EXAM #3 Penn State Nursing Exam (NOVEMBER 2nd Year)

For EXAM #3 In Penn State 2nd year Nursing Program (BSN)

Which structure is responsible for gas exchange in the lungs?

Alveoli

What term describes the normal sound heard over most lung fields during auscultation?

Vesicular breath sounds — soft, low-pitched sounds heard over peripheral lung fields.

Which abnormal finding is commonly associated with pneumonia?

Crackles — caused by fluid in alveoli, often present in pneumonia.

During a respiratory history, which subjective symptom is most significant to assess?

Shortness of breath (dyspnea) — critical indicator of respiratory compromise

What is the correct sequence for a respiratory physical assessment?

Inspection → Palpation → Percussion → Auscultation.

Which adventitious sound is described as discontinuous, popping noises heard during inspiration?

Crackles — caused by air passing through fluid or collapsed alveoli reopening.

Rhonchi are best described as:

Low-pitched, snoring-like sounds caused by secretions in large airways.

Which condition is characterized by wheezing due to airway narrowing?

Asthma — bronchoconstriction leads to wheezing.

Which physical change can reduce lung compliance and impair function?

Aging-related stiffening of the chest wall and loss of alveolar elasticity.

What finding suggests a pleural effusion during percussion?

Dullness — fluid accumulation dampens percussion sounds

Collapse of alveoli → decreased breath sounds, dull percussion, possible crackles.

Atelectasis

• Inflammation of bronchi → productive cough, rhonchi, sometimes wheezes.

• May show normal percussion but coarse breath sounds.

Bronchitis (acute or chronic)

• Destruction of alveolar walls → hyperresonant percussion, decreased breath sounds, barrel chest.

• Associated with COPD.

Emphysema

• Reversible airway obstruction → wheezing, prolonged expiration, possible use of accessory muscles.

• Triggered by allergens, exercise, or irritants.

Asthma

Fluid in pleural space → dull percussion, decreased breath sounds, possible dyspnea.

Pleural Effusion

Air in pleural space → hyperresonance, absent breath sounds, tracheal shift if severe.

Pneumothorax

Fluid overload → crackles at lung bases, dyspnea, orthopnea.

Congestive Heart Failure (pulmonary edema)

Infection of alveoli → dull percussion, increased tactile fremitus, crackles, bronchial breath sounds.

Pneumonia

Chronic infection → cough, hemoptysis, weight loss, night sweats; may show consolidation signs.

Tuberculosis

Blockage of pulmonary artery → sudden dyspnea, chest pain, tachypnea; breath sounds may be normal or show crackles.

Pulmonary Embolism

Continuous, low-pitched, snoring/gurgling sounds caused by mucus or secretions

Ronchi

Correctly describe the flow of blood through the heart

RA → RV → lungs → LA → LV → body

ardiac output is defined as the volume of blood ejected per beat

Stroke volume

Which finding suggests right-sided heart failure

Jugular venous distension (JVD)

Which parts of the heart activates during S1 (Lub)

Mitral and Tricuspid 

Which parts of the heart activates during S2 (Dub)

Aortic and Pulmonary

S3 is…

Protodiastolic

The Heart’s Electric Cycle order

Protodiastolic (Rapid filling) > Diastole (slow filling) > Preystole > Isometric Contraction > Systole Ejection > Isometric Relaxation > Diastole (Raping filling)

P wave: 

Depolarization of the atria 

QRS:

Depolarization of the ventricles

T wave

Repolarization of ventricles

Preload:

Venous return that builds during diastole

Afterload:

Pressure against the ventricle to open the aortic valve

The Heart during Pregnancy:

Blood volume increases 30%-40%. Arterial blood pressure decreases

The Heart for Older Adults: 

The left ventricular wall thickens, arteries stiffen, systolic blood pressure rises, and pulse pressure widens.

The jugular vein…

empties oxygenated blood into superior vena cava 

Veins…

Bring DEoxygenated blood back to the heart

Arteries…

Take oxygenated blood AWAY from the heart toward the rest of the body

4 heart chambers

Right and Left Atrium, Right and Left Ventricle

Purpose of Valves:

To prevent backflow

During Diastole…

Ventricles relax and fill with blood

During Systole…

The heart contracts and eject blood (SL valves close)

S3 is which phase?

Protodiastolic (Rapid Filing)

Heart murmurs sound like

Gentle, blowing, whooshing

The heart pumps ___ Liters of blood per minute

40-60 liters

Angina is...

Chest discomfort caused by myocardial ischemia. (When the heart tissues does not get enough blood

Atherosclerosis: 

Plaque build up on arterial walls, making it narrow 

Bruit:

Turbulence in blood flow

Signs of Heart failure

S3 gallop, JVD, Decreased urine output, enlarged spleen and live, ascites

Ascites:

Abnormal fluid in the peritoneal cavity of the abdomen

APE TO MAN

2nd, 2nd, 3rd, 4th, 5th, 5th

Arterial complications

Ischemia (tissue death), gangrene, PAD, necrosis, cold extremities, numbness

Test for Gallbladder inflammation: 

Murphy’s Sign: 

Palpate under right costal margin at midclavicular line while patient takes a deep breath. If they stop breathing suddenly, they are positive

Test for Appendicitis

Rosving’s/McBurney’s point

Pain in lower left quadrant

Shifting dullness means…

Ascites