Midterm Exam: NR 509 / NR509 (Latest 2023/ 2024 Update) Advanced Physical Assessment Exam Review | Weeks 5-8 Covered| Verified Questions
Midterm Exam: NR 509 / NR509 (Latest
2023/ 2024 Update) Advanced Physical
Assessment Exam Review | Weeks 5-8
Covered| Questions and Verified Answers
QUESTION
A 39-year-old architect comes to the clinic for a 2-day history of fever, chills, cough productive
of green sputum, and dyspnea. He has no history
of serious illness. His temperature is 101.2ºF. His other vital signs are within normal limits. Late
inspiratory crackles are heard on auscultation over the left lower lung posteriorly. When the
clinician listens over that area and instructs the patient to say “ee,” it sounds like “A.” Which of
the following would most likely be found on percussion of his lungs?
Answer:
a. Flatness
b. Hyperresonance c. Stridor
d. Tympany e. Dullness
QUESTION
A student is practicing the performance of a lung examination on a classmate. Which of the
following is the correct order for performing the components of the lung examination?
Answer:
a. Auscultation, inspection, palpation, and percussion
b. Auscultation, percussion, palpation, and inspection c. Inspection, palpation, percussion, and
auscultation d. Auscultation, inspection, palpation, and percussion e. Inspection, auscultation,
percussion, and palpation f. Palpation, inspection, auscultation, and percussion
QUESTION
A 14-year-old high school student comes to the clinic for a 3-month history of periodic dyspnea
when playing basketball. It resolves shortly after resting. He has not had fever, chills, cough,
sputum production, or chest pain. He has no history of serious illness. Based on the boy’s history,
asthma is suspected. Which of the following sounds heard on expiration during lung auscultation
would be most suggestive of asthma?
Answer:
a. Mediastinal crunch
b. Pleural rub c. Rhonchi
d. Wheezes e. Stridor
QUESTION
A clinician is percussing the lungs of a patient with chronic obstructive pulmonary disease to see
if they sound hyperresonant. Which of the following
is an example of good technique for percussion?
Answer:
a. Strike using the tip of the third finger.
b. The proximal interphalangeal joint is the joint that is struck.
c. Put the third and fourth fingers next to each other on the chest. d. Strike using the finger pad of
the fourth finger.
e. The wrist is kept still during percussion. Submit
QUESTION
A 29-year-old waiter comes to the clinic for a 2-month history of a cough. When he lowers his
gown so the clinician can listen to his lungs, the clinician notices a depression of the lower part
of his sternum. Which of the following best describes the appearance of his chest?
Answer:
a. Barrel chest
b. Flail chest
c. Pectus excavatum d. Pigeon chest
e. Thoracic kyphoscoliosis
QUESTION
A 13-year-old girl is brought by her mother to the clinic one day before
the start of eighth grade because of a 3-day history of episodes of shortness of breath. When she
gets the shortness of breath, she also notices tingling around her lips. She has no fever, cough,
sputum production, or chest pain. She has no history of serious illness and takes no medications.
Vital signs are within normal limits. Cardiac, lung, and extremity examinations show
no abnormalities. Which of the following is the most likely diagnosis?
Answer:
a. Aspiration of a foreign body
b. Anxiety c. Asthma
d. Left-sided heart failure e. Pneumonia
QUESTION
A 70-year-old patient has suspected chronic obstructive pulmonary dis- ease. The clinician
instructs the patient to take a deep breath in, and then with his mouth open, breathe out as fast
and completely as he can. For what is the clinician checking?
Answer:
a. Bronchophony
b. Egophony
c. Tactile fremitus
d. Forced expiratory time e. Whispered pectoriloquy
QUESTION
After examining a patient who is in the hospital for shortness of breath, the clinician records the
following for lung examination
Answer:
“There is dullness
to percussion over the right lung base. Breath sounds are absent at the right lung base. There are
no crackles, wheezes, or rhonchi. There are no transmitted voice sounds.” Which of the following is the most likely diagnosis?
Answer:
a. Atelectasis
b. Left-sided heart failure c. Pneumonia
d. Pneumothorax
e. Chronic obstructive pulmonary disease (COPD)
QUESTION
A 16-year-old boy is brought to the Emergency Department (ED) after a motor vehicle accident
for shortness of breath for 1 hour. A chest x-ray shows a rib fracture and a pneumothorax on the
right side. The ED physician decides that a chest tube needs to be placed in the fourth intercostal
space. How does he determine where the fourth intercostal space is?
Answer:
a. He finds the suprasternal notch and then moves his finger laterally to the third rib. The fourth
intercostal space is just below the third rib.
b. He finds the angle of Louis and then moves laterally to the first rib. He walks down from there
to the fourth intercostal space.
c. He finds the sternal angle and then moves his finger laterally to the second rib. He then walks
down to the second intercostal space, third rib, third intercostal space, fourth rib and then the
fourth intercostal space.
d. He finds the clavicle. The second intercostal space is just below the clavicle. He then walks
down to third rib, third intercostal space, fourth rib, and then the fourth intercostal space.
e. He finds the angle of Louis and then moves his finger laterally to the third rib. The fourth
intercostal space is just below the third rib.
QUESTION
An elderly patient with a history of smoking two packs of cigarettes a day for 50 years complains
to her physician of progressive shortness of breath. On cardiac examination, the physician feels
the most prominent palpable impulse to be in the xiphoid area. This is most likely a result of
what condition?
Answer:
a. Aortic stenosis
b. Hypertrophic cardiomyopathy c. Hypertension
d. Pulmonary hypertension e. Mitral regurgitation
QUESTION
A newborn baby has an embryologic defect affecting the aortic valve. What other cardiac valve
is most likely to be affected?
Answer:
a. Tricuspid valve
b. Pulmonic valve c. Mitral valve
d. Pyloric valve
e. Eustachian valve
QUESTION
A 77-year-old man is experiencing progressive shortness of breath and dizziness. The patient
undergoes cardiac catheterization, and the systolic blood pressure measured in the left ventricle
is 180 mm Hg, while the systolic blood pressure measured in the aorta is 140 mm Hg. The
patient is most likely experiencing symptoms related to what valvular condition?
Answer:
a. Aortic insufficiency
b. Mitral stenosis c. Aortic stenosis
d. Mitral regurgitation e. Pulmonic stenosis
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