Adult Critical Care Specialty (ACCS) Practice Exam

What are the audible signs that suggest congestive heart failure?

1. Wheezing

2. Coarse crackles

3. Stridor

4. Rhonchi

The correct answer is: Coarse crackles

Coarse crackles are considered audible signs that suggest congestive heart failure due to their association with fluid accumulation in the alveoli of the lungs. When the left ventricle fails to pump blood effectively, it can lead to increased pressure in the pulmonary circulation, causing transudation of fluid into the lung interstitium and alveolar spaces. This fluid interferes with normal breathing mechanics and creates the characteristic crackling sound during inhalation. Healthcare providers often listen for these coarse crackles during auscultation as an indication of underlying heart failure and pulmonary congestion, which is a common clinical manifestation in patients with this condition. Wheezing, stridor, and rhonchi are distinct lung sounds that suggest other respiratory conditions. Wheezing is often heard in conditions such as asthma or bronchospasm, stridor indicates upper airway obstruction, and rhonchi are associated with secretions in the larger airways or bronchial tubes. These sounds do not primarily signify congestive heart failure, making coarse crackles the most relevant choice in this context.