Health Assessment Test Bank Module 4:
Chest, Lungs, Heart
The anteroposterior diameter of the chest is normally approximately the same as the transverse
diameter in which age group?
a.Infants
b.School-age children
c.Adolescents
d.Young adults - ANS A
The chest of infants is generally round, with equal dimensions of anteroposterior and transverse
diameters.
A 44-year-old male patient who complains of a cough has presented to the emergency
department. He admits to smoking one pack per day. During your inspection of his chest, the
most appropriate lighting source to highlight chest movement is:
a.bright tangential lighting.
b.daylight from a window.
c.flashlight in a dark room.
d.fluorescent ceiling lights. - ANS A
Bright tangential light is best for visualizing chest movements.
When auscultating the apex of the lung, you should listen at a point:
a.even with the second rib.
b.4 cm above the first rib.
c.higher on the right side.
d.on the convex diaphragm surface. - ANS B
The apex of the lung is 4 cm above the first rib.
,You are documenting a rash between the eighth and ninth ribs on the lateral border. This
intercostal space will be documented in terms of the:
a.rib immediately above it.
b.rib immediately below it.
c.number of centimeters it is positioned below the clavicle.
d.number of inches it is positioned below the clavicle. - ANS A
The number of each intercostal space corresponds to that of the rib immediately above it.
To count the ribs and the intercostal spaces, you begin by palpating the reference point of the:
a.distal point of the xiphoid.
b.manubriosternal junction.
c.suprasternal notch.
d.acromion process. - ANS B
The angle of Louis, the junction of the manubrium and the sternum, corresponds to the second
rib, the reference point for counting ribs and intercostal spaces.
When the umbilical cord is cut:
a.blood flows through the infants lungs more vigorously.
b.lungs fill with air.
c.closure of the foramen ovale occurs
d.closure of the ductus arteriosus occurs. - ANS A
The lungs fill with air at the infant's initial first gasp. The closure of the foramen ovale occurs
within minutes after birth and closure of the ductus arteriosus occurs when arterial blood flows
through the lung and there is increased oxygen tension. Once the umbilical cord is cut, there is
a decrease in maternal blood causing an increase in blood in the infant lungs.
fetal gas exchange is mediated by the:
a.lungs.
b.heart.
,c.amniotic fluid.
d.placenta. - ANS D
The placenta is the source of fetal gas exchange; the lungs contain no air and the alveoli are
collapsed. It is not mediated by the heart.
The foramen ovale should close:
a.by 24 weeks of gestation.
b.within minutes of birth.
c.by 4 weeks of age.
d.By 12 months of age. - ANS B
The decrease in pulmonary pressures within the first minutes of life leads to closure of the
foramen ovale.
Increased oxygen tension in the arterial blood of a newborn infant causes:
a.closure of the ductus arteriosus.
b.hyperinflation of the lungs.
c.passive respiratory movements.
d.reopening of the foramen ovale. - ANS A
Increased oxygen tension in the arterial blood usually stimulates contraction and closure of the
ductus arteriosus
To accommodate the enlarging uterus of pregnancy, chest changes result in:
a.intercostal muscle atrophy.
b.lowering of the resting diaphragm.
c.a decrease in alveoli expansion.
d.an increase in the subcostal angle. - ANS D
The subcostal angle progressively increases from approximately 68.5 to 103.5 degrees in later
pregnancy.
The characteristic barrel chest of the older adult is the result of a combination of factors,
including:
, a.skeletal changes of aging.
b.increased muscular expansion of the chest wall.
c.less fibrous alveoli.
d.increased vital capacity. - ANS A
Skeletal changes associated with aging include an emphasis of the dorsal curve of the thoracic
spine, which contributes to a barrel chest.
Nancy Walker is a 16-year-old girl who presents to the clinic with complaints of severe, acute
chest pain. Her mother reports that, apart from occasional colds, Nancy is not prone to
respiratory problems. Which potential risk factor is most important to assess with regard to
Nancy's current problem?
a.Anorexia symptoms
b.Cocaine use
c.Last menses
d.Signs of rheumatic fever - ANS B
Illegal drug use of cocaine is especially important to prioritize as a social history question for all
adolescents and adults who complain of severe chest pain. Cocaine can lead to tachycardia,
hypertension, coronary arterial spasm with infarction, and pneumothorax.
The patient tells you that she uses herbal and other alternative therapies to maintain her health.
This information is recorded in the:
a.past medical history.
b.chief complaint.
c.social history.
d.family history. - ANS C
Patient data concerning the use of herbal or other remedies and other complementary or
alternative therapies are recorded in the social history component of the history and physical.
Mr. Curtis is a 44-year-old patient who has presented to the emergency department with
shortness of breath. During the history, the patient describes shortness of breath that gets worse
when he sits up. To document this, you will use the term:
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