AGNP BOARD EXAM QUESTIONS Respiratory Assessment (51 Questions)
Question:
Which technique best determines whether the tissues in the chest are air-filled, fluid-
filled, or solid?
Auscultation
Palpation
Inspection
Percussion Correct
Explanation:
Percussion of the chest produces audible sounds and palpable vibrations, thus, assisting
in determining if the underlying tissues are filled with air or fluid or if they are solid.
However, percussion will not help detect deep seated lesions. Auscultation assesses the
flow of air through the tracheobronchial tree. Palpation focuses on tenderness and
abnormalities in the overlying skin , respiratory expansion, and fremitus. Inspection
notes the shape of the chest and they way it moves with inspiration and expiration.
Question:
The midaxillary line:
extends from the anterior axillary fold where the pectoralis major muscle inserts.
continues from the posterior axillary fold where the latissimus dorsi muscle inserts.
runs down from the apex of the axilla and lies between and parallel to the anterior
and posterior lines. Correct
extends through the inferior angle of the scapula when the arms are at the sides of
the body.
Explanation:
The anterior axillary line extends from the anterior axillary fold where the pectoralis
major muscle inserts. The posterior axillary line continues from the posterior axillary
fold where the latissimus dorsi muscle inserts. The midaxillary line runs from the apex of
the axilla and lies between and parallel to the other two. The scapular line extends
through the inferior angle of the scapula when the arms are at the sides of the body.
Question:
When percussing the lower posterior chest, begin by:
standing on the side rather than directly behind the patient. Correct
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:
A 65-year-old obese man with a past medical history of hypertension complains of
increased fatigue during the day. The practitioner orders a polysomnogram to test for:
congestive heart failure (CHF).
gastroesophageal reflux disease (GERD).
obstructive sleep apnea (OSA). Correct
chronic obstructive pulmonary disease (COPD).
Explanation:
A polysomnography is a standard diagnostic test for the diagnosis of obstructive sleep
apnea (OSH) through sleep evaluation. OSH is also referred to as obstructive sleep
apnea-hypopnea. This disorder involves cessation or a significant decrease in airflow in
the presence of breathing effort and is characterized by recurrent episodes of upper
airway collapse during sleep. It is also associated with excessive daytime sleepiness.
Question:
Pain from pleurisy may be referred to the:
right shoulder.
retrosternal area.
epigastric area. Correct
back.
Explanation:
Referred pain is defined as pain that is felt in more distal sites than the initial pain site.
Pain from pleurisy or inferior wall myocardial infarction may be referred to the epigastric
area. Referred pain from the biliary tree may be perceived in the right shoulder or the
right posterior chest. Referred pain of duodenal or pancreatic origin may be referred to
the back. Heartburn may be associated with retrosternal burning pain.
Question:
An acute viral illness that presents with a burning retrosternal discomfort and a dry
cough is suggestive of:
tracheobronchitis. Correct
chronic bronchitis.
bronchiectasis.
laryngitis.
Explanation:
An acute viral illness that presents with a burning retrosternal discomfort and a dry
cough is tracheobronchitis. An acute, mild illness associated with viral nasopharyngitis
and hoarseness is laryngitis. The initial cough is dry and nonproductive but may become
productive over time. A chronic bronchitis cough is characteristically productive with
mucoid to purulent sputum and may be blood tinged. Bronchiectasis produces a chronic
cough with sputum that is copious and foul-smelling. It may be blood tinged or bloody.
Question:
When examining a patient for chest expansion, begin by:
hyperextending the examiner's middle finger of the left hand (pleximeter finger) and
pressing its distal interphalangeal joint firmly on the surface to be examined.
, placing the thumbs of the examiner at about the level of the tenth ribs with the
fingers loosely grasping and parallel to the lateral rib cage. Correct
positioning the examiner's right forearm close to the chest surface with the hand
cocked upward.
standing on the side rather than directly behind the patient.
Explanation:
When examining a patient for chest expansion, begin by placing the thumbs of the
examiner at about the level of the tenth ribs with the fingers loosely grasping and
parallel to the lateral rib cage and slide them medially just enough to raise a loose fold
of skin on each side of between the thumb and the spine. Watch chest expansion as the
patient inhales and exhales checking for symmetry and range. The other choices are
steps used when percussing the chest.
Question:
A patient who presents with a long history of cigarette smoking exhibits a dry to
productive cough with dyspnea and weight loss. These symptoms could be consistent
with:
a pulmonary embolus.
asthma.
a neoplasm of the lung. Correct
chronic obstructive pulmonary disease.
Explanation:
The characteristic cough associated with smoking is usually productive. A long history of
smoking, dry cough, dyspnea, and weight loss could be suggestive of cancer of the
lung. A pulmonary embolus is usually accompanied by a dry to productive bloody
cough, dyspnea, anxiety, chest pain, and fever. Cigarette smoking is not directly linked
to pulmonary embolus. Episodic wheezing and dyspnea are characteristic of asthma.
Symptoms associated with chronic obstructive lung disease include slowly progressive
dyspnea accompanied by a scant mucoid sputum. The dyspnea is aggravated by
exertion.
Question:
The hilar region of the lungs describes:
the area around the heart. Correct
the base of the lungs.
the posterior chest.
the upper, anterior area of the chest.
Explanation:
The area around the heart near the center of the lungs describes the hilar region. The
hila are structures consisting of the major bronchi and pulmonary veins and arteries.
Hilar lymph nodes are not normally visible on chest X-ray.
Question:
A condition associated with a chronic cough that produces copious amounts of purulent
sputum is most likely:
tracheobronchitis.
chronic bronchitis.
Question:
Which technique best determines whether the tissues in the chest are air-filled, fluid-
filled, or solid?
Auscultation
Palpation
Inspection
Percussion Correct
Explanation:
Percussion of the chest produces audible sounds and palpable vibrations, thus, assisting
in determining if the underlying tissues are filled with air or fluid or if they are solid.
However, percussion will not help detect deep seated lesions. Auscultation assesses the
flow of air through the tracheobronchial tree. Palpation focuses on tenderness and
abnormalities in the overlying skin , respiratory expansion, and fremitus. Inspection
notes the shape of the chest and they way it moves with inspiration and expiration.
Question:
The midaxillary line:
extends from the anterior axillary fold where the pectoralis major muscle inserts.
continues from the posterior axillary fold where the latissimus dorsi muscle inserts.
runs down from the apex of the axilla and lies between and parallel to the anterior
and posterior lines. Correct
extends through the inferior angle of the scapula when the arms are at the sides of
the body.
Explanation:
The anterior axillary line extends from the anterior axillary fold where the pectoralis
major muscle inserts. The posterior axillary line continues from the posterior axillary
fold where the latissimus dorsi muscle inserts. The midaxillary line runs from the apex of
the axilla and lies between and parallel to the other two. The scapular line extends
through the inferior angle of the scapula when the arms are at the sides of the body.
Question:
When percussing the lower posterior chest, begin by:
standing on the side rather than directly behind the patient. Correct
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:
A 65-year-old obese man with a past medical history of hypertension complains of
increased fatigue during the day. The practitioner orders a polysomnogram to test for:
congestive heart failure (CHF).
gastroesophageal reflux disease (GERD).
obstructive sleep apnea (OSA). Correct
chronic obstructive pulmonary disease (COPD).
Explanation:
A polysomnography is a standard diagnostic test for the diagnosis of obstructive sleep
apnea (OSH) through sleep evaluation. OSH is also referred to as obstructive sleep
apnea-hypopnea. This disorder involves cessation or a significant decrease in airflow in
the presence of breathing effort and is characterized by recurrent episodes of upper
airway collapse during sleep. It is also associated with excessive daytime sleepiness.
Question:
Pain from pleurisy may be referred to the:
right shoulder.
retrosternal area.
epigastric area. Correct
back.
Explanation:
Referred pain is defined as pain that is felt in more distal sites than the initial pain site.
Pain from pleurisy or inferior wall myocardial infarction may be referred to the epigastric
area. Referred pain from the biliary tree may be perceived in the right shoulder or the
right posterior chest. Referred pain of duodenal or pancreatic origin may be referred to
the back. Heartburn may be associated with retrosternal burning pain.
Question:
An acute viral illness that presents with a burning retrosternal discomfort and a dry
cough is suggestive of:
tracheobronchitis. Correct
chronic bronchitis.
bronchiectasis.
laryngitis.
Explanation:
An acute viral illness that presents with a burning retrosternal discomfort and a dry
cough is tracheobronchitis. An acute, mild illness associated with viral nasopharyngitis
and hoarseness is laryngitis. The initial cough is dry and nonproductive but may become
productive over time. A chronic bronchitis cough is characteristically productive with
mucoid to purulent sputum and may be blood tinged. Bronchiectasis produces a chronic
cough with sputum that is copious and foul-smelling. It may be blood tinged or bloody.
Question:
When examining a patient for chest expansion, begin by:
hyperextending the examiner's middle finger of the left hand (pleximeter finger) and
pressing its distal interphalangeal joint firmly on the surface to be examined.
, placing the thumbs of the examiner at about the level of the tenth ribs with the
fingers loosely grasping and parallel to the lateral rib cage. Correct
positioning the examiner's right forearm close to the chest surface with the hand
cocked upward.
standing on the side rather than directly behind the patient.
Explanation:
When examining a patient for chest expansion, begin by placing the thumbs of the
examiner at about the level of the tenth ribs with the fingers loosely grasping and
parallel to the lateral rib cage and slide them medially just enough to raise a loose fold
of skin on each side of between the thumb and the spine. Watch chest expansion as the
patient inhales and exhales checking for symmetry and range. The other choices are
steps used when percussing the chest.
Question:
A patient who presents with a long history of cigarette smoking exhibits a dry to
productive cough with dyspnea and weight loss. These symptoms could be consistent
with:
a pulmonary embolus.
asthma.
a neoplasm of the lung. Correct
chronic obstructive pulmonary disease.
Explanation:
The characteristic cough associated with smoking is usually productive. A long history of
smoking, dry cough, dyspnea, and weight loss could be suggestive of cancer of the
lung. A pulmonary embolus is usually accompanied by a dry to productive bloody
cough, dyspnea, anxiety, chest pain, and fever. Cigarette smoking is not directly linked
to pulmonary embolus. Episodic wheezing and dyspnea are characteristic of asthma.
Symptoms associated with chronic obstructive lung disease include slowly progressive
dyspnea accompanied by a scant mucoid sputum. The dyspnea is aggravated by
exertion.
Question:
The hilar region of the lungs describes:
the area around the heart. Correct
the base of the lungs.
the posterior chest.
the upper, anterior area of the chest.
Explanation:
The area around the heart near the center of the lungs describes the hilar region. The
hila are structures consisting of the major bronchi and pulmonary veins and arteries.
Hilar lymph nodes are not normally visible on chest X-ray.
Question:
A condition associated with a chronic cough that produces copious amounts of purulent
sputum is most likely:
tracheobronchitis.
chronic bronchitis.
