1
NUR 505 Module 8 Study Guide with Answers |
2026 Update complete - University of Alabama.
This exam is designed to test your knowledge of advanced health assessment of the chest and lungs, as
covered in the University of Alabama’s NUR 505 course. Each question is followed by the correct answer
and a detailed rationale.
QUESTIONS 1–180
Q1. Which of the following is the primary muscle of inspiration?
A) External intercostals
B) Diaphragm ✅
C) Sternocleidomastoid
D) Abdominal muscles
Rationale: The diaphragm is the primary muscle of inspiration. When it contracts, it flattens, increasing
thoracic volume and decreasing intra-thoracic pressure, drawing air into the lungs.
Q2. A nurse auscultates breath sounds that are soft, low-pitched, and heard over most of the peripheral
lung fields. Inspiration is longer than expiration. These are:
A) Vesicular breath sounds ✅
B) Bronchovesicular breath sounds
C) Bronchial breath sounds
D) Tubular breath sounds
Rationale: Vesicular breath sounds are normal over peripheral lung fields. They are soft, low-pitched,
and have a longer inspiratory phase.
Q3. Which of the following breath sounds is normally heard over the manubrium (sternal angle)?
A) Vesicular
B) Bronchovesicular ✅
C) Bronchial
D) Tracheal
Rationale: Bronchovesicular breath sounds are normally heard over the major bronchi, such as the 1st
and 2nd intercostal spaces anteriorly and between the scapulae posteriorly.
,2
Q4. A patient with pneumonia has increased vocal resonance. The nurse hears the spoken “99” as
louder and clearer over the affected area. This is known as:
A) Egophony
B) Bronchophony ✅
C) Whispered pectoriloquy
D) Tactile fremitus
Rationale: Bronchophony is an increase in the loudness and clarity of spoken words when auscultating
the chest, indicating lung consolidation.
Q5. The nurse hears a high-pitched, monophonic, musical sound primarily during inspiration. This
finding is most consistent with:
A) Wheezing
B) Stridor ✅
C) Crackles
D) Rhonchi
Rationale: Stridor is a high-pitched, inspiratory sound caused by upper airway obstruction (e.g., croup,
foreign body). It is a medical emergency.
Q6. A patient with heart failure presents with fine, high-pitched crackles at the end of inspiration. These
crackles are best described as:
A) Coarse crackles
B) Fine crackles ✅
C) Rhonchi
D) Pleural friction rub
Rationale: Fine crackles are high-pitched, discrete, popping sounds heard at the end of inspiration, often
associated with interstitial lung disease or pulmonary edema.
Q7. The nurse percusses a patient’s chest and notes a dull note over the left lower lobe. This finding
suggests:
A) Pneumothorax
B) Pleural effusion or consolidation ✅
C) Normal lung
D) COPD
Rationale: Dullness on percussion indicates increased tissue density, such as fluid (pleural effusion) or
solid tissue (consolidation, tumor).
,3
Q8. A patient with COPD has a barrel-shaped chest and hyperresonance on percussion. Hyperresonance
indicates:
A) Increased air content ✅
B) Fluid in the pleural space
C) Solid mass
D) Normal lung
Rationale: Hyperresonance is a booming, hollow sound that occurs when there is excessive air in the
lungs, as in emphysema or pneumothorax.
Q9. The nurse palpates tactile fremitus and finds it decreased on the right side. This may be due to:
A) Pleural effusion ✅
B) Lobar pneumonia
C) Lung consolidation
D) Normal variation
Rationale: Decreased or absent tactile fremitus occurs when there is fluid (effusion), air
(pneumothorax), or thickened pleura that dampens vibration transmission.
Q10. During auscultation, the nurse hears a grating sound during both inspiration and expiration. This
sound is most consistent with:
A) Crackles
B) Pleural friction rub ✅
C) Wheezes
D) Stridor
Rationale: A pleural friction rub is a dry, grating, rubbing sound caused by inflamed pleural surfaces
rubbing together. It is heard during both phases of respiration.
Q11. A 6-month-old infant is in respiratory distress. Which of the following findings would the nurse
expect?
A) Bradypnea
B) Nasal flaring and retractions ✅
C) Vesicular breath sounds
D) Eupnea
Rationale: Infants in respiratory distress often exhibit nasal flaring, intercostal or subcostal retractions,
grunting, and tachypnea.
Q12. A pregnant patient reports mild shortness of breath. The nurse understands that this is most likely
due to:
, 4
A) Elevation of the diaphragm ✅
B) Decreased tidal volume
C) Pulmonary edema
D) Asthma exacerbation
Rationale: During pregnancy, the diaphragm is elevated by the gravid uterus, leading to a sensation of
dyspnea, which is usually normal (dyspnea of pregnancy).
Q13. The nurse is assessing an elderly patient. Which age-related change increases the risk for
pneumonia?
A) Increased chest wall compliance
B) Diminished cough reflex ✅
C) Increased vital capacity
D) Hyperresonance on percussion
Rationale: In older adults, the cough reflex is often diminished, allowing aspiration and retained
secretions, increasing the risk of pneumonia.
Q14. A patient with diabetic ketoacidosis has deep, rapid, labored breathing. This pattern is called:
A) Cheyne-Stokes respirations
B) Biot respirations
C) Kussmaul breathing ✅
D) Apneustic breathing
Rationale: Kussmaul breathing is deep, rapid, and labored, seen in metabolic acidosis as a compensatory
mechanism to blow off CO₂.
Q15. Cheyne-Stokes respirations are characterized by:
A) A cycle of gradually increasing and then decreasing depth and rate followed by apnea ✅
B) Irregular breathing with periods of tachypnea and apnea
C) Deep, rapid breathing
D) Shallow, slow breathing
Rationale: Cheyne-Stokes respirations are a crescendo-decrescendo pattern followed by apnea. They
are often seen in heart failure, stroke, or brain injury.
Q16. A patient with a lung abscess may have which type of breath odor?
A) Sweet, fruity
B) Foul, feculent (putrid) ✅
C) Ammonia
D) Cinnamon
NUR 505 Module 8 Study Guide with Answers |
2026 Update complete - University of Alabama.
This exam is designed to test your knowledge of advanced health assessment of the chest and lungs, as
covered in the University of Alabama’s NUR 505 course. Each question is followed by the correct answer
and a detailed rationale.
QUESTIONS 1–180
Q1. Which of the following is the primary muscle of inspiration?
A) External intercostals
B) Diaphragm ✅
C) Sternocleidomastoid
D) Abdominal muscles
Rationale: The diaphragm is the primary muscle of inspiration. When it contracts, it flattens, increasing
thoracic volume and decreasing intra-thoracic pressure, drawing air into the lungs.
Q2. A nurse auscultates breath sounds that are soft, low-pitched, and heard over most of the peripheral
lung fields. Inspiration is longer than expiration. These are:
A) Vesicular breath sounds ✅
B) Bronchovesicular breath sounds
C) Bronchial breath sounds
D) Tubular breath sounds
Rationale: Vesicular breath sounds are normal over peripheral lung fields. They are soft, low-pitched,
and have a longer inspiratory phase.
Q3. Which of the following breath sounds is normally heard over the manubrium (sternal angle)?
A) Vesicular
B) Bronchovesicular ✅
C) Bronchial
D) Tracheal
Rationale: Bronchovesicular breath sounds are normally heard over the major bronchi, such as the 1st
and 2nd intercostal spaces anteriorly and between the scapulae posteriorly.
,2
Q4. A patient with pneumonia has increased vocal resonance. The nurse hears the spoken “99” as
louder and clearer over the affected area. This is known as:
A) Egophony
B) Bronchophony ✅
C) Whispered pectoriloquy
D) Tactile fremitus
Rationale: Bronchophony is an increase in the loudness and clarity of spoken words when auscultating
the chest, indicating lung consolidation.
Q5. The nurse hears a high-pitched, monophonic, musical sound primarily during inspiration. This
finding is most consistent with:
A) Wheezing
B) Stridor ✅
C) Crackles
D) Rhonchi
Rationale: Stridor is a high-pitched, inspiratory sound caused by upper airway obstruction (e.g., croup,
foreign body). It is a medical emergency.
Q6. A patient with heart failure presents with fine, high-pitched crackles at the end of inspiration. These
crackles are best described as:
A) Coarse crackles
B) Fine crackles ✅
C) Rhonchi
D) Pleural friction rub
Rationale: Fine crackles are high-pitched, discrete, popping sounds heard at the end of inspiration, often
associated with interstitial lung disease or pulmonary edema.
Q7. The nurse percusses a patient’s chest and notes a dull note over the left lower lobe. This finding
suggests:
A) Pneumothorax
B) Pleural effusion or consolidation ✅
C) Normal lung
D) COPD
Rationale: Dullness on percussion indicates increased tissue density, such as fluid (pleural effusion) or
solid tissue (consolidation, tumor).
,3
Q8. A patient with COPD has a barrel-shaped chest and hyperresonance on percussion. Hyperresonance
indicates:
A) Increased air content ✅
B) Fluid in the pleural space
C) Solid mass
D) Normal lung
Rationale: Hyperresonance is a booming, hollow sound that occurs when there is excessive air in the
lungs, as in emphysema or pneumothorax.
Q9. The nurse palpates tactile fremitus and finds it decreased on the right side. This may be due to:
A) Pleural effusion ✅
B) Lobar pneumonia
C) Lung consolidation
D) Normal variation
Rationale: Decreased or absent tactile fremitus occurs when there is fluid (effusion), air
(pneumothorax), or thickened pleura that dampens vibration transmission.
Q10. During auscultation, the nurse hears a grating sound during both inspiration and expiration. This
sound is most consistent with:
A) Crackles
B) Pleural friction rub ✅
C) Wheezes
D) Stridor
Rationale: A pleural friction rub is a dry, grating, rubbing sound caused by inflamed pleural surfaces
rubbing together. It is heard during both phases of respiration.
Q11. A 6-month-old infant is in respiratory distress. Which of the following findings would the nurse
expect?
A) Bradypnea
B) Nasal flaring and retractions ✅
C) Vesicular breath sounds
D) Eupnea
Rationale: Infants in respiratory distress often exhibit nasal flaring, intercostal or subcostal retractions,
grunting, and tachypnea.
Q12. A pregnant patient reports mild shortness of breath. The nurse understands that this is most likely
due to:
, 4
A) Elevation of the diaphragm ✅
B) Decreased tidal volume
C) Pulmonary edema
D) Asthma exacerbation
Rationale: During pregnancy, the diaphragm is elevated by the gravid uterus, leading to a sensation of
dyspnea, which is usually normal (dyspnea of pregnancy).
Q13. The nurse is assessing an elderly patient. Which age-related change increases the risk for
pneumonia?
A) Increased chest wall compliance
B) Diminished cough reflex ✅
C) Increased vital capacity
D) Hyperresonance on percussion
Rationale: In older adults, the cough reflex is often diminished, allowing aspiration and retained
secretions, increasing the risk of pneumonia.
Q14. A patient with diabetic ketoacidosis has deep, rapid, labored breathing. This pattern is called:
A) Cheyne-Stokes respirations
B) Biot respirations
C) Kussmaul breathing ✅
D) Apneustic breathing
Rationale: Kussmaul breathing is deep, rapid, and labored, seen in metabolic acidosis as a compensatory
mechanism to blow off CO₂.
Q15. Cheyne-Stokes respirations are characterized by:
A) A cycle of gradually increasing and then decreasing depth and rate followed by apnea ✅
B) Irregular breathing with periods of tachypnea and apnea
C) Deep, rapid breathing
D) Shallow, slow breathing
Rationale: Cheyne-Stokes respirations are a crescendo-decrescendo pattern followed by apnea. They
are often seen in heart failure, stroke, or brain injury.
Q16. A patient with a lung abscess may have which type of breath odor?
A) Sweet, fruity
B) Foul, feculent (putrid) ✅
C) Ammonia
D) Cinnamon
