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NUR-634 ADVANCED PHYSICAL
ASSESSMENT MIDTERM STUDY
GUIDE 2026/2027 ACTUAL
QUESTIONS WITH VERIFIED
ANSWERS.
Subjective Data - ANSWER--symptoms from the client's point
of view and include: feelings, perceptions, and concerns
-what the patient tells you
Objective Data - ANSWER--what the health professional
observes by inspecting, palpating, percussing, and auscultating
during the physical examination
-observed signs
Assessment - ANSWER--the clinical reasoning process that
interprets the patient's history and physical examination, singles
out identified problems, and movement from each problems to
its action plan
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Plan - ANSWER--incorporates patient education, changes in
medications, needed tests, referrals to other clinicians, and
return visits for counseling and support
-requires good interpersonal skills and sensitivity to the patients
goals, economic means, competing responsibilities, and family
struggles/dynamics
Percussion - ANSWER--a diagnostic procedure designed to
determine the density of a body part by the sound produced by
tapping the surface with the fingers
-use of the striking or plexor finger (usually the 3rd) to deliver a
rapid tap or blow against the distal pleximeter finger (usually
the distal 3rd finger of the left hand laid against the surface) to
evoke a sound wave
-the 5 sounds are resonant, flat, dull, hyper resonant, and
tympanic
-Resonant sounds are low pitched, hollow sounds heard over
normal lung tissue.
-Flat are normally heard over solid areas such as bones. thigh
-Dull or thudlike sounds are normally heard over dense areas
such as the heart or liver. Dullness replaces resonance when
fluid or solid tissue replaces air-containing lung tissues, such as
occurs with pneumonia, pleural effusions, or tumors.
-Hyperresonant sounds that are louder and lower pitched than
resonant sounds are normally heard when percussing the
chests of children and very thin adults. Hyperresonant sounds
may also be heard when percussing lungs hyperinflated with
air, such as may occur in patients with COPD, or patients
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having an acute asthmatic attack. An area of hyperresonance
on one side of the chest may indicate a pneumothorax.
-Tympanic sounds are hollow, high, drumlike sounds. Tympany
is normally heard over the stomach, but is not a normal chest
sound. Tympanic sounds heard over the chest indicate
excessive air in the chest, such as may occur with
pneumothorax.
Attributes of a Symptom - ANSWER--seven attributes
-OPQRST & Associated manifestations (anything else
accompanying it)
-onset, provocative/palliative, quality, region/radiation, severity,
timing
Talkative Challenging Patient Intervention - ANSWER--give 5-
10 minutes uninterrupted
-focus on and ask questions to what seems most important to
patient
-summarize concerns and focus on #1 concern today
-avoid impatience
Angry Challenging Patient Intervention - ANSWER--
acknowledge any involvement you may have in their anger and
make amends
NUR-634 ADVANCED PHYSICAL
ASSESSMENT MIDTERM STUDY
GUIDE 2026/2027 ACTUAL
QUESTIONS WITH VERIFIED
ANSWERS.
Subjective Data - ANSWER--symptoms from the client's point
of view and include: feelings, perceptions, and concerns
-what the patient tells you
Objective Data - ANSWER--what the health professional
observes by inspecting, palpating, percussing, and auscultating
during the physical examination
-observed signs
Assessment - ANSWER--the clinical reasoning process that
interprets the patient's history and physical examination, singles
out identified problems, and movement from each problems to
its action plan
,2 | Page
Plan - ANSWER--incorporates patient education, changes in
medications, needed tests, referrals to other clinicians, and
return visits for counseling and support
-requires good interpersonal skills and sensitivity to the patients
goals, economic means, competing responsibilities, and family
struggles/dynamics
Percussion - ANSWER--a diagnostic procedure designed to
determine the density of a body part by the sound produced by
tapping the surface with the fingers
-use of the striking or plexor finger (usually the 3rd) to deliver a
rapid tap or blow against the distal pleximeter finger (usually
the distal 3rd finger of the left hand laid against the surface) to
evoke a sound wave
-the 5 sounds are resonant, flat, dull, hyper resonant, and
tympanic
-Resonant sounds are low pitched, hollow sounds heard over
normal lung tissue.
-Flat are normally heard over solid areas such as bones. thigh
-Dull or thudlike sounds are normally heard over dense areas
such as the heart or liver. Dullness replaces resonance when
fluid or solid tissue replaces air-containing lung tissues, such as
occurs with pneumonia, pleural effusions, or tumors.
-Hyperresonant sounds that are louder and lower pitched than
resonant sounds are normally heard when percussing the
chests of children and very thin adults. Hyperresonant sounds
may also be heard when percussing lungs hyperinflated with
air, such as may occur in patients with COPD, or patients
, 3 | Page
having an acute asthmatic attack. An area of hyperresonance
on one side of the chest may indicate a pneumothorax.
-Tympanic sounds are hollow, high, drumlike sounds. Tympany
is normally heard over the stomach, but is not a normal chest
sound. Tympanic sounds heard over the chest indicate
excessive air in the chest, such as may occur with
pneumothorax.
Attributes of a Symptom - ANSWER--seven attributes
-OPQRST & Associated manifestations (anything else
accompanying it)
-onset, provocative/palliative, quality, region/radiation, severity,
timing
Talkative Challenging Patient Intervention - ANSWER--give 5-
10 minutes uninterrupted
-focus on and ask questions to what seems most important to
patient
-summarize concerns and focus on #1 concern today
-avoid impatience
Angry Challenging Patient Intervention - ANSWER--
acknowledge any involvement you may have in their anger and
make amends
