Nokea
A patient was admitted yesterday with pneumonia. When auscultating his breath sounds you detect rales in the right lower lobe. How quickly should you reassess this abnormal finding?
- A. Within 15 minutes
- B. Within 60 minutes
- C. In less than 2 hours
- D. In 4 hours or less
- E. When the patient complains of dyspnea
Correct Answer: C
Rationale: Rales (crackles) indicate fluid in the lungs, requiring reassessment within 2 hours to monitor for worsening pneumonia or respiratory distress.
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The cone portion of each lung extends approximately 1 inch above the medial aspect of the clavicle and is called what?
- A. Lower lobe
- B. PMI
- C. Bronchus
- D. Apex
- E. Base
Correct Answer: D
Rationale: The apex is the top portion of the lung extending above the clavicle.
Which lobe(s) of the lungs is(are) accessible for auscultation both anteriorly and posteriorly?
- A. The left upper lobe
- B. The left lower lobe
- C. The right upper lobe
- D. The right middle lobe
- E. The right lower lobe
Correct Answer: A,C
Rationale: The left and right upper lobes can be auscultated anteriorly and posteriorly due to their position in the chest.
Percussion of a patient's abdomen and chest provides you with what information about the patient?
- A. Density of underlying structures
- B. Presence of fluid or air
- C. Organ size and position
- D. All of the above
Correct Answer: D
Rationale: Percussion reveals density, fluid, air, and organ size/position through sound differences (e.g., dullness, tympany).
You know that when assessing the pulse there is more than one characteristic you should assess. Which of the following best identifies the characteristics you must assess?
- A. Rate, rhythm, and strength
- B. Rate, volume, and strength
- C. Regularity and number of beats per minute
- D. Site of PMI, rate, and strength
Correct Answer: A
Rationale: Pulse assessment includes rate (beats per minute), Rhythm (regular or irregular), and strength (force of the pulse).
Which of the following can be indicators of a person's hydration level?
- A. Color of nailbeds
- B. Temperature of skin on lower extremities
- C. Sluggish capillary refill
- D. Positive consensual reflex
- E. Weight
- F. Thirst
Correct Answer: C,E,F
Rationale: Sluggish capillary refill (C), weight changes (E), and thirst (F) are direct indicators of hydration status, reflecting fluid volume and body water needs.