A nurse expects to hear which percussion sounds over muscles and tissues?
Flatness.
Dullness.
Tympany.
Resonance.
The Correct Answer is A
Choice A rationale
Flatness is the percussion sound typically heard over muscles and solid tissues. It is characterized by a high-pitched, soft sound, which indicates that the underlying tissue is denser and less air-filled compared to lungs.
Choice B rationale
Dullness is heard over solid organs such as the liver or spleen but not typically over muscles.
Choice C rationale
Tympany is a drum-like sound heard over areas filled with gas, such as the stomach or intestines.
Choice D rationale
Resonance is heard over air-filled lungs and not over muscles and solid tissues.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
While the upper outer quadrant can be prone to injury and calcifications, this is not the primary reason for its importance in breast examinations. Calcifications can occur in various parts of the breast and are often detected through mammography rather than physical examination.
Choice B rationale
Suspensory ligaments, also known as Cooper's ligaments, provide structural support to the breast. They attach to the skin and the underlying pectoral fascia. However, these ligaments are distributed throughout the breast and are not confined to the upper outer quadrant.
Choice C rationale
The upper outer quadrant is not the largest quadrant of the breast. All quadrants have relatively similar sizes. Therefore, the size of the quadrant is not the reason for its importance in breast examinations.
Choice D rationale
The upper outer quadrant of the breast is the most common location for breast tumors. This is because a significant portion of the breast tissue, including the axillary tail (an extension of breast tissue into the armpit), is located in this quadrant. Therefore, careful examination of this area is crucial for early detection of breast cancer.
Correct Answer is D
Explanation
Choice A rationale
The Whisper test evaluates hearing acuity, while the Romberg test assesses balance and proprioception by having the client stand with feet together and eyes closed. Both tests involve sensory assessments but do not directly assess cranial nerve VIII, which is the vestibulocochlear nerve responsible for hearing and balance.
Choice B rationale
PERRLA (pupils equal, round, reactive to light and accommodation) assesses cranial nerves II and III, while EOMs (extraocular movements) assess cranial nerves III, IV, and VI. These tests do not evaluate cranial nerve VIII.
Choice C rationale
Snellen and Rosenbaum tests measure visual acuity for distance and near vision, respectively. These tests assess cranial nerves II and III but do not evaluate cranial nerve VIII.
Choice D rationale
The Rinne and Weber tests are audiometric assessments that specifically evaluate cranial nerve VIII, which controls hearing and balance. The Rinne test compares air and bone conduction of sound, while the Weber test assesses sound lateralization, making them appropriate tests for assessing cranial nerve VIII.
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