NUR 2092 HEALTH ASSESSMENT EXAM 2 REVIEW
2026/2027 | Rated A Questions and Answers | Rasmussen
College | Pass Guaranteed
Domain 1: Thorax & Lung Assessment (Questions 1-20)
Q1: A 68-year-old male with a 40 pack-year smoking history presents with a productive
cough and hemoptysis. During percussion of the posterior chest, the nurse notes a dull
sound over the right lower lobe. Which finding is most consistent with this percussion
note?
A. Pneumothorax
B. Consolidation or pleural effusion [CORRECT]
C. Emphysema
D. Normal lung tissue
Correct Answer: B
Rationale: Dull percussion notes indicate increased density of underlying tissue, which
occurs with consolidation (pneumonia, atelectasis) or fluid accumulation (pleural
effusion). The patient's smoking history, productive cough, and hemoptysis raise
concern for lung cancer with post-obstructive pneumonia or effusion. Pneumothorax
produces hyperresonance due to air in pleural space. Emphysema causes
hyperresonance due to air trapping. Normal lung tissue produces resonance.
Why others are incorrect:
● A: Pneumothorax = hyperresonance or tympany, not dullness
● C: Emphysema = hyperresonance due to decreased lung density
● D: Normal lung = resonance, not dullness
,Q2: A nurse auscultates the lungs of a 25-year-old female with asthma. Which breath
sound description indicates her condition is worsening?
A. Bilateral wheezing on expiration
B. Decreased or absent wheezing with silent chest and decreased air movement
[CORRECT]
C. Crackles at the lung bases
D. Prolonged inspiratory phase
Correct Answer: B
Rationale: In severe asthma exacerbation, the "silent chest" is a life-threatening finding
indicating severe airway obstruction with minimal air movement. Wheezing requires air
movement; when air movement decreases significantly, wheezing disappears. This
signals impending respiratory failure and requires immediate intervention. Bilateral
wheezing is expected in asthma. Crackles suggest fluid or secretions, not typical
asthma. Prolonged expiration, not inspiration, characterizes obstructive disease.
Why others are incorrect:
● A: Expected finding in asthma; not indicator of worsening
● C: Crackles indicate fluid/alveolar disease; not typical asthma finding
● D: Asthma causes prolonged expiration, not inspiration
Q3: During auscultation of the anterior chest, the nurse places the stethoscope over the
2nd intercostal space at the right sternal border. Which lung structure is being
assessed?
A. Right middle lobe
B. Right upper lobe [CORRECT]
C. Right lower lobe
D. Lingula
,Correct Answer: B
Rationale: The right upper lobe is auscultated at the 2nd ICS at the right sternal border
and midclavicular line. The right middle lobe is at the 4th-5th ICS right midclavicular line.
The right lower lobe is posterior and lateral at the base. The lingula is part of the left
upper lobe, assessed at the left 4th-5th ICS midclavicular line (analogous to right middle
lobe).
Why others are incorrect:
● A: Right middle lobe = 4th-5th ICS right midclavicular line
● C: Right lower lobe = posterior/lateral bases
● D: Lingula = left side, not right
Q4: A patient with pneumonia has bronchial breath sounds auscultated over the right
lower lobe posteriorly. Which pathophysiology explains this finding?
A. Air trapping in alveoli
B. Consolidation of lung tissue transmitting bronchial sounds to periphery [CORRECT]
C. Collapsed alveoli with no air movement
D. Increased airway resistance
Correct Answer: B
Rationale: Bronchial breath sounds are normally heard over the trachea and bronchi
(high-pitched, loud, harsh with pause between inspiration and expiration). When heard
peripherally, it indicates lung consolidation (pneumonia, atelectasis, tumor) that
transmits central airway sounds to the chest wall. Air must reach bronchi for sound
production; consolidation conducts sound to periphery. Air trapping (emphysema)
causes decreased breath sounds. Collapsed alveoli without consolidation wouldn't
transmit bronchial sounds. Increased airway resistance causes wheezing or prolonged
expiration.
, Why others are incorrect:
● A: Air trapping = decreased breath sounds, hyperresonance
● C: Collapse without consolidation = decreased/absent sounds
● D: Increased resistance = wheezing, not bronchial sounds
Q5: A nurse assesses a patient with COPD and notes a barrel chest, tripod positioning,
and pursed-lip breathing. Which finding indicates compensated respiratory acidosis?
A. Rapid, shallow breathing
B. Use of accessory muscles at rest [CORRECT]
C. Bradypnea
D. Absent breath sounds
Correct Answer: B
Rationale: Use of accessory muscles (sternocleidomastoid, scalenes, intercostals) at
rest indicates increased work of breathing and compensated respiratory acidosis in
COPD. The tripod position (leaning forward with arms supported) optimizes accessory
muscle use. Barrel chest indicates chronic air trapping. Pursed-lip breathing creates
positive end-expiratory pressure (PEEP), preventing airway collapse. These are chronic
compensation mechanisms. Rapid shallow breathing indicates decompensation.
Bradypnea is not typical of COPD exacerbation. Absent breath sounds indicate
pneumothorax or severe obstruction.
Why others are incorrect:
● A: Rapid shallow breathing indicates decompensation, not compensation
● C: Bradypnea not typical; COPD patients usually tachypneic
● D: Absent sounds = pneumothorax, not compensated COPD
2026/2027 | Rated A Questions and Answers | Rasmussen
College | Pass Guaranteed
Domain 1: Thorax & Lung Assessment (Questions 1-20)
Q1: A 68-year-old male with a 40 pack-year smoking history presents with a productive
cough and hemoptysis. During percussion of the posterior chest, the nurse notes a dull
sound over the right lower lobe. Which finding is most consistent with this percussion
note?
A. Pneumothorax
B. Consolidation or pleural effusion [CORRECT]
C. Emphysema
D. Normal lung tissue
Correct Answer: B
Rationale: Dull percussion notes indicate increased density of underlying tissue, which
occurs with consolidation (pneumonia, atelectasis) or fluid accumulation (pleural
effusion). The patient's smoking history, productive cough, and hemoptysis raise
concern for lung cancer with post-obstructive pneumonia or effusion. Pneumothorax
produces hyperresonance due to air in pleural space. Emphysema causes
hyperresonance due to air trapping. Normal lung tissue produces resonance.
Why others are incorrect:
● A: Pneumothorax = hyperresonance or tympany, not dullness
● C: Emphysema = hyperresonance due to decreased lung density
● D: Normal lung = resonance, not dullness
,Q2: A nurse auscultates the lungs of a 25-year-old female with asthma. Which breath
sound description indicates her condition is worsening?
A. Bilateral wheezing on expiration
B. Decreased or absent wheezing with silent chest and decreased air movement
[CORRECT]
C. Crackles at the lung bases
D. Prolonged inspiratory phase
Correct Answer: B
Rationale: In severe asthma exacerbation, the "silent chest" is a life-threatening finding
indicating severe airway obstruction with minimal air movement. Wheezing requires air
movement; when air movement decreases significantly, wheezing disappears. This
signals impending respiratory failure and requires immediate intervention. Bilateral
wheezing is expected in asthma. Crackles suggest fluid or secretions, not typical
asthma. Prolonged expiration, not inspiration, characterizes obstructive disease.
Why others are incorrect:
● A: Expected finding in asthma; not indicator of worsening
● C: Crackles indicate fluid/alveolar disease; not typical asthma finding
● D: Asthma causes prolonged expiration, not inspiration
Q3: During auscultation of the anterior chest, the nurse places the stethoscope over the
2nd intercostal space at the right sternal border. Which lung structure is being
assessed?
A. Right middle lobe
B. Right upper lobe [CORRECT]
C. Right lower lobe
D. Lingula
,Correct Answer: B
Rationale: The right upper lobe is auscultated at the 2nd ICS at the right sternal border
and midclavicular line. The right middle lobe is at the 4th-5th ICS right midclavicular line.
The right lower lobe is posterior and lateral at the base. The lingula is part of the left
upper lobe, assessed at the left 4th-5th ICS midclavicular line (analogous to right middle
lobe).
Why others are incorrect:
● A: Right middle lobe = 4th-5th ICS right midclavicular line
● C: Right lower lobe = posterior/lateral bases
● D: Lingula = left side, not right
Q4: A patient with pneumonia has bronchial breath sounds auscultated over the right
lower lobe posteriorly. Which pathophysiology explains this finding?
A. Air trapping in alveoli
B. Consolidation of lung tissue transmitting bronchial sounds to periphery [CORRECT]
C. Collapsed alveoli with no air movement
D. Increased airway resistance
Correct Answer: B
Rationale: Bronchial breath sounds are normally heard over the trachea and bronchi
(high-pitched, loud, harsh with pause between inspiration and expiration). When heard
peripherally, it indicates lung consolidation (pneumonia, atelectasis, tumor) that
transmits central airway sounds to the chest wall. Air must reach bronchi for sound
production; consolidation conducts sound to periphery. Air trapping (emphysema)
causes decreased breath sounds. Collapsed alveoli without consolidation wouldn't
transmit bronchial sounds. Increased airway resistance causes wheezing or prolonged
expiration.
, Why others are incorrect:
● A: Air trapping = decreased breath sounds, hyperresonance
● C: Collapse without consolidation = decreased/absent sounds
● D: Increased resistance = wheezing, not bronchial sounds
Q5: A nurse assesses a patient with COPD and notes a barrel chest, tripod positioning,
and pursed-lip breathing. Which finding indicates compensated respiratory acidosis?
A. Rapid, shallow breathing
B. Use of accessory muscles at rest [CORRECT]
C. Bradypnea
D. Absent breath sounds
Correct Answer: B
Rationale: Use of accessory muscles (sternocleidomastoid, scalenes, intercostals) at
rest indicates increased work of breathing and compensated respiratory acidosis in
COPD. The tripod position (leaning forward with arms supported) optimizes accessory
muscle use. Barrel chest indicates chronic air trapping. Pursed-lip breathing creates
positive end-expiratory pressure (PEEP), preventing airway collapse. These are chronic
compensation mechanisms. Rapid shallow breathing indicates decompensation.
Bradypnea is not typical of COPD exacerbation. Absent breath sounds indicate
pneumothorax or severe obstruction.
Why others are incorrect:
● A: Rapid shallow breathing indicates decompensation, not compensation
● C: Bradypnea not typical; COPD patients usually tachypneic
● D: Absent sounds = pneumothorax, not compensated COPD
