Samuel Merritt University HESI Prep - Health Assessment
Practice Questions
89. The nurse is auscultating the lungs of a patient who had been
sleeping and notices short, popping, crackling sounds that stop
after a few breaths. The nurse recognizes that these breath
sounds are:
A) atelectatic crackles, and that they are not pathologic.
B) fine crackles, and that they may be a sign of pneumonia.
C) vesicular breath sounds.
D) fine wheezes. Correct Answers A) atelectatic crackles, and
that they are not pathologic.
Pages: 429-430. One type of adventitious sound, atelectatic
crackles, is not pathologic. They are short, popping, crackling
sounds that sound like fine crackles but do not last beyond a few
breaths. When sections of alveoli are not fully aerated (as in
people who are asleep or in the elderly), they deflate slightly and
accumulate secretions. Crackles are heard when these sections
are expanded by a few deep breaths. Atelectatic crackles are
heard only in the periphery, usually in dependent portions of the
lungs, and disappear after the first few breaths or after a cough.
,90. The nurse is assessing voice sounds during a respiratory
assessment. Which of these findings indicates a normal
assessment? Select all that apply.
A) Voice sounds are faint, muffled, and almost inaudible when
the patient whispers "one, two, three" in a very soft voice.
B) As the patient says "ninety-nine" repeatedly, the examiner
hears the words "ninety-nine" clearly.
C) When the patient speaks in a normal voice, the examiner can
hear a sound but cannot distinguish exactly what is being said.
D) As the patient says a long "ee-ee-ee" sound, the examiner
also hears a long "ee-ee-ee" sound.
E) As the patient says a long "ee-ee-ee" sound, the examiner
hears a long "aaaaaa" sound. Correct Answers A) Voice sounds
are faint, muffled, and almost inaudible when the patient
whispers "one, two, three" in a very soft voice.
C) When the patient speaks in a normal voice, the examiner can
hear a sound but cannot distinguish exactly what is being said.
D) As the patient says a long "ee-ee-ee" sound, the examiner
also hears a long "ee-ee-ee" sound.
Page: 446. As a patient says "ninety-nine" repeatedly, normally,
the examiner hears sound but cannot distinguish what is being
said. If a clear "ninety-nine" is auscultated, then it could indicate
increased lung density, which enhances transmission of voice
,sounds. This is a measure of bronchophony. When a patient says
a long "ee-ee-ee" sound, normally the examiner also hears a
long "ee-ee-ee" sound through auscultation. This is a measure of
egophony. If the examiner hears a long "aaaaaa" sound instead,
this could indicate areas of consolidation or compression. With
whispered pectoriloquy, as when a patient whispers a phrase
such as "one-two-three," the normal response when auscultating
voice sounds is to hear sounds that are faint, muffled, and almost
inaudible. If the examiners hears the whispered voice clearly, as
if the patient is speaking through the stethoscope, then
consolidation of the lung fields may exist.
91. During an assessment of a 68-year-old man with a recent
onset of right-sided weakness, the nurse hears a blowing,
swishing sound with the bell of the stethoscope over the left
carotid artery. This finding would indicate:
A) a valvular disorder.
B) blood flow turbulence.
C) fluid volume overload.
D) ventricular hypertrophy. Correct Answers B) blood flow
turbulence.
Page: 471. A bruit is a blowing, swishing sound indicating blood
flow turbulence; normally none is present.
, 92. During an assessment of a healthy adult, where would the
nurse expect to palpate the apical impulse?
A) Third left intercostal space at the midclavicular line
B) Fourth left intercostal space at the sternal border
C) Fourth left intercostal space at the anterior axillary line
D) Fifth left intercostal space at the midclavicular line Correct
Answers D) Fifth left intercostal space at the midclavicular line
Pages: 473-474. The apical impulse should occupy only one
intercostal space, the fourth or fifth, and it should be at or medial
to the midclavicular line.
93. The nurse is preparing to auscultate for heart sounds. Which
technique is correct?
A) Listen to the sounds at the aortic, tricuspid, pulmonic, and
mitral areas.
B) Listen by inching the stethoscope in a rough Z pattern, from
the base of the heart across and down, then over to the apex.
C) Listen to the sounds only at the site where the apical pulse is
felt to be the strongest.
Practice Questions
89. The nurse is auscultating the lungs of a patient who had been
sleeping and notices short, popping, crackling sounds that stop
after a few breaths. The nurse recognizes that these breath
sounds are:
A) atelectatic crackles, and that they are not pathologic.
B) fine crackles, and that they may be a sign of pneumonia.
C) vesicular breath sounds.
D) fine wheezes. Correct Answers A) atelectatic crackles, and
that they are not pathologic.
Pages: 429-430. One type of adventitious sound, atelectatic
crackles, is not pathologic. They are short, popping, crackling
sounds that sound like fine crackles but do not last beyond a few
breaths. When sections of alveoli are not fully aerated (as in
people who are asleep or in the elderly), they deflate slightly and
accumulate secretions. Crackles are heard when these sections
are expanded by a few deep breaths. Atelectatic crackles are
heard only in the periphery, usually in dependent portions of the
lungs, and disappear after the first few breaths or after a cough.
,90. The nurse is assessing voice sounds during a respiratory
assessment. Which of these findings indicates a normal
assessment? Select all that apply.
A) Voice sounds are faint, muffled, and almost inaudible when
the patient whispers "one, two, three" in a very soft voice.
B) As the patient says "ninety-nine" repeatedly, the examiner
hears the words "ninety-nine" clearly.
C) When the patient speaks in a normal voice, the examiner can
hear a sound but cannot distinguish exactly what is being said.
D) As the patient says a long "ee-ee-ee" sound, the examiner
also hears a long "ee-ee-ee" sound.
E) As the patient says a long "ee-ee-ee" sound, the examiner
hears a long "aaaaaa" sound. Correct Answers A) Voice sounds
are faint, muffled, and almost inaudible when the patient
whispers "one, two, three" in a very soft voice.
C) When the patient speaks in a normal voice, the examiner can
hear a sound but cannot distinguish exactly what is being said.
D) As the patient says a long "ee-ee-ee" sound, the examiner
also hears a long "ee-ee-ee" sound.
Page: 446. As a patient says "ninety-nine" repeatedly, normally,
the examiner hears sound but cannot distinguish what is being
said. If a clear "ninety-nine" is auscultated, then it could indicate
increased lung density, which enhances transmission of voice
,sounds. This is a measure of bronchophony. When a patient says
a long "ee-ee-ee" sound, normally the examiner also hears a
long "ee-ee-ee" sound through auscultation. This is a measure of
egophony. If the examiner hears a long "aaaaaa" sound instead,
this could indicate areas of consolidation or compression. With
whispered pectoriloquy, as when a patient whispers a phrase
such as "one-two-three," the normal response when auscultating
voice sounds is to hear sounds that are faint, muffled, and almost
inaudible. If the examiners hears the whispered voice clearly, as
if the patient is speaking through the stethoscope, then
consolidation of the lung fields may exist.
91. During an assessment of a 68-year-old man with a recent
onset of right-sided weakness, the nurse hears a blowing,
swishing sound with the bell of the stethoscope over the left
carotid artery. This finding would indicate:
A) a valvular disorder.
B) blood flow turbulence.
C) fluid volume overload.
D) ventricular hypertrophy. Correct Answers B) blood flow
turbulence.
Page: 471. A bruit is a blowing, swishing sound indicating blood
flow turbulence; normally none is present.
, 92. During an assessment of a healthy adult, where would the
nurse expect to palpate the apical impulse?
A) Third left intercostal space at the midclavicular line
B) Fourth left intercostal space at the sternal border
C) Fourth left intercostal space at the anterior axillary line
D) Fifth left intercostal space at the midclavicular line Correct
Answers D) Fifth left intercostal space at the midclavicular line
Pages: 473-474. The apical impulse should occupy only one
intercostal space, the fourth or fifth, and it should be at or medial
to the midclavicular line.
93. The nurse is preparing to auscultate for heart sounds. Which
technique is correct?
A) Listen to the sounds at the aortic, tricuspid, pulmonic, and
mitral areas.
B) Listen by inching the stethoscope in a rough Z pattern, from
the base of the heart across and down, then over to the apex.
C) Listen to the sounds only at the site where the apical pulse is
felt to be the strongest.
