PHYSICAL ASSESSMENT FINAL ACTUAL EXAM
2026 QUESTIONS SOLUTIONS GRADED A+
◉ Abdominal Quadrants. Answer: Four areas: RLQ, RUQ, LUQ, LLQ
used for assessment and identifying organ locations.
◉ Bowel Sounds. Answer: Normal sounds heard in each quadrant;
may be hypoactive (few sounds) or hyperactive (increased sounds
when hungry).
◉ Absent Bowel Sounds. Answer: Must listen 5 minutes in each
quadrant before documenting as absent; may indicate obstruction.
◉ Solid Viscera. Answer: Organs that maintain shape: liver, pancreas,
spleen, kidneys.
◉ Hollow Viscera. Answer: Organs that change shape depending on
contents: stomach, gallbladder, small intestine, large intestine,
bladder.
◉ Non-palpable Viscera. Answer: Internal organs normally not felt:
pancreas, spleen, stomach, gallbladder, small intestine.
,◉ Vascular Structures of Abdomen. Answer: Abdominal aorta and
right/left iliac arteries; may be palpable.
◉ Older Adult: Pain Sensitivity. Answer: Elderly have diminished
pain sensitivity and need careful abdominal assessment.
◉ Older Adult: Appetite Changes. Answer: Aging decreases appetite
due to altered metabolism, taste changes, mobility decline, and
depression.
◉ Older Adult: Diarrhea Complications. Answer: Higher risk for
dehydration, fluid deficits, and electrolyte imbalance due to higher
fat-to-lean mass ratio.
◉ Older Adult: UTI Risk. Answer: Increased UTI risk because
protective urinary bacteria decline with age.
◉ USPSTF AAA Screening. Answer: One-time screening for
abdominal aortic aneurysm for men 65-75 who have smoked;
selectively for those who haven't; not recommended for women.
◉ COLDSPA. Answer: A mnemonic for symptom assessment:
Character, Onset, Location, Duration, Severity, Pattern, Associated
factors.
,◉ Abdominal Inspection. Answer: Observe skin color, vascularity,
striae, scars, lesions, umbilicus, contour, symmetry, pulsations, and
peristaltic waves.
◉ Abdominal Auscultation. Answer: Listen for bowel sounds,
vascular sounds, venous hum, and friction rubs.
◉ Abdominal Percussion. Answer: Assess tone (typically tympany),
liver span, spleen, and perform blunt percussion over kidneys/liver.
◉ Abdominal Palpation. Answer: Light and deep palpation to assess
tenderness, masses, and organ size; palpate aorta, liver, spleen,
kidneys, bladder.
◉ Ascites. Answer: Abnormal fluid in abdomen; evaluated with
shifting dullness and fluid wave tests.
◉ Rebound Tenderness. Answer: Pain upon release in RLQ—
suggests appendicitis.
◉ Rovsing's Sign. Answer: Pressure in LLQ causes pain in RLQ;
indicates appendicitis.
, ◉ Referred Rebound Tenderness. Answer: Releasing pressure in LLQ
causes RLQ pain; suggests appendicitis.
◉ Psoas Sign. Answer: Pain in RLQ when lifting or extending right
leg; associated with appendicitis.
◉ Murphy's Sign. Answer: Pain with inhalation during palpation of
gallbladder area; indicates cholecystitis.
◉ CVA Tenderness. Answer: Pain during percussion over kidneys;
indicates kidney inflammation or infection.
◉ Umbilical Hernia. Answer: Bulge near umbilicus due to weakness
in abdominal wall.
◉ Epigastric Hernia. Answer: Hernia through linea alba between
xiphoid and umbilicus.
◉ Incisional Hernia. Answer: Hernia through previous surgical
incision site.
◉ Diastasis Recti. Answer: Separation of abdominal muscles causing
midline bulge.
2026 QUESTIONS SOLUTIONS GRADED A+
◉ Abdominal Quadrants. Answer: Four areas: RLQ, RUQ, LUQ, LLQ
used for assessment and identifying organ locations.
◉ Bowel Sounds. Answer: Normal sounds heard in each quadrant;
may be hypoactive (few sounds) or hyperactive (increased sounds
when hungry).
◉ Absent Bowel Sounds. Answer: Must listen 5 minutes in each
quadrant before documenting as absent; may indicate obstruction.
◉ Solid Viscera. Answer: Organs that maintain shape: liver, pancreas,
spleen, kidneys.
◉ Hollow Viscera. Answer: Organs that change shape depending on
contents: stomach, gallbladder, small intestine, large intestine,
bladder.
◉ Non-palpable Viscera. Answer: Internal organs normally not felt:
pancreas, spleen, stomach, gallbladder, small intestine.
,◉ Vascular Structures of Abdomen. Answer: Abdominal aorta and
right/left iliac arteries; may be palpable.
◉ Older Adult: Pain Sensitivity. Answer: Elderly have diminished
pain sensitivity and need careful abdominal assessment.
◉ Older Adult: Appetite Changes. Answer: Aging decreases appetite
due to altered metabolism, taste changes, mobility decline, and
depression.
◉ Older Adult: Diarrhea Complications. Answer: Higher risk for
dehydration, fluid deficits, and electrolyte imbalance due to higher
fat-to-lean mass ratio.
◉ Older Adult: UTI Risk. Answer: Increased UTI risk because
protective urinary bacteria decline with age.
◉ USPSTF AAA Screening. Answer: One-time screening for
abdominal aortic aneurysm for men 65-75 who have smoked;
selectively for those who haven't; not recommended for women.
◉ COLDSPA. Answer: A mnemonic for symptom assessment:
Character, Onset, Location, Duration, Severity, Pattern, Associated
factors.
,◉ Abdominal Inspection. Answer: Observe skin color, vascularity,
striae, scars, lesions, umbilicus, contour, symmetry, pulsations, and
peristaltic waves.
◉ Abdominal Auscultation. Answer: Listen for bowel sounds,
vascular sounds, venous hum, and friction rubs.
◉ Abdominal Percussion. Answer: Assess tone (typically tympany),
liver span, spleen, and perform blunt percussion over kidneys/liver.
◉ Abdominal Palpation. Answer: Light and deep palpation to assess
tenderness, masses, and organ size; palpate aorta, liver, spleen,
kidneys, bladder.
◉ Ascites. Answer: Abnormal fluid in abdomen; evaluated with
shifting dullness and fluid wave tests.
◉ Rebound Tenderness. Answer: Pain upon release in RLQ—
suggests appendicitis.
◉ Rovsing's Sign. Answer: Pressure in LLQ causes pain in RLQ;
indicates appendicitis.
, ◉ Referred Rebound Tenderness. Answer: Releasing pressure in LLQ
causes RLQ pain; suggests appendicitis.
◉ Psoas Sign. Answer: Pain in RLQ when lifting or extending right
leg; associated with appendicitis.
◉ Murphy's Sign. Answer: Pain with inhalation during palpation of
gallbladder area; indicates cholecystitis.
◉ CVA Tenderness. Answer: Pain during percussion over kidneys;
indicates kidney inflammation or infection.
◉ Umbilical Hernia. Answer: Bulge near umbilicus due to weakness
in abdominal wall.
◉ Epigastric Hernia. Answer: Hernia through linea alba between
xiphoid and umbilicus.
◉ Incisional Hernia. Answer: Hernia through previous surgical
incision site.
◉ Diastasis Recti. Answer: Separation of abdominal muscles causing
midline bulge.
