., bronchophony, egophony, whispered pectoriloquy) during a respiratory examination?

To assess for consolidation or compression of lung tissue. (B) Signup and view all the answers

In the context of pulmonary embolism, what is the most critical implication of spared alveoli during the initial stages?

It contributes to a ventilation-perfusion mismatch, affecting gas exchange despite potentially normal initial lung sounds. (A) Signup and view all the answers

Why might a patient with a pulmonary embolism present with a normal S2 heart sound, and what condition might alter this presentation?

A normal S2 can occur initially if pulmonary artery pressure isn't significantly elevated; developing pulmonary hypertension can cause an accentuated S2. (B) Signup and view all the answers

How does the body's response to a pulmonary artery obstruction caused by an embolus directly contribute to the common clinical signs observed in a patient with a pulmonary embolism?

The obstruction elevates pulmonary vascular resistance, potentially causing hypotension and triggering compensatory mechanisms like diaphoresis. (B) Signup and view all the answers

Considering the potential for normal lung sounds in a patient with a pulmonary embolism, what is the most critical implication for diagnostic and treatment strategies?

Normal lung sounds do not exclude PE; further investigations are needed to confirm or exclude PE due to possible ventilation-perfusion mismatch. (D) Signup and view all the answers

In a patient with a suspected pulmonary embolism, how do the presenting symptoms of dyspnea, cyanosis, and hypotension interact to influence the immediate clinical management strategy?

These symptoms collectively indicate severe cardiopulmonary compromise, necessitating immediate interventions such as oxygen therapy, hemodynamic support, and anticoagulation evaluation. (B) Signup and view all the answers

During a thoracic examination, which of the following findings would suggest the presence of a pleural effusion?

Dullness to percussion. (D) Signup and view all the answers

A patient with suspected pneumonia is undergoing tactile fremitus assessment. Which instruction to the patient would be MOST appropriate for this part of the examination?

Say 'ninety-nine' each time you feel my hands touch your chest. (A) Signup and view all the answers

In assessing a patient with a known history of asthma, which percussion finding would be MOST anticipated during a thoracic examination?

Hyperresonance over the lung fields. (D) Signup and view all the answers

While auscultating a patient's lungs, the nurse hears a clear transmission of the whispered phrase 'one-two-three'. This finding indicates:

Lung consolidation. (D) Signup and view all the answers

During the examination of a patient, the nurse notes the presence of crepitus. Which condition is Most Likely associated with this finding?

Subcutaneous Emphysema. (B) Signup and view all the answers

When performing egophony on a patient, which finding would indicate a potential area of consolidation?

The patient's spoken 'ee' sounds are heard as 'ay'. (B) Signup and view all the answers

A patient is being evaluated for a possible pneumothorax. Which of the following assessment findings would be MOST consistent with this condition?

Decreased tactile fremitus and hyperresonance to percussion. (A) Signup and view all the answers

Following a motor vehicle accident, a patient reports chest pain and difficulty breathing. Upon examination, the nurse observes asymmetrical chest expansion. This finding MOST likely indicates:

Flail Chest or Pneumothorax. (A) Signup and view all the answers

Flashcards

Tactile Fremitus

Vibration felt on the chest wall during speech. It indicates the density of underlying lung tissue.

Lung Percussion Sounds

Sound produced by tapping the chest. Dullness suggests density; hyperresonance suggests extra air.

Breath Sound Auscultation

Sounds heard through a stethoscope. Louder sounds indicate consolidation; diminished sounds indicate air or fluid.