NBCE Part 4 Clinical & Set-Ups| 279 QUESTIONS| WITH COMPLETE SOLUTIONS

NBCE Part 4 Clinical & Set-Ups| 279 QUESTIONS|
WITH COMPLETE SOLUTIONS
Case History - CORRECT ANSWERS - - Identifying Data (name, age, etc.)
- Chief Complaint
- Present Illness (OPPQRST)
- Past History
- (SHITM)
- Family History
- Occupational History
- Social History
- Review of Systems

Vitals - CORRECT ANSWERS - - Temperature
- Pulse
- Respiration
- Blood Pressure
- Height
- Weight

Blood Pressure - CORRECT ANSWERS - How to do Blood Pressure:
1. Patient seated
2. Arm elevated (doctor braces patient's wrist)
3. Empty air from cuff, wrap tight on patient
4. Palpatory systolic (on the way up until disappears)
5. Place stethoscope in ears
6. Pump 30-40 higher
7. Auscultate to O (recording true systolic/diastolic values)

Physical Exam - CORRECT ANSWERS - - Skin Exam XXX
- Eye Exam
- Nose Exam XXX
- Ear Exam
- Mouth & Throat Exam XXX
- Endocrinology Exam XXX
- Genital Exam XXX
- Lymphatic Exam
- Peripheral Exam
- Lung Exam
- Heart Exam
- Abdominal Exam

Eye Exam: CN III, IV, VI - CORRECT ANSWERS - Cardinal Field of Gaze

Eye Exam: CN II & III - CORRECT ANSWERS - - Direct (ipsilateral eye)

,- Indirect ( contralateral eye)

Eye Exam: CN II & III Accommodation reflex - CORRECT ANSWERS -
Accommodation: Converge & Constrict

Follow up questions to a + Eye Exam? - CORRECT ANSWERS - - headaches?
- trouble reading?
- last eye exam?
- normally wear glasses/contacts?

Ear Exam: Weber & Rhinne - CORRECT ANSWERS - - Preform WEBER first
- Then preform Rhinne on the EAR that CAN HEAR
- *Every case has been Meinier's disease* (ask: ringing?, deafness?, dizzyness?)

Lymphatic Exam: palpation - CORRECT ANSWERS - palpate w/ 3 fingers

- *Neck* (EENT questions)
- Supraclavicular (ROS)
- *Axillary* (breast, chest, and arms questions) 4 walls
- Inguinal (legs/STDs)

Peripheral Vascular Exam (PVE): upper extremity palpation - CORRECT ANSWERS -
*3 of them/ Seated*
- Unlar
- Radial
- Subclavian
- Carotid
- Temporal

Peripheral Vascular Exam (PVE): lower extremity palpation - CORRECT ANSWERS -
*Supine*
- Femoral
- Popliteal
- Posterior Tibial
- Dorsal Pedis

Peripheral Vascular Exam (PVE): special tests - CORRECT ANSWERS - - Capillary
Refill
- Allen's Test
- Claudication Test
- Buerger's test
- Homan's test

Peripheral Vascular Exam (PVE): auscultation - CORRECT ANSWERS - *BELL*
- @ carotid bifurcation (c4)
- bruit

, -turbulance

Heart Exam: palpate & auscultate valve sites - CORRECT ANSWERS - *A* - 2nd right
intercostal space (parasternal)
*P* - 2nd left intercostal space (parasternal)
E - *NOT A VALVE*
*T* - 4th/5th left intercostal space ( parasternal)
*M* - 5th left intercostal space (midclavicular) *location of the apical pulse*

Heart Exam: PERCUSSION (borders of the heart) - CORRECT ANSWERS - a) Left
side (lateral to medial) 3, 4, & 5 intercostal spaces
b) Right side (superior to inferior) right sternal border

Abdominal Aorta Exam - CORRECT ANSWERS - Auscultate with bell

Palpate lateral to medial

Lung Exam: Posterior Thoracic Palpation - CORRECT ANSWERS - *SEATED*
- Respiratory Excursions/expansion
- *Tactile Fremitus* ("99"):

Lung Exam: Posterior Thoracic Percussion - CORRECT ANSWERS - "Scan APEX (3
taps)

*Sounds*
- Flat: tumor/collapse
- Dull: fluid
- Resonant: normal
- Hyperresonant: Air (COPD)

*Diaphragmatic Expansion*

Lung Exam: Posterior Thoracic Auscultation - CORRECT ANSWERS - - deep breath
- whispered pectoriloquy ("1,2,3")
- bronchophony ("99")
- egophony ("E")

Lung Exam: Anterior Thorax - CORRECT ANSWERS - - Fremitus ("99")
- Percussion
- Auscultation

Abdominal Exam: auscultation - CORRECT ANSWERS - - Bowel sounds (diaphragm)
indicates: borborygmi

- Vessels (bell) aorta, renal & iliac; indicates: vessel turbulence