APEA Final Study Exam Questions and Answers
100%
A 3 year-old presents with a history of fever and cough over the past 24 hours.
Findings on exam reveal: temperature of 102°F, apical heart rate of 157
beats/minute, and respiratory rate of 40 breaths/minute. Tachypnea in this child
is most likely related to
Paradoxical respirations.
The child's febrile state. Correct
The child's age.
An airway obstruction.
Explanation:
In children, heart and respiratory rates will increase with fever. For every degree
of fever the respiratory rate will increase 3-4 breaths/minutes and the heart rate
will increase 8-10 beats/minute.
Question 2
Q) When percussing the lower posterior chest, begin by:
Correct: standing on the side rather than directly behind the patient.
Having the patient lie supine on the examining
table. Carefully palpating any area the patient
has reported pain. Using the ball or the ulnar
surface of the hand.
Explanation:
,When percussing the lower posterior chest, stand on the side rather than directly
behind the patient. This position allows the ability to place the pleximeter finger
more firmly on the chest and the plexor is more effective in making a better
percussion note. If the patient is lying supine, the posterior chest will not be able
to be percussed. Palpating painful areas is not percussion, so is not correct. Using
the bony part of the palm at the base of the fingers or the ulnar surface is a
technique used to detect tactile fremitus.
Question 3
The palpation technique used to assess respiratory expansion of the chest is
placing the hands on the eight or tenth ribs posteriorly with the thumbs close to
the vertebrae, sliding the hand medially and grasping a small fold of skin between
the thumbs. Then:
,Ask the patient to cough and note chest expansion.
Correct: ask the patient to take a deep breath and note any delay in expansion
during inhalation.
Have the patient hold his breath for 15 seconds then note
chest expansion. Have the patient exhale forcefully noting
expansion on expiration.
Explanation:
To assess the respiratory expansion of the chest, the examiner places his hands
on the eight or tenth ribs posteriorly with the thumbs close to the vertebrae,
slides the hand medially and grasps a small fold of skin between the thumbs then
asks the patient to take a deep breath. The thumbs should move evenly away
from the vertebrae during inspiration and there should be no delay in expansion.
Question 4
When trying to differentiate between hemoptysis or blood streaked material,
which one of the following observations is correct?
Hemoptysis is seen frequently in infants, children, and adolescents with allergic
rhinitis.
Blood originating in the stomach is usually brighter than blood originating from
the respiratory tract. Hemoptysis is common in children with cystic fibrosis.
Correct: Blood streaked material often originates from the gastrointestinal tract.
Explanation:
Hemoptysis is rare in infants, children, and adolescents, although common in
those with cystic fibrosis. Blood originating in the stomach is usually darker than
blood from the respiratory tract and may be mixed with food particles. Blood or
blood-streaked material may originate in the mouth, pharynx, or less commonly
from the gastrointestinal tract.
, Question 5
When percussing the chest in a patient who has left sided heart failure, the sound
emanated would be:
Resonant. Correct
Dull tympany.
Diffusely
Hyper resonant.
Explanation: A patient with left sided heart failure experiences increased
pressure in the pulmonary veins causing congestion and interstitial edema.
Percussion sounds emitted would most likely be
100%
A 3 year-old presents with a history of fever and cough over the past 24 hours.
Findings on exam reveal: temperature of 102°F, apical heart rate of 157
beats/minute, and respiratory rate of 40 breaths/minute. Tachypnea in this child
is most likely related to
Paradoxical respirations.
The child's febrile state. Correct
The child's age.
An airway obstruction.
Explanation:
In children, heart and respiratory rates will increase with fever. For every degree
of fever the respiratory rate will increase 3-4 breaths/minutes and the heart rate
will increase 8-10 beats/minute.
Question 2
Q) When percussing the lower posterior chest, begin by:
Correct: standing on the side rather than directly behind the patient.
Having the patient lie supine on the examining
table. Carefully palpating any area the patient
has reported pain. Using the ball or the ulnar
surface of the hand.
Explanation:
,When percussing the lower posterior chest, stand on the side rather than directly
behind the patient. This position allows the ability to place the pleximeter finger
more firmly on the chest and the plexor is more effective in making a better
percussion note. If the patient is lying supine, the posterior chest will not be able
to be percussed. Palpating painful areas is not percussion, so is not correct. Using
the bony part of the palm at the base of the fingers or the ulnar surface is a
technique used to detect tactile fremitus.
Question 3
The palpation technique used to assess respiratory expansion of the chest is
placing the hands on the eight or tenth ribs posteriorly with the thumbs close to
the vertebrae, sliding the hand medially and grasping a small fold of skin between
the thumbs. Then:
,Ask the patient to cough and note chest expansion.
Correct: ask the patient to take a deep breath and note any delay in expansion
during inhalation.
Have the patient hold his breath for 15 seconds then note
chest expansion. Have the patient exhale forcefully noting
expansion on expiration.
Explanation:
To assess the respiratory expansion of the chest, the examiner places his hands
on the eight or tenth ribs posteriorly with the thumbs close to the vertebrae,
slides the hand medially and grasps a small fold of skin between the thumbs then
asks the patient to take a deep breath. The thumbs should move evenly away
from the vertebrae during inspiration and there should be no delay in expansion.
Question 4
When trying to differentiate between hemoptysis or blood streaked material,
which one of the following observations is correct?
Hemoptysis is seen frequently in infants, children, and adolescents with allergic
rhinitis.
Blood originating in the stomach is usually brighter than blood originating from
the respiratory tract. Hemoptysis is common in children with cystic fibrosis.
Correct: Blood streaked material often originates from the gastrointestinal tract.
Explanation:
Hemoptysis is rare in infants, children, and adolescents, although common in
those with cystic fibrosis. Blood originating in the stomach is usually darker than
blood from the respiratory tract and may be mixed with food particles. Blood or
blood-streaked material may originate in the mouth, pharynx, or less commonly
from the gastrointestinal tract.
, Question 5
When percussing the chest in a patient who has left sided heart failure, the sound
emanated would be:
Resonant. Correct
Dull tympany.
Diffusely
Hyper resonant.
Explanation: A patient with left sided heart failure experiences increased
pressure in the pulmonary veins causing congestion and interstitial edema.
Percussion sounds emitted would most likely be
