NBCE Part 4 Clinical & Set-Ups EXAM AND STUDY GUIDE LATEST 2025/2026 ACTUAL EXAM QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES(VERIFIED ANSWERS)|ALREADY GRADED A+

NBCE Part 4 Clinical & Set-Ups EXAM AND STUDY GUIDE LATEST
2025/2026 ACTUAL EXAM QUESTIONS AND CORRECT DETAILED
ANSWERS WITH RATIONALES(VERIFIED ANSWERS)|ALREADY GRADED
A+
Case History - correct answer- Identifying Data (name, age, etc.)
- Chief Complaint
- Present Illness (OPPQRST)
- Past History
- (SHITM)
- Family History
- Occupational History
- Social History
- Review of Systems
Vitals - correct answer- Temperature
- Pulse
- Respiration
- Blood Pressure
- Height
- Weight
Blood Pressure - correct answerHow to do Blood Pressure:
1. Patient seated
2. Arm elevated (doctor braces patient's wrist)
3. Empty air from cuff, wrap tight on patient
4. Palpatory systolic (on the way up until disappears)
5. Place stethoscope in ears
6. Pump 30-40 higher
7. Auscultate to O (recording true systolic/diastolic values)

,Physical Exam - correct answer- Skin Exam XXX
- Eye Exam
- Nose Exam XXX
- Ear Exam
- Mouth & Throat Exam XXX
- Endocrinology Exam XXX
- Genital Exam XXX
- Lymphatic Exam
- Peripheral Exam
- Lung Exam
- Heart Exam
- Abdominal Exam
Eye Exam: CN III, IV, VI - correct answerCardinal Field of Gaze
Eye Exam: CN II & III - correct answer- Direct (ipsilateral eye)
- Indirect ( contralateral eye)
Eye Exam: CN II & III Accommodation reflex - correct answerAccommodation: Converge &
Constrict
Follow up questions to a + Eye Exam? - correct answer- headaches?
- trouble reading?
- last eye exam?
- normally wear glasses/contacts?
Ear Exam: Weber & Rhinne - correct answer- Preform WEBER first
- Then preform Rhinne on the EAR that CAN HEAR
- *Every case has been Meinier's disease* (ask: ringing?, deafness?, dizzyness?)
Lymphatic Exam: palpation - correct answerpalpate w/ 3 fingers


- *Neck* (EENT questions)

,- Supraclavicular (ROS)
- *Axillary* (breast, chest, and arms questions) 4 walls
- Inguinal (legs/STDs)
Peripheral Vascular Exam (PVE): upper extremity palpation - correct answer*3 of them/
Seated*
- Unlar
- Radial
- Subclavian
- Carotid
- Temporal
Peripheral Vascular Exam (PVE): lower extremity palpation - correct answer*Supine*
- Femoral
- Popliteal
- Posterior Tibial
- Dorsal Pedis
Peripheral Vascular Exam (PVE): special tests - correct answer- Capillary Refill
- Allen's Test
- Claudication Test
- Buerger's test
- Homan's test
Peripheral Vascular Exam (PVE): auscultation - correct answer*BELL*
- @ carotid bifurcation (c4)
- bruit
-turbulance
Heart Exam: palpate & auscultate valve sites - correct answer*A* - 2nd right intercostal space
(parasternal)
*P* - 2nd left intercostal space (parasternal)
E - *NOT A VALVE*

, *T* - 4th/5th left intercostal space ( parasternal)
*M* - 5th left intercostal space (midclavicular) *location of the apical pulse*
Heart Exam: PERCUSSION (borders of the heart) - correct answera) Left side (lateral to medial)
3, 4, & 5 intercostal spaces
b) Right side (superior to inferior) right sternal border
Abdominal Aorta Exam - correct answerAuscultate with bell


Palpate lateral to medial
Lung Exam: Posterior Thoracic Palpation - correct answer*SEATED*
- Respiratory Excursions/expansion
- *Tactile Fremitus* ("99"):
Lung Exam: Posterior Thoracic Percussion - correct answer"Scan APEX (3 taps)


*Sounds*
- Flat: tumor/collapse
- Dull: fluid
- Resonant: normal
- Hyperresonant: Air (COPD)


*Diaphragmatic Expansion*
Lung Exam: Posterior Thoracic Auscultation - correct answer- deep breath
- whispered pectoriloquy ("1,2,3")
- bronchophony ("99")
- egophony ("E")
Lung Exam: Anterior Thorax - correct answer- Fremitus ("99")
- Percussion
- Auscultation