The first examination technique, careful observation of color, shape, symmetry, and movement, is inspection.
Missing Word
inspection
Inspection is purposeful looking, and sometimes listening and smelling, before touching the patient. It begins the exam of every system.
Category: Examination Techniques
Question 2
A palpable vibration felt over the heart or a blood vessel, caused by turbulent blood flow, is a thrill.
Missing Word
thrill
A thrill is the vibration that turbulent flow produces, felt with the palm or the base of the fingers. A thrill is expected over a working dialysis access site, but elsewhere it points to abnormal flow and is reported.
Category: Lung and Heart Findings
Question 3
Percussion is tapping on the body surface to tell whether the tissue underneath holds air, fluid, or solid material.
Missing Word
Percussion
Percussion produces sounds such as resonance, tympany, and dullness that reveal what lies beneath the surface.
Category: Examination Techniques
Question 4
Auscultation is listening, usually with a stethoscope, to sounds produced inside the body.
Missing Word
Auscultation
Auscultation is used to hear heart, lung, bowel, and blood vessel sounds. In most systems it is the last technique used.
Category: Examination Techniques
Question 5
Using the hands and fingers to feel the body for texture, temperature, moisture, pulses, and masses is palpation.
Missing Word
palpation
Palpation follows inspection in most body systems. Light palpation comes before deep palpation, and tender areas are palpated last so the patient does not guard.
Category: Examination Techniques
Question 6
A bluish color of the lips, mucous membranes, or nail beds caused by poorly oxygenated blood is cyanosis.
Missing Word
cyanosis
Cyanosis appears when blood carries less oxygen than normal. Bluish lips or tongue are a serious sign that needs prompt action.
Category: Skin and Circulation
Question 7
During the pupil check, the nurse tests accommodation by having the patient shift focus from a distant object to a near one and watching the pupils constrict and the eyes converge.
Missing Word
accommodation
In the routine pupil check, accommodation is tested by watching the pupils constrict and the eyes turn inward as the patient focuses on a near object. Strictly, accommodation is the lens adjustment for near vision, which occurs together with these visible changes.
Category: Head and Neuro Findings
Question 8
A whooshing sound heard over an artery, caused by turbulent blood flow, is a bruit.
Missing Word
bruit
A bruit suggests narrowing of an artery, such as the carotid artery. It is low pitched and best heard with the bell of the stethoscope.
Category: Lung and Heart Findings
Question 9
The flat side of the stethoscope chest piece, called the diaphragm, best picks up high-pitched sounds such as normal breath sounds.
Missing Word
diaphragm
The diaphragm is pressed firmly on the skin to hear high-pitched sounds, including breath sounds, normal heart sounds, and bowel sounds.
Category: Lung and Heart Findings
Question 10
Asking patients to state their name, location, and the date assesses orientation to person, place, and time.
Missing Word
orientation
Orientation is part of the neurologic assessment. A patient who cannot say who and where they are or the date may have confusion that needs further evaluation.
Category: Head and Neuro Findings
Question 11
The nurse assesses gait by watching the pattern, balance, and rhythm of the patient's walking.
Missing Word
gait
Gait is the way a person walks. An unsteady or shuffling gait raises fall risk and can point to neurologic or musculoskeletal problems.
Category: Head and Neuro Findings
Question 12
A sense of mutual understanding and ease between nurse and patient, which therapeutic communication helps establish alongside trust, is called rapport.
Missing Word
rapport
Rapport is the comfortable, mutual understanding that lets a patient speak openly. Nurses nurture rapport through attentive, respectful communication while keeping the relationship professional rather than a friendship.
Category: Patient Communication
Question 13
The white outer layer of the eye, where yellowing from liver problems is often first noticed, is the sclera.
Missing Word
sclera
The sclera is the tough white coat of the eye. Yellowing of the sclera can show jaundice even before the skin changes, particularly in people with darker skin.
Category: Head and Neuro Findings
Question 14
A drumlike sound heard when percussing over gas-filled bowel is tympany.
Missing Word
tympany
Tympany is the normal percussion sound over most of the abdomen because the bowel contains gas.
Category: Examination Techniques
Question 15
A blowing or whooshing sound heard over the heart, produced by turbulent blood flow through a valve, is a murmur.
Missing Word
murmur
A murmur is heard with a stethoscope over the heart and can come from a narrowed or leaking valve. A new murmur is reported to the provider.
Category: Lung and Heart Findings