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CMN 568 Module 2 Exam Study Questions With Complete Solutions
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CMN 568 Module 2 Exam Study Questions WithComplete Solutions 2024-2025
What breath sounds are soft, rustling sounds heard during the entire inspiration that
fade during expiration?
Normal breath sounds over the periphery/ Vesicular
What breath sounds are louder, high-pitched, hollow quality, and louder on expiration?
Normal breath sounds over the suprasternal notch/tracheal or broncheal
_________ alone is not a reliable indicator of hypoxemia. What two tests can reliably
measure for hypoxemia?
Cyanosis; obtain arterial PO2 or HgB saturation
Which of the following is the most accurate measurement of oxygen saturation? Which
will the FNP use in the ambulatory care setting to measure oxygen saturation?
ABGs (arterial blood gases) most reliable; Pulse Oximetry-most non-invasive will be
done in the outpatient.
For cyanosis to become apparent, the amount of deoxygenated hemoglobin levels
circulating within the blood must be greater than or equal to _____g/dl
5 g/dl
_________provides an indirect measurement of pulmonary hypertension due to blood
flow of the heart from the right atrium->tricupsid valve->right ventricle->pulmonary
veins->lungs. If there is increased pressure in the lungs, then the fluid is going to have to
back up somewhere to the peripheral extremities.
Bilateral lower extremity edema
If the FNP sees a patient with use of accessory muscles at rest, what should they do?
This is a sign of significant respiratory distress and the patient should be referred to the
ER STAT.
In what scenario would the NP note hyperresonance on percussion?
,It would indicate overinflation-too much air-of the lungs-think ephysema, COPD,
pneumothorax.
How does the NP distinguish hyperresonance caused by pneumothorax versus COPD or
emphysema?
COPD and emphysema hyperresonance would be bilateral while pneumothorax would
likely be unilateral-on one side of the patient.
What would it mean if the NP palpated dullness over lungs areas that should be
tympanic?
It would indicate hyperdensity caused by liquid or solid tissue-think pneumonia, pleural
effusion, or tumors
What does it mean when you have a patient who has globally-all over-diminished air
flow?
They cannot get air in or out-anaphylactic patient/everything has collapsed.
Which two lung sounds are continuous adventitious lung sounds?
Rhonchi and Wheezing
Which lung sounds are discontinuous adventitious lung sounds that are brief, discreet,
NONMUSICAL, and POPPING?
Fine or Coarse Crackles
What is a continuous, high-pitched, MUSICAL sound with distinct whistle sound in the
lungs?
Wheezing due to bronchospasm, mucosal edema, and excessive secretions due to a
narrow airway. (Strong sign of obstructive lung disease like asthma, COPD, or
ephysema)
What is a low pitched, snorous, gurgling quality lung sound heard in larger airways?
Rhonchi caused by excessive secretions and abnormal airway collapse with repetitive
, rupture of fluid films that clear after cough
What testing can be done in clinic by the NP to test the pulmonary function?
PFTs=Pulmonary Function Tests
If a patient is having an exacerbation of asthma, should the NP do spirometry or
pulmonary function tests?
No; it is not helpful to do so during exacerbations. The NP should give an inhaler or neb
treatment.
What diagnostic tests would the NP need to order in the outpatient clinic to provide a
diagnosis of asthma, COPD, or emphysema?
Pulmonary Function Tests (PFTs): FEV (forced expiratory volume), FEV1 (amt of air
exhaled during forced breaths), FVC (forced vital capacity-total amt of air exhaled
during the entire FEV test.)
If the NP ordered spirometry and nebulizer treatments and then ordered repeat
spirometry tests, which of the following respiratory disease results would improve and
which would not?
Asthma would improve; COPD would not
What is the most common etiology of community-acquired pneumonia in children?
Bacterial or Viral
What is the Gold Standard for an official diagnosis of community-acquired pneumonia?
Chest X-ray
What would the NP want to rule out first before prescribing antibiotics for a suspected
respiratory illness when the most common cause of respiratory illness is viral?
The NP would want to rule out viral illness by performing rapid testing for Covid,
influenza, (and RSV in children < age 2.) These are all viral and do not respond to ABX.
Can a child be diagnosed with both viral and bacterial illnesses at the same time? What
is the likely cause of a bacterial infection along with a viral URI?
Yes; when the child is demonstrating signs and symptoms of URI it is always important
to assess for acute otitis media (bacterial)/ear infection as this is a common
comorbidity. The FNP would need to instruct the patient in the management of
symptoms related to a viral illness and provide antibiotics for the ear infection.
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