NURS 612 Advanced Health Assessment - Week 5 Quiz (Thorax, Lungs,
and Breast) 2026 |Maryville
1. A 55-year-old female presents with a crusty, red, and scaling area around her
right nipple that has not healed with topical steroids. What is the most likely
diagnosis?
A. Mastitis
B. Paget disease of the breast
C. Intraductal papilloma
D. Fibrocystic breast disease
Answer: B
Rationale: Paget disease of the breast is a rare form of breast cancer that starts on the
nipple and extends to the areola. It often mimics eczema or dermatitis with crusting and
scaling.
2. When palpating the chest of a patient with lobar pneumonia, the nurse
practitioner expects to find which of the following?
A. Decreased tactile fremitus
B. Hyperresonance on percussion
C. Increased tactile fremitus
D. Diaphragmatic excursion of 8 cm
Answer: C
Rationale: Tactile fremitus is increased over areas of consolidation, such as in lobar
pneumonia, because sound travels better through solid or fluid-filled tissue than through
air.
,3. Which anatomical landmark is used to locate the second rib and the
bifurcation of the trachea?
A. Suprasternal notch
B. Xiphoid process
C. Costal margin
D. Sternal angle (Angle of Louis)
Answer: D
Rationale: The sternal angle, or Angle of Louis, is continuous with the second rib and
marks the site of tracheal bifurcation into the right and left main bronchi.
4. During a breast exam, a patient is asked to lean forward. This maneuver is
specifically designed to highlight:
A. Symmetry of the breasts
B. Skin retraction or dimpling
C. Nipple discharge
D. The tail of Spence
Answer: B
Rationale: Leaning forward allows the breasts to hang freely, which can reveal skin
dimpling or retraction caused by underlying neoplasms that fixate to the chest wall.
5. A high-pitched, musical sound heard primarily during expiration in a patient
with asthma is called:
A. Crackles
B. Rhonchi
C. Wheeze
D. Stridor
Answer: C
Rationale: Wheezes are high-pitched, musical sounds caused by air squeezing through
narrowed or obstructed airways, common in asthma.
, 6. Which lymphatic nodes are responsible for draining most of the lymph from
the breast?
A. Axillary nodes
B. Internal mammary nodes
C. Supraclavicular nodes
D. Submandibular nodes
Answer: A
Rationale: Approximately 75% of lymph from the breast drains into the ipsilateral axillary
nodes.
7. An adult patient presents with a ‘barrel chest.’ This finding is most commonly
associated with:
A. Acute pneumonia
B. Thoracic kyphosis
C. Chronic obstructive pulmonary disease (COPD)
D. Congestive heart failure
Answer: C
Rationale: A barrel chest occurs when the anteroposterior diameter of the chest is equal to
the transverse diameter, often due to hyperinflation of the lungs in COPD.
8. While auscultating the lungs, the practitioner hears a loud, high-pitched,
hollow sound over the manubrium. This sound is characterized as:
A. Vesicular
B. Bronchial
C. Bronchovesicular
D. Adventitious
Answer: B
Rationale: Bronchial (or tracheal) breath sounds are loud, high-pitched, and hollow, heard
over the trachea and manubrium.
and Breast) 2026 |Maryville
1. A 55-year-old female presents with a crusty, red, and scaling area around her
right nipple that has not healed with topical steroids. What is the most likely
diagnosis?
A. Mastitis
B. Paget disease of the breast
C. Intraductal papilloma
D. Fibrocystic breast disease
Answer: B
Rationale: Paget disease of the breast is a rare form of breast cancer that starts on the
nipple and extends to the areola. It often mimics eczema or dermatitis with crusting and
scaling.
2. When palpating the chest of a patient with lobar pneumonia, the nurse
practitioner expects to find which of the following?
A. Decreased tactile fremitus
B. Hyperresonance on percussion
C. Increased tactile fremitus
D. Diaphragmatic excursion of 8 cm
Answer: C
Rationale: Tactile fremitus is increased over areas of consolidation, such as in lobar
pneumonia, because sound travels better through solid or fluid-filled tissue than through
air.
,3. Which anatomical landmark is used to locate the second rib and the
bifurcation of the trachea?
A. Suprasternal notch
B. Xiphoid process
C. Costal margin
D. Sternal angle (Angle of Louis)
Answer: D
Rationale: The sternal angle, or Angle of Louis, is continuous with the second rib and
marks the site of tracheal bifurcation into the right and left main bronchi.
4. During a breast exam, a patient is asked to lean forward. This maneuver is
specifically designed to highlight:
A. Symmetry of the breasts
B. Skin retraction or dimpling
C. Nipple discharge
D. The tail of Spence
Answer: B
Rationale: Leaning forward allows the breasts to hang freely, which can reveal skin
dimpling or retraction caused by underlying neoplasms that fixate to the chest wall.
5. A high-pitched, musical sound heard primarily during expiration in a patient
with asthma is called:
A. Crackles
B. Rhonchi
C. Wheeze
D. Stridor
Answer: C
Rationale: Wheezes are high-pitched, musical sounds caused by air squeezing through
narrowed or obstructed airways, common in asthma.
, 6. Which lymphatic nodes are responsible for draining most of the lymph from
the breast?
A. Axillary nodes
B. Internal mammary nodes
C. Supraclavicular nodes
D. Submandibular nodes
Answer: A
Rationale: Approximately 75% of lymph from the breast drains into the ipsilateral axillary
nodes.
7. An adult patient presents with a ‘barrel chest.’ This finding is most commonly
associated with:
A. Acute pneumonia
B. Thoracic kyphosis
C. Chronic obstructive pulmonary disease (COPD)
D. Congestive heart failure
Answer: C
Rationale: A barrel chest occurs when the anteroposterior diameter of the chest is equal to
the transverse diameter, often due to hyperinflation of the lungs in COPD.
8. While auscultating the lungs, the practitioner hears a loud, high-pitched,
hollow sound over the manubrium. This sound is characterized as:
A. Vesicular
B. Bronchial
C. Bronchovesicular
D. Adventitious
Answer: B
Rationale: Bronchial (or tracheal) breath sounds are loud, high-pitched, and hollow, heard
over the trachea and manubrium.
