NUR-634 ADVANCED PHYSICAL ASSESSMENT MIDTERM –
EXAM QUESTIONS AND CORRECT ANSWERS (VERIFIED
ANSWERS) PLUS RATIONALE | 2027 Q&A | INSTANT
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Subjective Data - Correct Answer -symptoms from the client's point of view and include:
feelings, perceptions, and concerns -what the patient tells you
Objective Data - Correct Answer -what the health professional observes by inspecting, palpating,
percussing, and auscultating during the physical examination -observed signs
Assessment - Correct Answer -the clinical reasoning process that interprets the patient's history
and physical examination, singles out identified problems, and movement from each problems to
its action plan
Plan - Correct Answer -incorporates patient education, changes in medications, needed tests,
referrals to other clinicians, and return visits for counseling and support -requires good
interpersonal skills and sensitivity to the patients goals, economic means, competing
responsibilities, and family struggles/dynamics
Percussion - Correct Answer -a diagnostic procedure designed to determine the density of a body
part by the sound produced by tapping the surface with the fingers -use of the striking or plexor
finger (usually the 3rd) to deliver a rapid tap or blow against the distal pleximeter finger (usually
the distal 3rd finger of the left hand laid against the surface) to evoke a sound wave -the 5 sounds
are resonant, flat, dull, hyper resonant, and tympanic -Resonant sounds are low pitched, hollow
sounds heard over normal lung tissue. -Flat are normally heard over solid areas such as bones.
thigh -Dull or thudlike sounds are normally heard over dense areas such as the heart or liver.
Dullness replaces resonance when fluid or solid tissue replaces air-containing lung tissues, such
as occurs with pneumonia, pleural effusions, or tumors. -Hyperresonant sounds that are louder
and lower pitched than resonant sounds are normally heard when percussing the chests of
children and very thin adults. Hyperresonant sounds may also be heard when percussing lungs
hyperinflated with air, such as may occur in patients with COPD, or patients having an acute
asthmatic attack. An area of hyperresonance on one side of the chest may indicate a
pneumothorax. -Tympanic sounds are hollow, high, drumlike sounds. Tympany is normally
heard over the stomach, but is not a normal chest sound. Tympanic sounds heard over the chest
indicate excessive air in the chest, such as may occur with pneumothorax.
Attributes of a Symptom - Correct Answer -seven attributes -OPQRST & Associated
manifestations (anything else accompanying it) -onset, provocative/palliative, quality,
region/radiation, severity, timing
Talkative Challenging Patient Intervention - Correct Answer -give 5-10 minutes uninterrupted -
focus on and ask questions to what seems most important to patient -summarize concerns and
focus on #1 concern today -avoid impatience
, Angry Challenging Patient Intervention - Correct Answer -acknowledge any involvement you
may have in their anger and make amends -avoid reinforcing criticism of other clinicians -
validate their feelings without agreeing with their reasons -ensure a safe environment, alert
staff/security -stay calm and avoid being confrontational -keep a relaxed and nonthreatening
posture
Silent Challenging Patient Intervention - Correct Answer -be attentive and respectful and
encourage patient to continue when they are ready -watch for nonverbal cues such as difficulty
controlling emotions -watch for signs of depression -ask why they are quiet
Confusing Challenging Patient Intervention - Correct Answer -guide questions, ask for
clarification, and summarize -watch for underlying issue if there is interference with
communication -when there are multiple symptoms focus on context of the symptoms
emphasizing the patients perspective -consider delirium or intoxication -conduct a mental status
examination focusing on LOC. orientation, memory, and capacity to understand -ask for
permission to speak with family members to obtain their perspectives
Hearing Impaired Challenging Patient Intervention - Correct Answer -determine patients
preferred method of communication -do they belong to the deaf/hearing culture -when did the
hearing loss occur relative to the development of speech and language -kinds of schools patient
attended -use an interpreter -hand written questions (timely) -do they use hearing devices -
unilateral hearing loss sit on good side -remove background noise -face lip readers -speak normal
volume and rate -ask for teach back and give written instructions to take home
ABCDE-EFG - Correct Answer -method used to screen moles for melanomas -if >2 present risk
of melanoma increases and biopsy should be considered -Assymetry, Border irregularity, Color
Variations, Diameter >6mm, Evolving -EFG added to help detect aggressive nodular melanomas
(Elevated, Firm to palpation, growing progressively)
New Patient Documentation - Correct Answer -should consist of a comprehensive health history
consisting of identifying data and source of hx, chief complaint, HPI, PMH, Family history,
personal/social hx, ROS
Established Patient Documentation - Correct Answer -should consist of a focused assessment
consisting of chief complaint, assessment of symptoms restricted to a specific body system,
examination relevant to thorough assessment of problem area
Stages of Skin (Pressure) Ulcers - Correct Answer -Stage 1: presence of a reddened area that
fails to blanch with pressure and changes in temperature, consistency, sensation, or color -Stage
2: Skin forms a blister/sore, partial thickness skin loss or ulceration involving the epidermis,
dermis, or both -Stage 3: a crater appears in the skin with full thickness skin loss and damage to
or necrosis of subcutaneous tissue that may extend to but not through underlying muscle -Stage
4: the pressure ulcer deepens, there is full thickness skin loss with destruction, tissue necrosis, or
damage to underlying muscle, bone, and sometimes tendons/joints
EXAM QUESTIONS AND CORRECT ANSWERS (VERIFIED
ANSWERS) PLUS RATIONALE | 2027 Q&A | INSTANT
DOWNLOAD PDF
Subjective Data - Correct Answer -symptoms from the client's point of view and include:
feelings, perceptions, and concerns -what the patient tells you
Objective Data - Correct Answer -what the health professional observes by inspecting, palpating,
percussing, and auscultating during the physical examination -observed signs
Assessment - Correct Answer -the clinical reasoning process that interprets the patient's history
and physical examination, singles out identified problems, and movement from each problems to
its action plan
Plan - Correct Answer -incorporates patient education, changes in medications, needed tests,
referrals to other clinicians, and return visits for counseling and support -requires good
interpersonal skills and sensitivity to the patients goals, economic means, competing
responsibilities, and family struggles/dynamics
Percussion - Correct Answer -a diagnostic procedure designed to determine the density of a body
part by the sound produced by tapping the surface with the fingers -use of the striking or plexor
finger (usually the 3rd) to deliver a rapid tap or blow against the distal pleximeter finger (usually
the distal 3rd finger of the left hand laid against the surface) to evoke a sound wave -the 5 sounds
are resonant, flat, dull, hyper resonant, and tympanic -Resonant sounds are low pitched, hollow
sounds heard over normal lung tissue. -Flat are normally heard over solid areas such as bones.
thigh -Dull or thudlike sounds are normally heard over dense areas such as the heart or liver.
Dullness replaces resonance when fluid or solid tissue replaces air-containing lung tissues, such
as occurs with pneumonia, pleural effusions, or tumors. -Hyperresonant sounds that are louder
and lower pitched than resonant sounds are normally heard when percussing the chests of
children and very thin adults. Hyperresonant sounds may also be heard when percussing lungs
hyperinflated with air, such as may occur in patients with COPD, or patients having an acute
asthmatic attack. An area of hyperresonance on one side of the chest may indicate a
pneumothorax. -Tympanic sounds are hollow, high, drumlike sounds. Tympany is normally
heard over the stomach, but is not a normal chest sound. Tympanic sounds heard over the chest
indicate excessive air in the chest, such as may occur with pneumothorax.
Attributes of a Symptom - Correct Answer -seven attributes -OPQRST & Associated
manifestations (anything else accompanying it) -onset, provocative/palliative, quality,
region/radiation, severity, timing
Talkative Challenging Patient Intervention - Correct Answer -give 5-10 minutes uninterrupted -
focus on and ask questions to what seems most important to patient -summarize concerns and
focus on #1 concern today -avoid impatience
, Angry Challenging Patient Intervention - Correct Answer -acknowledge any involvement you
may have in their anger and make amends -avoid reinforcing criticism of other clinicians -
validate their feelings without agreeing with their reasons -ensure a safe environment, alert
staff/security -stay calm and avoid being confrontational -keep a relaxed and nonthreatening
posture
Silent Challenging Patient Intervention - Correct Answer -be attentive and respectful and
encourage patient to continue when they are ready -watch for nonverbal cues such as difficulty
controlling emotions -watch for signs of depression -ask why they are quiet
Confusing Challenging Patient Intervention - Correct Answer -guide questions, ask for
clarification, and summarize -watch for underlying issue if there is interference with
communication -when there are multiple symptoms focus on context of the symptoms
emphasizing the patients perspective -consider delirium or intoxication -conduct a mental status
examination focusing on LOC. orientation, memory, and capacity to understand -ask for
permission to speak with family members to obtain their perspectives
Hearing Impaired Challenging Patient Intervention - Correct Answer -determine patients
preferred method of communication -do they belong to the deaf/hearing culture -when did the
hearing loss occur relative to the development of speech and language -kinds of schools patient
attended -use an interpreter -hand written questions (timely) -do they use hearing devices -
unilateral hearing loss sit on good side -remove background noise -face lip readers -speak normal
volume and rate -ask for teach back and give written instructions to take home
ABCDE-EFG - Correct Answer -method used to screen moles for melanomas -if >2 present risk
of melanoma increases and biopsy should be considered -Assymetry, Border irregularity, Color
Variations, Diameter >6mm, Evolving -EFG added to help detect aggressive nodular melanomas
(Elevated, Firm to palpation, growing progressively)
New Patient Documentation - Correct Answer -should consist of a comprehensive health history
consisting of identifying data and source of hx, chief complaint, HPI, PMH, Family history,
personal/social hx, ROS
Established Patient Documentation - Correct Answer -should consist of a focused assessment
consisting of chief complaint, assessment of symptoms restricted to a specific body system,
examination relevant to thorough assessment of problem area
Stages of Skin (Pressure) Ulcers - Correct Answer -Stage 1: presence of a reddened area that
fails to blanch with pressure and changes in temperature, consistency, sensation, or color -Stage
2: Skin forms a blister/sore, partial thickness skin loss or ulceration involving the epidermis,
dermis, or both -Stage 3: a crater appears in the skin with full thickness skin loss and damage to
or necrosis of subcutaneous tissue that may extend to but not through underlying muscle -Stage
4: the pressure ulcer deepens, there is full thickness skin loss with destruction, tissue necrosis, or
damage to underlying muscle, bone, and sometimes tendons/joints
