Physical Examination and Assessment
Pre-Test Questions
Course Introduction
Physical Examination and Assessment is a foundational course that equips students with the knowledge and skills necessary to conduct systematic health assessments across the lifespan. Emphasizing the integration of clinical reasoning and evidence-based practice, the course covers essential techniques of inspection, palpation, percussion, and auscultation for all major body systems. Students learn to obtain comprehensive health histories, perform thorough physical examinations, and document findings accurately. Through lectures, demonstrations, and hands-on practice, participants develop the ability to identify normal versus abnormal findings, recognize early signs of illness, and communicate assessment results effectively within interprofessional healthcare teams.
Recommended Textbook
Seidels Guide to Physical Examination 9th Edition by Jane W. Ball
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Chapter 1: The History and Interviewing Process
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Q1) Tom is a 16-year-old diabetic who does not follow his diet. He enjoys his dirt bike and seems unconcerned about any consequences of his activities. Which factor is typical of adolescence and pertinent to Tom's health?
A) Attachment to parents
B) High self-esteem
C) Low peer support needs
D) Propensity for risk taking
Answer: D
Q2) To what extent should the patient with a physical disability or emotional disorder be involved in providing health history information to the health professional?
A) The patient should be present during information collection but should not be addressed directly.
B) All information should be collected from past records and family members while the patient is in another room.
C) The patient should be involved only when you sense that he or she may feel ignored.
D) The patient should be fully involved to the limit of his or her ability.
Answer: D
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3
Chapter 2: Cultural Competency
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Sample Questions
Q1) Mr. L presents to the clinic with severe groin pain and a history of kidney stones. Mr. L's son tells you that for religious reasons, his father wishes to keep any stone that is passed into the urine filter that he has been using. What is your most appropriate response?
A) "With your father's permission, we will examine the stone and request that it be returned to him."
B) "The stone must be sent to the lab for examination and therefore cannot be kept."
C) "We cannot let him keep his stone because it violates our infection control policy."
D) "We don't know yet if your father has another kidney stone, so we must analyze this one."
Answer: A
Q2) An example of a cold condition is:
A) a fever.
B) a rash.
C) tuberculosis.
D) an ulcer.
Answer: C
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4
Chapter 3: Examination Techniques and Equipment
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Sample Questions
Q1) Mr. Walters, a 32-year-old patient, tells you that his ears are "stopped up." An objective assessment of this complaint is achieved by using the:
A) tuning fork.
B) reflex hammer.
C) otoscope with pneumatic attachment.
D) tympanometer.
Answer: D
Q2) You are auscultating a patient's chest. The sounds are not clear, and you are having difficulty distinguishing between respirations and heartbeats. Which 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.
Answer: B
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5
Chapter 4: Clinical Reasoning
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Sample Questions
Q1) 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
Q2) 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.
Q3) 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.
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Chapter 5: Documentation
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Sample Questions
Q1) A SOAP note is used in which type of recording system?
A) Preventive care
B) Problem oriented
C) Systems review
D) Traditional treatment
Q2) The patient's perceived disabilities and functional limitations are recorded in the:
A) problem list.
B) general patient information.
C) social history.
D) history of present illness.
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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Q1) Which pulse characteristic in the neonate may indicate infection?
A) Bounding pulse rate
B) Regular pulse rate
C) Sustained high pulse rate
D) Intermittent slow pulse rate
Q2) 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.
Q3) Infants delivered by Cesarean section demonstrate which respiratory characteristic in comparison to infants delivered vaginally?
A) Slower respiratory rate
B) Faster respiratory rate
C) Shallower respirations
D) Deeper respirations
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Chapter 7: Mental Status
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Sample Questions
Q1) Under most conditions, adult patients should be able to repeat forward a series of _____________ numbers.
Q2) The ability for abstract thinking normally develops during:
A) infancy.
B) early childhood.
C) adolescence.
D) adulthood.
Q3) You are interviewing a 20-year-old patient with a new-onset psychotic disorder. The patient is apathetic and has disturbed thoughts and language patterns. The nurse recognizes this behavior pattern as consistent with a diagnosis of:
A) depression.
B) autistic disorder.
C) mania.
D) schizophrenia.
Q4) Impairment of arithmetic skills is often the result of:
A) impaired execution of motor skills.
B) impaired judgment.
C) perceptual distortions.
D) depression.
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Chapter 8: Growth, Measurement, and Nutrition
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Sample Questions
Q1) What is the youngest age at which pubic hair growth in the male may be considered normal?
A) 7 years
B) 8 years
C) 9 years
D) 10 years
Q2) To estimate an individual's frame size, the examiner should measure:
A) skull circumference.
B) the length from the olecranon process to the acromion process.
C) elbow breadth.
D) hip circumference.
Q3) 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.
Q4) The term large for gestational age (LGA) indicates that an infant is larger than ____% of infants born at the same number of weeks' gestation.
Q5) Infants normally increase their birth length by ____% during the first year of life.
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Chapter 9: Skin, Hair, and Nails
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Sample Questions
Q1) A Dennie-Morgan fold is probably caused by:
A) birth trauma.
B) high fever.
C) excess adipose tissue.
D) chronic rubbing.
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) Tangential lighting is best used for inspecting skin:
A) color.
B) contour.
C) exudates.
D) symmetry.
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Chapter 10: Lymphatic System
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Sample Questions
Q1) 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.
Q2) The harder and more discrete a node, the more likely that there is a(n):
A) innocent cause.
B) infection.
C) malignancy.
D) metabolic disease.
Q3) Which nodes are most often associated with inflammation?
A) Shotty
B) Movable
C) Fixed
D) Tender
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Chapter 11: Head and Neck
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Sample Questions
Q1) Mr. Donaldson is a 64-year-old patient with complaints of headaches. As the examiner, you are palpating his head during your physical examination. Which of the following would be your first step?
A) Palpate the patient's hair, noting texture, color, and distribution.
B) Palpate the temporomandibular joint.
C) Palpate the skull from front to back.
D) Palpate the temporal artery.
Q2) Mr. Johnson presents with a freely movable cystic mass in the midline of the high neck region, at the base of the tongue. This is most likely a:
A) parotid gland tumor.
B) branchial cleft cyst.
C) Stensen duct stone.
D) thyroglossal duct cyst.
Q3) 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) 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) The criterion for determining the adequacy of a patient's visual field is:
A) the ability to discriminate primary colors.
B) the ability to discriminate details.
C) correspondence with the visual field of the examiner.
D) distance vision equal to that of an average person.
Q3) Mr. Older is a 40-year-old patient who presents to the office for a follow-up eye examination after the diagnosis of myopia. To see retinal details in a myopic patient, you will need to:
A) adjust your ophthalmoscope into the plus lens.
B) move your ophthalmoscope backward.
C) move your hand farther forward.
D) turn your ophthalmoscope to a minus lens.
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Page 14
Chapter 13: Ears, Nose, and Throat
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Sample Questions
Q1) 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
Q2) Nasal symptoms that imply an allergic response include:
A) purulent nasal drainage.
B) bluish gray turbinates.
C) small, atrophied nasal membranes.
D) firm consistency of turbinates.
Q3) You are performing Weber and Rinne hearing tests. For the Weber test, the sound lateralized to the unaffected ear; for the Rinne test, air conduction-to-bone conduction ratio is less than 2:1. You interpret these findings as suggestive of:
A) a defect in the inner ear.
B) a defect in the middle ear.
C) otitis externa.
D) impacted cerumen.
Q4) When you ask the patient to identify smells, you are assessing cranial nerve __.
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Chapter 14: Chest and Lungs
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Sample Questions
Q1) Which finding suggests a minor structural variation?
A) Barrel chest
B) Clubbed fingers
C) Pectus carinatum
D) Chest wall retractions
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) 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.
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) You are listening to a patient's heart sounds in the aortic and pulmonic areas. The sound becomes asynchronous during inspiration. The prevalent heart sound in this area is most likely:
A) S<sub>1</sub>.
B) S<sub>2</sub>.
C) S<sub>3</sub>.
D) S<sub>4</sub>.
Q2) A condition that is likely to present with dizziness and syncope is:
A) bacterial endocarditis.
B) hypertension.
C) sick sinus syndrome.
D) pericarditis.
Q3) A lift along the left sternal border is most likely the result of:
A) aortic stenosis.
B) atrial septal defect.
C) pulmonary hypertension.
D) right ventricular hypertrophy.
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Chapter 16: Blood Vessels
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Sample Questions
Q1) Which are risk factors for varicose veins? (Select all that apply.)
A) Gender
B) Alcohol use
C) Lower extremity trauma
D) Increased body mass
E) Hypertension
F) Diabetes
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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Chapter 17: Breasts and Axillae
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Sample Questions
Q1) 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.
Q2) Ms. Lawson is a 41-year-old patient who presents for a routine annual examination. During her breast examination, you are also completing a lymphatic examination. Which of the following lymph nodes are examined during a breast examination? (Select all that apply.)
A) Supraclavicular
B) Lateral axillary nodes
C) Anterior cervical nodes
D) Anterior axillary nodes
E) Posterior cervical nodes
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Chapter 18: Abdomen
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Sample Questions
Q1) Infants born weighing less than 1500 g are at higher risk for:
A) hepatitis A.
B) necrotizing enterocolitis.
C) urinary urgency.
D) pancreatitis.
Q2) When assessing abdominal pain in a college-age woman, one must include:
A) history of interstate travel.
B) food likes and dislikes.
C) age at completion of toilet training.
D) the first day of the last menstrual period.
Q3) Flatulence, diarrhea, dysuria, and tenderness with abdominal palpation are findings usually associated with:
A) diverticulitis.
B) pancreatitis.
C) ruptured ovarian cyst.
D) splenic rupture.
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Page 20
Chapter 19: Female Genitalia
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Sample Questions
Q1) A mother brings her 8-year-old daughter to the clinic because the child says it hurts to urinate after she fell while riding her bicycle. On inspection, you find posterior vulvar and gross perineum bruising. These findings are consistent with:
A) chronic masturbation.
B) congenital defects.
C) acute urinary tract infection.
D) sexual abuse.
Q2) Which structure is located posteriorly on each side of the vaginal orifice?
A) Skene glands
B) Clitoris
C) Perineum
D) Bartholin glands
Q3) 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.
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Chapter 20: Male Genitalia
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Sample Questions
Q1) Mr. L has an unusually thick scrotum, with edema and pitting. He has a history of cardiac problems. The appearance of his scrotum is most likely a(n):
A) congenital defect that has worsened.
B) indication of general fluid retention.
C) normal consequence of aging.
D) complication of the development of mumps.
Q2) Inspection of the scrotum should reveal:
A) lightly pigmented skin.
B) two testes per sac.
C) smooth scrotal sacs.
D) the left scrotal sac lower than the right.
Q3) 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.
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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) Your patient's chief complaint is repeated, pencil-like stools. Further examination should include:
A) a stool culture.
B) parasite testing.
C) a digital rectal examination (DRE).
D) a prostate examination.
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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Page 23
Chapter 22: Musculoskeletal System
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Sample Questions
Q1) The temporomandibular joint is palpated:
A) under the mandible, anterior to the sternocleidomastoid muscle.
B) above the mandible at midline.
C) anterior to the tragus.
D) at the mastoid process.
Q2) Skeletal changes in older adults are the result of:
A) increased bone deposition.
B) increased bone resorption.
C) decreased bone deposition.
D) decreased bone resorption.
Q3) Ulnar deviation and swan neck deformities are characteristics of:
A) rheumatoid arthritis.
B) osteoarthritis.
C) osteoporosis.
D) congenital defects.
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) You are initially evaluating the equilibrium of Ms. Q. You ask her to stand, with her feet together and arms at her sides. She loses her balance. Ms. Q has a positive:
A) Kernig sign.
B) Homan sign.
C) McMurray test.
D) Romberg sign.
Q2) On a scale of 1+ to 4+, which deep tendon reflex score is appropriate for a finding of clonus in a patient?
A) 1+
B) 2+
C) 3+
D) 4+
Q3) Normal changes of the aging brain include:
A) increased velocity of nerve conduction.
B) diminished perception of touch.
C) increased total number of neurons.
D) diminished intelligence quotient.
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Chapter 24: Sports Participation Evaluation
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Q1) Part of the screening orthopedic component of the examination includes evaluating the person while he or she is:
A) performing push-ups.
B) duck walking.
C) twisting at the waist.
D) crossing the arms over the chest.
Q2) 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.
Q3) A parent is advised to restrict contact sports participation for their child. An example of a sport in which this child could participate is:
A) hockey.
B) roller skating.
C) riflery.
D) skateboarding.
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Chapter 25: Putting it All Together
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Q1) Examination of the patient in the lithotomy, or knee-chest, position includes:
A) inspection for inguinal hernias.
B) palpation of anal sphincter tone.
C) percussion of pelvic structures.
D) stereognosis testing.
Q2) When examining a "difficult" patient, it is best to allow which person in the examination room?
A) The clinician
B) Patient's small children
C) An interpreter
D) A chaperone
Q3) Palpation of the epitrochlear nodes is part of the:
A) examination of the upper extremities.
B) assessment of the chest and thorax.
C) palpation of the abdomen.
D) examination of the head and neck.
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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Q1) Until they are stabilized, trauma patients require reevaluation:
A) every 2 minutes.
B) every 5 minutes.
C) every 10 minutes.
D) every hour.
Q2) You would complete a Glasgow Coma Scale rating during the:
A) health history.
B) physical examination.
C) primary survey.
D) secondary survey.
Q3) Blood, vomitus, and foreign bodies are removed from the oropharynx of the unconscious patient by:
A) stimulating the cough reflex.
B) using a sweeping motion with the finger.
C) performing a back thrust.
D) using suction.
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