NURS 6225 ADVANCED HEALTH ASSESSMENT
EXAM 2 QUESTIONS AND ANSWERS LATEST
2025-2026 UPDATE
Apical Impulse (PMI) - Answer-Point of Maximal Impulse (Apex of the
heart): between 4th to 5th intercostal space, midclavicular
Apex beat is palpable in only 25-40% of healthy adults in supine
position and 50% in left lateral decubitus position—>especially those
who are thin
Some hide behind rib cage, despite positioning
diaphragmatic excursion - Answer-*assesses degree and symmetry of
diaphragm movement; percuss from areas of resonance to dullness
* not percussing the diaphragm itself you are identifying the resonant
lung tissue and the duller structures below.
* you can infer the probable location of the diaphragm from the level of
dullness
during diaphragmatic excursion an "absent decent" means what? -
Answer-An abnormally high level suggests a pleural effusion or an
elevated hemidiaphragm from atelectasis or phrenic nerve paralysis
fine crackles/rales - Answer-occurrence- on end inspiration; dont clear
with cough.
,When examining a patient for the apical impulse (PMI), which of the
following is LEAST important to assess?
A. Location
B. Amplitude
C. Rhythm
D. Diameter - Answer-C. Rhythm
Assess location, amplitude, duration, and diameter
5 A's of tobacco cessation - Answer-
What is tactile fremitus? - Answer-palpable vibrations transmitted
through the bronchopulmonary tree to the chest wall as the patient is
speaking "99"
NORMAL= buzzing on hands when patient say "99"
SOLIDS CONDUCT SOUND/VIBRATIONS BETTER THAN AIR
Conditions where tactile fremitus is absent or decreased - Answer-
Fremitus is decreased or absent when the transmission of vibrations is
impeded.
Feeling little or no buzzing at all compared to similar lung areas;
LARGE POCKETS OF AIR IN THE LUNGS
thick chest wall
,obstructed bronchus
COPD
pleural effusion
fibrosis
pneumo (Air)
infiltrating tumor
fibrosis
emphysema
consolidation
Asthma
Causes of asymmetrical fremitus - Answer-Decreased fremitus
Unilateral pleural effusion
Pneumo
neoplasm
Increased fremitus
Unilateral pneumonia
Causes of increased fremitus - Answer-feeling of a strong vibration
compared to similar lung areas
Consolidation of lung tissue
pneumonia
, atelectasis
bronchitis
Quality- High pitched short crackling
Causes- collapses or fluid-filled alveoli open
Course crackles/rales - Answer-Occurrence- End inspiration, doesn't
clear with cough
Quality- Loud, moist, low-pitched, bubbling
Causes- Collapsed or fluid-filled alveoli open
Wheezes - Answer-Occurrence- Expiration and inspiration when severe
Quality- High-pitched, continuous
Causes- blocked airflow as in asthma, infection, foreign body
obstruction
EXAM 2 QUESTIONS AND ANSWERS LATEST
2025-2026 UPDATE
Apical Impulse (PMI) - Answer-Point of Maximal Impulse (Apex of the
heart): between 4th to 5th intercostal space, midclavicular
Apex beat is palpable in only 25-40% of healthy adults in supine
position and 50% in left lateral decubitus position—>especially those
who are thin
Some hide behind rib cage, despite positioning
diaphragmatic excursion - Answer-*assesses degree and symmetry of
diaphragm movement; percuss from areas of resonance to dullness
* not percussing the diaphragm itself you are identifying the resonant
lung tissue and the duller structures below.
* you can infer the probable location of the diaphragm from the level of
dullness
during diaphragmatic excursion an "absent decent" means what? -
Answer-An abnormally high level suggests a pleural effusion or an
elevated hemidiaphragm from atelectasis or phrenic nerve paralysis
fine crackles/rales - Answer-occurrence- on end inspiration; dont clear
with cough.
,When examining a patient for the apical impulse (PMI), which of the
following is LEAST important to assess?
A. Location
B. Amplitude
C. Rhythm
D. Diameter - Answer-C. Rhythm
Assess location, amplitude, duration, and diameter
5 A's of tobacco cessation - Answer-
What is tactile fremitus? - Answer-palpable vibrations transmitted
through the bronchopulmonary tree to the chest wall as the patient is
speaking "99"
NORMAL= buzzing on hands when patient say "99"
SOLIDS CONDUCT SOUND/VIBRATIONS BETTER THAN AIR
Conditions where tactile fremitus is absent or decreased - Answer-
Fremitus is decreased or absent when the transmission of vibrations is
impeded.
Feeling little or no buzzing at all compared to similar lung areas;
LARGE POCKETS OF AIR IN THE LUNGS
thick chest wall
,obstructed bronchus
COPD
pleural effusion
fibrosis
pneumo (Air)
infiltrating tumor
fibrosis
emphysema
consolidation
Asthma
Causes of asymmetrical fremitus - Answer-Decreased fremitus
Unilateral pleural effusion
Pneumo
neoplasm
Increased fremitus
Unilateral pneumonia
Causes of increased fremitus - Answer-feeling of a strong vibration
compared to similar lung areas
Consolidation of lung tissue
pneumonia
, atelectasis
bronchitis
Quality- High pitched short crackling
Causes- collapses or fluid-filled alveoli open
Course crackles/rales - Answer-Occurrence- End inspiration, doesn't
clear with cough
Quality- Loud, moist, low-pitched, bubbling
Causes- Collapsed or fluid-filled alveoli open
Wheezes - Answer-Occurrence- Expiration and inspiration when severe
Quality- High-pitched, continuous
Causes- blocked airflow as in asthma, infection, foreign body
obstruction
