NURS 607 Bundled Study Guides —
Comprehensive Exam with correct
answers and rationale graded A+
new!!
Section 1: Respiratory Physiology & Assessment
1. The nurse knows that expected assessment findings in the normal adult lung
include which of the following?
A. Adventitious sounds and limited chest expansion
B. Increased tactile fremitus and dull percussion tones
C. Muffled voice sounds and symmetric tactile fremitus
D. Absent voice sounds and hyperresonant percussion tones
Rationale: Normal lung assessment includes muffled voice sounds (egophony) and
symmetric tactile fremitus. Adventitious sounds, dull tones, and absent voice sounds
indicate abnormalities.
2. The primary muscles of respiration include the:
A. Diaphragm and intercostals
B. Sternomastoids and scaleni
C. Trapezii and rectus abdominis
D. External obliques and pectoralis major
Rationale: The diaphragm and intercostal muscles are the primary muscles
responsible for breathing. Accessory muscles are recruited during respiratory distress.
3. When assessing a patient's lungs, the nurse recalls that the left lung:
A. Consists of two lobes
B. Is divided by the horizontal fissure
C. Primarily consists of an upper lobe on the posterior chest
D. Is shorter than the right lung because of the underlying stomach
Rationale: The left lung has two lobes (upper and lower) separated by the oblique
fissure. The right lung has three lobes.
4. The apices of the lungs:
A. Are at the level of the second rib anteriorly
B. Extend 3 to 4 cm above the inner third of the clavicles
,C. Are located at the sixth rib anteriorly and the eighth rib laterally
D. Rest on the diaphragm at the fifth intercostal space in the midclavicular line
Rationale: The lung apices extend above the clavicles, which is why apical breath
sounds must be assessed in this region.
5. During an examination of the anterior thorax, the nurse is aware that the
trachea bifurcates anteriorly at the:
A. Costal angle
B. Sternal angle
C. Xiphoid process
D. Suprasternal notch
Rationale: The trachea bifurcates at the sternal angle (angle of Louis), which is a key
landmark for anterior chest assessment
6. When auscultating the lungs of an adult patient, the nurse notes low-pitched,
soft breath sounds over the posterior lower lobes with inspiration longer than
expiration. The nurse interprets these as:
A. Normally auscultated over the trachea
B. Bronchial breath sounds and normal in that location
C. Vesicular breath sounds and normal in that location
D. Bronchovesicular breath sounds and normal in that location
Rationale: Vesicular sounds are low-pitched, soft, and heard over most of the lung
fields. Inspiration is longer than expiration in vesicular sounds.
7. The correct method to use when progressing from one auscultatory site to
another is:
A. Side-to-side comparison
B. Top-to-bottom progression
C. Posterior-to-anterior progression
D. Interspace-by-interspace progression
Rationale: Side-to-side comparison allows the nurse to detect subtle differences
between symmetric lung fields.
8. What is considered a normal adult respiratory rate?
A. 10-15 breaths per minute
B. 12-20 breaths per minute
C. 18-24 breaths per minute
D. 20-30 breaths per minute
Rationale: Normal adult respiratory rate is 12-20 breaths per minute. Rates above 20
indicate tachypnea.
, 9. A patient with acute asthma presents with accessory muscle use, wheezing,
and SpO2 of 84%. What is the priority intervention?
A. Administer bronchodilator and supplemental oxygen
B. Encourage ambulation
C. Apply warm compresses
D. Document findings
Rationale: Severe hypoxemia with accessory muscle use indicates impending
respiratory failure. Immediate bronchodilation and oxygen are required
10. Absorption atelectasis is accelerated when:
A. Nitrogen is retained in the alveoli
B. Nitrogen is actively washed out of the lung by high oxygen concentrations
C. Low V/Q ratios are present in non-dependent regions
D. The patient breathes room air
Rationale: When nitrogen is replaced by oxygen or nitrous oxide, alveoli in
dependent regions with low V/Q ratios are vulnerable to collapse because oxygen is
rapidly absorbed.
Section 2: Airway Management & Ventilation
11. The posterior cricoarytenoid muscles:
A. Abduct the vocal folds
B. Adduct the vocal folds
C. Tense the vocal folds
D. Relax the vocal folds
Rationale: The posterior cricoarytenoid is the only muscle that abducts (opens) the
vocal cords, making it critical for airway patency
12. The lateral cricoarytenoid muscles:
A. Abduct the vocal folds
B. Adduct the vocal folds
C. Elevate the larynx
D. Depress the epiglottis
Rationale: The lateral cricoarytenoids adduct (close) the vocal folds
13. Sensory innervation to the mucous membrane of the larynx superior to the
vocal cords is provided by:
A. Recurrent laryngeal nerve
Comprehensive Exam with correct
answers and rationale graded A+
new!!
Section 1: Respiratory Physiology & Assessment
1. The nurse knows that expected assessment findings in the normal adult lung
include which of the following?
A. Adventitious sounds and limited chest expansion
B. Increased tactile fremitus and dull percussion tones
C. Muffled voice sounds and symmetric tactile fremitus
D. Absent voice sounds and hyperresonant percussion tones
Rationale: Normal lung assessment includes muffled voice sounds (egophony) and
symmetric tactile fremitus. Adventitious sounds, dull tones, and absent voice sounds
indicate abnormalities.
2. The primary muscles of respiration include the:
A. Diaphragm and intercostals
B. Sternomastoids and scaleni
C. Trapezii and rectus abdominis
D. External obliques and pectoralis major
Rationale: The diaphragm and intercostal muscles are the primary muscles
responsible for breathing. Accessory muscles are recruited during respiratory distress.
3. When assessing a patient's lungs, the nurse recalls that the left lung:
A. Consists of two lobes
B. Is divided by the horizontal fissure
C. Primarily consists of an upper lobe on the posterior chest
D. Is shorter than the right lung because of the underlying stomach
Rationale: The left lung has two lobes (upper and lower) separated by the oblique
fissure. The right lung has three lobes.
4. The apices of the lungs:
A. Are at the level of the second rib anteriorly
B. Extend 3 to 4 cm above the inner third of the clavicles
,C. Are located at the sixth rib anteriorly and the eighth rib laterally
D. Rest on the diaphragm at the fifth intercostal space in the midclavicular line
Rationale: The lung apices extend above the clavicles, which is why apical breath
sounds must be assessed in this region.
5. During an examination of the anterior thorax, the nurse is aware that the
trachea bifurcates anteriorly at the:
A. Costal angle
B. Sternal angle
C. Xiphoid process
D. Suprasternal notch
Rationale: The trachea bifurcates at the sternal angle (angle of Louis), which is a key
landmark for anterior chest assessment
6. When auscultating the lungs of an adult patient, the nurse notes low-pitched,
soft breath sounds over the posterior lower lobes with inspiration longer than
expiration. The nurse interprets these as:
A. Normally auscultated over the trachea
B. Bronchial breath sounds and normal in that location
C. Vesicular breath sounds and normal in that location
D. Bronchovesicular breath sounds and normal in that location
Rationale: Vesicular sounds are low-pitched, soft, and heard over most of the lung
fields. Inspiration is longer than expiration in vesicular sounds.
7. The correct method to use when progressing from one auscultatory site to
another is:
A. Side-to-side comparison
B. Top-to-bottom progression
C. Posterior-to-anterior progression
D. Interspace-by-interspace progression
Rationale: Side-to-side comparison allows the nurse to detect subtle differences
between symmetric lung fields.
8. What is considered a normal adult respiratory rate?
A. 10-15 breaths per minute
B. 12-20 breaths per minute
C. 18-24 breaths per minute
D. 20-30 breaths per minute
Rationale: Normal adult respiratory rate is 12-20 breaths per minute. Rates above 20
indicate tachypnea.
, 9. A patient with acute asthma presents with accessory muscle use, wheezing,
and SpO2 of 84%. What is the priority intervention?
A. Administer bronchodilator and supplemental oxygen
B. Encourage ambulation
C. Apply warm compresses
D. Document findings
Rationale: Severe hypoxemia with accessory muscle use indicates impending
respiratory failure. Immediate bronchodilation and oxygen are required
10. Absorption atelectasis is accelerated when:
A. Nitrogen is retained in the alveoli
B. Nitrogen is actively washed out of the lung by high oxygen concentrations
C. Low V/Q ratios are present in non-dependent regions
D. The patient breathes room air
Rationale: When nitrogen is replaced by oxygen or nitrous oxide, alveoli in
dependent regions with low V/Q ratios are vulnerable to collapse because oxygen is
rapidly absorbed.
Section 2: Airway Management & Ventilation
11. The posterior cricoarytenoid muscles:
A. Abduct the vocal folds
B. Adduct the vocal folds
C. Tense the vocal folds
D. Relax the vocal folds
Rationale: The posterior cricoarytenoid is the only muscle that abducts (opens) the
vocal cords, making it critical for airway patency
12. The lateral cricoarytenoid muscles:
A. Abduct the vocal folds
B. Adduct the vocal folds
C. Elevate the larynx
D. Depress the epiglottis
Rationale: The lateral cricoarytenoids adduct (close) the vocal folds
13. Sensory innervation to the mucous membrane of the larynx superior to the
vocal cords is provided by:
A. Recurrent laryngeal nerve
