Chapter 4 Physical Examination

Chapter 4 Physical Examination fd fd fd




Chapter 4: Physical Examination - Practice Exam
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Instructions: Choose the single best answer for each question.fd fd fd fd fd fd fd fd




1. A nurse is preparing to perform a physical examination on a new patient. Which of the f
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ollowing actions should the nurse take FIRST to ensure a safe and effective examination?
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• A) Palpate the abdomen before auscultation.
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• B) Defer the examination if the patient is in any pain.
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• C) Ensure the environment is private, warm, and well-lit.
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• D) Begin the examination with the most invasive procedure first.
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Answer: C) Ensure the environment is private, warm, and well-
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lit. (Providing a comfortable, private environment is the first step to putting the patient at ease a
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nd ensuring an effective exam.)
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2. During an abdominal assessment, a nurse should perform the techniques in which of th
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e following orders to prevent altering the bowel sounds?
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• A) Inspection, Palpation, Percussion, Auscultation
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• B) Auscultation, Inspection, Percussion, Palpation
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• C) Inspection, Auscultation, Percussion, Palpation
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• D) Palpation, Percussion, Inspection, Auscultation
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Answer: C) Inspection, Auscultation, Percussion, Palpation. (Auscultation is performed before
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percussion and palpation because these techniques can stimulate peristalsis and alter bowel sou
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nds. Inspection is always first.)
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3. A healthcare provider uses the fingertips to feel for tactile fremitus (vibrations) on a pat
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ient's chest. The patient is asked to repeat "ninety-
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nine" while the provider palpates. This is an example of which physical examination techni
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que?

• A) Light Palpation
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, • B) Deep Palpation
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• C) Bimanual Palpation
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• D) Indirect (mediate) Percussion
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Answer: A) Light Palpation. (Light palpation with the fingertips is used to assess for pulses, ten
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derness, and tactile fremitus on the chest. It involves gentle pressure, depressing the skin about 1
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cm.)
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4. The nurse is assessing a patient's heart sounds and hears a low-
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pitched murmur. Which part of the stethoscope should the nurse use to best auscultate thi
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s sound?
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• A) The bell, held lightly against the skin.
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• B) The bell, held firmly against the skin.
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• C) The diaphragm, held firmly against the skin.
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• D) The diaphragm, held lightly against the skin.
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Answer: A) The bell, held lightly against the skin. (The bell is designed to transmit low-
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frequency sounds. Holding it lightly creates a seal and is best for hearing low-
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pitched murmurs and vascular sounds.)
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5. A patient complains of pain in the right lower quadrant of their abdomen. The nurse pe
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rforms palpation in the left lower quadrant, which causes the patient to experience pain in
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the right lower quadrant. This is a positive sign for which condition?
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• A) Constipationfd




• B) Rebound tenderness
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• C) Appendicitis (Rovsing's sign)
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• D) Peritoneal irritation (Blumberg's sign)
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Answer: C) Appendicitis (Rovsing's sign). (Rovsing's sign is pain in the right lower quadrant eli
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cited by deep palpation in the left lower quadrant. It is a classic sign of appendicitis.)
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6. During an inspection, the nurse notes that a patient's skin has a bluish discoloration to t
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he lips and nail beds. The nurse correctly documents this finding as:
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