NR509 Real Bates Test Bank Actual Midterm 2025 LATEST COMPLETE
QUESTION AND ANSWER PLUS RATIONALES Already GRADED A+ 100%
VERIFIED BY EXPERTS
Which of the following anatomic landmark associations is correct?
A) 2nd intercostal space for needle insertion in tension pneumothorax
B) T6 for lower margin of endotracheal tube
C) Sternal angle marks the 4th rib
D) 5th intercostal space for chest tube insertion
A) 2nd intercostal space for needle insertion in tension pneumothorax
The 2nd intercostal space is indeed the correct location for insertion of a needle in tension
pneumothorax. The other answers are incorrect.
.
A 55-year-old smoker complains of chest pain and gestures with a closed fist over her sternum to
describe it. Which of the following diagnoses should you consider because of her gesture?
A) Bronchitis
B) Costochondritis
C) Pericarditis
D) Angina pectoris
D) Angina pectoris
The clenched fist of Levine's sign, while not completely specific for ischemic pain, should
definitely cause you to consider this etiology.
.
A 62-year-old smoker complains of "coughing up small amounts of blood," so you consider
hemoptysis. Which of the following should you also consider?
A) Intestinal bleeding
B) Hematoma of the nasal septum
,C) Epistaxis
D) Bruising of the tongue
C) Epistaxis
When you suspect hemoptysis, you must consider other etiologies for bleeding.
Commonly, epistaxis can mimic this as well as bleeding from the gastrointestinal tract. The other
answers, although they involve bleeding, are contained or distant from the pharynx.
.
Which of the following occurs in respiratory distress?
A) Speaking in sentences of 10-20 words
B) Skin between the ribs moves inward with inspiration
C) Neck muscles are relaxed
D) Patient torso leans posteriorly
B) Skin between the ribs moves inward with inspiration
This description is consistent with retractions that occur with respiratory distress. Other features
include speaking in short sentences, use of accessory muscles, leaning forward
to gain mechanical advantage for the diaphragm, and pursed lip breathing, in which the patient
exhales against his lips, which are pressed together.
Which of the following is consistent with good percussion technique?
A) Allow all of the fingers to touch the chest while performing percussion.
B) Maintain a stiff wrist and hand.
C) Leave the plexor finger on the pleximeter after each strike.
D) Strike the pleximeter over the distal interphalangeal joint.
D) Strike the pleximeter over the distal interphalangeal joint
Percussion takes practice to master. Most struggle initially with keeping the wrist and hand
relaxed. Other challenges include removing the plexor quickly and keeping the other
,fingers off the chest wall.
.
Which of the following percussion notes would you obtain over the gastric bubble?
A) Resonance
B) Tympany
C) Hyperresonance
D) Flatness
B) Tympany
The gastric bubble produces one of the longest percussion notes. A patient with
COPD may have hyperresonance over his chest, while a normal person would have resonance.
Dullness is heard over a normal liver, and flatness is heard if one percusses a large muscle.
Which of the following conditions would produce a hyperresonant percussion note?
A) Large pneumothorax
B) Lobar pneumonia
C) Pleural effusion
D) Empyema
A) Large pneumothorax
There is a great deal of free air in the chest with a large pneumothorax, which
produces a hyperresonant note. The other three conditions produce dullness by dampening the
percussion note with fluid.
.
Which lung sound possesses the characteristics of being louder and higher in pitch, with a short
silence between inspiration and expiration and with expiration being longer than inspiration?
, A) Bronchovesicular
B) Vesicular
C) Bronchial
D) Tracheal
C) Bronchial
A patient complains of shortness of breath for the past few days. On examination, you note late
inspiratory crackles in the lower third of the chest that were not present a week ago.
What is the most likely explanation for these?
A) Asthma
B) COPD
C) Bronchiectasis
D) Heart failure
D) Heart failure
The timing of crackles within inspiration provides important clues. These late
inspiratory crackles that appeared suddenly would be most consistent with heart failure. COPD
and asthma usually produce early inspiratory crackles. Bronchiectasis, as seen in cystic
fibrosis, classically produces mid-inspiratory crackles, but this is not always reliable.
.
When crackles, wheezes, or rhonchi clear with a cough, which of the following is a likely
etiology?
A) Bronchitis
B) Simple asthma
C) Cystic fibrosis
D) Heart failure
A) Bronchitis
Adventitious sounds that clear with cough are usually consistent with bronchitis or
QUESTION AND ANSWER PLUS RATIONALES Already GRADED A+ 100%
VERIFIED BY EXPERTS
Which of the following anatomic landmark associations is correct?
A) 2nd intercostal space for needle insertion in tension pneumothorax
B) T6 for lower margin of endotracheal tube
C) Sternal angle marks the 4th rib
D) 5th intercostal space for chest tube insertion
A) 2nd intercostal space for needle insertion in tension pneumothorax
The 2nd intercostal space is indeed the correct location for insertion of a needle in tension
pneumothorax. The other answers are incorrect.
.
A 55-year-old smoker complains of chest pain and gestures with a closed fist over her sternum to
describe it. Which of the following diagnoses should you consider because of her gesture?
A) Bronchitis
B) Costochondritis
C) Pericarditis
D) Angina pectoris
D) Angina pectoris
The clenched fist of Levine's sign, while not completely specific for ischemic pain, should
definitely cause you to consider this etiology.
.
A 62-year-old smoker complains of "coughing up small amounts of blood," so you consider
hemoptysis. Which of the following should you also consider?
A) Intestinal bleeding
B) Hematoma of the nasal septum
,C) Epistaxis
D) Bruising of the tongue
C) Epistaxis
When you suspect hemoptysis, you must consider other etiologies for bleeding.
Commonly, epistaxis can mimic this as well as bleeding from the gastrointestinal tract. The other
answers, although they involve bleeding, are contained or distant from the pharynx.
.
Which of the following occurs in respiratory distress?
A) Speaking in sentences of 10-20 words
B) Skin between the ribs moves inward with inspiration
C) Neck muscles are relaxed
D) Patient torso leans posteriorly
B) Skin between the ribs moves inward with inspiration
This description is consistent with retractions that occur with respiratory distress. Other features
include speaking in short sentences, use of accessory muscles, leaning forward
to gain mechanical advantage for the diaphragm, and pursed lip breathing, in which the patient
exhales against his lips, which are pressed together.
Which of the following is consistent with good percussion technique?
A) Allow all of the fingers to touch the chest while performing percussion.
B) Maintain a stiff wrist and hand.
C) Leave the plexor finger on the pleximeter after each strike.
D) Strike the pleximeter over the distal interphalangeal joint.
D) Strike the pleximeter over the distal interphalangeal joint
Percussion takes practice to master. Most struggle initially with keeping the wrist and hand
relaxed. Other challenges include removing the plexor quickly and keeping the other
,fingers off the chest wall.
.
Which of the following percussion notes would you obtain over the gastric bubble?
A) Resonance
B) Tympany
C) Hyperresonance
D) Flatness
B) Tympany
The gastric bubble produces one of the longest percussion notes. A patient with
COPD may have hyperresonance over his chest, while a normal person would have resonance.
Dullness is heard over a normal liver, and flatness is heard if one percusses a large muscle.
Which of the following conditions would produce a hyperresonant percussion note?
A) Large pneumothorax
B) Lobar pneumonia
C) Pleural effusion
D) Empyema
A) Large pneumothorax
There is a great deal of free air in the chest with a large pneumothorax, which
produces a hyperresonant note. The other three conditions produce dullness by dampening the
percussion note with fluid.
.
Which lung sound possesses the characteristics of being louder and higher in pitch, with a short
silence between inspiration and expiration and with expiration being longer than inspiration?
, A) Bronchovesicular
B) Vesicular
C) Bronchial
D) Tracheal
C) Bronchial
A patient complains of shortness of breath for the past few days. On examination, you note late
inspiratory crackles in the lower third of the chest that were not present a week ago.
What is the most likely explanation for these?
A) Asthma
B) COPD
C) Bronchiectasis
D) Heart failure
D) Heart failure
The timing of crackles within inspiration provides important clues. These late
inspiratory crackles that appeared suddenly would be most consistent with heart failure. COPD
and asthma usually produce early inspiratory crackles. Bronchiectasis, as seen in cystic
fibrosis, classically produces mid-inspiratory crackles, but this is not always reliable.
.
When crackles, wheezes, or rhonchi clear with a cough, which of the following is a likely
etiology?
A) Bronchitis
B) Simple asthma
C) Cystic fibrosis
D) Heart failure
A) Bronchitis
Adventitious sounds that clear with cough are usually consistent with bronchitis or
