NURS 304 Exam 1 – Study Guide and Exam Review Material
assessment techniques - correct answer ✔✔sequence of procedures designed to evaluate the
health status of a patient
ADPIE - Nursing Process - correct answer ✔✔Assessment, Diagnosis, Plan, Intervention,
Evaluation
collection of data from - correct answer ✔✔review of clinical record
-interview
-health history
-physical exam
-functional exam
-cultural and spiritual assessment
-consultation
-review of literature
Physical Exam Techniques - correct answer ✔✔Inspection
Palpation
Percussion
Auscultation
Inspection Technique - correct answer ✔✔-concentrated staring
-use all senses
- begins when you meet the individual
-body parts assessed for shape, color, odor, symmetry
, -requires good lighting
-side to side comparison
Palpation techniques - correct answer ✔✔Fingertips: best for fine tactile discrimination of skin
texture, swelling, pulsation, determining presence of lumps
Fingers and thumb: detection of position, shape, and consistency of an organ or mass
Dorsa of hands and fingers: best for determining temperature because skin here is thinner than
on palms
Base of fingers or ulnar surface of hand: best for vibration
Percussion Technique - correct answer ✔✔Assessment of sounds to determine body organ
borders, shape, and position; not always used in a NFPA
direct percussion - correct answer ✔✔involves striking a finger or hand directly against the
patient's body
indirect percussion - correct answer ✔✔strike finger or hand placed over body surface
Auscultation technique - correct answer ✔✔Use of stethoscope to exclude environmental
sound and augment internal sound
-NEVER listen through clothing
-always clean stethoscope between uses
what type of data would be obtained utilizing each technique? - correct answer ✔✔objective
assessment techniques - correct answer ✔✔sequence of procedures designed to evaluate the
health status of a patient
ADPIE - Nursing Process - correct answer ✔✔Assessment, Diagnosis, Plan, Intervention,
Evaluation
collection of data from - correct answer ✔✔review of clinical record
-interview
-health history
-physical exam
-functional exam
-cultural and spiritual assessment
-consultation
-review of literature
Physical Exam Techniques - correct answer ✔✔Inspection
Palpation
Percussion
Auscultation
Inspection Technique - correct answer ✔✔-concentrated staring
-use all senses
- begins when you meet the individual
-body parts assessed for shape, color, odor, symmetry
, -requires good lighting
-side to side comparison
Palpation techniques - correct answer ✔✔Fingertips: best for fine tactile discrimination of skin
texture, swelling, pulsation, determining presence of lumps
Fingers and thumb: detection of position, shape, and consistency of an organ or mass
Dorsa of hands and fingers: best for determining temperature because skin here is thinner than
on palms
Base of fingers or ulnar surface of hand: best for vibration
Percussion Technique - correct answer ✔✔Assessment of sounds to determine body organ
borders, shape, and position; not always used in a NFPA
direct percussion - correct answer ✔✔involves striking a finger or hand directly against the
patient's body
indirect percussion - correct answer ✔✔strike finger or hand placed over body surface
Auscultation technique - correct answer ✔✔Use of stethoscope to exclude environmental
sound and augment internal sound
-NEVER listen through clothing
-always clean stethoscope between uses
what type of data would be obtained utilizing each technique? - correct answer ✔✔objective
