NURS 190 Exam 2025 Graded A+

4 basic physical assessment techniques - - inspection Palpation Percussion Auscultation How to do a physical assessment on the abdomen? And why? - - inspection Auscultation Percussion Palpation - so that we DO NOT allow for hyperactive bowel sounds before auscultating What are the sensitive areas of the hand? - - • The finger pads are used for discrimination of underlying structures and functions such as pulses, superficial lymph nodes, or crepitus. • Vibrations (vibrations) are best perceived by the examiner when using the base of the fingers (metacarpophalangeal joints). • The ulnar surface of the hand, including the finger, is most sensitive to vibrations such as fremitus. • The palmar aspect of the fingers is used to determine position, consistency, texture, size of structures, pain, and tenderness. • The dorsal surface of the fingers is most sensitive to temperature. • The dominant hand is always more sensitive than the non-dominant hand. What is light palpation used for? - -Light palpation is used with the pads of the fingers to help assess the skin surface, pulses, textures, tenderness (1cm) What is deep palpation? - -Used to palpate abdomen and internal organs (2-4cm) What is contraindicated for deep palpation? - -Dissecting aneurysms, peritonitis, ectopic pregnancy What is percussion? - -tapping the person's skin with short, sharp strokes to assess underlying structures NURS 190 What is direct percussion? - -Technique of tapping the body with the fingertips of the dominant hand. What is direct percussion used to assess for? - -Adult sinuses What is blunt percussion? - -Non dominant hand is flat and dominant hand hits over non dominant with a fist What is blunt percussion used for? - -Assess for pain and tenderness in gallbladder, liver, and kidneys What is indirect percussion? - -It's the technique most commonly used (sounds are clearer & more easily interpreted). A hammer or tapping finger is used What is a tympany sound? - -loud, high pitched Where would you hear a tympanic sound? - -stomach or intestines What is a resonance sound? - -loud, low pitched, hollow Where would you hear a resonance sound? - -lungs What is a hyperresonance sound? - -loud, low pitched Where would you hear a hyper resonance sound? - -air is trapped in lungs, common among the elderly What is a dullness sound? - -soft, high-pitched Where would you hear a dullness sound? - -solid body organs- liver or stool-filled colon What is a flatness sound? - -soft, high-pitched Where would you hear a flatness sound? - -solid tissue- muscle and bone What is a goniometer? - -measures the degree of joint and flexion and extension What is the skin fold caliper? - -measure the thickness of subcutaneous tissue What is a transilluminator? - -detects blood, fluid, or masses in body cavities What are wood lamps? - -detects fungal infections of the skin What is a monofilament? - -Assesses neuropathy of diabetic patients NURS 190 NURS 190 NURS 190 What are the parts of the stethoscope? - -Binaurals (earpieces) Felxible tubing End piece (bell and diaphragm) Bell vs. Diaphragm - -Bell is for low pitch sounds (murmurs) Diaphragm is used for high pitch sounds (heart and lung sounds) Can you hear better with short or long tubing of the stethoscope? - -short tubing What is a doppler? - -Uses ultrasonic waves to detect sounds that are difficult to hear with a regular stethoscope Ex) fetal heart sounds and peripheral pulses that cannot be easily palpated What is an opthalmoscope? - -used to view internal structure of the eye What is an otoscope? - -inspects the external ear structures What should patients do before an examination? - -empty their bladder Remove clothing, jewelry, hair pieces, enamel What makes up the integumentary system? - -skin, hair, nails The cutaneous membrane is made up of what? - -Epidermis and dermis What is the epidermis? And what do they produce? - -outermost layer of skin About 25% of the cells in the stratum basale are melanocytes, which produce the skin pigment called melanin. What is the dermis? - -layer of connective tissue that lies just below the epidermis Collagen- gives skin toughness Elastin- elasticity What is subcutaneous tissue? AKA? - -Hypodermis Store's body's fat cells. Used for cushion and insulation What is eccrine? - -More numerous and more widely distributed. They produce a clear perspiration mostly made up of water and salts, which they release into funnel-shaped pores at the skin surface. What is apocrine? - -Found primarily in the axillary and anogenital regions. They are dormant until the onset of puberty. Apocrine glands produce a secretion made up of NURS 190 NURS 190 water, salts, fatty acids, and proteins, which is released into hair follicles. When apocrine sweat mixes with bacteria on the skin surface, it assumes a musky odor. Sebaceous glands - -secrete sebum (oil) into the hair follicles where the hair shafts pass through the dermis Arrector pili - -A muscle that causes the hair to contract and stand upright when a person is under stress or exposed to cold. Nails - -Thin plates of keratinized epidermal cells that shield the distal ends of the fingers and toe Protect the dorsal surface of the last bone of each toe and finger What is trichotillomania? - -hair pulling/twisiting disorder Some individuals with dark skin have increased pigmentation in the creases of the palms and soles, as well as yellow or brown-tinged sclerae. These are normal findings. - - Vitiligo - -It's patchy & depigmented areas over the face, neck, hands feet & body folds Most common among darker skin tones Severe disturbance of body image Pitting edema - -It's a decrease in skin mobility