NUR 2092 HEALTH ASSESSMENT EXAM 2 REVIEW
2026/2027 | Rated A | Rasmussen College Complete Guide |
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DOMAIN 1: THORAX & LUNG ASSESSMENT (20 Questions)
Q1
A 68-year-old male with a 40-pack-year smoking history presents with progressive
dyspnea on exertion and a chronic productive cough. During posterior chest
auscultation, the nurse hears low-pitched, continuous sounds during expiration that
clear with coughing. These sounds are best described as:
A. Fine crackles indicating pulmonary edema
B. Rhonchi caused by secretions in large airways [CORRECT]
C. Wheezes indicating bronchospasm
D. Pleural friction rub suggesting pleurisy
Correct Answer: B
Rationale: Rhonchi are low-pitched, continuous, snoring-like sounds caused by
secretions or narrowing in large airways (trachea, bronchi). They are heard during
expiration (and sometimes inspiration), clear with coughing, and indicate obstruction
from secretions rather than structural airway narrowing. This patient's smoking history
and productive cough suggest chronic bronchitis or COPD with mucus production. Fine
crackles (Option A) are high-pitched, discontinuous, heard at end-inspiration, don't clear
with coughing, and indicate alveolar fluid (edema, fibrosis). Wheezes (Option C) are
,high-pitched, musical, indicate bronchospasm or narrowed airways, and don't clear with
coughing. Pleural friction rub (Option D) is grating, heard during both inspiration and
expiration, indicates inflamed pleura, and doesn't change with coughing.
Q2
A nurse is assessing a 45-year-old female with sudden onset pleuritic chest pain and
shortness of breath. Percussion over the right lower lobe reveals hyperresonance, and
breath sounds are absent. The nurse should suspect:
A. Right lower lobe pneumonia with consolidation
B. Right-sided pneumothorax with lung collapse [CORRECT]
C. Pleural effusion in the right hemithorax
D. Atelectasis of the right lower lobe
Correct Answer: B
Rationale: Pneumothorax presents with hyperresonant percussion (air in pleural space),
absent or diminished breath sounds (collapsed lung not ventilating), and sudden
pleuritic chest pain. The hyperresonance distinguishes pneumothorax from other
conditions. Pneumonia with consolidation (Option A) shows dullness to percussion
(solid tissue/fluid) and bronchial breath sounds (increased transmission through
consolidated lung). Pleural effusion (Option C) shows dullness or flatness to percussion
(fluid) and absent breath sounds at base with bronchial breathing above if lung
compressed. Atelectasis (Option D) shows dullness to percussion (collapsed tissue
density) and absent or decreased breath sounds.
Q3
,During anterior chest auscultation of a healthy 25-year-old male, the nurse places the
stethoscope over the 2nd intercostal space at the right sternal border. Which sound is
normally heard at this location?
A. Aortic valve closure
B. Pulmonic valve closure
C. Tricuspid valve closure
D. Erb's point
Correct Answer: A
Rationale: The 2nd intercostal space at the right sternal border is the aortic area where
A2 (aortic valve closure) is best heard. This is a standard cardiac auscultation site, not
pulmonary. The 2nd intercostal space at the left sternal border (Option B) is the
pulmonic area (P2). The 4th-5th intercostal space at left lower sternal border (Option C)
is the tricuspid area. Erb's point (Option D) is the 3rd intercostal space at left sternal
border where S1 and S2 are heard equally. This question tests anatomical
landmarks—the right 2nd ICS is exclusively aortic.
Q4
A 72-year-old female with heart failure is assessed for pulmonary status. The nurse
auscultates fine, high-pitched, discontinuous crackling sounds during late inspiration at
the lung bases bilaterally. These findings indicate:
A. Normal breath sounds in an elderly patient
B. Coarse crackles from secretions
, C. Fine crackles from pulmonary edema [CORRECT]
D. Sibilant wheezes from asthma
Correct Answer: C
Rationale: Fine crackles (rales) are high-pitched, discontinuous, short-duration sounds
heard during late inspiration, caused by sudden opening of alveoli or air moving through
fluid-filled alveoli. In heart failure, pulmonary edema causes fluid accumulation in alveoli
and interstitium, producing bilateral basilar fine crackles. They are not cleared by
coughing. Coarse crackles (Option B) are lower-pitched, longer, heard earlier in
inspiration, indicate secretions in larger airways, and often clear with coughing. Sibilant
wheezes (Option D) are high-pitched, musical, continuous, indicate narrowed airways,
and are heard during expiration. Normal breath sounds (Option A) in elderly may include
decreased vesicular sounds but not crackles—crackles are always abnormal.
Q5
A nurse is teaching a patient about proper technique for using an incentive spirometer.
Which instruction is CORRECT?
A. "Take rapid, shallow breaths to maximize volume"
B. "Exhale normally, then inhale slowly and deeply, holding for 3-5 seconds" [CORRECT]
C. "Use the device every hour while awake, taking 2-3 breaths each time"
D. "Blow into the device as forcefully as possible"
Correct Answer: B
2026/2027 | Rated A | Rasmussen College Complete Guide |
Pass Guaranteed
DOMAIN 1: THORAX & LUNG ASSESSMENT (20 Questions)
Q1
A 68-year-old male with a 40-pack-year smoking history presents with progressive
dyspnea on exertion and a chronic productive cough. During posterior chest
auscultation, the nurse hears low-pitched, continuous sounds during expiration that
clear with coughing. These sounds are best described as:
A. Fine crackles indicating pulmonary edema
B. Rhonchi caused by secretions in large airways [CORRECT]
C. Wheezes indicating bronchospasm
D. Pleural friction rub suggesting pleurisy
Correct Answer: B
Rationale: Rhonchi are low-pitched, continuous, snoring-like sounds caused by
secretions or narrowing in large airways (trachea, bronchi). They are heard during
expiration (and sometimes inspiration), clear with coughing, and indicate obstruction
from secretions rather than structural airway narrowing. This patient's smoking history
and productive cough suggest chronic bronchitis or COPD with mucus production. Fine
crackles (Option A) are high-pitched, discontinuous, heard at end-inspiration, don't clear
with coughing, and indicate alveolar fluid (edema, fibrosis). Wheezes (Option C) are
,high-pitched, musical, indicate bronchospasm or narrowed airways, and don't clear with
coughing. Pleural friction rub (Option D) is grating, heard during both inspiration and
expiration, indicates inflamed pleura, and doesn't change with coughing.
Q2
A nurse is assessing a 45-year-old female with sudden onset pleuritic chest pain and
shortness of breath. Percussion over the right lower lobe reveals hyperresonance, and
breath sounds are absent. The nurse should suspect:
A. Right lower lobe pneumonia with consolidation
B. Right-sided pneumothorax with lung collapse [CORRECT]
C. Pleural effusion in the right hemithorax
D. Atelectasis of the right lower lobe
Correct Answer: B
Rationale: Pneumothorax presents with hyperresonant percussion (air in pleural space),
absent or diminished breath sounds (collapsed lung not ventilating), and sudden
pleuritic chest pain. The hyperresonance distinguishes pneumothorax from other
conditions. Pneumonia with consolidation (Option A) shows dullness to percussion
(solid tissue/fluid) and bronchial breath sounds (increased transmission through
consolidated lung). Pleural effusion (Option C) shows dullness or flatness to percussion
(fluid) and absent breath sounds at base with bronchial breathing above if lung
compressed. Atelectasis (Option D) shows dullness to percussion (collapsed tissue
density) and absent or decreased breath sounds.
Q3
,During anterior chest auscultation of a healthy 25-year-old male, the nurse places the
stethoscope over the 2nd intercostal space at the right sternal border. Which sound is
normally heard at this location?
A. Aortic valve closure
B. Pulmonic valve closure
C. Tricuspid valve closure
D. Erb's point
Correct Answer: A
Rationale: The 2nd intercostal space at the right sternal border is the aortic area where
A2 (aortic valve closure) is best heard. This is a standard cardiac auscultation site, not
pulmonary. The 2nd intercostal space at the left sternal border (Option B) is the
pulmonic area (P2). The 4th-5th intercostal space at left lower sternal border (Option C)
is the tricuspid area. Erb's point (Option D) is the 3rd intercostal space at left sternal
border where S1 and S2 are heard equally. This question tests anatomical
landmarks—the right 2nd ICS is exclusively aortic.
Q4
A 72-year-old female with heart failure is assessed for pulmonary status. The nurse
auscultates fine, high-pitched, discontinuous crackling sounds during late inspiration at
the lung bases bilaterally. These findings indicate:
A. Normal breath sounds in an elderly patient
B. Coarse crackles from secretions
, C. Fine crackles from pulmonary edema [CORRECT]
D. Sibilant wheezes from asthma
Correct Answer: C
Rationale: Fine crackles (rales) are high-pitched, discontinuous, short-duration sounds
heard during late inspiration, caused by sudden opening of alveoli or air moving through
fluid-filled alveoli. In heart failure, pulmonary edema causes fluid accumulation in alveoli
and interstitium, producing bilateral basilar fine crackles. They are not cleared by
coughing. Coarse crackles (Option B) are lower-pitched, longer, heard earlier in
inspiration, indicate secretions in larger airways, and often clear with coughing. Sibilant
wheezes (Option D) are high-pitched, musical, continuous, indicate narrowed airways,
and are heard during expiration. Normal breath sounds (Option A) in elderly may include
decreased vesicular sounds but not crackles—crackles are always abnormal.
Q5
A nurse is teaching a patient about proper technique for using an incentive spirometer.
Which instruction is CORRECT?
A. "Take rapid, shallow breaths to maximize volume"
B. "Exhale normally, then inhale slowly and deeply, holding for 3-5 seconds" [CORRECT]
C. "Use the device every hour while awake, taking 2-3 breaths each time"
D. "Blow into the device as forcefully as possible"
Correct Answer: B
