Certified Medical-Surgical Registered Nurse Practice Exam

What type of breath sounds would a nurse expect to hear over areas of consolidation when auscultating a patient with pneumonia?

1. Bronchial

2. Bronchovesicular

3. Tubular

4. Vesicular

The correct answer is: Bronchial

When auscultating a patient with pneumonia, the nurse would expect to hear bronchial breath sounds over areas of consolidation. This finding occurs because, in healthy lungs, bronchial breath sounds are typically heard over the trachea and other large airways, while normal lung fields exhibit vesicular breath sounds that are softer and longer during inspiration than expiration. In the case of pneumonia, the lung tissue becomes consolidated due to fluid, infection, or inflammation, which changes the characteristics of the breath sounds. Over areas of consolidation, the denser lung tissue conducts sound more effectively, causing the normal vesicular sounds to be replaced by bronchial sounds. This indicates that sounds originating from the bronchi are now being transmitted through areas of affected lung tissue, signifying the presence of fluid or solid material in those regions. Bronchovesicular sounds may also be heard but typically are located between the phases of bronchi and vesicular sounds and indicate normal lung functioning in specific areas, rather than consolidation. Tubular sounds generally refer to abnormal breath sounds often associated with obstacles in the airways, while vesicular sounds are expected in healthy lung tissue. Thus, bronchial sounds are a key auscultatory finding indicative of lung consolidation, reinforcing the diagnosis of pneumonia.