Nokea
Your instructor has asked you to come to the patient's room to hear a good example of a murmur and a bruit. You know that there are specific instances when you use the bell versus the diaphragm side on your stethoscope and when you use light pressure as opposed to pressing to make a firm seal against the patient's skin. Which of the following correctly describes how to use the bell and diaphragm chest piece of your stethoscope?
- A. Use the flat diaphragm to auscultate lower-pitched sounds
- B. Use the bell to auscultate lower-pitched sounds
- C. When using the bell, press firmly to seal it against the skin
- D. When using the flat diaphragm, press it firmly to seal it against the skin
- E. Murmurs and bruits are considered high-pitched sounds
- F. The S1 and S2 are considered high-pitched sounds
Correct Answer: B,D
Rationale: The bell is used for low-pitched sounds with light pressure, while the diaphragm is pressed firmly for high-pitched sounds like murmurs and bruits.
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Blood pressure can provide you with information regarding which of the following?
- A. Central nervous system
- B. Cardiovascular system
- C. Integumentary system
- D. Renal system
- E. Fluid status
- F. Infection
Correct Answer: B,D,E
Rationale: Blood pressure reflects cardiovascular function (B), renal function (D) through regulation of blood volume, and fluid status (E) as it affects vascular volume.
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.
Describe the assessments that you will perform to establish the status of his renal system and ensure that he is not getting into fluid overload problems.
- A. Urine output, weight, edema, breath sounds
- B. Blood pressure, serum creatinine, BUN
- C. Fluid intake, electrolyte levels, lung auscultation
- D. All of the above
Correct Answer: D
Rationale: Renal system assessment includes urine output, weight, edema, breath sounds, blood pressure, serum creatinine, BUN, fluid intake, and electrolyte levels to monitor for fluid overload.
Which of the two heart sounds is the loudest?
- A. S1
- B. S2
- C. S3
- D. S4
Correct Answer: A
Rationale: S1 is typically louder than S2 because it involves the closure of the mitral and tricuspid valves, which produce a stronger sound.
Score the patient responses on the Glasgow Coma Scale. Calculate the patient's total score. Would you consider this patient as having a significant neurological impairment?
- A. Eye opening to pain: 2, Withdraws from pain: 4, Incomprehensible sounds: 2, Total: 8, Significant impairment
- B. Eye opening to pain: 2, Withdraws from pain: 5, Incomprehensible sounds: 2, Total: 9, Moderate impairment
- C. Eye opening to pain: 3, Withdraws from pain: 4, Incomprehensible sounds: 3, Total: 10, Moderate impairment
- D. Eye opening to pain: 2, Withdraws from pain: 4, Incomprehensible sounds: 3, Total: 9, Moderate impairment
Correct Answer: A
Rationale: Glasgow Coma Scale: Eye opening to pain (2), withdraws from pain (4), incomprehensible sounds (2), total = 8, indicating significant neurological impairment (score ?¤8 is severe).