Physical Diagnosis
Exam Solutions
Course Introduction
Physical Diagnosis is a foundational medical course designed to equip students with the essential skills and knowledge needed to systematically evaluate a patient's physical state through clinical examination. The course emphasizes the development of competency in patient interviewing, observation, inspection, palpation, percussion, and auscultation techniques across all major body systems. Students learn to recognize normal and abnormal physical signs, accurately document findings, and integrate clinical data with patient history to form differential diagnoses. Through a combination of lectures, hands-on practice, and simulated patient encounters, the course prepares future healthcare professionals to approach patient assessment with confidence, precision, and professionalism.
Recommended Textbook
Seidels Guide to Physical Examination 9th Edition by Jane W. Ball
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648 Flashcards
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Chapter 1: The History and Interviewing Process
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Sample Questions
Q1) After you ask a patient about her family history, she says, "Tell me about your family now." Which response is generally most appropriate?
A) Ignore the patient's comment and continue with the interview.
B) Give a brief, undetailed answer.
C) Ask the patient why she needs to know.
D) Tell the patient that you do not discuss your family with patients.
Answer: B
Q2) Ms. A states, "My life is just too painful. It isn't worth it." She appears depressed. Which one of the following statements is the most appropriate caregiver response?
A) "Try to think about the good things in life."
B) "What in life is causing you such pain?"
C) "You can't mean what you're saying."
D) "If you think about it, nothing is worth getting this upset about."
Answer: B
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3
Chapter 2: Cultural Competency
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Sample Questions
Q1) Mr. Marks is a 66-year-old patient who presents for a physical examination to the clinic. Which question has the most potential for exploring a patient's cultural beliefs related to a health problem?
A) "How often do you have medical examinations?"
B) "What is your age, race, and educational level?"
C) "What types of symptoms have you been having?"
D) "Why do you think you are having these symptoms?"
Answer: D
Q2) As you explain your patient's condition to her husband, you notice that he is leaning toward you and pointedly blinking his eyes. Knowing that he is from England, your most appropriate response to this behavior is to:
A) tell him that you understand his need to be alone.
B) ask whether he has any questions.
C) ask whether he would prefer to speak to the clinician.
D) tell him that it is all right to be angry.
Answer: B
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Chapter 3: Examination Techniques and Equipment
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Sample Questions
Q1) Tuning forks with a frequency of 500 to 1000 Hz are most commonly used to measure:
A) buzzing or tingling sensations.
B) buzzing from bone conduction.
C) hearing range of normal speech.
D) noise above the threshold level.
Answer: C
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) Tympanic thermometers measure body temperature when a probe is placed:
A) anterior to the ear.
B) posterior to the ear.
C) under the ear.
D) in the auditory canal.
Answer: D
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5
Chapter 4: Clinical Reasoning
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Sample Questions
Q1) Utilitarianism can be described as:
A) balancing interests.
B) preventing harm.
C) choosing wisely.
D) doing good.
Q2) When utilizing a joint approach with the patient, which factors are likely to be considered? (Select all that apply.)
A) Consultations
B) Laboratory studies
C) Assistive technology
D) Patient education
E) Practitioner background
Q3) Which is an accepted method of making a diagnosis?
A) Relying on intuition
B) Making maximal use of laboratory tests
C) Using first assumptions
D) Using algorithms
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Chapter 5: Documentation
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Sample Questions
Q1) Allergies to drugs and foods are generally listed in which section of the medical record?
A) History of present illness
B) Past medical history
C) Social history
D) Problem list
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 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
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Chapter 6: Vital Signs and Pain Assessment
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Sample Questions
Q1) The perception of pain:
A) is the same across cultures.
B) can be easily assessed in neonates.
C) is predictable with the same circumstances.
D) is affected by emotions and quality of sleep.
Q2) Which occurs with malignant hypertension? (Select all that apply.)
A) Blurred vision
B) Sleep disturbance
C) Tachycardia
D) Dyspnea
E) Encephalopathy
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) A 69-year-old truck driver presents with a sudden loss of the ability to understand spoken language. This indicates a lesion in the:
A) temporal lobe.
B) Broca area.
C) frontal cortex.
D) cerebellum.
Q2) Which condition is considered progressive rather than reversible?
A) Delirium
B) Dementia
C) Depression
D) Anxiety
Q3) Which clinical assessments test attention span?
A) Spell WORLD backward.
B) Draw a clock.
C) Say the days of the week.
D) Do arithmetic calculations.
E) Explain "a stitch in time saves nine."
Q4) The examiner should be concerned about neurologic competence if a social smile cannot be elicited by the time a child is _________ old.
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Chapter 8: Growth, Measurement, and Nutrition
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Sample Questions
Q1) Which situation poses the most concern?
A) The child whose weight and height ratios have remained at the 50th percentile
B) The child whose weight and height ratios have stayed between the 90th and 95th percentiles
C) The child whose weight and height ratios have never been above the 50th percentile
D) The child whose weight and height ratios have dropped 15 percentiles since the last visit
Q2) By 10 to 12 years of age, lymphatic tissues are about:
A) 25% of adult size.
B) 50% of adult size.
C) the same as adult size.
D) twice the size of those in the adult.
Q3) Which are signs and symptoms of hydrocephalus? (Select all that apply.)
A) Early closed suture lines
B) Hyperreflexia Y
C) Irritable, poor feeding Y
D) Does not meet expected height and weight
E) Difficulty holding head up Y
F) Rapidly increasing head circumference Y
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Page 10
Chapter 9: Skin, Hair, and Nails
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Sample Questions
Q1) A flat, nonpalpable lesion is described as a macule if the diameter is:
A) larger than 1 cm.
B) smaller than 1 cm.
C) 3 cm exactly.
D) too irregular to measure.
Q2) Mrs. Leonard brings her newborn infant into the pediatrician's office for a first well-baby visit. As the healthcare provider, you teach her that newborns are more vulnerable to hypothermia because of:
A) the presence of coarse terminal hair.
B) desquamation of the stratum corneum.
C) their covering of vernix caseosa.
D) a poorly developed subcutaneous fat layer.
Q3) The characteristic that best differentiates psoriasis from other skin abnormalities is the:
A) color of the scales.
B) formation of tiny papules.
C) general distribution over the body.
D) recurrence.
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Chapter 10: Lymphatic System
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Sample Questions
Q1) Mrs. Sing is a 44-year-old patient who presents to the office with a complaint of enlarged lymph nodes. When enlarged, which lymph nodes are most likely to be a sign of pathology (e.g., malignancy)?
A) Occipital
B) Anterior cervical
C) Supraclavicular
D) Femoral
Q2) 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.
Q3) Tender nodes associated with cat scratch disease are usually found in which area?
A) Epitrochlear area
B) Popliteal area
C) Axilla
D) Inguinal area
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Chapter 11: Head and Neck
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Sample Questions
Q1) The premature union of cranial sutures that involves the shape of the head without mental retardation is:
A) craniosynostosis.
B) encephalocele.
C) microcephaly.
D) myxedema.
Q2) Which cranial nerves innervate the face?
A) II and V
B) III and VI
C) V and VII
D) VIII and IX
Q3) Which type of headache usually occurs at night, is precipitated by alcohol consumption, and occurs more often in men than in women?
A) Classic migraine
B) Temporal arteritis
C) Cluster
D) Hypertensive
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Chapter 12: Eyes
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Sample Questions
Q1) When inspecting the region of the lacrimal gland, palpate:
A) the lower orbital rim, near the inner canthus.
B) in the area between the arch of the eyebrow and upper lid.
C) beneath the lower lid, adjacent to the inner canthus.
D) adjacent to the lateral aspect of the eye, just beneath the upper lid.
Q2) If a patient has early papilledema, using an ophthalmoscope, the examiner will be able to detect:
A) dilated retinal veins.
B) retinal vein pulsations.
C) sharply defined optic discs.
D) visual defects.
Q3) You are attempting to examine the eyes of a newborn. To facilitate eye opening, you would first:
A) dim the room lights.
B) elicit pain.
C) place him in the supine position.
D) shine the penlight in his or her eyes.
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14
Chapter 13: Ears, Nose, and Throat
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Sample Questions
Q1) Speech with a monotonous tone and erratic volume may indicate:
A) otitis externa.
B) hearing loss.
C) serous otitis media.
D) sinusitis.
Q2) You are using a pneumatic attachment on the otoscope while assessing tympanic membrane movement. You gently squeeze the bulb but see no movement of the membrane. Your next action should be to:
A) remove all cerumen from the canal.
B) change to a larger speculum.
C) squeeze the bulb with more force.
D) insert the speculum to a depth of 2 cm.
Q3) To inspect the lateral borders of the tongue, you should:
A) ask the patient to extend the tongue outward.
B) insert the tongue blade obliquely against the tongue.
C) lift the tongue upward with gloved fingers.
D) pull the gauze-wrapped tongue to each side.
Q4) When you ask the patient to identify smells, you are assessing cranial nerve __.
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Page 15
Chapter 14: Chest and Lungs
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Sample Questions
Q1) The best time to observe and count respirations is while:
A) the patient is answering questions.
B) weighing the patient.
C) palpating the pulse.
D) the patient is sleeping.
Q2) Which site of chest wall retractions indicates a more severe obstruction in the asthmatic patient?
A) Lower chest
B) Along the anterior axillary line
C) Above the clavicles
D) At the nipple line
Q3) You would expect to document the presence of a pleural friction rub for a patient being treated for:
A) pneumonia.
B) atelectasis.
C) pleurisy.
D) emphysema.
Q4) An Apgar score of __________ is given to the infant who demonstrates irregular respiratory effort.
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Chapter 15: Heart
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Sample Questions
Q1) In the adult, the apical impulse should be most visible when the patient is in what position?
A) Supine
B) Upright
C) Lithotomy
D) Right lateral recumbent
Q2) Which of the following information belongs in the past medical history section related to heart and blood vessel assessment?
A) Adolescent inguinal hernia
B) Childhood mumps
C) History of bee stings
D) Previous unexplained fever
Q3) Your patient, who abuses intravenous (IV) drugs, has a sudden onset of fever and symptoms of congestive heart failure. Inspection of the skin reveals nontender erythematic lesions to the palms. These findings are consistent with the development of:
A) rheumatic fever.
B) cor pulmonale.
C) pericarditis.
D) endocarditis.
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Chapter 16: Blood Vessels
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Sample Questions
Q1) The most prominent component of the jugular venous pulse is the:
A) a wave.
B) c wave.
C) v wave.
D) x slope.
Q2) When palpating the carotid artery, which of the following is most important? (Select all that apply.)
A) Rotate the patient's head to the side being examined to relax the sternocleidomastoid.
B) Excessive carotid sinus massage can compromise blood flow to the brain.
C) Excessive carotid sinus massage can cause slowing of the pulse.
D) Palpate both sides simultaneously.
Q3) Which of the following statements is true regarding the development of venous ulcers in older adults?
A) The major symptom is severe leg pain, especially when walking.
B) The affected leg is commonly pale and hairless, and pulses are difficult to palpate.
C) Diabetes, peripheral neuropathy, and nutritional deficiencies are causative factors.
D) The ulcers are generally located on the tips of toes.
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Chapter 17: Breasts and Axillae
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Sample Questions
Q1) Male gynecomastia associated with illicit or prescription drug use can be expected to:
A) lessen when the body becomes accustomed to the drug.
B) resolve after the drug is discontinued.
C) leave permanent breast enlargement when the drug is discontinued.
D) cause purulent drainage if left untreated.
Q2) You are conducting a clinical breast examination for your 30-year-old patient. Her breasts are symmetric, with bilateral, multiple tender masses that are freely movable and with well-defined borders. You recognize that these symptoms and assessment findings are consistent with:
A) fibroadenoma.
B) Paget disease.
C) cancer.
D) fibrocystic changes.
Q3) Montgomery tubercles are most prominent in the breasts of:
A) adult males.
B) patients with lung disease.
C) pregnant women.
D) pubertal females.
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Chapter 18: Abdomen
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Sample Questions
Q1) In older adults, overflow fecal incontinence is commonly caused by:
A) malabsorption.
B) parasitic diarrhea.
C) fecal impaction.
D) fistula formation.
Q2) You are completing a general physical examination on Mr. Rock, a 39-year-old man with complaints of constipation. When examining a patient with tense abdominal musculature, a helpful technique is to have the patient:
A) hold his or her breath.
B) sit upright.
C) flex his or her knees.
D) raise his or her head off the pillow.
Q3) Your patient is complaining of acute, intense, sharp epigastric pain that radiates to the back and left scapula, with nausea and vomiting. Based on this history, your prioritized physical examination should be to:
A) percuss for ascites.
B) assess for rebound tenderness.
C) inspect for ecchymosis of the flank.
D) auscultate for abdominal bruits.
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Page 20
Chapter 19: Female Genitalia
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Sample Questions
Q1) The mother of an 8-year-old child reports that she has recently noticed a discharge stain on her daughter's underwear. Both the mother and daughter appear nervous and concerned. You would need to ask questions to assess the child's:
A) drug ingestion.
B) fluid intake.
C) risk for sexual abuse.
D) hormone responsiveness.
Q2) Which systemic feature is related to the effects of menopause?
A) Increased abdominal fat distribution
B) Decreased LDL levels
C) Cold intolerance
D) Decreased cholesterol levels
Q3) The assessment of which structure is not part of the bimanual examination?
A) Cervix
B) Bladder
C) Uterus
D) Ovaries
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Chapter 20: Male Genitalia
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Sample Questions
Q1) Which condition is of minor consequence in an adult male?
A) Adhesions of the foreskin
B) Continuous penile erection
C) Lumps in the scrotal skin
D) Venous dilation in the spermatic cord
Q2) A characteristic related to syphilis or diabetic neuropathy is testicular:
A) dropping, with asymmetry.
B) enlargement.
C) insensitivity to painful stimulation.
D) recession into the abdomen.
Q3) On palpation, a normal vas deferens should feel:
A) beaded.
B) smooth.
C) ridged.
D) spongy.
Q4) The most common cancer in young men ages 15 to 30 years is:
A) testicular.
B) penile.
C) prostate.
D) anal.
Page 22
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Chapter 21: Anus, Rectum, and Prostate
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Sample Questions
Q1) Factors associated with increased risk of prostate cancer include:
A) African descent.
B) cigarette smoking.
C) a low-fat diet.
D) alcoholism.
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) Nodules found in the peritoneum through the anterior rectal wall:
A) are found with bidigital palpation.
B) are called shelf lesions.
C) are chronic fibrosis.
D) are found by having the patient bear down.
Q4) The cervix may be palpated through the:
A) anterior rectal wall.
B) internal umbilical wall.
C) lateral urethral meatus.
D) posterior uterine surface.
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Chapter 22: Musculoskeletal System
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Sample Questions
Q1) Carpal tunnel syndrome would result in:
A) a negative Tinel sign.
B) a negative Phalen test.
C) reduced abduction of the thumb.
D) palm tingling.
Q2) Expected normal findings during the inspection of spinal alignment include:
A) asymmetric skin folds at the neck.
B) slight right-sided scapular elevation.
C) concave lumbar curve.
D) the head positioned superiorly to the gluteal cleft.
Q3) A goniometer is used to assess:
A) bone maturity.
B) joint proportions.
C) range of motion.
D) muscle strength.
Q4) The tibia, fibula, and talus articulate to form the:
A) ankle.
B) knee.
C) hip.
D) pelvis.
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Chapter 23: Neurologic System
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Sample Questions
Q1) At what age should the infant begin to transfer objects from hand to hand?
A) 2 months
B) 4 months
C) 7 months
D) 10 months
Q2) To assess a cremasteric reflex, the nurse strokes the:
A) sole of the foot and observes whether the toes fan down and out.
B) abdomen and observes whether the umbilicus moves away from the stimulus.
C) inner thigh and observes whether the testicle and scrotum rise on the stroked side.
D) palm and observes whether the fingers attempt to grasp.
Q3) You are most concerned for the infant who has a:
A) weak palmar grasp at 3 months.
B) strong stepping reflex at 2 months.
C) weak plantar reflex at 9 months.
D) strong tonic neck at 6 months.
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Chapter 24: Sports Participation Evaluation
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Sample Questions
Q1) The checkout station for preparticipation physical evaluation is critical because at this point:
A) all completed forms are distributed.
B) parental signatures are obtained.
C) the relevant history is obtained.
D) the coordination of follow-ups is reviewed.
Q2) 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.
Q3) Your 15-year-old patient is athletic and thin. Radiography of an ankle injury reveals a stress fracture. You should question this patient about her:
A) sleep patterns.
B) salt intake.
C) aerobic workouts.
D) menstrual cycles.
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26
Chapter 25: Putting it All Together
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Sample Questions
Q1) Which action should the nurse take before auscultating bowel sounds in an 18-month-old child?
A) Stand to the left of the child
B) Palpate the abdomen
C) Loosen the diaper
D) Position the child prone
Q2) Functional assessment is most important during the examination of a(n):
A) adolescent.
B) infant.
C) older adult.
D) young adult.
Q3) When assessing the abdomen, the examiner needs to expose the patient:
A) from the waist down.
B) from the pubis to the epigastrium.
C) in entirety.
D) at no point during the examination.
Q4) Mrs. Jones is a 44-year-old patient who presents for a routine physical examination. The patient is unable to shrug her shoulders against the examiner's hands during the examination. The cranial nerve involved with successful shoulder shrugging is CN ____.
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Chapter 26: Emergency or Life-Threatening Situations
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Sample Questions
Q1) Which injury is the most common precipitator of blunt trauma?
A) Age-related falls
B) Motor vehicle accidents
C) Work-related injuries
D) Childhood play injuries
Q2) You have gone by ambulance to a construction site where an adult male is lying on the street. The only information you have is that he fell three stories. His neck is immobilized with sacks of concrete mix on either side. Your first action should be to determine:
A) airway patency.
B) bleeding sites.
C) cranial nerve function.
D) limb position.
Q3) If trauma above the clavicle is suspected, it is important to:
A) test range of motion of the neck.
B) remove any headgear.
C) arrange for neck extension x-ray studies.
D) stabilize the neck in a neutral position.
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