Patient Assessment & Diagnosis Flashcards

A patient with COPD presents with accessory muscle use, pursed-lip breathing, and a barrel chest. Which physical finding is most consistent with hyperinflation?

Answer: Decreased diaphragmatic excursion

Hyperinflation flattens the diaphragm, reducing its excursion and limiting effective breathing mechanics.

Which spirometry pattern is characterized by a reduced FVC, reduced FEV1, and a normal or elevated FEV1/FVC ratio?

Answer: Restrictive pattern

A restrictive pattern shows proportionally reduced FVC and FEV1 with a preserved or elevated FEV1/FVC ratio.

A respiratory educator is reviewing a patient's ABG: pH 7.30, PaCO2 55 mmHg, HCO3 27 mEq/L. What is the primary disorder?

Answer: Respiratory acidosis with partial compensation

Elevated PaCO2 with low pH indicates respiratory acidosis; the elevated HCO3 shows renal compensation has begun.

When performing a 6-minute walk test (6MWT) on a COPD patient, which finding most indicates a need to stop the test immediately?

Answer: SpO2 drops below 80%

An SpO2 below 80% is a critical stopping criterion for the 6MWT due to severe hypoxemia risk.

Which auscultation finding is most commonly associated with pulmonary fibrosis?

Answer: Fine, late-inspiratory crackles (Velcro crackles)

Pulmonary fibrosis produces fine, late-inspiratory crackles often described as Velcro-like due to fibrotic tissue opening during inspiration.

A peak flow reading of 65% of a patient's personal best indicates the patient is in which asthma action zone?

Answer: Yellow zone — caution

A peak flow of 50–79% of personal best places a patient in the yellow (caution) zone, warranting use of rescue medication and reassessment.

Which clinical sign best differentiates cardiac pulmonary edema from an acute asthma exacerbation on physical exam?

Answer: S3 gallop and jugular venous distension

An S3 gallop and jugular venous distension point to cardiac failure as the etiology of pulmonary edema rather than bronchoconstriction.