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Chest X-ray interpretation: Not just black and white

doi: 10.1097/01.NURSE.0000441900.80913.f5
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INSTRUCTIONS Chest X-ray interpretation: Not just black and white


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Chest X-ray interpretation: Not just black and white

GENERAL PURPOSE: To help nurses recognize both normal anatomy and life-threatening abnormalities on a chest X-ray (CXR). LEARNING OBJECTIVES: After reading this article and taking this test, you should be able to: 1. Identify normal findings on a CXR. 2. Discuss CXR findings that indicate pathology.

  1. Which statement is true regarding CXR views?
    1. Portable CXRs provide posteroanterior (PA) views.
    2. For PA views, the X-ray beam passes from the front to the back of the chest.
    3. Patients must stand for anteroposterior (AP) views.
    4. In the AP view, the heart is magnified.
  2. On maximum inspiration, the diaphragm should be seen at the segment of the
    1. 6th rib anteriorly.
    2. 8th rib posteriorly.
    3. 10th rib anteriorly.
    4. 12th rib posteriorly.
  3. The most common location of pleural effusions on erect CXRs is the
    1. right middle lobe.
    2. lung apices.
    3. lung bases.
    4. mediastinum.
  4. Which of the following shows up as a radiolucent area on a CXR?
    1. trachea
    2. fat pads
    3. ECG electrodes
    4. heart
  5. When a CXR has good penetration, the
    1. left hemidiaphragm is usually higher than the right.
    2. lower thoracic vertebral bodies can be seen through the heart.
    3. diaphragm will appear black.
    4. breasts will appear white.
  6. Posterior structures on a CXR include
    1. bilateral upper lung lobes.
    2. the right and left heart borders.
    3. the right lung's middle lobe.
    4. the descending aorta.
  7. A deviated trachea on CXR may indicate any of the following except
    1. improper patient positioning.
    2. thyroid enlargement.
    3. pneumonia.
    4. tension pneumothorax.
  8. An endotracheal tube is placed correctly when the tip is
    1. 1 to 2 cm in the right bronchus.
    2. 1 to 2 cm above the carina.
    3. 3 to 5 cm above the carina.
    4. 3 to 5 cm in the left bronchus.
  9. Widened intercostal spaces may be associated with
    1. pneumothorax.
    2. hyperinflation of the lungs.
    3. cardiomegaly.
    4. acute respiratory distress syndrome.
  10. An enlarged mediastinum may indicate
    1. an aortic aneurysm.
    2. pneumonia.
    3. tuberculosis.
    4. pulmonary edema.
  11. A flattened diaphragm is often seen in patients who have
    1. a pleural effusion.
    2. abdominal distension.
    3. phrenic nerve compression.
    4. COPD.
  12. The tip of a temporary transvenous pacemaker's lead should be in the
    1. proximal left pulmonary artery.
    2. superior vena cava.
    3. right ventricular apex.
    4. right atrium.
  13. When the silhouette sign is seen in the anterior thoracic structures, pneumonia is found in
    1. an upper lung lobe.
    2. the left lower lung lobe.
    3. the right middle lung lobe.
    4. the right lower lung lobe.
  14. Which statement is correct about atelectasis on CXR?
    1. Lung volume is reduced.
    2. Diaphragmatic depression is present.
    3. Alveoli are hyperinflated.
    4. Lower lobe density is decreased.
  15. All of the following may indicate pulmonary edema on CXR except
    1. a butterfly pattern.
    2. an air bronchogram sign.
    3. a ground-glass appearance.
    4. Kerley B lines.
  16. The lobe most likely to become atelectatic is the
    1. right upper lobe.
    2. left lower lobe.
    3. right middle lobe.
    4. left upper lobe.
  17. Findings on CXR that may indicate calcifications include lesions with
    1. speculated edges.
    2. the same density as water.
    3. lobulated edges.
    4. the same density as bone.
  18. Cavitation of the lung on CXR is seen with
    1. an abscess.
    2. bullae.
    3. tuberculosis.
    4. blebs.


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