Podcast
Questions and Answers
Which examination technique involves tapping the patient's skin with short, sharp strokes?
Which examination technique involves tapping the patient's skin with short, sharp strokes?
When performing palpation, it is best to begin with deep palpation to quickly identify any masses or tenderness.
When performing palpation, it is best to begin with deep palpation to quickly identify any masses or tenderness.
False
What part of the stethoscope is best used for listening to low-pitched sounds like extra heart sounds?
What part of the stethoscope is best used for listening to low-pitched sounds like extra heart sounds?
The bell
______ is concentrated watching that's done 1st when you meet the patient.
______ is concentrated watching that's done 1st when you meet the patient.
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Match the following terms with their descriptions:
Match the following terms with their descriptions:
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What is the primary purpose of comparing the left and right sides of a patient’s body during inspection?
What is the primary purpose of comparing the left and right sides of a patient’s body during inspection?
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When performing auscultation, a noisy room can enhance the quality of the exam by providing a diverse range of sounds.
When performing auscultation, a noisy room can enhance the quality of the exam by providing a diverse range of sounds.
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Which of the following factors is NOT generally assessed using palpation?
Which of the following factors is NOT generally assessed using palpation?
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Which of the following instruments uses ultrasonic waves to detect difficult-to-hear sounds?
Which of the following instruments uses ultrasonic waves to detect difficult-to-hear sounds?
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Standard precautions are only applied when the patient has a confirmed infection.
Standard precautions are only applied when the patient has a confirmed infection.
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What is the most important step to decrease the risk of microorganism transmission?
What is the most important step to decrease the risk of microorganism transmission?
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For airborne precautions, in addition to standard precautions, a gown, gloves, and a _________ are required.
For airborne precautions, in addition to standard precautions, a gown, gloves, and a _________ are required.
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Match the following age groups to the appropriate examination considerations:
Match the following age groups to the appropriate examination considerations:
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Which of the following best describes how to begin a physical examination with a patient?
Which of the following best describes how to begin a physical examination with a patient?
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A penlight is used to funnel light into the ear canal.
A penlight is used to funnel light into the ear canal.
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You should rub an alcohol-based hand sanitizer for how many seconds for effective hand hygiene?
You should rub an alcohol-based hand sanitizer for how many seconds for effective hand hygiene?
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For droplet precautions, in addition to standard precautions, a _________ is required.
For droplet precautions, in addition to standard precautions, a _________ is required.
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Which of the following is NOT a generally accepted time for hand hygiene?
Which of the following is NOT a generally accepted time for hand hygiene?
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It is generally acceptable to have a school-age child remain in their street clothes during an exam.
It is generally acceptable to have a school-age child remain in their street clothes during an exam.
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What are the three types of transmission-based precautions?
What are the three types of transmission-based precautions?
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A _____ is used to test deep tendon reflexes.
A _____ is used to test deep tendon reflexes.
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Match the following PPE to the appropriate transmission-based precaution:
Match the following PPE to the appropriate transmission-based precaution:
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For an adolescent, the physical exam should be performed:
For an adolescent, the physical exam should be performed:
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Study Notes
Assessment Techniques & Safety
- Inspection: Initial visual assessment of the patient (general survey). Compare left and right sides of the body. Requires good lighting, exposure, and possibly instruments.
Palpation
- Palpation: Touch to assess factors like texture, temperature, moisture, organ location/size, swelling, vibration/pulsation, rigidity/spasticity, crepitation, lumps/masses, tenderness/pain.
- Start with light palpation to ease the patient.
Percussion
- Percussion: Tapping the skin with short, sharp strokes to assess underlying structures.
- Sounds indicate density:
- Dull: soft sound.
- Resonance: medium-loud sound.
- Hyperresonance: loud sound.
- Airy structures (lungs) produce louder sounds; dense structures (liver) produce softer sounds.
- Stationary hand avoids bony prominences; striking hand aims near the nail bed.
Auscultation
- Auscultation: Listening to body sounds (heart, blood vessels, lungs, abdomen).
- Diaphragm (flat surface): High-pitched sounds (breath, bowel, normal heart sounds).
- Bell (cup-like shape): Low-pitched sounds (extra heart sounds, murmurs).
- Keep room quiet, stethoscope warm, and wet excessive chest hair to minimize crackling sounds. Stethoscope should be placed directly on skin.
Equipment
- Otoscope: Light for ear canal and tympanic membrane.
- Ophthalmoscope: Light for internal eye structures.
- Tuning fork: Auditory screening and vibratory sensation.
- Percussion/reflex hammer: Deep tendon reflexes (DTRs).
- Doppler: Amplifies difficult-to-hear sounds (fetal heart tones).
- Penlight: Focused light source for inspection.
Standard Precautions
- Applied to all patients, regardless of infection status.
- Includes: hand hygiene, gloves, gowns, eye/face protection, respiratory hygiene/cough etiquette.
Hand Hygiene
- Essential for minimizing microorganism transmission.
- Before/after each patient encounter, after contact with body fluids/equipment, and after glove removal.
- Alcohol-based sanitizer: rub for 20-30 seconds.
Transmission-Based Precautions
- Additional precautions for infectious agents.
- Contact: direct contact (e.g., C. diff). Requires gown & gloves.
- Droplet: close respiratory contact (e.g., influenza). Requires surgical mask.
- Airborne: airborne agents (e.g., tuberculosis). Requires gown, respirator (N95), eye protection, gloves.
Physical Exam Process
- Start by touching the patient's hands (assessing skin color, nail beds, metacarpophalangeal joints) to ease the patient.
- May require position changes.
- Maintain patient privacy and prevent chilling with drapes.
- Provide brief, relevant patient education.
- Summarize findings, share information, and thank the patient. State next steps.
Developmental Considerations
- Infant: Examine 1-2 hours post-feeding. Nude. Warm hands. Use toys for distraction. Heart, lungs, abdomen first.
- Toddler: Difficult due to fear, dislike of restraint. Use caregiver for position changes. Security object. Greet caregiver. Non-threatening areas first. Offer choices. Involve caregiver.
- Preschool: Noninvasive areas first (head, eyes, ears, nose). Throat last. Cooperative, helpful. Explain steps. Allow playing with equipment.
- School-age: Cooperative, desiring approval. Sit/lay on table. May not need caregiver. Gown. Small talk. Equipment demonstration. Teaching about body function. Head-to-toe approach.
- Adolescent: Comfortable with themselves and peers. Exam without caregiver. Genitalia last. Focus on teaching healthy habits. Dress clothes allowed.
- Aging adult: Focus on meaning of life, adjust to changes. Use physical touch when appropriate. Adjust pace. Minimize position changes. Head-to-toe approach.
- Sick patient: Adapt to comfort level, mini-assessment if needed before full assessment.
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Description
This quiz covers fundamental assessment techniques used in healthcare, including inspection, palpation, percussion, and auscultation. Understanding these techniques is crucial for evaluating patients accurately and providing effective care. Challenge your knowledge and improve your clinical skills with this assessment quiz.
