,West Coast University NURS 190 Module Exam 2 | Physical Assessment
(2026) Q&A
1. During a respiratory assessment, the nurse notes a palpable vibration increased over the
right lower lobe. This finding is consistent with which condition?
A) Pneumonia with consolidation
B) Pneumothorax
C) Pleural effusion
D) Bronchial obstruction
Correct Answer: Pneumonia with consolidation
Rationale: Increased tactile fremitus occurs when lung tissue is consolidated, as in
pneumonia, because solid tissue transmits sound vibrations more effectively than air-filled
tissue. Pneumothorax, pleural effusion, and bronchial obstruction typically decrease or
obstruct the transmission of vibrations, leading to decreased or absent fremitus.
2. The nurse is percussing the lungs of a patient with chronic obstructive pulmonary disease
(COPD). What percussion note is most likely to be heard?
A) Resonance
B) Hyperresonance
C) Dullness
D) Tympany
Correct Answer: Hyperresonance
Rationale: Hyperresonance is a lower-pitched, booming sound found when too much air is
present, such as in emphysema or COPD. Normal lung tissue produces resonance. Dullness is
heard over solid tissue or fluid, and tympany is typically heard over the stomach.
3. While auscultating the lungs, the nurse hears high-pitched, short, popping sounds during
inspiration that are not cleared by coughing. How should the nurse document this?
,A) Wheezes
B) Coarse crackles
C) Fine crackles
D) Rhonchi
Correct Answer: Fine crackles
Rationale: Fine crackles are high-pitched, short, popping sounds heard during inspiration
that do not clear with coughing. They usually indicate fluid in the small airways. Wheezes are
continuous musical sounds, coarse crackles are lower-pitched and may clear with coughing,
and rhonchi are low-pitched snoring sounds.
4. The nurse is assessing the thorax of an adult patient and notes an anteroposterior (AP) to
transverse diameter ratio of 1:1. This is known as:
A) Pectus excavatum
B) Pectus carinatum
C) Kyphosis
D) Barrel chest
Correct Answer: Barrel chest
Rationale: A barrel chest has an equal AP-to-transverse diameter (1:1 ratio) and is
associated with aging and chronic emphysema. Pectus excavatum is a sunken chest, pectus
carinatum is a pigeon chest, and kyphosis is an exaggerated curvature of the thoracic spine.
5. Where are bronchial breath sounds normally heard during a physical assessment?
A) Over the trachea and larynx
B) Over the peripheral lung fields
C) Over the major bronchi
D) Between the scapulae
Correct Answer: Over the trachea and larynx
, Rationale: Bronchial breath sounds are high-pitched and loud, normally heard only over
the trachea and larynx. Vesicular sounds are heard over the peripheral lung fields, and
bronchovesicular sounds are heard over the major bronchi and between the scapulae.
6. A patient presents with 'orthopnea.' How should the nurse proceed with the assessment?
A) Assess the patient's ability to breathe while lying flat
B) Ask how many pillows the patient uses to sleep
C) Monitor the patient for coughing up blood
D) Check for pain upon deep inspiration
Correct Answer: Ask how many pillows the patient uses to sleep
Rationale: Orthopnea is difficulty breathing when supine; nurses often quantify this by the
number of pillows needed for comfort. Hemoptysis is coughing up blood, and pleuritic pain
is pain upon deep inspiration.
7. When assessing for symmetric chest expansion, where should the nurse place their
hands?
A) At the level of T1-T2
B) At the level of the xiphoid process
C) Over the clavicles
D) At the level of T9 or T10
Correct Answer: At the level of T9 or T10
Rationale: Chest expansion is checked by placing hands at the posterolateral chest wall
with thumbs at the level of T9 or T10. This allows the nurse to observe for symmetric
movement during deep inspiration.
8. Which heart sound is caused by the closure of the atrioventricular (AV) valves?
A) S3
(2026) Q&A
1. During a respiratory assessment, the nurse notes a palpable vibration increased over the
right lower lobe. This finding is consistent with which condition?
A) Pneumonia with consolidation
B) Pneumothorax
C) Pleural effusion
D) Bronchial obstruction
Correct Answer: Pneumonia with consolidation
Rationale: Increased tactile fremitus occurs when lung tissue is consolidated, as in
pneumonia, because solid tissue transmits sound vibrations more effectively than air-filled
tissue. Pneumothorax, pleural effusion, and bronchial obstruction typically decrease or
obstruct the transmission of vibrations, leading to decreased or absent fremitus.
2. The nurse is percussing the lungs of a patient with chronic obstructive pulmonary disease
(COPD). What percussion note is most likely to be heard?
A) Resonance
B) Hyperresonance
C) Dullness
D) Tympany
Correct Answer: Hyperresonance
Rationale: Hyperresonance is a lower-pitched, booming sound found when too much air is
present, such as in emphysema or COPD. Normal lung tissue produces resonance. Dullness is
heard over solid tissue or fluid, and tympany is typically heard over the stomach.
3. While auscultating the lungs, the nurse hears high-pitched, short, popping sounds during
inspiration that are not cleared by coughing. How should the nurse document this?
,A) Wheezes
B) Coarse crackles
C) Fine crackles
D) Rhonchi
Correct Answer: Fine crackles
Rationale: Fine crackles are high-pitched, short, popping sounds heard during inspiration
that do not clear with coughing. They usually indicate fluid in the small airways. Wheezes are
continuous musical sounds, coarse crackles are lower-pitched and may clear with coughing,
and rhonchi are low-pitched snoring sounds.
4. The nurse is assessing the thorax of an adult patient and notes an anteroposterior (AP) to
transverse diameter ratio of 1:1. This is known as:
A) Pectus excavatum
B) Pectus carinatum
C) Kyphosis
D) Barrel chest
Correct Answer: Barrel chest
Rationale: A barrel chest has an equal AP-to-transverse diameter (1:1 ratio) and is
associated with aging and chronic emphysema. Pectus excavatum is a sunken chest, pectus
carinatum is a pigeon chest, and kyphosis is an exaggerated curvature of the thoracic spine.
5. Where are bronchial breath sounds normally heard during a physical assessment?
A) Over the trachea and larynx
B) Over the peripheral lung fields
C) Over the major bronchi
D) Between the scapulae
Correct Answer: Over the trachea and larynx
, Rationale: Bronchial breath sounds are high-pitched and loud, normally heard only over
the trachea and larynx. Vesicular sounds are heard over the peripheral lung fields, and
bronchovesicular sounds are heard over the major bronchi and between the scapulae.
6. A patient presents with 'orthopnea.' How should the nurse proceed with the assessment?
A) Assess the patient's ability to breathe while lying flat
B) Ask how many pillows the patient uses to sleep
C) Monitor the patient for coughing up blood
D) Check for pain upon deep inspiration
Correct Answer: Ask how many pillows the patient uses to sleep
Rationale: Orthopnea is difficulty breathing when supine; nurses often quantify this by the
number of pillows needed for comfort. Hemoptysis is coughing up blood, and pleuritic pain
is pain upon deep inspiration.
7. When assessing for symmetric chest expansion, where should the nurse place their
hands?
A) At the level of T1-T2
B) At the level of the xiphoid process
C) Over the clavicles
D) At the level of T9 or T10
Correct Answer: At the level of T9 or T10
Rationale: Chest expansion is checked by placing hands at the posterolateral chest wall
with thumbs at the level of T9 or T10. This allows the nurse to observe for symmetric
movement during deep inspiration.
8. Which heart sound is caused by the closure of the atrioventricular (AV) valves?
A) S3
