What should the examiner do during auscultation of breath sounds?
Listen with the bell of the stethoscope.
Listen only to the posterior chest for adventitious sounds.
Instruct the patient to breathe in and hold their breath.
Compare the sounds on the left and right sides.
The Correct Answer is D
Choice A rationale
The bell of the stethoscope is designed to auscultate low-frequency sounds, such as certain heart murmurs or bowel sounds, due to its larger surface area and lower diaphragm tension. Breath sounds, however, are generally higher frequency and require the diaphragm for optimal clarity and discrimination of adventitious sounds, which are often subtle and require careful attention to pitch and quality.
Choice B rationale
Limiting auscultation to only the posterior chest misses significant lung fields, especially the anterior and lateral segments of the upper and middle lobes. Comprehensive respiratory assessment necessitates evaluating all accessible lung surfaces to detect localized abnormalities, ensuring no consolidation, atelectasis, or pleural effusions are overlooked, providing a complete diagnostic picture.
Choice C rationale
Instructing the patient to breathe in and hold their breath would prevent the continuous airflow necessary to generate breath sounds. Auscultation relies on the movement of air through the tracheobronchial tree. Holding the breath eliminates this vital acoustic phenomenon, rendering the assessment ineffective for evaluating air entry, presence of adventitious sounds, or symmetry.
Choice D rationale
Comparing sounds on the left and right sides allows for the identification of unilateral abnormalities, which are crucial for diagnosing localized pathologies. This systematic approach helps detect differences in breath intensity, the presence of unilateral adventitious sounds like wheezes or crackles, or diminished air entry, guiding further diagnostic investigation and treatment.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale
Changes in peripheral vision in response to light are not directly related to visual accommodation. Peripheral vision is mediated by rod photoreceptors and is assessed through visual field testing, whereas accommodation involves the crystalline lens and its ability to change shape for focusing.
Choice B rationale
Visual accommodation is the process by which the eye changes its optical power to maintain a clear image or focus on an object as its distance varies. When looking at a near object, the ciliary muscles contract, relaxing the suspensory ligaments, allowing the lens to become more convex (thicker) to increase refractive power. This change in lens shape is accompanied by pupillary constriction (miosis) and convergence of the visual axes (medial movement of the eyeballs) to maintain binocular vision.
Choice C rationale
Involuntary blinking in the presence of bright light is a reflex action called the blink reflex, serving to protect the eye from excessive light and maintain lubrication. It is a protective mechanism and not a component of the physiological process of visual accommodation, which focuses on near objects.
Choice D rationale
Dilation of the pupils (mydriasis) occurs when looking at a far object or in dim light conditions to allow more light to enter the eye. This is regulated by the sympathetic nervous system and is opposite to the pupillary constriction that accompanies accommodation for near vision.
Correct Answer is C
Explanation
Choice A rationale
While method of administration is crucial, controlled substance schedule and identification are not universally required on every prescription. The core components for safe and effective medication administration are paramount for all prescriptions.
Choice B rationale
This choice omits the method of administration, which is vital for safe and effective drug delivery. Without this information, there is a risk of administering the medication incorrectly, potentially leading to adverse effects or lack of therapeutic benefit.
Choice C rationale
A complete prescription scientifically requires the drug name for identification, the dose to ensure therapeutic effect and prevent toxicity, the method of administration for correct delivery route, and the prescriber's signature for legal authorization and accountability.
Choice D rationale
Controlled substance schedules are specific to certain medications and identification is not a standard universal requirement on all prescriptions. The core components for general medication administration are the drug name, dose, method, and prescriber signature.
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