NURS 190 PHYSICAL ASSESSMENT
WEEK 5: THORAX, LUNGS, AND
BREASTS
1. During a thoracic assessment, the nurse finds that the client has a costal angle of 110
degrees. This finding is most consistent with which condition?
A. Normal thoracic configuration
B. Pneumothorax
C. Chronic obstructive pulmonary disease (COPD)
D. Pleuritis
Answer: C
Conceptual Explanation: A costal angle greater than 90 degrees is typically seen in
patients with COPD due to chronic hyperinflation of the lungs, leading to a barrel chest
configuration.
2. The nurse is performing tactile fremitus. Which finding would the nurse expect in a patient
with lobar pneumonia?
A. Increased fremitus
,B. Absent fremitus
C. Decreased fremitus
D. Normal fremitus
Answer: A
Conceptual Explanation: Increased tactile fremitus occurs with compression or
consolidation of lung tissue (e.g., lobar pneumonia) because solid tissue conducts
vibrations better than air-filled tissue.
3. Where is the angle of Louis (manubriosternal junction) located?
A. At the level of the first rib
B. At the level of the fourth rib
C. At the level of the second rib
D. At the level of the xiphoid process
Answer: C
Conceptual Explanation: The angle of Louis is continuous with the second rib and is a
useful place to start counting ribs and intercostal spaces.
4. When auscultating the lungs of an adult, which technique is most correct?
A. Auscultate from base to apex
B. Use the bell of the stethoscope to hear high-pitched sounds
, C. Listen to one full respiration at each site
D. Auscultate while the patient breathes through the nose
Answer: C
Conceptual Explanation: The nurse should listen for at least one full spontaneous
expiration/inspiration cycle at each site to ensure no adventitious sounds are missed.
5. Which breath sounds are normally heard over the peripheral lung fields where air flows
through smaller bronchioles and alveoli?
A. Bronchial
B. Vesicular
C. Bronchovesicular
D. Tracheal
Answer: B
Conceptual Explanation: Vesicular breath sounds are soft, low-pitched sounds heard over
the majority of the peripheral lung fields.
6. A patient presents with a ‘barrel chest.’ What ratio of anteroposterior (AP) to transverse
diameter would the nurse expect?
A. 1:1
B. 2:1
C. 1:2
WEEK 5: THORAX, LUNGS, AND
BREASTS
1. During a thoracic assessment, the nurse finds that the client has a costal angle of 110
degrees. This finding is most consistent with which condition?
A. Normal thoracic configuration
B. Pneumothorax
C. Chronic obstructive pulmonary disease (COPD)
D. Pleuritis
Answer: C
Conceptual Explanation: A costal angle greater than 90 degrees is typically seen in
patients with COPD due to chronic hyperinflation of the lungs, leading to a barrel chest
configuration.
2. The nurse is performing tactile fremitus. Which finding would the nurse expect in a patient
with lobar pneumonia?
A. Increased fremitus
,B. Absent fremitus
C. Decreased fremitus
D. Normal fremitus
Answer: A
Conceptual Explanation: Increased tactile fremitus occurs with compression or
consolidation of lung tissue (e.g., lobar pneumonia) because solid tissue conducts
vibrations better than air-filled tissue.
3. Where is the angle of Louis (manubriosternal junction) located?
A. At the level of the first rib
B. At the level of the fourth rib
C. At the level of the second rib
D. At the level of the xiphoid process
Answer: C
Conceptual Explanation: The angle of Louis is continuous with the second rib and is a
useful place to start counting ribs and intercostal spaces.
4. When auscultating the lungs of an adult, which technique is most correct?
A. Auscultate from base to apex
B. Use the bell of the stethoscope to hear high-pitched sounds
, C. Listen to one full respiration at each site
D. Auscultate while the patient breathes through the nose
Answer: C
Conceptual Explanation: The nurse should listen for at least one full spontaneous
expiration/inspiration cycle at each site to ensure no adventitious sounds are missed.
5. Which breath sounds are normally heard over the peripheral lung fields where air flows
through smaller bronchioles and alveoli?
A. Bronchial
B. Vesicular
C. Bronchovesicular
D. Tracheal
Answer: B
Conceptual Explanation: Vesicular breath sounds are soft, low-pitched sounds heard over
the majority of the peripheral lung fields.
6. A patient presents with a ‘barrel chest.’ What ratio of anteroposterior (AP) to transverse
diameter would the nurse expect?
A. 1:1
B. 2:1
C. 1:2
