Health Assessment Test Revision

1.What are subjective data and objective data collected from a physical
assessment?
Give eight examples.(Respiratory system)

Subjective data Def:

-May be called “covert data”
-Not measurable or observable
-Obtained from client (primary source), significant others, or health professionals
(secondary sources).

Objective data Def:

-May be called “overt data”
-Can be detected by someone other than the client
-Includes measurable and observable client behavior

Inspection Inspection
Respiratory rate and pattern
Obvious lung sound without stethoscope
Signs of cyanosis(cant breath)
Use of accessory muscles
Skin color
Palpation Palpation
Position of trachea Area of pain
Enlarged lymph nodes Area of itchiness
Chest excursion Feeling burn
Tactile fremitus Feeling hot/cold
Area of abnormalities (tenderness/lesions/bruises)
Percussion Percussion
Dullness (Pleural effusion/pneumonia/tumour)
Hyperresonance (emphysema/pneumothorax)
Auscultation Auscultation
Lung sound
2. For a patient with a respiratory or gastrointestinal condition, what history-
taking questions would you ask? Give eight examples.

Family History (Lung cancer, Tuberculosis, COPD)

(cancer/alcoholism)

Personal History of lung disease/allergies/abdominal surgery/trauma

Concern signs & symptoms (productive/non-productive cough/fever/sputum

characteristic) (Black tarry stool/constipation/abdominal pain)

Risk factors (drug abuse)

(NSAIDS, antibiotics)
3. If you are going to conduct a systematic assessment for the respiratory system,
what will you do in terms of inspection, percussion, palpation, and auscultation?

Inspection
Respiratory rate pattern
Sign of cyanosis (cannot breath)
-purple lips/ /blue nails
Use of accessory muscles
Chest asymmetry
Shape/configuration/movement during respiration
Chest skin color

Percussion
Percuss in the interspace to test if lung tissue is fill with air/fluid/solid
Normal: Vesicular sound should be soft
Dullness: pleural effusion, pneumonia, tumour
Hyperresonance: emphysema, pneumothorax

Palpation (palpate)
-Lymph nodes enlargement
-Position of the trachea
-Area of abnormalities (tenderness, lesions, bruises)
-Chest excursion
-Tactile fremitus
Auscultation
Use diaphragm of stethoscope (listen for a cycle)
Breathe with mouth
Listen to the duration/pitch/intensity of the lung sound
-Crackles
-Wheezes
-Rhonchi
-Stridor
-Pleural friction Rub
4. What are the indications for a 12-lead ECG?
A. Suspected cardiac patient
B. Suspected tricyclic overdose
C. Electrical injuries
D. Syncope
E. Fatigue, nausea or dizziness in the elderly or those with cardiac risk factors
F. Unexplained shortness of breath
G. Patients on dialysis

5. How many electrodes are needed for a 12-lead ECG?

The 12-lead ECG records 12 different electrical views of the heart, but only 10
electrodes are placed on the skin. There are two groups of electrodes: six chest
electrodes (see right) and four limb electrodes. The four limb electrodes, placed on
the wrists and ankles, provide the electrical information that produces the six limb
leads on the ECG.

6.Where are the precordial electrodes placed on the chest?

(V1, V2, V3, V4, V5, V6)

The six precordial leads are placed on the anterior chest in a standard configuration.
V1 is placed on the right side of the sternum at the fourth intercostal, or rib space,
while V2 is placed directly across the sternum on the left side of the chest. V4 is
positioned at the fifth intercostal space below the middle of the left clavicle. Working
backward, precordial lead V3 is applied directly between V2 and V4. V5 and V6 are
placed at the same level as V4 at the left anterior axillary line and the left midaxillary
line, respectively.
7. What is contact dermatitis? What are the common signs and symptoms?

Contact dermatitis is a red, itchy rash caused by direct contact with a substance or an
allergic reaction to it.

-A red rash

-Itching, which may be severe

-Dry, cracked, scaly skin

-Bumps and blisters, sometimes with oozing and crusting

-Swelling, burning or tenderness

8. What are the pain characteristics for a patient with acute appendicitis?
The main symptom of appendicitis is abdominal pain.

9. What is rebound tenderness? What is the clinical significance of rebound

tenderness?
Rebound tenderness is a clinical sign where palpation of a patient’s abdomen followed
by a quick release causes an increase in pain levels. This can indicate that the
peritoneum, the material that lines the abdomen, may be inflamed.

10. What is renal colic? Is it a type of pain? What are the causes of renal colic?
Renal colic is a type of pain caused by kidney stones. Kidney stones (urolithiasis) are
crystals that form from chemicals in the urine. Usually, a stone develops because too
much of a single chemical is present in the urine. A stone may block the flow of urine
and can cause pain if it travels down the tubes of the urinary tract.

11. What is a positive psoas sign? What does it mean from the clinical
perspective?
The Psoas sign is an indication that the iliopsoas muscle is irritated. The iliopsoas
muscle is responsible, along with other muscles, for the flexion of the hips, being
located at the level of the abdomen. In the medical literature, it is also known as the
Obraztsova’s sign. The psoas test can be performed in order to identify the
inflammation of the appendix or in case of pelvic pain. The doctor might also decide
to perform the psoas test in patients who complain of low back pain.
12. Where should the loudest S1 (the first heart sound) be heard?
S1 can be best heard over the apex, using a stethoscope's bell or diaphragm. The first
heart sound is caused by turbulence created when the mitral and tricuspid values
close.

13. What are the heart sound characteristics for a patient with mitral
regurgitation?
Blowing Murmurs – Seen in Mitral Regurgitation

14. What is S3 (the third heart sound)? What causes an extra heart sound (S3)?
Produced by rapid filling (& expansion) of ventricles. It occurs just after S2 in
diastole when the AV valves open.
It may be a normal finding in young patients & pregnancy, but almost always
pathological after 40 years.
The most common cause of pathological S3 is a congestive cardiac failure.

15. What is Homan’s sign test?

Homan’s sign is a well-known diagnostic indicator that represents the results obtained
after performing the Homan’s test. The result can be either positive or negative and
accordingly, the presence or absence of DVT is predicted.

16. After the inspection of the abdomen, why should you auscultate the abdomen
before percussion and palpation?
Ensures that the examiner is listening to undisturbed bowel sounds. In addition, if the
patient is complaining of pain, leaving the palpation until last allows the examiner to
gather other data before potentially causing the patient more discomfort.
17. What the signs and symptoms of eczema, xerosis, and psoriasis?
Eczema
• Extremely itchy and dry skin
• Dry, leathery areas that may appear lighter or darker than your normal skin
tone, this is known as lichenification
• Thickened or scaling skin
• Blisters that may be crusty and ooze (these usually occur during flare-ups)
• Red skin forming around blisters
• Raw areas of skin that develop from scratching, these can cause bleeding

Xerosis cutis
• overcleansing or overscrubbing the skin
• taking baths or showers using excessively hot water
• bathing too frequently
• vigorous towel-drying
• living in areas of low humidity
• living in areas with cold, dry winters
• using central heating in your home or workplace
• dehydration, or not drinking enough water
• extended sun exposure

Psoriasis
Dry, thick, and raised patches on the skin are the most common sign of psoriasis.
These patches are often covered with a silvery-white coating called scale, and they
tend to itch.

While patches of thickened, dry skin are common, psoriasis can cause many signs and
symptoms.