Primary Care Assessment Final Exam
Course Introduction
Primary Care Assessment introduces students to the foundational principles and practices of evaluating patients within a primary care setting. The course emphasizes a holistic, patient-centered approach to health assessment across the lifespan, incorporating techniques for comprehensive history taking, physical examination, and risk assessment. Students will learn to integrate evidence-based tools for identifying common acute and chronic conditions, differentiate between normal and abnormal findings, and develop effective communication skills with patients and healthcare teams. Through case studies and practical exercises, the course prepares students to deliver effective, high-quality primary care assessments in diverse clinical contexts.
Recommended Textbook
Seidels Guide to Physical Examination 9th Edition by Jane W. Ball
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648 Verified Questions
648 Flashcards
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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) 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
Q2) A 22-year-old female nurse is interviewing an 86-year-old male patient. The patient avoids eye contact and answers questions only by saying, "Yeah," "No," or "I guess so."
Which of the following is appropriate for the interviewer to say or ask?
A) "We will be able to communicate better if you look at me."
B) "It's hard for me to gather useful information because your answers are so short."
C) "Are you uncomfortable talking with me?"
D) "Does your religion make it hard for you to answer my questions?"
Answer: C
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4
Chapter 3: Examination Techniques and Equipment
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Sample Questions
Q1) The pneumatic attachment for the otoscope is used to evaluate:
A) ear canal patency.
B) eardrum landmarks.
C) hearing acuity.
D) tympanic membrane movement.
Answer: D
Q2) Which of the following are the causes of hyperreflexia? (Select all that apply.)
A) Cold stirrups
B) Standard scale
C) Insertion of a speculum
D) Fever
E) Pressure during bimanual examination
Answer: A, C, E
Q3) Expected normal percussion tones include:
A) dullness over the lungs.
B) hyperresonance over the lungs.
C) tympany over an empty stomach.
D) flatness over an empty stomach.
Answer: C
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Page 5
Chapter 4: Clinical Reasoning
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Sample Questions
Q1) The most important guide to sequencing actions should be:
A) probability and utility.
B) assumption and intuition.
C) costs and risks of procedures.
D) reimbursement potential and patient acceptance.
Q2) 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
Q3) Mr. Johnson actually has streptococcal pharyngitis; however, the throat culture is initially read as negative. This situation describes a test with a:
A) low sensitivity.
B) high sensitivity.
C) high specificity.
D) low specificity.
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Chapter 5: Documentation
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Sample Questions
Q1) 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
Q2) Ms. S reports that she is concerned about her loss of appetite. During the history, you learn that her last child recently moved out of her house to go to college. Rather than infer the cause of Ms. S's loss of appetite, it would be better to:
A) defer or omit her comments.
B) have her husband call you.
C) quote her concerns verbatim.
D) refer her for psychiatric treatment.
Q3) A SOAP note is used in which type of recording system?
A) Preventive care
B) Problem oriented
C) Systems review
D) Traditional treatment
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Chapter 6: Vital Signs and Pain Assessment
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Sample Questions
Q1) During expiration, the internal intercostals:
A) increase the force of muscular contraction.
B) decrease the lateral diameter during expiration.
C) decrease the intrathoracic space.
D) increase elastic recoil during expiration.
Q2) The most frequent cause of serious hypertension in children is:
A) heart disease.
B) liver failure.
C) renal disease.
D) rheumatic fever.
Q3) 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.
Q4) 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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Chapter 7: Mental Status
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Sample Questions
Q1) A clinical syndrome of failing memory and impairment of other intellectual functions, usually related to obvious structural diseases of the brain, describes:
A) delirium.
B) dementia.
C) depression.
D) anxiety.
Q2) Which are signs and symptoms of dementia?
A) Aphasia
B) Apathy
C) Odd behaviors
D) Disintegration of personality
E) Lack of awareness of others
Q3) Under most conditions, adult patients should be able to repeat forward a series of _____________ numbers.
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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Page 9
Chapter 8: Growth, Measurement, and Nutrition
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Sample Questions
Q1) Healthy term babies generally double their birth weight by what age?
A) 3 months
B) 5 months
C) 9 months
D) 12 months
Q2) 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
Q3) The legs are the fastest growing body part during:
A) early infancy.
B) late infancy.
C) childhood.
D) early adulthood.
Q4) Infants normally increase their birth length by ____% during the first year of life.
Q5) The term large for gestational age (LGA) indicates that an infant is larger than ____% of infants born at the same number of weeks' gestation.
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Chapter 9: Skin, Hair, and Nails
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Sample Questions
Q1) Which identify the signs and symptoms of basal cell cancer? (Select all that apply.)
A) Itching
B) Reddish patch
C) Starts from a nevi
D) Various clinical forms-cystic, nodular, pigmented
E) Macule type
Q2) A 5-year-old child presents with discrete vesicles on an erythematous base that began near her scalp and are spreading to the trunk. The child has a low-grade fever and feels tired. What is the nurse's next action?
A) Teach infectious control measures.
B) Inquire about other patterns of physical abuse.
C) Inspect the buccal mucosa for Koplik spots.
D) Inform the parent that this will resolve within a couple of days.
Q3) 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.
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11
Chapter 10: Lymphatic System
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Sample Questions
Q1) Which nodes are most often associated with inflammation?
A) Shotty
B) Movable
C) Fixed
D) Tender
Q2) A red streak that follows the course of the lymphatic collecting duct is a finding associated with:
A) Hodgkin disease.
B) lymphangitis.
C) lymphedema.
D) lymphoma.
Q3) 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.
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Chapter 11: Head and Neck
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Sample Questions
Q1) Which of the following is true regarding a cephalohematoma?
A) It is bound by suture lines.
B) The affected part feels soft.
C) It is obvious at birth.
D) The margins are poorly defined.
Q2) Which of the following is an expected change in the assessment of the thyroid during pregnancy?
A) Palpation of the gland becomes difficult.
B) A bruit is auscultated.
C) Inspection reveals a goiter.
D) The gland is tender on palpation.
Q3) 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.
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Chapter 12: Eyes
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Sample Questions
Q1) Mr. Morris is a 38-year-old patient who presents to the clinic with complaints of allergies. An allergy can cause the conjunctiva to have a:
A) cobblestone pattern.
B) dry surface.
C) subconjunctival hemorrhage.
D) rust-colored pigment.
Q2) Ask the patient to look directly at the light of the ophthalmoscope when you are ready to examine the:
A) retina.
B) optic disc.
C) retinal vessels.
D) macula.
Q3) When drusen bodies are noted to be increasing in number or in intensity of color, the patient should be further evaluated with a(n):
A) Amsler grid.
B) Snellen E chart.
C) litmus test.
D) confrontation test.
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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) 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.
Q3) 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.
Q4) For best results, an otoscopic and oral examination in a child should be:
A) conducted at the beginning of the assessment.
B) done after inspection.
C) performed at the end of the examination.
D) performed before palpation.
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Chapter 14: Chest and Lungs
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Sample Questions
Q1) 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
Q2) 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.
Q3) Which lung sounds are associated with atelectasis? (Select all that apply.)
A) Wheezes
B) Ronchi
C) Crackles
D) Crepitus
E) Rales
Q4) An Apgar score of __________ is given to the infant who demonstrates irregular respiratory effort.
Page 16
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Chapter 15: Heart
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Sample Questions
Q1) If the apical impulse is more vigorous than expected, it is called a:
A) lift.
B) thrill.
C) bruit.
D) murmur.
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) 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) To assess a patient's jugular veins, the patient should first be placed in which position?
A) Supine
B) Semi-Fowler
C) Upright
D) Left lateral recumbent
Q2) In children, coarctation of the aorta should be suspected if you detect:
A) a delay between the radial and femoral pulses.
B) a simultaneous radial and femoral pulse.
C) an absent femoral pulse on the left.
D) bilateral absence of femoral pulses.
Q3) You are palpating bilateral pedal pulses and cannot feel one of the pulses. The feet are equally warm. You find that both great toes are pink, with a capillary refill within 2 seconds. Which of the following statements is correct?
A) Immediate emergency surgery is indicated.
B) Pedal pulses are not always palpable.
C) Unilateral pulses are never normal.
D) Venogram studies will be needed.
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18
Chapter 17: Breasts and Axillae
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Sample Questions
Q1) A 23-year-old white woman has come to the clinic because she has missed two menstrual periods. She states that her breasts have enlarged and that her nipples have turned a darker color. Your response to this finding is to:
A) instruct her that this is a side effect of birth control injection therapy.
B) suggest pregnancy testing.
C) question her use of tanning beds.
D) schedule an appointment with a surgeon.
Q2) 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.
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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Chapter 18: Abdomen
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Sample Questions
Q1) Mr. Robins is a 45-year-old man who presents to the emergency department with a complaint of constipation. During auscultation, you note borborygmi sounds. This is associated with:
A) gastroenteritis.
B) peritonitis.
C) satiety.
D) paralytic ileus.
Q2) Your patient presents with symptoms that lead you to suspect acute appendicitis. Which assessment finding is least likely to be associated with this condition?
A) Positive psoas sign
B) Positive McBurney sign
C) Consistent right lower quadrant (RLQ) pain
D) Rebound tenderness
Q3) When percussing a spleen, Traube's space is a:
A) semilunar region.
B) splenic percussion sign.
C) left-sided pleural effusion.
D) solid mass.
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Chapter 19: Female Genitalia
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Sample Questions
Q1) The form of gynecologic cancer that is increased in obese women is:
A) vaginal.
B) cervical.
C) ovarian.
D) endometrial.
Q2) A bluish color to the cervix during pregnancy is called (the):
A) McDonald sign.
B) Spinnbarkeit.
C) Goodell sign.
D) Chadwick sign.
Q3) The vaginal mucosa of a woman of childbearing years should appear:
A) smooth and pink.
B) moist and excoriated.
C) dry and papular.
D) transversely rugated.
Q4) 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.
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Chapter 20: Male Genitalia
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Sample Questions
Q1) The most common type of hernia occurring in young males is:
A) hiatal.
B) incarcerated femoral.
C) indirect inguinal.
D) umbilical.
Q2) In an uncircumcised male, retraction of the foreskin may reveal a cheesy white substance. This is usually:
A) evidence of a fungal infection.
B) a collection of sebaceous material.
C) indicative of penile carcinoma.
D) suggestive of diabetes.
Q3) 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
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22
Chapter 21: Anus, Rectum, and Prostate
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Sample Questions
Q1) Pinworms and Candida may both cause:
A) constipation.
B) hemorrhoids.
C) perirectal irritation.
D) perirectal protrusion.
Q2) Prostate-specific antigen (PSA) screening is controversial because:
A) there are many false-negative results.
B) PSA is produced by many other tissues.
C) it is less sensitive than digital rectal examination.
D) no data have proved that it decreases mortality.
Q3) Tarry black stools should make you suspect:
A) internal hemorrhoids.
B) rectal fistula.
C) upper intestinal tract bleeding.
D) prostatic cancer.
Q4) Factors associated with increased risk of prostate cancer include:
A) African descent.
B) cigarette smoking.
C) a low-fat diet.
D) alcoholism.
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Chapter 22: Musculoskeletal System
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Sample Questions
Q1) Light skin and thin body habitus are risk factors for:
A) rheumatoid arthritis.
B) osteoarthritis.
C) congenital bony defects.
D) osteoporosis.
Q2) When the shoulder contour is asymmetric and one shoulder has hollows in the rounding contour, you would suspect:
A) kyphosis.
B) fractured scapula.
C) a dislocated shoulder.
D) muscle wasting.
Q3) Spinal vertebrae are separated from each other by:
A) bursae.
B) tendons.
C) disks.
D) ligaments.
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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) 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) 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.
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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) Which medical condition would exclude a person from sports participation?
A) Asthma
B) Fever
C) Controlled seizures
D) HIV-positive status
Q3) You are conducting a preparticipation physical examination for a 10-year-old girl with Down syndrome who will be playing basketball. She has slight torticollis and mild ankle clonus. Which additional diagnostic test would be required for her?
A) Cervical spine radiography
B) Visual acuity
C) Mini-Mental State Examination
D) Nerve conduction studies
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26
Chapter 25: Putting it All Together
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Sample Questions
Q1) Which is true regarding the relationship between the examiner and patient?
A) It is the examiner's responsibility to help the patient understand that he or she is qualified to make decisions regarding health care.
B) The patient must trust the examiner completely.
C) The examiner-patient relationship is enhanced by ignoring cultural issues.
D) The patient is a full partner with the examiner.
Q2) Throughout the history and physical examination, the clinician should:
A) concentrate on emotional issues.
B) follow an inflexible sequence.
C) evaluate the whole patient.
D) deal only with previously identified problems.
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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Sample Questions
Q1) A life-threatening condition is recognized with the assessment of:
A) pain with downward pressure on both anterior superior iliac spines.
B) guarding and intense pain with deep palpation of the abdomen.
C) distant and muffled heart sounds, with distended neck veins.
D) severe throbbing pain in one eye, with photophobia.
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) Delayed capillary refill may alert you to:
A) hypovolemic shock.
B) moderate hypoxemia.
C) subnormal intracranial pressure.
D) upper respiratory infection.
Q4) Paradoxical chest movement suggests a:
A) spontaneous pneumothorax.
B) flail chest.
C) clavicle fracture.
D) pulmonary contusion.
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