The nurse is assessing voice sounds during a respiratory assessment. Which of these findings indicates a normal assessment? Select all that apply
a. Voice sounds are faint, muffled, and almost inaudible when the patient whispers "one, two, three" in a very soft voice.
b. As the patient repeatedly says "ninety-nine," the examiner clearly hears the words "ninety-nine."
c. When the patient speaks in a normal voice, the examiner can hear a sound but cannot exactly distinguish what is being said.
d. As the patient says a long "ee-ee-ee" sound, the examiner also hears a long "ee-ee-ee" sound.
e. As the patient says a long "ee-ee-ee" sound, the examiner hears a long "aaaaaa" sound.
ANS: A, C, D
As a patient repeatedly says "ninety-nine," normally the examiner hears voice sounds but cannot distinguish what is being said. If a clear "ninety-nine" is auscultated, then it could indicate increased lung density, which enhances the transmission of voice sounds, which is a measure of bronchophony. When a patient says a long "ee-ee-ee" sound, normally the examiner also hears a long "ee-ee-ee" sound through auscultation, which is a measure of egophony. If the examiner hears a long "aaaaaa" sound instead, this sound could indicate areas of consolidation or compression. With whispered pectoriloquy, as when a patient whispers a phrase such as "one-two-three," the normal response when auscultating voice sounds is to hear sounds that are faint, muffled, and almost inaudible. If the examiner clearly hears the whispered voice, as if the patient is speaking through the stethoscope, then consolidation of the lung fields may exist.
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