NU 650 Final Exam SG With Complete
Solution
Order of Assessment - Answer Inspection, Palpation, Percussion and Auscultation.
EXCEPT with abdomen
Comprehensive Health History - Answer chief complaint, reason for visit, ROS, past
medical and surgical history, social history and family history
Pediatric Body measurements - Answer length, height, weight, head circumference fro
birth to 36 months
Normal/Hypertension cut off - Answer <130 normal 140+ hypertension
Fontanel Closure - Answer posterior 1-2 months, anterior 9mo-2years
otoscope - Answer adult-up and back, peds- down and back, using largest speculum
that will fit comforably
tympanic membrane - Answer Cone of light R-5 l-7
EOM testing - Answer CN III, IV, VI
AP diameter of chest - Answer 1:2 (AP less than transverse)
barrel chest - Answer COPD
Flat or Dull percussion - Answer effusion or pneumonia
normal resonant percussion - Answer healthy lung
Hyperressonance (percussion) - Answer trapped air
crackles/rales - Answer high pitched, discontinuous
Wheezes - Answer high-pitched whistling or squeaking sounds during inspiration or
expiration
Rhonchi - Answer snoring, rumbling sounds heard upon auscultation of the chest during
respiration-low pitched
, tactile fremitus - Answer • INCREASED FREMITUS
- Means there is liquid or solid inside the lungs (consolidation such as with pneumonia)
- Remember Liquid or solid transmits vibrations better than air
• DECREASED FREMITUS
Means air trapping such as with emphysema or bronchial obstruction.
Bronchophony - Answer the spoken voice sound heard through the stethoscope, which
sounds soft, muffled, and indistinct over normal lung tissue, clearer over disease
Egophony - Answer abnormal change in tone of voice that is heard when auscultating
the lungs EE-->AA
UE Arteries - Answer radial-thumb side, ulnar pinky side
Pulse grading - Answer 0 absent
1+ weak
2+ normal
3+ increased
4+ bounding
palpate bilaterally
PMI - Answer point of maximal impulse mid-clavicular and 5th ICS
S1 - Answer normal, closure of AV, Start of systole, loudest at Apex, contraction of
ventricles
S2 - Answer normal, closure of semilunar, end of systole, loudest at base, filling of
ventricles
S3 - Answer third heart sound (normal in pregnant young adults, and children), gallop
S4 - Answer extra heart sound, end of diastole, indicative of disease-AFIB
murmur grading scale - Answer I-Barely Audible
II-Quiet, Clearly Audible
III-moderately Loud
IV-loud, thrill
V-Very loud, can palpate thrill
VI-Very loud, thrill palpable and visible
clubbing - Answer bulbous enlargement of distal phalanges of fingers and toes that
occurs with chronic cyanotic heart and lung conditions
Solution
Order of Assessment - Answer Inspection, Palpation, Percussion and Auscultation.
EXCEPT with abdomen
Comprehensive Health History - Answer chief complaint, reason for visit, ROS, past
medical and surgical history, social history and family history
Pediatric Body measurements - Answer length, height, weight, head circumference fro
birth to 36 months
Normal/Hypertension cut off - Answer <130 normal 140+ hypertension
Fontanel Closure - Answer posterior 1-2 months, anterior 9mo-2years
otoscope - Answer adult-up and back, peds- down and back, using largest speculum
that will fit comforably
tympanic membrane - Answer Cone of light R-5 l-7
EOM testing - Answer CN III, IV, VI
AP diameter of chest - Answer 1:2 (AP less than transverse)
barrel chest - Answer COPD
Flat or Dull percussion - Answer effusion or pneumonia
normal resonant percussion - Answer healthy lung
Hyperressonance (percussion) - Answer trapped air
crackles/rales - Answer high pitched, discontinuous
Wheezes - Answer high-pitched whistling or squeaking sounds during inspiration or
expiration
Rhonchi - Answer snoring, rumbling sounds heard upon auscultation of the chest during
respiration-low pitched
, tactile fremitus - Answer • INCREASED FREMITUS
- Means there is liquid or solid inside the lungs (consolidation such as with pneumonia)
- Remember Liquid or solid transmits vibrations better than air
• DECREASED FREMITUS
Means air trapping such as with emphysema or bronchial obstruction.
Bronchophony - Answer the spoken voice sound heard through the stethoscope, which
sounds soft, muffled, and indistinct over normal lung tissue, clearer over disease
Egophony - Answer abnormal change in tone of voice that is heard when auscultating
the lungs EE-->AA
UE Arteries - Answer radial-thumb side, ulnar pinky side
Pulse grading - Answer 0 absent
1+ weak
2+ normal
3+ increased
4+ bounding
palpate bilaterally
PMI - Answer point of maximal impulse mid-clavicular and 5th ICS
S1 - Answer normal, closure of AV, Start of systole, loudest at Apex, contraction of
ventricles
S2 - Answer normal, closure of semilunar, end of systole, loudest at base, filling of
ventricles
S3 - Answer third heart sound (normal in pregnant young adults, and children), gallop
S4 - Answer extra heart sound, end of diastole, indicative of disease-AFIB
murmur grading scale - Answer I-Barely Audible
II-Quiet, Clearly Audible
III-moderately Loud
IV-loud, thrill
V-Very loud, can palpate thrill
VI-Very loud, thrill palpable and visible
clubbing - Answer bulbous enlargement of distal phalanges of fingers and toes that
occurs with chronic cyanotic heart and lung conditions
