WILKES NSG 500 TEST 2 STUDY GUIDE 2026
QUESTIONS WITH COMPLETE SOLUTIONS
GRADED A+
◉ dullness on percussion Answer: present in pleural effusion or
lobar pneumonia
◉ tactile fremitus. Answer: decreased or absent if excess air in lungs
(emphysema), pelural thickening or effusion, bronchial obstruction
increased if presence of fluids, solid mass, consolidation
◉ trachea exam Answer: eviation: volume loss from fibrosis or
atelactasis will pull the trachea that direction. mau also be anterior
mediastinal tumor, inlammation
◉ lung percussion Answer: dull=cardiac, luver
tympany--stomach
resonant--lungs
flat--muscles and bones
◉ lung percussion order Answer: back (10 areas), right lateral--4
areas, left lateral 4 areas, front8 areas
,◉ classification of breath sounds Answer: vesicular--low pitched,
low intesity (normal healthy tissue)
bronchovesicular--over major bronchi, moderate in pitch and
intensity
bronchial breath soudns--highest in pitch and intensity--over
trachea
◉ bronchovesicular and bronchial breath sounds over peripheral
lung tissue Answer: ABNORMAL
◉ breath sounds like blowing across the mouth of a bottle Answer:
amphoric=stiff pulmonary caivty or tension pneumothorax
◉ rub sound--lungs Answer: cratchy and high pitched
◉ types of crackles Answer: fine: high pitched discrete with end of
inspiration, doesn't clear with cough
medium: lower more in middle stage of inspiration
coarse: bubbly with inspiration, loud
◉ rhonchi Answer: deeper rumbling more pronounced during
expiration. d/t thick secretions
,◉ vocal resonance with lung ausculatation Answer: bronchophony--
consolidation in lungs--even a whisper can be heard clearly
egophony--consolidation of lung tissue--ee turns into "a"
◉ bronchial breath sounds Answer: harsh, hollow sound - best
heard over trachea and larynx
◉ bronchovesicular breath s Answer: over bronchi, med pitch and
loudness
◉ vesicular sounds Answer: heard every where else, softest and
lowest pitch
◉ fine crackles are more often in Answer: bases of lungs
◉ coarse crackles more often in Answer: trachea and large bronchi
◉ rhonchi are due to Answer: airway obstruction from mass,
secretions, muscular constriction
◉ wheezes are due to Answer: constriction, mass, secretions
, ◉ stridor Answer: strained, high-pitched sound heard on inspiration
caused by obstruction in the pharynx or larynx
◉ S1 heart sound Answer: mitral and tricuspid valve closure with
ventricular contraction
◉ s2 Answer: initiation of diastole aortic and pulmonic valves
closing after ventricles have emptied
◉ s3 Answer: sometimes occurs when ventricular filling is almost
complete. due to RAPID ventricular filling. low pitch, use bell
◉ s4 Answer: occurs with atria contraction to ensure ejection of any
remaining blood. Due to forceful atrial ejection into distended
ventricle. low pitch, use bell
◉ chest pain: cardiac Answer: substernal provoked by effort,
emotion, eating and relieved by rest, nitro, often accompanied by
diaphoresis and sometimes nausea
◉ chest pain: pleural Answer: with breathing or coughing: sharp,
present with respiration, absend when holding breath
QUESTIONS WITH COMPLETE SOLUTIONS
GRADED A+
◉ dullness on percussion Answer: present in pleural effusion or
lobar pneumonia
◉ tactile fremitus. Answer: decreased or absent if excess air in lungs
(emphysema), pelural thickening or effusion, bronchial obstruction
increased if presence of fluids, solid mass, consolidation
◉ trachea exam Answer: eviation: volume loss from fibrosis or
atelactasis will pull the trachea that direction. mau also be anterior
mediastinal tumor, inlammation
◉ lung percussion Answer: dull=cardiac, luver
tympany--stomach
resonant--lungs
flat--muscles and bones
◉ lung percussion order Answer: back (10 areas), right lateral--4
areas, left lateral 4 areas, front8 areas
,◉ classification of breath sounds Answer: vesicular--low pitched,
low intesity (normal healthy tissue)
bronchovesicular--over major bronchi, moderate in pitch and
intensity
bronchial breath soudns--highest in pitch and intensity--over
trachea
◉ bronchovesicular and bronchial breath sounds over peripheral
lung tissue Answer: ABNORMAL
◉ breath sounds like blowing across the mouth of a bottle Answer:
amphoric=stiff pulmonary caivty or tension pneumothorax
◉ rub sound--lungs Answer: cratchy and high pitched
◉ types of crackles Answer: fine: high pitched discrete with end of
inspiration, doesn't clear with cough
medium: lower more in middle stage of inspiration
coarse: bubbly with inspiration, loud
◉ rhonchi Answer: deeper rumbling more pronounced during
expiration. d/t thick secretions
,◉ vocal resonance with lung ausculatation Answer: bronchophony--
consolidation in lungs--even a whisper can be heard clearly
egophony--consolidation of lung tissue--ee turns into "a"
◉ bronchial breath sounds Answer: harsh, hollow sound - best
heard over trachea and larynx
◉ bronchovesicular breath s Answer: over bronchi, med pitch and
loudness
◉ vesicular sounds Answer: heard every where else, softest and
lowest pitch
◉ fine crackles are more often in Answer: bases of lungs
◉ coarse crackles more often in Answer: trachea and large bronchi
◉ rhonchi are due to Answer: airway obstruction from mass,
secretions, muscular constriction
◉ wheezes are due to Answer: constriction, mass, secretions
, ◉ stridor Answer: strained, high-pitched sound heard on inspiration
caused by obstruction in the pharynx or larynx
◉ S1 heart sound Answer: mitral and tricuspid valve closure with
ventricular contraction
◉ s2 Answer: initiation of diastole aortic and pulmonic valves
closing after ventricles have emptied
◉ s3 Answer: sometimes occurs when ventricular filling is almost
complete. due to RAPID ventricular filling. low pitch, use bell
◉ s4 Answer: occurs with atria contraction to ensure ejection of any
remaining blood. Due to forceful atrial ejection into distended
ventricle. low pitch, use bell
◉ chest pain: cardiac Answer: substernal provoked by effort,
emotion, eating and relieved by rest, nitro, often accompanied by
diaphoresis and sometimes nausea
◉ chest pain: pleural Answer: with breathing or coughing: sharp,
present with respiration, absend when holding breath
