Chapter 19: Thorax and Lungs (by Jarvis)
Which of these statements is true regarding the vertebra prominens? The vertebra
prominens is:
a. The spinous process of C7.
b. Usually nonpalpable in most individuals
с. Opposite the interior border of the scapula.
d. Located next to the manubrium of the sternum. - AnswerA
When performing respiratory assessment on a patient, the nurse notices a costal angle
of approximately 90 degrees. This characteristic is:
a. Observed in patients with kyphosis. b. Indicative of pectus excavatum.
c. A normal finding in a healthy adult.
d. An expected finding in a patient with a barrel chest. - AnswerC
When assessing a patients lungs, the nurse recalls that the left lung:
a. Consists of two lobes.
b. Is divided by the horizontal fissure.
c. Primarily consists of an upper lobe on the posterior chest
d. Is shorter than the right lung because of underlying stomach. - AnswerA
Which statement about apices of the lungs is true? The apices of the lungs:
а. Are at the level of the second rib anteriorly
b. Extend 3 to 4 cm above the inner third of the clavicles.
с. Are located at the sixth rib anteriorly and the eighth rib laterally
d. Rest on the diaphragm at the fifth intercostal space in the midclavicular line (MCL). -
AnswerB
During an examination of the anterior thorax, the nurse is aware that the trachea
bifurcates anteriorly at the:
а. Costal angle
b. Sternal angle.
с. Xiphoid process.
d. Suprasternal notch. - AnswerB
During an assessment, the nurse knows that expected assessment findings in the
normal adult lung include the presence of
a. Adventitious sounds and limited chest expansion.
b. Increased tactile fremitus and dull percussion tones.
c. Muffled voice sounds and symmetric tactile fremitus.
d. Absent voice sounds and hyperresonant percussion tones. - AnswerC
The primary muscles of respiration include the:
a. Diaphragm and intercostals.
b. Sternomastoids and scaleni.
, с. Trapezii and rectus abdominis.
d. External obliques and pectoralis major. - AnswerA
A 65-year-old patient with a history of heart failure comes to the clinic with complaints of
being awakened from sleep with shortness of breath. Which action by the nurse is most
appropriate?
a. Obtaining a detailed health history of the patients allergies and a history of asthma
b. Telling the patient to sleep on his or her right side to facilitate ease of respirations
c. Assessing for other signs and symptoms of paroxysmal nocturnal dyspnea
d. Assuring the patient that paroxysmal nocturnal dyspnea is normal and will probably
resolve within the next week - AnswerC
When assessing tactile fremitus, the nurse recalls that it is normal to feel tactile fremitus
most intensely over which location?
а. Between the scapulae
b. Third intercostal space, MCL
с. Fifth intercostal space, midaxillary line (MAL)
d. Over the lower lobes, posterior side - AnswerA
The nurse is reviewing the technique of palpating for tactile fremitus with a new
graduate. Which statement by the graduate nurse reflects a correct understanding of
tactile fremitus? Tactile fremitus:
a. Is caused by moisture in the alveoli. b. Indicates that air is present in the
subcutaneous tissues.
c. Is caused by sounds generated from the larynx.
d. Reflects the blood flow through the pulmonary arteries. - AnswerC
During percussion, the nurse knows that a dull percussion note elicited over a lung lobe
most likely results from:
a. Shallow breathing.
b. Normal lung tissue.
c. Decreased adipose tissue.
d. Increased density of lung tissue. - AnswerD
The nurse is observing the auscultation technique of another nurse. The correct method
to use when progressing from one auscultatory site on the thorax to another is
___________comparison.
a. Side-to-side
b. Top-to-bottom
с. Posterior-to-anterior
d. Interspace-by-interspace - AnswerA
Which of these statements is true regarding the vertebra prominens? The vertebra
prominens is:
a. The spinous process of C7.
b. Usually nonpalpable in most individuals
с. Opposite the interior border of the scapula.
d. Located next to the manubrium of the sternum. - AnswerA
When performing respiratory assessment on a patient, the nurse notices a costal angle
of approximately 90 degrees. This characteristic is:
a. Observed in patients with kyphosis. b. Indicative of pectus excavatum.
c. A normal finding in a healthy adult.
d. An expected finding in a patient with a barrel chest. - AnswerC
When assessing a patients lungs, the nurse recalls that the left lung:
a. Consists of two lobes.
b. Is divided by the horizontal fissure.
c. Primarily consists of an upper lobe on the posterior chest
d. Is shorter than the right lung because of underlying stomach. - AnswerA
Which statement about apices of the lungs is true? The apices of the lungs:
а. Are at the level of the second rib anteriorly
b. Extend 3 to 4 cm above the inner third of the clavicles.
с. Are located at the sixth rib anteriorly and the eighth rib laterally
d. Rest on the diaphragm at the fifth intercostal space in the midclavicular line (MCL). -
AnswerB
During an examination of the anterior thorax, the nurse is aware that the trachea
bifurcates anteriorly at the:
а. Costal angle
b. Sternal angle.
с. Xiphoid process.
d. Suprasternal notch. - AnswerB
During an assessment, the nurse knows that expected assessment findings in the
normal adult lung include the presence of
a. Adventitious sounds and limited chest expansion.
b. Increased tactile fremitus and dull percussion tones.
c. Muffled voice sounds and symmetric tactile fremitus.
d. Absent voice sounds and hyperresonant percussion tones. - AnswerC
The primary muscles of respiration include the:
a. Diaphragm and intercostals.
b. Sternomastoids and scaleni.
, с. Trapezii and rectus abdominis.
d. External obliques and pectoralis major. - AnswerA
A 65-year-old patient with a history of heart failure comes to the clinic with complaints of
being awakened from sleep with shortness of breath. Which action by the nurse is most
appropriate?
a. Obtaining a detailed health history of the patients allergies and a history of asthma
b. Telling the patient to sleep on his or her right side to facilitate ease of respirations
c. Assessing for other signs and symptoms of paroxysmal nocturnal dyspnea
d. Assuring the patient that paroxysmal nocturnal dyspnea is normal and will probably
resolve within the next week - AnswerC
When assessing tactile fremitus, the nurse recalls that it is normal to feel tactile fremitus
most intensely over which location?
а. Between the scapulae
b. Third intercostal space, MCL
с. Fifth intercostal space, midaxillary line (MAL)
d. Over the lower lobes, posterior side - AnswerA
The nurse is reviewing the technique of palpating for tactile fremitus with a new
graduate. Which statement by the graduate nurse reflects a correct understanding of
tactile fremitus? Tactile fremitus:
a. Is caused by moisture in the alveoli. b. Indicates that air is present in the
subcutaneous tissues.
c. Is caused by sounds generated from the larynx.
d. Reflects the blood flow through the pulmonary arteries. - AnswerC
During percussion, the nurse knows that a dull percussion note elicited over a lung lobe
most likely results from:
a. Shallow breathing.
b. Normal lung tissue.
c. Decreased adipose tissue.
d. Increased density of lung tissue. - AnswerD
The nurse is observing the auscultation technique of another nurse. The correct method
to use when progressing from one auscultatory site on the thorax to another is
___________comparison.
a. Side-to-side
b. Top-to-bottom
с. Posterior-to-anterior
d. Interspace-by-interspace - AnswerA
