C HAPTER 8: T HE T HORAX AND L UNGS
MULTIPLE CHOICE
1. When auscultating the lungs of an adult patient, the nurse notes that low -
pitched, soft breath s ounds are heard over the posterior lower lobes, with
inspiration being longer than expiration. The nurse interprets that these
sounds are:
a. Normall y auscultated over the trachea.
b. Bronchial breath sounds and normal in that location.
c. Vesicular breath sound s and normal in that location.
d. Bronchovesicular breath sounds and normal in that location.
ANS: C
Vesicular breath sounds are low -pitched, soft sounds with inspiration
being longer than expiration. These breath sounds are expected over
the peripheral lung fields where air flows through smaller bronchioles
and alveoli.
DIF: Cognitive Level: Appl ying (Application) REF: p. 430 MSC:
Client Needs: Safe and Effective Care Environment: Management of
Care
2. The nurse is auscultating the chest in an adult. Which tec hnique is
correct?
a. Instructing the patient to take deep, rapid breaths
b. Instructing the patient to breathe in and out through his or her nose
, c. Firml y holding the diaphragm of the stethoscope against the chest
d. Lightl y holding the bell of the stethoscope a gainst the chest to
avoid friction
ANS: C
Firml y holding the diaphragm of the stethoscope against the chest is
the correct way to auscultate breath sounds. The patient should be
instructed to breathe through his or her mouth, a little deeper than
usual, but not to hyperventilate.
DIF: Cognitive Level: Understanding (Comprehension) REF: p. 429
MSC: Client Needs: Safe and Effective Care Environment:
Management of Care
3. The nurse is percussing over the lungs of a patient with pneumonia. The
nurse knows that per cussion over an area of atelectasis in the lungs will
reveal:
a. Dullness.
b. Tympany.
c. Resonance.
d. Hyperresonance.
ANS: A
A dull percussion note signals an abnormal densit y in the lungs, as
with pneumonia, pleural effusion, atelectasis, or a tumor.
, DIF: Cognitive Level: Understanding (Comprehension) REF: p. 427
MSC: Client Needs: Physiologic Integrit y: Physiologic
Adaptation
4. During auscultation of the lungs, the nurse expects decreased breath
sounds to be heard in which situation?
a. When the bronchial tree is obstructed
b. When adventitious sounds are present
c. In conjunction with whispered pectoriloquy
d. In conditions of consolidation, such as pneumonia
ANS: A
Decreased or absen t breath sounds occur when the bronchial tree is
obstructed, as in emphysema, and when sound transmission is
obstructed, as in pleurisy, pneumothorax, or pleural effusion.
DIF: Cognitive Level: Understanding (Comprehension) REF: p. 430
MSC: Client Needs: P hysiologic Integrit y: Physiologic
Adaptation
5. The nurse knows that a normal finding when assessing the respiratory
s ystem of an older adult is:
a. Increased thoracic expansion.
b. Decreased mobilit y of the thorax.
c. Decreased anteroposterior diameter.
d. Bronchovesicular breath sounds throughout the lungs.
ANS: B
MULTIPLE CHOICE
1. When auscultating the lungs of an adult patient, the nurse notes that low -
pitched, soft breath s ounds are heard over the posterior lower lobes, with
inspiration being longer than expiration. The nurse interprets that these
sounds are:
a. Normall y auscultated over the trachea.
b. Bronchial breath sounds and normal in that location.
c. Vesicular breath sound s and normal in that location.
d. Bronchovesicular breath sounds and normal in that location.
ANS: C
Vesicular breath sounds are low -pitched, soft sounds with inspiration
being longer than expiration. These breath sounds are expected over
the peripheral lung fields where air flows through smaller bronchioles
and alveoli.
DIF: Cognitive Level: Appl ying (Application) REF: p. 430 MSC:
Client Needs: Safe and Effective Care Environment: Management of
Care
2. The nurse is auscultating the chest in an adult. Which tec hnique is
correct?
a. Instructing the patient to take deep, rapid breaths
b. Instructing the patient to breathe in and out through his or her nose
, c. Firml y holding the diaphragm of the stethoscope against the chest
d. Lightl y holding the bell of the stethoscope a gainst the chest to
avoid friction
ANS: C
Firml y holding the diaphragm of the stethoscope against the chest is
the correct way to auscultate breath sounds. The patient should be
instructed to breathe through his or her mouth, a little deeper than
usual, but not to hyperventilate.
DIF: Cognitive Level: Understanding (Comprehension) REF: p. 429
MSC: Client Needs: Safe and Effective Care Environment:
Management of Care
3. The nurse is percussing over the lungs of a patient with pneumonia. The
nurse knows that per cussion over an area of atelectasis in the lungs will
reveal:
a. Dullness.
b. Tympany.
c. Resonance.
d. Hyperresonance.
ANS: A
A dull percussion note signals an abnormal densit y in the lungs, as
with pneumonia, pleural effusion, atelectasis, or a tumor.
, DIF: Cognitive Level: Understanding (Comprehension) REF: p. 427
MSC: Client Needs: Physiologic Integrit y: Physiologic
Adaptation
4. During auscultation of the lungs, the nurse expects decreased breath
sounds to be heard in which situation?
a. When the bronchial tree is obstructed
b. When adventitious sounds are present
c. In conjunction with whispered pectoriloquy
d. In conditions of consolidation, such as pneumonia
ANS: A
Decreased or absen t breath sounds occur when the bronchial tree is
obstructed, as in emphysema, and when sound transmission is
obstructed, as in pleurisy, pneumothorax, or pleural effusion.
DIF: Cognitive Level: Understanding (Comprehension) REF: p. 430
MSC: Client Needs: P hysiologic Integrit y: Physiologic
Adaptation
5. The nurse knows that a normal finding when assessing the respiratory
s ystem of an older adult is:
a. Increased thoracic expansion.
b. Decreased mobilit y of the thorax.
c. Decreased anteroposterior diameter.
d. Bronchovesicular breath sounds throughout the lungs.
ANS: B
