Clinical Examination

Question 1

What paperwork must be looked at prior to a clinical examination?

Answer 1

NEWS charts.
Nursing / medical notes.

Question 2

What information can be gathered about a patient’s appearance?

Answer 2

Sex.
Estimates on age and weight.
Rashes, colour and sweating.

Question 3

What can be gathered about a patient’s cognitive state?

Answer 3

Agitation and anxiety.
Confusion.

Question 4

What can be gathered about a patient’s environment?

Answer 4

Medical equipment.
Walking aids.
Medication and carers.

Question 5

How can you reflect on the initial assessment of a patient?

Answer 5

Urgent rapid assessment (ABCD).
Treatment (medication).
Steps to improve the consultation.

Question 6

How do you introduce yourself in a clinical examination?

Answer 6

Wash your hands.
Say your name and status.
Ask the patient for their name and DOB.

Question 7

How do you get consent from a patient?

Answer 7

Verbally.
Explain that you would like to examine them, and what the examination will entail.

Question 8

How do you prepare the patient for clinical examination?

Answer 8

Ask the patient to remove necessary clothes.
Position the patient at 45 degrees.
Adjust the bed height for your comfort.

Question 9

What do you do first when examining a patient’s hands?

Answer 9

Radial pulse and respiratory rate.
General colour (tar staining?).
Nails (colour? shape? texture?)
Capillary refill time.

Question 10

What do you check on the palms of a patient’s hands?

Answer 10

Colour of creases.
Temperature / sweatiness.

Question 11

How do you check for tremors of a patient’s hands?

Answer 11

Stretch out their hands with their fingers up.
Fine / coarse / flapping.

Question 12

How do you examine a patient’s arms?

Answer 12

Bruising / pigmentation / rashes / lesions / scars / wounds.
Venous damage.
Skin turgor.

Question 13

How do you examine a patient’s face?

Answer 13

Facial symmetry / colour / hair distribution.
Facial expressions specific to an illness.

Question 14

How do you examine a patient’s ears?

Answer 14

Shape / swelling.
Presence of a hearing aid.

Question 15

How do you examine a patient’s eyes?

Answer 15

Unequal pupils / yellow sclerae / eyelid position / symmetry.

Question 16

How do you examine a patient’s conjuctiva and buccal mucosa?

Answer 16

Pull down lower eyelids and ask the patient to look up, to examine the conjunctiva.
Use a pen torch to see ulceration or pigmentation of the buccal mucosa.

Question 17

How do you examine a patient’s mouth?

Answer 17

Colour of lips.
Tonsils (use a wooden spatula).
Swelling of gum margins.
State of dentition.
Colour / size / shape / movements / texture / moistness of the tongue.

Question 18

How do you examine a patient’s lymph nodes?

Answer 18

From the back.
Shoulders, up the side of their neck.
From the jaw to the chin.
In front of and behind the ears.
From the ears, down the neck.

Question 19

How do you examine a patient’s chest?

Answer 19

Inspect and palpate any skin lesions.
Check for gynaecomastia.

Question 20

How do you examine a patient’s lower limbs?

Answer 20

Skin - colour / hair distribution / ulcerations / varicose veins.
Temperature - palpate to check.
Check the soles of the feet.

Question 21

How do you examine deformities of a patient’s lower limbs?

Answer 21

Joint swelling.
Skin thickness.
Toe movement.

Question 22

How do you conclude a clinical examination?

Answer 22

Let the patient know you have finished and thank them.
Given them privacy to redress.
Wash your hands.

Question 23

How do you document any findings?

Answer 23

Write legibly, in a clear and logical sequence.
Identify each sheet with the patient’s ID / initials.
Date, time and sign your notes.
Print your name and status on your notes.

Question 24

What are the four examination stages?

Answer 24

Inspection - looking.
Palpation - feeling.
Percussion - tapping.
Auscultation - listening.

Question 25

Which side do you examine a patient on?

Answer 25

The right side.