Respiratory Question #32


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:
  2. Fine crackles.
    • Rationale:
  3. Sonorous wheezes.
    • Rationale:
  4. Pleural friction rub.
    • Rationale:



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. Coarse crackles are generally heard in early inspiration and sound harsh or moist and are caused by mucous in larger bronchioles as heard in COPD. 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. 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 coined as rhonchi. Pleural friction rub is a creaking, grating sound most heard on inspiration. To differentiate a pleural from pericardial rub, the client holds breath for few seconds. If rubbing sound continues, it is pericardial, and if it stops with breathing it is a pleural rub.

Learning Outcomes

Test Taking Tip

Video Rationale