MARYVILLE NURS 612 EXAM 2 UPDATED EXAM
SCRIPT WITH COMPLETE ANSWERS
◉ What is the normal AP to transverse chest diameter?
Answer: 1:2
◉ What should you inspect during a respiratory assessment?
Answer: Respiratory rate, rhythm, effort, chest symmetry, AP
diameter, use of accessory muscles, posture, skin color, lips, nails,
and chest deformities.
◉ Normal respiratory rate in adults
Answer: 12-20 breaths/minute
◉ What abnormal respiratory finding suggests increased work of
breathing?
Answer: Use of accessory muscles, nasal flaring, intercostal
retractions, tripod positioning.
◉ What should you assess on the lips and nail beds during the
respiratory exam?
Answer: Color and cyanosis; normal lips and nail beds are pink.
,◉ How is the trachea assessed?
Answer: Palpate for midline position; deviation may indicate
pneumothorax, pleural effusion, or atelectasis.
◉ What is thoracic expansion?
Answer: Symmetric expansion of the chest during inspiration.
◉ How do you assess thoracic expansion?
Answer: Place hands on posterior chest at T9-T10 with thumbs near
the spine and observe for equal movement during deep inspiration.
◉ What does decreased thoracic expansion indicate?
Answer: COPD, pneumonia, pleural effusion, pneumothorax, or
atelectasis.
◉ What is tactile fremitus?
Answer: Palpable vibration transmitted through the
bronchopulmonary tree while the patient says "99."
◉ What causes increased tactile fremitus?
Answer: Lobar pneumonia (consolidation).
,◉ What causes decreased tactile fremitus?
Answer: COPD, pleural effusion, pneumothorax, tumor, or obesity.
◉ How should chest percussion be performed?
Answer: Percuss side-to-side, comparing symmetric intercostal
spaces from apices to bases.
◉ What percussion note is expected over healthy lung tissue?
Answer: Resonance.
◉ What does dullness to percussion indicate?
Answer: Consolidation, atelectasis, pleural effusion, or tumor.
◉ What does hyperresonance indicate?
Answer: Air trapping as seen in COPD or pneumothorax.
◉ Normal diaphragmatic excursion
Answer: 3-5 cm and symmetric bilaterally.
◉ What does decreased diaphragmatic excursion suggest?
Answer: Pleural effusion, diaphragmatic paralysis, or hyperinflated
lungs.
, ◉ Where are vesicular breath sounds heard?
Answer: Over most peripheral lung fields.
◉ Describe vesicular breath sounds
Answer: Soft, low-pitched; inspiration is longer than expiration.
◉ Where are bronchovesicular breath sounds heard?
Answer: 1st and 2nd intercostal spaces anteriorly and between the
scapulae posteriorly.
◉ Describe bronchovesicular breath sounds
Answer: Medium pitch and intensity; inspiration equals expiration.
◉ Where are bronchial breath sounds heard?
Answer: Over the manubrium/trachea.
◉ Describe bronchial breath sounds
Answer: Loud, high-pitched; expiration is longer than inspiration.
◉ Describe crackles (rales)
SCRIPT WITH COMPLETE ANSWERS
◉ What is the normal AP to transverse chest diameter?
Answer: 1:2
◉ What should you inspect during a respiratory assessment?
Answer: Respiratory rate, rhythm, effort, chest symmetry, AP
diameter, use of accessory muscles, posture, skin color, lips, nails,
and chest deformities.
◉ Normal respiratory rate in adults
Answer: 12-20 breaths/minute
◉ What abnormal respiratory finding suggests increased work of
breathing?
Answer: Use of accessory muscles, nasal flaring, intercostal
retractions, tripod positioning.
◉ What should you assess on the lips and nail beds during the
respiratory exam?
Answer: Color and cyanosis; normal lips and nail beds are pink.
,◉ How is the trachea assessed?
Answer: Palpate for midline position; deviation may indicate
pneumothorax, pleural effusion, or atelectasis.
◉ What is thoracic expansion?
Answer: Symmetric expansion of the chest during inspiration.
◉ How do you assess thoracic expansion?
Answer: Place hands on posterior chest at T9-T10 with thumbs near
the spine and observe for equal movement during deep inspiration.
◉ What does decreased thoracic expansion indicate?
Answer: COPD, pneumonia, pleural effusion, pneumothorax, or
atelectasis.
◉ What is tactile fremitus?
Answer: Palpable vibration transmitted through the
bronchopulmonary tree while the patient says "99."
◉ What causes increased tactile fremitus?
Answer: Lobar pneumonia (consolidation).
,◉ What causes decreased tactile fremitus?
Answer: COPD, pleural effusion, pneumothorax, tumor, or obesity.
◉ How should chest percussion be performed?
Answer: Percuss side-to-side, comparing symmetric intercostal
spaces from apices to bases.
◉ What percussion note is expected over healthy lung tissue?
Answer: Resonance.
◉ What does dullness to percussion indicate?
Answer: Consolidation, atelectasis, pleural effusion, or tumor.
◉ What does hyperresonance indicate?
Answer: Air trapping as seen in COPD or pneumothorax.
◉ Normal diaphragmatic excursion
Answer: 3-5 cm and symmetric bilaterally.
◉ What does decreased diaphragmatic excursion suggest?
Answer: Pleural effusion, diaphragmatic paralysis, or hyperinflated
lungs.
, ◉ Where are vesicular breath sounds heard?
Answer: Over most peripheral lung fields.
◉ Describe vesicular breath sounds
Answer: Soft, low-pitched; inspiration is longer than expiration.
◉ Where are bronchovesicular breath sounds heard?
Answer: 1st and 2nd intercostal spaces anteriorly and between the
scapulae posteriorly.
◉ Describe bronchovesicular breath sounds
Answer: Medium pitch and intensity; inspiration equals expiration.
◉ Where are bronchial breath sounds heard?
Answer: Over the manubrium/trachea.
◉ Describe bronchial breath sounds
Answer: Loud, high-pitched; expiration is longer than inspiration.
◉ Describe crackles (rales)
