NUR-634 Advanced Physical
Assessment Midterm Study Guide with
questions and well verified answers
actual exam!!! 2026
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
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 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.
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
-avoid reinforcing criticism of other clinicians
-validate their feelings without agreeing with their reasons
-ensure a safe environment, alert staff/security
-stay calm and avoid being confrontational
-keep a relaxed and nonthreatening posture
Silent Challenging Patient Intervention - ANSWER --be attentive and respectful and
encourage patient to continue when they are ready
-watch for nonverbal cues such as difficulty controlling emotions
-watch for signs of depression
-ask why they are quiet
Assessment Midterm Study Guide with
questions and well verified answers
actual exam!!! 2026
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
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 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.
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
-avoid reinforcing criticism of other clinicians
-validate their feelings without agreeing with their reasons
-ensure a safe environment, alert staff/security
-stay calm and avoid being confrontational
-keep a relaxed and nonthreatening posture
Silent Challenging Patient Intervention - ANSWER --be attentive and respectful and
encourage patient to continue when they are ready
-watch for nonverbal cues such as difficulty controlling emotions
-watch for signs of depression
-ask why they are quiet
