Medical Surgical Assessment & Lung sounds #2


During the respiratory assessment, the nurse auscultates low-pitched sounds that sound like ripping of Velcro and will document what findings that describe the sounds?


  1. Coarse crackles.
    • Rationale:

      This answer is correct because coarse crackles may sound like low-pitched sounds that resemble ripping of Velcro or pouring a bottle of water out and may be heard in adult respiratory distress syndrome, early congestive heart failure, and pulmonary edema.

  2. Fine crackles.
    • Rationale:

      This answer is not correct because fine crackles are heard during late inspiration and may sound like hair rubbing together, and such sounds originate in smaller airways/alveoli and may be heard in interstitial pneumonia or pulmonary fibrosis.

  3. Sonorous wheezes.
    • Rationale:

      This answer is not correct because sonorous wheezes are low-pitched rumbling of air as it moves through tracheal-bronchial passages in the presence of respiratory secretions and is not gurgling. Sonorous wheezes are sometimes distinguished as rhonchi.

  4. Pleural friction rub.
    • Rationale:

      This answer is not correct because a pleural friction rub is a creaking, grating sound most heard on inspiration. To differentiate a pleural rub from a pericardial rub, the client holds the breath for a few seconds. If a rubbing sound continues, it is pericardial, and if it stops with breathing, it is a pleural rub.


The focus of this question is having an understanding of the various adventitious breath sounds. It is important to be able to distinguish coarse crackles from other adventitious breath sounds when performing a respiratory assessment on a client.


Learning Outcomes

The presence of crackles in a lung field indicates the presence of fluid within the small airways. Crackles may be described as fine or coarse. Coarse crackles are low-pitched sounds that are auscultated commonly in clients with chronic bronchitis, bronchiectasis, pneumonia, or severe pulmonary edema.

Test Taking Tip

Practice with various auscultation equipment in order to learn the different sounds heard when listening to breath sounds. Actually hearing the various adventitious sounds will help to learn the sounds more effectively than just memorizing a description.

Video Rationale