NUR 2092 HEALTH ASSESSMENT EXAM 2 REVIEW
2026/2027 | Rated A Questions and Answers | Rasmussen
College | Pass Guaranteed
Domain 1: Thorax & Lung Assessment (20 Questions)
Q1: A 58-year-old male with a 40 pack-year smoking history presents with progressive
dyspnea and chronic productive cough. On auscultation, the nurse hears continuous,
high-pitched musical sounds during expiration that are louder over the chest wall than
through the stethoscope. Which breath sound has been identified?
A. Crackles (rales) indicating alveolar fluid or opening
B. Wheezes indicating narrowed airways and turbulent airflow [CORRECT]
C. Rhonchi indicating secretions in large airways
D. Pleural friction rub indicating pleural inflammation
Correct Answer: B
Rationale: Wheezes are continuous, high-pitched, musical sounds produced by turbulent
airflow through narrowed bronchioles. They are typically expiratory (indicating
intrathoracic obstruction) and are louder over the chest wall than through the
stethoscope in severe cases. In this patient with COPD/smoking history, wheezes
indicate airway obstruction from chronic bronchitis or emphysema. Option A is incorrect
because crackles are discontinuous, popping sounds from alveolar opening or fluid, not
continuous musical sounds. Option C is incorrect because rhonchi are low-pitched,
snoring sounds from secretions in larger airways, not high-pitched musical sounds.
,Option D is incorrect because friction rubs are grating, discontinuous sounds from
inflamed pleural surfaces rubbing together, not musical or continuous.
Q2: A nurse is percussing the posterior chest of a patient with pneumonia and notes
dullness over the right lower lobe. Which pathophysiological change explains this
finding?
A. Air trapping and hyperinflation
B. Consolidation of lung tissue with increased density [CORRECT]
C. Pneumothorax with air in pleural space
D. Collapsed lung with absence of air
Correct Answer: B
Rationale: Dullness to percussion indicates increased density in the underlying tissue. In
pneumonia, consolidation (alveoli filled with exudate/pus) replaces air with solid/fluid
material, creating dullness (flatness) rather than the normal resonance of air-filled lung.
Option A is incorrect because air trapping causes hyperresonance or tympany, not
dullness. Option C is incorrect because pneumothorax causes hyperresonance
(tympany) due to air in the pleural space. Option D is incorrect while atelectasis
(collapse) does cause dullness, the clinical context of pneumonia indicates
consolidation; however, both consolidation and collapse increase density. The key
distinction is that consolidation is the primary finding in pneumonia, producing dullness
with bronchial breath sounds and egophony, whereas atelectasis produces absent
breath sounds.
Q3: A patient presents with sudden onset of sharp, pleuritic chest pain and dyspnea. On
examination, the nurse notes absent breath sounds on the left side with hyperresonance
,to percussion and tracheal deviation to the right. Which condition requires immediate
intervention?
A. Left-sided pleural effusion
B. Tension pneumothorax [CORRECT]
C. Left lower lobe pneumonia
D. Acute bronchitis
Correct Answer: B
Rationale: Tension pneumothorax is a life-threatening emergency characterized by
absent breath sounds, hyperresonance, tracheal deviation away from the affected side
(to the right in this case), and hemodynamic compromise. The pleuritic pain and sudden
onset suggest air under pressure in the pleural space collapsing the lung and shifting
mediastinal structures. Immediate needle decompression is required. Option A is
incorrect because pleural effusion causes dullness to percussion, not hyperresonance,
and tracheal deviation toward the affected side only with massive effusion. Option C is
incorrect because pneumonia causes dullness, bronchial breath sounds, and crackles,
not absent sounds or hyperresonance. Option D is incorrect because bronchitis causes
diffuse rhonchi/wheezes, not unilateral absent sounds or mediastinal shift.
Q4: A nurse is auscultating the lungs of a patient with pulmonary edema and hears fine,
late inspiratory crackles that do not clear with coughing. These crackles are primarily
heard at the lung bases. Which pathophysiological mechanism produces these sounds?
A. Opening of collapsed small airways
B. Sudden opening of fluid-filled alveoli during inspiration [CORRECT]
C. Secretions moving in large airways
, D. Air passing through narrowed bronchioles
Correct Answer: B
Rationale: Fine, late inspiratory crackles (formerly called rales) in pulmonary edema
result from sudden opening of fluid-filled alveoli or terminal bronchioles during late
inspiration when sufficient negative pressure is generated. They are not cleared by
coughing because they originate at the alveolar level, not in large airways. The basilar
distribution reflects gravity-dependent fluid accumulation in a supine or upright patient.
Option A is incorrect because this describes early inspiratory crackles from small airway
disease (bronchiolitis, COPD) that often clear with coughing or change with position.
Option C is incorrect because secretions in large airways produce rhonchi, which are
coarse, continuous sounds that clear with coughing. Option D is incorrect because air
through narrowed bronchioles produces wheezes, which are continuous, musical
sounds, not discontinuous crackles.
Q5: A nurse is teaching a patient with asthma about proper use of a peak flow meter.
Which instruction demonstrates the most accurate technique?
A. "Take a shallow breath and blow slowly into the device"
B. "Take a deep breath, place lips tightly around the mouthpiece, and blow out as hard
and fast as possible" [CORRECT]
C. "Blow normally for 10 seconds and record the average"
D. "Use the device only when you feel short of breath"
Correct Answer: B
Rationale: Peak expiratory flow measures the maximum speed of expiration, which
requires a maximal effort. Proper technique: stand up, take a deep breath in, seal lips
tightly, blow out as hard and fast as possible (like blowing out candles), and record the
2026/2027 | Rated A Questions and Answers | Rasmussen
College | Pass Guaranteed
Domain 1: Thorax & Lung Assessment (20 Questions)
Q1: A 58-year-old male with a 40 pack-year smoking history presents with progressive
dyspnea and chronic productive cough. On auscultation, the nurse hears continuous,
high-pitched musical sounds during expiration that are louder over the chest wall than
through the stethoscope. Which breath sound has been identified?
A. Crackles (rales) indicating alveolar fluid or opening
B. Wheezes indicating narrowed airways and turbulent airflow [CORRECT]
C. Rhonchi indicating secretions in large airways
D. Pleural friction rub indicating pleural inflammation
Correct Answer: B
Rationale: Wheezes are continuous, high-pitched, musical sounds produced by turbulent
airflow through narrowed bronchioles. They are typically expiratory (indicating
intrathoracic obstruction) and are louder over the chest wall than through the
stethoscope in severe cases. In this patient with COPD/smoking history, wheezes
indicate airway obstruction from chronic bronchitis or emphysema. Option A is incorrect
because crackles are discontinuous, popping sounds from alveolar opening or fluid, not
continuous musical sounds. Option C is incorrect because rhonchi are low-pitched,
snoring sounds from secretions in larger airways, not high-pitched musical sounds.
,Option D is incorrect because friction rubs are grating, discontinuous sounds from
inflamed pleural surfaces rubbing together, not musical or continuous.
Q2: A nurse is percussing the posterior chest of a patient with pneumonia and notes
dullness over the right lower lobe. Which pathophysiological change explains this
finding?
A. Air trapping and hyperinflation
B. Consolidation of lung tissue with increased density [CORRECT]
C. Pneumothorax with air in pleural space
D. Collapsed lung with absence of air
Correct Answer: B
Rationale: Dullness to percussion indicates increased density in the underlying tissue. In
pneumonia, consolidation (alveoli filled with exudate/pus) replaces air with solid/fluid
material, creating dullness (flatness) rather than the normal resonance of air-filled lung.
Option A is incorrect because air trapping causes hyperresonance or tympany, not
dullness. Option C is incorrect because pneumothorax causes hyperresonance
(tympany) due to air in the pleural space. Option D is incorrect while atelectasis
(collapse) does cause dullness, the clinical context of pneumonia indicates
consolidation; however, both consolidation and collapse increase density. The key
distinction is that consolidation is the primary finding in pneumonia, producing dullness
with bronchial breath sounds and egophony, whereas atelectasis produces absent
breath sounds.
Q3: A patient presents with sudden onset of sharp, pleuritic chest pain and dyspnea. On
examination, the nurse notes absent breath sounds on the left side with hyperresonance
,to percussion and tracheal deviation to the right. Which condition requires immediate
intervention?
A. Left-sided pleural effusion
B. Tension pneumothorax [CORRECT]
C. Left lower lobe pneumonia
D. Acute bronchitis
Correct Answer: B
Rationale: Tension pneumothorax is a life-threatening emergency characterized by
absent breath sounds, hyperresonance, tracheal deviation away from the affected side
(to the right in this case), and hemodynamic compromise. The pleuritic pain and sudden
onset suggest air under pressure in the pleural space collapsing the lung and shifting
mediastinal structures. Immediate needle decompression is required. Option A is
incorrect because pleural effusion causes dullness to percussion, not hyperresonance,
and tracheal deviation toward the affected side only with massive effusion. Option C is
incorrect because pneumonia causes dullness, bronchial breath sounds, and crackles,
not absent sounds or hyperresonance. Option D is incorrect because bronchitis causes
diffuse rhonchi/wheezes, not unilateral absent sounds or mediastinal shift.
Q4: A nurse is auscultating the lungs of a patient with pulmonary edema and hears fine,
late inspiratory crackles that do not clear with coughing. These crackles are primarily
heard at the lung bases. Which pathophysiological mechanism produces these sounds?
A. Opening of collapsed small airways
B. Sudden opening of fluid-filled alveoli during inspiration [CORRECT]
C. Secretions moving in large airways
, D. Air passing through narrowed bronchioles
Correct Answer: B
Rationale: Fine, late inspiratory crackles (formerly called rales) in pulmonary edema
result from sudden opening of fluid-filled alveoli or terminal bronchioles during late
inspiration when sufficient negative pressure is generated. They are not cleared by
coughing because they originate at the alveolar level, not in large airways. The basilar
distribution reflects gravity-dependent fluid accumulation in a supine or upright patient.
Option A is incorrect because this describes early inspiratory crackles from small airway
disease (bronchiolitis, COPD) that often clear with coughing or change with position.
Option C is incorrect because secretions in large airways produce rhonchi, which are
coarse, continuous sounds that clear with coughing. Option D is incorrect because air
through narrowed bronchioles produces wheezes, which are continuous, musical
sounds, not discontinuous crackles.
Q5: A nurse is teaching a patient with asthma about proper use of a peak flow meter.
Which instruction demonstrates the most accurate technique?
A. "Take a shallow breath and blow slowly into the device"
B. "Take a deep breath, place lips tightly around the mouthpiece, and blow out as hard
and fast as possible" [CORRECT]
C. "Blow normally for 10 seconds and record the average"
D. "Use the device only when you feel short of breath"
Correct Answer: B
Rationale: Peak expiratory flow measures the maximum speed of expiration, which
requires a maximal effort. Proper technique: stand up, take a deep breath in, seal lips
tightly, blow out as hard and fast as possible (like blowing out candles), and record the
