To assess for the presence of egophony, which instruction should the nurse give the client who has a lung abscess?

Breathe in and out while all lobes of both lungs are auscultated.

Whisper "one, two, three" in sequence during auscultation of the thorax.

Repeat the number "99" during a systematic auscultation of the thorax.

Repeat vocalizing the letter "E" while the thorax is auscultated.

Answer and Explanation

The Correct Answer is D

A.   This is not specific for egophony. While lung auscultation is part of a thorough assessment, egophony is assessed when the patient vocalizes a specific sound, not just breathing in and out.
B.   This is a technique used to assess for whispered pectoriloquy, not egophony. The nurse would be looking for clarity of the whispered words, which is different from assessing for egophony.
C.   This test is used to assess for bronchophony, where the nurse listens for clarity or increased volume of spoken words over the lungs. It is not related to egophony, which is a change in the sound when the client says "E."
D.   This is the correct method for assessing egophony. In this test, the client is asked to say "E," and the nurse listens for any change in the sound. Normally, the "E" should sound like "E." If it sounds like "A," it indicates egophony, which can suggest a lung consolidation, such as might occur with a lung abscess.

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Correct Answer is D

Explanation

A. This is a normal finding where the right pupil constricts when the light is directed at it, and the left pupil constricts consensually as well. This suggests normal function of the pupillary light reflex pathway, and no further evaluation is needed.
B. This also indicates normal pupillary function. Equal pupil size and appropriate constriction to light are typical findings, suggesting no immediate issues with the nervous system.
C. Pupil size should not change in response to distance unless there is a near response (accommodation). If the pupil size changes to distance of the light source instead of light reflex, this suggests potential abnormality in the pupillary reflex response.
D. This is an abnormal finding. A "notched" iris suggests possible damage or congenital anomalies, and minimal change in pupil size may indicate impaired pupil reflexes, requiring further evaluation to rule out neurological or ophthalmologic issues.

A. Hematocrit changes from 36% to 32%. B. Hemoglobin A1C changes from 10% to 8%. C. Prothrombin time (PT) changes from 12 seconds to 18 seconds. D. Guaiac test changes from positive to negative.

Correct Answer is A

Explanation

A. A decrease in hematocrit from 36% to 32% suggests ongoing blood loss and that the client’s GI bleeding has not yet resolved. Hematocrit is a key indicator of the client’s blood volume and oxygen- carrying capacity.
B. Hemoglobin A1C reflects long-term blood sugar control, not current blood loss. A change in A1C is not indicative of GI bleeding resolution.
C. An increase in prothrombin time (PT) from 12 to 18 seconds indicates clotting abnormalities, which may occur with liver dysfunction or anticoagulant therapy, but it doesn't directly relate to GI bleeding resolution.
D. A positive to negative change in the guaiac test (fecal occult blood test) would indicate that the blood in the stool is no longer present, suggesting resolution of bleeding, which doesn’t match the question’s context.

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To assess for the presence of egophony, which instruction should the nurse give the client who has a lung abscess?

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Naxlex Comprehensive Predictor Exams

While conducting a physical assessment, the nurse shines a pen light into a client's right eye and moves the light source to check the client's left eye. Which finding indicates the need for further evaluation?

Correct Answer is D

Explanation

Correct Answer is A

Explanation

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