NR 302 EXAM 2 STUDY GUIDE
Chapter 8
1. Define and describe the technique of the 4 physical examination skills:
a. Inspection: concentrated watching, close careful scrutiny of a person’s
appearance. Always comes first. Compare the L and R sides of the body
together.
b. Palpation: use touch to assess texture, temp., moisture, organ location & size,
swelling, tenderness, pain, vibration, pulsation, rigidity/spasticity, crepitation.
c. Percussion: taping the skin with short, sharp, strokes to assess underlying
structures. The characteristic sound depicts the location, size & density of the
organ.
d. Auscultation: listening to the sounds of the body (heart, lungs, blood vessels and
abdomen)
2. Define the characteristics of the following percussion notes: (pitch, amplitude, quality,
duration)
a. Hyperresonance: low, louder, booming, longer (m=normal in child, abnormal in
adult such as in emphysema)
b. Tympany: high, loud, musical & drum like, sustained longest (over air filled
viscous in the stomach and intestines)
c. Dull: high, soft, muffled thud, short (dense organ as in liver or spleen.
d. Flat: high, very soft, a dead stop sound, absolute dullness, very short (no air
present such as over thigh muscle, bone or tumor)
3. Differentiate among light, and bimanual palpation.
a. Light: detects surface characterisitcs and accustom person to being touched
b. Bimanual: uses both hands to evelope certain body parts/structures (kidneys)
4. List the two end pieces of the stethoscope and the conditions for which each is best
suited.
a. Diaphragm: for high pitched sounds (breath, bowel, heart)
b. Bell: for soft, low pitched sounds (extra heart sounds, murmurs)
5. Describe the environmental conditions to consider in preparing the examination setting.
a. Eliminate room noise, keep exam room warm, private and well lit
6. List 4 situations in which you clean your hands promptly and thoroughly.
a. Before direct contact with pt
, b. After contact with blood, bodily fluids, wound dressing, etc..
c. Contact with pt skin
d. After removing gloves
7. Describe your own preparation as you encounter the patient for examination: your own
dress, your demeanor, safety/universal precautions, sequence of examination steps,
instructions to patient.
a. My dress would be neat and clean, well put together. My demeanor will be
pleasant, encouraging, and friendly. I will use PPE whenever touching a pt is
required as well as use hand hygiene before and after an examination. I would
introduce myself to the pt, tell them my title, what I will be doing, how the
procedure will be done and the time frame for the procedure. Get consent from
the pt before touching, and always thank them after wards. I will give the pt any
educational materials needed or requested.
8. What age- specific considerations would you make for the examination of the:
a. Infant: establish trust, parent must be present, 1-2 hr after feedin, use pacifier for
crying infants, offer toys, let older babies touch equipment (stethoscope, tongue
blade)
b. Toddler: let them sit in parents lap for the exam, have parent undress the child
c. Preschooler: 4-6 y/o can sit on the exam table, use short and simple explanations
d. School-age child: child can self undress, demonstrate equipement, exlplain how
the bodo works in simple terms, talk about school or family to break the ice
e. Adolescent: examine alone without parent, comminucate with care (don’t treat
like a child), focus on health promotion, give positive feedback about
development, genitalia exam done last and do quickly
f. Older adult: allow periods of rest, tough is important as other sense may be
diminished, they are adjusting to changes in physical strength and health
g. Acutely ill person: alter position to comfortable state, exam the problem areas
first, collect a mini database, then finish assessment after problem is resolved
Chapter 9
1. List the significant information considered in each of the 4 areas of a general survey-
physical appearance, body structure, mobility, and behavior.
a. Physical: age, sex, LOC, skin color, facial features
b. Body structure: Stature, nutrition, symmetry, posture, position, body build
c. Mobility: gait, ROM
d. Behavior: facial expression, mood and affect, speech, dress, personal hygiene
2. Describe the normal posture, body build, and proportions.
a. Pt laying or sitting comfortably erect as appropriate for age
b. Contur, proportions are correct, arm span equals height, body length from crown
to pubis is roughly equal to length from pubis to sole
Chapter 8
1. Define and describe the technique of the 4 physical examination skills:
a. Inspection: concentrated watching, close careful scrutiny of a person’s
appearance. Always comes first. Compare the L and R sides of the body
together.
b. Palpation: use touch to assess texture, temp., moisture, organ location & size,
swelling, tenderness, pain, vibration, pulsation, rigidity/spasticity, crepitation.
c. Percussion: taping the skin with short, sharp, strokes to assess underlying
structures. The characteristic sound depicts the location, size & density of the
organ.
d. Auscultation: listening to the sounds of the body (heart, lungs, blood vessels and
abdomen)
2. Define the characteristics of the following percussion notes: (pitch, amplitude, quality,
duration)
a. Hyperresonance: low, louder, booming, longer (m=normal in child, abnormal in
adult such as in emphysema)
b. Tympany: high, loud, musical & drum like, sustained longest (over air filled
viscous in the stomach and intestines)
c. Dull: high, soft, muffled thud, short (dense organ as in liver or spleen.
d. Flat: high, very soft, a dead stop sound, absolute dullness, very short (no air
present such as over thigh muscle, bone or tumor)
3. Differentiate among light, and bimanual palpation.
a. Light: detects surface characterisitcs and accustom person to being touched
b. Bimanual: uses both hands to evelope certain body parts/structures (kidneys)
4. List the two end pieces of the stethoscope and the conditions for which each is best
suited.
a. Diaphragm: for high pitched sounds (breath, bowel, heart)
b. Bell: for soft, low pitched sounds (extra heart sounds, murmurs)
5. Describe the environmental conditions to consider in preparing the examination setting.
a. Eliminate room noise, keep exam room warm, private and well lit
6. List 4 situations in which you clean your hands promptly and thoroughly.
a. Before direct contact with pt
, b. After contact with blood, bodily fluids, wound dressing, etc..
c. Contact with pt skin
d. After removing gloves
7. Describe your own preparation as you encounter the patient for examination: your own
dress, your demeanor, safety/universal precautions, sequence of examination steps,
instructions to patient.
a. My dress would be neat and clean, well put together. My demeanor will be
pleasant, encouraging, and friendly. I will use PPE whenever touching a pt is
required as well as use hand hygiene before and after an examination. I would
introduce myself to the pt, tell them my title, what I will be doing, how the
procedure will be done and the time frame for the procedure. Get consent from
the pt before touching, and always thank them after wards. I will give the pt any
educational materials needed or requested.
8. What age- specific considerations would you make for the examination of the:
a. Infant: establish trust, parent must be present, 1-2 hr after feedin, use pacifier for
crying infants, offer toys, let older babies touch equipment (stethoscope, tongue
blade)
b. Toddler: let them sit in parents lap for the exam, have parent undress the child
c. Preschooler: 4-6 y/o can sit on the exam table, use short and simple explanations
d. School-age child: child can self undress, demonstrate equipement, exlplain how
the bodo works in simple terms, talk about school or family to break the ice
e. Adolescent: examine alone without parent, comminucate with care (don’t treat
like a child), focus on health promotion, give positive feedback about
development, genitalia exam done last and do quickly
f. Older adult: allow periods of rest, tough is important as other sense may be
diminished, they are adjusting to changes in physical strength and health
g. Acutely ill person: alter position to comfortable state, exam the problem areas
first, collect a mini database, then finish assessment after problem is resolved
Chapter 9
1. List the significant information considered in each of the 4 areas of a general survey-
physical appearance, body structure, mobility, and behavior.
a. Physical: age, sex, LOC, skin color, facial features
b. Body structure: Stature, nutrition, symmetry, posture, position, body build
c. Mobility: gait, ROM
d. Behavior: facial expression, mood and affect, speech, dress, personal hygiene
2. Describe the normal posture, body build, and proportions.
a. Pt laying or sitting comfortably erect as appropriate for age
b. Contur, proportions are correct, arm span equals height, body length from crown
to pubis is roughly equal to length from pubis to sole
