Deck 3: Examination Techniques and Equipment

Question 1

One recommendation to prevent latex allergy is to

A)wear latex gloves frequently to reduce sensitivity.
B)forcefully snap off examination gloves to remove excess powder from the gloves.
C)wash hands with mild soap after removing gloves and then dry the hands thoroughly.
D)use well-powdered gloves with an increased protein content.
E)use oil-based creams or lotions before donning gloves.

Answer 1

wash hands with mild soap after removing gloves and then dry the hands thoroughly.

Question 2

The use of secondary, tangential lighting is most helpful in the detection of

A)variations in skin color.
B)enlarged tonsils.
C)foreign objects in the nose or ear.
D)variations in contour of the body surface.
E)variations in texture and mobility.

Answer 2

variations in contour of the body surface.

Question 3

You are conducting a head to toe examination as part of a patient's preventive health assessment. The room has adequate lighting, and you have access to both sides of the examining table. What position should you assume while conducting this examination?

A)Behind the patient
B)To the left side of the patient
C)Seated in a chair in front of the patient
D)To the right side of the patient
E)Standing in front of the patient

Answer 3

To the right side of the patient

Question 4

Which examination technique should be used first?

A)Deep palpation
B)Inspection
C)Percussion
D)Auscultation
E)Light palpation

Question 5

During percussion, the downward snap of the striking fingers should originate from the

A)wrist.
B)forearm.
C)shoulder.
D)interphalangeal joint.
E)elbow.

Question 6

Standard Precautions apply to all patients

A)with bloodborne infections.
B)with infected, draining wounds.
C)in intensive care units.
D)receiving care in hospitals.
E)believed to have an infectious disease.

Question 7

When percussing, a dull tone is expected to be heard over

A)most of the abdomen.
B)emphysemic lungs.
C)the liver.
D)healthy lung tissue.
E)an empty stomach.

Question 8

According to the guidelines for Standard Precautions

A)hand washing is not needed between tasks and procedures on the same patient.
B)the caregiver's hands should be washed only after touching blood products with ungloved hands and after caring for infectious patients.
C)the caregiver's hands should be washed only after working with patients who are thought to be infectious.
D)the caregiver's hands should be washed after touching any body fluids and contaminated items regardless of whether gloves are worn.
E)the caregiver's hands should be washed only after touching body fluids with ungloved hands and between patient contact.

Question 9

Which technique is commonly used to elicit tenderness arising from the liver, gallbladder, or kidneys?

A)Finger percussion
B)Only indirect percussion techniques are ever used to elicit tenderness.
C)Fist percussion
D)Thumb percussion
E)Palmer percussion

Question 10

The degree of percussion tone is determined by the density of the medium through which the sound waves travel. Which statement is true regarding the relationship between density of the medium and percussion tone?

A)The more dense the medium, the louder the percussion tone.
B)The less dense the medium, the louder the percussion tone.
C)The more hollow the area percussed, the quieter the percussion tone.
D)Percussion over bony areas produces the loudest percussion tones.
E)Percussion tones are produced by the structure immediately beneath the skin.

Question 11

Expected normal percussion tones include

A)dullness over the lungs.
B)hyperresonance over the lungs.
C)tympany over an empty stomach.
D)flatness over an empty stomach.
E)resonance over the liver.

Question 12

When using mediate or indirect percussion, which technique is appropriate?

A)Place the palmar surface of the nondominant hand on the body surface with the fingers held together.
B)Place the palmar surface of the nondominant hand on the body surface with the fingers slightly spread apart.
C)Mediate or indirect percussion involves striking the finger or hand directly against the body.
D)Place the ulnar surface of the nondominant hand on the body surface with the fingers slightly spread apart.
E)Place the ulnar surface of the nondominant hand on the body surface with the fingers together.

Question 13

A nonambulatory 80-year-old male patient tells the female nurse that he feels like he is having drainage from his rectum. Which initial nursing action is appropriate?

A)Drape the patient and observe the rectal area.
B)Tell the patient that his physician will be notified of his problem.
C)Tell the patient that you will ask the male nurse on the next shift to check on the problem.
D)Give the patient an ice pack to apply to the area.
E)Give the patient a specimen cup to collect the drainage.

Question 14

The dorsal surface of the hand is most often used for the assessment of

A)crepitus.
B)thrills.
C)texture.
D)vibration.
E)temperature.

Question 15

Which technique is used during the history taking and the physical examination process?

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

Question 16

Which part of the examiner's hand is best for palpating vibration?

A)Dorsal surface
B)The thumb
C)Fingertips
D)Ulnar surface and base of the fingers
E)Finger pads

Question 17

Which patient position is useful for auscultating heart tones?

A)Lithotomy
B)Dorsal recumbent
C)Left lateral recumbent
D)Right Sims
E)Prone

Question 18

Which patient is at the highest risk for the development of latex allergy?

A)A new patient who has no chronic illness and has never been hospitalized
B)A patient who has had multiple procedures or surgeries
C)A patient who is allergic to eggs
D)A patient who is allergic to contrast dye
E)A patient who is a vegetarian

Question 19

Guidelines for Standard Precautions indicate that mask and eye protection or a face mask should be worn while performing

A)suture removal.
B)trachea care and suctioning.
C)wet-to-dry dressing changes.
D)patient bathing.
E)tube feedings.

Question 20

When conducting the abdominal examination, after you inspect, you proceed next to

A)percussion.
B)deep palpation.
C)the rectal examination.
D)auscultation.
E)light palpation.

Question 21

Which of the following statements is true regarding tympanic membrane temperature?

A)It is taken by placing an infrared probe anterior to the ear.
B)The probe is placed in the external auditory canal to occlude it.
C)Temperatures taken with a tympanic thermometer never vary from those taken by the oral or rectal route.
D)It is an accurate measurement of body temperature because the tympanic membrane shares its blood supply with the hypothalamus.
E)It is taken by placing an infrared probe posterior to the ear.

Question 22

A patient in the emergency department has a concussion to the head. You suspect that the patient may also have a retinal hemorrhage. You are using the ophthalmoscope to examine the retina of this patient. Which aperture of the ophthalmoscope is most appropriate for this patient?

A)Strabismoscope
B)Red-free filter
C)Slit lamp
D)Small aperture
E)Grid

Question 23

A rubber or plastic ring should be around the bell endpiece of a stethoscope to

A)prevent the transmission of static electricity.
B)avoid cold metal from touching the patient.
C)prevent the sharp edge of the stethoscope from damaging the patient's skin.
D)allow firm pressure to be applied without discomfort.
E)ensure secure contact with the body surface.

Question 24

The Tumbling "E" vision acuity chart would most likely be used for _____ patients.

A)older
B)infant
C)pregnant
D)preschool
E)color-blind adult

Question 25

The stethoscope's diaphragm is most useful in the assessment of _____ sounds.

A)high-pitched
B)dull
C)low-pitched
D)rhythmic
E)tympanic

Question 26

Which technique should be used to stabilize the stethoscope during auscultation?

A)The tubing should be held lightly near the endpiece.
B)The tubing should be held firmly near the endpiece.
C)The endpiece should be held between the second and third fingers.
D)The endpiece should be covered with the examiner's flattened hand.
E)The endpiece should be held with all the examiner's fingers.

Question 27

When examining the abdomen, which technique should be used first?

A)Inspection
B)Light palpation
C)Percussion
D)Auscultation
E)Direct palpation

Question 28

A scale used to assess a patient's weight should be calibrated

A)when the patient tells you the weight is not correct.
B)by a qualified technician at regularly scheduled intervals.
C)each time it is used.
D)when necessary, with the patient standing on the scale.
E)only by the manufacturer.

Question 29

Auscultation should be carried out last except when examining

A)the neck area.
B)the abdomen.
C)the lungs.
D)the heart.
E)none of the above; auscultation is always carried out last in a proper physical examination.

Question 30

The pneumatic attachment for the otoscope is used to evaluate

A)ear canal patency.
B)eardrum landmarks.
C)hearing acuity.
D)tympanic membrane movement.
E)tympanic membrane temperature.

Question 31

The patient tells you that his ears are "stopped up." An objective assessment of this complaint is achieved by using a(n)

A)nasal speculum.
B)neurologic hammer.
C)otoscope with pneumatic attachment.
D)tympanometer.
E)tuning fork.

Question 32

Which of the following occurs when firm pressure is used to apply the stethoscope's bell endpiece to the skin?

A)It transmits low-pitched sounds.
B)It functionally converts to a diaphragm endpiece.
C)Assessment findings are more accurate.
D)Most sounds are occluded.
E)Abnormally low sounds are better transmitted.

Question 33

Tuning forks with a frequency of 500 to 1000 Hz are most commonly used to measure

A)vibratory sensations.
B)hearing from bone conduction.
C)hearing range of normal speech.
D)noise above the threshold level.
E)peripheral motor nerve damage.

Question 34

You are using an ophthalmoscope to examine a patient's inner eye. You rotate the lens selector clockwise and then counterclockwise to compensate for

A)amblyopia.
B)astigmatism.
C)cataracts.
D)strabismus.
E)myopia.

Question 35

Weak pulses, fetal heart activity, and vessel patency are all best assessed with which type of stethoscope?

A)Diaphragm end of an acoustic stethoscope
B)Electronic
C)Ultrasonic
D)Magnetic
E)Bell end of an acoustic stethoscope

Question 36

An infant should be placed in which position to have his or her height or length measured?

A)Vertical, with the examiner's hands under the infant's axilla
B)Supine on a measuring board
C)While being held by a parent
D)In the lateral position with the toes against a measuring board
E)Prone on a measuring board

Question 37

During auscultation, you can limit your perceptual field best by

A)asking patients to describe their symptoms.
B)listening through the patient's clothing.
C)closing your eyes.
D)performing palpation before percussion.
E)turning out the lights in the examination room.

Question 38

The height-measuring attachment of the standing platform scale should be pulled out

A)before the patient steps on the scale.
B)before the scale is balanced.
C)after the patient steps on the scale.
D)while the weight is being determined.
E)only after the weight has been assessed.

Question 39

You are auscultating a patient's chest. The sounds are not clear, and you are having difficulty distinguishing between respirations and heartbeats. What technique can you use to facilitate your assessment?

A)Anticipate the next sounds.
B)Isolate each cycle segment.
C)Listen to all sounds together.
D)Move the stethoscope clockwise.
E)Ask the patient to whisper his or her name.

Question 40

Which type of speculum should be used to examine a patient's tympanic membrane?

A)The smallest speculum that will illuminate the ear
B)The largest speculum that will fit comfortably in the ear
C)The shortest speculum available
D)Any speculum that will fit the otoscope head
E)The longest speculum available

Question 41

Transillumination functions on the principle that

A)infrared radiation is easily detected.
B)black light causes certain substances to fluoresce.
C)converging and diverging light brings structures into focus.
D)tangential light casts shadows that illuminate contours.
E)air, fluid, and tissue transmit light differentially.

Question 42

When monitoring serial measurements, such as head circumference or abdominal girth, which procedure is best to ensure that the tape measure is placed in the same position each time?

A)Record the anatomic location for tape placement in the patient's chart.
B)Mark the borders of the tape at several intervals on the skin with a pen.
C)Demonstrate proper tape placement to all members of the health care team.
D)Ask the same person to perform the measurement each time.
E)Ask the patient if the tape measure is on the same spot.

Question 43

For a woman with a small vaginal opening, the examiner should use a _____ speculum.

A)plastic Graves
B)Pederson
C)pediatric
D)nasal
E)metal Graves

Question 44

You are performing a vaginal examination on a patient with a history of spina bifida. As you insert the metal speculum, the patient suddenly feels nauseated and is sweating, and her skin turns blotchy. What is your most immediate reaction to this situation?

A)Replace the metal speculum with a plastic one.
B)Put a blanket over the patient's legs.
C)Remove the speculum.
D)Take her blood pressure.
E)Raise her legs above her heart.

Question 45

When performing transillumination of a body cavity, the use of which of the following could be harmful to the patient?

A)Penlight
B)Performing the test in a darkened room
C)Halogen bulb
D)Otoscope light
E)Flashlight

Question 46

A variant of the percussion hammer is a neurologic hammer, which is equipped with which of the following?

A)Brush and needle
B)Tuning fork and cotton swab
C)Penlight and goniometer
D)Ruler and bell
E)Transilluminator

Question 47

To perform a deep tendon reflex measurement, you should

A)briskly tap the tendon with the rubber end of the hammer.
B)place the hammer firmly on the tendon for 3 to 5 seconds.
C)tap the silver end of the hammer on the tendon.
D)use the needle implement to determine sensory perception.
E)never use the pointed end to strike your finger placed over a tendon.