A nurse is auscultating the lungs of a client and hears low-pitched, soft breath sounds over the posterior lower lobes and inspiration that is longer than expiration. How should the nurse interpret these findings?

These sounds are normally auscultated over the trachea

These are bronchial breath sounds and normal in that location

These are bronchovesicular breath sounds and normal in that location

These are vesicular breath sounds and normal in that location

Answer and Explanation

The Correct Answer is D

A) These sounds are normally auscultated over the trachea:
This is incorrect. The tracheal breath sounds are harsh, loud, and high-pitched, typically heard over the trachea and larynx. These characteristics differ from the soft, low-pitched sounds described in the question, which are more consistent with vesicular breath sounds.

B) These are bronchial breath sounds and normal in that location:
This is incorrect. Bronchial breath sounds are typically heard over the trachea and larynx, not the lower lobes of the lungs. Bronchial sounds are loud, high-pitched, and have a longer expiration phase compared to inspiration, unlike the low-pitched, soft sounds with longer inspiration that are heard in the lower lobes.

C) These are bronchovesicular breath sounds and normal in that location:
This is incorrect. Bronchovesicular breath sounds are a mix of bronchial and vesicular sounds, with inspiration and expiration of about equal duration. They are typically heard over the major bronchi, near the sternum and between the scapulae, rather than over the posterior lower lobes. The description in the question suggests vesicular breath sounds, which have a longer inspiration phase.

D) These are vesicular breath sounds and normal in that location:
This is the correct answer. Vesicular breath sounds are soft, low-pitched, and typically heard over the peripheral lung fields, including the posterior lower lobes. These sounds have a longer inspiration phase than expiration and are considered normal in this location. The description in the question fits the characteristics of vesicular breath sounds perfectly.

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Correct Answer is C

Explanation

A) Daily, during the shower or bath:
This is incorrect. Performing a breast self-examination (BSE) daily is not necessary. The goal of BSE is to check for any changes over time, not to examine the breasts every day. It's more effective to perform the exam regularly at a consistent time each month.

B) One week after the menstrual period:
This is incorrect. This instruction is relevant for pre-menopausal women, where the hormonal changes associated with the menstrual cycle can cause breast tissue to feel lumpy or swollen. The best time for them to perform a BSE is one week after the menstrual period ends when the breasts are least likely to be swollen or tender. However, for postmenopausal women, this is not necessary, as their hormonal levels are stable throughout the month.

C) On the same day every month:
This is the correct answer. For postmenopausal women, who no longer have menstrual cycles, the best time to perform a breast self-exam is on the same day every month. This ensures consistency and makes it easier for the client to notice any changes in the breast tissue over time. The day chosen should be one that is convenient and easy to remember, and it does not matter whether it is during the shower or bath, as long as the examination is done regularly.

D) Weekly, at the client's convenience:
This is incorrect. While performing a BSE weekly is not necessary, the key is consistency rather than frequency. Performing the exam monthly is sufficient, and it should be on a specific day each month, rather than at the client’s convenience on an irregular basis.

A. Tactile fremitus B. Adventitious sounds C. Friction rub D. Crepitus

Correct Answer is D

Explanation

A) Tactile fremitus:
Tactile fremitus refers to the vibrations felt on the chest wall when a patient speaks. It is assessed by placing the hands on the chest while the patient says "ninety-nine" or a similar phrase. Tactile fremitus is used to detect changes in lung density, such as consolidation or fluid. It does not describe a crackling sensation on the skin surface. A coarse, crackling sensation is more indicative of a different condition.

B) Adventitious sounds:
Adventitious sounds are abnormal lung sounds, such as crackles, wheezes, or rhonchi, heard during auscultation. These sounds are typically related to lung conditions, such as pneumonia, asthma, or fluid accumulation in the lungs. While adventitious sounds are significant findings during auscultation, they do not describe the physical sensation of crackling felt on the skin surface. Therefore, adventitious sounds are not the correct diagnosis for a tactile sensation over the chest.

C) Friction rub:
A friction rub is a harsh, grating sound heard during auscultation and is caused by inflammation of the pleura (the lining around the lungs). It occurs when the inflamed pleural surfaces rub together during breathing. While it is a distinct sound, a friction rub is not a tactile or palpable sensation. The crackling sensation described in the question is not related to the sounds produced by a pleural friction rub.

D) Crepitus:
Crepitus is the correct answer. It refers to a coarse, crackling sensation felt on the skin surface when air or gas is trapped under the skin, often due to conditions such as subcutaneous emphysema. This can occur when there is air leaking from the lungs or other parts of the respiratory system, often following trauma (e.g., rib fractures or surgery) or infection (e.g., gas gangrene). The crackling sensation felt during palpation of the chest wall is characteristic of crepitus, making this the most appropriate finding in this scenario.

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A nurse is auscultating the lungs of a client and hears low-pitched, soft breath sounds over the posterior lower lobes and inspiration that is longer than expiration. How should the nurse interpret these findings?

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Naxlex Comprehensive Predictor Exams

The nurse is discussing Breast Self Examination (BSE) with a postmenopausal client. What instructions should the nurse give to the client about the correct time to perform BSE?

Correct Answer is C

Explanation

A nurse is palpating a client's anterior chest wall and notices a course, crackling sensation over the skin surface. Which of the following should the nurse suspect from these findings?

Correct Answer is D

Explanation

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