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UCLA SCHOOL OF NURSING MSN, Advanced Practice Nursing, Primary Care FNP, AGNP & AGNP-OEH students Advanced

Physical Assessment Skills and Competencies Checklist Class of 2013 Student name_____________________________ Include signature, full legibly printed name or stamp, and date. Skills may be signed off by any Program Faculty or Preceptor. Copy to be signed by Clinical Faculty at end of each Quarter (N440, 429A-E or 439A-E). Completion required for Graduation.

Comprehensive Physical Exam of Adults


SYSTEM Skills
GENERAL APPEARANCE Development, BMI, Waist Circumference, Grooming, Affect, Speech, Hearing HEENT AND NECK Scalp / Hair CN V, VII (motor & sensory) Lymph Nodes Thyroid Trachea Muscle Strength (CN XI) Visual Acuity (CN II) EOMs (CN III, IV, VI) Eyelids / Eyebrows Conjunctivae / Cornea Pupils (PERRLA) Red reflex

States normal range

Uses correct technique

Uses precise anatomic terminology

States abnormal findings

Links abnormal findings with diagnoses

UCLA SCHOOL OF NURSING MSN, Advanced Practice Nursing, Primary Care FNP, AGNP & AGNP-OEH students Advanced Physical Assessment Skills and Competencies Checklist Class of 2013 Student name_____________________________ Include signature, full legibly printed name or stamp, and date. Skills may be signed off by any Program Faculty or Preceptor. Copy to be signed by Clinical Faculty at end of each Quarter (N440, 429A-E or 439A-E). Completion required for Graduation.
SYSTEM Skills
Opthalmoscope (Fundoscopic) Vision Screening Gross hearing test (CN VIII) Weber response Rinne response External ears & traguses Otoscope (canals & TMs) Nose Mouth Lips, Buccal Mucosa, Teeth, Gums, Palate, Tonsils Tongue & CN XII (motor) Pharynx (CN XI, X) (motor) Sinuses RESPIRATORY Lungs Inspect: Musculature; AP Diameter; Respiratory Rate Percuss: Lung Fields (8 sites and RML)

States normal range

Uses correct technique

Uses precise anatomic terminology

States abnormal findings

Links abnormal findings with diagnoses

UCLA SCHOOL OF NURSING MSN, Advanced Practice Nursing, Primary Care FNP, AGNP & AGNP-OEH students Advanced Physical Assessment Skills and Competencies Checklist Class of 2013 Student name_____________________________ Include signature, full legibly printed name or stamp, and date. Skills may be signed off by any Program Faculty or Preceptor. Copy to be signed by Clinical Faculty at end of each Quarter (N440, 429A-E or 439A-E). Completion required for Graduation.
SYSTEM Skills
Diaphragmatic Excursion Auscultate: Breath sounds (min. 8 sites post + RML) and distinguish normal & adventitious sounds Egophony Whispered Pectoriloquy CARDIOVASCULAR Heart Inspect: Apical impulse Palpate: Precordium / Apical Impulse Auscultate with diaphragm and bell: Aortic area Pulmonic area Tricuspid area Mitral area Describe murmers / Distinguish systolic and diastolic murmers Describe extra heart sounds (S3, S4) / Distinguish from split S2 Peripheral Vascular

States normal range

Uses correct technique

Uses precise anatomic terminology

States abnormal findings

Links abnormal findings with diagnoses

UCLA SCHOOL OF NURSING MSN, Advanced Practice Nursing, Primary Care FNP, AGNP & AGNP-OEH students Advanced Physical Assessment Skills and Competencies Checklist Class of 2013 Student name_____________________________ Include signature, full legibly printed name or stamp, and date. Skills may be signed off by any Program Faculty or Preceptor. Copy to be signed by Clinical Faculty at end of each Quarter (N440, 429A-E or 439A-E). Completion required for Graduation.
SYSTEM Skills
Inspect & Palpate Legs: color, veins, lesions, nails, hair growth, temp, edema Pulses: Carotid Radial Femoral Posterior Tibial Dorsalis Pedis Auscultate: Carotids for bruits Jugular Venous Pressure Measurement ABDOMINAL Inspect: Coloring, scars, striae, musculature, distension, pulsations Auscultate: Bowel sounds (4 quads) Aortic bruit Percuss: All quadrants Kidneys (CVA tenderness)

States normal range

Uses correct technique

Uses precise anatomic terminology

States abnormal findings

Links abnormal findings with diagnoses

UCLA SCHOOL OF NURSING MSN, Advanced Practice Nursing, Primary Care FNP, AGNP & AGNP-OEH students Advanced Physical Assessment Skills and Competencies Checklist Class of 2013 Student name_____________________________ Include signature, full legibly printed name or stamp, and date. Skills may be signed off by any Program Faculty or Preceptor. Copy to be signed by Clinical Faculty at end of each Quarter (N440, 429A-E or 439A-E). Completion required for Graduation.
SYSTEM Skills
Liver at MCL Gastric Air Bubble Palpate: All quads lightly, deeply Liver Border Spleen Kidneys Inguinal Lymph Nodes McBurneys, Point Murphys Sign 1 Test for peritoneal irritation MUSCULOSKELETAL Gait Inspect, Palpate & ROM Spine Inspect, Palpate & ROM: TMJ Hands / Fingers Wrists

States normal range

Uses correct technique

Uses precise anatomic terminology

States abnormal findings

Links abnormal findings with diagnoses

UCLA SCHOOL OF NURSING MSN, Advanced Practice Nursing, Primary Care FNP, AGNP & AGNP-OEH students Advanced Physical Assessment Skills and Competencies Checklist Class of 2013 Student name_____________________________ Include signature, full legibly printed name or stamp, and date. Skills may be signed off by any Program Faculty or Preceptor. Copy to be signed by Clinical Faculty at end of each Quarter (N440, 429A-E or 439A-E). Completion required for Graduation.
SYSTEM Skills
Elbows Shoulders Hips Knees Ankles Feet C Spine: Spurling Manuever Adsons Test L-S Spine: Heel and Toe Walk, Squat Straight Leg Raises Femoral Nerve Stretch Test Trendelenbergs Test Patricks Test Figure 4 Waddells Sign Hoover Test Hip: Thomas Test Obers Test

States normal range

Uses correct technique

Uses precise anatomic terminology

States abnormal findings

Links abnormal findings with diagnoses

UCLA SCHOOL OF NURSING MSN, Advanced Practice Nursing, Primary Care FNP, AGNP & AGNP-OEH students Advanced Physical Assessment Skills and Competencies Checklist Class of 2013 Student name_____________________________ Include signature, full legibly printed name or stamp, and date. Skills may be signed off by any Program Faculty or Preceptor. Copy to be signed by Clinical Faculty at end of each Quarter (N440, 429A-E or 439A-E). Completion required for Graduation.
SYSTEM Skills
Shoulder: Internal Rotation External Rotation Abduction Abduction with thumbs down and arms forward 30 degrees (Empty Can) Cross-over Test Neers Test Hawkins Test (Kiss The Elbow) Yergasons Test Speeds Test Apprehension Test Drop Arm Test Anterior Drawer Test Sulcus Sign Elbow: Cozens Test Valgus Test Varus Test Tinels Sign

States normal range

Uses correct technique

Uses precise anatomic terminology

States abnormal findings

Links abnormal findings with diagnoses

UCLA SCHOOL OF NURSING MSN, Advanced Practice Nursing, Primary Care FNP, AGNP & AGNP-OEH students Advanced Physical Assessment Skills and Competencies Checklist Class of 2013 Student name_____________________________ Include signature, full legibly printed name or stamp, and date. Skills may be signed off by any Program Faculty or Preceptor. Copy to be signed by Clinical Faculty at end of each Quarter (N440, 429A-E or 439A-E). Completion required for Graduation.
SYSTEM Skills
Compression of Medial Epicondyle Compression of Lateral Epicondyle Hand & Wrist: Finkelsteins Test Phalans Test Tinels Test Compression Test Flexor Digitorum Superficialis Test Flexor Digitorum Profundus Test Allens Test Thumb CMC Grind Test Snuff Box Knee: McMurrays Test Anterior Drawer Posterior Drawer Valgus Stress Test Lachmans Test Patella Femoral Grinding Test

States normal range

Uses correct technique

Uses precise anatomic terminology

States abnormal findings

Links abnormal findings with diagnoses

UCLA SCHOOL OF NURSING MSN, Advanced Practice Nursing, Primary Care FNP, AGNP & AGNP-OEH students Advanced Physical Assessment Skills and Competencies Checklist Class of 2013 Student name_____________________________ Include signature, full legibly printed name or stamp, and date. Skills may be signed off by any Program Faculty or Preceptor. Copy to be signed by Clinical Faculty at end of each Quarter (N440, 429A-E or 439A-E). Completion required for Graduation.
SYSTEM Skills
Apprehension Test Sag Sign Knee Joint Effusion Test Apleys Compression Test Apleys Distraction Test Bounce Test Steinmans Tenderness Displacement Test Foot & Ankle: Thompsons Test Talar Tilt Test Anterior Drawer Test Heel Squeeze Forefoot Squeeze Webspace Squeeze Passive Dorsiflexion of Toes Standing on Toes of Affected Foot Standing on Heel of Affected Foot

States normal range

Uses correct technique

Uses precise anatomic terminology

States abnormal findings

Links abnormal findings with diagnoses

UCLA SCHOOL OF NURSING MSN, Advanced Practice Nursing, Primary Care FNP, AGNP & AGNP-OEH students Advanced Physical Assessment Skills and Competencies Checklist Class of 2013 Student name_____________________________ Include signature, full legibly printed name or stamp, and date. Skills may be signed off by any Program Faculty or Preceptor. Copy to be signed by Clinical Faculty at end of each Quarter (N440, 429A-E or 439A-E). Completion required for Graduation.
SYSTEM Skills
NEUROLOGICAL Coordination and Balance Romberg Tandem walk or hop -L & R Fine Motor Muscle strength Upper extremities (3 muscle groups) Lower extremities (3 muscle groups) Palpate: Sensory System Light touch Pain Vibratory sensation Graphesthesia (test each hand) Percuss Reflexes: Brachioradialis Biceps Triceps

States normal range

Uses correct technique

Uses precise anatomic terminology

States abnormal findings

Links abnormal findings with diagnoses

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UCLA SCHOOL OF NURSING MSN, Advanced Practice Nursing, Primary Care FNP, AGNP & AGNP-OEH students Advanced Physical Assessment Skills and Competencies Checklist Class of 2013 Student name_____________________________ Include signature, full legibly printed name or stamp, and date. Skills may be signed off by any Program Faculty or Preceptor. Copy to be signed by Clinical Faculty at end of each Quarter (N440, 429A-E or 439A-E). Completion required for Graduation.
SYSTEM Skills
Patellar Achilles Plantar INTEGUMENTARY Inspect and Palpate: Skin: Color, uniformity, hygiene, texture, exudates, moisture, temperature, texture, turgor, mobility Identifying marks, scars Describe normal and abnormal lesions Hair: distribution, quantity, texture, areas of hair loss Nails: color, symmetry, cleanliness, opacity, trauma, ridging, pitting, nail plate for adherence, thickness MALE GENITOURINARY Inspect and Palpate: Tanner Stage, Penis shaft, glans, corona, foreskin, urethral meatus Scrotum, Testes, Epididymis, Vas Deferens, Spermatic Cord Describe Testicular masses Inguinal Canal (hernias) Digital Rectal Exam

States normal range

Uses correct technique

Uses precise anatomic terminology

States abnormal findings

Links abnormal findings with diagnoses

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UCLA SCHOOL OF NURSING MSN, Advanced Practice Nursing, Primary Care FNP, AGNP & AGNP-OEH students Advanced Physical Assessment Skills and Competencies Checklist Class of 2013 Student name_____________________________ Include signature, full legibly printed name or stamp, and date. Skills may be signed off by any Program Faculty or Preceptor. Copy to be signed by Clinical Faculty at end of each Quarter (N440, 429A-E or 439A-E). Completion required for Graduation.
SYSTEM Skills
Describe normal and abnormal Prostate FEMALE BREAST Inspect: Contour, Nipple Direction, Spontaneous Discharge (3 positions) Palpate: Supraclavicular, Infraclavicular & Axillary Nodes 5 sided area; vertical strip; superficial, mid & deep depth Describe Masses: position, depth, size, shape, delimitation, consistency & mobility FEMALE GENETOURINARY External, Labia, Clitoris, Bartholin & Skene Glands Muscle Tone (Cystocele,Rectocele) Speculum: Vaginal Walls, Lesions, Discharge Cervix Bimanual Palpation: Uterus, Adnexa Rectovaginal / Identify Uterine Position MENTAL AND FUNCTIONAL STATUS AND CENTRAL NERVOUS SYSTEM Alertness, Orientation Functional Status / ADLs

States normal range

Uses correct technique

Uses precise anatomic terminology

States abnormal findings

Links abnormal findings with diagnoses

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UCLA SCHOOL OF NURSING MSN, Advanced Practice Nursing, Primary Care FNP, AGNP & AGNP-OEH students Advanced Physical Assessment Skills and Competencies Checklist Class of 2013 Student name_____________________________ Include signature, full legibly printed name or stamp, and date. Skills may be signed off by any Program Faculty or Preceptor. Copy to be signed by Clinical Faculty at end of each Quarter (N440, 429A-E or 439A-E). Completion required for Graduation.
SYSTEM Skills
Substance Use Screening Suicide / Homicide Risk Screening

States normal range

Uses correct technique

Uses precise anatomic terminology

States abnormal findings

Links abnormal findings with diagnoses

Diagnostic Test Interpretation of Adults


RESPIRATORY Administration and Interpretation of Office Spirometry Testing Administration and Interpretation of Office Pulmonary Function Testing Interpretation of A-P & Lateral Chest x-ray for Pneumonia, Pneumothorax, Masses CARDIOVASCULAR 12-lead EKG: Identify Normal Sinus Rhythm, ST elevations 12-lead EKG: Identify Common Rhythm Abnormalities Interpretation of Chest X-ray for Cardiomegaly. Pleural Effusion ABDOMINAL Interpretation of Abdominal X-ray for Bowel Obstruction

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UCLA SCHOOL OF NURSING MSN, Advanced Practice Nursing, Primary Care FNP, AGNP & AGNP-OEH students Advanced Physical Assessment Skills and Competencies Checklist Class of 2013 Student name_____________________________ Include signature, full legibly printed name or stamp, and date. Skills may be signed off by any Program Faculty or Preceptor. Copy to be signed by Clinical Faculty at end of each Quarter (N440, 429A-E or 439A-E). Completion required for Graduation.
MUSCULOSKELETAL Interpretation of X-rays for Acute Fractures INTEGUMENTARY KOH Specimen Collection and Microscopic Evaluation FEMALE GENETOURINARY Specimen Collection & Preparation of: Normal Saline Wet Mount KOH Test pH Test Microscopic Examination of Wet Mount & KOH NEUROLOGICAL MoCA MMSE MiniCog PHQ 9 Depression Screen Geriatric Depression Scale

Primary Care Procedures for Adults


MUSCULOSKELETAL Splinting of Suspected Fractures - State

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UCLA SCHOOL OF NURSING MSN, Advanced Practice Nursing, Primary Care FNP, AGNP & AGNP-OEH students Advanced Physical Assessment Skills and Competencies Checklist Class of 2013 Student name_____________________________ Include signature, full legibly printed name or stamp, and date. Skills may be signed off by any Program Faculty or Preceptor. Copy to be signed by Clinical Faculty at end of each Quarter (N440, 429A-E or 439A-E). Completion required for Graduation.
INTEGUMENTARY Local Anesthesia Administration - State Punch Biopsy Shave Biopsy Incision and Drainage of Abscess - State Suturing: Wound Assessment, Irrigation, Debridement - State Basic Wound Closure Techniques Digital Block Local Anesthesia Administration State Nail Removal - State FEMALE GENETOURINARY Pap Smear Specimen Collection and Preparation (Liquid and Conventional) GC/CT Culture Specimen Collection and Preparation Endometrial Biopsy IUD Insertion IUD Removal OTHER

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UCLA SCHOOL OF NURSING MSN, Advanced Practice Nursing, Primary Care FNP, AGNP & AGNP-OEH students Advanced Physical Assessment Skills and Competencies Checklist Class of 2013 Student name_____________________________ Include signature, full legibly printed name or stamp, and date. Skills may be signed off by any Program Faculty or Preceptor. Copy to be signed by Clinical Faculty at end of each Quarter (N440, 429A-E or 439A-E). Completion required for Graduation.

COMMENTS: Clinical Faculty Signature _____________________________________________________ COMMENTS: Clinical Faculty Signature _____________________________________________________ COMMENTS: Clinical Faculty Signature _____________________________________________________ COMMENTS: Clinical Faculty Signature _____________________________________________________ N429/439C Date________________ N429/439B Date________________ N429/439A Date_______________ N440 Date_______________

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UCLA SCHOOL OF NURSING MSN, Advanced Practice Nursing, Primary Care FNP, AGNP & AGNP-OEH students Advanced Physical Assessment Skills and Competencies Checklist Class of 2013 Student name_____________________________ Include signature, full legibly printed name or stamp, and date. Skills may be signed off by any Program Faculty or Preceptor. Copy to be signed by Clinical Faculty at end of each Quarter (N440, 429A-E or 439A-E). Completion required for Graduation.

COMMENTS: Clinical Faculty Signature _____________________________________________________ COMMENTS: STUDENT HAS MET GRADUATION REQUIREMENT: _________ Clinical Faculty Signature _____________________________________________________ N429/439E Date________________ N429/439D Date________________

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