The nurse is doing an assessment of an adult client and noticed unequal chest expansion. The nurse recognizes that unequal chest expansion occurs:

When part of the lung is obstructed or collapsed

When bulging of the intercostal spaces is present

In an obese patient

When accessory muscles are used to augment respiratory effort

Answer and Explanation

The Correct Answer is A

A. When part of the lung is obstructed or collapsed: This statement is accurate. Unequal chest expansion can occur when part of the lung is obstructed or collapsed, preventing the affected area from expanding normally during inhalation.

B. When bulging of the intercostal spaces is present: This statement is not accurate. Unequal chest expansion typically refers to decreased expansion on one side, not bulging of intercostal spaces.

C. In an obese patient: This statement is not accurate. Obesity can affect breathing patterns and lung function, but it is not the primary cause of unequal chest expansion.

D. When accessory muscles are used to augment respiratory effort: This statement is not accurate. The use of accessory muscles to augment respiratory effort can be a sign of respiratory distress, but it doesn't directly cause unequal chest expansion. Unequal expansion is more indicative of specific lung conditions or issues with lung mechanics.

Nursing Test Bank

Test Bank #1: RN Pharmacology Exams Test Bank #2: RN Medical-Surgical Exams Test Bank #3: RN Fundamentals Exams Test Bank #4: RN Maternal-Newborn Exams Test Bank #5: RN Anatomy and Physiology Exams Test Bank #6: RN Obstetrics and Pediatrics Exams Test Bank #7: RN Fluid and Electrolytes Exams Test Bank #9: RN Adult Health Test Bank #10: RN Dosage Calculation Test Bank #11: RN Community Health Exams Test Bank #12: RN Psychology Exams Test Bank #13: RN Nursing Care Of Children Test Bank #14: RN Foundations of Nursing Exams

Get 100+ Naxlex Exit Exams for $79 Try Naxlex NCLEX-RN (14 Day Free-Trial)

Naxlex Comprehensive Predictor Exams

Exam #1: RN Comprehensive predictor 2023 proctored exam Exam #2: Ati rn vati comprehensive predictor proctored exam Exam #3: Ati Rn Comprehensive Predictor Proctored Exam 2023 Exam #4: Rn Comprehensive Predictor 2023 Proctored Exam - St. Joseph Exam #5: RN Comprehensive Predictor Proctored Exam (National U CA San Diego) Exam #6: Ati rn comprehensive predictor 2023 retake proctored exam Exam #7: RN Hesi Exit Proctored Exam Exam #8: Hesi RN Exit proctored exam Exam #9: Hesi rn exit proctored exam Exam #10: Hesi Rn compass exit B proctored exam

Free Nursing Study Resources

Correct Answer is D

Explanation

A. Listening for all possible sounds at a time at each specified area: This approach does not allow for specific localization of different heart sounds and murmurs, making it difficult to accurately assess the heart's condition.

B. Listening to the sounds at the aortic, tricuspid, pulmonic, and mitral areas: This option is close but lacks the systematic approach of method D. Listening at specific anatomical locations (aortic, tricuspid, pulmonic, mitral) is important, but the Z pattern allows for thorough coverage and precise localization of any abnormal sounds.

C. Listening to the sounds only at the site where the apical pulse is felt to be the strongest: This method does not cover all the important auscultation sites on the heart and may miss significant findings.

D. Listening by inching the stethoscope in a rough Z pattern, from the base of the heart across and down, then over to the apex: This technique involves a systematic approach where the nurse listens at specific locations in a structured manner, ensuring comprehensive coverage of the heart sounds and murmurs.

A. Wheezes B. Whispered pectoriloquy C. Bronchial sounds D. Bronchophony

Correct Answer is A

Explanation

A. Wheezes:

Wheezes are continuous, high-pitched, whistling lung sounds that are heard especially during expiration and sometimes during inspiration. They are caused by the rapid movement of air through narrowed or constricted airways, which is common in conditions like asthma. Wheezing is a characteristic adventitious sound associated with asthma and other obstructive respiratory disorders.

B. Whispered Pectoriloquy:

Whispered Pectoriloquy is an increased loudness of whispering noted during auscultation with a stethoscope on the lung fields. This phenomenon occurs when sound is transmitted clearly through consolidated or compressed lung tissue, making whispered sounds more distinct. It is a sign of lung consolidation, often seen in conditions like pneumonia.

C. Bronchial Sounds:

Bronchial sounds are harsh, high-pitched sounds heard over the trachea and the large bronchi. These sounds are normally heard during expiration. If they are heard over peripheral lung areas, it can indicate consolidation or compression of lung tissue, possibly due to pneumonia or tumor.

D. Bronchophony:

Bronchophony is a phenomenon in which spoken sounds are heard more clearly and distinctly through the stethoscope on auscultation of the lungs. Normally, sounds are muffled during auscultation. Increased clarity of spoken sounds can indicate lung consolidation, similar to whispered pectoriloquy, and is often associated with conditions like pneumonia.

View Question and Answer

Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.

Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today

The nurse is doing an assessment of an adult client and noticed unequal chest expansion. The nurse recognizes that unequal chest expansion occurs:

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is preparing to auscultate for heart sounds on a client. Which of the following technique should be used by the nurse?

Correct Answer is D

Explanation

The nurse is listening to the breath sounds of young adult client with severe asthma. The nurse recognizes that air passing through narrowed bronchioles would produce which of these adventitious sounds?

Correct Answer is A

Explanation

The nurse is caring for an older adult client who has recently had a stroke. The nurse assesses that the right side of the client's face is drooping. The nurse might also expect which of the following assessment findings?

The nurse is performing a breast exam on a client. The client asks the nurse why the left breast is slightly larger than the right breast. Which of the following should be the appropriate response by the nurse?

The nurse examines a client's auditory canal and tympanic membrane with an otoscope. The nurse recognizes that which of the following is considered an abnormal finding?

The nurse recognizes that the following statement is true regarding the internal structures of the breast: The breast is made up of:

The nurse is assessing the heart sounds of a client. The nurse understands that to listen to the pulmonic valve, the stethoscope should be placed where?

The nurse is performing an assessment of the clients lungs. The nurse recognizes that the left lung:

The nurse is teaching a group of clients about modifiable risk factors for cardiovascular disease. Which of the following should the nurse include in the teaching? (Select all that apply)

The nurse is performing a breast examination on a client. The nurse understands that examining the upper outer quadrant of the breast is especially important because this part is: