Physical Assessment- Mental Health, GCS, Skin

Question 1

What is Infection control in physical assessment?

Answer 1

hand hygiene,
standard/additional precautions,
cleaning of equipment

Question 2

Correct environment for physical assessment?

Answer 2

privacy & dignity,
warm, quiet, lighting, equipment
clean, working and available
e.g. Stethescope, blanket etc

Question 3

A Patient- (physical & psychological) before physical assessment?

Answer 3

explain in appropriate terminology (therapeutic interaction), 
informed consent, appropriate 
dress, empty bladder 
(abdominal), assess for pain, 
correct position.

Question 4

What does IPPA stand for?

Answer 4

I-Inspection (sight, sound, smell)
P-Palpation (touch)
P-Percussion (touch, sound)
A-Auscultation (sound via stethoscope)

Question 5

What is inspection in physical assessment?

Answer 5

• Look: 
– collecting objective data 
• Inspection: 
– concentrated observation 
– Careful scrutiny 
– Comparing 
– Counting 
– Measuring 
– Smelling

Question 6

What is palpation?

Answer 6

The act of touching a patient in a therapeutic manner to elicit specific information

Question 7

What tools do you need for palpation?

Answer 7

Tools: Hands
– Clean
– Short nails
– Warm

Question 8

What is the purpose for palpation?

Answer 8

• Locate organs and assess size of organs
  – Assess texture/temperature/moisture/lumps
  – Measure, pulsations, rigidity, swelling, tenderness

Question 9

What is the technique used for palpation?

Answer 9

– Informative
– Slow
– Systematic
– Gentle

Question 10

When do you use your fingertips for palpation?

Answer 10

fine tactile discrimination eg. Palpate pulses & breast examination

Question 11

When do you use the Dorsum of the hand in palpation?

Answer 11

Temperature

Question 12

When do you use the Palmar pads of the metacarpal

phalangeal joints in palpation?

Answer 12

for vibration (use palmar pads for thrills or vibration 
of the precordium)

Question 13

When do you use the Palmar pads or ulnar surface in palpation?

Answer 13

of the hand, also for vibration (use for tactile fremitus over the thorax)

Question 14

Fingertips in palpation?

Answer 14

grasp the skin over the sternum to assess turgor

Question 15

What is percussion?

Answer 15

The technique of striking one object against another that

produces sound

Question 16

Guidelines for percussion?

Answer 16

Short finger nails

Question 17

What is the technique used in percussion?

Answer 17

o Firm, rapid, sharp strikes 
o Wrist only, forearm still 
o Remove striking finger after 
strike 
o Tapping sound 
o Indirect, mediate percussion

Question 18

What is auscultation?

Answer 18

The act of listening to sounds produced by the body
 Direct Auscultation: listening with unaided ear
 Indirect auscultation: listening with amplification or mechanical
device

Question 19

What is the diaphragm of a stethoscope used for?

Answer 19

flat edge, for high pitch sounds: breath, bowel, normal heart sounds

Question 20

What is the bell of a stethoscope used for?

Answer 20

the end piece, deep hollow cup shape, low pitch, heart murmurs, extra heart sounds

Question 21

What is and how to use a Doppler ultrasonic stethoscope?

Answer 21

Gel is placed on the body part being 
assessed then the doppler placed 
directly.. 
This device amplifies sounds, and 
tones that are unpalpable: pulses

Question 22

What can interfere when auscultating?

Answer 22

– Hair
– Shivering
– Clothing

Question 23

What is the purpose of a mental health assessment?

Answer 23

Assess capacity to think, sense, perceive and move

Question 24

What does a mental health assessment include?

Answer 24

Mental and emotional status 
Appearance 
Behaviour 
Cognition 
Thought process 
Sensation and perception 
Motor function

Question 25

What is a past health history in mental health assessment?

Answer 25

Previous problems, substance abuse medical hx, surgical hx, medications, communicable diseases, injuries and accidents

Question 26

What is family history in mental health assessment?

Answer 26

Headaches, epilepsy, Alzheimer's disease, | Huntington’s chorea, muscular dystrophies, mental illness

Question 27

What is environmental hx in mental health assessment?

Answer 27

exposure to chemicals, travel hx

Question 28

What is psychological in mental health assessment?

Answer 28

self-esteem and stress caused by mental or neurological illness, support system, spouse, children, friends, coping mechanism, recent loss, grief

Question 29

What should you do before you begin a mental health assessment?

Answer 29

ensure privacy, consider influencing factors, | enable eye contact, ideally sit at same level

Question 30

What does a integument assessment include?

Answer 30

Skin, hair, nails

Question 31

What are the functions of the skin?

Answer 31

``` →Protect →Prevent →Sense →Regulate →Secrete →Promote ```

Question 32

What is past health history in integument assessment?

Answer 32

thorough, any past skin issues, piercings, | alopecia, hair distribution

Question 33

What is family health history in integument assessment?

Answer 33

any skin, hair or nail conditions in the family

Question 34

What is social history in integument assessment?

Answer 34

includes alcohol, smoking, environment, products used

Question 35

What equipment do you need for integument assessment?

Answer 35

– Magnifying glass – Lighting: natural light & pen light – Gloves – Ruler

Question 36

What do you inspect for examination of the skin?

Answer 36

``` Colour – Bleeding – Ecchymosis – Vascularity – Lesions – Moisture – Temperature – Texture – Turgor – Oedema ```

Question 37

What do you palpate in the examination of the skin?

Answer 37

``` – Moisture – Temperature – Tenderness – Texture: finger pads – Turgor (elasticity): pinch – Oedema ```

Question 38

How do you inspect and palpate the hair?

Answer 38

``` • Colour • Distribution: – Alopecia – Hirsutism. • Scalp lesions • Palpate texture ```

Question 39

What do you inspect and palpate for the nail?

Answer 39

``` Function of nail Cleanliness Color Texture Capillary refill ```