NUR 505 Module 1 - 8
Advanced Health
Assessment of the
Chest and Lungs 2026
Update
Module 1: Thoracic Anatomy & Physiology (1-25)
Question 1: The trachea bifurcates into the right and left mainstem
bronchi at the level of the:
A. Sternal angle (Angle of Louis)
B. Xiphoid process
C. Suprasternal notch
D. 10th thoracic vertebra
✔✔✔ANSW✔✔: A. Sternal angle (Angle of Louis)
Rationale: The tracheal bifurcation (carina) lies at the level of the
sternal angle anteriorly (T4-T5 posteriorly). This landmark also marks
the division between the superior and inferior mediastinum.
,Question 2: Which bronchus is wider, shorter, and more vertical,
making it the most common site for aspirated foreign bodies?
A. Left mainstem bronchus
B. Right mainstem bronchus
C. Bronchus intermedius
D. Lingular bronchus
✔✔✔ANSW✔✔: B. Right mainstem bronchus
Rationale: The right mainstem bronchus has a more vertical orientation,
is shorter, and has a larger diameter than the left. Aspirated objects
preferentially enter the right lung, most often the right lower lobe or
posterior segment of the right upper lobe when supine.
Question 3: The horizontal fissure separates which lobes of the right
lung?
A. Upper and middle lobes
B. Middle and lower lobes
C. Upper and lower lobes
D. Superior and inferior segments of the upper lobe
✔✔✔ANSW✔✔: A. Upper and middle lobes
Rationale: The minor (horizontal) fissure separates the right upper lobe
from the right middle lobe. The major (oblique) fissure separates the
lower lobe from both the upper and middle lobes on the right.
Question 4: A patient has a patient has a patient has a left lower lobe
pneumonia. On posterior chest examination, the nurse practitioner
anticipates auscultating adventitious sounds over which vertebral levels?
A. T1-T3
B. T3-T6
C. T6-T10
D. T10-L1
,✔✔✔ANSW✔✔: C. T6-T10
Rationale: Posteriorly, the lower lobes extend from approximately T6 to
T10. The right lower lobe extends slightly lower than the left due to the
liver. Breath sounds and pathology in the lower lobes are best assessed
posteriorly and at the bases.
Question 5: The visceral pleura:
A. Lines the inner thoracic wall and diaphragm
B. Covers the lung surface and extends into the fissures
C. Contains pain and pressure nerve fibers
D. Is separated from the parietal pleura by the mediastinum
✔✔✔ANSW✔✔: B. Covers the lung surface and extends into the
fissures
Rationale: The visceral pleura adheres directly to the lung parenchyma
and follows the contours of the fissures. It lacks sensory nerves (pain
fibers are in the parietal pleura). The pleural space (potential space)
separates the two layers.
Question 6: Which intercostal space is used for needle decompression
of a tension pneumothorax in the midclavicular line?
A. 2nd intercostal space
B. 4th intercostal space
C. 5th intercostal space
D. 6th intercostal space
✔✔✔ANSW✔✔: A. 2nd intercostal space
Rationale: The second intercostal space, midclavicular line, is the
landmark for emergency needle decompression because it avoids the
major vessels and the heart. For chest tube placement, the 4th-5th
intercostal space, anterior axillary line, is preferred.
, Question 7: The angle of Louis (sternal angle) is a palpable landmark
that corresponds to the:
A. Xiphoid process
B. Second rib articulation
C. Suprasternal notch
D. Costochondral junction of the 5th rib
✔✔✔ANSW✔✔: B. Second rib articulation
Rationale: The sternal angle is where the manubrium meets the body of
the sternum and is the articulation point for the second rib. Counting ribs
from this landmark ensures accurate intercostal space identification.
Question 8: Which muscle is the primary muscle of inspiration during
normal, quiet breathing?
A. External intercostals
B. Internal intercostals
C. Diaphragm
D. Sternocleidomastoid
✔✔✔ANSW✔✔: C. Diaphragm
Rationale: The diaphragm is responsible for ~75% of the work of
breathing during tidal volume ventilation. Accessory muscles
(sternocleidomastoid, scalenes, external intercostals) are recruited during
exercise or respiratory distress.
Question 9: The apex of the lung extends approximately how many
centimeters above the clavicle?
A. 1-2 cm
B. 2-4 cm
C. 5-6 cm
D. 7-8 cm
Advanced Health
Assessment of the
Chest and Lungs 2026
Update
Module 1: Thoracic Anatomy & Physiology (1-25)
Question 1: The trachea bifurcates into the right and left mainstem
bronchi at the level of the:
A. Sternal angle (Angle of Louis)
B. Xiphoid process
C. Suprasternal notch
D. 10th thoracic vertebra
✔✔✔ANSW✔✔: A. Sternal angle (Angle of Louis)
Rationale: The tracheal bifurcation (carina) lies at the level of the
sternal angle anteriorly (T4-T5 posteriorly). This landmark also marks
the division between the superior and inferior mediastinum.
,Question 2: Which bronchus is wider, shorter, and more vertical,
making it the most common site for aspirated foreign bodies?
A. Left mainstem bronchus
B. Right mainstem bronchus
C. Bronchus intermedius
D. Lingular bronchus
✔✔✔ANSW✔✔: B. Right mainstem bronchus
Rationale: The right mainstem bronchus has a more vertical orientation,
is shorter, and has a larger diameter than the left. Aspirated objects
preferentially enter the right lung, most often the right lower lobe or
posterior segment of the right upper lobe when supine.
Question 3: The horizontal fissure separates which lobes of the right
lung?
A. Upper and middle lobes
B. Middle and lower lobes
C. Upper and lower lobes
D. Superior and inferior segments of the upper lobe
✔✔✔ANSW✔✔: A. Upper and middle lobes
Rationale: The minor (horizontal) fissure separates the right upper lobe
from the right middle lobe. The major (oblique) fissure separates the
lower lobe from both the upper and middle lobes on the right.
Question 4: A patient has a patient has a patient has a left lower lobe
pneumonia. On posterior chest examination, the nurse practitioner
anticipates auscultating adventitious sounds over which vertebral levels?
A. T1-T3
B. T3-T6
C. T6-T10
D. T10-L1
,✔✔✔ANSW✔✔: C. T6-T10
Rationale: Posteriorly, the lower lobes extend from approximately T6 to
T10. The right lower lobe extends slightly lower than the left due to the
liver. Breath sounds and pathology in the lower lobes are best assessed
posteriorly and at the bases.
Question 5: The visceral pleura:
A. Lines the inner thoracic wall and diaphragm
B. Covers the lung surface and extends into the fissures
C. Contains pain and pressure nerve fibers
D. Is separated from the parietal pleura by the mediastinum
✔✔✔ANSW✔✔: B. Covers the lung surface and extends into the
fissures
Rationale: The visceral pleura adheres directly to the lung parenchyma
and follows the contours of the fissures. It lacks sensory nerves (pain
fibers are in the parietal pleura). The pleural space (potential space)
separates the two layers.
Question 6: Which intercostal space is used for needle decompression
of a tension pneumothorax in the midclavicular line?
A. 2nd intercostal space
B. 4th intercostal space
C. 5th intercostal space
D. 6th intercostal space
✔✔✔ANSW✔✔: A. 2nd intercostal space
Rationale: The second intercostal space, midclavicular line, is the
landmark for emergency needle decompression because it avoids the
major vessels and the heart. For chest tube placement, the 4th-5th
intercostal space, anterior axillary line, is preferred.
, Question 7: The angle of Louis (sternal angle) is a palpable landmark
that corresponds to the:
A. Xiphoid process
B. Second rib articulation
C. Suprasternal notch
D. Costochondral junction of the 5th rib
✔✔✔ANSW✔✔: B. Second rib articulation
Rationale: The sternal angle is where the manubrium meets the body of
the sternum and is the articulation point for the second rib. Counting ribs
from this landmark ensures accurate intercostal space identification.
Question 8: Which muscle is the primary muscle of inspiration during
normal, quiet breathing?
A. External intercostals
B. Internal intercostals
C. Diaphragm
D. Sternocleidomastoid
✔✔✔ANSW✔✔: C. Diaphragm
Rationale: The diaphragm is responsible for ~75% of the work of
breathing during tidal volume ventilation. Accessory muscles
(sternocleidomastoid, scalenes, external intercostals) are recruited during
exercise or respiratory distress.
Question 9: The apex of the lung extends approximately how many
centimeters above the clavicle?
A. 1-2 cm
B. 2-4 cm
C. 5-6 cm
D. 7-8 cm
