Health Assessment/physical exam

Question 1

• What is this examination position?
• What is it best used for?

Answer 1

Sitting position

• Head, neck, back, thorax and lungs, heart, upper extremeties

Question 2

If patient is unable to maintain sitting position, what is the best alternative?

Answer 2

Supine position with head elevated

Question 3

• What is this position?
• What areas are assessed?

Answer 3

Supine position

Head, neck, front chest and lungs, axillae, heart, and abdomen

Question 4

If patient becomes short of breath easily, how do you position them in a supine position?

Answer 4

Raise head of bed

Question 5

What position is this?

What areas are assessed?

Answer 5

Dorsal recumbent

Best for abdominal assessment (promotes relaxation)

Question 6

For patients with painful disorders, how do you position them in dorsal recumbent?

Answer 6

Knees flexed (bent)

Question 7

What position is this?

What areas are assessed?

Answer 7

Lithotomy position

Best for female genitalia inspection

Question 8

What position is this?

What areas are assessed?

Answer 8

Sims position

Rectum and vagina

Question 9

What position is this?

What areas are assessed?

Answer 9

Prone position

Hip joints, skin, and butt

Question 10

What position is this?

What areas are assessed?

Answer 10

Lateral Recumbent

Detecting heart murmurs

Question 11

What position is this?

What areas are assessed?

Answer 11

knee-chest position

rectum

Question 12

When performing a physical examination, what are the steps (in order) that should be taken?

Answer 12

1. Inspection
2. Palpation
3. Percussion
4. Ausculation (listen)

Question 13

When inspecting, what should be done?

Answer 13

1. Close scrutiny (Look, listen, and smell)
2. General survey
3. Use of equipment

Discuss with client what you are doing

Question 14

What is included in a general survey?

Answer 14

1. Appearance and hygeine
2. Body structure and position
3. Movement
4. Emotional/mental status

Question 15

What do these odors indicate:

• Ammonia in the urine
• Feces from oral cavity

Answer 15

• Urinary tract infection
• Bowel obstruction

Question 16

What do these odors indicate:

• Sweet, fruity breath
• Stale urine

Answer 16

• Diabetic acidosis
• Uremic acidosis

Question 17

What do these odors indicate:

• Sweet, heavy odor from wound
• Musty odor from cast

Answer 17

• Pseudomonas bacteria
• Infection

Question 18

What part of the hand should be used when assessing texture, consistency, masses, and fluids?

Answer 18

The palm or fingertips

Question 19

What part of the hand should be used when assessing temperatures?

• Tactile discrimination (texture,swelling…)

Answer 19

• Temp= Dorsal part of hand
• Tactile= fingertips

Question 20

• What part of the hand should be used when assessing postions/shape of organs/mass?
• Vibrations?

Answer 20

• Positions= Fingers and thumb
• Vibrations= ulnar surface of hand

Question 21

When describing sound, what terms should you use?

Answer 21

1. Frequency
2. Loudness
3. Quality
4. Duration

Question 22

What do these ausculation description terms mean:

• Frequency
• Quality

Answer 22

Frequency= pitch

Quality= characteristics like “gurgling”, “blowing”

Question 23

Describe the pressure used when palpating:

• Strength and regularity:

Answer 23

Start light: accustoms patient

Perform deeper palpations when needed

• Irregular pressure better than continuous

Question 24

What are the uses of percussion?

Answer 24

1. Mapping location of organs
2. Determining density
3. Detecting abnormal mass
4. Eliciting pain

Question 25

How can percussion determine abnormal, superficial masses?

Answer 25

Percussion vibrations will cause change in percussion.

• Deeper mass would give no change

Question 26

What are the two percussion methods?

Answer 26

1. Direct
   
   1. Striking directly onto skin
2. Indirect
   
   1. Placing one hand on skin and striking that hand