When auscultating the chest, the continuous musical sound heard on expiration is called

RUHS, Jaipur, M.Sc Nursing Entrance Exam-2022

Medical Surgical Nursing

Easy

Appeared in: RUHS, Jaipur, M.Sc Nursing Entrance Exam-2022

Explanation

Wheeze is defined as a continuous, high-pitched, musical or whistling sound.
It is generated by turbulent airflow through narrowed small airways (bronchi and bronchioles).
While it can occur during both inspiration and expiration, it is most commonly and prominently heard during the expiratory phase due to dynamic airway compression.
This sound is a classic sign of conditions causing bronchoconstriction or inflammation, such as asthma and COPD.

Option A: Crackles are discontinuous, non-musical, popping sounds, which is the opposite of the 'continuous musical sound' described in the question.
Option C: Crepitation is a synonym for crackles. Therefore, it describes a discontinuous, popping sound, not a continuous musical one.
Option D: Rhonchi are continuous sounds, but they are low-pitched and have a snoring or rattling quality, not the high-pitched musical sound of a wheeze.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Identification of adventitious breath sounds during respiratory assessment as background academic context rather than a clinical decision trigger.
Accurate identification of adventitious breath sounds is a fundamental nursing skill for assessing a patient's respiratory status and monitoring for changes.
Documenting the type of sound (wheeze, crackles, etc.), its location (e.g., bilateral bases, right upper lobe), and timing in the respiratory cycle (inspiratory/expiratory) is crucial for diagnosis and evaluating treatment effectiveness.
What if? If the sound was a high-pitched musical sound heard only on inspiration, it would be classified as stridor. This indicates an upper airway obstruction (e.g., in the larynx or trachea) and is a medical emergency requiring immediate intervention.

How to Approach the Question

First, break down the question to identify the key descriptors of the sound: 'continuous', 'musical', and 'heard on expiration'.
Next, recall the definitions of the four types of breath sounds listed in the options.
Evaluate 'Crackles' and 'Crepitation'. These are discontinuous, popping sounds, so they can be eliminated.
Compare 'Wheeze' and 'Rhonchi'. Both are continuous sounds. However, the question specifies a 'musical' sound.
Wheezes are high-pitched and musical, while rhonchi are low-pitched and snoring. The term 'musical' directly points to wheeze.
Finally, confirm that wheezes are predominantly expiratory, which matches the question's description, solidifying it as the correct answer.

Concept Tested & Keywords

Concept Tested: Identification of adventitious breath sounds during respiratory assessment.
Stem keywords: auscultating, chest, continuous musical sound, expiration
Lead-in keywords: is called
Negative lead-in flag: false

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