NURS 8020C RESPIRATORY ASSESSMENT
QUESTIONS AND CORRECT ANSWERS (VERIFIED
ANSWERS) PLUS RATIONALES 2026 Q&A | INSTANT
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CORE DOMAINS
Foundational Respiratory Anatomy and Physiology
Advanced Health History and Interviewing
Physical Examination Techniques: Inspection, Palpation, Percussion, Auscultation
Diagnostic Reasoning and Interpretation of Respiratory Findings
Arterial Blood Gas Analysis and Acid-Base Balance
Pulse Oximetry and Oxygen Therapy
Regulatory, Legal, and Ethical Standards in Respiratory Care
Special Populations and Cultural Considerations
Evidence-Based Practice and Clinical Decision-Making
INTRODUCTION
This examination is designed to evaluate the advanced practice nursing student's
mastery of comprehensive respiratory assessment, diagnostic reasoning, and clinical
decision-making within the context of the DNP curriculum. It assesses foundational and
applied knowledge, including physical examination techniques, interpretation of
diagnostic data, and the integration of regulatory, legal, and ethical standards into
patient care. The multiple-choice and scenario-based format emphasizes real-world
application, critical thinking, and the ability to formulate safe, evidence-based
differential diagnoses. The examination prepares the advanced practice nurse to
deliver high-quality, patient-centered respiratory care across diverse populations and
clinical settings.
,SECTION ONE: QUESTIONS 1–300
1. During auscultation of the posterior chest, the advanced practice nurse identifies a
high-pitched, discontinuous sound during inspiration that clears with coughing. Which
term best describes this finding?
A. Fine crackles
B. Coarse crackles
C. Pleural friction rub
D. Rhonchi
✔✔ B. Coarse crackles
RATIONALE: Coarse crackles are high-pitched, discontinuous sounds that often clear
with coughing and are associated with fluid or secretions in the larger airways. Fine
crackles are lower-pitched and do not clear with coughing. Pleural friction rub is a
continuous, grating sound. Rhonchi are continuous, low-pitched sounds.
2. A patient presents with a history of chronic bronchitis and reports a productive
cough. Which adventitious breath sound is most consistent with this condition?
A. Wheezes
B. Stridor
C. Rhonchi
D. Pleural friction rub
✔✔ C. Rhonchi
RATIONALE: Rhonchi are continuous, low-pitched sounds caused by secretions in the
large airways and are commonly heard in chronic bronchitis. Wheezes are high-pitched
and associated with bronchoconstriction. Stridor is a high-pitched inspiratory sound
indicating upper airway obstruction. Pleural friction rub is associated with pleural
inflammation.
,3. The advanced practice nurse is assessing tactile fremitus. Which technique is
correct for this assessment?
A. Place the diaphragm of the stethoscope over the posterior chest and ask the patient
to whisper.
B. Use the ulnar surface of the hand to percuss the chest wall.
C. Place the palmar surface of the hands on the chest wall and ask the patient to repeat
"ninety-nine."
D. Auscultate the chest while the patient performs deep breathing exercises.
✔✔ C. Place the palmar surface of the hands on the chest wall and ask the patient to
repeat "ninety-nine."
RATIONALE: Tactile fremitus is assessed by placing the palmar surface of the hands
on the chest wall and asking the patient to repeat a phrase such as "ninety-nine." This
technique evaluates the transmission of vocal vibrations through the lung tissue. The
other options describe techniques for auscultation or percussion.
4. A patient with a suspected pneumothorax is being assessed. Which finding is most
likely to be observed on the affected side?
A. Increased tactile fremitus
B. Dullness to percussion
C. Hyperresonance to percussion
D. Increased breath sound intensity
✔✔ C. Hyperresonance to percussion
RATIONALE: A pneumothorax results in air accumulation in the pleural space, leading
to hyperresonance on percussion and decreased or absent breath sounds on the
affected side. Tactile fremitus is decreased or absent. Dullness would suggest
consolidation or fluid.
5. Which of the following is the primary purpose of performing a respiratory
assessment?
, A. To determine the patient's baseline functional status
B. To identify normal and abnormal findings and guide clinical decision-making
C. To document the patient's insurance eligibility
D. To evaluate the patient's nutritional status
✔✔ B. To identify normal and abnormal findings and guide clinical decision-making
RATIONALE: The primary purpose of a respiratory assessment is to identify normal
and abnormal findings, establish a baseline, and guide evidence-based clinical
decision-making. It is a core component of advanced health assessment.
6. A patient reports a sudden onset of sharp chest pain that worsens with deep
inspiration. Which condition should be highest on the differential diagnosis?
A. Myocardial infarction
B. Pulmonary embolism
C. Gastroesophageal reflux disease
D. Musculoskeletal strain
✔✔ B. Pulmonary embolism
RATIONALE: Sudden-onset pleuritic chest pain that worsens with inspiration is a
classic presentation of pulmonary embolism. While musculoskeletal strain can cause
pleuritic pain, the sudden onset and severity warrant immediate consideration of PE,
especially in at-risk patients.
7. The advanced practice nurse is preparing to auscultate lung sounds. Where should
the stethoscope be placed to best hear bronchial breath sounds?
A. Over the trachea and larynx
B. Over the peripheral lung fields
C. Between the scapulae
D. At the base of the lungs
QUESTIONS AND CORRECT ANSWERS (VERIFIED
ANSWERS) PLUS RATIONALES 2026 Q&A | INSTANT
DOWNLOAD PDF
CORE DOMAINS
Foundational Respiratory Anatomy and Physiology
Advanced Health History and Interviewing
Physical Examination Techniques: Inspection, Palpation, Percussion, Auscultation
Diagnostic Reasoning and Interpretation of Respiratory Findings
Arterial Blood Gas Analysis and Acid-Base Balance
Pulse Oximetry and Oxygen Therapy
Regulatory, Legal, and Ethical Standards in Respiratory Care
Special Populations and Cultural Considerations
Evidence-Based Practice and Clinical Decision-Making
INTRODUCTION
This examination is designed to evaluate the advanced practice nursing student's
mastery of comprehensive respiratory assessment, diagnostic reasoning, and clinical
decision-making within the context of the DNP curriculum. It assesses foundational and
applied knowledge, including physical examination techniques, interpretation of
diagnostic data, and the integration of regulatory, legal, and ethical standards into
patient care. The multiple-choice and scenario-based format emphasizes real-world
application, critical thinking, and the ability to formulate safe, evidence-based
differential diagnoses. The examination prepares the advanced practice nurse to
deliver high-quality, patient-centered respiratory care across diverse populations and
clinical settings.
,SECTION ONE: QUESTIONS 1–300
1. During auscultation of the posterior chest, the advanced practice nurse identifies a
high-pitched, discontinuous sound during inspiration that clears with coughing. Which
term best describes this finding?
A. Fine crackles
B. Coarse crackles
C. Pleural friction rub
D. Rhonchi
✔✔ B. Coarse crackles
RATIONALE: Coarse crackles are high-pitched, discontinuous sounds that often clear
with coughing and are associated with fluid or secretions in the larger airways. Fine
crackles are lower-pitched and do not clear with coughing. Pleural friction rub is a
continuous, grating sound. Rhonchi are continuous, low-pitched sounds.
2. A patient presents with a history of chronic bronchitis and reports a productive
cough. Which adventitious breath sound is most consistent with this condition?
A. Wheezes
B. Stridor
C. Rhonchi
D. Pleural friction rub
✔✔ C. Rhonchi
RATIONALE: Rhonchi are continuous, low-pitched sounds caused by secretions in the
large airways and are commonly heard in chronic bronchitis. Wheezes are high-pitched
and associated with bronchoconstriction. Stridor is a high-pitched inspiratory sound
indicating upper airway obstruction. Pleural friction rub is associated with pleural
inflammation.
,3. The advanced practice nurse is assessing tactile fremitus. Which technique is
correct for this assessment?
A. Place the diaphragm of the stethoscope over the posterior chest and ask the patient
to whisper.
B. Use the ulnar surface of the hand to percuss the chest wall.
C. Place the palmar surface of the hands on the chest wall and ask the patient to repeat
"ninety-nine."
D. Auscultate the chest while the patient performs deep breathing exercises.
✔✔ C. Place the palmar surface of the hands on the chest wall and ask the patient to
repeat "ninety-nine."
RATIONALE: Tactile fremitus is assessed by placing the palmar surface of the hands
on the chest wall and asking the patient to repeat a phrase such as "ninety-nine." This
technique evaluates the transmission of vocal vibrations through the lung tissue. The
other options describe techniques for auscultation or percussion.
4. A patient with a suspected pneumothorax is being assessed. Which finding is most
likely to be observed on the affected side?
A. Increased tactile fremitus
B. Dullness to percussion
C. Hyperresonance to percussion
D. Increased breath sound intensity
✔✔ C. Hyperresonance to percussion
RATIONALE: A pneumothorax results in air accumulation in the pleural space, leading
to hyperresonance on percussion and decreased or absent breath sounds on the
affected side. Tactile fremitus is decreased or absent. Dullness would suggest
consolidation or fluid.
5. Which of the following is the primary purpose of performing a respiratory
assessment?
, A. To determine the patient's baseline functional status
B. To identify normal and abnormal findings and guide clinical decision-making
C. To document the patient's insurance eligibility
D. To evaluate the patient's nutritional status
✔✔ B. To identify normal and abnormal findings and guide clinical decision-making
RATIONALE: The primary purpose of a respiratory assessment is to identify normal
and abnormal findings, establish a baseline, and guide evidence-based clinical
decision-making. It is a core component of advanced health assessment.
6. A patient reports a sudden onset of sharp chest pain that worsens with deep
inspiration. Which condition should be highest on the differential diagnosis?
A. Myocardial infarction
B. Pulmonary embolism
C. Gastroesophageal reflux disease
D. Musculoskeletal strain
✔✔ B. Pulmonary embolism
RATIONALE: Sudden-onset pleuritic chest pain that worsens with inspiration is a
classic presentation of pulmonary embolism. While musculoskeletal strain can cause
pleuritic pain, the sudden onset and severity warrant immediate consideration of PE,
especially in at-risk patients.
7. The advanced practice nurse is preparing to auscultate lung sounds. Where should
the stethoscope be placed to best hear bronchial breath sounds?
A. Over the trachea and larynx
B. Over the peripheral lung fields
C. Between the scapulae
D. At the base of the lungs
