Exam by body system

How to examine the lungs

Other platforms explain it with text and video. In VMS you practice it on the patient.

MD / DOPANursing (NCLEX)
Practice it in VR with Blocky

The lung exam is look, feel, tap and listen, always comparing left with right at the same level.

Step by step

  1. Prepare

    Clean your hands, introduce yourself, get consent, sit the patient up and expose the chest with a drape. [1]

  2. Inspect

    Breathing rate and effort, use of neck muscles, chest shape, symmetry, color of lips and fingers, clubbing. [1]

  3. Trachea and expansion

    Check the trachea is in the middle. Hands on the back with thumbs together near T10: ask for a deep breath and watch both thumbs move apart equally. [1]

  4. Percuss

    Tap side to side, top to bottom. Resonant is normal; dull suggests fluid or solid lung; hyper-resonant suggests air. [1]

  5. Listen

    Diaphragm on skin, patient breathing deeply through the mouth. Go side to side in a ladder pattern: back, sides and front. [1]

  6. Name the sounds

    Normal vesicular sounds; crackles (fluid), wheezes (narrow airways), rhonchi (secretions), stridor (upper airway, urgent) and pleural rub. [1]

  7. Finish

    Cover the patient, thank them and record the findings by area. [1]

Common errors

Practice it in VMS

In VMS you do this on the patient, not on paper: every step goes on the checklist with a score, and in Teach mode Blocky tells you what comes next.

VMS cases that train this skill

118 VMS cases train this skill: open the case library

Sources

  1. Open RN, Nursing Skills 2e (Chippewa Valley Technical College) (CC BY 4.0)
  2. NCCPA PANCE Content Blueprint

Steps adapted from Open RN, Nursing Skills 2e (Chippewa Valley Technical College), licensed under CC BY 4.0. Facts and steps also follow NCCPA PANCE Content Blueprint. VMS is not affiliated with these organizations. Updated: 2026-10-11.