Emergency Medical Technician (EMT) Basic Certification Practice Exam

In patients with pneumonia, what respiratory sign may indicate alveolar involvement?

1. Rhonchi

2. Wheezing

3. Crackles

4. Clear breath sounds

The correct answer is: Crackles

The presence of crackles in patients with pneumonia is indicative of alveolar involvement due to fluid accumulation and inflammation in the lung tissue. Crackles, also known as rales, are soft, discontinuous sounds that may be heard during inhalation when air passes through fluid or secretions in the alveoli. This can occur in conditions like pneumonia, where the alveoli become filled with pus, fluid, or other inflammatory materials, leading to a characteristic sound that can be auscultated during a physical examination. In contrast, other respiratory signs such as rhonchi and wheezing are associated with different pathophysiological processes. Rhonchi are typically larger airway sounds resulting from thick secretions or obstructions, often indicating bronchial rather than alveolar involvement. Wheezing is a high-pitched sound caused by narrow airways, usually present in conditions like asthma or bronchoconstriction but not specifically indicative of alveolar damage or infection. Clear breath sounds suggest open and unobstructed airways without fluid or alveolar involvement, which would not align with pneumonia. Thus, crackles are the specific sign that reflects the underlying nature of pneumonia-related alveolar changes.