NBCE BOARDS FINAL PAPER 2025 QUESTIONS AND
ANSWERS RATED A+
✔✔Dekleyn's - ✔✔Patient supine w/ head extended off table. Dr. instructs pt to
hyperextend and rotate the head. hole for 15-45 seconds.
(+) if produces vertigo, blurred vision, nausea, syncope, nystagmus
(ind) vertebrobasilar artery circulation compromise
✔✔Vertebrobasilar Artery Functional Maneuvar - ✔✔patient seated, auscultate (bell)
and palpate subclavian and carotid arteries. If no bruit, patient rotates and hyperextends
the head to each side
(+) if produces vertigo, blurred vision, nausea, syncope, nystagmus
(ind) vertebrobasilar artery circulation compromise
✔✔Ptosis - ✔✔Bilateral (ind) Myasthenia Gravis
Unilateral (ind) Horner's Syndrome or CN III lesion
✔✔Iritis/ Uveitis - ✔✔Seen in early stages of AS
✔✔Papilledema - ✔✔an indication of increased intracranial pressure
✔✔Arteriosclerosis on eye exam - ✔✔AV nicking, silver wire arterioles, widened light
reflex
✔✔Hypertension on eye exam - ✔✔flame hemmorhages, cotton wool spots, narrow
light reflex
✔✔Diabetes Mellitus - ✔✔yellow, hard, waxy exudates; neovascularization,
microaneurysms, absent red light reflex
✔✔Weber Test - ✔✔place 512 Hz tuning fork on the vertex of the patient's head and
ask if they hear the sound equally on both sides.
If louder on one side, can indicate:
air conduction hearing loss on that side
neural hearing loss on opposite side
✔✔Rinne Test - ✔✔Place tuning fork on mastoid and ask patient to verbalize when they
can no longer hear it. After sound stops, place beside EAM.
Normal: air conduction twice as long as bone conduction
✔✔Respiratory excursion - ✔✔place hands over posterior ribs and have patient take
three deep breaths
, ✔✔Tactile Fremitus - ✔✔Palpable symmetrical vibrations
Increased with fluid (pneumonia)
Decreased with air (emphysema)
✔✔Diaphragmatic Excursion - ✔✔Dr asks patient to exhale and hold, percuss down
back until sounds change from resonant to dull & mark; have patient take deep breath
and hold, repeat percussion. Normal result is approx 2" between marks bilaterally
✔✔Dullness with percussion - ✔✔pneumonia, atelectasis, pleurisy
✔✔resonance with percussion - ✔✔normal, bronchitis
✔✔hyperresonance with percussion - ✔✔Emphysema, pneumothorax
✔✔Tracheal Breath Sounds - ✔✔found over trachea
✔✔Bronchial Breath Sounds - ✔✔found over manubrium
✔✔Bronchovesicular Breath Sounds - ✔✔found betreen ribs 1&2 anteriorly and
between the scapulae posteriorly
✔✔Vesicular Breath Sounds - ✔✔found over lung field
✔✔Bronchophony - ✔✔patient says 99
if clear distinct sounds are heard, consolidation is present
✔✔Egophony - ✔✔if you hear "aaaaaa" as the patient says "eeeeee" then consolidation
is present
✔✔Whispered pectoriloquy - ✔✔if 99 is heard clearly and distinctly, consolidation is
present
✔✔Lobar Pneumonia - ✔✔percussion is dull over fluid, rales aka crackles, increased
tactile fremitus, productive cough @ 10 days, rusty brown sputum, with possible fever
✔✔Tb - ✔✔caused by mycobacterium tuberculosis, presents with low grade fever, night
sweats, productive cough, yellow/green sputum, starts in apices, crackles in upper lobe
Labs: tine/mantoux, purified protein derivative, most definitive test: sputum culture
✔✔Pleurisy - ✔✔Inflammation of the pleura, usually producing an exudative pleural
effusion and stabbing chest pain made worse by breathing and coughing
Dull on percussion, dry cough, decreased respiratory excursion, decreased tactile
fremitus, dull on percussion, friction rubs present, decreased breath sounds
ANSWERS RATED A+
✔✔Dekleyn's - ✔✔Patient supine w/ head extended off table. Dr. instructs pt to
hyperextend and rotate the head. hole for 15-45 seconds.
(+) if produces vertigo, blurred vision, nausea, syncope, nystagmus
(ind) vertebrobasilar artery circulation compromise
✔✔Vertebrobasilar Artery Functional Maneuvar - ✔✔patient seated, auscultate (bell)
and palpate subclavian and carotid arteries. If no bruit, patient rotates and hyperextends
the head to each side
(+) if produces vertigo, blurred vision, nausea, syncope, nystagmus
(ind) vertebrobasilar artery circulation compromise
✔✔Ptosis - ✔✔Bilateral (ind) Myasthenia Gravis
Unilateral (ind) Horner's Syndrome or CN III lesion
✔✔Iritis/ Uveitis - ✔✔Seen in early stages of AS
✔✔Papilledema - ✔✔an indication of increased intracranial pressure
✔✔Arteriosclerosis on eye exam - ✔✔AV nicking, silver wire arterioles, widened light
reflex
✔✔Hypertension on eye exam - ✔✔flame hemmorhages, cotton wool spots, narrow
light reflex
✔✔Diabetes Mellitus - ✔✔yellow, hard, waxy exudates; neovascularization,
microaneurysms, absent red light reflex
✔✔Weber Test - ✔✔place 512 Hz tuning fork on the vertex of the patient's head and
ask if they hear the sound equally on both sides.
If louder on one side, can indicate:
air conduction hearing loss on that side
neural hearing loss on opposite side
✔✔Rinne Test - ✔✔Place tuning fork on mastoid and ask patient to verbalize when they
can no longer hear it. After sound stops, place beside EAM.
Normal: air conduction twice as long as bone conduction
✔✔Respiratory excursion - ✔✔place hands over posterior ribs and have patient take
three deep breaths
, ✔✔Tactile Fremitus - ✔✔Palpable symmetrical vibrations
Increased with fluid (pneumonia)
Decreased with air (emphysema)
✔✔Diaphragmatic Excursion - ✔✔Dr asks patient to exhale and hold, percuss down
back until sounds change from resonant to dull & mark; have patient take deep breath
and hold, repeat percussion. Normal result is approx 2" between marks bilaterally
✔✔Dullness with percussion - ✔✔pneumonia, atelectasis, pleurisy
✔✔resonance with percussion - ✔✔normal, bronchitis
✔✔hyperresonance with percussion - ✔✔Emphysema, pneumothorax
✔✔Tracheal Breath Sounds - ✔✔found over trachea
✔✔Bronchial Breath Sounds - ✔✔found over manubrium
✔✔Bronchovesicular Breath Sounds - ✔✔found betreen ribs 1&2 anteriorly and
between the scapulae posteriorly
✔✔Vesicular Breath Sounds - ✔✔found over lung field
✔✔Bronchophony - ✔✔patient says 99
if clear distinct sounds are heard, consolidation is present
✔✔Egophony - ✔✔if you hear "aaaaaa" as the patient says "eeeeee" then consolidation
is present
✔✔Whispered pectoriloquy - ✔✔if 99 is heard clearly and distinctly, consolidation is
present
✔✔Lobar Pneumonia - ✔✔percussion is dull over fluid, rales aka crackles, increased
tactile fremitus, productive cough @ 10 days, rusty brown sputum, with possible fever
✔✔Tb - ✔✔caused by mycobacterium tuberculosis, presents with low grade fever, night
sweats, productive cough, yellow/green sputum, starts in apices, crackles in upper lobe
Labs: tine/mantoux, purified protein derivative, most definitive test: sputum culture
✔✔Pleurisy - ✔✔Inflammation of the pleura, usually producing an exudative pleural
effusion and stabbing chest pain made worse by breathing and coughing
Dull on percussion, dry cough, decreased respiratory excursion, decreased tactile
fremitus, dull on percussion, friction rubs present, decreased breath sounds
