Final Integrated Exam

Question 1

Before starting the exam

Answer 1

introduce self to client
washes hands
check ID
provides privacy, comfort and confidentiality
prepares appropriate equipment
uses appropriate question to assess level of orientation

Question 2

at beginning of exam

Answer 2

inform patient of your actions, and what you will do
inquire about allergies

Question 3

head and neck

Answer 3

inspect face, head for shape, symmetry (normocephalic)
inspect external nose and lips (symmetrical)
check potency of nose (use pen light) (nares are patent)
inspect and palpate scalp (comment on hair, skin)
palpate maxillary and frontal sinus (ask if tender)
palpate temporal arterty (comment)
inspect neck and trachea
inspect lymph nodes (name 10 groups)

Question 4

ears

Answer 4

palpate external ears (tragus pinna, and mastoid process) (ask if tender)

Question 5

eyes

Answer 5

test pupillary reflexes- direct and consensual
(state cranial nerve 2 and 3)

Question 6

upper extremities

Answer 6

inspect skin and palpate for temp (comment)
assess nails (shape, color, and capillary refill) (comment)
check radial pulses bilaterally, comment (symmetry and amplitude) (document finding on documentation form)

Question 7

thorax

Answer 7

preforms exam from right side of patient
inspect for JVD
palpate carotid (one at a time)
auscultate carotid arteries for bruits (use bell and tell patient to hold breath)
listen to trachea (identify bronchial sounds)
assess for tenting (under clavicle)
auscultate anterior chest (identify brochovesicular and vesicular lung sound areas)
auscultate posterior thorax (identity bronochovesicular and vesicular
auscultate with diaphragm S1 and S2 (VERBALIZE WOULD COUNT FOR 1 MIN)
auscultate with diaphragm and bell over 5 areas over precordium (comment on landmarks and valve location)
auscultate with bell for s3 and s4 left lateral position

Question 8

abdomen

Answer 8

inspect contour and symmetry, skin lesions, pulsations, peristalsis
auscultate bowel sounds (4 quadrants in proper order)
comment on presence of bowel sounds
auscultate for vascular sounds (aorta, renal, iliac) use bell, comment on name and location
percuss abdomen, using zig-zag pattern (comment on sounds, tympany)
lightly palpate abdomen using zigzag pattern (comment on findings)

Question 9

lower extremities

Answer 9

inspect skin and palpate for temp
palpate femoral pulse bilaterally
palpate lower extremities for edema
palpate popliteal pulse bilaterally
palpate posterior tibial pulse
palpate dorsalils pedis pulse
perform passive ROM hip (stating flexion, extension, hip adduction, abduction)
prerform passive ROM ankle (stating plantar flexion and dorsiflexion)

Question 10

conclude exam

Answer 10

closes exam with profession comments
thanks patient for exam
student looks and acts profession during exam