Physical Examination and Assessment
Textbook Exam Questions
Course Introduction
Physical Examination and Assessment is a foundational course designed to equip students with the essential knowledge and skills for conducting comprehensive health assessments. The course covers systematic approaches to evaluating patients through techniques such as inspection, palpation, percussion, and auscultation. Students will learn to gather health histories, interpret physical findings, and document assessment data accurately. Emphasis is placed on developing critical thinking and clinical reasoning skills to identify normal versus abnormal findings, enabling students to formulate appropriate care plans and communicate effectively within healthcare teams. By the end of the course, students will be proficient in performing head-to-toe assessments across diverse populations in various healthcare settings.
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) JM has been seen in your clinic for 5 years. She presents today with signs and symptoms of acute sinusitis. The type of history that is warranted is a(n) _________ history.
A) complete
B) inventory
C) problem or focused
D) interim
Answer: C
Q2) Direct questioning about domestic violence in the home should be:
A) a routine component of history taking with female patients.
B) avoided for fear of offending the woman's partner.
C) conducted only in cases in which there is a history of abuse.
D) used only when the patient is obviously being victimized.
Answer: A
Q3) Which question would be considered a "leading question?"
A) "What do you think is causing your headaches?"
B) "You don't get headaches often, do you?"
C) "On a scale of 1 to 10, how would you rate the severity of your headaches?"
D) "At what time of the day are your headaches the most severe?"
Answer: B
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Chapter 2: Cultural Competency
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Sample Questions
Q1) An image of any group that rejects its potential for originality or individuality is known as a(n):
A) acculturation.
B) norm.
C) stereotype.
D) ethnos.
Answer: C
Q2) An example of a cold condition is:
A) a fever.
B) a rash.
C) tuberculosis.
D) an ulcer.
Answer: C
Q3) Mr. Jones is a 45-year-old patient who presents to the office. A person's definition of illness is likely to be most influenced by:
A) race.
B) socioeconomic class.
C) enculturation.
D) age group.
Answer: C
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Chapter 3: Examination Techniques and Equipment
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Sample Questions
Q1) Mrs. Berger is a 39-year-old woman who presents with a complaint of epigastric abdominal pain. You have completed the inspection of the abdomen. What is your next step in the assessment process?
A) Light palpation
B) Deep palpation
C) Percussion
D) Auscultation
Answer: D
Q2) Which technique is commonly used to elicit tenderness arising from the liver, gallbladder, or kidneys?
A) Finger percussion
B) Palmar percussion
C) Fist percussion
D) Forearm percussion
Answer: C
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5
Chapter 4: Clinical Reasoning
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Sample Questions
Q1) 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.
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) A specific test is one that has the ability to:
A) correctly identify those who have the disease.
B) correctly identify those who do not have the disease.
C) be exclusively used to make a diagnosis.
D) exclude competing explanations for another test finding.
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6
Chapter 5: Documentation
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Sample Questions
Q1) Which of the following is not a component of the plan portion of the problem-oriented medical record?
A) Diagnostics ordered
B) Therapeutics
C) Patient education
D) Differential diagnosis
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) The review of systems is a component of the: A) physical examination.
B) health history.
C) assessment.
D) past medical-surgical history.
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Chapter 6: Vital Signs and Pain Assessment
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Sample Questions
Q1) 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
Q2) The pyrexia response is triggered by the production and release of:
A) prostaglandins.
B) endogenous pyrogens.
C) hypothalamic enzymes.
D) thyroid hormones.
Q3) 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
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8
Chapter 7: Mental Status
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Sample Questions
Q1) Mrs. Griffiths, a 28-year-old patient, presents to your office to discuss her attention-deficit/hyperactivity disorder (ADHD). Which statement is true in regard to ADHD?
A) It occurs before 7 years of age.
B) It is usually related to mental retardation.
C) It is usually related to dementia.
D) It is manifested by prolonged periods of catatonic behavior.
Q2) You ask the patient to follow a series of short commands to assess:
A) judgment.
B) attention span.
C) arithmetic calculations.
D) abstract reasoning.
Q3) The Glasgow Coma Scale is used to:
A) determine the cause of decreased consciousness.
B) diagnose disorders that alter level of consciousness.
C) quantify consciousness.
D) predict response to stimulant medications.
Q4) Under most conditions, adult patients should be able to repeat forward a series of _____________ numbers.
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Chapter 8: Growth, Measurement, and Nutrition
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Sample Questions
Q1) The upper-to-lower segment ratio should be calculated:
A) bimonthly for the first year of life.
B) annually for the first 5 years.
C) only when a child is suspected of having a growth problem or unusual body proportions.
D) in children of first-generation immigrants.
Q2) Optimal infant birth weight is difficult for pregnant adolescents to obtain because:
A) they have not completed their own growth spurt.
B) there are insufficient uterine supporting structures.
C) the amniotic fluid is variable in pregnant adolescents.
D) blood volume has not reached adult proportions.
Q3) Which of the following is the most accurate reflection of an individual's food intake?
A) 24-hour diet recall
B) Food diary
C) Computerized nutrient analysis
D) Serum protein assay
Q4) 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) You are inspecting the lower extremities of a patient and have noted pale, shiny skin of the lower extremities. This may reflect:
A) systemic disease.
B) a history of vigorous exercise.
C) peptic ulcer disease.
D) mental retardation.
Q2) Brittle nails are typical findings in:
A) adolescents.
B) infants.
C) pregnant women.
D) older adults.
Q3) You have just completed a skin assessment on Mr. Baker. During your assessment, you have transilluminated a skin lesion. During the physical examination, you know that skin lesions are transilluminated to distinguish:
A) vascular from nonvascular lesions.
B) furuncles from folliculitis lesions.
C) fluid-filled lesions from solid cysts or masses.
D) herpes zoster from varicella.
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11
Chapter 10: Lymphatic System
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Sample Questions
Q1) Which nodes are also called Virchow nodes?
A) Internal mammary
B) Anterior axillary
C) Deep cervical
D) Supraclavicular
Q2) Which finding indicates that the examiner is assessing a blood vessel rather than a lymph node?
A) A bruit
B) Inflammation
C) Tenderness
D) Redness
Q3) The most important clue to the diagnosis of immunodeficiency disease in a child is:
A) family history.
B) illness in siblings.
C) previous hospitalizations.
D) serious recurring infections.
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Chapter 11: Head and Neck
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Sample Questions
Q1) You are palpating a patient's thyroid and find that its broadest dimension measures 4 cm. The right lobe is 25% larger than the left. These data would indicate:
A) a congenital anomaly.
B) a multinodular goiter.
C) a normal thyroid gland.
D) thyroiditis.
Q2) Mrs. Britton brings her 16-year-old son in with a complaint that he is not developing correctly into adolescence. Which structures disproportionately enlarge in the male during adolescence?
A) Coronal sutures
B) Hyoid and cricoid cartilages
C) Mandible and maxilla bones
D) Nose and thyroid cartilages
Q3) Which cranial nerves innervate the face?
A) II and V
B) III and VI
C) V and VII
D) VIII and IX
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13
Chapter 12: Eyes
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Sample Questions
Q1) Which maneuver can be done to reduce the systemic absorption of cycloplegic and mydriatic agents when examining a pregnant woman if the examination is mandatory?
A) Have the woman keep her eyes closed for several minutes.
B) Instill half the usual dosage.
C) Keep the patient supine, with her head turned and flexed.
D) Use nasolacrimal occlusion after instillation.
Q2) Cotton wool spots are most closely associated with:
A) glaucoma.
B) normal aging processes.
C) hypertension.
D) eye trauma.
Q3) 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.
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14
Chapter 13: Ears, Nose, and Throat
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Sample Questions
Q1) Mr. Spencer presents with the complaint of hearing loss. You specifically inquire about current medications. Which medications, if listed, are likely to contribute to his hearing loss?
A) Chlorothiazide
B) Acetaminophen
C) Salicylates
D) Cephalosporins
Q2) You are interviewing a parent whose child has a fever, is pulling at her right ear, and is irritable. You ask the parent about the child's appetite and find that the child has a decreased appetite. This additional finding is more suggestive of:
A) acute otitis media.
B) otitis externa.
C) serous otitis media.
D) middle ear effusion.
Q3) A hairy tongue with yellowish brown to black elongated papillae on the dorsum:
A) is indicative of oral cancer.
B) is sometimes seen following antibiotic therapy.
C) usually indicates vitamin deficiency.
D) usually indicates anemia.
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Page 15
Chapter 14: Chest and Lungs
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Sample Questions
Q1) To count the ribs and the intercostal spaces, you begin by palpating the reference point of the:
A) distal point of the xiphoid.
B) manubriosternal junction.
C) suprasternal notch.
D) acromion process.
Q2) Mr. Curtis is a 44-year-old patient who has presented to the emergency department with shortness of breath. During the history, the patient describes shortness of breath that gets worse when he sits up. To document this, you will use the term:
A) platypnea.
B) orthopnea.
C) tachypnea.
D) bradypnea.
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.
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Chapter 15: Heart
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Sample Questions
Q1) A palpable rushing vibration over the base of the heart at the second intercostal space is called a:
A) heave.
B) lift.
C) thrill.
D) thrust.
Q2) An apical PMI palpated beyond the fifth intercostal space may indicate:
A) decreased cardiac output.
B) obesity.
C) left ventricular hypertrophy.
D) hyperventilation.
Q3) 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.
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17
Chapter 16: Blood Vessels
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Sample Questions
Q1) You are assessing Mr. Z's fluid volume status as a result of heart failure. If your finger depresses a patient's edematous ankle to a depth of 6 mm, you should record this pitting as:
A) 1+.
B) 2+.
C) 3+.
D) 4+.
Q2) A bounding pulse in an infant may be associated with:
A) patent ductus arteriosus.
B) coarctation of the aorta.
C) decreased cardiac output.
D) peripheral vaso-occlusion.
Q3) 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.
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Page 18
Chapter 17: Breasts and Axillae
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Sample Questions
Q1) In patients with breast cancer, peau d'orange skin is often first evident:
A) in the axilla.
B) in the upper inner quadrant.
C) on or around the nipple.
D) at the inframammary ridge.
Q2) Montgomery tubercles are most prominent in the breasts of:
A) adult males.
B) patients with lung disease.
C) pregnant women.
D) pubertal females.
Q3) A nursing mother complains that her breasts are tender. You assess hard, shiny, and erythemic breasts bilaterally. You should advise the patient to:
A) massage gently and continue nursing.
B) apply warm compresses and stop nursing.
C) monitor her temperature and restrict fluids.
D) sleep wearing a bra and wash her breasts with antibacterial soap.
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19
Chapter 18: Abdomen
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Sample Questions
Q1) When percussing a spleen, Traube's space is a:
A) semilunar region.
B) splenic percussion sign.
C) left-sided pleural effusion.
D) solid mass.
Q2) To document absent bowel sounds correctly, one must listen continuously for:
A) 30 seconds.
B) 1 minute.
C) 3 minutes.
D) 5 minutes.
Q3) 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.
Q4) In older adults, overflow fecal incontinence is commonly caused by:
A) malabsorption.
B) parasitic diarrhea.
C) fecal impaction.
D) fistula formation.
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Chapter 19: Female Genitalia
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Sample Questions
Q1) The risk of ovarian cancer is increased by:
A) the use of oral contraceptives.
B) cigarette smoking.
C) age between 35 and 50 years.
D) early age at first intercourse.
Q2) When collecting specimens, which sample should be obtained first?
A) Chlamydial swab
B) Gonococcal culture
C) Pap smear
D) Wet mount
Q3) The female patient should ideally be in which position for the pelvic examination?
A) Fowler
B) Prone
C) Lateral supine
D) Lithotomy
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21
Chapter 20: Male Genitalia
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Sample Questions
Q1) A 12-year-old boy relates that his left scrotum has a soft swollen mass. The scrotum is not painful on palpation. The left inguinal canal is without masses. The mass transilluminates with a penlight. This collection of symptoms is consistent with: A) orchitis.
B) a hydrocele.
C) a rectocele.
D) a scrotal hernia.
Q2) 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
Q3) The most common cancer in young men ages 15 to 30 years is:
A) testicular.
B) penile.
C) prostate.
D) anal.
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22
Chapter 21: Anus, Rectum, and Prostate
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Sample Questions
Q1) Mr. Dunn is a 62-year-old man who has presented for a routine annual examination. On examination of the prostate you note a hard, irregular, painless nodule and obliteration of the median sulcus. These are signs of:
A) benign prostatic hypertrophy.
B) cancer of the prostate.
C) long-standing prostatitis.
D) swelling as a result of aging.
Q2) Palpation of the anal ring is done by:
A) bidigital palpation with the thumbs.
B) inserting the smallest finger into the anus.
C) pressing a gauze pad over the anus.
D) rotation of the forefinger inside the anus.
Q3) Pinworms and Candida may both cause:
A) constipation.
B) hemorrhoids.
C) perirectal irritation.
D) perirectal protrusion.
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Chapter 22: Musculoskeletal System
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Sample Questions
Q1) The elasticity of pelvic ligaments and softening of cartilage in a pregnant woman are the result of:
A) decreased mineral deposition.
B) increased hormone secretion.
C) uterine enlargement.
D) gait changes.
Q2) The tibia, fibula, and talus articulate to form the:
A) ankle.
B) knee.
C) hip.
D) pelvis.
Q3) 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.
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Chapter 23: Neurologic System
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Sample Questions
Q1) 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+
Q2) Which condition is potentially life-threatening if not treated expeditiously with antibiotics?
A) HIV encephalopathy
B) Dementia
C) Parkinson disease
D) Bacterial meningitis
Q3) Deep pressure tests are used mostly for patients who are experiencing:
A) absent superficial pain sensation.
B) gait and stepping disturbances.
C) lordosis, osteoporosis, or arthritis.
D) tonic neck or torso spasms.
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Chapter 24: Sports Participation Evaluation
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Sample Questions
Q1) 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.
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) Which medical condition would exclude a person from sports participation?
A) Asthma
B) Fever
C) Controlled seizures
D) HIV-positive status
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26
Chapter 25: Putting it All Together
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Sample Questions
Q1) Mrs. Kia has brought her newborn infant in for a 2-week examination. The examination of the newborn should begin with:
A) inspection.
B) palpation.
C) vital signs.
D) auscultation.
Q2) Which position is most likely the most comfortable for a patient who is 6 months pregnant?
A) Side-lying
B) Lithotomy
C) Prone
D) Flexed-knee
Q3) Observation of the child playing in the playroom provides information about which two systems?
A) Dermatologic and cardiovascular
B) Neurologic and musculoskeletal
C) Respiratory and ear, nose, and throat
D) Gastrointestinal and genitourinary
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Chapter 26: Emergency or Life-Threatening Situations
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Sample Questions
Q1) Respiratory distress may be evidenced by:
A) retractions of accessory muscles.
B) bradycardia.
C) flushed skin.
D) decreased capillary refill time.
Q2) During injury assessment, one of the most crucial historical components is:
A) number of siblings.
B) history of prior fractures.
C) mechanism of injury.
D) past and current occupational exposure.
Q3) When calculating the force of impact of a penetrating object, use:
A) the size of the missile and size of the patient.
B) the time of the incident and depth of the wound.
C) the amount of blood loss and level of consciousness.
D) the velocity of the missile and distance from the source.
Q4) The application of blunt sternal pressure is used to detect:
A) a fracture of attached ribs.
B) the motor function of the T7 dermatome.
C) pneumothorax.
D) cardiac contusion.
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