Which physical finding might indicate asthma exacerbation?

Hyper-resonance with percussion can indicate an asthma exacerbation because it may suggest increased air trapping in the lungs. During an asthma episode, the airways become inflamed and obstructed, leading to difficulty in exhaling. This results in more air remaining in the lungs, which can create a hyper-resonant sound upon percussion due to the increased lung volume and decreased density of lung tissue in the affected areas.

Normal breath sounds, clear voice sounds, and absent wheezing do not typically indicate an exacerbation. Normal breath sounds could suggest that there is no significant airway obstruction at that moment. Clear voice sounds imply that there is effective transmission of voice through the lung fields, which often occurs when the pathways are not significantly compromised. Absent wheezing might suggest that the airways are not currently constricted or that airflow is severely limited to the point that wheezing cannot be heard, which might occur in severe cases but is not typical of all exacerbations.