A nurse is performing a respiratory physical examination on a healthy patient. When performing the percussion physical assessment technique, the lung percussion note should be:
Resonance
Tympanic
Flat
Dullness
The Correct Answer is A
Choice a reason:
Resonance is the expected percussion note when percussing over normal, healthy lung tissue. This sound is produced due to the presence of air in the lung parenchyma, which allows for the transmission of sound waves through the air-filled spaces. In a healthy individual, the resonance indicates that the lungs are free from any significant abnormalities that could alter the sound, such as fluid or solid masses.
Choice b reason:
Tympanic notes are typically heard over hollow, air-containing structures like the stomach. This sound is not expected in lung percussion unless there is a large, air-filled cavity within the lung tissue, which would be abnormal and indicative of a pathological condition such as a pneumothorax.
Choice c reason:
A flat percussion note is usually heard over dense tissues where air is not present, such as over the thigh muscles or areas of the chest where lung tissue has been replaced by something more solid, like in the case of a pleural effusion or a lung mass.
Choice d reason:
Dullness on percussion usually indicates that the lung is not air-filled and may be suggestive of underlying conditions such as pneumonia, tumor, or atelectasis. It is a higher-pitched sound compared to flatness and is typically found in areas of the lung that are filled with fluid or solid tissue rather than air.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason:
Facial expression is an important aspect of the general survey as it can provide clues about a patient's emotional state and possible pain. However, it is not directly related to the patient's level of consciousness. After a motor vehicle crash, assessing facial expression is crucial to identify any signs of distress, trauma, or neurological impairment.
Choice B reason:
Level of consciousness is a critical component of the general survey, especially in the context of trauma or potential neurological injury. It refers to the patient's awareness and responsiveness to the environment. Assessing the level of consciousness involves determining if the patient is awake, alert, and oriented to time, place, and person, which is essential for establishing a baseline cognitive function and detecting any changes that may indicate deterioration or improvement in their condition.
Choice C reason:
Posture, gait, motor activity, and speech are assessed to evaluate the musculoskeletal and neurological systems. While these are important in the context of a motor vehicle crash, they are not specifically related to the level of consciousness. These assessments help identify any deficits that may result from injuries sustained during the crash, such as fractures, dislocations, or neurological damage affecting movement and coordination.
Choice D reason:
The apparent state of health is a broad assessment that includes the patient's overall appearance and any signs that may indicate acute or chronic illness. In the emergency setting, this may involve observing for signs of trauma, shock, or other life-threatening conditions. While it is an essential part of the general survey, it is not specifically focused on the level of consciousness but rather on the patient's general well-being and any obvious health concerns.
Correct Answer is C
Explanation
Choice A Reason:
The facial nerve, or cranial nerve VII, is responsible for the taste sensation in the anterior two-thirds of the tongue, not the posterior third. It carries taste sensations from the front part of the tongue via the chorda tympani branch.
Choice B Reason:
The abducens nerve, or cranial nerve VI, has no role in taste sensation. It is primarily involved in controlling the lateral rectus muscle of the eye, which abducts the eye.
Choice C Reason:
The glossopharyngeal nerve, or cranial nerve IX, provides special sensory innervation for taste to the posterior third of the tongue. This enables the sensation of various tastes like salty, sweet, sour, and bitter in this region.
Choice D Reason:
The hypoglossal nerve, or cranial nerve XII, is responsible for motor control of the tongue muscles but does not provide sensory innervation for taste.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.