USU
1. Which of the following factors can aggravate costochondritis?
A) Movement of the chest, trunk, and arms
B) Deep breathing and coughing
C) Lying flat on the back
D) Eating a heavy meal
Correct Answer: A) Movement of the chest, trunk, and arms
Rationale: Costochondritis is inflammation of the cartilage where ribs attach to the sternum.
Pain is typically aggravated by movement of the chest, trunk, and arms, as well as by deep
palpation. Lying flat or eating a heavy meal does not directly aggravate this condition.
2. An NP is evaluating a patient with stridor. Which of the following conditions is most
associated with this finding?
A) Asthma
B) Foreign body obstruction
C) Pneumonia
D) Pleural effusion
Correct Answer: B) Foreign body obstruction
Rationale: Stridor is a high-pitched, musical sound heard on inspiration that indicates upper
airway obstruction. Foreign body obstruction is the most common cause in children, though it
can occur in adults. Asthma causes wheezing, pneumonia causes crackles, and pleural
effusion causes decreased breath sounds.
3. An NP is evaluating an adolescent for a wellness visit. The patient reports vaping
"occasionally." The NP is aware that this patient is at greatest risk for which of the following?
,A) Chemical injuries
B) Bacterial pneumonia
C) Tuberculosis
D) Pulmonary embolism
Correct Answer: A) Chemical injuries
Rationale: Vaping exposes the lungs to heated chemicals, including nicotine, flavorings, and
other additives. This can cause direct chemical injury to the airways and alveoli, leading to
conditions such as EVALI (e-cigarette or vaping product use-associated lung injury).
4. An NP is assessing a patient with decreased tactile fremitus and absent breath sounds over
the left lobe. Which of the following conditions is most often associated with these objective
findings?
A) Lobar pneumonia
B) Pleural effusion
C) Asthma
D) Chronic bronchitis
Correct Answer: B) Pleural effusion
Rationale: Pleural effusion is the accumulation of fluid in the pleural space, which separates
the lung from the chest wall. This blocks the transmission of sound and vibration, leading to
decreased tactile fremitus and absent breath sounds.
5. Which of the following findings should the NP anticipate during percussion in an adult
with lobar pneumonia?
A) Hyperresonance
B) Tympany
C) Dullness
D) Resonance
, Correct Answer: C) Dullness
Rationale: Lobar pneumonia causes consolidation of lung tissue, which increases density.
Percussion over consolidated lung produces a dull note. Hyperresonance is heard with
emphysema or pneumothorax, and tympany is heard over the stomach.
6. A young adult patient presents to the clinic for an annual exam. Physical examination
revealed a blood pressure of 135/82 mmHg and a heart rate of 108 but otherwise
unremarkable. Which of the following historical factors is the most likely contributor to the
abnormal findings?
A) 3-year history of vaping
B) Occasional alcohol use
C) Regular caffeine intake
D) Sedentary lifestyle
Correct Answer: A) 3-year history of vaping
Rationale: Vaping is associated with sympathetic nervous system stimulation, which can
elevate heart rate and blood pressure. The other options are less likely to cause acute
elevations in a young adult.
7. An NP is assessing a patient with a suspected pleural effusion. Which of the following
characteristics is accurate of pleural rubs and differentiates them from pericardial friction
rubs?
A) A pleural rub is biphasic, heard during inspiration and expiration
B) A pleural rub is monophasic, heard only during inspiration
C) A pleural rub is continuous and musical
D) A pleural rub is best heard at the apex of the heart
Correct Answer: A) A pleural rub is biphasic, heard during inspiration and expiration