NUR 2092 HEALTH ASSESSMENT EXAM 2 QUIZ BANK
2026/2027 | Questions and Answers with Rationale |
Rasmussen College | Pass Guaranteed - A+ Graded
Domain 1: Thorax & Lung Assessment (20 Questions)
Q1: A 68-year-old male with a 40-pack-year smoking history presents with progressive
dyspnea and chronic productive cough. During posterior chest auscultation, the nurse
hears low-pitched, continuous sounds during expiration that resemble snoring. These
sounds are loudest over the right lower lobe and do not clear with coughing. Which
assessment finding is described?
A. High-pitched wheezes indicating bronchospasm
B. Sibilant wheezes from narrowed small airways
C. Sonorous wheezes (rhonchi) indicating secretions in large airways [CORRECT]
D. Pleural friction rub from inflamed pleural surfaces
Correct Answer: C
Rationale: Sonorous wheezes (rhonchi) are low-pitched, continuous, snore-like sounds
caused by air moving through secretions or narrowed large airways (trachea, bronchi).
They are typically heard during expiration and may clear with coughing (though this
patient shows persistent findings suggesting significant secretions). The description
matches rhonchi in the large airway of the right lower lobe. Option A describes wheezes
but incorrect pitch (high-pitched wheezes are sibilant). Option B describes sibilant
wheezes (high-pitched, musical, small airways). Option D describes a grating, rubbing
sound synchronous with respiration, not continuous snoring sounds. The patient's
smoking history and symptoms suggest COPD with secretions.
,Q2: A nurse is percussing the posterior chest of a healthy 25-year-old adult. Which
percussion note is expected over normal lung tissue?
A. Dullness over lung fields indicating consolidation
B. Resonance indicating air-filled lung tissue [CORRECT]
C. Flatness suggesting pleural effusion
D. Tympany indicating gastric air bubble
Correct Answer: B
Rationale: Resonance is the low-pitched, clear, hollow sound heard over normal air-filled
lung tissue. It is the standard percussion note for healthy lungs. Option A (dullness)
indicates solidification or fluid (consolidation, tumor, atelectasis). Option C (flatness)
indicates large pleural effusion or massive consolidation. Option D (tympany) is the
drum-like sound heard over air-filled stomach or intestine, not lung tissue. Percussion
assesses tissue density; normal lungs are resonant due to air content.
Q3: During assessment of a patient with pneumonia, the nurse notes increased tactile
fremitus over the right lower lobe. Which principle explains this finding?
A. Decreased lung density transmits vibrations poorly
B. Solidification of lung tissue transmits vibrations more efficiently to the chest wall
[CORRECT]
C. Pleural fluid blocks all vibration transmission
D. Hyperinflation improves vibration conduction
Correct Answer: B
Rationale: Tactile fremitus (palpable vibrations during speech) increases when lung
tissue becomes more dense (consolidation in pneumonia, tumor) because solid tissue
transmits sound waves better than air-filled tissue. "Ninety-nine" or "one-two-three" is
spoken while palpating the chest. Option A is opposite (decreased density = decreased
,fremitus). Option C describes pleural effusion (decreased/absent fremitus due to fluid
barrier). Option D is incorrect (hyperinflation/COPD decreases fremitus due to increased
air trapping).
Q4: A patient with asthma presents with acute exacerbation. Which breath sound is
most characteristic of this condition?
A. Crackles (rales) from alveolar fluid
B. High-pitched, musical, polyphonic wheezes during expiration indicating narrowed
airways [CORRECT]
C. Stridor from upper airway obstruction
D. Absent breath sounds from pneumothorax
Correct Answer: B
Rationale: Asthma causes bronchospasm and inflammation of small airways, producing
high-pitched, musical, polyphonic (multiple notes) wheezes, typically heard during
expiration due to dynamic airway compression. Wheezes indicate airflow obstruction.
Option A (crackles) suggests fluid (heart failure, pneumonia), not asthma. Option C
(stridor) is a harsh, high-pitched inspiratory sound from upper airway obstruction
(foreign body, epiglottitis). Option D suggests pneumothorax or severe obstruction
(silent chest in severe asthma is ominous, not typical).
Q5: A nurse is teaching a student about proper stethoscope placement for auscultating
lung sounds. Which statement is correct regarding the sequence of auscultation?
A. Auscultate only the anterior chest; posterior sounds are redundant
B. Compare symmetric points bilaterally, moving from apex to base, listening to one full
respiratory cycle at each site [CORRECT]
C. Listen only during inspiration; expiration sounds are not clinically significant
D. Place the bell of the stethoscope firmly against the chest wall for all lung sounds
, Correct Answer: B
Rationale: Systematic lung auscultation requires: (1) Comparison of symmetric points
(right vs. left at same level), (2) Vertical progression (apex to base or vice versa), (3)
Complete respiratory cycle at each site (inspiration and expiration), (4) Use of
diaphragm (firm pressure) for most lung sounds (high-pitched), (5) 12-16 anterior and
posterior sites minimum. Option A misses posterior lung fields (lower lobes primarily
posterior). Option C misses expiratory sounds (where wheezes often occur). Option D is
partially incorrect (bell is used for low-pitched sounds like S3, S4, murmurs; diaphragm
for high-pitched lung sounds).
Q6: A patient with COPD presents for assessment. Which chest wall finding is expected
on inspection?
A. Increased anteroposterior (AP) diameter, horizontal ribs, and pursed-lip breathing
[CORRECT]
B. Decreased AP diameter and rapid, shallow respirations
C. Normal chest configuration with symmetric expansion
D. Asymmetric chest wall movement with paradoxical motion
Correct Answer: A
Rationale: Chronic COPD causes barrel chest (increased AP diameter, ratio approaching
1:1 with lateral diameter), horizontal ribs (loss of normal downward slope), and
pursed-lip breathing (prolonged expiration through pursed lips to prevent airway
collapse). These adaptations result from chronic air trapping and hyperinflation. Option
B describes restrictive lung disease. Option C is normal, not COPD. Option D describes
flail chest or diaphragmatic paralysis.
2026/2027 | Questions and Answers with Rationale |
Rasmussen College | Pass Guaranteed - A+ Graded
Domain 1: Thorax & Lung Assessment (20 Questions)
Q1: A 68-year-old male with a 40-pack-year smoking history presents with progressive
dyspnea and chronic productive cough. During posterior chest auscultation, the nurse
hears low-pitched, continuous sounds during expiration that resemble snoring. These
sounds are loudest over the right lower lobe and do not clear with coughing. Which
assessment finding is described?
A. High-pitched wheezes indicating bronchospasm
B. Sibilant wheezes from narrowed small airways
C. Sonorous wheezes (rhonchi) indicating secretions in large airways [CORRECT]
D. Pleural friction rub from inflamed pleural surfaces
Correct Answer: C
Rationale: Sonorous wheezes (rhonchi) are low-pitched, continuous, snore-like sounds
caused by air moving through secretions or narrowed large airways (trachea, bronchi).
They are typically heard during expiration and may clear with coughing (though this
patient shows persistent findings suggesting significant secretions). The description
matches rhonchi in the large airway of the right lower lobe. Option A describes wheezes
but incorrect pitch (high-pitched wheezes are sibilant). Option B describes sibilant
wheezes (high-pitched, musical, small airways). Option D describes a grating, rubbing
sound synchronous with respiration, not continuous snoring sounds. The patient's
smoking history and symptoms suggest COPD with secretions.
,Q2: A nurse is percussing the posterior chest of a healthy 25-year-old adult. Which
percussion note is expected over normal lung tissue?
A. Dullness over lung fields indicating consolidation
B. Resonance indicating air-filled lung tissue [CORRECT]
C. Flatness suggesting pleural effusion
D. Tympany indicating gastric air bubble
Correct Answer: B
Rationale: Resonance is the low-pitched, clear, hollow sound heard over normal air-filled
lung tissue. It is the standard percussion note for healthy lungs. Option A (dullness)
indicates solidification or fluid (consolidation, tumor, atelectasis). Option C (flatness)
indicates large pleural effusion or massive consolidation. Option D (tympany) is the
drum-like sound heard over air-filled stomach or intestine, not lung tissue. Percussion
assesses tissue density; normal lungs are resonant due to air content.
Q3: During assessment of a patient with pneumonia, the nurse notes increased tactile
fremitus over the right lower lobe. Which principle explains this finding?
A. Decreased lung density transmits vibrations poorly
B. Solidification of lung tissue transmits vibrations more efficiently to the chest wall
[CORRECT]
C. Pleural fluid blocks all vibration transmission
D. Hyperinflation improves vibration conduction
Correct Answer: B
Rationale: Tactile fremitus (palpable vibrations during speech) increases when lung
tissue becomes more dense (consolidation in pneumonia, tumor) because solid tissue
transmits sound waves better than air-filled tissue. "Ninety-nine" or "one-two-three" is
spoken while palpating the chest. Option A is opposite (decreased density = decreased
,fremitus). Option C describes pleural effusion (decreased/absent fremitus due to fluid
barrier). Option D is incorrect (hyperinflation/COPD decreases fremitus due to increased
air trapping).
Q4: A patient with asthma presents with acute exacerbation. Which breath sound is
most characteristic of this condition?
A. Crackles (rales) from alveolar fluid
B. High-pitched, musical, polyphonic wheezes during expiration indicating narrowed
airways [CORRECT]
C. Stridor from upper airway obstruction
D. Absent breath sounds from pneumothorax
Correct Answer: B
Rationale: Asthma causes bronchospasm and inflammation of small airways, producing
high-pitched, musical, polyphonic (multiple notes) wheezes, typically heard during
expiration due to dynamic airway compression. Wheezes indicate airflow obstruction.
Option A (crackles) suggests fluid (heart failure, pneumonia), not asthma. Option C
(stridor) is a harsh, high-pitched inspiratory sound from upper airway obstruction
(foreign body, epiglottitis). Option D suggests pneumothorax or severe obstruction
(silent chest in severe asthma is ominous, not typical).
Q5: A nurse is teaching a student about proper stethoscope placement for auscultating
lung sounds. Which statement is correct regarding the sequence of auscultation?
A. Auscultate only the anterior chest; posterior sounds are redundant
B. Compare symmetric points bilaterally, moving from apex to base, listening to one full
respiratory cycle at each site [CORRECT]
C. Listen only during inspiration; expiration sounds are not clinically significant
D. Place the bell of the stethoscope firmly against the chest wall for all lung sounds
, Correct Answer: B
Rationale: Systematic lung auscultation requires: (1) Comparison of symmetric points
(right vs. left at same level), (2) Vertical progression (apex to base or vice versa), (3)
Complete respiratory cycle at each site (inspiration and expiration), (4) Use of
diaphragm (firm pressure) for most lung sounds (high-pitched), (5) 12-16 anterior and
posterior sites minimum. Option A misses posterior lung fields (lower lobes primarily
posterior). Option C misses expiratory sounds (where wheezes often occur). Option D is
partially incorrect (bell is used for low-pitched sounds like S3, S4, murmurs; diaphragm
for high-pitched lung sounds).
Q6: A patient with COPD presents for assessment. Which chest wall finding is expected
on inspection?
A. Increased anteroposterior (AP) diameter, horizontal ribs, and pursed-lip breathing
[CORRECT]
B. Decreased AP diameter and rapid, shallow respirations
C. Normal chest configuration with symmetric expansion
D. Asymmetric chest wall movement with paradoxical motion
Correct Answer: A
Rationale: Chronic COPD causes barrel chest (increased AP diameter, ratio approaching
1:1 with lateral diameter), horizontal ribs (loss of normal downward slope), and
pursed-lip breathing (prolonged expiration through pursed lips to prevent airway
collapse). These adaptations result from chronic air trapping and hyperinflation. Option
B describes restrictive lung disease. Option C is normal, not COPD. Option D describes
flail chest or diaphragmatic paralysis.
