Sherpath Chapter 19, Thorax and LungsFindings for Chest and Lungs

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Question 1 of 24

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Which tracing represents the rate and rhythm of normal breath sounds on inspection?Image depicting normal pattern of breathing. (From Ball JW, Dains JE, Flynn JA, Solomon BS, Stewart RW: Seidel’s Guide to Physical Examination, ed 8, St. Louis, 2015, Mosby.)

  • Correct
    • ANormal breath sounds are expected to be regular and at a rate of 12-20 per minute.
    • BIncreased difficulty of getting air out is air trapping and is considered an abnormal finding.
    • CBreathing faster than 20 breaths per minute is tachypnea, an abnormal finding.
    • DBreathing slower than 12 breaths per minute is bradypnea, an abnormal finding.

Question 2 of 24

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On inspection, the nurse expects the anterior-posterior diameter of the chest to be roughly __ the transverse diameter. (Express your answer in decimals and with a leading zero, if required.)

    • Your answer: 0.5Correct answer: 0.5The anterior-posterior diameter of the chest should be half the transverse diameter.

Question 3 of 24

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The expected rate at which a healthy patient breathes is 10 to __ respirations per minute.

    • Your answer: 20Correct answer: 20A healthy patient would be expected to breathe 12 to 20 respirations per minute.

Question 4 of 24

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Which finding regarding the quality of the tactile fremitus is considered normal on palpation of the chest?

    • AbsentDecreased or absent fremitus is an abnormal finding and may be caused by excess air in the lungs.
    • Coarse/roughCoarse or rough fremitus is an unexpected finding and may be caused by the presence of fluids or a tumor in the lungs.
  • Correct
    • Bilateral symmetryThe tactile fremitus should be bilaterally symmetric.
    • Tremulous and gentleTremulous and gentle fremitus is unexpected and may occur with lung consolidations and some inflammatory and infectious processes.

Question 5 of 24

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Which is a normal finding on palpation of the ribs?

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    • ElasticityThe ribs are expected to be slightly elastic on palpation.
    • CrepitusCrepitus is an unexpected finding on palpation of the ribs.
    • RigidityRigidity of the ribs is an unexpected finding on palpation of the ribs. Rigidity is different from bone hardness. If the ribs are pushed inward, they should rebound to their original position.
    • TendernessTenderness is an unexpected finding on palpation of the ribs.

Question 6 of 24

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Which is a normal finding on palpation of the sternum?

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    • InflexibilityThe sternum and xiphoid are expected to be inflexible on palpation.
    • TendernessTenderness is an unexpected finding on palpation of the sternum.
    • PulsationsPulsations are an unexpected finding on palpation of the sternum.
    • ElasticityAlthough the rib cage may be slightly elastic, this is not a normal finding on palpation of the sternum.

Question 7 of 24

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Which tone would the nurse expect to hear when percussing the indicated area?(From Thompson, JM, Wilson, SF: Health assessment for nursing practice, ed 1, St. Louis, 1996, Mosby.)

    • DullnessThe nurse would expect to hear dullness over the heart, not the viscera.
  • Correct
    • FlatnessThe nurse would expect to hear flatness when percussing the viscera.
    • ResonanceThe nurse would expect to hear resonance over the lungs, not the viscera.
    • TympanyThe nurse would expect to hear tympany over the stomach, not the viscera.

Question 8 of 24

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Which tone would the nurse expect to hear when percussing the indicated area?(From Thompson, JM, Wilson, SF: Health assessment for nursing practice, ed 1, St. Louis, 1996, Mosby.)

    • DullnessThe nurse would expect to hear dullness over the heart, not the lungs.
    • FlatnessThe nurse would expect to hear flatness over heavy muscles, not the lungs.
  • Correct
    • ResonanceThe nurse would expect to hear resonance when percussing the lungs.
    • TympanyThe nurse would expect to hear tympany over the stomach, not the lungs.

Question 9 of 24

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When comparing the diaphragmatic excursion of the left and right sides of the body, what is the expected finding?

    • Equal distance on left and right sidesThe diaphragm would not be expected to be symmetric.
    • Diaphragm higher on left sideThe diaphragm would not be expected to be higher on the left side compared to the right side.
  • Correct
    • Diaphragm higher on right sideThe diaphragm is typically higher on the right side versus the left side because it sits on the liver.
    • Excursion typically not measurable on right sideDiaphragmatic excursion can be measured on both the left and right sides.

Question 10 of 24

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Match the normal breath sounds with the appropriate description.

  • Vesicular
  • Bronchovesicular
  • Bronchotracheal

Question 11 of 24

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Which breath sounds would be expected on auscultation of the bronchi?

    • VesicularVesicular breath sounds would be expected over the lungs, not the bronchi.
  • Correct
    • BronchovesicularBronchovesicular breath sounds would be expected over the bronchi.
    • Bronchial/trachealBronchial/tracheal breath sounds would be expected over the trachea, not the bronchi.
    • TubularTubular breath sounds would be expected over the trachea, not the bronchi.

Question 12 of 24

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Which breath sound would be expected on auscultation of the indicated area?Image of a torso with the areas over which vesicular breath sounds should be auscultated. (From Wilson SF, Giddens, JF: Health Assessment for Nursing Practice, ed 5, St. Louis, 2013, Mosby.)

  • Correct
    • VesicularVesicular breath sounds would be expected over the lungs.
    • BronchovesicularBronchovesicular breath sounds would be expected over the bronchi, not the lungs.
    • Bronchial/trachealBronchial/tracheal breath sounds would be expected over the trachea, not the lungs.
    • TubularTubular breath sounds would be expected over the trachea, not the lungs.

Question 13 of 24

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Match the age of the infant/child with the expected respiration rate.

  • 60 breaths per minute
  • 25 breaths per minute
  • 12 breaths per minute

Question 14 of 24

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On assessment of the chest and lungs in a newborn, which findings are considered normal?

  • Correct
    • SneezingSneezing is an expected finding during the chest and lung examination of a newborn.
    • CoughingCoughing is not an expected finding in a newborn and is considered a problem.
  • Correct
    • Paradoxical breathingParadoxical, or periodic, breathing is an expected finding during the chest and lung examination of a newborn.
  • Correct
    • Diaphragmatic breathingDiaphragmatic breathing is an expected finding during the chest and lung examination of a newborn.
  • Correct
    • Respiratory rate of 50 breaths per minuteRespiratory rate of 50 breaths per minutes is an expected finding (normal rate = 40-60 breaths per minute) during the chest and lung examination of a newborn.

Question 15 of 24

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How do the breath sounds of a young child differ from those of an adult?

  • Correct
    • HarsherThe breath sounds of a young child may be harsher than those of an adult.
  • Correct
    • More bronchialThe breath sounds of a young child may be more bronchial than those of an adult.
  • Correct
    • LouderThe breath sounds of a young child may be louder than those of an adult.
    • More vesicularThe breath sounds of a child are not more vesicular than those of an adult.
  • Correct
    • Bronchovesicular breath sounds can be heard throughout the chestBronchovesicular breath sounds can be heard throughout the chest of a child but not an adult.

Question 16 of 24

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Match the age group with normal chest and lung examination findings.

  • Infant
  • Child
  • Older adult

Question 17 of 24

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In which way do older adults compensate for decreased chest expansion caused by calcification of rib articulations?

    • Diaphragmatic breathingOlder adults would not use diaphragmatic breathing to compensate for calcification of rib articulations.
    • Decrease in respirationsOlder adults would not decrease respirations to compensate for calcification of rib articulations.
    • Increase in respirationsOlder adults would not increase respirations to compensate for calcification of rib articulations.
  • Correct
    • Use of accessory musclesCalcification of rib articulations may decrease chest expansion in older adults, requiring the use of accessory muscles to compensate.

Question 18 of 24

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Match the special consideration for chest and lung examination with the age group for which it is used.

  • Infant
  • Child
  • Older adult

Question 19 of 24

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Match the abnormal condition with the associated finding.

  • Crackly or crinkly sensation
  • Musical sound on inspiration or exhalation
  • Increased respiratory effort
  • Shortness of breath relieved by lying down

Question 20 of 24

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Which condition is indicated by the findings of deep, rapid breathing, pursed lips, barrel chest, and diminished fremitus?

    • PneumoniaPneumonia is not characterized by deep, rapid breathing with pursed lips, a barrel chest, and diminished fremitus.
  • Correct
    • EmphysemaEmphysema is characterized by deep, rapid breathing with pursed lips and a barrel chest.
    • Pleural effusionPleural effusion is not characterized by deep, rapid breathing with pursed lips, a barrel chest, and diminished fremitus.
    • BronchiectasisBronchiectasis is not characterized by deep, rapid breathing with pursed lips, a barrel chest, and diminished fremitus.

Question 21 of 24

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Which abnormal condition is characterized by a coarse grating sensation palpated during inspiration?

    • BronchitisBronchitis is not characterized by a coarse grating sensation on inspiration.
  • Correct
    • CrepitusCrepitus is characterized by a coarse grating sensation on inspiration.
    • PneumothoraxPneumothorax is not characterized by a coarse grating sensation on inspiration.
    • Chronic obstructive pulmonary diseaseChronic obstructive pulmonary disease is not characterized by a coarse grating sensation on inspiration.

Question 22 of 24

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Match the percussion tone heard over the lungs with the condition it indicates.

  • Resonance
  • Hyperresonance
  • Dullness

Question 23 of 24

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Match the sound heard on auscultation with the pathologic breath sounds.

  • Rhonchi
  • Wheeze
  • Pleural friction rub
  • Fine crackles

Question 24 of 24

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Which condition is characterized by diminished breath sounds, wheezes, rhonchi, crackles, and percussed dullness over the lung?

    • AsthmaAsthma is not characterized by dullness over the lungs, rhonchi, and crackles.
    • BronchitisBronchitis is not characterized by dullness over the lungs and diminished breath sounds.
  • Correct
    • AtelectasisAtelectasis is characterized by dullness over the lungs, diminished breath sounds, wheezing, rhonchi, and crackles.
    • Pneumonia consolidationAlthough there would be diminished breath sounds over the area of consolidation, pneumonia consolidation is not characterized by wheezing.