Introduction to Physical Assessment and Vital Signs and Health History

Question 1

What is the correct order for the skills for the physical examination?

Answer 1

Inspection, Palpation, Percussion, Auscultation

Question 2

What is the back of the hand best for when using palpation?

Answer 2

Best for determining temperature

Question 3

Which hand feature is best for determining texture, swelling, pulsation, and presence of lumps?

Answer 3

Fingertips

Question 4

What three features is percussion best used to determine?

Answer 4

Location, Size and Density

Question 5

What kind of structure with more air produces a louder, deeper, longer sound?

Answer 5

The lungs

Question 6

Example of structure that is dense, more solid with softer, shorter, higher sound? (auscultation)?

Answer 6

The liver

Question 7

What is the diaphragm of stethoscope best used for and how is it used?

Answer 7

Best used for high pitch sounds (breath, bowel, heart sounds) - flat shape
Hold diaphragm firmly against person’s skin

Question 8

What is the bell of stethoscope best used for and how is it used?

Answer 8

Best used for low pitch sounds (heart murmurs, extra heart sounds) - cup like shape
Hold it lightly against person’s skin

Question 9

You should listen through the gown T or F?

Answer 9

False

Question 10

Describe how an examination room should be?

Answer 10

Examination room should be warm, comfortable, quiet, private, and well lit

Question 11

Describe what an otoscope is used for?

Answer 11

Funnels light into the ear canal, and onto tympanic membrane

Five specula used (short, broad speculum used for viewing nares, largest one used for ear canal

Question 12

Describe what an ophthalmoscope is used for?

Answer 12

Used to view through pupil at the fundus (background of eye)

Question 13

When should the mechanical action of hand washing be used?

Answer 13

When hands are visibly soiled and when the person is infected with spore forming organisms (C. Diff)

Question 14

When should you wear gloves?

Answer 14

When anticipating contact with blood, infectious materials, mucous membranes, nonintact skin, and infected intact skin

Question 15

When should you wear a gown?

Answer 15

When contacting blood, body fluids, secretions or excretions

Question 16

When should you wear eye protection?

Answer 16

When there is potential splashes, sprays of blood, body fluids, secretions, excretions

Question 17

When should you wear a mask?

Answer 17

when treating persons with transmissable respiratory infections

Question 18

Describe some important steps for examining infants?

Answer 18

Once baby is able to sit without support (around 6 months) examination should be performed on on the caregivers lap

caregiver must be in infants vision at 9-12 months

examination should be done 1-2 hours after feeding in warm environment

use toys for distraction and medical tools for older babies

listen to heart, lung, ab sounds when baby is sleeping and do most invasive and Moro reflex last

Question 19

Preschoolers like to help with the examination true or false?

Answer 19

True

Question 20

With preschoolers head, eye, ear, nose and throat should be observed first or last?

Answer 20

Last

Question 21

It is important to allow rest periods during examination for older adults true or false?

Answer 21

True

Question 22

What is a normal temperature adult temperature?

Answer 22

96.8-100.4 degrees Farenheit

Question 23

What is a normal neonate temperature?

Answer 23

97.7-99.7 degrees Farenehit

Question 24

What is a normal infant temperature?

Answer 24

98.6-99.5 degrees Farenheit

Question 25

What factors affect temperature?

Answer 25

age, exercise, heart rhythms, stress and environment

Question 26

When and where is the oral thermometer used?

Answer 26

For adolescence underneath the sublingual pocket

Question 27

Rectal temperature?

Answer 27

Closest to approx. core temperature (most accurate) | Insert 2.5 cm with lube or 1/2 inch for newborn

Question 28

What three fingers are used to palpate the radial pulse?

Answer 28

The pads of your first three fingers

Question 29

What is bradycardia?

Answer 29

Heart rate less than 50 beats/min

Question 30

What is a normal pulse?

Answer 30

60-95 beats/min

Question 31

What is tachycardia?

Answer 31

Over 100 beats per minute

Question 32

What are the different heart rates based on age?

Answer 32

``` Neonate: 110-160 Infant: 90-160 Toddler: 80-140 Pre K: 70-120 School: 60-110 Adol: 50-100 ```

Question 33

What is a normal respiratory rate?

Answer 33

12-20 beats per minute

Question 34

What are the different respiratory rates?

Answer 34

``` Neonate: 30-60 Infant: 25-30 Toddler: 25-30 pre-ke: 20-25 school: 20-25 Adol: 16-20 ```

Question 35

What is the stroke volume?

Answer 35

The amount of blood the heart pumps into the aorta every beat

Question 36

What is a normal blood pressure?

Answer 36

120/80

Question 37

What is the systolic blood pressure?

Answer 37

peak pressure in arteries when contracting ventricles

Question 38

What is the diastolic blood pressure?

Answer 38

peak pressure in the arteries when ventricles are relaxed

Question 39

What is the pulse pressure?

Answer 39

The difference between the systolic and diastolic pressure (reflects stroke volume)

Question 40

What factors influence bp?

Answer 40

``` Age Gender Ethnicity and Genetics (higher bp in AA's) Stress Daily Variations Meds Activity Wt Smoking ```

Question 41

What are the Kortkoff Sounds?

Answer 41

BP with sphygmonanometer 1 inch above brachial artery in the AC fossa Listening for first and last sounds (1-closure of AV valve, 2-swoosh, 3-knock, 4-muffle, 5-diastolic)

Question 42

What sites are appropriate to take BP on?

Answer 42

upper arm, wrist, ankle, thigh (don't use near IV site, lymph node removal, dialysis fistula) Bladder width is 40% , length is 80%

Question 43

Hypertension Stages

Answer 43

Elevated: 120-129/80 or less Stage 1: 130-139/80-89 Stage 2: More than 140/More than 90 Crisis: Over 180/Over 110

Question 44

What is hypotension?

Answer 44

Systolic bp less than 90 Orthostatic Hypotension is change in position causes bp to decrease by 20 Pale, cunfused, neuoro change

Question 45

BP's by age group

Answer 45

infant: 64/41 child: 88/44 pre-k: 92/51 school: 100/59 adol: 112/64

Question 46

What is the difference between a sign and a symptom?

Answer 46

A symptom is a subjective sensation that the person feels from the disorder A sign is an objective abnormality that one could detect from a physical examination Put patient's exact words in quotation marks with time frame - no diagnostic statement

Question 47

What are the components of the interview phase?

Answer 47

1. Orientation and setting and agenda (private, greet by name, explain purpose) 2. Working phase and collecting data (Ask questions, listen, attentive) 3. Termination phase (restate info, patient summarize) * Assure confidentiality

Question 48

What is included in demographic information?

Answer 48

name, address, phone number, age, date of birth, birthplace, sex, marital status, race, ethnicity, occupation

Question 49

Who is a reliable source for information regarding health history?

Answer 49

patient, parents, interpreter, or caseworker (less reliable - relative or friend)

Question 50

What is the chief complaint?

Answer 50

Brief spontaneous statement in person's own words describing reasons for visit