Head, Face,Neck, Thorax & Abdomen

Question 1

When assessing someone’s thyroid gland, what’s the first assessment technique you should use?

Answer 1

Inspection

Question 2

What is meant by the term tangential lighting?

Answer 2

shinning parallel to the surface

Question 3

When palpating lymph nodes, use ______ pressure.

Answer 3

gental

Question 4

Normal lymph nodes, when they are palpable, should feel ______, _______, ______, and _________.

Answer 4

movable
discrete
soft
non-tender

Question 5

The conjunctiva should be ____ and the sclera should be _______.

Answer 5

clear

white

Question 6

What are three normal variations you can sometimes see when inspecting the eyes of African American individuals?

Answer 6

gray-blue or “muddy” color
yellowish fatty deposits
small brown macule

Question 7

What is the term for a yellowing of the sclera that indicates jaundice?

Answer 7

scleral icterus

Question 8

What is the term for “pink eye”?

Answer 8

conjunctivitis

Question 9

PERRL

Answer 9

Pupils, Equal, Round, React to Light

Question 10

Most adults’ resting pupil size is ___ to ___mm.

Answer 10

3 to 5

Question 11

Anisocoria

Answer 11

pupils of two different sizes

Question 12

nystagmus

Answer 12

a fine oscillating movement best seen around the iris

Question 13

When would nystagmus be normal?

Answer 13

at an extreme lateral gaze

Question 14

If the reflection is not in the same spot, what does that mean?

Answer 14

asymmetry of the light reflex indicates deviation in alignment from eye muscle weakness or paralysis

Question 15

What instrument do you need to check for a red reflex?

Answer 15

opthalmascope

Question 16

If a person has difficulty hearing whispered words, what type of hearing loss are they likely suffering from?

Answer 16

high frequency

Question 17

At what stage in the assessment should a child’s tympanic membranes be examined?

Answer 17

at the end

Question 18

Before inserting the speculum in the ear of an infant or child less than three years, pull the pinna _________.

Answer 18

straight down

Question 19

For an adult, pull the pinna _____.

Answer 19

up & back

Question 20

Describe a normal TM.

Answer 20

pearly gray, shinny, translucent

Question 21

When palpating the sinuses, what should the patient feel?

Answer 21

firm pressure but no pain

Question 22

What are two reasons a person’s sinuses might be tender to palpitation?

Answer 22

chronic allergies

acute infection

Question 23

What are some conditions which might cause unequal chest expansion?

Answer 23

marked atelectasis, lobar pneumonia, pleural effusion, thoracic trauma (fractured ribs or pneumothorax)

Question 24

What does the word remits mean?

Answer 24

palpable vibration (generated by the larynx)

Question 25

Which part of your hands should you use when assessing for vibration?

Answer 25

``` palmar base (the ball) of the fingers the ulnar edge of the hand ```

Question 26

Why should you avoid assessing for vibration?

Answer 26

bone damps out sound transmission

Question 27

If someone has lobar pneumonia, would you expect increased or decreased fremitus over that area?

Answer 27

increased

Question 28

If someone has a pneumothorax, would you expect increased or decreased fremitus over that area?

Answer 28

decrease

Question 29

What is the predominate percussion sound should expect to hear over the lungs field?

Answer 29

resonance

Question 30

What might an area of hyperresonance indicate?

Answer 30

too much air

Question 31

What might an area of dullness indicate

Answer 31

``` abnormal density in the lungs tumor lung cancer pneumonia pleural effusion atelectasis ```

Question 32

Should you use the bell or the diaphragm of you stethoscope when auscultating lung sounds?

Answer 32

diaphragm

Question 33

How hard should your patent breathe during lung auscultation?

Answer 33

a little deeper than normal

Question 34

What should you do if your client has a particularly hairy chest?

Answer 34

press harder or wet hair with a damp cloth

Question 35

What is the name of the sound you should normally hear when auscultating peripheral lung fields?

Answer 35

vesicular

Question 36

When you lower auscultating

Answer 36

lower

Question 37

Where is S1 heard?

Answer 37

apex

Question 38

Where is S2 heard?

Answer 38

base

Question 39

What condition can displace the PMI down and/or to the left?

Answer 39

cardiac enlargement

Question 40

What are the two normal heart sounds you are supposed to hear?

Answer 40

S1 S2

Question 41

Why is it important to not press too firmly on the carotid arteries?

Answer 41

it will slow down the heart rate

Question 42

Why is it important to assess only one carotid artery at a time?

Answer 42

to avoid compromising arterial blood to the brain

Question 43

Which end piece of your stethoscope should you use when auscultating bowel sounds?

Answer 43

diaphragm

Question 44

Why is it important to auscultate the abdomen before percussing or palpating it?

Answer 44

can increase peristalsis / create sounds that weren't there

Question 45

What might rebound tenderness indicate?

Answer 45

apendicitis

Question 46

After abdominal surgery, the best way to determine GI motility is to measure......

Answer 46

return of flatus & first postoperative bowel movement

Question 47

When auscultating the lungs, the examiner should remember to...

Answer 47

Auscultate lung sounds directly on the client's skin w/ the diaphragm Have the patient to breath through their mouth Listen to one full inspiration & expiration before moving to the next site Auscultate in a side-to-side pattern to compare Listen to the front & backside of the patient

Question 48

Two main challenges w/ lung auscultation

Answer 48

1.Lung sounds can be difficult to hear. Best heard 1,000 - 5,000 Hz Normal lung sounds < 500 Hz 2. The sounds we are trying to hear are often very short.

Question 49

bronchial breath sounds

Answer 49

the sound air makes when flowing through a tube. Relatively high pitch, which makes them easier to hear The expiratory phase is long (at least as long as inspiration). There's a tiny gap b/w inspiration and expiration.

Question 50

Alveolar sacs

Answer 50

air filled sacs in the lungs

Question 51

vesicular breath sounds

Answer 51

Lower frequency, which makes them harder to hear The expiratory phase is short There is no silent pause

Question 52

Bronchial breath sounds are only ______ if heard over the neck.

Answer 52

normal | *They're not supposed to be heard anywhere else.

Question 53

The normal chest is supposed to contain ______ _____ that transforms the sound into ______ breath sounds.

Answer 53

alveolar air, vesicular

Question 54

If you hear bronchial breath sounds over the lung fields, the _____ have either _______ or _______ w/ fluid (blood, puss, or pulmonary edema).

Answer 54

alveoli, collapsed, filled

Question 55

Crackles

Answer 55

Very important findings discontinuous (very short) sounds Taken together, crackers can have a long duration Normally heard on inspiration

Question 56

Early inspiratory

Answer 56

Air flowing through large central bronchus covered in secretions Bubbling noise Possible: Bronchitis

Question 57

Mid Inspiratory

Answer 57

Inflamed, partially dilated medium sized bronchi | Possible: Bronchiectasis

Question 58

Late Inspiratory

Answer 58

Small, distal airways that are partially collapsed | Possible: Fluid, pulmonary fibrosis, pulmonary hemorrhage, pneumonia, pulmonary edema, heart failure (left side)

Question 59

Wheezes

Answer 59

high-pitche, typically expiratory, and longer Air flows through narrow airway a suckling effect is created on the airway wall (airway flutter) Inspiratory & expiratory or just expiratory

Question 60

Does narrowing of the airway necessarily mean that causes wheezing?

Answer 60

No. Its the speed of the air.

Question 61

Beware of the silent asthmatic

Answer 61

Asthmatics on the brink of respiratory failure might not wheeze Not wheezing anymore may be a sign of the condition worsening

Question 62

Exhaling w/ too much force during lung auscultation may cause ______.

Answer 62

wheezing

Question 63

If you hear a wheezing type noise that is only on inspiration, you're probably hearing _______.

Answer 63

stridor

Question 64

Stridor

Answer 64

the result of closing (adduction) of the vocal cords.

Question 65

Rhonchi

Answer 65

``` Similar to wheezes They are longer Snoring quality to them Often caused by thick secretions that narrow the airway Can diffuse but often localized ```

Question 66

A persistent ________ localized to a specific area can be a sign of neoplasm.

Answer 66

rhoncus