131 Worksheet

Which of the following conditions would tend to shift the point of maximal impulse (PMI) farther to the left?

1) Collapse of the left lower lobe 2) Right sided tension pneumothorax

In which of the following disorders is digital clubbing a common physical sign?

1) Congenital heart failure 2) Lung cancer 3) Chronic obstructive pulmonary disease 4) Bronchiectasis

While percussing a patients chest wall you encounter an area that produces a decreased resonance to percussion. Which of the following are potential causes of this feeling?

1) Pleural effusion 2) Pneumonia 3) Atelectasis

Which of the following are true of early inspiratory crackles?

1) They most often occur in COPD patients 2) They generally indicate severe airway obstruction 3) They are not affected by coughing or positional change 4) They are usually scant (few in number)

The vibration created by percussion penetrates the lung to about what depth?

5 to 7 cm

What is the normal range for diastolic blood pressure in the adult patient?

60 to 90 mm Hg

What is the normal range for systolic blood pressure in the adult patient?

90 to 140 mm Hg

Which of the following is a common cause of pulsus paradoxus?

Acute asthma attack

What is indicated by retractions?

An increase in the work of breathing

What artery is most often used to assess arterial blood pressure?

Brachial

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

Bronchial

While observing a patients 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?

Cheyne Stokes breathing

Normal heart sounds are created primarily by which of the following?

Closing of the heart valves

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

Closure of the atrioventricular valves

During auscultation of a patient's chest you hear abnormal discontinuous bubbling sounds at the lung bases. Which of the following chart entries best describes this finding?

Crackles heard at the lung bases

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

Drugs and medications

What is the most common cause of hypothermia?

Exposure ti cold environment

Where is the normal apical impulse (point of maximal impulse) usually identified?

Fifth left intercostal space midclavicular line

A creaking or grating sound that increased in intensity with deep breathing and is similar to coarse crackles, but is not affected by coughing best describes which of the following?

Friction rub

Which of the following is least likely to cause tachycardia?

Hypothermia

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

No, the patient may have left upper lobe atelectasis

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

Orthopnea

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

Pneumonia

While palpating the chest of a patient who repeats the words ninety nine you note an area of increased tactile fremitus over the left lower lobe. Which of the following could explain this finding?

Pneumonia

What two factors determine cardiac output?

Stroke volume and heart rate

Your patient has an abnormal sensorium. Which of the following is most likely true?

The patient is confused about where he or she is

Why should the respiratory therapist perform a blood pressure assessment fairly quickly?

The procedure cuts off blood flow to the forearm temporarily

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

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

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

Which of the following abnormalities should the practitioner be on the lookout for during inspiration of the extremities?

1) Digital clubbing 2) Peripheral cyanosis 3) Pedal edema 4) Impaired capillary refill 5) Low peripheral skin temperature

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) Pulmonary hyperinflation

Diastolic murmurs are generally associated with which of the following?

1) Incompetent semilunar valve 2) Stenotic atrioventricular valve

A clinician unsuccessfully tried to take the pulse of a patient who is suffering from an asthma attack in the ER. The patient's breath sounds are diminished to absent bilaterally with a BP pf 110 mm Hg systolic and 90 mm Hg diastolic. What can be concluded about this patients condition?

1) Lung hyperinflation is present 2) Pulsus paradoxus is present

In which of the following conditions would late inspiratory crackles be most likely to occur?

1) Pulmonary fibrosis 2) Pneumonia 3) Pulmonary edema 4) Atelectasis

While palpating the thorax of a patient who repeats the words ninety nine you note a localized are of decreased tactile fremitus on the lower right side. Which of the following could explain this finding?

1) Right sided lower pneumothorax 2) Right sided lower pleural effusion 3) Obstruction of a bronchus in the right lung

What is the normal range for pulse pressure?

30 to 40 mm Hg

A 55 year old patient who has been smoking a pack and a half of cigarettes ( 30 cigarettes) per day for 30 years. What is the patient's smoking history?

40 Pack years

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

Airways popping open during inspiration

What term is used to describe the chest pain associates with blockage of the coronary artery?

Angina

A 23 year old patient enters the emergency room complaining of dyspnea. The RT places the patient on oxygen as per hospital protocol and begins to interview the patient about her symptoms. She states that she's having difficulty taking a breath with chest tightness. Patient has a respiratory rate of 28 breaths/minute with a loose productive cough. During auscultation, the RT hears bilateral wheezing in the lungs What is the most likely cause of the patient's symptoms?

Asthma

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 are potential causes of this abnormality?

Central nervous system disorder

Which of the following is the least likely cause of lymphadenopathy in the neck?

Congestive heart failure

An emergency room patient is lying on his bed with his head elevated at a 45 degree angle. An RT who is coming to examine the patient notices that the patient's jugular vein extends approximately 7 cm above his sternal angle. What can the RT assume about this patient's condition?

Cor pulmonale

Which of the following pulmonary disorders is most likely yo result in hepatomegaly?

Cor pulmonale

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

Diaphragm fatigue

What disease is associated with a barrel chest?

Emphysema

What is the most common cause of pedal edema?

Heart failure

Which of the following is NOT associated with diaphoresis?

Hemoptysis

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

Hemoptysis

What term is used to describe the breathing pattern seen in COPD patients in whom lower costal margins of the chest wall draw inward with each inspiration?

Hoover's sign

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

Hypocarbia

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

Hypothalamus

In auscultating the precordium of a patient you hear a high pitched whooshing noise occurring simultaneously with S1. This finding is most considered with which of the following?

Incompetent mitral valve

You observe a patient's breathing pattern as very irregular and interspersed with long periods of apnea. Which of the following is the most likely cause of this problem?

Increased intracranial pressure

Splitting of the second heart sound (S2) is normally most pronounced during which of the following?

Inhalation

What breathing pattern is associated with diabetic ketoacidosis?

Kussmaul breathing

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

Kyphosis

Right ventricular hypertrophy often produces a systolic thrust that can be felt and seen near which of the following?

Lower left border of the sternum

Which of the following changes in the characteristics of wheezing indicate improvement in airway obstruction following bronchodilator therapy?

Lower pitch, shorter duration

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

Marital status

In which of the following patient categories would the intensity of the point of maximal impulse be most difficult to palpate?

Mitral (bicuspid) stenosis

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

More rapid rate

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

Movement of excessive secretions in the airways

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

Narcotic overdose

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

Peripheral vasoconstriction due to inadequate perfusion

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

Phlegm

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

Platypnea

What is the area of the anterior chest wall overlying the heart called?

Precordium

A patient with asthma would tend to exhibit which of the following?

Prolonged exhalation

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

Promotes more complete emptying of the lungs

Which of the following conditions is most likely to cause a dry, nonproductive cough?

Pulmonary fibrosis

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

Pulmonary hypertension

Which of the following factors has minimal or no impact on the effectiveness of the patient's cough?

Pulmonary vascular resistance

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

Purulent

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

Radiates to the arm

To minimize bony interference with percussion on the posterior chest wall, the practitioner should have the patient do which of the following?

Raise his or her arms above the shoulders

What breathing pattern is associated with severe atelectasis?

Rapid and shallow

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

Rectal

During examination of a patients extremities you press firmly for a brief period on a fingernail. You observe that it takes about 5 seconds for the color to return to the nail bed. This finding is most consistent with which of the following?

Reduction in cardiac output or poor peripheral perfusion

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

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

Right upper lobe atelectasis

IN patients with chronic respiratory disease what does pedal edema indicate?

Right ventricular failure

Which of the following is associated with tripodding?

Severe pulmonary hyperinflation

Which of the following is TRUE of peripheral cyanosis?

Sign of inadequate tissue perfusion

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

Stridor

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?

Subcutaneous emphysema

Which of the following is a TRUE statement about the cause of systemic hypertension in adult patients?

The cause is often unknown

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

The closure of the semilunar valves

Which of the fowling is/are advantages of the digital blood pressure measurement devices?

They reduce the the risk of human error

What does the presence of stridor indicate?

Upper airway obstruction

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

Vesicular