Physical Examination and Health Assessment 8th Edition 0323510809
Chapter 19: Thorax and Lungs Jarvis: Physical Examination and Health Assessment, 8th Edition MULTIPLE CHOICE 1. Which of these statements is true regarding the vertebra prominens? a. It is the spinous process of C7. b. It is nonpalpable in most individuals. c. It is opposite the interior border of the scapula. d. It is located next to the manubrium of the sternum. ANS: A
The spinous process of C7 is the vertebra prominens and is the most prominent bony spur protruding at the base of the neck. Counting ribs and intercostal spaces on the posterior thorax is difficult because of the muscles and soft tissue. The vertebra prominens is easier to identify and is used as a starting point in counting thoracic processes and identifying landmarks on the posterior chest. The vertebra prominens is not opposite the interior border of the scapula or next to the manubrium of the sternum. Instead, the vertebra prominens is the spinous process of C7. It is the most prominent bony spur protruding at the base of the neck, thus, it is easy to identify and palpate. Because counting ribs and intercostal spaces on the posterior thorax is difficult due to the number of muscles and soft tissue, the vertebra prominens is used as a starting point in counting thoracic processes and identifying landmarks on the posterior chest. DIF: Cognitive Level: Remembering (Knowledge) MSC: Client Needs: Health Promotion and Maintenance 2. When performing a respiratory assessment on a patient, the nurse notices a costal angle of
approximately 90 degrees. What should the nurse recognize about this finding? a. Observed in patients with kyphosis. b. Indicative of pectus excavatum. c. A normal finding in a healthy adult. d. An expected finding in a patient with a barrel chest. ANS: C
The right and left costal margins form an angle where they meet at the xiphoid process. Usually, this angle is 90 degrees or less. The angle increases when the rib cage is chronically overinflated (barrel chest), as in emphysema.This is a normal finding and is not associated with kyphosis or indicative of pectus excavatum. DIF: Cognitive Level: Understanding (Comprehension) MSC: Client Needs: Health Promotion and Maintenance 3. When assessing a patient’s lungs, what should the nurse recall about the left lung? a. Consists of two lobes. b. Is divided by the horizontal fissure. c. Primarily consists of an upper lobe on the posterior chest. d. Is shorter than the right lung because of the underlying stomach. ANS: A
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