A nurse is examining a client for tactile fremitus. The nurse should understand that what action is of primary importance when examining for tactile fremitus?

Palpate the chest symmetrically

Ask the client to cough

Use the bell of the stethoscope

instruct the client to breathe deeply

Answer and Explanation

The Correct Answer is A

A) Palpate the chest symmetrically:
Palpating the chest symmetrically is crucial when assessing tactile fremitus, as it allows the nurse to compare the intensity of vibrations felt on both sides of the chest. Tactile fremitus refers to the palpable vibrations transmitted through the bronchopulmonary system when a person speaks or breathes. Symmetrical palpation ensures that the nurse can detect any differences in fremitus, which may indicate abnormalities such as lung consolidation (e.g., pneumonia), pleural effusion, or pneumothorax. Uneven fremitus can suggest a pathological condition, and symmetrical palpation helps identify these variations.

B) Ask the client to cough:
Asking the client to cough is not directly related to the assessment of tactile fremitus. Coughing may be used in other aspects of the respiratory assessment (e.g., to clear secretions or to assess for a productive cough), but it is not necessary for palpating fremitus. Tactile fremitus is assessed while the client is speaking (e.g., repeating the phrase "ninety-nine") or breathing, not coughing.

C) Use the bell of the stethoscope:
The bell of the stethoscope is used for auscultating low-pitched sounds, such as heart murmurs or some lung sounds (e.g., certain adventitious sounds like crackles or wheezes). However, it is not used for palpating tactile fremitus, which is a physical exam technique that involves using the hands to feel for vibrations. Fremitus is a tactile (not auscultatory) finding, so the stethoscope, whether bell or diaphragm, is not relevant in this assessment.

D) Instruct the client to breathe deeply:
While it is important for the client to breathe deeply during a lung exam, deep breathing is not directly required for assessing tactile fremitus. Tactile fremitus is typically assessed while the client is speaking. When the client repeats a phrase like "ninety-nine," vibrations are transmitted through the chest wall, and the nurse can assess the intensity of the vibrations. Deep breathing would be more relevant for assessing breath sounds or the general respiratory effort.

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Correct Answer is ["A","B","D","E"]

Explanation

A) High cholesterol: Elevated cholesterol levels, particularly low-density lipoprotein (LDL) cholesterol, are a significant risk factor for cardiovascular disease. High cholesterol can lead to the buildup of plaques in the arteries, which increases the risk of heart attacks and strokes. Managing cholesterol through diet, exercise, and medication can reduce cardiovascular risk.

B) Diabetes: Diabetes, especially poorly controlled blood sugar levels, significantly increases the risk of cardiovascular disease. High blood glucose can damage blood vessels and nerves, leading to complications such as coronary artery disease and stroke. Effective management of diabetes through lifestyle changes and medication can help mitigate these risks.

C) Age: While age is a risk factor for cardiovascular disease, it is a non-modifiable factor. As people age, the risk of developing cardiovascular issues naturally increases due to changes in the cardiovascular system. Since age cannot be altered, it is not included in the list of modifiable risk factors.

D) Weight: Excess body weight, particularly obesity, is associated with an increased risk of cardiovascular disease. Obesity contributes to conditions like hypertension, diabetes, and dyslipidemia, all of which elevate cardiovascular risk. Weight management through diet, exercise, and healthy lifestyle choices is crucial for reducing this risk.

E) Smoking: Smoking is a major modifiable risk factor for cardiovascular disease. It damages the blood vessels, increases blood pressure, and reduces oxygen supply to the heart, contributing to the development of atherosclerosis and other cardiovascular conditions. Quitting smoking is one of the most effective ways to lower cardiovascular risk

A. Bronchial sounds B. Crackles C. Whispered pectoriloquy D. Bronchophony

Correct Answer is B

Explanation

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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A nurse is examining a client for tactile fremitus. The nurse should understand that what action is of primary importance when examining for tactile fremitus?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse s teaching a group of clients about modifiable risk factors for cardiovascular disease. Which of the following should the nurse include in the teaching? (Select All that Apply).

Correct Answer is ["A","B","D","E"]

Explanation

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

Correct Answer is B

Explanation

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