Download NURS 316 Final Exam Questions With Complete Solutions: Human Anatomy and Physiology and more Exams Nursing in PDF only on Docsity!
NURS 316 Final Exam Questions With
Complete Solutions
Where does the trachea bifurcate? correct answer: Manubrium (Angle of Louis) Where does the trachea begins? correct answer: Level of cricoid cartilage Costal Angle correct answer: The right and left costal margins form a 90 degree angle where they meet at xiphoid process. Costalchondritis correct answer: Inflammation of costal cartilage. When does the costal angle increases? correct answer: Costal angle increases when the lungs or rib cage are hyperextended such as in diseases like emphysema and COPD. What is another name for Angle of Louis? correct answer: Manubriosternal angle When someone aspirate which lung would most likely be affected? correct answer: The right lung because it's bronchi is wider and shorter than the left. What is bronchial (tracheal) sounds? correct answer: - Pitch: High
- Duration: Inspiration < Expiration
- Quality: Harsh, hallow tubular
- Location: Trachea and Larynx What happens to the diaphragm during normal breath? correct answer: Inspiration the diaphragm goes down. Expiration the diaphragm goes up. Where is the apex of the lungs? correct answer: C What is bronchovesicular breath sound? correct answer: - Pitch: Moderate
- Amplitude: Moderate
- Duration: Inspiration = Expiration
- Quality: Mixed
- Location: Over major bronchi Where is the base of the lungs? correct answer: T What level does the trachea bifurcate? correct answer: T4 or T How many lobes are in the right lung? correct answer: 3 lobes How many lobes are in the left lung? correct answer: 2 lobes What level does the lungs expand during deep inspiration? correct answer: T Dyspnea correct answer: - Difficulty or labored breathing, shortness of breathe.
- A sign of serious disease of the airway, lungs, or heart.
transmission of vibration (obstructed bronchus, pneumothorax, emphysema)
- Increased fremitus: occurs with compression or consolidation of lung tissue (lobar pneumonia)
- This is present when the bronchus is patent and when the consolidation extends to the lung surface.
- Rhoncal fremitus: is palpable with thick bronchial secretions.
- Pleural friction fremitus: is palpable with inflammation of the pleura.
- Crepitus: is a coarse, crackling sensation palpable over the skin surface. Chest Expansion correct answer: Placing your warmed hand on the posterolateral chest wall with thumbs at the level of T9 or T10. Slide your hands medially to pinch up a small fold of skin between your thumb. Ask the person to take a deep breath. Your thumb should move apart symmetrically. Tactile Fremitus correct answer: Use either the palmar base of the fingers or the ulnar edge of one hand, and touch the person's chest while he or she repeats the words "ninety-nine" or "blue moon". These are resonant phrases that generate strong vibration. Start over the lung apices and palpate from one side to another. What causes dull sounds over lung tissue when percussing? correct answer: - In heavily obese adult in whom subcutaneous fat produces scattered dullness.
- A dull note (soft, muffled thud) signals abnormal density in the lungs, as with pneumonia, pleural effusion, atelactasis, or tumor.
Bronchophony correct answer: Positive bronchophony is loud and distint "99" are heard. Egophony correct answer: Positive egophony is "AAA" sounds is heard instead of "EEE" sounds. Whispered Pectoriloquy correct answer: Positive whispered pectoriloquy is "1, 2, 3" sounds are distinct and clear. Respiratory Developmental Findings in Aging Adults correct answer: - Chest cage commonly shows an increased anteroposterior diameter, giving a round barrel shape.
- Kyphosis: "hunchback" an outward curvature of thoracic spine. Tachyapnea correct answer: is rapid breathing. Bradypnea correct answer: is abnormally slow breathing rate. How to hear a split S2? correct answer: - A split S2 is heard only in the pulmonic valve area, the second left interspace.
- The split S2 occurs about every fourth heartbeat.
- Occurs toward the end of inspiration in some people.
- Aortic valve closes before the pulmonic valve. What sounds indicate inflation of the pericardium? correct answer: - Inflammation of the pericardium gives rise to a friction rub. The sound is high pitched and scratchy, like sandpaper being rubbed.
- It is best heard with the diaphragm, with the person sitting up and leaning forward, and with the breath held in expiration.
What causes increased of intraocular pressure? correct answer: - Coughing, vomiting, weight lifting, labor during childbirth, straining at stool, or trauma
- Determined by a balance between the amount of aqueous produced and resistance it its outflow at the angle of the anterior chamber. What is the Organ of Corti? correct answer: - The numerous fibers along the basilar membrane are the receptor hair cells of the organ of Corti, the sensory organ of hearing. As the hair cells bend, they mediate the vibrations into electric impulses. The electrical impulses are conducted by the auditory portion of cranial nerve VIII to the brainstem. What is the Cochlea? correct answer: - The cochlea (Latin for "snail shell") contains the central hearing apparatus. Although the inner ear is not accessible to direct examination, you can assess its functions. What is the Labrynth? correct answer: - The inner ear is embedded in bone. It contains the bony labyrinth, which holds the sensory organs for equilibrium and hearing. Within the bony labyrinth, the vestibule and the semicircular canals compose the vestibular apparatus and the cochlea (Latin for "snail shell") contains the central hearing apparatus. What is causes osteoporosis? correct answer: - Decrease in skeletal bone mass occurring when rate of bone resorption is greater than that of bone formation. The weakened bone state increases risk for stress fractures, especially at wrist, hip, and
vertebrae. Occurs primarily in postmenopausal white women. Osteoporosis risk also is associated with smaller height and weight, younger age at menopause, lack of physical activity, and lack of estrogen in women. What is tendinitis? correct answer: - Tendinitis is worse in morning, improves during the day.
- A tendon is a cord of tough tissue that connects muscle to bone. The tendon is surrounded by a sheath that protects and lubricates the tendon.
- This sheath is lined by a layer of cells called the synovium. Occasionally, the tendon will become inflamed (called tendinitis) or the tendon sheath will become inflamed (called tenosynovitis). These conditions together are known as tendinitis and result in pain, stiffness and sometimes swelling. What is osteoarthritis? correct answer: - Osteoarthritis is worse later in the day; tendinitis is worse in morning, improves during the day.
- Noninflammatory, localized, progressive disorder involving deterioration of articular cartilages and subchondral bone and formation of new bone (osteophytes) at joint surfaces. Aging increases incidence; nearly all adults older than 60 years have some radiographic signs of osteoarthritis. -Asymmetric joint involvement commonly affects hands, knees, hips, and lumbar and cervical segments of the spine. Affected joints have stiffness, swelling with hard, bony protuberances, pain with motion, and limitation of motion
stripped out of leg to eliminate varicose veins or used as source of grafts in coronary bypass surgery. What is Ataxia? correct answer: Staggering, wide based gait; difficulty with turns; uncoordinated movement. Caused by alcohol/barbiturate effect on cerebellum, cerebellar tumor, multiple sclerosis. Test: Romberg Test What is Asteriogenesis? correct answer: Inability to identify object correctly. Occurs in sensory cortex lesions (ex: brain attack - stroke) Test: Stereognosis What is Dysdiadochokinesia? correct answer: Slow, clumsy, and sloppy response. Occurs with cerebellar disease. Test: Rapid Alternating Movements What is Kinesthesia? correct answer: Ability to perceive passive movements of extremities. Test: Position (Fingers) What is Cerebrum? correct answer: Divided into two hemispheres, four lobes (frontal, parietal, temporal, and occipital. What is Cerebellum? correct answer: Coiled structure under occipital lobe concerned with motor coordination of voluntary movements, equilibrium, and muscle tone. DOESN'T initiate movement, but coordinates/smoothes movement.
Cranial nerves: Enter and exit the brain. CN I and II extend from cerebrum; CN III - XII extend from lower diencephalon and brainstem. Supply primarily head and neck (except Vagus Nerve - travels to heart, respiratory, muscles, stomach and gallbladder). What is Medulla Oblongata? correct answer: Part of brainstem; continuation of spinal cord in brain that contains all ascending and descending fiber tracts. Has vital autonomic centers (resp, heart, GI function) and nuclei for CN VIII - XII. Site of pyramidal decussation (crossing of motor fibers). What happens if there is nystagmus? correct answer: The back- and-forth oscillation of the eyes, eyes move really fast. Usually occurs with vestibular, cerebellar, or brainstem disease. End- point nystagmus (few beats horizontal nystagmus at extreme lateral gaze) occurs normally. Assess other nystagmus noting presence in one/both eyes, pendular/jerk movements, amplitude (fine, medium, coarse), frequency, and plane of movement. What is the Glasgow coma scale? correct answer: Is a quantitative tool that is useful in testing consciousness in aging persons in whom confusion is common. It gives a numerical value to the person's response in eye-opening, best verbal response, and best motor response. This system avoids ambiguity when numerous examiners care for the same person. What is the Glasgow coma scale for brain's functional level? correct answer: Total score reflects brain's functional level. 15 = fully alert, normal person ≤7 = coma
What is atherosclerosis? correct answer: - Plaque buildup in arteries. What is lymphedema? correct answer: - Is high protein swelling of the limb, most commonly due to breast cancer treatment. What does positive shifting dullness means? correct answer: Large volume of ascitic fluid; it will not detect less than 500ml of fluid. What does positive fluid test means? correct answer: Large amount of ascitic fluid. NOTE: The blow will generate a fluid wave through the abdomen and you will feel a distinct tap on your left hand. What are signs of intra-abdominal bleeding? correct answer: 1. Vomit bright red blood (bleeding in the stomach)
- Blood in the stool (bleeding in the GI tract)
- Black tarry stool (bleeding from stomach or duodenum)
- Bruising surrounding the umbilicus (Cullen's sign)
- Bruising in the flanks (Grey-Turner sign) What are the characteristic of an enlarged spleen? correct answer: - It retains the splenic notch on the medial edge.
- During acute infection, it is moderately enlarged and soft with rounded edges.
- During chronic cause, the enlargement is firm or hard with sharp edges.
- An enlarged spleen is usually not tender to palpation.
- It is tender only if the peritoneum is also inflamed.
Difference between an enlarge spleen and an enlarge kidney? correct answer: - The spleen may have a sharp edge, whereas the kidney never does.
- The spleen retains the splenic notch, whereas the kidney has no palpable notch.
- Percussion over the spleen is dull, whereas over the kidney it is tympanitic because of the overriding bowel. What is an umbilical hernia? correct answer: - Umbilical hernia is soft, skin-covered mass, which is the protrusion of the omentum or intestine through a weakness or incomplete closure in the umbilical ring. What are symptoms of an abdominal tumor? correct answer: - Localized distension
- Normal bowel sounds
- Dull over mass if reached up to skin surface
- Define borders. Distinguish from enlarged organ or normally palpable structure What is peptic ulcer? correct answer: - Is an open sore or raw area in the lining of the stomach or intestines.
- Occurs with frequent use of nonsteroidal anti-inflammatory drugs (NSAIDs), alcohol, smoking, and Helicobacter pylori infection.
- Sharp pain in the epigastric region. What is appendicitis? correct answer: - Appendicitis typically starts as dull, diffuse pain in periumbilical region that later shifts
- Percussion. Tympany at top where intestines float. Dull over fluid. Produces fluid wave and shifting dullness.
- Palpation. Taut skin and increased intra-abdominal pressure limit palpation. How to assess for constipation? correct answer: - Inspection. Localized distention.
- Auscultation. Normal bowel sounds.
- Percussion. Tympany predominates. Scattered dullness over fecal mass.
- Palpation. Plastic-like or rope-like mass with feces in intestines. How to assess for distended bladder? correct answer: - Dullness with percussion
- Midline How to assess for abdominal tumor? correct answer: - Inspection. Localized distention.
- Auscultation. Normal bowel sounds.
- Percussion. Dull over mass if reaches up to skin surface.
- Palpation. Define borders. Distinguish from enlarged organ or normally palpable structure. What causes dull sounds over lung tissues when percussing? correct answer: - The sound is dull when percussing over bone.
- Dullness can also signal abnormal density in the lungs, as with pneumonia, pleural effusion, atelactesis, or tumor. What is bronchial (tracheal)? correct answer: - High
- Loud
- Inspiration < Expiration
- Harsh, hollow tubular
- Trachea and larynx What is the brochovesicular? correct answer: - Moderate
- Moderate
- Inspiration = Expiration
- Mixed
- Over major bronchi where fewer alveoli are located: posterior, between scapulae especially on right; anterior, around upper sternum in first and second intercostal spaces. What is the vesicular? correct answer: - Low
- Soft
- Inspiration > Expiration
- Rustling, like sound of the wind in the trees
- Over perpheral lung fields where air flows through smaller bronchioles and alveoli What is intermittant claudication? correct answer: - Feels like "cramp," "numbness and tingling," "feeling of cold"
- Typically occurs with walking and goes away with rest.
- Occurs due to poor circulation of blood in arteries of the legs (narrowing of arteries that supply leg with blood limits supply of oxygen to leg muscles, oxygen requirement of these muscles rise with exercise which is why it occurs with walking. Which two musculoskeletal disease are worse in the morning? correct answer: 1. Tendinitis
- Rheumatoid Arthritis (RA)
What is not suppose to be in the midline of the abdomen? correct answer: - Uterus (enlarged)
- Bladder (distended) Abdominal Developmental change in Aging Adults correct answer: - In females, some fat accumulates in suprapubic area as a result of decreased estrogen levels.
- In males, fat deposits in abdominal areas resulting in "spare tire"
- Salivation decreases causing dry mouth
- Decrease in sense of taste
- An aging person is fed in supine position, increases risk of aspiration
- Gallstones increases with age
- Liver size decreases with age
- Blood flow through the liver decreases What is dysphagia? correct answer: Difficulty swallowing What is the pattern of pubic hair growth? correct answer: - In males, diamond shape.
- In females, inverted triangle shape. Where should you begin auscultation of the abdomen? correct answer: Begin in the RLQ at ileocecal valve area because bowel sounds are normally always present here. What is hyperperistalsis? correct answer: - When you feel your "stomach growling"
- Also called Borborygmus.
What are the mean liver span for male and female? correct answer: - For male, 10.5cm.
- For female, 7 cm. Is the spleen normally palpable? correct answer: Normally spleen is not palpable and must be enlarged three times its normal size to be felt. What is the Blumbergs sign (rebound tenderness)? correct answer: Positive result is pain on release of pressure. What is the Murphy's sign (inspiratory arrest)? correct answer: Test for Cholecystitis pain on deep inspiration? What is the Iliopsoas muscle test? correct answer: - Perform when an acute abdominal pain of appendicitis is suspected.
- Supine patient lifts right leg straight up you push down on lower thigh while person tries to keep leg up if positive will cause pain. What is a positive fecal occult blood test? correct answer: Blue means blood is present in the stool. Test for peptic ulcer disease. What causes drier cerumen in aging adults? correct answer: Atrophy of apocrine glands. What is otosclerosis? correct answer: - Gradual hardening that causes foot plate of stapes to become fixed in oval window, impeding transmission of sound and causing progressive deafness.
