Lung Activities to Accompany Delmar’s Heart & Lung Sounds for Nurses CD-ROM
Directions:
- Read the sections on General Auscultation on pages 468-469 and the section on Auscultation on page 815 in Health Assessment & Physical Examination, third edition.
- Listen to Lung Sounds, Auscultation on Delmar’s Heart Lung Sounds CD-ROM.
- Lung sounds should be auscultated with:
(a)the bell of the stethoscope.
(b)the diaphragm of the stethoscope.
(c)a Doppler ultrasonic stethoscope.
(d)a goniometer.
Answer: b
Rationale: The diaphragm of the stethoscope transmits the high-pitched sounds heard in the lungs.
- When auscultating lungs:
(a)alternate front to back to compare sounds of same lung site.
(b)listen top to bottom on one side and then repeat on the other side.
(c)alternate right to left to compare sounds of same lung site on both sides.
(d)listen bottom to top on one side and then repeat on the other side.
Answer: c
Rationale: Comparing sides gives a better basis for judging sounds heard in each area.
- When auscultating the anterior chest, listen to this number of sites, at a minimum:
(a)4
(b)6
(c)8
(d)10
Answer: b
Rationale: There are three types of breath sounds, heard at different structures of the lungs.They should be auscultated on both sides.
- When auscultating the posterior chest, listen to this number of sites, at a minimum:
(a)6
(b)8
(c)10
(d)12
Answer: a
Rationale: There are three types of breath sounds, heard at different structures of the lungs.They should be auscultated on both sides.
Directions:
- Read the sections on Breath Sounds on pages 469-470, and Auscultation, page 815in Health Assessment Physical Examination, third edition.
- Listen to Lung Sounds, Normal on Delmar’s Heart Lung Sounds CD-ROM.
- When listening to normal lung sounds, the following is true (choose two):
(a)Inspiration is softer than expiration.
(b)Expiration is louder than inspiration.
(c)Inspiration is louder than expiration.
(d)Expiration is softer than inspiration.
Answer: c, d
Rationale: Inspiration is louder because of turbulence as air strikes the bronchial walls.There is less turbulence as air exits, going from smaller to larger spaces.
- The characteristics of normal bronchial sounds include:
(a)low pitch, soft intensity, and a breezy quality.
(b)medium pitch, medium intensity, and combined blowing, breezy quality.
(c)high pitch, loud intensity, and blowing quality.
(d)high pitch, soft intensity, and breezy quality.
Answer: c
Rationale: Bronchial sounds are found over the trachea and are not muffled.
- The characteristics of normal bronchovesicular sounds include:
(a)low pitch, soft intensity, and a breezy quality.
(b)medium pitch, medium intensity, and combined blowing, breezy quality.
(c)high pitch, loud intensity, and coarse, blowing quality.
(d)high pitch, softintensity, and breezy quality.
Answer: b
Rationale: Bronchovesicular sounds are found over the mainstem bronchi and have characteristics of both bronchial and vesicular sounds.
- The characteristics of normal vesicular sounds include:
(a)low pitch, soft intensity, and a breezy quality.
(b)medium pitch, medium intensity, and combined blowing, breezy quality.
(c)high pitch, loud intensity, and coarse, blowing quality.
(d)high pitch, soft intensity, and breezy quality.
Answer: a
Rationale: Vesicular sounds are found over the peripheral lung fields over the alveolar tissue.
- Vesicular sounds are:
(a)louder and shorter during inspiration than expiration.
(b)softer and shorter during inspiration than expiration.
(c)louder and longer during inspiration than expiration.
(d)softer and longer during inspiration than expiration.
Answer: c
Rationale: Air meets more resistance going from larger to smaller airways.
- Bronchial sounds have all of these characteristics except that they:
(a)are heard primarily over the trachea.
(b)are heard primarily during inspiration.
(c)are heard primarily during expiration.
(d)may have a slight pause between the inspiratory and expiratory phases.
Answer: b
Rationale: There may be a time lag between inspiration and expiration. The quality of the sound is to be expected with air passing through a single hollow tube.
- Bronchovesicular sounds are heard anteriorly:
(a)over the manubrium.
(b)over both apices.
(c)over both bases.
(d)1st and 2nd intercostal spaces lateral to the sternum.
Answer: d
Rationale: Bronchovesicular sounds are heard over the mainstem bronchi.Visualize the anatomy(page 470 and lung sounds–normal, bronchovesicular, auscultation).
Directions:
- Read the section on Breath Sounds, pages 469 and 471 in Health Assessment Physical Examination, third edition.
- Listen to Lung Sounds, Abnormal on Delmar’s Heart Lung Sounds CD-ROM.
- Abnormal breath sounds (choose two):
(a)are normal sounds that are unusually soft or heard in the wrong place.
(b)may indicate poor auscultation technique.
(c)always indicate underlying pathology.
(d)the same as adventitious breath sounds.
Answer: a, b
Rationale: Abnormal breath sounds do not always indicate pathology.Adventitious sounds are superimposed on normal sounds.
- Abnormal bronchial sounds:
(a)are caused by a lobectomy.
(b)may be caused by pneumonia, pleural effusion, or pulmonary edema.
(c)are never heard over the trachea.
(d)are only heard posteriorly.
Answer: b
Rationale: Abnormal bronchial sounds are normal sounds heard in abnormal places.
- Diminished or absent breath sounds can be caused by:
(a)hyperventilation.
(b)mouth breathing by the patient.
(c)supplemental oxygen.
(d)endotracheal tube misplacement.
Answer: d
Rationale: If endotracheal tubes are inserted too far, they may slip into a mainstem bronchus (usually the right).
Directions:
- Read the sections on Breath Sounds, pages 469 and 470, and Auscultation, page 468 in Health Assessment Physical Examination, third edition.
- Listen to Lung Sounds, Adventitious on Delmar’s Heart Lung Sounds CD-ROM.
- Adventitious sounds are:
(a)normal sounds heard in abnormal areas.
(b)heard only on inspiration.
(c)heard only on expiration.
(d)heard in addition to normal sounds.
Answer: d
Rationale: Adventitious sounds are abnormal sounds heard in addition to normal inspiratory and expiratory sounds.
- Which two statements are true of fine crackles?
(a)They are discontinuous.
(b)They are low-pitched.
(c)They may sound like rubbing hair together near one’s ear.
(d)They are due to narrowing of the airway.
Answer: a, c
Rationale: They are high-pitched and are caused by air passing through moist small airways, which then reinflate.
- Which two statements are true of coarse crackles?
(a)They are discontinuous.
(b)They are high-pitched.
(c)They are heard predominantly with expiration.
(d)They may clear with a cough.
Answer: a, d
Rationale: They are low-pitched and heard predominantly with inspiration.
- Which two statements are true of sonorous wheezes?
(a)They are heard predominantly on inspiration.
(b)They are discontinuous.
(c)They are low-pitched.
(d)They may clear with a cough.
Answer: c, d
Rationale: They are continuous and heard predominantly on expiration.
- Which two statements are true of sibilant wheezes?
(a)They are heard predominantly on inspiration.
(b)They are continuous.
(c)They are low-pitched.
(d)They may be due to a foreign body obstruction.
Answer: b, d
Rationale: They are heard predominantly on expiration (page 471 and lung sounds–adventitious, sibilant wheeze).
- Which two statements are true of pleural friction rubs?
(a)They are heard throughout the respiratory cycle.
(b)They have a creaking, grating sound.
(c)They may clear with a cough.
(d)They have a high-pitched, musical sound.
Answer: a, b
Rationale: They will not clear with a cough, because the pathology is outside of the lungs, in the pleura.The sound is low-pitched and not musical-sounding.
- Which two statements are true of stridor?
(a)It is discontinuous.
(b)It is heard over the trachea primarily during inspiration.
(c)It is caused by a partial obstruction of the larynx or trachea.
(d)It may be due to congestive heart failure or pneumonia.
Answer: b, c
Rationale: It is a continuous sound produced by an obstruction in the larger airways.
Directions:
- Read the sections on Voice Sounds, pages 472-473, in Health Assessment & Physical Examination, third edition.
- Listen to Voice Sounds, Auscultation on Delmar’s Heart Lung Sounds CD-ROM.
- Voice sounds should be checked in all of the following except:
(a)with every patient assessment.
(b)only if an abnormality is detected.
(c)over the area of abnormality.
(d)over the peripheral lung fields.
Answer: a
Rationale: Voice sounds should be checked over the area of abnormality if detected during auscultation.
- Voice sounds are transmitted most clearly over areas:
(a)of fluid or consolidation.
(b)filled with normal amounts of air.
(c)filled with greater than normal amounts of air.
(d)with a pneumothorax.
Answer: a
Rationale: Sound is transmitted more clearly through fluids and solids than air.
- A positive result when checking voice sounds will include (choose two):
(a)diminished “99” or “1-2-3” during bronchophony or whispered pectoriloquy.
(b)clear transmission of “99” or “1-2-3” during bronchophony or whispered pectoriloquy.
(c)clear transmission of “ee” during egophony.
(d)“ee” sounding like “ay” during egophony.
Answer: b, d
Rationale: A positive result indicates pathology.
Lung Activities, page 1 of 5Copyright 2006 Thomson Delmar Learning. All rights reserved.