A nurse is auscultating breath sounds of a client with pneumonia. The nurse should recognize that lung consolidation produces which adventitious sound?

Bronchial sounds

Crackles

Whispered pectoriloquy

Bronchophony

Answer and Explanation

The Correct Answer is B

A) Bronchial sounds:
Bronchial breath sounds are normal over the trachea and large bronchi but are considered abnormal if heard over the peripheral lung fields. In the case of pneumonia or other types of lung consolidation, bronchial sounds may be transmitted to more peripheral areas of the lungs where they are typically not heard. However, bronchial sounds themselves are not the specific adventitious sound produced by lung consolidation, though their presence can suggest consolidation.

B) Crackles:
Crackles (also known as rales) are the adventitious sounds most commonly associated with lung consolidation, such as in pneumonia. Crackles occur when air bubbles move through the fluid or mucus in the alveoli and small airways. In pneumonia, the inflammation and accumulation of fluid or pus in the alveoli (consolidation) causes crackling or popping sounds during inspiration. Crackles are a key indicator of consolidation in the lungs, making this the correct choice.

C) Whispered pectoriloquy:
Whispered pectoriloquy is a type of vocal fremitus that can be heard during auscultation when the patient whispers a phrase. It is an abnormal finding that can occur in the presence of lung consolidation, where the whispered sounds are heard more clearly or louder than normal. While it is related to lung consolidation, it is not an adventitious sound like crackles. Instead, it is a sign that can indicate the presence of consolidation when paired with other findings like bronchophony.

D) Bronchophony:
Bronchophony is the increased clarity and intensity of spoken sounds during auscultation, which occurs in areas of lung consolidation. When a patient says "99," the sound may become more distinct and louder when consolidation is present. Although bronchophony is another finding that may suggest consolidation, it is a vocal sound rather than an adventitious breath sound. Bronchophony refers specifically to changes in voice transmission, not to the crackling or popping sounds caused by consolidation itself.

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Correct Answer is A

Explanation

A) II:
This is the correct answer. The optic nerve (cranial nerve II) is responsible for visual acuity, as it transmits visual information from the retina to the brain. When assessing visual acuity, the nurse is evaluating the function of the optic nerve, which is responsible for the sense of vision. Therefore, cranial nerve II should be assessed during a visual acuity exam.

B) I:
This is incorrect. The olfactory nerve (cranial nerve I) is responsible for the sense of smell, not vision. Visual acuity is not related to the olfactory nerve, so it is not involved in this type of assessment.

C) VI:
This is incorrect. The abducens nerve (cranial nerve VI) controls the lateral rectus muscle of the eye, which is responsible for outward eye movement. While cranial nerve VI plays a role in eye movement, it is not directly involved in measuring visual acuity, which pertains to the function of the optic nerve.

D) IV:
This is incorrect. The trochlear nerve (cranial nerve IV) controls the superior oblique muscle, which helps with eye movement, specifically downward and inward eye movements. This nerve is not involved in measuring visual acuity.

A. The presence of cerumen in the ear canal B. A shiny, pearly white color tympanic membrane C. A clear presence of a cone of light D. A yellow or amber color to the tympanic membrane

Correct Answer is D

Explanation

A) The presence of cerumen in the ear canal:
This is incorrect. The presence of cerumen (earwax) in the ear canal is not inherently abnormal. In fact, cerumen is a natural substance produced by the body to protect and clean the ear canal. While excessive buildup can lead to blockages or hearing impairment, some amount of cerumen is normal and does not indicate an abnormal finding.

B) A shiny, pearly white color tympanic membrane:
This is incorrect. A shiny, pearly white tympanic membrane is a normal finding. This color and appearance indicate a healthy, intact eardrum. The tympanic membrane should be translucent with a smooth surface and this typical pearly appearance in a healthy ear.

C) A clear presence of a cone of light:
This is incorrect. The cone of light is a normal finding during otoscopic examination. It is a reflection of the otoscope light off the tympanic membrane and should be visible in the anterior-inferior quadrant of the tympanic membrane. The presence of the cone of light suggests that the eardrum is intact and in a normal position.

D) A yellow or amber color to the tympanic membrane:
This is the correct answer. A yellow or amber color of the tympanic membrane suggests the presence of fluid behind the eardrum, which may indicate an ear infection or otitis media. This color change is considered abnormal and should prompt further investigation, as it can be a sign of inflammation, infection, or the accumulation of fluid in the middle ear.

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A nurse is auscultating breath sounds of a client with pneumonia. The nurse should recognize that lung consolidation produces which adventitious sound?

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Naxlex Comprehensive Predictor Exams

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Correct Answer is A

Explanation

A nurse examines a client's auditory canal and tympanic membrane with an otoscope. The nurse should recognize that which of the following is considered an abnormal finding?

Correct Answer is D

Explanation

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