Question

a 72 - year - old woman with a history of hypertension presents with ankle swelling. jvp is observed at 5 cm above the sternal angle at 30°. elevated jvp, consistent with dehydration. normal finding. artifact, should be ignored. elevated jvp, consistent with heart failure. question 38 (2 points) on tactile fremitus, you note increased vibration over the right lower lobe. which condition is this most consistent with? pleural effusion pneumothorax lobar pneumonia normal finding

Explanation:

1. For the first question about JVP: The normal JVP is usually less than 3 cm above the sternal angle at 45 - degree elevation. Here, it is 5 cm at 30 - degree elevation, indicating an elevated JVP. Ankle swelling and elevated JVP are common in heart failure, not dehydration (which would cause low JVP). It is not a normal finding or an artifact.
2. For the second question about tactile fremitus: Tactile fremitus is increased when there is consolidation of lung tissue. Lobar pneumonia causes consolidation, while pleural effusion and pneumothorax decrease tactile fremitus. It is not a normal finding.

Answer:

1. Elevated JVP, consistent with heart failure.
2. Lobar pneumonia