Physical Examination - General Appearance and Vitals

Question 1

​Clinical Skills

What is the general order of a physical exam?

(NOTE: not all the steps will be involved in each exam.)

OPPA

Answer 1

1. Observation / inspection
2. Palpation
3. Percussion
4. Auscultation

Question 2

Clinical Skills

Which exam does not follow the following order of steps?

1. Observation / inspection

2. Palpation

3. Percussion

4. Auscultation

Answer 2

The abdominal exam

(Auscultation must be before palpation.)

Question 3

Clinical Skills

Tier 1 maneuvers should be performed on which patients?

Tier 2 maneuvers should be performed on which patients?

Answer 3

All - these are screening maneuvers;

those with abnormal tier 1 results

Question 4

Clinical Skills

When does the general physicial exam begin?

Answer 4

When you enter the room!

(Pay attention to general appearance for odors, position, disposition, skin, hair, and nail issues)

Question 5

Clinical Skills

What are some of the general physicial appearance to pay attention to when entering the examination room?

Answer 5

Patient positioning and mood,

skin (and hair and nails) abnormalities,

odor

Question 6

Clinical Skills

Name specific patient smells that could indicate the following pathologies:

• DKA*
• Liver failure*
• Renal failure*

Answer 6

Acetone breath — DKA

Fetor hepaticus (musty smell) — liver failure

Ammonia (azotemia) — renal failure

Question 7

Clinical Skills

Name the major vital signs.

Answer 7

1. Temperature
2. Heart rate
3. Blood pressure
4. Respiratory rate
5. SpO₂

Question 8

Clinical Skills

Besides temperature, respiratory rate, blood pressure, heart rate, and pulse oximetry, what are some other vital signs that can be measured?

Answer 8

Weight,

height,

BMI

Question 9

Clinical Skills

What is the most common form of temperature taking that is most acceptable to patients?

Answer 9

Oral temperature

Question 10

Clinical Skills

In what situations is a rectal temperature often used?

Answer 10

1. For infants and children

2. When core temperature is necessary

Question 11

Clinical Skills

How long does it take for a digital thermometer to get a reading?

And a mercury thermometer?

Answer 11

30 - 60 seconds

3 minutes

Question 12

Clinical Skills

How are rectal temperatures taken?

Answer 12

1. Select proper size tip
2. Lubricate and insert 1.5 inches into anal canal

(if insertion is difficult, ask patient to bear down and then relax for insertion)

Question 13

Clinical Skills

At least how long should you count the number of beats in taking a radial pulse?

Answer 13

20 seconds (multiply by 3)

Question 14

Clinical Skills

At least how long should you count the number of breaths in taking a respiratory rate?

Answer 14

30 seconds (multiply by 2)

Question 15

Clinical Skills

Which portion of the stethoscope should be used in taking a blood pressure reading?

Answer 15

The bell

Question 16

Clinical Skills

In taking a blood pressure,

(1) make sure your patient is sitting with both feet flat on the ground,
(2) make sure the patient has had no ________ or ________ for at least 30 minutes prior to measurement.

Answer 16

Clinical Skills

In taking a blood pressure,

(1) make sure your patient is sitting with both feet flat on the ground,
(2) make sure the patient has had no caffeine or nicotene for at least 30 minutes prior to measurement.

Question 17

Clinical Skills

If it’s a patient’s first visit, you should take their blood pressure measurement in which arm?

Answer 17

Both

Question 18

Clinical Skills

In taking a patient’s blood pressure, what is considered a normal systolic pressure range?

Answer 18

95 - 140 mmHg

Question 19

Clinical Skills

In taking a patient’s blood pressure, what is considered a normal diastolic pressure range?

Answer 19

60 - 90 mmHg

Question 20

Clinical Skills

When taking a patient’s blood pressure in the initial visit, how do you approximate their systolic pressure?

Answer 20

1. Palpate radial pulse

2. Inflate BP cuff until pulse disappears (note pressure)

3. Deflate cuff

4. Inflate cuff 30 mmHg over noted pressure

Question 21

Clinical Skills

When taking a patient’s blood pressure in the initial visit, how do you approximate their systolic pressure?

1. Palpate ______ pulse

2. Inflate BP cuff until pulse _________ (note pressure)

3. Deflate cuff

4. Inflate cuff ____ mmHg over noted pressure

Answer 21

1. Palpate radial pulse

2. Inflate BP cuff until pulse disappears (note pressure)

3. Deflate cuff

4. Inflate cuff 30 mmHg over noted pressure