Download CHAPTER 19. LUNGS,THORAX STUDY GUIDE LATEST 2025| QS WITH DEFINITIVE SOLUTIONS|A+RATED and more Exams Nursing in PDF only on Docsity!
CHAPTER 19. LUNGS, THORAX STUDY GUIDE LATEST
2025| QUESTIONS WITH DEFINITIVE SOLUTIONS|
A+RATED
decreased, because a pneumothorax is a collapsed lung. During the assessment of a client with a pneumothorax, what change should the nurse anticipate when auscultating for fremitus? nighttime when laying down Which characteristic of a cough should alert the nurse to assess the client for other findings of sinusitis? ineffective airway clearance A client presents to the health care facility with sudden onset of shortness of breath, inability to lie flat, and a deep, wet cough. A nurse observes a respiratory rate of 18 breaths per minute, use of accessory muscles to breathe, and inability to cough up secretions. Which nursing diagnosis can be confirmed with this data? Are you taking any medication on a regular basis?
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? "Do you feel that you are under a great deal of stress?' "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?" Pleural effusion= excess fluid builds up AROUND the lungs not in the lungs The nurse obtains a flat sound when percussing the right lower lobe of a patient. What does this assessment finding indicate to the nurse? Pleural effusion Chronic bronchitis Healthy lung tissue Gastric air bubble
Impaired Gas Exchange A client presents to the health care facility with a 2-week history of persistent dry, hacky cough, chest tightness, and shortness of breath with activity. The client admits to a 1-pack-per-day history of cigarette smoking for 20 years. The nurse observes a respiratory rate of 16 breaths per minute, easy and regular. Which nursing diagnosis should the nurse confirm based on this assessment data? Disturbed Sleep Pattern Risk for Imbalanced Nutrition Impaired Gas Exchange Ineffective Airway Clearance Sibilant wheezes heard primarily during expiration but may also be heard on inspiration A nurse is assessing a client with acute asthma. Which adventitious breath sound should the nurse expect to hear in this client? Course crackles occurring from early inspiration to early expiration Sibilant wheezes heard primarily during expiration but may also be heard on inspiration
Fine crackles occurring late in inspiration Sonorous wheezes heard primarily during expiration but may be heard throughout the respiratory cycle seventh The spinous process termed the vertebra prominens is in which cervical vertebra? Fifth. Eighth. Sixth. Seventh. tuberculosis 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 tuberculosis. asthma. pulmonary edema.
lower lobe middle lobe major lobe upper lobe The thoracic cavity enlarges Which observation confirms to the nurse that the client is experiencing a normal inspiration? Air can be heard moving out of the tracheobronchial tree. The diaphragm is seen relaxing. The thoracic cavity enlarges. The abdominal wall is pushed inward. lung abscess A client is coughing copious amounts of purulent mucous. What disease condition is related to this finding? lung abscess pneumococcal pneumonia
lung cancer cystic fibrosis coarse crackles When auscultating a client's lungs, the nurse hears a loud popping sound that clears when the client coughs. What sound is this client most likely demonstrating? fine crackles rhonchi wheezes coarse crackles collapsed lung What is a pneumothorax? coarse crackles During the lung assessment for a client with pneumonia, the nurse auscultates low-pitched bubbling, moist sounds that persists from
Which description of exterior landmarks indicates normal positioning of the lungs? Anteriorly, the lower border of the lung crosses the 6th rib at the midclavicular line. Posteriorly, the lower border of the lung lies at the level of T9. Posteriorly, the lower border of the lung ascends to the level of T during inspiration. The anterior baseline of the lungs cross the midaxillary line at the 7th rib. A 64-year-old man with COPD who is short of breath and has a respiratory rate of 32 breaths/min 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 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 57-year-old woman who had surgery yesterday for a small bowel obstruction with possible wound dehiscence
A 29-year-old woman with a history of drug abuse and a heart rate of 124 beats/min friction rub What would the nurse expect to hear when auscultating the lungs of a client with pleuritis? Sibilant wheeze Friction rub Decreased breath sounds Stridor have the client cough and then listen again Adventitious sounds are heard when auscultating a client's lungs. Which of the following would the nurse do first? Auscultate for egophony Perform bronchophony Have the client cough and then listen again Refer the client for further medical evaluation
COPD
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? Carcinoma of the lungs Pneumothorax Chronic obstructive pulmonary disease Tuberculosis Pneumonia 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? Chronic obstructive pulmonary disease (COPD) Spontaneous pneumothorax Asthma Pneumonia Skin between the ribs moves inward with inspiration. Which of the following occurs in respiratory distress? Skin between the ribs moves inward with inspiration. The client speaks in sentences of 10-20 words. Client torso leans posteriorly. Neck muscles are relaxed. diaphram Which of the following muscles is primarily responsible for thoracic cavity enlargement?
Listen again with the bell of the stethoscope Have the client breathe through the mouth Instruct the client to cough forcefully COPD Upon inspection of a client's chest, a nurse observes an increase in the ratio of anteroposterior to transverse diameter. The nurse recognizes this as a finding in which disease process? Tuberculosis Pneumothorax Chronic obstructive pulmonary disease Carcinoma of the lungs Angina, edema, orthopnea (shortness of breath) A nurse is interviewing a client who complains of dyspnea. Which of the following findings would tend to indicate an underlying cardiovascular problem in the client? Select all that apply. Snoring and gasping while sleeping Angina
Edema Coughing occurring at night Orthopnea Coughing that produces white sputum funnel chest The nurse is reviewing the client's health history and notes he has pectus excavatum. The nurse would assess the client for what? Intercostal bulging Pigeon chest Pectoriloquy Funnel chest pulmonary edema The client tells the nurse that he has been coughing up pink, frothy sputum. The nurse notifies the health care provider because the client may have what condition? Tuberculosis
While assessing the thoracic area of an adult client, the nurse plans to auscultate for voice sounds. To assess bronchophony, the nurse should ask the client to repeat the phrase "ninety-nine." repeat the letter "A." repeat the letter "E." whisper the phrase "one-two-three." patient C 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? Patient B Patient A
Patient C Patient D fluid in the alveoli A client comes to the clinic and states, "I have a bad cold and am having trouble breathing." The nurse checks the client's breath sounds and hears bilateral fine crackles at the base. Of what is this finding indicative? No fluid present Fluid in the bronchioles Fluid in the bronchus Fluid in the alveoli stridor A high-pitched crowing sound from the upper airway results from tracheal or laryngeal spasm and is called what? Crackles Rales Stridor
