,26/27 NSG500/NSG 500 EXAM 2 | ADVANCED
HEALTH ASSESSMENT | WILKES | Q +A &
DETAILED RATIONALES
1. During assessment of tactile fremitus, which finding is most consistent with lobar
pneumonia?
A) Fremitus is absent bilaterally
B) Fremitus decreases over the consolidated area
C) Fremitus increases over the consolidated area
D) Fremitus can only be assessed by auscultation
Correct Answer: Fremitus increases over the consolidated area
Rationale: Tactile fremitus represents palpable vibration transmitted through the
bronchopulmonary system while the patient speaks. Consolidated lung tissue transmits
vibration more efficiently than normally aerated lung, so pneumonia can increase fremitus.
Pleural effusion, pneumothorax, and marked emphysema generally reduce transmission.
2. Which percussion note is most likely over healthy adult lung tissue?
A) Resonance
B) Dullness
C) Flatness
D) Tympany
Correct Answer: Resonance
Rationale: Normal lung contains a large amount of air and produces a resonant percussion
note. Dullness suggests increased tissue density, such as consolidation or pleural fluid,
whereas hyperresonance may occur with excessive air trapping.
, 3. Hyperresonance over both lung fields is most consistent with:
A) Lobar pneumonia
B) Emphysema
C) Pleural effusion
D) Pulmonary fibrosis
Correct Answer: Emphysema
Rationale: Emphysema increases retained air and destroys normal elastic lung
architecture. This can produce hyperresonance to percussion, diminished breath sounds,
and reduced diaphragmatic excursion.
4. Fine late-inspiratory crackles at the lung bases are most suggestive of:
A) Upper-airway obstruction
B) Bronchospasm alone
C) Fluid or reopening of collapsed small airways
D) Pleural friction only
Correct Answer: Fluid or reopening of collapsed small airways
Rationale: Crackles are discontinuous nonmusical sounds caused by abrupt opening of
small airways or movement of air through fluid. They may occur in pulmonary edema,
interstitial lung disease, pneumonia, or atelectatic processes.
5. Which sound is most characteristic of narrowed lower airways?
A) Wheeze
B) Pleural rub
C) Stridor
D) Bronchial voice sound
Correct Answer: Wheeze
, Rationale: Wheezes are musical, often high-pitched sounds produced as air moves through
narrowed bronchi. They are commonly associated with asthma and other obstructive
airway diseases.
6. A harsh, high-pitched inspiratory sound heard loudest over the neck should be
interpreted as:
A) Rhonchi
B) Fine crackles
C) Egophony
D) Stridor
Correct Answer: Stridor
Rationale: Stridor reflects significant upper-airway narrowing and is often loudest over the
neck. Because severe obstruction can progress quickly, stridor is an important respiratory
warning sign.
7. Rhonchi are generally produced by:
A) Secretions in larger airways
B) Pleural surfaces rubbing together
C) Narrowing of the larynx
D) Fluid within the pleural cavity only
Correct Answer: Secretions in larger airways
Rationale: Rhonchi are lower-pitched, coarse, continuous sounds caused by airflow
through larger airways containing secretions or obstruction. They may partially clear after
coughing.
8. A pleural friction rub is caused by:
A) Bronchial secretions
B) Excess air in the pleural space
HEALTH ASSESSMENT | WILKES | Q +A &
DETAILED RATIONALES
1. During assessment of tactile fremitus, which finding is most consistent with lobar
pneumonia?
A) Fremitus is absent bilaterally
B) Fremitus decreases over the consolidated area
C) Fremitus increases over the consolidated area
D) Fremitus can only be assessed by auscultation
Correct Answer: Fremitus increases over the consolidated area
Rationale: Tactile fremitus represents palpable vibration transmitted through the
bronchopulmonary system while the patient speaks. Consolidated lung tissue transmits
vibration more efficiently than normally aerated lung, so pneumonia can increase fremitus.
Pleural effusion, pneumothorax, and marked emphysema generally reduce transmission.
2. Which percussion note is most likely over healthy adult lung tissue?
A) Resonance
B) Dullness
C) Flatness
D) Tympany
Correct Answer: Resonance
Rationale: Normal lung contains a large amount of air and produces a resonant percussion
note. Dullness suggests increased tissue density, such as consolidation or pleural fluid,
whereas hyperresonance may occur with excessive air trapping.
, 3. Hyperresonance over both lung fields is most consistent with:
A) Lobar pneumonia
B) Emphysema
C) Pleural effusion
D) Pulmonary fibrosis
Correct Answer: Emphysema
Rationale: Emphysema increases retained air and destroys normal elastic lung
architecture. This can produce hyperresonance to percussion, diminished breath sounds,
and reduced diaphragmatic excursion.
4. Fine late-inspiratory crackles at the lung bases are most suggestive of:
A) Upper-airway obstruction
B) Bronchospasm alone
C) Fluid or reopening of collapsed small airways
D) Pleural friction only
Correct Answer: Fluid or reopening of collapsed small airways
Rationale: Crackles are discontinuous nonmusical sounds caused by abrupt opening of
small airways or movement of air through fluid. They may occur in pulmonary edema,
interstitial lung disease, pneumonia, or atelectatic processes.
5. Which sound is most characteristic of narrowed lower airways?
A) Wheeze
B) Pleural rub
C) Stridor
D) Bronchial voice sound
Correct Answer: Wheeze
, Rationale: Wheezes are musical, often high-pitched sounds produced as air moves through
narrowed bronchi. They are commonly associated with asthma and other obstructive
airway diseases.
6. A harsh, high-pitched inspiratory sound heard loudest over the neck should be
interpreted as:
A) Rhonchi
B) Fine crackles
C) Egophony
D) Stridor
Correct Answer: Stridor
Rationale: Stridor reflects significant upper-airway narrowing and is often loudest over the
neck. Because severe obstruction can progress quickly, stridor is an important respiratory
warning sign.
7. Rhonchi are generally produced by:
A) Secretions in larger airways
B) Pleural surfaces rubbing together
C) Narrowing of the larynx
D) Fluid within the pleural cavity only
Correct Answer: Secretions in larger airways
Rationale: Rhonchi are lower-pitched, coarse, continuous sounds caused by airflow
through larger airways containing secretions or obstruction. They may partially clear after
coughing.
8. A pleural friction rub is caused by:
A) Bronchial secretions
B) Excess air in the pleural space
