,Arkansas State University NURS 6023 Exam 2 | Advanced
Assessment & Diagnostic Evaluation (2026) Q&A
1. Which of the following best describes the primary purpose of percussion during a
thoracic assessment?
A) To assess the density of underlying lung tissue by producing sound waves
B) To directly visualize the symmetry of chest wall expansion
C) To palpate for tactile fremitus and crepitus
D) To auscultate for adventitious breath sounds
Correct Answer: To assess the density of underlying lung tissue by producing
sound waves
Rationale: Percussion involves tapping the chest wall to produce sounds that
reflect the density of underlying tissues. Dense structures such as consolidation or
fluid produce dullness, while air-filled normal lung produces resonance. This
technique helps delineate organ borders and detect abnormalities. Inspection,
palpation, and auscultation serve different assessment purposes.
2. What is the primary function of the sternal angle (Angle of Louis) as a clinical
landmark?
A) It marks the level of the second rib and serves as a reference point for counting
ribs
B) It indicates the location of the apical impulse of the heart
C) It marks the level of the fifth intercostal space for chest tube insertion
D) It identifies the lower border of the parietal pleura
,Correct Answer: It marks the level of the second rib and serves as a reference
point for counting ribs
Rationale: The sternal angle is the palpable ridge where the manubrium joins the
body of the sternum. It articulates with the second rib and is a reliable landmark for
counting ribs and intercostal spaces. This reference point is essential for accurate
localization of findings and procedures. The apical impulse is typically at the fifth
intercostal space.
3. According to Bates' framework, which percussion note is expected over normal
lung tissue?
A) Dullness
B) Tympany
C) Resonance
D) Flatness
Correct Answer: Resonance
Rationale: Resonance is the low-pitched, hollow sound heard over normal, air-
filled lung tissue. Dullness is heard over solid structures such as the liver or
consolidated lung. Tympany is heard over the stomach or bowel, and flatness is
heard over muscle or bone. Recognizing normal percussion notes is fundamental to
detecting abnormalities.
4. A researcher is studying the mechanics of breathing. Which muscle is primarily
responsible for quiet inspiration at rest?
A) External intercostals
B) Diaphragm
C) Internal intercostals
, D) Abdominal rectus
Correct Answer: Diaphragm
Rationale: The diaphragm is the primary muscle of inspiration, contributing
approximately 75% of the tidal volume during quiet breathing. The external
intercostals assist by elevating the ribs. The internal intercostals and abdominal
muscles are primarily involved in forced expiration. Understanding respiratory
mechanics is essential for assessing breathing patterns.
5. Which term refers to the normal breath sound heard over most of the lung fields?
A) Bronchial
B) Bronchovesicular
C) Vesicular
D) Tracheal
Correct Answer: Vesicular
Rationale: Vesicular breath sounds are soft, low-pitched, and heard over most of
the peripheral lung fields. They have a longer inspiratory phase than expiratory
phase. Bronchial sounds are loud and high-pitched, heard over the trachea.
Bronchovesicular sounds are heard over the mainstem bronchi, and tracheal sounds
are harsh.
6. What is the most likely outcome if a patient has a large pleural effusion?
A) Hyperresonance to percussion over the affected area
B) Dullness to percussion with decreased breath sounds
C) Tympany to percussion with increased tactile fremitus
Assessment & Diagnostic Evaluation (2026) Q&A
1. Which of the following best describes the primary purpose of percussion during a
thoracic assessment?
A) To assess the density of underlying lung tissue by producing sound waves
B) To directly visualize the symmetry of chest wall expansion
C) To palpate for tactile fremitus and crepitus
D) To auscultate for adventitious breath sounds
Correct Answer: To assess the density of underlying lung tissue by producing
sound waves
Rationale: Percussion involves tapping the chest wall to produce sounds that
reflect the density of underlying tissues. Dense structures such as consolidation or
fluid produce dullness, while air-filled normal lung produces resonance. This
technique helps delineate organ borders and detect abnormalities. Inspection,
palpation, and auscultation serve different assessment purposes.
2. What is the primary function of the sternal angle (Angle of Louis) as a clinical
landmark?
A) It marks the level of the second rib and serves as a reference point for counting
ribs
B) It indicates the location of the apical impulse of the heart
C) It marks the level of the fifth intercostal space for chest tube insertion
D) It identifies the lower border of the parietal pleura
,Correct Answer: It marks the level of the second rib and serves as a reference
point for counting ribs
Rationale: The sternal angle is the palpable ridge where the manubrium joins the
body of the sternum. It articulates with the second rib and is a reliable landmark for
counting ribs and intercostal spaces. This reference point is essential for accurate
localization of findings and procedures. The apical impulse is typically at the fifth
intercostal space.
3. According to Bates' framework, which percussion note is expected over normal
lung tissue?
A) Dullness
B) Tympany
C) Resonance
D) Flatness
Correct Answer: Resonance
Rationale: Resonance is the low-pitched, hollow sound heard over normal, air-
filled lung tissue. Dullness is heard over solid structures such as the liver or
consolidated lung. Tympany is heard over the stomach or bowel, and flatness is
heard over muscle or bone. Recognizing normal percussion notes is fundamental to
detecting abnormalities.
4. A researcher is studying the mechanics of breathing. Which muscle is primarily
responsible for quiet inspiration at rest?
A) External intercostals
B) Diaphragm
C) Internal intercostals
, D) Abdominal rectus
Correct Answer: Diaphragm
Rationale: The diaphragm is the primary muscle of inspiration, contributing
approximately 75% of the tidal volume during quiet breathing. The external
intercostals assist by elevating the ribs. The internal intercostals and abdominal
muscles are primarily involved in forced expiration. Understanding respiratory
mechanics is essential for assessing breathing patterns.
5. Which term refers to the normal breath sound heard over most of the lung fields?
A) Bronchial
B) Bronchovesicular
C) Vesicular
D) Tracheal
Correct Answer: Vesicular
Rationale: Vesicular breath sounds are soft, low-pitched, and heard over most of
the peripheral lung fields. They have a longer inspiratory phase than expiratory
phase. Bronchial sounds are loud and high-pitched, heard over the trachea.
Bronchovesicular sounds are heard over the mainstem bronchi, and tracheal sounds
are harsh.
6. What is the most likely outcome if a patient has a large pleural effusion?
A) Hyperresonance to percussion over the affected area
B) Dullness to percussion with decreased breath sounds
C) Tympany to percussion with increased tactile fremitus
