Bedside Assessment of the Patient
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| Splitting of the second heart sound (S2) is normally most pronounced during which of the following? | Inhalation
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| In what space is the patient interview conducted by the clinician? | Personal space
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| To minimize bony interference with percussion on the posterior chest wall, the practitioner should have the patient do which of the following? | Raise his arms above his shoulders.
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| What change in the patient's respiratory breathing pattern is commonly seen with significant fever? | More rapid rate
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| What two factors determine cardiac output? | Stroke volume and heart rate
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| Your patient has an abnormal sensorium. Which of the following is most likely true? | He is confused about where he is.
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| What term is used to describe difficult breathing in the reclining position? | Orthopnea
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| What term best describes a loud, high-pitched continuous sound heard (often with the unaided ear) primarily over the larynx or trachea during inhalation in patients with upper airway obstruction? | Stridor
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| Which of the following changes in the characteristics of wheezing indicate improvement in airway obstruction following bronchodilator therapy? | Lower pitch, shorter duration
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| Which of the following conditions would tend to shift the point of maximal impulse (PMI) farther to the left? | II. Collapse of the left lower lobe IV. Right-sided tension pneumothorax
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| What is the technical term for secretions from the tracheobronchial tree that have not been contaminated by the mouth? | Phlegm
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| What term is used to describe an abnormal anteroposterior curvature of the spine? | Kyphosis
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| In patients with chronic respiratory disease, what does pedal edema indicate? | Right ventricular failure
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| While observing a patient's breathing, you note that the depth and rate first increase, then decrease, followed by a period of apnea. Which of the following terms would you use in charting this observation? | I. Central nervous system disorder II. Congestive heart failure
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| Which of the following is NOT a purpose of the interview? | To identify plans for payment.
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| What is indicated by retractions? | An increase in the work of breathing
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| During auscultation of a patient's chest, you hear coarse crackles throughout both inspiration and expiration. These sound clear when the patient coughs. Which of the following is the most likely cause of these adventitious sounds? | Movement of excessive secretions in the airways.
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| Why should the respiratory therapist perform a blood pressure assessment fairly quickly? | The procedure cuts off blood flow to the forearm temporarily.
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| What is indicated by the presence of central cyanosis? | Respiratory failure
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| What artery is most often used to assess arterial blood pressure? | Brachial
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| Which of the following is/are advantages of the digital blood pressure measurement devices? | They reduce the risk of human error.
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| In auscultating the precordium of a patient, you hear a high-pitched "whooshing" noise occurring simultaneously with S1. This finding is most consistent with which of the following? | Incompetent mitral valve
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| What breathing pattern is associated with severe atelectasis? | Rapid and shallow
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| In which of the following disorders is digital clubbing a common physical sign? | I. Congenital heart disease II. Lung cancer IV. Bronchiectasis
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| What breathing pattern is associated with diabetic ketoacidosis? | Kussmaul breathing
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| Which of the following conditions is most likely to cause a dry, nonproductive cough? | Pulmonary fibrosis
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| While palpating the thorax of a patient who repeats the words "ninety-nine," you note a localized area of decreased tactile fremitus on the lower right side. Which of the following could explain this finding? | II. Right-sided lower pneumothorax. III. Right-sided lower pleural effusion. IV. Obstruction of a bronchus in the right lung.
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| A patient with asthma would tend to exhibit which of the following? | Prolonged exhalation
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| During examination of a patient's extremities, you press firmly for a brief period on a fingernail. You observe that it takes about 5 seconds for the color to return to the nail bed. This finding is most consistent with which of the following? | Reduction in cardiac output or poor peripheral perfusion.
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| All of the following are critical elements of a patient's past medical history except. | Marital status
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| An increase in intensity and clarity of vocal resonance because of enhanced transmission of sound is referred to as which of the following? | Bronchophony
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| Which of the following is TRUE of peripheral cyanosis? | Sign of inadequate tissue perfusion.
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| What is the normal range for pulse pressure? | 30 to 40 mm Hg
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| Inspiratory crackles in patients without excess secretions are most commonly associated with which of the following? | Airways popping open during inspiration
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| What does the presence of stridor indicate? | Upper airway obstruction
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| The vibration created by percussion penetrates the lung to about what depth? | 5 to 7 cm
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| While palpating the chest of a patient who repeats the words "ninety-nine," you note an area of increased tactile fremitus over the left lower lobe. Which of the following could explain this finding? | III. Pneumonia
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| On palpating the neck region of a patient on a mechanical ventilator, you notice a crackling sound and sensation. What is the most likely cause of this observation? | Subcutaneous emphysema
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| While percussing a patient's chest wall, you encounter an area that produces a decreased resonance to percussion. Which of the following are potential causes of this finding? | II. Pleural effusion III. Pneumonia IV. Atelectasis
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| Diastolic murmurs are generally associated with which of the following? | III. Incompetent semilunar valve IV. Stenotic atrioventricular valve
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| What is the normal range for systolic blood pressure in the adult patient? | 90 to 140 mm Hg
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| Which of the following terms is used to describe coughing up blood-streaked sputum? | Hemoptysis
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| What is the most common cause of jugular venous distention (JVD)? | Right-sided heart failure
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| In which of the following conditions might the intensity of the heart sounds be reduced? | I. Heart failure II. Severe obesity III. Pneumothorax IV. Pleural effusion V. Pulmonary hyperinflation
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| What term is used to describe sputum that has pus in it? | Purulent
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| During posterior thoracic palpation of an adult, you notice little or no movement on the right side during a full, deep breath. Which of the following conditions could explain this finding? | II. Right-sided pleural effusion III. Atelectasis of the right lower lobe IV. Right lobar consolidation
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| Which of the following characteristics is least typical for pleuritic chest pain? | Radiates to the arm
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| Which of the following is a common cause of pulsus paradoxus? | Acute asthma attack
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| What disease is associated with a barrel chest? | Emphysema
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| In auscultating the heart sounds of a patient with chronic hypoxemia, you notice a marked increase in the intensity of the second heart sound (S2) and no splitting during inhalation. This finding is most consistent with which of the following? | Pulmonary hypertension
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