NUR 2092 HEALTH ASSESSMENT EXAM 2 REVIEW
2026/2027 | Latest Rasmussen College Complete Guide |
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 on exertion and chronic productive cough. During posterior chest auscultation,
the nurse hears low-pitched, continuous sounds during expiration that clear with
coughing. Which finding is most consistent with this presentation?
A. Fine crackles (rales) indicating pulmonary edema
B. Rhonchi indicating airway obstruction from secretions [CORRECT]
C. Pleural friction rub indicating pleuritis
D. Wheezes indicating bronchospasm
Correct Answer: B
Rationale: Rhonchi are low-pitched, continuous, snoring-like sounds caused by air
passing through secretions in large airways. They are most prominent during expiration
and often clear with coughing, which distinguishes them from other adventitious
sounds. This patient's smoking history, chronic cough, and productive sputum point
toward chronic bronchitis/COPD with excessive mucus production. Rhonchi are
characteristic of conditions with secretions in the trachea or bronchi.
● A is incorrect: Fine crackles are high-pitched, discontinuous sounds (like Velcro)
heard during inspiration, typically indicating alveolar disease (pulmonary edema,
fibrosis). They do not clear with coughing and are not described as continuous or
low-pitched.
, ● C is incorrect: Pleural friction rubs are grating, creaking sounds heard during both
inspiration and expiration, caused by inflamed pleural surfaces rubbing together.
They do not clear with coughing and are associated with pleuritic pain.
● D is incorrect: Wheezes are high-pitched, musical sounds caused by narrowed
airways (bronchospasm, asthma). While common in COPD, wheezes do not
typically clear with coughing and are higher pitched than rhonchi.
Q2: A nurse is assessing a 24-year-old female with sudden onset pleuritic chest pain
and shortness of breath. Percussion over the right lower lung field reveals
hyperresonance. Which condition should the nurse suspect?
A. Right lower lobe pneumonia with consolidation
B. Right-sided pneumothorax with air in pleural space [CORRECT]
C. Right pleural effusion with fluid accumulation
D. Atelectasis of the right lower lobe
Correct Answer: B
Rationale: Percussion sounds indicate underlying tissue density: hyperresonance
(booming, louder than normal) indicates increased air content. In a young patient with
sudden pleuritic chest pain and dyspnea, hyperresonance suggests pneumothorax—air
in the pleural space collapsing the lung. This is a medical emergency. The
hyperresonance occurs because air conducts sound better than lung tissue.
● A is incorrect: Pneumonia with consolidation produces dullness or flatness due
to fluid-filled alveoli replacing air.
● C is incorrect: Pleural effusion produces dullness to flatness over the fluid
accumulation, with possible bronchial breath sounds above the fluid line.
● D is incorrect: Atelectasis (collapsed lung) produces dullness due to loss of air
volume and increased density.
Q3: During anterior chest inspection, a nurse observes that the patient's rib angle is
increased to approximately 120 degrees (normal is 90 degrees or less). The
,anteroposterior diameter appears equal to the transverse diameter. Which condition is
associated with this finding?
A. Pneumothorax
B. Barrel chest associated with chronic obstructive pulmonary disease [CORRECT]
C. Pectus excavatum
D. Thoracic scoliosis
Correct Answer: B
Rationale: Barrel chest is characterized by: increased anteroposterior (AP) diameter (AP
= transverse), increased rib angle (>90 degrees), horizontal ribs, and kyphotic posture.
This results from chronic air trapping in emphysema/COPD, where the chest remains
partially expanded due to loss of lung elasticity. The ribs are fixed in an elevated,
outward position.
● A is incorrect: Pneumothorax causes asymmetry (tracheal deviation, unequal
chest expansion) rather than symmetric barrel deformity.
● C is incorrect: Pectus excavatum is a congenital depression of the sternum
(funnel chest), not a generalized diameter increase.
● D is incorrect: Scoliosis causes lateral curvature and rib hump asymmetry, not
symmetric AP diameter increase.
Q4: A nurse auscultates the chest of a 45-year-old male with heart failure and hears
discontinuous, high-pitched popping sounds during late inspiration at the lung bases.
These sounds do not clear with coughing. Which term describes these findings?
A. Sonorous wheezes
B. Fine crackles (rales) indicating alveolar fluid [CORRECT]
C. Stridor
D. Bronchial breath sounds
Correct Answer: B
, Rationale: Fine crackles (formerly called rales) are discontinuous, high-pitched, popping
sounds caused by sudden opening of deflated small airways and alveoli. They are heard
during late inspiration (as air finally reaches fluid-filled alveoli), are most common at
lung bases (gravity-dependent fluid accumulation), and do not clear with coughing. In
heart failure, these represent pulmonary edema (fluid in alveoli). The timing (late
inspiration) and location (bases) are classic.
● A is incorrect: Sonorous wheezes are low-pitched, continuous, musical sounds
from large airway narrowing; they occur throughout respiratory cycle, not just late
inspiration.
● C is incorrect: Stridor is a high-pitched, harsh sound heard over the trachea
during inspiration, indicating upper airway obstruction.
● D is incorrect: Bronchial breath sounds are loud, high-pitched sounds with pause
between inspiration and expiration, heard over consolidation (pneumonia) or
normally over trachea.
Q5: When assessing diaphragmatic excursion, the nurse percusses downward along the
scapular line until the sound changes from resonant to dull, marking the diaphragm
level. The patient is instructed to take a deep breath and hold it. The nurse notes the
diaphragm descends 4 cm on the right and 6 cm on the left. Which interpretation is
correct?
A. Normal diaphragmatic excursion bilaterally
B. Impaired right hemidiaphragm movement suggesting phrenic nerve dysfunction or
subpulmonic process [CORRECT]
C. Excessive left diaphragm movement indicating left lung hyperinflation
D. Normal variation; left diaphragm normally moves more than right
Correct Answer: B
Rationale: Normal diaphragmatic excursion is 3-5 cm bilaterally (typically 5-6 cm), with
the right hemidiaphragm usually slightly higher than the left (due to liver). Reduced
excursion on one side indicates: phrenic nerve palsy, subphrenic abscess, subpulmonic
2026/2027 | Latest Rasmussen College Complete Guide |
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 on exertion and chronic productive cough. During posterior chest auscultation,
the nurse hears low-pitched, continuous sounds during expiration that clear with
coughing. Which finding is most consistent with this presentation?
A. Fine crackles (rales) indicating pulmonary edema
B. Rhonchi indicating airway obstruction from secretions [CORRECT]
C. Pleural friction rub indicating pleuritis
D. Wheezes indicating bronchospasm
Correct Answer: B
Rationale: Rhonchi are low-pitched, continuous, snoring-like sounds caused by air
passing through secretions in large airways. They are most prominent during expiration
and often clear with coughing, which distinguishes them from other adventitious
sounds. This patient's smoking history, chronic cough, and productive sputum point
toward chronic bronchitis/COPD with excessive mucus production. Rhonchi are
characteristic of conditions with secretions in the trachea or bronchi.
● A is incorrect: Fine crackles are high-pitched, discontinuous sounds (like Velcro)
heard during inspiration, typically indicating alveolar disease (pulmonary edema,
fibrosis). They do not clear with coughing and are not described as continuous or
low-pitched.
, ● C is incorrect: Pleural friction rubs are grating, creaking sounds heard during both
inspiration and expiration, caused by inflamed pleural surfaces rubbing together.
They do not clear with coughing and are associated with pleuritic pain.
● D is incorrect: Wheezes are high-pitched, musical sounds caused by narrowed
airways (bronchospasm, asthma). While common in COPD, wheezes do not
typically clear with coughing and are higher pitched than rhonchi.
Q2: A nurse is assessing a 24-year-old female with sudden onset pleuritic chest pain
and shortness of breath. Percussion over the right lower lung field reveals
hyperresonance. Which condition should the nurse suspect?
A. Right lower lobe pneumonia with consolidation
B. Right-sided pneumothorax with air in pleural space [CORRECT]
C. Right pleural effusion with fluid accumulation
D. Atelectasis of the right lower lobe
Correct Answer: B
Rationale: Percussion sounds indicate underlying tissue density: hyperresonance
(booming, louder than normal) indicates increased air content. In a young patient with
sudden pleuritic chest pain and dyspnea, hyperresonance suggests pneumothorax—air
in the pleural space collapsing the lung. This is a medical emergency. The
hyperresonance occurs because air conducts sound better than lung tissue.
● A is incorrect: Pneumonia with consolidation produces dullness or flatness due
to fluid-filled alveoli replacing air.
● C is incorrect: Pleural effusion produces dullness to flatness over the fluid
accumulation, with possible bronchial breath sounds above the fluid line.
● D is incorrect: Atelectasis (collapsed lung) produces dullness due to loss of air
volume and increased density.
Q3: During anterior chest inspection, a nurse observes that the patient's rib angle is
increased to approximately 120 degrees (normal is 90 degrees or less). The
,anteroposterior diameter appears equal to the transverse diameter. Which condition is
associated with this finding?
A. Pneumothorax
B. Barrel chest associated with chronic obstructive pulmonary disease [CORRECT]
C. Pectus excavatum
D. Thoracic scoliosis
Correct Answer: B
Rationale: Barrel chest is characterized by: increased anteroposterior (AP) diameter (AP
= transverse), increased rib angle (>90 degrees), horizontal ribs, and kyphotic posture.
This results from chronic air trapping in emphysema/COPD, where the chest remains
partially expanded due to loss of lung elasticity. The ribs are fixed in an elevated,
outward position.
● A is incorrect: Pneumothorax causes asymmetry (tracheal deviation, unequal
chest expansion) rather than symmetric barrel deformity.
● C is incorrect: Pectus excavatum is a congenital depression of the sternum
(funnel chest), not a generalized diameter increase.
● D is incorrect: Scoliosis causes lateral curvature and rib hump asymmetry, not
symmetric AP diameter increase.
Q4: A nurse auscultates the chest of a 45-year-old male with heart failure and hears
discontinuous, high-pitched popping sounds during late inspiration at the lung bases.
These sounds do not clear with coughing. Which term describes these findings?
A. Sonorous wheezes
B. Fine crackles (rales) indicating alveolar fluid [CORRECT]
C. Stridor
D. Bronchial breath sounds
Correct Answer: B
, Rationale: Fine crackles (formerly called rales) are discontinuous, high-pitched, popping
sounds caused by sudden opening of deflated small airways and alveoli. They are heard
during late inspiration (as air finally reaches fluid-filled alveoli), are most common at
lung bases (gravity-dependent fluid accumulation), and do not clear with coughing. In
heart failure, these represent pulmonary edema (fluid in alveoli). The timing (late
inspiration) and location (bases) are classic.
● A is incorrect: Sonorous wheezes are low-pitched, continuous, musical sounds
from large airway narrowing; they occur throughout respiratory cycle, not just late
inspiration.
● C is incorrect: Stridor is a high-pitched, harsh sound heard over the trachea
during inspiration, indicating upper airway obstruction.
● D is incorrect: Bronchial breath sounds are loud, high-pitched sounds with pause
between inspiration and expiration, heard over consolidation (pneumonia) or
normally over trachea.
Q5: When assessing diaphragmatic excursion, the nurse percusses downward along the
scapular line until the sound changes from resonant to dull, marking the diaphragm
level. The patient is instructed to take a deep breath and hold it. The nurse notes the
diaphragm descends 4 cm on the right and 6 cm on the left. Which interpretation is
correct?
A. Normal diaphragmatic excursion bilaterally
B. Impaired right hemidiaphragm movement suggesting phrenic nerve dysfunction or
subpulmonic process [CORRECT]
C. Excessive left diaphragm movement indicating left lung hyperinflation
D. Normal variation; left diaphragm normally moves more than right
Correct Answer: B
Rationale: Normal diaphragmatic excursion is 3-5 cm bilaterally (typically 5-6 cm), with
the right hemidiaphragm usually slightly higher than the left (due to liver). Reduced
excursion on one side indicates: phrenic nerve palsy, subphrenic abscess, subpulmonic
