During auscultation of the lungs, the nurse expects decreased breath sounds to be heard in which situation?
When adventitious sounds are present
When the bronchial tree is obstructed
In conjunction with whispered pectoriloquy
In conditions of consolidation, such as pneumonia
The Correct Answer is B
A. Adventitious sounds (e.g., wheezing, crackles, or stridor) are abnormal sounds that may be heard in addition to breath sounds. They do not specifically correlate with decreased breath sounds.
B. When there is obstruction in the bronchial tree (such as in conditions like asthma, chronic obstructive pulmonary disease (COPD), or a foreign body obstruction), the airflow is reduced, leading to decreased breath sounds in the affected areas.
C. Whispered pectoriloquy refers to hearing whispered sounds through the stethoscope, which would be more clearly heard with consolidation or lung tissue becoming more solid (e.g., in pneumonia), not with decreased breath sounds.
D. In consolidation (such as pneumonia), breath sounds are typically increased or bronchial, not decreased. The consolidation makes the lung tissue more solid, which can amplify breath sounds.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Tympany is a high-pitched sound typically heard over a hollow organ such as the stomach.
B. Hyperresonance is often heard in patients with COPD, as the lungs are hyperinflated, leading to an increased resonance when percussed.
C. Resonance is normal and would be heard in healthy, air-filled lungs.
D. Dullness would suggest a solid or fluid-filled area, which is not typical of COPD unless there is a complication like pleural effusion.
Correct Answer is {"A":{"answers":"E"},"B":{"answers":"A"},"C":{"answers":"D"},"D":{"answers":"B"},"E":{"answers":"C"}}
Explanation
Palpate the preauricular nodes (1st):
The preauricular lymph nodes are located in front of the ears, near the temple. The nurse starts at the head and neck to assess the regional nodes. Palpation of the preauricular nodes is often performed first because they are closest to the head and may be involved in infections affecting the eyes, ears, or sinuses.
Palpate the submandibular nodes (2nd):
The submandibular nodes are located beneath the jaw and are often involved in respiratory or oral infections. They are assessed after the preauricular nodes, as they are still part of the head and neck region, just below the chin.
Palpate the supraclavicular nodes (5th):
These nodes are located above the clavicle and are often associated with more serious conditions, such as cancer. Assessing them early in the examination can help identify any potential red flags.
Palpate the axillary nodes (3rd):
The axillary lymph nodes are located in the armpits and are important for breast tissue, upper limb, and chest infections. These are assessed after the head and neck nodes because they are part of the upper body region and located further down, near the chest.
Palpate the popliteal nodes (4th):
The popliteal nodes are located behind the knees. These nodes are assessed next, as part of the lower extremity examination. Palpating these nodes after the axillary nodes ensures a thorough systematic approach from upper to lower body.
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