NUR-634 ADVANCED PHYSICAL
ASSESSMENT MIDTERM STUDY
GUIDE 2025 ACTUAL VERIFIED
STUDY QUESTIONS AND ANSWERS
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.
Attributes of a Symptom - ANSWER--seven attributes
-OPQRST & Associated manifestations (anything else accompanying it)
-onset, provocative/palliative, quality, region/radiation, severity, timing
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
ASSESSMENT MIDTERM STUDY
GUIDE 2025 ACTUAL VERIFIED
STUDY QUESTIONS AND ANSWERS
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.
Attributes of a Symptom - ANSWER--seven attributes
-OPQRST & Associated manifestations (anything else accompanying it)
-onset, provocative/palliative, quality, region/radiation, severity, timing
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
