Deck 12: Assessing the Respiratory System

Question 1

The major function of the lungs is gas exchange and the delivery of oxygen to all parts of the body. The other body systems that maintain the respiratory system include which of the following? Select all that apply.

A) Circulatory system
B) Musculoskeletal system
C) Neurological system
D) Gastrointestinal system

Answer 1

Circulatory system
Musculoskeletal system
Neurological system

Question 2

During inhalation the nasal cavity performs which of the following functions? Select all that apply.

A) Warms air
B) Humidifies air
C) Filters air
D) Concentrates oxygen

Answer 2

Warms air
Humidifies air
Filters air

Question 3

The patient presents at the urgent care center with shortness of breath. Which questions would be appropriate to ask this patient? Select all that apply.

A) "How far can you walk without becoming short of breath?"
B) "Do you use oxygen? How often? How much?"
C) "Does a certain position relieve your shortness of breath?"
D) "How would you rate your shortness of breath on a scale of 1 to 10?"

Answer 3

"How far can you walk without becoming short of breath?"
"Do you use oxygen? How often? How much?"
"Does a certain position relieve your shortness of breath?"
"How would you rate your shortness of breath on a scale of 1 to 10?"

Question 4

Ethnic differences in asthma prevalence, morbidity, and mortality are highly correlated with which of the following? Select all that apply.

A) Poverty
B) Urban air quality
C) Indoor allergens
D) Lack of patient education
E) Inadequate medical care

Question 5

In preparation for assessment of the chest the nurse would do which of the following? Select all that apply.

A) Instruct the patient to lie supine on the examining table.
B) Advise the patient to breathe normally.
C) Compare findings on the same level on each side as each assessment technique is performed.
D) To maintain modesty, the nurse should keep the anterior chest covered until the anterior lungs are assessed.

Question 6

The nurse teaches her patient ways to promote respiratory health and includes which of the following? Select all that apply.

A) Do not smoke.
B) Avoid exposure to secondhand smoke, air pollutants, and chemicals.
C) Perform good hand and oral hygiene to prevent infection.
D) Get vaccinated every 5 years against influenza.

Question 7

The nurse uses a peak flow meter during a respiratory assessment. She instructs the patient to do which of the following? Select all that apply.

A) Take a deep breath and hold it.
B) Place the meter in the mouth with the tongue under the mouthpiece.
C) Close the lips tightly around the mouthpiece.
D) Blow slowly until as much air as possible is exhaled.

Question 8

When doing a respiratory assessment on an adult the nurse remembers which of the following is true? Select all that apply.

A) The normal respiratory rate is 15 to 25 breaths per minute.
B) The normal inspiratory-to-expiratory ratio is 1:2.
C) The chest is a conical shape: larger at the top and narrows at the bottom.
D) The chest movement is symmetrical.

Question 9

When assessing a patient's history of respiratory problems it would be important to ask about which of the following? Select all that apply.

A) Asthma
B) Chronic obstructive pulmonary disease (COPD)
C) Cystic fibrosis
D) Bronchitis
E) Pneumonia

Question 10

In the lungs, gases move across systemic capillaries and an exchange of oxygen and carbon dioxide occurs at the cellular level. Which of the following is true regarding carbon dioxide? Select all that apply.

A) It is a waste product of oxygen metabolism.
B) It is released from the lungs at the alveoli tissue level.
C) It influences the respiratory center of the brain to increase or decrease respiratory rate.
D) It helps maintain acid/base balance.

Question 11

The alveoli in the lungs secrete surfactant, which serves to do which of the following? Select all that apply.

A) Increase oxygen transfer.
B) Reduce surface tension in the alveoli.
C) Keep alveoli moist.
D) Control blood acid-base balance.

Question 12

You are inspecting the thoracic cage of a middle-aged male. He does not have a history of smoking or chronic pulmonary disease. Identify the normal findings. Select all that apply.

A) AP-to-lateral ratio approximately 1:2
B) AP-to-lateral ratio approximately 1:1
C) Costal angle greater than 90 degrees
D) Conical shape
E) Accessory muscle retractions
F) Symmetrical
G) Color uniform

Question 13

You are performing the respiratory assessment technique of tactile fremitus. The purpose of this technique is to:

A) Palpate voice sound vibrations through the bronchi.
B) Palpate tissue density in the upper lobes.
C) Auscultate breath sounds as they travel down the larger bronchi.
D) Percuss for adventitious sounds in the upper bronchi.

Question 14

During a respiratory assessment, the purpose of palpating the thorax is to assess for:

A) Skeletal deformities and color.
B) Respiratory distress and abnormal sounds.
C) Surface characteristics and tenderness.
D) Color of skin and tissue density.

Question 15

A patient comes to the health clinic complaining of cough, wheezing, and chest tightness. You are going to assess for posterior symmetrical expansion. Where will you place your hands?

A) Thoracic 5 or 6
B) Thoracic 7 or 8
C) Thoracic 9 or 10
D) Thoracic 11 or 12

Question 16

You are performing a respiratory assessment and palpating for tactile fremitus on an older patient. The patient has a past medical history of pneumonia. If the patient has pneumonia again, what will be the findings?

A) Equal palpable vibrations
B) Unequal palpable vibrations
C) Decreased fremitus
D) Increased fremitus

Question 17

A patient comes to the health-care provider's office stating she has been short of breath for the past 2 days. She rates her shortness of breath a 6/10. The patient has a past medical history of asthma. You are percussing the lungs and will do all of the following EXCEPT:

A) Percuss the intercostal spaces, moving from the apex to the base using direct percussion.
B) Percuss the intercostal spaces, moving on each side of the anterior lung fields.
C) Percuss the intercostal spaces, moving on each side of the posterior lung fields.
D) Percuss each side of the lateral lung fields using the direct percussion technique.

Question 18

You are auscultating the mid-chest anterior intercostal spaces of a middle-aged adult.
What are the medium-pitched sounds?

A) Vesicular
B) Bronchovesicular
C) Tracheal
D) Bronchial

Question 19

During the assessment, the nurse explains to the patient that the structure that has roles in speech, breathing, and prevention of aspiration is the:

A) Nasopharynx.
B) Oropharynx.
C) Bronchi.
D) Trachea.

Question 20

The serous membrane that lines and adheres to the thoracic wall and produces pleural fluid is the:

A) Surfactant.
B) Parietal pleura.
C) Visceral pleura.
D) Pulmonary pleura.

Question 21

The percent of arterial hemoglobin saturated with oxygen is tested at the bedside with:

A) Arterial blood gases.
B) Pulse oximeter.
C) Thoracentesis.
D) Bronchoscopy.

Question 22

The nurse asks the patient about his smoking history. He has smoked one-half pack of cigarettes daily for the past 20 years. You document his pack-year smoking history as:

A) 5 pack-year.
B) 10 pack-year.
C) 15 pack-year.
D) 20 pack-year.

Question 23

The highest concentrations of carcinogens are found in:

A) Smoke exhaled by the smoker.
B) Sidestream smoke.
C) Secondhand smoke.
D) All forms are equally carcinogenic.

Question 24

The nurse assesses a patient with chronic obstructive pulmonary disease. The patient reports difficulty breathing sometimes accompanied by wheezing. The nurse knows that this is indicative of:

A) Cardiac dyspnea.
B) Expiratory dyspnea.
C) Orthopnea.
D) Paroxysmal nocturnal dyspnea.

Question 25

The nurse assesses that the patient is frequently coughing up sputum and documents this as a:

A) Hacking cough.
B) Chronic cough.
C) Productive cough.
D) Dry cough.

Question 26

The nurse uses the proper sequence of assessment of the lungs, which is:

A) Inspection, palpation, percussion, auscultation.
B) Palpation, percussion, auscultation, inspection.
C) Percussion, auscultation, inspection, palpation.
D) Auscultation, inspection, palpation, percussion.

Question 27

When percussing the lungs the nurse hears a soft muffled sound over an area normally filled with air and recognizes that this indicates:

A) An area of consolidation.
B) Overinflation of the lungs.
C) Pneumothorax.
D) Crepitus.

Question 28

The nurse uses a peak flow meter to measure the patient's ability to push air out of the lungs and repeats the test three times. When documenting the results, the nurse notes:

A) The highest number obtained.
B) The lowest number obtained.
C) The average result of all attempts.
D) The results of all attempts.

Question 29

The patient uses the peak flow meter with results in the yellow zone. The nurse interprets this to mean that the patient:

A) Can go about his usual activities.
B) May begin to have shortness of breath.
C) Should get help right away.
D) Should be able to sleep without trouble.

Question 30

The nurse is assessing a 67-year-old male patient. During the respiratory assessment the nurse asks:

A) "Have you received the pneumonia vaccine yet?"
B) "Have you had your annual pneumonia vaccination?"
C) "Why haven't you received your pneumonia shot?"
D) "Considering your age and health, why haven't you gotten your Pneumovax shot?"

Question 31

In mapping the thoracic cage, the right midclavicular line, midsternal line, and left midclavicular line are references for the:

A) Anterior thorax.
B) Posterior thorax.
C) Left lateral thorax.
D) Right lateral thorax.

Question 32

During the assessment, patients in respiratory distress may assume which position?

A) Sitting on the side of the examining table
B) Lying supine
C) Assuming the tripod position
D) Standing and leaning on a chair for support

Question 33

The nurse assesses the anterior-posterior to lateral ratio as 1:1 and the costal angle is greater than 90 degrees. This assessment indicates a condition known as:

A) Pectus excavatum.
B) Pigeon breast.
C) Barrel chest.
D) Pectus carinatum.

Question 34

If the nurse palpates decreased fremitus in the lungs in the left lower lobe, it might indicate:

A) Pleural effusion.
B) Increased density of lung tissue.
C) Lung mass.
D) Pneumonia.

Question 35

The adventitious breath sound that indicates upper airway obstruction and is a medical emergency is:

A) Wheeze.
B) Rhonchi.
C) Stridor.
D) Rales.

Question 36

Arrange the assessment techniques of the chest in the proper sequence (1-4). (Enter the number of each step in the proper sequence. Do not use punctuation or spaces. Example: 1234.)
____1. Palpation
____2. Inspection
____3. Auscultation
____4. Percussion

Question 37

You are performing a respiratory assessment on a patient with complaints of wheezing and productive cough. Arrange the steps in assessing symmetrical expansion of the thoracic cage in proper sequence (1-7). (Enter the number of each step in the proper sequence. Do not use punctuation or spaces. Example: 1234.)
____1. Observe chest expansion and the expansion of your hands and thumbs.
____2. Repeat on the anterior thorax.
____3. Pinch up a small fold of skin between your fingers.
____4. Document your findings.
____5. Place the patient in the sitting position.
____6. Place your warmed hands on the posterior chest wall with thumbs at level T (thoracic) 9 or T10.
____7. Instruct the patient to inhale deeply through the nose and to exhale through the mouth.

Question 38

The low-pitched, clear, hollow sound that is percussed over healthy, air-filled lung fields is called ____________________.

Question 39

Breath sounds that are not normally heard in the chest are called ____________________ breath sounds.

Question 40

A respiratory rate of less than 10 breaths per minute is called ____________________.

Question 41

Gradual increase in depth of respirations, followed by gradual decrease and then a period of apnea, is called ____________________ respirations.

Question 42

The nurse assesses the patient's skin color to have a bluish hue. This is called ____________.