NR 509 APEA 3P WEEK 8 FINAL
EXAM Practice Questions And
Correct Answers (Verified Answers)
Plus Rationales 2026 Q&A | Instant
Download Pdf
Question 1
A 3 year-old presents with a history of fever and cough over the past 24 hours.
Findings on exam reveal: temperature of 102°F, apical heart rate of 157
beats/minute, and respiratory rate of 40 breaths/minute. Tachypnea in this child is
most likely related to:
• A. Paradoxical respirations
• B. The child's febrile state
• C. The child's age
• D. An airway obstruction
Correct Answer: B. The child's febrile state
Rationale: In children, heart and respiratory rates increase with fever. For every
degree of fever, the respiratory rate increases 3-4 breaths/minute and the heart rate
increases 8-10 beats/minute. This physiologic response helps dissipate heat
through increased respiratory effort .
,Question 2
When percussing the lower posterior chest, begin by:
• A. Standing on the side rather than directly behind the patient
• B. Having the patient lie supine on the examining table
• C. Carefully palpating any area the patient has reported pain
• D. Using the ball or the ulnar surface of the hand
Correct Answer: A. Standing on the side rather than directly behind the
patient
Rationale: Standing on the side allows the examiner to place the pleximeter finger
more firmly on the chest and use the plexor more effectively to produce a better
percussion note. The posterior chest cannot be percussed if the patient is supine,
palpation is not percussion, and the ulnar surface is used for detecting tactile
fremitus, not percussion .
Question 3
The palpation technique used to assess respiratory expansion of the chest involves
placing the hands on the eighth or tenth ribs posteriorly with the thumbs close to
the vertebrae, sliding the hands medially and grasping a small fold of skin between
the thumbs. Then:
• A. Ask the patient to cough and note chest expansion
• B. Ask the patient to take a deep breath and note any delay in expansion
during inhalation
• C. Have the patient hold their breath for 15 seconds then note chest
expansion
• D. Have the patient exhale forcefully noting expansion on expiration
,Correct Answer: B. Ask the patient to take a deep breath and note any delay
in expansion during inhalation
Rationale: During normal inspiration, the thumbs should move evenly away from
the vertebrae. Any delay in expansion suggests pathology such as consolidation,
pleural effusion, or pneumothorax .
Question 4
When trying to differentiate between hemoptysis or blood streaked material, which
one of the following observations is correct?
• A. Hemoptysis is seen frequently in infants, children, and adolescents with
allergic rhinitis
• B. Blood originating in the stomach is usually brighter than blood
originating from the respiratory tract
• C. Hemoptysis is common in children with cystic fibrosis
• D. Blood streaked material often originates from the gastrointestinal tract
Correct Answer: C. Hemoptysis is common in children with cystic fibrosis
Rationale: Hemoptysis is rare in infants, children, and adolescents but is common
in those with cystic fibrosis. Blood originating in the stomach is usually darker
than blood from the respiratory tract and may be mixed with food particles. Blood-
streaked material may originate in the mouth, pharynx, or less commonly from the
gastrointestinal tract .
Question 5
, When percussing the chest in a patient who has left-sided heart failure, the sound
emanated would be:
• A. Resonant
• B. Dull
• C. Tympany
• D. Diffusely hyperresonant
Correct Answer: A. Resonant
Rationale: A patient with left-sided heart failure experiences increased pressure in
the pulmonary veins, causing congestion and interstitial edema. Percussion sounds
emitted would most likely be resonant. Consolidation produces dullness,
pneumothorax produces tympany, and COPD produces diffusely hyperresonant
sounds .
Question 6
The line that extends through the inferior angle of the scapula when the arms are at
the sides of the body is the:
• A. Midvertebral line
• B. Scapular line
• C. Midclavicular line
• D. Midspinal line
Correct Answer: B. Scapular line
Rationale: The line that extends through the inferior angle of the scapula when the
arms are at the sides of the body is the scapular line. This is an important landmark
for documenting chest findings .
EXAM Practice Questions And
Correct Answers (Verified Answers)
Plus Rationales 2026 Q&A | Instant
Download Pdf
Question 1
A 3 year-old presents with a history of fever and cough over the past 24 hours.
Findings on exam reveal: temperature of 102°F, apical heart rate of 157
beats/minute, and respiratory rate of 40 breaths/minute. Tachypnea in this child is
most likely related to:
• A. Paradoxical respirations
• B. The child's febrile state
• C. The child's age
• D. An airway obstruction
Correct Answer: B. The child's febrile state
Rationale: In children, heart and respiratory rates increase with fever. For every
degree of fever, the respiratory rate increases 3-4 breaths/minute and the heart rate
increases 8-10 beats/minute. This physiologic response helps dissipate heat
through increased respiratory effort .
,Question 2
When percussing the lower posterior chest, begin by:
• A. Standing on the side rather than directly behind the patient
• B. Having the patient lie supine on the examining table
• C. Carefully palpating any area the patient has reported pain
• D. Using the ball or the ulnar surface of the hand
Correct Answer: A. Standing on the side rather than directly behind the
patient
Rationale: Standing on the side allows the examiner to place the pleximeter finger
more firmly on the chest and use the plexor more effectively to produce a better
percussion note. The posterior chest cannot be percussed if the patient is supine,
palpation is not percussion, and the ulnar surface is used for detecting tactile
fremitus, not percussion .
Question 3
The palpation technique used to assess respiratory expansion of the chest involves
placing the hands on the eighth or tenth ribs posteriorly with the thumbs close to
the vertebrae, sliding the hands medially and grasping a small fold of skin between
the thumbs. Then:
• A. Ask the patient to cough and note chest expansion
• B. Ask the patient to take a deep breath and note any delay in expansion
during inhalation
• C. Have the patient hold their breath for 15 seconds then note chest
expansion
• D. Have the patient exhale forcefully noting expansion on expiration
,Correct Answer: B. Ask the patient to take a deep breath and note any delay
in expansion during inhalation
Rationale: During normal inspiration, the thumbs should move evenly away from
the vertebrae. Any delay in expansion suggests pathology such as consolidation,
pleural effusion, or pneumothorax .
Question 4
When trying to differentiate between hemoptysis or blood streaked material, which
one of the following observations is correct?
• A. Hemoptysis is seen frequently in infants, children, and adolescents with
allergic rhinitis
• B. Blood originating in the stomach is usually brighter than blood
originating from the respiratory tract
• C. Hemoptysis is common in children with cystic fibrosis
• D. Blood streaked material often originates from the gastrointestinal tract
Correct Answer: C. Hemoptysis is common in children with cystic fibrosis
Rationale: Hemoptysis is rare in infants, children, and adolescents but is common
in those with cystic fibrosis. Blood originating in the stomach is usually darker
than blood from the respiratory tract and may be mixed with food particles. Blood-
streaked material may originate in the mouth, pharynx, or less commonly from the
gastrointestinal tract .
Question 5
, When percussing the chest in a patient who has left-sided heart failure, the sound
emanated would be:
• A. Resonant
• B. Dull
• C. Tympany
• D. Diffusely hyperresonant
Correct Answer: A. Resonant
Rationale: A patient with left-sided heart failure experiences increased pressure in
the pulmonary veins, causing congestion and interstitial edema. Percussion sounds
emitted would most likely be resonant. Consolidation produces dullness,
pneumothorax produces tympany, and COPD produces diffusely hyperresonant
sounds .
Question 6
The line that extends through the inferior angle of the scapula when the arms are at
the sides of the body is the:
• A. Midvertebral line
• B. Scapular line
• C. Midclavicular line
• D. Midspinal line
Correct Answer: B. Scapular line
Rationale: The line that extends through the inferior angle of the scapula when the
arms are at the sides of the body is the scapular line. This is an important landmark
for documenting chest findings .
