NR 302 Final Comprehensive Exam
2025/2026 | Verified Questions &
Answers with Rationales | A+ Health
Assessment Review
Thoracic Cage - Answer-Sternum
12 pairs of ribs
12 thoracic vertebrae
Muscles and Cartilage
Diaphragm is "floor"
Diaphragm - Answer-Musculotendinous septum that separates the thoracic cavity from
the abdomen
First 7 ribs - Answer-Attach to the sternum via costal cartilages
Ribs 8, 9, 10 - Answer-Attach to costal cartilage above
Ribs 11 & 12 - Answer-"Floating"
Free palpable tips
Costochondral junctions - Answer-Points at which the ribs join at their cartilages
Not palpable
Suprasternal notch - Answer-U-shaped depression just above the sternum, between the
clavicles
Sternum - Answer-Breast bone
Has three parts: manubrium, body, and xiphoid process
Sternal angle - Answer-"angle of Louis"
Articulation of the manubrium and body of the sternum
Continuous with the second rib
Marks the site of tracheal bifurcation into the right and left main bronchi
Corresponds with upper border of the atria
,Lies above the 4th thoracic vertebra on the back
Tracheal Bifurcation - Answer-The division of the trachea into the right and left main
bronchi
Costal angle - Answer-Right and left costal margins form an angle where they meet at
the xiphoid process
Usually 90 degrees or less
Angle increases when rib cage is chronically overinflated (emphysema)
Coarse crackles - Answer-Loud, low pitched bubbling and gurgling sounds
Start in early inspiration and may be present in expiration
May decrease somewhat by suctioning or coughing but reappear shortly
Sounds like velcro fastener
-Inhaled air collides with secretions in the trachea and large bronchi
Pleural friction rub - Answer-Superficial sound that is coarse and low pitched
Has grating quality as if two pieces of leather are being rubbed together
Sounds like crackles but close to the ear
Sounds louder if you push stethoscope harder into chest wall
Sounds is inspiratory and expiratory
-Caused when pleurae become inflamed and lose their normal lubricating fluid
-Heard best in anterolateral wall where greatest lung mobility exists
Late inspiratory crackles - Answer-Occur with restrictive disease:
-Pneumonia
-Heart failure
-Interstital fibrosis
Early inspiratory crackles - Answer-Occur with obstructive disease:
Chronic bronchitis
Asthma
Emphysema
Posturally induced crackles (PICs) - Answer-Fine crackles that appear with a change
from sitting to the supine position or with position change from supine to supine with
legs elevated
Coarse crackles: Clinical example - Answer-Pulmonary edema
Pneumonia
Pulmonary fibrosis
Terminally ill who have depressed cough reflex
,Atelectatic crackles: Clinical example - Answer-Aging adults
Bedridden persons
Persons just aroused from sleep
Pleural friction rub: Clinical example - Answer-Pleuritis, accompanied by pain with
breathing
Wheeze (high-pitched:sibilant): Clinical example - Answer-Diffuse airway obstruction
from acute asthma or chronic emphysema
Wheeze (low-pitched: sonorous rhonchi): Clinical example - Answer-Bronchitis
Single bronchus obstruction from airway tumor
Stridor: Clinical example - Answer-Croup and acute epiglottitis in children and foreign
inhalation
Obstructed airway may be life-threatening
Subjective data - Answer-Difficulty breathing
Difficulty sleeping
Cough and sputum
Smoking history
Environmental exposure
Chest pain
Calculating smoking pack-years - Answer--Multiply # of cigarettes smoked per day by
the number of years smoked
-Divide by 20
Diaphragmatic excursion - Answer-Used to note the change from resonance to dull on
each side. should be equal bilaterally
Estimates the level of the diaphragm separating the lungs from the abdominal viscera
May be somewhat higher on the right side because of liver
Bronchophony - Answer-Ask the person to repeat "ninety-nine" while you listen with
stethoscope over chest wall
Bronchophony: normal finding - Answer-Soft, muffled, and indistinct
Can hear sound thru stethoscope but cannot distinguish exactly what is being said
Bronchophony: abnormal finding - Answer-Auscultate a clear "ninety-nine"
Words are more distinct than normal and sound close to ear
-Pathology that increases density enhances transmission of voice sounds
Egophony - Answer-"the voice of a goat"
Auscultate the chest while the person phonates a long "eeeeee" sounds
, Egophony: Normal finding - Answer-You should hear "eeeeeeeee" through your
stethoscope
Egophony: abnormal finding - Answer-"eeeee" sound changes to a bleating long "aaaa"
sound over area of consolidation or compression
Whispered pectoriloquy - Answer-Ask the patient to whisper a phrase such as "one-two-
three" as you auscultate
Whispered pectoriloquy: normal finding - Answer-Response is faint, muffled, and almost
inaudible
Whispered pectoriloquy: abnormal finding - Answer-Whispered voice is transmitted very
clearly and distinctly, although still somewhat faint with only small amounts of
consolidation
Sounds as if the person is whispering right into your stethoscope
Inspection: Normal findings - Answer-RR 14 regular, even and unlabored (eupnea)
Skin and nails pink
No cyanosis
Relaxed posture
Shape symmetric AP:Transverse 1:2
Costal abgle <90 degrees
Palpation: Normal findings - Answer-Chest expansion symmetric
Tactile fremitus symmetric
No tenderness
No crepitus
No lumps or masses
Percussion: Normal findings - Answer-Resonance throughout
Diaphragmatic excursion equal bilaterally
Tachypnea - Answer-Rapid, shallow breathing
Increased rate >24 /minute
Normal response to fever, fear, or exercise
Rate also increases with respiratory insufficiency, pneumonia, alkalosis, pleurisy, and
lesions in the pons
Hyperventilation - Answer-Increase in both rate and depth
Normally occurs with extreme exertion, fear, or anxiety
Also occurs with diabetic ketoacidosis , hepatic coma, salicylate overdose, lesions on
the midbrain, and alteration in blood gas concentration (increase in CO2 or decrease in
O2)
Bradypnea - Answer-Slow breathing
2025/2026 | Verified Questions &
Answers with Rationales | A+ Health
Assessment Review
Thoracic Cage - Answer-Sternum
12 pairs of ribs
12 thoracic vertebrae
Muscles and Cartilage
Diaphragm is "floor"
Diaphragm - Answer-Musculotendinous septum that separates the thoracic cavity from
the abdomen
First 7 ribs - Answer-Attach to the sternum via costal cartilages
Ribs 8, 9, 10 - Answer-Attach to costal cartilage above
Ribs 11 & 12 - Answer-"Floating"
Free palpable tips
Costochondral junctions - Answer-Points at which the ribs join at their cartilages
Not palpable
Suprasternal notch - Answer-U-shaped depression just above the sternum, between the
clavicles
Sternum - Answer-Breast bone
Has three parts: manubrium, body, and xiphoid process
Sternal angle - Answer-"angle of Louis"
Articulation of the manubrium and body of the sternum
Continuous with the second rib
Marks the site of tracheal bifurcation into the right and left main bronchi
Corresponds with upper border of the atria
,Lies above the 4th thoracic vertebra on the back
Tracheal Bifurcation - Answer-The division of the trachea into the right and left main
bronchi
Costal angle - Answer-Right and left costal margins form an angle where they meet at
the xiphoid process
Usually 90 degrees or less
Angle increases when rib cage is chronically overinflated (emphysema)
Coarse crackles - Answer-Loud, low pitched bubbling and gurgling sounds
Start in early inspiration and may be present in expiration
May decrease somewhat by suctioning or coughing but reappear shortly
Sounds like velcro fastener
-Inhaled air collides with secretions in the trachea and large bronchi
Pleural friction rub - Answer-Superficial sound that is coarse and low pitched
Has grating quality as if two pieces of leather are being rubbed together
Sounds like crackles but close to the ear
Sounds louder if you push stethoscope harder into chest wall
Sounds is inspiratory and expiratory
-Caused when pleurae become inflamed and lose their normal lubricating fluid
-Heard best in anterolateral wall where greatest lung mobility exists
Late inspiratory crackles - Answer-Occur with restrictive disease:
-Pneumonia
-Heart failure
-Interstital fibrosis
Early inspiratory crackles - Answer-Occur with obstructive disease:
Chronic bronchitis
Asthma
Emphysema
Posturally induced crackles (PICs) - Answer-Fine crackles that appear with a change
from sitting to the supine position or with position change from supine to supine with
legs elevated
Coarse crackles: Clinical example - Answer-Pulmonary edema
Pneumonia
Pulmonary fibrosis
Terminally ill who have depressed cough reflex
,Atelectatic crackles: Clinical example - Answer-Aging adults
Bedridden persons
Persons just aroused from sleep
Pleural friction rub: Clinical example - Answer-Pleuritis, accompanied by pain with
breathing
Wheeze (high-pitched:sibilant): Clinical example - Answer-Diffuse airway obstruction
from acute asthma or chronic emphysema
Wheeze (low-pitched: sonorous rhonchi): Clinical example - Answer-Bronchitis
Single bronchus obstruction from airway tumor
Stridor: Clinical example - Answer-Croup and acute epiglottitis in children and foreign
inhalation
Obstructed airway may be life-threatening
Subjective data - Answer-Difficulty breathing
Difficulty sleeping
Cough and sputum
Smoking history
Environmental exposure
Chest pain
Calculating smoking pack-years - Answer--Multiply # of cigarettes smoked per day by
the number of years smoked
-Divide by 20
Diaphragmatic excursion - Answer-Used to note the change from resonance to dull on
each side. should be equal bilaterally
Estimates the level of the diaphragm separating the lungs from the abdominal viscera
May be somewhat higher on the right side because of liver
Bronchophony - Answer-Ask the person to repeat "ninety-nine" while you listen with
stethoscope over chest wall
Bronchophony: normal finding - Answer-Soft, muffled, and indistinct
Can hear sound thru stethoscope but cannot distinguish exactly what is being said
Bronchophony: abnormal finding - Answer-Auscultate a clear "ninety-nine"
Words are more distinct than normal and sound close to ear
-Pathology that increases density enhances transmission of voice sounds
Egophony - Answer-"the voice of a goat"
Auscultate the chest while the person phonates a long "eeeeee" sounds
, Egophony: Normal finding - Answer-You should hear "eeeeeeeee" through your
stethoscope
Egophony: abnormal finding - Answer-"eeeee" sound changes to a bleating long "aaaa"
sound over area of consolidation or compression
Whispered pectoriloquy - Answer-Ask the patient to whisper a phrase such as "one-two-
three" as you auscultate
Whispered pectoriloquy: normal finding - Answer-Response is faint, muffled, and almost
inaudible
Whispered pectoriloquy: abnormal finding - Answer-Whispered voice is transmitted very
clearly and distinctly, although still somewhat faint with only small amounts of
consolidation
Sounds as if the person is whispering right into your stethoscope
Inspection: Normal findings - Answer-RR 14 regular, even and unlabored (eupnea)
Skin and nails pink
No cyanosis
Relaxed posture
Shape symmetric AP:Transverse 1:2
Costal abgle <90 degrees
Palpation: Normal findings - Answer-Chest expansion symmetric
Tactile fremitus symmetric
No tenderness
No crepitus
No lumps or masses
Percussion: Normal findings - Answer-Resonance throughout
Diaphragmatic excursion equal bilaterally
Tachypnea - Answer-Rapid, shallow breathing
Increased rate >24 /minute
Normal response to fever, fear, or exercise
Rate also increases with respiratory insufficiency, pneumonia, alkalosis, pleurisy, and
lesions in the pons
Hyperventilation - Answer-Increase in both rate and depth
Normally occurs with extreme exertion, fear, or anxiety
Also occurs with diabetic ketoacidosis , hepatic coma, salicylate overdose, lesions on
the midbrain, and alteration in blood gas concentration (increase in CO2 or decrease in
O2)
Bradypnea - Answer-Slow breathing
