Nr 509 Exam Study Guides Qustions & Correct Answers
Crepitus
A grating or grinding sensation caused by fractured bone ends or joints rubbing
together; also air bubbles under the skin that produce a crackling sound or crinkly
feeling. can be with or without pain.
Retractions
Occurs in severe asthma, COPD, or any upper airway obstruction.
What is fremitus?
Fremitus refers to the palpable vibrations that are transmitted through the
bronchopulmonary tree to the chest wall as the patient is speaking and is normally
symmetric.
Where should one palpate when assessing for fremitus?
Fremitus is typically more prominent in the inter-scapular area than in the lower
lung fields over the right lung fields, and it is easy to detect other the right lung vs
the left lung. It disappears below the diaphragm.
What would cause tactile fremitus to be decreased?
Asymmetric decreased fremitus raises the likelihood of unilateral pleural effusion,
pneumothorax, or neoplasm.
What is the purpose of percussion?
Percussion sets the chest wall and underlying tissues in motion, producing audible
sound and palpable vibrations. Percussion helps you establish whether the
underlying tissues are air-filled, fluid-filled, or consolidated.
, 62 yr old male, everyday smoker, chronic cough, some SOB. He says he's had
some nasal drainage but nothing else. Vital signs are normal, but he has decreased
breath sounds in all lung fields. No dullness, fremitus, positive for rhonchi. What
can be the cause of his symptoms?
COPD: affects smokers and those of older age.
Exam: barrel chest
Ausc: Rhonchi, decreased breath sounds.
Percussion: Hyperresonance
What valve is responsible for the inspiratory splitting of S2 heart sound?
Closure of the aortic & pulmonic valves
Where would the provider more than likely hear a heart murmur ONLY over the
cardiac apex?
Mitral valve: MV murmurs are best heard over this area.
Orthopnea presents itself in people as:
May show up in CHF patients and is relieved when the patient sits up after lying
down.
What is the 1 determining factor when hypothesizing rather or not a patient will
develop heart disease in 10 years?
Gender: men have a higher risk than women.
What are the ABCDEs of melanoma?
A: asymmetric
B: irregular borders
C: color changes
(especially blue color)
D: diameter/size > 0.5 cm
E: evolution/change that occurs to longstanding pigmented areas.
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