Thorax and Lungs 1
How many lobes does each lung have?
Right: 3
Left: 2
Where does gas exchange occur?
Alveoli
What is the most common chronic disease in childhood?
Asthma
What adventitious lung sound is described as sounding moist, bubbling, or gurgling?
a. Wheeze
b. Stridor
c. Crackles (rales)
d. Pleural friction rub
c. Crackles (rales)
Your client weighs 183lbs, how many kgs do they weigh? Round to the tenths place if needed.
83.2kg
183lbs / 2.2 lbs = 83.2kg
Which action by the student nurse requires intervention by the nurse?
a. When auscultating lung sounds, the student nurse instructs the client to breathe in through their nose
b. The student nurse counts one full respiration at each location when auscultating and compares sounds bilaterally
c. The student nurse palpates for chest expansion as well as tactile fremitus on both the chest and back
d. The student nurse percusses in intercostal spaces instead of on the bone
a. When auscultating lung sounds, the student nurse instructs the client to breathe in through their nose
Right lung due to the liver
T/F: when auscultating the lungs you listen over breast tissue
False
Which adventitious lung sound is described as a continuous grating sound?
a. Wheeze
b. Stridor
c. Crackles (rales)
d. Pleural friction rub
d. Pleural friction rub
The physician orders ibuprofen 200mg to be given q8hrs PRN. Available are ibuprofen 25mg scored tablets. How many tablets will you give for each dose?
8 tablets
200mg / 25mg = 8
8 x 1 tablet = 8 tablets
What type of lung sounds are heard over the trachea, are louder and higher pitched, hollow, and tubular?
a. Bronchovesicular
b. Bronchial
c. Vesicular
d. There are no lung sounds described as this
b. Bronchial
Which lung is narrower and why?
Left lung because heart bulges to the left
What type of lung sounds are heard over lung fields, except upper sternum and between scapulae, and are quiet and low pitched, "breezy"?
a. Bronchovesicular
b. Bronchial
c. Vesicular
d. There are no lung sounds described as this
c. Vesicular
What type of lung sounds are heard over main bronchi, have a medium pitch, and are "breezy and tubular"?
a. Bronchovesicular
b. Bronchial
c. Vesicular
d. There are no lung sounds described as this
a. Bronchovesicular
The physician writes an order for 1,500mL of D5W to be infused through your client's IV over 10 hours. What rate will you set the IV pump to?
150mL/hr
1,500mL / 10 hours = 150mL/hr
The nurse gets report on four client. Which client should the nurse see first?
a. The 12-year-old client with asthma who has stridor
b. The 56-year-old client who is wheezing
c. The 73-year-old client with inspiratory crackles
d. The 27-year-old client with tachypnea
a. The 12-year-old client with asthma who has stridor
a. "The right lung has three lobes while the left lung has two lobes."
b. "The lungs are precisely symmetric structures."
c. "Asthma has the highest burden on people living at or below the federal poverty level."
d. "Lung cancer is the most commonly diagnosed cancer."
b. "The lungs are precisely symmetric structures."
How do you perform the whispered pectoriloquy test? What is the normal finding?
Whisper a phrase while listening to chest wall
Normal is muffled/inaudible, abnormal is clear and distinct
How do you perform the bronchophony test? What is the normal finding?
Client says "ninety-nine" while listening to chest wall
Normal voice transmission is soft/muffled/indistinct, abnormal is clear
0.75mL
12.5mg / 50mg = 0.25
0.25 x 2mL = 0.75mL
Which of the following is true regarding aging changes of the lungs and thorax? Select all that apply.
a. Older clients have increased lung capacity
b. Older clients may have a change in the chest wall
c. Older clients have a decreased chest expansion
d. You do not need to take breaks with older clients when performing an assessment
b. Older adults may have a change in the chest wall (kyphosis)
c. Older clients have a decreased chest expansion
Which of the following are abnormal findings of an assessment of the thorax and lungs? Select all that apply.
a. Cyanosis of the nail bed
b. Decreased level of consciousness
c. Symmetrical chest expansion
d. Tenderness upon percussion
e. Hearing crackles during auscultation
f. Bradypnea
a. Cyanosis of the nail bed
b. Decreased level of consciousness
d. Tenderness upon percussion
e. Hearing crackles during auscultation
f. Bradypnea
How do you perform the egophony test? What is the normal finding?
Client says "eee-ee-ee” while listening to chest wall
Normally hear “eee”, abnormal is “aaa”
Define the following terms:
1. Dyspnea
2. Orthopnea
3. Paroxysmal nocturnal dyspnea
1. Difficulty breathing
2. Difficulty breathing when lying down
3. SOB that wakes patient up
The doctor writes an order for an IV bolus. The order says to administer 20 mg IV BID. Available is a vial that is labeled 40mg/5ml. How many ml will the patient receive daily?
20mg / 40mg = 0.5
0.5 x 5mL = 2.5mL
2.5 x 2 (BID) = 5mL