STEPP EXAM II COMPREHENSIVE TEST PAPER
QUESTIONS AND SOLUTIONS
◉ What is subjective data? what is an example?
Answer: SD is what the patient tells you
Example: headache, chest pain
◉ What is objective data? what is an example?
Answer: OD are the signs perceived by the examiner through
physical examination during assessment
Example: rash seen by a nurse, or temp taken with a thermometer
◉ In what order are skills performed during a typical assessment?
Answer: 1. Inspection
2. Palpation
3. Percussion
4. Auscultation
◉ If a patient has abdomen pain, what order do you do the
assessment? Why?
Answer: 1. Inspection
2. AUSCULTATION
,3. Palpation
4. Percussion
Because of pain, don't touch or tap the tender area first. Start by
inspecting and then listening before you feel the area.
◉ What occurs during inspection, the first step?
Answer: -ALWAYS COMES FIRST
-begins when you first meet a person w/ a general survey
-you should start assessment of each body system with inspection
-requires: good lighting, adequate exposure, use of instruments
including otoscope, opthalmoscope, penlight, or specula
◉ What occurs during palpation, the second step?
Answer: Palpation applies sense of touch to assess
Can include:
temperature, texture, moisture, organ location and size, swelling,
vibration or pulsation, rigidity or spasticity, crepitation, presence of
lumps or masses, presence of tenderness or pain
-use fingers unless taking temperature
◉ How can you assess factors during the palpation step?
,Answer: by using different parts of the hands
◉ During palpation, what should fingertips be used to feel?
Answer: -best for fine tactile discrimination of skin texture, swelling,
pulsation, and determining presence of lumps
◉ During palpation, what should fingers and thumb be used for?
Answer: -detection of position, shape, and consistency of an organ or
mass
◉ During palpation, what should the dorsa of hands and fingers be
used for?
Answer: -best for determining temperature because skin here is
thinner than on palms
◉ During palpation, what should the base of fingers or the ulnar
surface of hand be used for?
Answer: -best for vibration
**-vibrations are felt on the ulnar side of hand
◉ During palpation, what type of palpation should you start with
and why? What steps are next?
Answer: 1. start with LIGHT palpation to detect surface
characteristics and accustom person to being touched
, -1 cm
2. then deeper palpations when needed
-intermittent pressure better than one long continuous palpation
-5 to 8 cm or 2-3 in
ALSO: bimanual palpation- requires use of both hands to envelop or
capture certain body parts or organs such as kidneys, uterus or
adnexa for precise delimitation
◉ What occurs during percussion, the third step?
Answer: -consists of tapping a person's skin with short, sharp
strokes to assess underlying structures
◉ What uses does percussion have?
Answer: -mapping location and size of organs
-signaling density of a structure by a characteristic note
-detecting a superficial abnormal mass
1. percussion vibrations penetrate about 5 cm
deep
2. deeper mass would give no change in percussion
-eliciting pain if underlying structure is inflamed
-eliciting deep tendon reflex using percussion hammer
QUESTIONS AND SOLUTIONS
◉ What is subjective data? what is an example?
Answer: SD is what the patient tells you
Example: headache, chest pain
◉ What is objective data? what is an example?
Answer: OD are the signs perceived by the examiner through
physical examination during assessment
Example: rash seen by a nurse, or temp taken with a thermometer
◉ In what order are skills performed during a typical assessment?
Answer: 1. Inspection
2. Palpation
3. Percussion
4. Auscultation
◉ If a patient has abdomen pain, what order do you do the
assessment? Why?
Answer: 1. Inspection
2. AUSCULTATION
,3. Palpation
4. Percussion
Because of pain, don't touch or tap the tender area first. Start by
inspecting and then listening before you feel the area.
◉ What occurs during inspection, the first step?
Answer: -ALWAYS COMES FIRST
-begins when you first meet a person w/ a general survey
-you should start assessment of each body system with inspection
-requires: good lighting, adequate exposure, use of instruments
including otoscope, opthalmoscope, penlight, or specula
◉ What occurs during palpation, the second step?
Answer: Palpation applies sense of touch to assess
Can include:
temperature, texture, moisture, organ location and size, swelling,
vibration or pulsation, rigidity or spasticity, crepitation, presence of
lumps or masses, presence of tenderness or pain
-use fingers unless taking temperature
◉ How can you assess factors during the palpation step?
,Answer: by using different parts of the hands
◉ During palpation, what should fingertips be used to feel?
Answer: -best for fine tactile discrimination of skin texture, swelling,
pulsation, and determining presence of lumps
◉ During palpation, what should fingers and thumb be used for?
Answer: -detection of position, shape, and consistency of an organ or
mass
◉ During palpation, what should the dorsa of hands and fingers be
used for?
Answer: -best for determining temperature because skin here is
thinner than on palms
◉ During palpation, what should the base of fingers or the ulnar
surface of hand be used for?
Answer: -best for vibration
**-vibrations are felt on the ulnar side of hand
◉ During palpation, what type of palpation should you start with
and why? What steps are next?
Answer: 1. start with LIGHT palpation to detect surface
characteristics and accustom person to being touched
, -1 cm
2. then deeper palpations when needed
-intermittent pressure better than one long continuous palpation
-5 to 8 cm or 2-3 in
ALSO: bimanual palpation- requires use of both hands to envelop or
capture certain body parts or organs such as kidneys, uterus or
adnexa for precise delimitation
◉ What occurs during percussion, the third step?
Answer: -consists of tapping a person's skin with short, sharp
strokes to assess underlying structures
◉ What uses does percussion have?
Answer: -mapping location and size of organs
-signaling density of a structure by a characteristic note
-detecting a superficial abnormal mass
1. percussion vibrations penetrate about 5 cm
deep
2. deeper mass would give no change in percussion
-eliciting pain if underlying structure is inflamed
-eliciting deep tendon reflex using percussion hammer
