College
1. When auscultating the lungs of a healthy adult, the nurse expects to hear
which predominant percussion sound over the lung fields?
A. Resonance
B. Tympany
C. Hyperresonance
D. Dullness
Answer: A
Rationale: Resonance is the normal percussion sound heard over healthy lung tissue.
Dullness suggests fluid or solid tissue, while hyperresonance suggests trapped air.
2. Which adventitious breath sound is characterized by high-pitched, musical
sounds heard primarily during expiration?
A. Coarse crackles
B. Pleural friction rub
C. Wheezes
D. Stridor
Answer: C
Rationale: Wheezes are high-pitched musical sounds caused by air flowing through
narrowed or obstructed airways, most common in asthma or COPD.
,3. The nurse is assessing a patient for tactile fremitus. Which condition would
cause an increase in fremitus?
A. Pneumonia with lung consolidation
B. Pleural effusion
C. Pneumothorax
D. Emphysema
Answer: A
Rationale: Consolidation of lung tissue, as seen in pneumonia, enhances the transmission
of vocal vibrations, thereby increasing tactile fremitus.
4. Where is the Angle of Louis located, and why is it a significant clinical
landmark?
A. At the xiphoid process; it marks the liver border
B. At the mid-clavicular line; it marks the apex of the heart
C. At the suprasternal notch; it identifies the trachea
D. At the articulation of the manubrium and body of the sternum; it identifies the second rib
Answer: D
Rationale: The Angle of Louis (manubriosternal angle) is continuous with the second rib
and is a starting point for counting ribs and intercostal spaces.
5. A patient complains of needing to sit upright in a chair at night to breathe
comfortably. The nurse documents this finding as:
A. Dyspnea
B. Orthopnea
C. Paroxysmal nocturnal dyspnea
D. Platypnea
Answer: B
Rationale: Orthopnea is the inability to breathe easily except in an upright position.
Patients often use multiple pillows or sleep in a chair.
, 6. The ‘S1’ heart sound is produced by the closure of which valves?
A. Mitral and Tricuspid
B. Aortic and Pulmonic
C. Aortic and Mitral
D. Pulmonic and Tricuspid
Answer: A
Rationale: S1 occurs when the atrioventricular (AV) valves—the mitral and tricuspid—
close at the beginning of systole.
7. To auscultate the aortic valve area, the nurse should place the stethoscope in
which location?
A. Second intercostal space at the left sternal border
B. Fifth intercostal space at the left midclavicular line
C. Second intercostal space at the right sternal border
D. Fourth intercostal space at the left sternal border
Answer: C
Rationale: The aortic valve area is located at the second right intercostal space at the
sternal border.
8. A nurse identifies a ‘3+’ pulse while assessing a patient’s radial artery. How
should the nurse describe this pulse?
A. Normal
B. Full and increased
C. Weak and thready
D. Bounding
Answer: B
Rationale: On the standard 4-point scale, 1+ is weak/thready, 2+ is normal, 3+ is
full/increased, and 4+ is bounding.