adult

Question 1

LOC and Orientation

Answer 1

Alert, lethargic, obtunded, comatose
person, place, time and situation
hygiene and general appearance

Question 2

speech

Answer 2

clear, appropriate, inappropriate, aphasic

Question 3

coloration

Answer 3

vascularity, bleeding, bruising, rashes

Question 4

lesions

Answer 4

size, shape, color, drainage, odor, dressing

Question 5

skin (general)

Answer 5

temperature, texture

moisture, turgor, edema

Question 6

nails

Answer 6

shape, texture, color

Question 7

hair/scalp

Answer 7

color, texture, distribution

Question 8

eyes

Answer 8

conjunctiva, sclera, symmetry, alignment, PERRLA, eye movement with cranial nerves 3, 4, and 6

Question 9

ears

Answer 9

shape, size, lesions, discharge

Question 10

nose

Answer 10

is it patent

Question 11

mouth

Answer 11

tongue, dentition, mucous membranes, palate symmetry

Question 12

lymph nodes

Answer 12

preauricular, postauricular, submandibular, submental, cervical, supraclavicular

Question 13

neck

Answer 13

auscultate carotid arteries
inspect trachea and palpate thyroid by having them swallow
with bed at 30-45 degrees look for JVD

Question 14

cardiovascular

Answer 14

auscultate apical pulse for one minute then
Aorta (2nd right intercostal space), Pulmonic (left 2nd intercostal space), Tricuspid (4th intercostal space) Mitral (L at the 5th intercostal space mid clavicular line)
listening for rate, rhythm, and abnormal sounds

Question 15

thorax and lungs

Answer 15

anterior: auscultate lungs, assess cough (dry/wet, productive/nonproductive)
posterior: symmetry of expansion and muscle use, AP/lateral diameters (2:1), respiratory effort, auscultate lungs for rate, depth and quality (adventitious sounds: wheeze, fine/course crackles, stridor)

Question 16

GI/GU

Answer 16

on the patient’s back check for CVA tenderness
last BM, passing gas, voiding?
inspect for: color, contour, pulsations, umbilicus, rashes, lesions, masses, scars, distention
auscultate: all 4 quads and aorta (hyperactive, hypoactive, absent)
percuss all 4
palpate all 4

Question 17

upper extremities

Answer 17

inspection, grip strength, radial and brachial pulses, cap refill

Question 18

lower extremities

Answer 18

inspection (color, varicosities, hair growth, nail growth, edema), palpate for edema, pulses as posterior tibial, dorsalis pedis and popliteal, dorsiflexion/plantar flexion, strength, cap refill and Babinski reflex

Question 19

spine

Answer 19

scoliosis, kyphosis, lordosis and observe gait