All of the following are respiratory signs and symptoms that may threaten a client's health, except: Bronchial sounds Crackles Wheezes Dyspnea To manage respiratory signs and symptoms, the nurse should be able to do all of the following, except: Pinpoint abnormal findings and prescribe medications Thoroughly assess respiratory signs and symptoms Differentiate normal findings from abnormal findings Determine the probable cause of abnormal findings These are examples of adventitious breath sounds: Crackles and wheezes Stridor and bronchial Stertor and vesicular Bronchovesicular and bronchial This statement about bronchial breath sounds is most true: They are loud, high-pitched sounds that last equally as long during inhalation and exhalation They are the softest and lowest breath sounds because they normally occur over the trachea They are normally heard over lung tissue and are twice as long on inhalation as they are on exhalation They have a medium intensity and pitch and are heard equally as long during inhalation and exhalation Vesicular breath sounds are normally heard: Over lung tissue Over the trachea Posteriorly between the scapulae to the right of the spine Anteriorly in the first and second intercostal spaces Vesicular breath sounds normally occur: Farthest from major airways Over the trachea Over lung tissue Anteriorly in the first and second intercostal spaces Normally, inspired air creates: Turbulence and loud, high-pitched bronchial sounds near the bifurcation of the mainstem bronchi Soft, low-pitched vesicular sounds near the bifurcation of the mainstem bronchi or trachea Turbulence and loud, high-pitched bronchial sounds in the lungs central and peripheral areas Soft, low-pitched vesicular sounds as it passes through an airless and dense peripheral lung tissue This may be heard over airless and solid peripheral lung tissue: Loud, high-pitched bronchial sounds Soft, low-pitched vesicular sounds Loud, high-pitched vesicular sounds Soft, low-pitched bronchial sounds Inspired air produces vesicular breath sounds as it passes through: Air-filled peripheral lung tissue Airless peripheral lung tissue Dense or solid peripheral lung tissue Fluid-filled peripheral lung tissue Crackles should be suspected if auscultation reveals: Discontinuous, coarse bubbling sounds on inspiration Continuous, coarse whistling sounds on inspiration and expiration The sound of squeaky leather, characterized by grating or rasping Loud, high-pitched vesicular sounds According to the video, fine crackles are: Soft and short and tend to be high-pitched Loud and long and tend to be high-pitched Soft and long and tend to be low-pitched Loud and short and tend to be low-pitched Sonorous wheezes typically result from: Excess mucus in the large upper airways Severe coarse crackles Collapsed or damaged alveolar cells Fluid-filled alveoli or collapsed terminal bronchioles To assess for vocal resonance, the nurse should: Ask the client to repeat a word or phrase while auscultating Ask the client to inhale and exhale through the mouth while auscultating Instruct the client to inhale forcefully and hold his/her breath for 3 seconds while auscultating Have the client cough forcefully and continuously while auscultating Bronchophony is the abnormal transmission of sounds from the lungs, which occurs when: Consolidated lung tissue amplifies vocal sounds Consolidated lung tissue muffles vocal sounds Air-filled lung tissue amplifies vocal sounds Fluid-filled lung tissue muffles vocal sounds When assessing a client's vocal resonance through auscultation, "E" normally sounds: Muffled but unchanged Sharp and loud Clear and amplified Exaggerated but unchanged To palpate a client's chest for tactile fremitus, the nurse should: Use the ulnar surface of his/her hands to apply even pressure on each side of the sternum and then feel for voice vibrations as the client says a word Use the dorsal surface of his/her hands to apply even pressure on each side of the abdomen and then feel for voice vibrations as the client says a word Use the ulnar surface of his/her hands to apply even pressure on each side of the abdomen and then feel for voice vibrations as the client coughs forcefully Use the dorsal surface of his/her hands to apply even pressure on each side of the sternum and then feel for voice vibrations as the client coughs forcefully Most specifically, tactile fremitus occurs when: Vocal sound waves are transmitted through the lungs to the chest wall The number of oxygenated red blood cells falls below 60% Dense, airless lung tissue only filters high-pitched vowel sounds Vocal sound waves pass through air-filled lung tissue Normally, tactile fremitus feels: Equally intense bilaterally and strongest in the second intercostal space and between the scapulae More intense in the second intercostal space to the right of the sternum More intense in the third intercostal space to the left of the sternum Equally intense bilaterally and weakest in the second intercostal space and between the scapulae When assessing the chest for lung expansion, the nurse should: Place the palms of both hands over the client's chest, with the thumbs along the costal margin and over the xiphoid process Place the dorsal surface of both hands over the client's abdomen, with the little fingers pointing at the sternum Place the palms of both hands over the client's chest, with the thumbs along the fourth or fifth rib and over the manubrium Place the dorsal surface of both hands over the client's abdomen, directly over the xiphoid process Reduced lung expansion may occur when: Exudate-filled lung tissue stiffens and does not fill completely with air during inhalation Air-filled, dense or solid lung tissue relaxes and fills completely with air during inhalation The diaphragm contracts and descends during inspiration The diaphragm expands and ascends during expiration When assessing for lung expansion, the thumbs normally: Diverge symmetrically as the lungs expand Converge symmetrically as the lungs expands Converge symmetrically as the client inhales Diverge symmetrically as the client exhales When percussing over the lungs, the nurse should: Follow the pattern for auscultation and compare the sounds on both sides Follow the pattern for palpation and compare the sounds on the upper and lower quadrants Strike the middle finger with the index finger of the nondominant hand Strike the index finger with the middle finger of the nondominant hand Percussion of the lungs is done by: Pressing the middle finger of the nondominant hand firmly on the skin and then striking it briskly with the middle finger of the dominant hand Pressing the middle finger of the nondominant hand lightly on the skin and then striking it briskly with the index finger of the dominant hand Pressing the index finger of the nondominant hand lightly on the skin and then striking it briskly with the middle finger of the dominant hand Pressing the middle finger of the dominant hand firmly on the skin and then striking it briskly with the middle finger of the nondominant hand According to the lesson, in regard to percussion, resonance is: A long, loud and low-pitched sound that is heard best over healthy air-filled lung tissue A short, loud and high-pitched sound that is heard best over healthy air-filled lung tissue A long, soft and low-pitched sound that is heard best over exudate-filled lung tissue A short, loud and low-pitched sound that is heard best over exudate-filled lung tissue All of the following assessment findings may indicate right lower lobe pneumonia, except: Increased hydatid fremitus Coarse crackles Bronchophony Egophony Pneumonia typically develops when: A microorganism multiplies in the lungs and invades the lung tissue The body triggers the release of excess RBCs, WBCs, antibodies and bradykinin RBCs and actomyosin enter an air-filled alveoli Gas exchange is impaired and hyperemia develops In regard to pneumonia, alveolar edema occurs when: Terminal bronchioles and alveoli fill with exudate Pulmonary hypertension develops Vocal sound waves are transmitted through the lungs to the chest wall Excess mucus is present in the large upper airways According to the video, when assessing the dyspnea of a client, the nurse should inquire about all of the following, except: Rate Onset Timing Severity The nurse should expect the physician to order a 12-lead ECG tracing and pulse oximetry when a postoperative client experiences all of the following, except: Eupnea along with anxiety Severe, constant dyspnea with a rapid onset Chest pain during inhalation Bloody sputum An oxygen saturation of 89 percent most specifically reflects: Hypoxemia Hypovolemia Hypotension Hyposmia Tachycardia is: An abnormally fast heart rate An abnormally slow heart rate An abnormally high body temperature An abnormally low body temperature Hypotension may result from all of the following, except: Increased cardiac output Reduced cardiac output Pulmonary embolism Pulmonary hypertension In pulmonary hypertension, the heart cannot move blood to the: Left side of the heart Right side of the heart Right atrium Inferior vena cava The pulmonic auscultatory site is in the: Second intercostal space at the left sternal border Second intercostal space at the right sternal border Fourth intercostal space at the left sternal border Fourth intercostal space at the right sternal border A single S₂ is produced when: The aortic and pulmonic valves close at nearly the same time The aortic valve closes before the pulmonic valve The aortic valve closes after the pulmonic valve The atria contracts forcefully to overcome an abnormally stiff ventricle Increased pulmonary pressure increases the: Resistance the right ventricle must pump against Resistance the left ventricle must pump against Aortic component of S₂ Pulmonic component of S₁ When assessing diaphragmatic excursion during exhalation, the nurse should mark the spot where: Dullness changes to resonance Resonance changes to tympany Hyper-resonance changes to resonance Hyper-resonance changes to dullness To assess diaphragmatic excursion during inhalation, the nurse should: Have the client inhale deeply and hold his/her breath while percussing from the right scapulae toward the diaphragm, then repeating on the other side Have the client inhale slowly and deeply while percussing from the fifth intercostal space to the second intercostal space, then repeating on the other side Have the client inhale rapidly and deeply while percussing from the third intercostal space to the fifth intercostal space, then repeating on the other side Have the client inhale slowly and deeply while percussing from the right sternum toward the fifth intercostal space, then repeating on the other side Diaphragmatic excursion measurement on the right may be higher because: The liver raises the diaphragm slightly The left lung is normally bigger than the right lung The diaphragm contracts during expiration The right lung has more bronchioles and alveoli This statement about a sibilant wheeze is most true: It is a high-pitched, musical adventitious breath sound It is a loud, grating sound during inspiration and expiration It occurs when fibrosis inflames the pleural tissues It indicates the widening of the bronchioles' terminal airway Pleural friction rub is: Indicative of inflamed pleural tissues A high-pitched, musical adventitious breath sound Indicative of widened terminal airways of the bronchioles A soft, grating, musical sound during expiration Pain in the calf during dorsiflexion of a client's foot at the ankle can indicate: Homan's sign Jugular vein distention Disseminated intravascular coagulation Erythema Pulmonary embolism related to deep vein thrombosis may be suspected if assessments show all of the following results, except: Whispered pectoriloquy Pleuritic chest pain Hemoptysis Tachycardia and hypotension Pulmonary embolism commonly occurs when: A leg vein thrombus leads to an embolus, which then lodges in a pulmonary vessel Increased ventilation perfusion causes the necrosis of alveolar cells J-receptors are stimulated to increase pressure and resistance in the pulmonary vessels Reduced surfactant level causes the collapse of alveoli and the development of atelectasis In a client with pulmonary embolism, ventilation-perfusion mismatch usually occurs when: Gas exchange cannot occur even though lung ventilation is adequate because the carbon dioxide-rich blood cannot reach the lung tissue An air bubble or a blood clot lodges in the left ventricle and reduces blood flow to the lungs Reduced surfactant level causes the collapse of more alveoli and the development of atelectasis J-receptors are stimulated to increase pressure and resistance in the pulmonary vessels This diagnostic test is performed to evaluate lung ventilation and perfusion in a pulmonary embolism client: Two-part V/Q scanning Pulmonary angiogram Ultrasonography Echocardiography In the ventilation part of the V/Q scan, the pulmonary embolism client: Inhales a radioactive gas then a nuclear scanner checks gas distribution during respiration Is injected with an isotope and a nuclear scanner traces radioactive particle uptake in the bronchioles and alveoli Is threaded with a catheter into the pulmonary artery while x-rays help visualize pulmonary vessel patency Takes a J-receptor stimulator drug then chest x-rays trace radioactive particle uptake in the alveoli In a pulmonary embolism client, a pulmonary angiogram is performed by: Threading a catheter into the pulmonary artery and injecting a radio-opaque contrast medium while x-rays help visualize pulmonary vessel patency Having the client inhale a radioactive gas, then a nuclear scanner checks gas distribution Having the client take a J-receptor stimulator drug, then chest x-rays trace radioactive particle uptake in the alveoli Injecting a radioactive isotope into the blood, then a nuclear scanner traces radioactive particle uptake in the pulmonary capillaries Nursing interventions during immediate treatment for pulmonary embolism should include all of the following, except: Obtaining the client's ECG tracing and ABG levels at least twice every day Assessing the client's vital signs at least every 4 hours Frequently checking the client's pulse oximetry reading to monitor oxygen saturation Auscultating the client's lungs at least every 2 to 4 hours to assess for the resolution of adventitious breath sounds In regard to the immediate treatment for pulmonary embolism, streptokinase is an example of: A thrombolytic An anticoagulant An antidiuretic An antihistamine These surgical procedures may be indicated to manage pulmonary embolism: Embolectomy and placement of an inferior vena cava filter Bursectomy and allotransplantation Chest physiotherapy and endoscopic nasopharyngectomy Lung volume reduction surgery and bursectomy All of the following are vascular signs and symptoms, except: Hypothyroidism Bruits Diminished pulses Uncontrolled hypertension According to the lesson, to minimize the dangerous effects of vascular signs and symptoms, the nurse should do all of the following, except: Ensure a patent airway Assess each sign and symptom in detail Pinpoint the probable cause Provide high quality nursing care Generally, these are the stated nurse's goals in a client with vascular signs and symptoms: Determine their cause and minimize their dangerous effects Treat the symptoms and monitor the client's vital signs Determine their cause and treat the symptoms Minimize their dangerous effects and continuously monitor the client's vital signs Bruit can be best described as: A harsh, blowing vascular sound The abnormal narrowing of blood vessels A condition in which the arterial walls thicken A clicking, rattling, or crackling sound heard during systole According to the lesson, carotid artery bruit usually occurs: During systole During diastole In late systole In late diastole According to the lesson, if a client's blood pressure drops during surgery, blood flow to the brain can fall dangerously low and may lead to: CVA Aortic aneurysm Cardiac arrest Myocardial infarction The carotid pulse is best heard: Beside the trachea, halfway between the jaw and the clavicle Along the mandible, on a line with the corners of the mouth On the temple directly in front of the ear Between the lateral wall of the axilla and the clavicle When auscultating for carotid artery bruits, the nurse should press the stethoscope lightly on the client's skin to avoid all of the following, except: Client discomfort Blocking the artery Blocking vascular sounds Creating a false bruit This suggests aortic stenosis: Harsh, mid-systolic crescendo-decrescendo murmur in the second intercostal space on the right Harsh, mid-systolic crescendo-decrescendo murmur in the second intercostal space on the left Harsh, mid-systolic crescendo-decrescendo murmur in the third intercostal space on the right Harsh, mid-systolic crescendo-decrescendo murmur in the third intercostal space on the left All of the following are appropriate techniques to differentiate a bruit from a venous hum, except: Ask the client to hold his/her breath while listening Know the sound characteristics of a venous hum Gently occlude the jugular vein with a finger while listening Ask the client to bear down while listening Venous hum most specifically occurs: Throughout diastole Throughout systole In early diastole In late systole According to the lesson, a venous hum is best heard: At the medial end of the clavicle, anterior to sternocleidomastoid muscle At the lateral end of the clavicle, anterior to sternocleidomastoid muscle At the medial end of the clavicle, posterior to sternocleidomastoid muscle At the lateral end of the clavicle, posterior to sternocleidomastoid muscle To avoid disrupting an atherosclerotic plaque when assessing for bruits in the carotid arteries, the nurse should most specifically: Palpate the arteries gently Tilt the client's head when palpating Palpate the arteries one at a time Palpate the arteries together According to the lesson, diminished pulse amplitude in a carotid artery with a bruit can be caused by: Atherosclerosis Hyperthyroidism Arteriosclerosis Hypothyroidism According to the lesson, when assessing for bruits, palpating the carotid arteries at the same time may: Reduce blood flow to the brain Diminish the pulse's amplitude Disrupt an atherosclerotic plaque Prevent the carotid artery from expanding fully According to the lesson, this diagnostic test can help confirm carotid artery stenosis as the probable cause of a client's bruit: Vascular ultrasound Computed tomography angiography Magnetic resonance imaging Arterial Duplex ultrasound Carotid endarterectomy is a surgical procedure usually performed in clients with carotid artery stenosis most specifically to: Remove the intimal lining of the artery and relieve stenosis Prevent thrombus formation and promote blood flow Relieve severe frontal headache and reduce the risk for CAD Correct aortic valve disorders as an alternative to aortic valve replacement To assess for CVA or TIA in a client with carotid artery stenosis, the nurse should look for all of the following neurologic signs and symptoms, except: Hearing impairment Vision changes Weakness Speech changes According to the lesson, this chronic condition can cause chest pain: Costochondritis Myocardial infarction Aortic dissection Ulcerative colitis According to the lesson, a chest pain can have an acute cause, such as: Myocardial infarction or aortic dissection Costochondritis or aortic dissection Myocardial infarction or ulcerative colitis Costochondritis or ulcerative colitis For a client with sudden, severe and unrelenting chest pain, the nurse should expect the physician to order a/an: 12-lead ECG tracing Coronary angiography MCG Echocardiogram In a client with aortic valve regurgitation, a damaged valve cusp allows blood to flow back into the: Left ventricle Right ventricle Left atrium Right atrium Arterial occlusion may diminish pulses: Unilaterally Bilaterally Peripherally Multilaterally A decrescendo heart murmur has: A gradually decreasing intensity A gradually increasing intensity A flat intensity throughout systole A flat intensity throughout diastole According to the lesson, capillary refill can be falsely delayed if the: Room is too cold Client moves while capillary refill is being checked Client has a fever Nurse induces too much pressure on the nail bed When checking the capillary refill time of a client, the nail bed normally returns to its normal color within: 2 seconds after the pressure is released 5 seconds after the pressure is released 8 seconds after the pressure is released 6 seconds after the pressure is released Reduced supply of blood and oxygen to muscles and peripheral nerves can cause: Decreased muscle strength Paresthesia Aortic dissection Neuropathy All of the following stated assessment findings may indicate aortic dissection, except: Paraparesis Tachycardia Diaphoresis Murmur of aortic valve regurgitation In a client with aortic dissection, expansion of an aortic hematoma toward the aortic valve can: Damage one or more valve cusps Increase blood flow to the distal arteries Reduce blood flow to the proximal arteries Lead to vasculitis and MI In an aortic dissection client, blockage of the aortic lumen due to an aortic hematoma can lead to: Ischemia and diminished pulses Ischemia and alveolitis MI and vasculitis Diminished pulses and vasculitis In a client with aortic dissection, this helps lower the systolic pressure to around 80 mm Hg: Sodium nitroprusside Metformin Sulfonylurea Coumadin A surgical procedure may be performed on a client with aortic dissection to achieve all of the following purposes, except: To reduce myocardial contractility To replace the aortic valve To evacuate the hematoma To repair the intimal tear During the continuing assessment of a client with aortic dissection, the nurse should evaluate the client's peripheral pulses at least once every: 30 to 60 minutes 15 to 30 minutes 30 to 45 minutes 15 to 45 minutes To avoid an auscultatory gap when assessing the blood pressure of a client suspected of having hypertension, the nurse should: Palpate the systolic pressure first Palpate the diastolic pressure first Check the respiratory rate first Check the tympanic temperature first Auscultatory gap is: The period of silence between Korotkoff sounds when auscultating the blood pressure Informally known as "Kentucky" gallop and occurs at the beginning of diastole after S₂ A sign of a pathologic state, usually a failing left ventricle, but can also be heard in other conditions, such as renal artery stenosis The period in which circulating blood exerts pressure on the walls of blood vessels According to the video, hypertensive crisis occurs when: The diastolic pressure rises rapidly and exceeds 120 mm Hg The pulsatile nature of the cardiac output causes the fluctuation of arterial pressure VPW is created by the heart during systole and originates in the descending aorta The systolic pressure rises to 120 to 139 mm Hg or the diastolic pressure to 80 to 89 mm Hg When assessing a hypertensive client's vital organ function, the nurse should start with the: Client's level of consciousness and orientation Client's leg and arm muscle strength Client's retinal changes and sensory deficits Client's heart rate and blood pressure In a hypertensive client, cerebral edema may be indicated by: A decreased level of consciousness or disorientation Retinal changes and sensory deficits Severe frontal headache or left-sided hemiparesis Severe occipital headache or right-sided hemiparesis In a hypertensive client, to protect the brain from excessive pressure, the cerebral arterioles: Constrict Dilate Tear Extend Prior to assessing a hypertensive client's retinal structure, these should be administered to dilate the eyes: Mydriatic and cycloplegic eyedrops Miotic and cycloplegic eyedrops Miotic and prostaglandin eyedrops Miotic and mydriatic eyedrops In an ophthalmologic examination, all of the following characterize a normal retina, except: Slightly opaque retinal arteries Retinal arteries that cross retinal veins Crisp and intact retinal vein borders, without narrowed areas Red orange color, without hemorrhage or exudate Papilledema is: The swelling of the optic disk The painful inflammation of the sclera The loss of the surface epithelial layer of the cornea A dangerous condition in which the lens become opaque The apical impulse is located in the: Fifth intercostal space at the midclavicular line Fourth intercostal space at the midclavicular line Fifth intercostal space along the substernal notch Fourth intercostal space along the substernal notch S₄ is also known as: Atrial gallop Ventricular gallop Summation gallop Protodiastolic gallop In a client with hypertension, S₄ is caused by: Increased resistance to ventricular filling Forceful but short pumping of the left atrium Decreased resistance to atrial filling Gentle but prolonged pumping of the right atrium When assessing a client with hypertension, the nurse should auscultate for bruits in all of the following arteries, except: Basilar Carotid Femoral Renal In a hypertensive client, to listen for bruits from the aorta, the nurse should: Auscultate the epigastric area Auscultate the periumbilical area Auscultate two inches below the substernal notch Inspect and percuss the chest area In a hypertensive client, this is released by the kidneys when blood flow is reduced: Renin Aldosterone Sodium Glucagon All of the following assessment findings suggest hypertensive crisis possibly caused by renal artery stenosis, except: S₃ heart sound A blood pressure of 220/122 mm Hg or higher Severe frontal headache Retinal changes This test uses radio-opaque dyes injected into an artery and x-rays visualize the vessel: Renal arteriogram Electrocardiogram Mammogram Electroencephalogram In the immediate treatment for hypertensive crisis caused by renal artery stenosis, the nurse should prepare the client for this procedure: Revascularization or balloon angioplasty Arthroscopic acromioplasty Atrial septostomy or coronary bypass surgery CABG or evisceration The vulva or external genitalia of the female is also known as the: Pudendum Mons pubis Large lips Small lips In female genitalia, the prepuce covers the: Clitoris Mons pubis Urethral orifice Labia The analog of clitoris in the male genitalia is the: Glans Folds Costa Gill clefts In female genitalia, this lies almost directly above one ovary: The vermiform appendix The alveolar arch A flagellum The mastoid bone The rectum and bladder are separated in the female by the: Uterus Cervix Ovary Fallopian tubes The deposit of fat that cushions the pubic bone is called the: Mons pubis Belly tissue Cellulitis pubis Atheroma The muscular lining of the uterus is the: Myometrium Endometrium Oviduct Placenta The mid-portion of the fallopian tube is called the: Ampulla Infundibulum Isthmus Fundus The opening of the cervix is called the: Cervical os Cervical cavity Ectocervix Cervical entry The mature follicles in the last stage of oocyte development are called: Graafian follicles Primordial follicles Sebaceous follicles Primeval follicles Mittelschmerz most specifically refers to: Abdominal pain in the middle of the menstrual cycle Abdominal pain at the beginning of the menstrual cycle Abdominal pain at the end of the menstrual cycle Abdominal pain throughout the menstrual cycle In the ovaries, these are left after the involution of the corpus luteum: Corpus albicans Corpus hemorrhagicum Corona radiata Zona pellucida Birth control pills mimic pregnancy by maintaining high levels of: Estrogen and progesterone Androgen and progestin Progestogen and corticoid Corticoid and estrogen Superfecundation refers to: Fertilization of multiple eggs Heavy menstruation The absence of menstruation The inability to fertilize eggs This menstruation phase usually lasts for 14 days: Postovulatory phase Secretory phase Preovulatory phase Proliferative phase After ejaculation, sperm is viable for: 48 hours 64 hours 72 hours 55 hours After ovulation, the ovum is viable for: 24 hours 48 hours 32 hours 72 hours After ovulation, fertilization usually occurs: In the fallopian tube In the uterus In the ovary In the vagina This is composed of alveoli, lined with secretory cells: Lobule Ampulla Annexa Dorsum The breasts are also called: Mammary glands Lachrymal glands Nabothian glands Sweat glands The basic structural unit of the breast is called a/an: Lobule Nipple Areola Lactiferous duct Lactation is controlled by this hormone: Oxytocin Pitocin Estrogen Progesterone The stated primary cause of breast cancer is: Prolonged exposure to estrogen Prolonged exposure to progesterone Inadequate estrogen Inadequate progesterone In women, nulliparity means: "No childbirths" Late menarche, early menopause Early menarche, late menopause Absence of menstruation