Certified Registered Nurse Anesthetist (CRNA) Practice Exam

What will be the most predominant auscultatory finding in a child with a foreign body lodged in the right mainstem bronchus?

1. Expiratory wheezing

2. Severely diminished airflow in the right lung

3. Inspiratory wheezing

4. Normal lung sounds

The correct answer is: Expiratory wheezing

In a child with a foreign body lodged in the right mainstem bronchus, the most predominant auscultatory finding would likely be expiratory wheezing. This occurs as the obstruction in the airway leads to turbulent airflow around the foreign body, primarily during expiration when the airway diameter decreases due to the increased intrathoracic pressure. The presence of wheezing, which is a high-pitched sound, indicates that narrowed airways are creating resistance to airflow. In this situation, expiratory wheezing is more common than inspiratory wheezing, particularly because expiratory airflow is more affected by obstruction in the bronchial tree when airways collapse during expiration. As for other auscultatory findings, severely diminished airflow in the right lung may be present, but this would not be as pronounced as the wheezing and could vary in presentation depending on the degree of obstruction. Normal lung sounds would not typically be expected, given that a foreign body typically causes significant changes in airflow and lung auscultation findings.