During palpation of the anterior chest wall, the nurse notices a coarse, crackling sensation over the skin surface. On the basis of these findings, the nurse suspects:

Tactile fremitus

Crepitus.

Adventitious sounds.

Friction rub

Answer and Explanation

The Correct Answer is B

A.   This is a vibration felt on the chest wall when a patient speaks, often used to assess lung sounds. It is not associated with the crackling sensation described here.
B.   The coarse, crackling sensation felt on the skin surface when palpating is crepitus, which occurs when air escapes into the subcutaneous tissue, often due to trauma, infection, or the presence of a pneumothorax.
C.   These are abnormal lung sounds, such as crackles, wheezes, or rhonchi, heard with a stethoscope during auscultation, not felt on the chest wall during palpation.
D.   A friction rub is a grating or scraping sound heard with a stethoscope, typically due to inflammation of the pleural surfaces. It is not a sensation felt on the chest wall.

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Correct Answer is B

Explanation

A. Exophthalmos, or bulging eyes, is associated with hyperthyroidism (such as in Graves' disease), not acromegaly.
B. This is a hallmark sign of acromegaly. People with acromegaly often develop coarse, enlarged facial features (e.g., thickened lips, enlarged nose, protruding jaw, and enlarged tongue), which occur due to excess growth hormone.
C. While acromegaly can cause abnormal bone growth, especially in the hands and feet, it does not typically result in bowed long bones. This would be more suggestive of conditions like rickets or osteomalacia.
D. While acromegaly can lead to changes in the skull, it does not typically result in a distinctly acorn- shaped cranium. This is not a primary diagnostic feature of acromegaly.

A. When adventitious sounds are present B. When the bronchial tree is obstructed C. In conjunction with whispered pectoriloquy D. In conditions of consolidation, such as pneumonia

Correct Answer is B

Explanation

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.

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During palpation of the anterior chest wall, the nurse notices a coarse, crackling sensation over the skin surface. On the basis of these findings, the nurse suspects:

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Naxlex Comprehensive Predictor Exams

During an admission assessment, the nurse notices that a male patient has an enlarged and rather thick skull. The nurse suspects acromegaly. What additional finding would the nurse assess for to confirm this suspicion?

Correct Answer is B

Explanation

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Correct Answer is B

Explanation

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