Deck 24: Putting It All Together

Question 1

The sequence of the physical examination should be individualized to

A)minimize the number of times that the patient must change positions.
B)maximize the convenience of the examiner.
C)improve patient flow.
D)minimize the time the patient is in the room.
E)maximize patient movements to assess their mobility.

Answer 1

minimize the number of times that the patient must change positions.

Question 2

Examination of the patient in the lithotomy, or knee-chest, position includes

A)inspection for inguinal hernias.
B)palpation of anal sphincter tone.
C)percussion of pelvic structures.
D)stereognosis testing.
E)percussion of abdominal structures.

Answer 2

palpation of anal sphincter tone.

Question 3

The cranial nerves are usually assessed while the patient is in which position?

A)Left lateral
B)Supine
C)Sitting
D)Prone
E)Standing

Answer 3

Sitting

Question 4

At your first meeting with a patient, it is usually best to say

A)"Let's get to the point."
B)"I hope you will learn to trust me."
C)"Let me tell you what I can do for you."
D)"Tell me about yourself."
E)"What is the purpose of your visit today?"

Question 5

Which of the following statements accurately reflects the sensitivity and specificity of laboratory tests?

A)Sensitivity and specificity are not related.
B)Sensitivity and specificity are inversely correlated.
C)Sensitivity and specificity are directly correlated.
D)No test has 100% sensitivity and specificity.
E)The "gold standard" test has 100% sensitivity and specificity.

Question 6

Which of the following data are not part of your general inspection?

A)Dress and habitus
B)Sinus tenderness
C)Gait
D)Facial expression
E)Degree of relaxation

Question 7

As you greet the patient, which examination technique is first implemented?

A)Auscultation
B)Inspection
C)Measurements
D)Palpation
E)Percussion

Question 8

The reliability of health-related findings and observations is the responsibility of the

A)patient.
B)health care professionals.
C)attending physician.
D)patient and patient's family.
E)professional and the patient.

Question 9

Proprioception should be assessed while the patient is

A)prone.
B)supine.
C)seated.
D)standing.
E)left lateral.

Question 10

According to the usual examination procedure, you would first assist your patient to assume which position?

A)Lithotomy
B)Prone
C)Standing
D)Supine
E)Sitting

Question 11

When assessing the abdomen, one needs to expose the patient

A)from the waist down.
B)from the pubis to the epigastrium.
C)from the clavicles to the hips.
D)at no point during the examination.
E)in the entirety.

Question 12

An ophthalmoscopic eye examination involves

A)lens inspection.
B)near vision evaluation.
C)sclera observation.
D)visual field assessment.
E)assessing extraocular eye muscles.

Question 13

Which one of the following patient characteristics is most likely to limit patient reliability during history taking?

A)The patient's measured IQ is above average.
B)The patient is alert and oriented to time and place.
C)The patient's sensory deprivation
D)The patient speaks the same language as examiner.
E)The patient appears emotionally stable.

Question 14

Which of the following are examined with the patient in a reclining 45-degree position?

A)Bilateral hips and popliteal angles
B)Facial bones and cranial nerves V and VII
C)Cardinal fields of gaze
D)Oropharynx and thyroid gland placement
E)Jugular venous pulsation and pressure

Question 15

Which of the following is true regarding the relationship between the examiner and the patient?

A)It is the examiner's responsibility to help the patient understand that he or she is qualified to make decisions regarding health care.
B)The patient must trust the examiner completely.
C)The examiner-patient relationship is enhanced by ignoring cultural issues.
D)The patient is a full partner with the examiner.
E)The examiner-patient relationship should never have priority over strict information gathering.

Question 16

Which portion of the physical examination is best done with the patient standing?

A)Spinal
B)Rectal
C)Neck
D)Musculoskeletal
E)Chest

Question 17

Which patient position facilitates inspection of the chest and shoulders?

A)Sitting
B)Supine
C)Trendelenburg
D)Prone
E)Lithotomy

Question 18

Which of the following is most likely to enhance examiner reliability?

A)The examiner seeks confirmation from others when necessary.
B)The examiner is uncomfortable with his or her own skills.
C)The examiner believes he or she must always be correct.
D)The examiner prejudges the patient and family.
E)The examiners use of unselective technology.

Question 19

An examiner might be able to help a patient who seems uncomfortable with close contact during an examination by

A)acknowledging the discomfort.
B)backing away from the patient.
C)joking about the patient's discomfort.
D)moving briskly to completion.
E)deferring parts of the examination.

Question 20

To inspect the abdominal muscles, ask the

A)supine patient to raise the head.
B)standing patient to bend forward.
C)prone patient to raise the lower legs.
D)standing patient to stand on tiptoes.
E)standing patient to lean backward.

Question 21

In crying infants, it is often difficult to

A)perform tactile fremitus assessments.
B)determine lung expansion.
C)auscultate heart sounds.
D)visualize the pharynx.
E)assess facial symmetry.

Question 22

To promote your examination time with a cooperative child, your approach to the examination should be to

A)ask the parent to give the child a bottle during the examination.
B)sing songs with the child during the examination.
C)conduct the physical examination on the child while the parent is holding the child.
D)let the child play with examination room equipment to feel more comfortable.
E)have the parent place the child in the prone position on the examination table.

Question 23

The best way to ease the apprehension of a 3-year-old child before a physical examination is to

A)explain that you will be gentle.
B)have the parents leave the examination room.
C)encourage child's participation.
D)tell the child he or she will get a lollipop for good behavior.
E)hand the child a picture book.

Question 24

The greatest risk for potential health problems occurs in which age group?

A)Newborn
B)Toddler
C)School age
D)Adolescence
E)Young adult

Question 25

Observation of the child playing in the playroom provides information about which two systems?

A)Dermatologic and cardiovascular
B)Neurologic and musculoskeletal
C)Respiratory and ear, nose, and throat
D)Gastrointestinal and genitourinary
E)Endocrine and hematopoietic

Question 26

Which of the following is not assessed in a newborn's Apgar score?

A)Color
B)Heart rate
C)Pupil reactivity
D)Muscle tone
E)Respirations

Question 27

When you attempt to move a 10-month-old child from his mother's lap to the examination table, he screams loudly. Your best action is to

A)move the child to the examination table and proceed matter-of-factly with the examination.
B)perform the examination while the child is in the mother's lap.
C)ask the mother to get the child to stop crying.
D)defer the examination until another day.
E)have the mother place the child on the examination table.

Question 28

Functional assessment is most important during the examination of a(n)

A)adolescent.
B)infant.
C)older adult.
D)young adult.
E)toddler.

Question 29

The examination of a newborn should begin with

A)percussion.
B)palpation.
C)vital signs.
D)auscultation.
E)inspection.

Question 30

When conveying "bad" or distasteful news to the patient and family, it is best to

A)avoid provision of any information until the entire family is assembled.
B)provide minimal information permitted by the patient.
C)be specific in all details.
D)rely on medical jargon to minimize distress.
E)let the patient inform the family.

Question 31

A common method of estimating gestational age of a newborn is to assess

A)middle finger length.
B)creases on the sole of the foot.
C)umbilical placement.
D)visual acuity.
E)creases on the palm of the hand.

Question 32

Throughout the history and physical examination, the clinician should

A)concentrate on emotional issues.
B)follow an inflexible sequence.
C)maintain a matter-of-fact demeanor.
D)deal only with previously identified problems.
E)evaluate the whole patient.

Question 33

When conducting a geriatric assessment, basic activities of daily living (ADLs) include

A)bathing.
B)housekeeping.
C)medication compliance.
D)communication skills.
E)money management.