Foundations of Clinical Examination
Mock Exam
Course Introduction
Foundations of Clinical Examination introduces students to the essential principles and techniques used in patient assessment. This course covers the systematic approach to history taking, the development of clinical reasoning skills, and hands-on physical examination procedures across body systems. Emphasis is placed on effective communication, patient safety, and ethical considerations, preparing students to perform thorough and accurate clinical evaluations. Through interactive lectures, practical demonstrations, and case-based learning, students gain the knowledge and confidence necessary for future clinical practice.
Recommended Textbook
Seidels Guide to Physical Examination 9th Edition by Jane W. Ball
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648 Flashcards
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Page 2
Chapter 1: The History and Interviewing Process
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Sample Questions
Q1) A guideline for history taking is for caregivers to:
A) ask direct questions before open-ended questions so that data move from simple to complex.
B) ask for a complete history at once so that data are not forgotten between meetings.
C) make notes sparingly so that the patient can be observed during the history taking.
D) write detailed information as stated by patients so that their priorities are reflected.
Answer: C
Q2) A tool used to screen adolescents for alcoholism is the: A) CAGE.
B) CRAFFT.
C) PACES.
D) HITS.
Answer: B
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3
Chapter 2: Cultural Competency
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Sample Questions
Q1) Campinha-Bacote's Process of Cultural Competence Model includes which cultural constructs? (Select all that apply.)
A) Desire
B) Awareness
C) Thought processes
D) Skill
E) Language
Answer: A, B, D
Q2) As the healthcare provider, you are informing a patient that he or she has a terminal illness. This discussion is most likely to be discouraged in which cultural group?
A) Navajo Native Americans
B) Dominant Americans
C) First-generation African descendants
D) First-generation European descendants
Answer: A
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Chapter 3: Examination Techniques and Equipment
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Sample Questions
Q1) The infant should be placed in which position to have his or her height or length measured?
A) Vertically, with the examiner's hands under the infant's axillae
B) Supine on a measuring board
C) Prone on a measuring board
D) In the lateral position, with the toes against a measuring board
Answer: B
Q2) A scale used to assess patients' weight should be calibrated:
A) only by the manufacturer.
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.
Answer: C
Q3) During auscultation, you can limit your perceptual field best by:
A) asking patients to describe their symptoms.
B) closing your eyes.
C) performing auscultation before percussion.
D) using an aneroid manometer.
Answer: B
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Page 5
Chapter 4: Clinical Reasoning
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Sample Questions
Q1) Medical decision making requires a balance between:
A) trust and suspicion.
B) ethical and unethical behavior.
C) remembering and superstition.
D) mechanism and probabilism.
Q2) After the subjective and objective data have been prioritized, the next step is to:
A) order laboratory tests.
B) formulate a problem list.
C) initiate appropriate referrals.
D) initiate therapy.
Q3) The adage that "common problems occur commonly" advises the practitioner to: A) always diagnose the patient's problem in terms of what their practice usually sees.
B) refer any uncommon complaints to specialists as soon as possible.
C) not consider more than one diagnosis unless necessary.
D) examine uncommon problems critically before assuming that the issue is an unusual presentation of a common problem.
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Chapter 5: Documentation
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Sample Questions
Q1) Which finding is unique to the documentation of a physical examination of an infant?
A) Fontanel size
B) Liver span
C) Prostate size
D) Thyroid position
Q2) The position on a clock, topographic notations, and anatomic landmarks:
A) are methods for recording locations of findings.
B) are used for noting disease progression.
C) are ways for recording laboratory study results.
D) should not be used in the legal record.
Q3) Which format would be used for visits that address problems not yet identified in the problem-oriented medical record (POMR)?
A) Brief SOAP note
B) Comprehensive health history
C) Progress note
D) Referral note
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Chapter 6: Vital Signs and Pain Assessment
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Sample Questions
Q1) Underestimation of blood pressure will occur if the cuff's width covers:
A) less than half of the upper arm.
B) less than 5 inches of the lower arm.
C) more than two-thirds of the upper arm.
D) more than 4 inches of the lower arm.
Q2) In a syndrome in which regional pain extends beyond this specific peripheral nerve injury, you would notice which of the following? (Select all that apply.)
A) Allodynia
B) Sleep disturbance
C) Blood flow changes
D) Numbness
E) Edema
Q3) The fifth vital sign is:
A) pain.
B) orientation.
C) waist-to-hip ratio.
D) body mass index (BMI).
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8
Chapter 7: Mental Status
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Sample Questions
Q1) Impairment of arithmetic skills is often the result of:
A) impaired execution of motor skills.
B) impaired judgment.
C) perceptual distortions.
D) depression.
Q2) When you ask the patient to tell you the meaning of a proverb or metaphor, you are assessing which of the following?
A) Level of consciousness
B) Abstract reasoning
C) Emotional stability
D) Memory
Q3) The examiner should be concerned about neurologic competence if a social smile cannot be elicited by the time a child is _________ old.
Q4) An aversion to touch or being held, along with delayed or absent language development, is characteristic of:
A) attention-deficit/hyperactivity disorder.
B) autism.
C) dementia.
D) mental retardation.
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Chapter 8: Growth, Measurement, and Nutrition
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Sample Questions
Q1) After 50 years of age, stature:
A) becomes fixed.
B) begins a barely perceptible secondary increase.
C) increases at a rate of 0.5 cm/year.
D) declines.
Q2) How much of the weight gained during a normal pregnancy is accounted for by the fetus?
A) Less than 5 pounds
B) 6 to 8 pounds
C) 9 to 12 pounds
D) 13 to 30 pounds
Q3) Which statement regarding female pubertal changes is true?
A) Most adolescent girls will develop breasts before they develop pubic hair.
B) Peak height velocity should occur after menarche.
C) Breast asymmetry is an abnormal finding.
D) Menarche should occur by Tanner breast stage 2.
Q4) An 11-year-old boy is brought in for an annual physical examination by his mother. The boy's height is 60 inches. You suspect Marfan syndrome because the boy's arm span is greater than _______________ inches.
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Chapter 9: Skin, Hair, and Nails
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Sample Questions
Q1) A single transverse line seen in the palm of a small child may imply:
A) Down syndrome.
B) Turner syndrome.
C) systemic sclerosis.
D) profound dehydration.
Q2) Which is a noncandidal fungal infection?
A) Pityriasis rosea
B) Psoriasis
C) Tinea corporis
D) Rosacea
Q3) Small, minute bruises are called:
A) ecchymoses.
B) petechiae.
C) spider veins.
D) telangiectasias.
Q4) Unusual white areas on the skin may be caused by:
A) adrenal disease.
B) polycythemia.
C) vitiligo.
D) Down syndrome.
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Chapter 10: Lymphatic System
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Sample Questions
Q1) Cells that line the lymph node sinuses perform the specific function of:
A) fat absorption.
B) fetal immunization.
C) hematopoiesis.
D) phagocytosis.
Q2) Mrs. Farrel brings in her 6-year-old son with complaints of a sore throat and fever. As the healthcare provider, you are concerned about his tonsils and adenoids. Enlarged tonsils and adenoids may obstruct the:
A) thoracic duct.
B) esophagus.
C) nasopharyngeal passageway.
D) external auditory meatus.
Q3) An organ that is essential to the development of protective immune function in the infant but has little or no demonstrated function in the adult is the:
A) spleen.
B) liver.
C) thymus.
D) pancreas.
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Chapter 11: Head and Neck
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Sample Questions
Q1) Which cranial nerves innervate the face?
A) II and V
B) III and VI
C) V and VII
D) VIII and IX
Q2) The correct way to transilluminate an infant's skull is to:
A) hold the light 18 inches from the skull.
B) move the light toward and then away from the head.
C) place the light firmly against the skull.
D) shine the light inside the infant's mouth.
Q3) Nuchal rigidity is most commonly associated with:
A) thyroiditis.
B) meningeal irritation.
C) Down syndrome.
D) cranial nerve V damage.
Q4) Which is the best way to position a patient's neck for palpation of the thyroid?
A) Flexed away from the side being examined
B) Flexed directly forward
C) Flexed toward the side being examined
D) Hyperextended directly backward
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Chapter 12: Eyes
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Sample Questions
Q1) Examination to assess for extraocular muscle imbalance is conducted by:
A) comparing pupillary responses to different shapes.
B) having the patient follow your finger through planes.
C) inspecting slightly closed lids for fasciculations.
D) transilluminating the cornea with tangential light.
Q2) Which are the signs and symptoms of infant retinoblastoma? (Select all that apply.)
A) White reflex
B) Red reflex
C) Corneal light reflex
D) Absence of a blink reflex
E) Autosomal dominant trait
F) Drainage from the affected eye
G) Visual acuity of 20/500
Q3) You observe pupillary response as the patient looks at a distant object and then at an object held 10 cm from the bridge of the nose. You are assessing for:
A) confrontation reaction.
B) accommodation.
C) pupillary light reflex.
D) nystagmus.
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Chapter 13: Ears, Nose, and Throat
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Sample Questions
Q1) Mr. Sprat is a 21-year-old patient who complains of nasal congestion. He admits to using recreational drugs. On examination, you have noted a septal perforation. Which of the following recreational drugs is commonly associated with nasal septum perforation?
A) Heroin
B) Cocaine
C) PCP
D) Ecstasy
Q2) You are performing hearing screening tests. Who would be expected to find difficulty in hearing the highest frequencies?
A) A 7-year-old
B) An 18-year-old
C) A 30-year-old
D) A 50-year-old
Q3) To approximate vocal frequencies, which tuning fork should be used to assess hearing?
A) 100 to 300 Hz
B) 200 to 400 Hz
C) 500 to 1000 Hz
D) 1500 to 2000 Hz
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Page 15
Chapter 14: Chest and Lungs
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Sample Questions
Q1) In which patient situation would you expect to assess tachypnea?
A) Patient who is depressed
B) Patient who abuses narcotics
C) Patient with metabolic acidosis
D) Patient with myasthenia gravis
Q2) Ms. Rudman, age 74 years, has no known health problems or diseases. You are doing a preventive healthcare history and examination. Which symptom is associated with intrathoracic infection?
A) Barrel chest
B) Cor pulmonale
C) Funnel chest
D) Malodorous breath
Q3) With consolidation in the lung tissue, the breath sounds are louder and easier to hear, whereas healthy lung tissue produces softer sounds. This is because:
A) consolidation echoes in the chest.
B) consolidation is a poor conductor of sound.
C) air-filled lung sounds are from smaller spaces.
D) air-filled lung tissue is an insulator of sound.
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16
Chapter 15: Heart
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Sample Questions
Q1) Chest pain with an organic cause in a child is most likely the result of:
A) cardiac disease.
B) asthma.
C) esophageal reflux.
D) arthritis.
Q2) To estimate heart size by percussion, you should begin tapping at the:
A) anterior axillary line.
B) left sternal border.
C) midclavicular line.
D) midsternal line.
Q3) To hear diastolic heart sounds, you should ask patients to:
A) lie on their back.
B) lie on their left side.
C) lie on their right side.
D) sit up and lean forward.
Q4) The most helpful finding in determining left-sided heart failure is:
A) dyspnea.
B) orthopnea.
C) jugular vein distention.
D) an S<sub>3</sub> heart sound.
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Chapter 16: Blood Vessels
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Sample Questions
Q1) You are examining Mr. S, a 79-year-old diabetic man complaining of claudication. Which of the following physical findings is consistent with the diagnosis of peripheral arterial disease?
A) Thick, calloused skin
B) Ruddy, thin skin
C) Warmer temperature of extremity in contrast to other body parts
D) Loss of hair over the extremities
Q2) You are performing a physical examination on a 46-year-old male patient. His examination findings include the following: positive peripheral edema, holosystolic murmur in the tricuspid region, and a pulsatile liver. His diagnosis is:
A) an aortic aneurysm.
B) an arteriovenous fistula.
C) tricuspid stenosis.
D) tricuspid regurgitation.
Q3) In infants or small children, a capillary refill time of 4 seconds:
A) is normal.
B) indicates hypervolemia.
C) indicates dehydration or hypovolemic shock.
D) indicates renal artery stenosis.
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Page 18
Chapter 17: Breasts and Axillae
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Sample Questions
Q1) If your patient has nipple discharge, you will most likely need a:
A) Vacutainer tube.
B) glass slide and fixative.
C) specimen jar with formaldehyde.
D) tape strip to test pH.
Q2) Mrs. Weber is a 65-year-old patient who has presented at the clinic with a complaint of a tender breast mass that she discovered during breast self-examination. You have completed a physical examination on Mrs. Weber and have palpated a mass of the right breast in the lower outer quadrant. When providing patient education to Mrs. Weber regarding the breast mass, you will explain that the characteristics of a cancerous mass would be which of the following? (Select all that apply.)
A) Immobile and firm
B) Pain on palpation
C) Irregular border edges
D) Mobile and rubbery
E) Nontender
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Chapter 18: Abdomen
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Sample Questions
Q1) Costovertebral angle tenderness should be assessed whenever you suspect that the patient may have:
A) cholecystitis.
B) pancreatitis.
C) pyelonephritis.
D) ulcerative colitis.
Q2) Mrs. James is 7 months' pregnant and states that she has developed a problem with constipation. She eats a well-balanced diet and is usually regular. You should explain that constipation is common during pregnancy because of changes in the colorectal areas, such as:
A) decreased movement through the colon and increased water absorption from the stool.
B) increased movement through the colon and increased salt taken from foods.
C) looser anal sphincter and fewer nutrients taken from foods.
D) tighter anal sphincter and less iron eliminated in the stool.
Q3) Infants born weighing less than 1500 g are at higher risk for:
A) hepatitis A.
B) necrotizing enterocolitis.
C) urinary urgency.
D) pancreatitis.
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Chapter 19: Female Genitalia
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Sample Questions
Q1) Which one of the following is a proper technique for the use of a speculum during a vaginal examination?
A) Allow the labia to spread, and insert the speculum slightly open.
B) Insert one finger, and insert the opened speculum.
C) Press the introitus downward, and insert the closed speculum obliquely.
D) Spread the labia, and insert the closed speculum horizontally.
Q2) The adnexa of the uterus are composed of the:
A) corpus and cervix.
B) fallopian tubes and ovaries.
C) uterosacral and broad ligaments.
D) vagina and fundus.
Q3) A 3-year-old girl is being seen because of a foul vaginal odor. To inspect the vaginal vault, you should first:
A) insert a pediatric vaginal speculum.
B) place the child prone and in the fetal position.
C) insert a cotton-tipped applicator and press down.
D) pull the labia forward and slightly to the side.
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Chapter 20: Male Genitalia
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Sample Questions
Q1) Expected genitalia changes that occur as men age include that:
A) the ejaculatory volume decreases with age.
B) erections develop more quickly.
C) the viability of sperm increases.
D) the scrotum becomes more pendulous.
Q2) Inspection of the male urethral orifice requires the examiner to:
A) ask the patient to bear down.
B) insert a small urethral speculum.
C) press the glans between the thumb and forefinger.
D) transilluminate the penile shaft.
Q3) Parents of a 6-year-old boy should be asked if he has:
A) erections.
B) nocturnal emissions.
C) rapid detumescence.
D) scrotal swelling.
Q4) The male with Peyronie disease will usually complain of:
A) painful, inflamed testicles.
B) deviation of the penis during erection.
C) lack of sexual interest.
D) painful lesions of the penis.
Page 22
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Chapter 21: Anus, Rectum, and Prostate
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Sample Questions
Q1) In males, which surface of the prostate gland is accessible by digital examination?
A) Median lobe
B) Posterior
C) Superior
D) Anterior
Q2) The rectal past medical history of all patients should include inquiry about:
A) bowel habits.
B) dietary habits.
C) hemorrhoid surgery.
D) laxative use.
Q3) The effects of aging on the gastrointestinal system lead to more frequent experiences of:
A) constipation.
B) prolonged satiety.
C) diarrhea.
D) prostate glandular atrophy.
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Chapter 22: Musculoskeletal System
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Sample Questions
Q1) When a patient abducts an arm and the ipsilateral scapula becomes more prominent (winged), this usually means that:
A) there has been an injury to the nerve of the anterior serratus muscle.
B) one of the clavicles has been fractured.
C) there is a unilateral trapezius muscle separation.
D) one shoulder is dislocated.
Q2) Spinal vertebrae are separated from each other by:
A) bursae.
B) tendons.
C) disks.
D) ligaments.
Q3) The musculoskeletal examination should begin when:
A) the patient enters the examination room.
B) during the collection of subjective data.
C) when height is measured.
D) when joint mobility is assessed.
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Chapter 23: Neurologic System
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Sample Questions
Q1) When you ask a patient to close his or her eyes and identify an object placed in the hand, you are evaluating:
A) stereognosis.
B) graphesthesia.
C) vibratory sensation.
D) extinction phenomenon.
Q2) The parasympathetic nervous system maintains the day-to-day function of:
A) digestion.
B) response to stress.
C) lymphatic supply to the brain.
D) lymphatic drainage of the brain.
Q3) A neurologic past medical history should include data about:
A) allergies.
B) circulatory problems.
C) educational level.
D) immunizations.
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Chapter 24: Sports Participation Evaluation
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Sample Questions
Q1) Why should the preparticipation sports examination take place well in advance of the planned sports activity? (Select all that apply.)
A) To allow completion of therapy for identified problems
B) Because routine health maintenance needs to be addressed
C) Because it should be 6 weeks prior to the planned sports event
D) To allow completion of follow-up testing
Q2) One of the most important aspects to consider in the orthopedic screening examination is:
A) muscle contraction.
B) flexibility.
C) symmetry.
D) balance.
Q3) A child has a poorly controlled seizure disorder. He has restricted sports participation but would be able to engage in:
A) archery.
B) swimming.
C) weight lifting.
D) badminton.
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26
Chapter 25: Putting it All Together
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Sample Questions
Q1) What is the "brown-bag approach" in regard to examining an older adult?
A) The patient's stool sample is brought to the examination in a brown bag.
B) The patient's medications are brought to the examination in a brown bag.
C) The patient's change of clothes is brought to the examination in a brown bag.
D) The patient's assistive device is brought to the examination in a brown bag.
Q2) Which patient position facilitates inspection of the chest and shoulders?
A) Sitting
B) Supine
C) Trendelenburg
D) Prone
Q3) When you attempt to move a 10-month-old child from his mother's lap to the examination table, he screams loudly. Your best action is to:
A) move the child to the examination table and proceed matter of factly with the examination.
B) ask the mother to try to get the child to stop crying.
C) perform the examination while the child is in the mother's lap.
D) defer the examination until another day.
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Page 27
Chapter 26: Emergency or Life-Threatening Situations
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Sample Questions
Q1) The approximate expected systolic blood pressure for a child older than 1 year is:
A) 120 + child's age in years.
B) 80 + child's age in years.
C) 120 ?- child's age in years.
D) 80 + (the child's age in years).
Q2) Until they are stabilized, trauma patients require reevaluation:
A) every 2 minutes.
B) every 5 minutes.
C) every 10 minutes.
D) every hour.
Q3) In life-threatening emergencies, consent for treatment:
A) is obtained before treatment to protect the facility from liability.
B) is not necessary.
C) occurs after treatment is administered.
D) is not valid because the patient is not competent.
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