Certified Respiratory Therapist Practice Exam

Which of the following is NOT suggested by a dull percussion note and bronchial breath sounds on examination?

1. Pneumonia

2. Atelectasis

3. Pulmonary infiltrates

4. Pneumothorax

The correct answer is: Pneumothorax

A dull percussion note and bronchial breath sounds are indicative of areas in the lungs where there is likely fluid, consolidation, or other dense material. In cases of pneumonia, for instance, alveoli filled with fluid or pus lead to decreased air density, producing the dull sound. Similarly, atelectasis involves collapsed lung tissue, which also generates a dull percussion note and can produce abnormal breath sounds if the area is consolidated or affected significantly. Pulmonary infiltrates, which can occur due to various conditions including infections or neoplasms, also present with dullness on percussion and can alter breath sounds similarly due to the presence of material in the lung tissue. Pneumothorax, on the other hand, typically results in hyper-resonance upon percussion, as the air in the pleural space decreases the density and resonance of the lung tissue. Additionally, breath sounds can be diminished or absent over the affected area due to the presence of air separating the lung from the chest wall. Hence, while other conditions suggest an abnormal presence in the lungs, pneumothorax stands out as not fitting the clinical findings described.