Physical Examination Purpose
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What is the primary purpose of gathering baseline data about a patient's health through physical examination?

  • To evaluate the effectiveness of care interventions
  • To establish a basis for future comparisons and evaluations (correct)
  • To identify potential risks for alterations in health
  • To make clinical judgments about a patient's changing health status

    • Which of the following is a purpose of physical examination that is closely related to the nursing history?

  • To make clinical judgments about a patient's changing health status
  • To supplement, confirm, or refute data obtained in the nursing history (correct)
  • To evaluate the physiological outcomes of care
  • To identify risks for alterations in health

    • What is the ultimate goal of making clinical judgments about a patient's changing health status through physical examination?

  • To identify potential risks for alterations in health
  • To develop a treatment plan
  • To manage the patient's health status (correct)
  • To evaluate the effectiveness of care interventions

    • What is the primary benefit of using physical examination to confirm or identify risks for alterations in health?

    <p>It allows healthcare professionals to identify potential health problems early</p> Signup and view all the answers

    Which of the following is a purpose of physical examination that is focused on the evaluation of care effectiveness?

    <p>To evaluate the physiological outcomes of care</p> Signup and view all the answers

    Which physical examination technique involves the use of senses to detect unusual odors?

    <p>Olfaction</p> Signup and view all the answers

    What is the primary objective of a head-to-toe review during physical examination?

    <p>To provide a thorough assessment of each body system</p> Signup and view all the answers

    Which physical examination technique involves tapping on the body surface to produce sounds?

    <p>Percussion</p> Signup and view all the answers

    What is the primary benefit of using a combination of physical examination techniques?

    <p>To provide a comprehensive assessment of the patient's condition</p> Signup and view all the answers

    What type of information is obtained through physical examination?

    <p>Objective information</p> Signup and view all the answers

    What is the term for the abnormal sound heard through a stethoscope due to turbulent blood flow in an artery?

    <p>Bruit</p> Signup and view all the answers

    What is the term for the loss of ability to understand or express speech caused by brain damage?

    <p>Aphasia</p> Signup and view all the answers

    What is the term for the natural substance that cleans, protects, and lubricates the external ear canal?

    <p>Cerumen</p> Signup and view all the answers

    What is the term for the white or gray rings that appear on the outer region of the cornea in aging?

    <p>Arcus Senilis</p> Signup and view all the answers

    What is the term for the wasting away of cells, usually due to underuse?

    <p>Atrophy</p> Signup and view all the answers

    What is the term for the condition characterized by a bluish coloring of the skin and mucus membranes due to inadequate oxygenation?

    <p>Cyanosis</p> Signup and view all the answers

    What is the term for the crackling sound made in breathing by a person with an inflamed lung, detected with a stethoscope?

    <p>Crepitation</p> Signup and view all the answers

    What is the term for the palpable or audible crackling, grating, or crunching sensation that occurs when air is pushed through the soft tissue in the chest?

    <p>Crepitus</p> Signup and view all the answers

    What is the term for a state of deep unconsciousness for a prolonged or indefinite period, especially as a result of severe injury or illness?

    <p>Comatose</p> Signup and view all the answers

    What is the term for an excessive amount of perspiration, such as when the entire skin is moist?

    <p>Diaphoresis</p> Signup and view all the answers

    What is the term for the accumulation of fluid in extracellular spaces?

    <p>Edema</p> Signup and view all the answers

    What is the term for the redness of the skin accompanied by warmth?

    <p>Erythema</p> Signup and view all the answers

    Which condition is characterized by the eyelid turning outward?

    <p>Ectropion</p> Signup and view all the answers

    What is the term for the collection of blood in subcutaneous tissues that causes a purplish discoloration?

    <p>Ecchymosis</p> Signup and view all the answers

    What is the term for the inversion or inward turning of the eyelid margin?

    <p>Entropion</p> Signup and view all the answers

    What is the primary purpose of assessing extraocular movements in a patient?

    <p>To identify any issues with eye movement or muscle weakness</p> Signup and view all the answers

    A patient has a Glasgow Coma Scale (GCS) score of 7. What can be inferred about the patient's condition?

    <p>The patient has a severe brain injury and is in a coma</p> Signup and view all the answers

    What is the term for the abnormal sounds heard when blood flows through the heart?

    <p>Murmurs</p> Signup and view all the answers

    What is the term for swollen and inflamed veins in the rectum and anus?

    <p>Hemorrhoids</p> Signup and view all the answers

    What is the term for the yellow appearance of the skin?

    <p>Jaundice</p> Signup and view all the answers

    What is the primary characteristic of a patient with lethargic behavior?

    <p>Arousable by gentle shaking and saying the patient's name</p> Signup and view all the answers

    What is the main effect of paralytic ileus on bowel activity?

    <p>Impaired motor activity</p> Signup and view all the answers

    What is the primary cause of pallor in an individual?

    <p>Decrease in circulating blood hemoglobin</p> Signup and view all the answers

    What is the characteristic eye movement associated with nystagmus?

    <p>All of the above</p> Signup and view all the answers

    What is the typical cause of paralytic ileus in patients who have undergone surgery?

    <p>Anesthesia used during surgery</p> Signup and view all the answers

    What is the characteristic of the pupils in a patient with PERRLA?

    <p>Equal, round, and reactive to light</p> Signup and view all the answers

    What is the location of the Point of Maximum Impulse (PMI) on the chest wall?

    <p>5th intercostal space, left midclavicular line</p> Signup and view all the answers

    What is the term for the type of bleeding characterized by small, purplish hemorrhagic spots on the skin?

    <p>Petechiae</p> Signup and view all the answers

    What is the term for the inflammation of a vein?

    <p>Phlebitis</p> Signup and view all the answers

    What is the term for the type of hearing loss due to aging?

    <p>Presbycusis</p> Signup and view all the answers

    What is the term for the drooping of the upper eyelid?

    <p>Ptosis</p> Signup and view all the answers

    What is the term for the vibration caused by blood flowing through the fistula?

    <p>Thrill</p> Signup and view all the answers

    What is the term for the tension of the skin determined by its hydration?

    <p>Turgor</p> Signup and view all the answers

    What is the term for a state of being unconscious most of the time?

    <p>Stuporous</p> Signup and view all the answers

    What is the term for impaired near vision due to aging?

    <p>Presbyopia</p> Signup and view all the answers

    What is the primary purpose of gathering baseline data about a patient's health through physical examination?

    <p>To create a foundation for future comparisons and assessments</p> Signup and view all the answers

    What is the primary benefit of using physical examination to confirm or identify risks for alterations in health?

    <p>To identify potential health problems early on</p> Signup and view all the answers

    What is the primary purpose of reassessing a patient's health status during physical examination?

    <p>To notice changes in the patient's health status</p> Signup and view all the answers

    What is the primary focus of physical examination when evaluating the effectiveness of care?

    <p>To evaluate the physiological outcomes of care</p> Signup and view all the answers

    What is the ultimate goal of making clinical judgments about a patient's changing health status through physical examination?

    <p>To make informed decisions about patient care</p> Signup and view all the answers

    What is the primary purpose of ensuring good lighting during physical assessment?

    <p>To assess the color, texture, and moisture of surfaces</p> Signup and view all the answers

    What is the primary consideration when preparing the equipment for physical assessment?

    <p>Ensuring the equipment is clean and warm</p> Signup and view all the answers

    Why is it essential to expose only the body parts to be inspected during physical assessment?

    <p>To promote patient modesty and dignity</p> Signup and view all the answers

    What is the primary benefit of considering the patient's age, gender, culture, health status, mobility, and privacy during physical assessment?

    <p>It ensures that the assessment is tailored to the patient's unique needs and circumstances</p> Signup and view all the answers

    Why is it essential to ensure the patient's comfort and relaxation during physical assessment?

    <p>It enhances the patient's ability to cooperate with the assessment process</p> Signup and view all the answers

    What is the primary purpose of comparing each area of the body with the opposite side during inspection?

    <p>To detect asymmetry</p> Signup and view all the answers

    What is the term for the technique of examining the body by feeling with the fingers or hand?

    <p>Palpation</p> Signup and view all the answers

    What is the purpose of using a combination of physical examination techniques?

    <p>To increase the accuracy of assessment findings</p> Signup and view all the answers

    What is the term for the technique of tapping on the body surface to produce sounds?

    <p>Percussion</p> Signup and view all the answers

    What is the term for listening to sounds within the body, such as heart and lung sounds?

    <p>Auscultation</p> Signup and view all the answers

    What type of sound is typically heard over normal, healthy lung tissue?

    <p>Resonance</p> Signup and view all the answers

    What is the term for the soft, high-pitched, thud-like sound that can be generally heard over dense organs, such as the liver?

    <p>Dullness</p> Signup and view all the answers

    What is the term for the loud, booming sound, usually heard over hyperinflated lung, as in patients with emphysema?

    <p>Hyperresonance</p> Signup and view all the answers

    What is the term for the high-pitch, drum-like sound, usually heard over the distended abdomen (stomach or abdomen filled with gas)?

    <p>Tympany</p> Signup and view all the answers

    What is the term for the soft, high-pitched sound, generally heard over bones, muscles, and tumors?

    <p>Flatness</p> Signup and view all the answers

    What is auscultation in the context of physical examination?

    <p>Listening to sounds within the body, such as heart and lung sounds</p> Signup and view all the answers

    What characteristics of sounds are evaluated during auscultation?

    <p>Pitch, loudness, and duration</p> Signup and view all the answers

    When is auscultation performed during physical examination?

    <p>First, except during abdominal examination</p> Signup and view all the answers

    What is the importance of auscultation in physical examination?

    <p>To listen to internal sounds</p> Signup and view all the answers

    What is the benefit of evaluating the characteristics of sounds during auscultation?

    <p>To identify abnormalities in internal organs</p> Signup and view all the answers

    What is the primary reason for positioning the patient during physical examination?

    <p>To expose the body part being assessed</p> Signup and view all the answers

    What is the primary psychological preparation technique for patients before an examination?

    <p>Providing detailed explanations of the examination procedure</p> Signup and view all the answers

    What is the primary benefit of maintaining patient privacy during physical examination?

    <p>Reducing anxiety and psychological distress</p> Signup and view all the answers

    What is the primary purpose of explaining the examination procedure to the patient?

    <p>To reduce anxiety and promote relaxation</p> Signup and view all the answers

    Why is it essential to expose only the body part being assessed during physical examination?

    <p>To maintain privacy and warmth</p> Signup and view all the answers

    Which physical examination technique is used to assess the level of consciousness?

    <p>Glasgow Coma Scale rating</p> Signup and view all the answers

    What is the term for the inspection of the skin, including color, temperature, vascularity, lesions, and ABCDEs of melanoma?

    <p>Integumentary examination</p> Signup and view all the answers

    What is the purpose of inspecting and palpating the neck during physical examination?

    <p>To evaluate jugular venous distension (JVD) and range of motion (ROM)</p> Signup and view all the answers

    What is the term for the technique of examining the thorax and breasts?

    <p>Inspection and palpation of the thorax and breasts</p> Signup and view all the answers

    What is the purpose of assessing memory and language during the neurological examination?

    <p>To assess the patient's mental status</p> Signup and view all the answers

    What is the term for the technique of listening to sounds within the body, such as heart and lung sounds?

    <p>Auscultation</p> Signup and view all the answers

    During physical assessment, what is the purpose of inspecting and palpating the abdomen?

    <p>To palpate for tenderness and percussion</p> Signup and view all the answers

    What is the primary focus of assessing the upper and lower extremities during physical examination?

    <p>To identify bruits or stenosis through auscultation</p> Signup and view all the answers

    What is the purpose of percussing the abdomen during physical assessment?

    <p>To examine the four quadrants of the abdomen</p> Signup and view all the answers

    During physical examination, what is the primary purpose of inspecting the lungs?

    <p>To auscultate lung sounds in at least 9 different locations</p> Signup and view all the answers

    What is the primary focus of inspecting the heart during physical examination?

    <p>To auscultate heart sounds and identify any bruits or stenosis</p> Signup and view all the answers

    What is the typical range of pulse rate in a normal adult?

    <p>60-100</p> Signup and view all the answers

    What is the characteristic of the skin in a normal adult?

    <p>Warm, dry, and intact</p> Signup and view all the answers

    What is the normal range of respirations in a normal adult?

    <p>12-20</p> Signup and view all the answers

    What is the characteristic of the joints in a normal adult?

    <p>Bilaterally equal in size, shape, and color</p> Signup and view all the answers

    What is the typical characteristic of the facial features in a normal adult?

    <p>Symmetrical facial features</p> Signup and view all the answers

    What is the characteristic of the chest contour during a normal physical examination?

    <p>Symmetric</p> Signup and view all the answers

    What is the characteristic of the breath sounds heard in the peripheral lung fields?

    <p>Vesicular</p> Signup and view all the answers

    What is the characteristic of the heart sounds heard during a normal physical examination?

    <p>Lub-dub</p> Signup and view all the answers

    What is the characteristic of the skin over the ribs, scapula, and heart and liver during a normal physical examination?

    <p>Dull</p> Signup and view all the answers

    What is the characteristic of the lymph nodes during a normal physical examination?

    <p>Non-palpable</p> Signup and view all the answers

    What is the characteristic of the abdomen during a normal physical examination?

    <p>Soft and relaxed</p> Signup and view all the answers

    What is the normal age-related physical change in older adults in the Musculoskeletal System?

    <p>Loss of muscle mass and strength</p> Signup and view all the answers

    What is the normal age-related physical change in older adults in the Integumentary System?

    <p>Wrinkles, dryness, scaling, and decreased turgor</p> Signup and view all the answers

    What is the normal age-related physical change in older adults in the Neurologic System?

    <p>Slower thought processes and verbal responses</p> Signup and view all the answers

    What is the normal age-related physical change in older adults in the Head and Neck?

    <p>Decreased color and peripheral vision</p> Signup and view all the answers

    What is the term for the age-related hearing loss in older adults?

    <p>Presbycusis</p> Signup and view all the answers

    What is a characteristic of the thorax in an older adult?

    <p>Increased anteroposterior chest diameter</p> Signup and view all the answers

    What is a common finding in the lungs of older adults?

    <p>Increased anteroposterior chest diameter</p> Signup and view all the answers

    What is a characteristic of the heart in an older adult?

    <p>Difficult to palpate apical pulse</p> Signup and view all the answers

    What is a characteristic of the upper extremities in an older adult?

    <p>More prominent and tortuous blood vessels</p> Signup and view all the answers

    What is a characteristic of the abdomen in an older adult?

    <p>Decreased abdominal tone</p> Signup and view all the answers

    What is a characteristic of the lower extremities in an older adult?

    <p>More prominent and tortuous blood vessels</p> Signup and view all the answers

    What is the primary purpose of performing mole/skin checks in patients?

    <p>To identify abnormal skin lesions</p> Signup and view all the answers

    What is a common self-screening examination performed by patients at home?

    <p>Breast and testicular exams</p> Signup and view all the answers

    What is the significance of the ABCDEs of moles in self-screening examinations?

    <p>They are used to identify abnormal skin lesions</p> Signup and view all the answers

    Why are self-screening examinations important for patients?

    <p>To identify abnormal skin lesions and detect cancer early</p> Signup and view all the answers

    What is the primary benefit of performing self-screening examinations regularly?

    <p>To improve treatment outcomes for cancer</p> Signup and view all the answers

    When conducting a physical assessment, what is the primary consideration when dealing with patients from diverse cultural backgrounds?

    <p>Being familiar with the general health beliefs and practices of the patient's culture</p> Signup and view all the answers

    Why is it essential for nurses to be aware of cultural differences in communication styles during physical assessment?

    <p>To avoid misinterpreting nonverbal cues</p> Signup and view all the answers

    When working with patients from diverse cultural backgrounds, what should a nurse avoid doing?

    <p>Making stereotypes about cultural practices</p> Signup and view all the answers

    What is the primary benefit of being aware of cultural differences in health beliefs and practices during physical assessment?

    <p>Providing culturally sensitive care</p> Signup and view all the answers

    What is the ultimate goal of considering cultural differences during physical assessment?

    <p>Delivering patient-centered care that respects diversity</p> Signup and view all the answers

    During a routine bedside head-to-toe physical assessment, what is the primary aspect of vital signs that is evaluated?

    <p>Temperature, pulse, respirations, and blood pressure</p> Signup and view all the answers

    What is the primary focus of the psychosocial aspect of the physical assessment?

    <p>Behavior and affect</p> Signup and view all the answers

    During the head-to-toe physical assessment, what is evaluated in the 'head, eyes, ears, nose' component?

    <p>Pupils, mouth, carotid arteries, and facial color</p> Signup and view all the answers

    What is the primary purpose of ensuring the patient's safety during the physical assessment?

    <p>To prevent falls and hazards</p> Signup and view all the answers

    What is the primary focus of the 'vital signs' component of the physical assessment?

    <p>Measuring the patient's temperature, pulse, respirations, and blood pressure</p> Signup and view all the answers

    What is primarily assessed during the evaluation of the chest?

    <p>Respirations, heart sounds, and lung sounds</p> Signup and view all the answers

    What is evaluated in the abdominal assessment?

    <p>Bowel sounds, tenderness, and distension</p> Signup and view all the answers

    What is assessed in the upper and lower extremities evaluation?

    <p>Skin, color, pulses, and temperature</p> Signup and view all the answers

    What is the primary focus of the therapeutic devices evaluation?

    <p>Peripheral and central venous access devices</p> Signup and view all the answers

    What is evaluated in the activity and movement pattern assessment?

    <p>Movement and ambulation, ability to move in bed</p> Signup and view all the answers

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