Asmt Ch 19 Thorax And Lungs

A client presents to the health care clinic and reports a recent onset of a persistent cough. The client denies any shortness of breath, change in activity level, or other findings of an acute upper respiratory tract illness. What question by the nurse is most appropriate to further assess the cause for the cough? - "Have you changed your diet within the past few weeks?" - "How much do you exercise during the week?" - "Are you taking any medications on a regular basis?" - "Do you feel that you are under a great deal of stress?'

Which of the following statements relating to assessment of the lungs and thorax is most accurate? - Hemoptysis is more common in children and adolescents than in older clients. - Moderate to severe chest pain is associated with a cardiac etiology, while mild to moderate chest pain is most often respiratory in origin. - Loud and very loud percussion notes denote pathological findings. - Bronchitis is characterized by excess mucus production and chronic cough.

An adult client visits the clinic and tells the nurse that he has been "spitting up rust-colored sputum." The nurse should refer the client to the physician for possible... - pulmonary edema. - bronchitis. - asthma. - tuberculosis.

The nurse is preparing to auscultate the posterior thorax of an adult female client. The nurse should - place the bell of the stethoscope firmly on the posterior chest wall. - auscultate from the base of the lungs to the apices. - ask the client to breathe deeply through her mouth. - ask the client to breathe normally through her nose.

A triage nurse is working in the emergency department of a busy hospital. Four patients have recently been admitted. Patient A has an arrhythmia diagnosed as atrial fibrillation; Patient B is in chronic congestive heart failure; Patient C is assessed and found to have a probable pulmonary embolism; Patient D complains of chest pain relieved by nitroglycerin and rest. Which patient would be the nurse's highest priority?

Which observation confirms to the nurse that the client is experiencing a normal inspiration? - The thoracic cavity enlarges. - The abdominal wall is pushed inward. - Air can be heard moving out of the tracheobronchial tree. - The diaphragm is seen relaxing.

Which action by a nurse demonstrates the proper sequence for auscultation of the lung fields? - Listen at each site for at least one complete respiratory cycle - Move from anterior to posterior on the same side - Instruct the client to breathe in and out rapidly through the mouth - Use the diaphragm then the bell in each location

The thoracic cavity contains which organs?

Adventitious sounds are heard when auscultating a client's lungs. Which of the following would the nurse do first?

While inspecting the thorax, the nurse views it from posterior and lateral positions to assess which of the following?

The staff educator from the hospital's respiratory unit is providing a public educational event. The educator is talking about health promotion activities for people with respiratory diseases or those who are at high risk for respiratory complications. What would the educator include in the presentation? - Encouraging adequate rest - Reinforcing the need for a high-calorie diet - Teaching strategies to reduce complications of existing diagnoses - Showing participants how to diagnose respiratory problems

The client has been admitted through the emergency department with chronic bronchitis, has elevated CO2 levels, and has been placed on O2. What priority assessment would the nurse include? - Assess for signs of nonproductive cough. - Review blood work including RBC and WBC. - Assess the characteristics of sputum. - Evaluate changes in respiratory pattern and rate.

A high-pitched crowing sound from the upper airway results from tracheal or laryngeal spasm and is called what? - stridor - crackles - wheeze - rales

Which action by a nurse demonstrates proper technique for assessment of chest expansion?

A client who just underwent hip replacement surgery reports pain at a 10 on a scale of 0 to 10 and receives 4 mg of morphine. A nurse on the orthopedic unit enters the client's room and finds that the client has a respiratory rate of 7 breaths/min. The client is groggy and hard to arouse. What could be contributing to the client's findings? - Opiates, which may cause hypoventilation - Opiates, which may cause hyperventilation - Anesthesia, from surgery that morning - Nothing, this is normal following surgery

A nurse is receiving report from the night shift about four clients. Which client would the nurse see first? - A 64-year-old man with COPD who is short of breath and has a respiratory rate of 32 breaths/min - A 57-year-old woman who had surgery yesterday for a small bowel obstruction with possible wound dehiscence - A 23-year-old woman who had a mountain biking accident in which she suffered a neck fracture and now has numbness and tingling in her right arm - A 29-year-old woman with a history of drug abuse and a heart rate of 124 beats/min

A 21-year-old college senior presents to the clinic reporting shortness of breath and a nonproductive nocturnal cough. She states she used to feel this way only with extreme exercise, but lately she has felt this way continuously. She denies any other upper respiratory, gastrointestinal, and urinary symptoms and says she has no chest pain. Her past medical history is significant only for seasonal allergies, for which she takes a nasal steroid spray; she takes no other medications. She has had no surgeries. Her mother has allergies and eczema; her father has high blood pressure. She is an only child. She denies smoking and illegal drug use but drinks three to four alcoholic beverages per weekend. She is a junior in finance at a local university and has recently started a job as a bartender in town. On examination she is in no acute distress. Temperature is 98.6, blood pressure is 120/80, pulse is 80, and respirations are 20. Head, eyes, ears, nose, and throat examinations are essentially normal. Inspection of her anterior and posterior chest shows no abnormalities. On auscultation of her chest, there is decreased air movement and a high-pitched whistling on expiration in all lobes. Percussion reveals resonant lungs. Which disorder of the thorax or lung does this presentation best describe?

A client reports sharp and stabbing chest pain that worsens with deep breathing and coughing. A cardiac cause to this pain is ruled out. The description of the pain is consistent with what respiratory condition? - Pleurisy - Pneumonia - Asthma - Rales

What action by the nurse when percussing a client's chest will help maximize the resulting vibrations?

A nurse performs a respiratory assessment on a client and notes the respiratory rate to be 8 breaths per minute. The nurse knows the proper term for this rate is what? - Bradypnea - Tachypnea - Hyperventilation - Hypoventilation

What would the nurse expect to hear when auscultating the lungs of a client with pleuritis? - Friction rub - Decreased breath sounds - Sibilant wheeze - Stridor

A client from a severe motor vehicle accident arrives in the emergency department. The nurse observes irregular respirations of varying depth and rate followed by periods of apnea. Which of the following would the nurse suspect? - Diabetic ketoacidosis - Renal failure - Narcotic overdose - Severe brain damage

Which of the following would be best for a nurse to use when assessing for fremitus in a client? - Dorsal hand surface - Pads of fingers - Palmar base (ulnar surface) - Fist

Upon inspection of a client's chest, a nurse observes an increase in the anterior posterior diameter. The nurse recognizes this as a finding in which disease process?

An elderly client reports a feeling of dyspnea with normal activities of daily living. What is an appropriate action by the nurse? - Report this to the health care provider immediately - Assess for symmetry of chest expansion - Observe the client's respiratory rate and pattern - Ask the client how long they have to rest between activities

A 47-year-old receptionist comes to the office with fever, shortness of breath, and a productive cough with golden sputum. She says she had a cold last week and her symptoms have only worsened despite using over-the-counter cold remedies. She denies any weight gain, weight loss, or cardiac or gastrointestinal symptoms. Her past medical history includes type 2 diabetes for 5 years and high cholesterol level. She takes an oral medication for both diseases. She has had no surgeries. She denies tobacco, alcohol, or drug use. Her mother has diabetes and high blood pressure. Her father passed away from colon cancer. Examination reveals a middle-aged woman appearing her stated age. She looks ill and her temperature is elevated at 101 degrees Farenheit. Her blood pressure and pulse are unremarkable. Her head, eyes, ears, nose, and throat examination are unremarkable except for edema of the nasal turbinates. On auscultation she has decreased air movement and coarse crackles are heard over the left lower lobe. There is dullness on percussion, increased fremitus during palpation, and egophony and whispered pectoriloquy on auscultation. What disorder of the thorax or lung best describes her symptoms?

A 62-year-old construction worker presents to the clinic reporting almost a chronic cough and occasional shortness of breath that have lasted for almost 1 year. Although symptoms have occasionally worsened with a cold, they have stayed about the same. The cough has occasional mucus drainage but never any blood. He denies any chest pain. He has had no weight gain, weight loss, fever, or night sweats. His past medical history is significant for high blood pressure and arthritis. He has smoked two packs a day for the past 45 years. He drinks occasionally but denies any illegal drug use. He is married with two children. He denies any foreign travel. His father died of a heart attack and his mother died of Alzheimer's disease. Examination reveals a man looking slightly older than his stated age. His blood pressure is 130/80 and his pulse is 88. He is breathing comfortably with respirations of 12. His head, eyes, ears, nose, and throat examinations are unremarkable. His cardiac examination is normal. On examination of his chest, the diameter seems enlarged. Breath sounds are decreased throughout all lobes. Rhonchi are heard over all lung fields. There is no area of dullness and no increased or decreased fremitus. What thorax or lung disorder is most likely causing his symptoms?

A grandmother brings her 13-year-old grandson for evaluation. She noticed last week when he took off his shirt that his breastbone seemed collapsed. He seems embarrassed and says that it has been that way for awhile. He states he has no symptoms from it and that he just tries not to take off his shirt in front of anyone. He denies any shortness of breath, chest pain, or lightheadedness on exertion. His past medical history is unremarkable. He is in sixth grade and just moved in with his grandmother after his father was transferred for a work contract. His mother died several years ago in a car accident. He states that he does not smoke and has never touched alcohol. Examination shows a teenage boy appearing his stated age. Visual examination of his chest reveals that the lower portion of the sternum is depressed. Auscultation of the lungs and heart is unremarkable. What disorder of the thorax best describes these findings?

Which of the following occurs in respiratory distress?

When percussing the posterior lung fields, which of the following findings is expected? - Hyperresonance over apices - Dullness over the lung bases - Resonance over all lung fields - Tympany over 11th interspace, right scapular line

Auscultation of a 23-year-old client's lungs reveals an audible wheeze. What pathological phenomenon underlies wheezing? - Fluid in the alveoli - Blockage of a respiratory passage - Decreased compliance of the lungs - Narrowing or partial obstruction of an airway passage

During the lung assessment for a client with pneumonia, the nurse auscultates low-pitched, bubbling, moist sounds that persist from early inspiration to early expiration. How should the nurse document these sounds? - Coarse crackles - Pleural friction rubs - Sonorous wheezes - Sibilant wheezes

A nurse auscultates a client's lungs and hears fine crackles. What is an appropriate action by the nurse? - Listen again with the bell of the stethoscope - Instruct the client to cough forcefully - Have the client breathe through the mouth - Assess for the use of accessory muscles

A nurse is interviewing a client who complains of dyspnea of sudden onset. Based on this finding, the nurse should suspect which of the following causes? - Emphysema - Lung cancer - Sleep apnea - Bacterial infection

The spinous process termed the vertebra prominens is in which cervical vertebra?

A patient comes to the clinic complaining of waking during the night with sudden shortness of breath. She is diagnosed with paroxysmal nocturnal dyspnea. Before leaving the clinic, the patient asks the nurse what causes paroxysmal nocturnal dyspnea. What would be the nurse's best response?