NSG 6020 MIDTERM QUESTIONS AND ANSWERS
What age does bronchiolitis occur? - Answers - most common at age 6 months- does
not occur after age 2
main symptom of bronchiolitis - Answers - wheezing-lasts about 7 days
most common cause of bronchiolitis - Answers - RSV
Treatment for bronchiolitis - Answers - No specific treatment
Order of lung exam - Answers - inspect, palpate, percuss, auscultate
Pectus Excavatum - Answers - congenital posterior displacement of lower aspect of
sternum
-hollowed-out appearance
-concave appearance of lower sternum
Pectus carinatum - Answers - at birth
-post CABG
mid childhood and 11-14 year old pubertal males undergoing a growth spurt
-convex deformity
-97% have MVP
Barrel Chest - Answers - associated with emphysema and lung hyperinflation
-accompanying x-ray demonstrates increased ant-post diameter as well as
diaphragmatic flattening
Tactile fremitus - Answers - palpable vibrations of the bronchiopulmonary tree as the
patient is speaking (99 or 1-2-3)
-impeded in COPD, pulm effusion or pneumothorax
-increased in consolidation and PNA
percussion:
flatness - Answers - (thigh)
Large Pleural effusion
Percussion- dullness - Answers - (liver)
Lobar PNA
Percussion: resonance - Answers - (Lung)
simple chronic bronchitis
Percussion: hyperresonance - Answers - None
-emphysema, pneumothorax
, Percussion: tympany - Answers - (gastric bubble)
-large pneumothorax
Auscultation: vesicular - Answers - soft and low pitched; usually heard over most of both
lungs
Auscultation: bronchial - Answers - louder and higher in pitch; usually heard over the
manubrium
Auscultation: bronchovesicular - Answers - intermediate intensity and pitch; usually
heard over the 1st and 2nd interspaces
Auscultation: tracheal - Answers - over the trachea and neck, very loud
Rhonchi - Answers - low-pitched snore-like sounds, often characterized by secretions
w/in the large airways
-sometimes cleared with a cough
Wheezes - Answers - continuous, high-pitched, musical, sounds that are produced by
air flowing through narrowed bronchi
-predominately expiratory
stridor - Answers - loud, rough, continuous, high-pitched sound that is pronounced
during inspiration
-indicates proximal airway obstruction
absent/attenuated sounds - Answers - NO airflow to the region being auscultated
-can occur in a pneumothorax, hemothorax, pleural effusion, or parenchymal
consolidation
Crackles - Answers - intermittent, nonmusical, very brief, more pronounced during
inspiration
-fine or course
fine (softer, higher in pitch)
course (louder, lower in pitch)
Bronchophony - Answers - ask pt to say "99"
-should be muffled and indistinct
-CLEAR sounds are called bronchophony
Egophony - Answers - ask pt to say "ee"
-you should hear a muffled long ee sound
-"ee" sounds like "ay" it is positive and called egophony
-present over consolidation
What age does bronchiolitis occur? - Answers - most common at age 6 months- does
not occur after age 2
main symptom of bronchiolitis - Answers - wheezing-lasts about 7 days
most common cause of bronchiolitis - Answers - RSV
Treatment for bronchiolitis - Answers - No specific treatment
Order of lung exam - Answers - inspect, palpate, percuss, auscultate
Pectus Excavatum - Answers - congenital posterior displacement of lower aspect of
sternum
-hollowed-out appearance
-concave appearance of lower sternum
Pectus carinatum - Answers - at birth
-post CABG
mid childhood and 11-14 year old pubertal males undergoing a growth spurt
-convex deformity
-97% have MVP
Barrel Chest - Answers - associated with emphysema and lung hyperinflation
-accompanying x-ray demonstrates increased ant-post diameter as well as
diaphragmatic flattening
Tactile fremitus - Answers - palpable vibrations of the bronchiopulmonary tree as the
patient is speaking (99 or 1-2-3)
-impeded in COPD, pulm effusion or pneumothorax
-increased in consolidation and PNA
percussion:
flatness - Answers - (thigh)
Large Pleural effusion
Percussion- dullness - Answers - (liver)
Lobar PNA
Percussion: resonance - Answers - (Lung)
simple chronic bronchitis
Percussion: hyperresonance - Answers - None
-emphysema, pneumothorax
, Percussion: tympany - Answers - (gastric bubble)
-large pneumothorax
Auscultation: vesicular - Answers - soft and low pitched; usually heard over most of both
lungs
Auscultation: bronchial - Answers - louder and higher in pitch; usually heard over the
manubrium
Auscultation: bronchovesicular - Answers - intermediate intensity and pitch; usually
heard over the 1st and 2nd interspaces
Auscultation: tracheal - Answers - over the trachea and neck, very loud
Rhonchi - Answers - low-pitched snore-like sounds, often characterized by secretions
w/in the large airways
-sometimes cleared with a cough
Wheezes - Answers - continuous, high-pitched, musical, sounds that are produced by
air flowing through narrowed bronchi
-predominately expiratory
stridor - Answers - loud, rough, continuous, high-pitched sound that is pronounced
during inspiration
-indicates proximal airway obstruction
absent/attenuated sounds - Answers - NO airflow to the region being auscultated
-can occur in a pneumothorax, hemothorax, pleural effusion, or parenchymal
consolidation
Crackles - Answers - intermittent, nonmusical, very brief, more pronounced during
inspiration
-fine or course
fine (softer, higher in pitch)
course (louder, lower in pitch)
Bronchophony - Answers - ask pt to say "99"
-should be muffled and indistinct
-CLEAR sounds are called bronchophony
Egophony - Answers - ask pt to say "ee"
-you should hear a muffled long ee sound
-"ee" sounds like "ay" it is positive and called egophony
-present over consolidation
