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PHYSICAL ASSESSMENT Exam Questions
With Correct Answers
Physical Assessment
Method for gathering health data - answer✔Assessment is 1st step of the nursing process and is
ongoing throughout the nurse-patient relationship.
It is process you use to collect physical data relevant to the patient's health.
Use four of your senses: sight, smell, hearing, and touch
Goal: To gather objective data about a client.
What is objective data? (measurable by nurse, classified as signs)
What is subjective data? (verbalized by patient, not directly measurable, classified as symptoms)
Clients are examined:
on admission (comprehensive, in depth)
briefly at the beginning of each shift (more focused)
any time the client's condition changes
When evaluating the effectiveness of nursing care
Anytime things do not "feel right"
PURPOSES of ASSESSMENT - answer✔Evaluate client's current physical condition
Detect early signs of developing health problems
Establish a baseline for future comparisons (done on admission)
Evaluate client's responses to medical and nursing interventions
Monitor for changes in body function
Detect specific body systems that need further assessment or testing
There are 5 basic techniques:
Inspection (look)
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Palpation (feel)
Percussion
Auscultation (listen)
Olfaction (smell)
3 Levels of Physical Assessment - answer✔1. Comprehensive Health Assessment
In-depth assessment of whole person (physical, mental, emotional, cultural, spiritual)
Data is collected through physical exam and interview
Generally done on admission to facility
2. Focused Assessment
Exam and interview regarding a specific body system (ex. Respiratory system)
Allows nurse to check only system related to patient's disease process or when performing
reassessment of a system in which abnormal findings were obtained earlier
3. Initial Head-to-Toe Shift Assessment
Quick overall assessment of patient's condition to establish baseline against which you can
compare later assessments (able to identify changes in pt.'s condition: improvement or
deterioration)
Focused assessment of the following systems in sequence from head to toe:
Neurological
Cardiovascular
Respiratory
Integumentary
Gastrointestinal
Genitourinary
Muscular
Skeletal
Also includes specific assessment of the patient's:
Vital signs, including pain and O2 saturation (SpO2)
Appearance
Speech
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Safety risk factors
Tubes and equipment
Comfort or complaints
Needs
Findings such as VS and from other systems will provide some info. about Immune System
Physical Assessment - answer✔Abnormal findings should be reassessed within 4 hours or
sooner depending on severity
Some abnormal findings are minor or may even be expected
Some abnormal findings may be totally unexpected and represent potentially serious conditions
Example: patient is admitted with upper respiratory infection and you note an occasional dry
cough. You instruct pt. to let you know if it gets worse. You would reassess the cough in 4 hrs. to
see if better, worse, or same.
Example: You assess a fever of 103 degrees. You need to take immediate action to treat fever
and reassess in one hour
Assessment Techniques - answer✔Most important tools you will need are your eyes, ears,
hands, nose, and critical thinking ability.
Always wash your hands prior to assessment
Interviewing (asking questions to determine the following):
Personal identity and demographics
Details of current condition (complaints, problems, reason for seeking medical care)
Medical history
Social history
Food and drug allergies
Height and weight
Expectation for hospitalization
Review Box 21-1, page 424-ways to foster rapport & communication
Use therapeutic communication techniques (review chapter 6)
INSPECTION - answer✔Purposeful observation of anything about the body that you can see
with naked eye or with use of equipment such as penlight, otoscope, etc...
Most frequently used assessment technique
PHYSICAL ASSESSMENT Exam Questions
With Correct Answers
Physical Assessment
Method for gathering health data - answer✔Assessment is 1st step of the nursing process and is
ongoing throughout the nurse-patient relationship.
It is process you use to collect physical data relevant to the patient's health.
Use four of your senses: sight, smell, hearing, and touch
Goal: To gather objective data about a client.
What is objective data? (measurable by nurse, classified as signs)
What is subjective data? (verbalized by patient, not directly measurable, classified as symptoms)
Clients are examined:
on admission (comprehensive, in depth)
briefly at the beginning of each shift (more focused)
any time the client's condition changes
When evaluating the effectiveness of nursing care
Anytime things do not "feel right"
PURPOSES of ASSESSMENT - answer✔Evaluate client's current physical condition
Detect early signs of developing health problems
Establish a baseline for future comparisons (done on admission)
Evaluate client's responses to medical and nursing interventions
Monitor for changes in body function
Detect specific body systems that need further assessment or testing
There are 5 basic techniques:
Inspection (look)
, ©THEBRIGHTSTARS 2024
Palpation (feel)
Percussion
Auscultation (listen)
Olfaction (smell)
3 Levels of Physical Assessment - answer✔1. Comprehensive Health Assessment
In-depth assessment of whole person (physical, mental, emotional, cultural, spiritual)
Data is collected through physical exam and interview
Generally done on admission to facility
2. Focused Assessment
Exam and interview regarding a specific body system (ex. Respiratory system)
Allows nurse to check only system related to patient's disease process or when performing
reassessment of a system in which abnormal findings were obtained earlier
3. Initial Head-to-Toe Shift Assessment
Quick overall assessment of patient's condition to establish baseline against which you can
compare later assessments (able to identify changes in pt.'s condition: improvement or
deterioration)
Focused assessment of the following systems in sequence from head to toe:
Neurological
Cardiovascular
Respiratory
Integumentary
Gastrointestinal
Genitourinary
Muscular
Skeletal
Also includes specific assessment of the patient's:
Vital signs, including pain and O2 saturation (SpO2)
Appearance
Speech
, ©THEBRIGHTSTARS 2024
Safety risk factors
Tubes and equipment
Comfort or complaints
Needs
Findings such as VS and from other systems will provide some info. about Immune System
Physical Assessment - answer✔Abnormal findings should be reassessed within 4 hours or
sooner depending on severity
Some abnormal findings are minor or may even be expected
Some abnormal findings may be totally unexpected and represent potentially serious conditions
Example: patient is admitted with upper respiratory infection and you note an occasional dry
cough. You instruct pt. to let you know if it gets worse. You would reassess the cough in 4 hrs. to
see if better, worse, or same.
Example: You assess a fever of 103 degrees. You need to take immediate action to treat fever
and reassess in one hour
Assessment Techniques - answer✔Most important tools you will need are your eyes, ears,
hands, nose, and critical thinking ability.
Always wash your hands prior to assessment
Interviewing (asking questions to determine the following):
Personal identity and demographics
Details of current condition (complaints, problems, reason for seeking medical care)
Medical history
Social history
Food and drug allergies
Height and weight
Expectation for hospitalization
Review Box 21-1, page 424-ways to foster rapport & communication
Use therapeutic communication techniques (review chapter 6)
INSPECTION - answer✔Purposeful observation of anything about the body that you can see
with naked eye or with use of equipment such as penlight, otoscope, etc...
Most frequently used assessment technique
