Chapter 16 Bedside Assessment in RT Care

Which of the following is NOT a cause of hypotension?

A. heart failure B. hypovelemia C. MILD TACHYCARDIA D. peripheral vasoconstriction

What term best describes a loud, high-pitched continuous sound heard (often with the unaided ear) primarily over the larynx or trachea during inhalation in patients with upper airway obstruction?

a. STRIDOR b. rhonchi c. crackles d. wheeze

Which of the following is TRUE of peripheral cyanosis?

a. reliable indicator of tissue hypoxia b. develops early in patients with anemia c. develops late in patients with polycythemia d. SIGN OF INADEQUATE TISSUE PERFUSION

Which of the following represent proper chest auscultation technique?

1. The practitioner should begin auscultation at the lung bases. 2. the bell or diaphragm should be placed directly on the chest wall. 3, the patient should be instructed to breathe through an open mouth. 4. the patient should be placed in a comfortable upright position. 5. the patient should be told to breathe more deeply than normal. a. TWO, THREE, FOUR, and FIVE b. 1,2,3, and 5 c. 3,4, and 5 d. 1,2,3,4, and 5

What disease is associated with a barrel chest?

A. EMPHYSEMA B. heart failure C. pneumonia D. pleural effusions

What term is used to describe difficult breathing in the reclining position?

A. ORTHROPNEA B. platypnea C. eupnea D. apnea

Which of the following is associated with tripodding?

A. SEVERE PULMONARY HYPERINFLATION B. congestive heart disease C. pneumonia D. pulmonary fibrosis

On palpating the neck region of a patient on a mechanical ventilator, you notice a crackling sound and sensation. What is the most likely cause of this observation?

A. SUBCUTANEOUS EMPHYSEMA B. upper bronchial obstruction C. pneumonia of the upper lobes D. atelectasis of the upper lobes

While observing a patient's breathing, you note that the depth and rate first increase, then decrease, followed by a period of apnea. Which of the following terms would you use in charting this observation?

A. apneustic breathing B. CHEYNE-STOKES breathing C. Biot's breathing D. paradoxical breathing

Which of the following sites is closes to core body temperature?

A. axillary B. oral C. RECTAL D. forehead

All of the following are critical elements of a patient's past medical history except:

A. childhood diseases B. prior major illnesses or surgery C. MARITAL STATUS D. drugs and immunizations

What term is used to describe sputum that has pus in it?

A. fetid B. mucoid C. PURULENT D. tenacious

Which of the following is least likely to cause tachycardia?

A. fever B. severe pain C. hypotension D. HYPOTHERMIA

Which of the following is NOT associated with diaphoresis?

A. fever B. severe stress C. acute anxiety D. HEMOPTYSIS

Which of the following terms is used to describe coughing up blood-streaked sputum?

A. hematemesis B. HEMOPTYSIS C. hemolysis D. hemostatis

Which of the following is NOT a common cause of an increase in the drive to breathe which would increase the sensation of dyspnea?

A. hypoxemia B. acidosis C. high fever D. HYPOCARBIA

Which of the following is NOT a common cause of tachypnea?

A. hypoxemia B. exercise C. NARCOTIC OVERDOSE D. metabolic acidosis

Which of the following characteristics is least typical for pleuritic chest pain?

A. located laterally B. sharp and stabbing in nature C. increases with breathing D. RADIATES TO THE ARM

All of the following are critical elements of a patients social and environmental history except:

A. occupation and employment B. DRUGS AND MEDICATIONS C. recent travel D. living arrangements

What therm is used to describe shortness of breath in the upright position?

A. orthopnea B. PLATYPNEA C. eupnea D. apnea

Which of the following would cause an increase in tactile fremitus?

A. pleural effusion B. PNEUMONIA C. emphysema D. pneumothorax

A patient with asthma would exhibit which of the following?

A. prolonged inhalation B. slow and shallow breathing C. PROLONGED EXHALATION D. deep and fast breathing

Which of the following may cause the trachea to shift to the right?

A. right-sided tension pneumothorax B. right-sided large plueral effusion C. RIGHT UPPER LOBE PNEUMONIA D. left lower lobe pneumonia

What is the technical term for secretions from the tracheobronchial tree that have not been contaminated by the mouth?

A. sputum B. PHLEGM C. mucus d. pus

What structure in the body is responsible for regulating the body temperature?

Hypothalamus

What breathing pattern is associated with diabetic ketoacidosis?

Kussmaul breathing

Diastolic murmurs are generally associated iwth which of the following? 1. stenotic semilunar valve 2. incompetent atrioventricular (AV) valve 3. incompetent semilunar valve 4. stenotic atrioventricular valve

a. 1,2, and 3 b. 2 and 4 c. THREE AND FOUR d. 1,2,3 and 4

In which of the following conditions might the intensity of the heart sounds be reduced? 1. heart failure 2, severe obesity 3. pneumothorax 4. pleural effusion 5. plumonary hyperinflation

a. 1,3, and 4 b. 2,3,4, and 5 c. ALL d. 3,4, and 5

Which of the following are potential causes of cardiac murmurs? 1. backflow of blood through an incompetent valve 2. forward flow through a stenotic valve 3. rapid flow through a normal valve

a. 2 and 3 b. 1 and 2 c. ONE TWO and THREE d. 1 and 3

While percussing a patient's chest wall, you encounter an area that produces and decreased resonance to percussion. Which of the following are potential causes of this finding? 1. pneumothorax 2. pleural effusion 3. pneumonia 4. atelectasis

a. 2 and 3 b. 2 and 4 c. TWO, THREE, and FOUR d. 1, 2, 3, and 4

Which of the following causes decreased breath sounds? 1. air or fluid in the pleural space 2. hyperinflation of lung tissue 3. mucus plugging of the airways 4. shallow or slow breathing

a. 2 and 4 b. 1,2, and 3 c. ONE, TWO, THREE, FOUR d. 2,3, and 4

In which of the following disorders is digital clubbing a common physical sign? 1. congenital heart disease 2. lung cancer 3. chronic obstructive pulmonary disease 4. bronchiectasis

a. 2 and 4 b. 1,3, and 4 c. 1,2, and 4 d. ALL

Which of the following abnormalities should the practitioner be on the lookout for during inspection of the extremities? 1. digital clubbing 2. peripheral cyanosis 3. pedal edema 4. impaired capillary refill 5. low peripheral skin temperature

a. 2,3,4 and 5 b. 1,3, and 4 c. 3,4, and 5 d. ALL

While palpating the chest of a patient who repeats the words "99" you note an area of increased tactile fremitus over the left lower lobe. Which of the following could explain this finding? 1. pneumothorax 2. emphysema 3. pneumonia

a. 2and 3 b. 1 and 2 c. 1, 2, and 3 d. THREE

The second heart sound (S2) is created primarily by which of the following?

a. CLOSURE OF THE SEMILUNAR VALVES b. opening of the atrioventricular valves c. closure of the atrioventricular valves d. opening of the semilunar valves

While percussing a patient's chest wall, you detect an abnormal increase in resonance. Which of the following are possible causes of this finding? 1. asthma 2. pneumothorax 3. emphysema 4. pneumonia

a. ONE, TWO and THREE b. 2 and 4 c. 1, 3, and 4 d. 1, 2, 3, and 4

In patients with chronic respiratory disease, what does pedal edema indicate?

a. RIGHT VENTRICULAR FAILURE b. impaired pulmonary diffusion c. systemic hypertension d. left ventricular hypertrophy

In which of the following conditions would late inspiratory crackles be most likely to occur? 1. emphysema 2. pulmonary fibrosis 3. pneumonia 4. pulmonary edema 5. atelectasis

a. TWO THREE FOUR and FIVE b. 1,3, and 5 c. 3,4, and 5 d. 1,2,4 and 5

While palpating the chest of a patient who repeats the words "99" you note a localized area of decreased tactile fremitus on the lower right side? Which of the following could explain this finding? 1. atelectasis on the right 2. right sided lower pneumothorax 3. right sided lower pleural effusion 4. obstruction of a bronchus in the right lung

a. TWO, THREE and FOUR b. 1 and 3 c. 3 and 4 d. 1, 3, and 4

Soft muffled sounds heard mainly during inspiration over the peripheral lung parenchyma best describe which of the following breath sounds?

a. VESICULAR b. bronchovesicular c. bronchial d. tracheal

An RT is examining a patient suspected to have a left-sided tension pneumothorax. During inspection and palpation, the RT notices the patient's trachea has shifted to the left. Is the patients diagnosis correct?

a. Yes, the patient may have left-sided tension pneumothorax b. NO THE PATIENT MAY HAVE LEFT UPPER LOBE ATELECTASIS c. no the patient may have right lower lobe pneumonai d. no the patient may have left sided large pleural effustion.

Loud, tubular breath sounds with an expiratory component equal to the inspiratory component best describe which of the following breath sounds?

a. adventitious b. BRONCHIAL c. vesicular d. brochovesicular

The first heart sound (S1) is created primarily by which of the following?

a. closure of the semilunar valves b. opening of the semilunar valves c. opening of the atrioventricular valves d. CLOSURE OF THE ATRIOVENTRICULAR VALVEs

In auscultating the heart sounds of a patient with chronic hypoxemia, you notice a marked increase in the intensity of the second hear sound (S2) and no splitting during inhalation. This finding is most consistent with which of the following?

a. mitral insufficiency b. left ventricular hypertrophy c. tricuspid valve stenosis d. PULMONARY HYPERTENSION

During auscultation of a patient's chest, you hear coarse crackles throughout both inspiration and expiration. These sounds clear when the patient coughs. Which of the following is the most likely cause of these adventitious sounds?

a. opening of closed smaller airways or alveoli b. opening of collapsed large, proximal airways c. variable obstruction to flow in the upper airway d. MOVEMENT OF EXCESSIVE SECRETIONS IN THE AIRWAYS.

In palpating a patient's feet and hands, you note extreme coolness to the touch. This finding is most consistent with which of the following?

a. presence of a disorder causing chronic hypoxemia b. reduction in venous return to the right side of the heart c. PERIPHERAL VASOCONSTRICTION DUE TO INADEQUATE PERFUSION d. presence of a disorder causing systemic hypertension

Inspiratory crackles in patients without excess secretions are most commonly associated with which of the following?

a. reduced chest-wall sound transmission b. AIRWAYS POPPING OPEN DURING INSPIRATION c. complete obstruction of the upper airway d. mucosal edema or inflammation

What is a common cause of pulsus paradoxus?

acute asthma attack

What is indicated by retractions?

an increase in the work of breathing

What term is used to describe the chest pain associated with blockage of the coronary arteries?

angina

What is indicated by the breathing pattern known as abdominal paradox?

diaphragm fatigue

What is the most common cause of hypothermia?

exposure to cold environment

What is the most common cause of pedal edema?

heart failure

What term is used to describe an abnormal anteroposterior curvature of the spine?

kyphosis

What change in the patient's respiratory breathing pattern is commonly seen with significant fever?

more rapid rate

What is the advantage of COPD patients breathing through pursed lips during exhalation?

promotes more complete emptying of the lungs

What is indicated by the presence of central cyanosis?

respiratory failure

What is the most common cause of jugular venous distention (JVD)?

right-sided heart failure

What two factors determine cardiac output?

stroke volume and heart rate

What does the presence of stridor indicate?

upper airway obstruction