Family Nurse Practitioner Exam

In a respiratory examination, which is considered an abnormal finding?

1. Vesicular breath sounds in the lower lobe

2. Bronchial breath sounds in the right upper lobe

3. Normal lung sounds during expiration

4. Increased fremitus in a healthy lung

The correct answer is: Bronchial breath sounds in the right upper lobe

Bronchial breath sounds are typically heard over the trachea and are considered abnormal when heard in areas of the lung where you would expect to find vesicular breath sounds, such as the peripheral regions of the lung. The presence of bronchial breath sounds in the right upper lobe suggests that there may be an underlying pathology, such as consolidation or a mass, that is causing the sound to be transmitted from the larger airways to the lung periphery. This abnormal finding could indicate conditions such as pneumonia or atelectasis. In contrast, vesicular breath sounds in the lower lobe are normal, as they are the expected sounds produced by healthy lung tissue during inspiration. Normal lung sounds during expiration also align with typical respiratory findings, as the sounds should change based on the phase of respiration. Increased fremitus typically suggests consolidation or fluid in the lungs, and it is usually not recognized as an abnormal finding in healthy lung tissue. Therefore, bronchial breath sounds in a location where you would not expect them signifies an abnormality that warrants further investigation.