REVIEWER FOR REVALIDA IN HEALTH ASSESSMENT FINALS

Topics Assessment
1. Assessing Cranial nerve VII Test CN VII (facial).

Type of impulse: Sensory. Contains sensory

fibers for taste on anterior two-thirds of tongue,
and stimulates secretions from salivary glands
(submaxillary and sublingual) and tears from
lacrimal glands.

Type of impulse: Motor. Supplies the facial

muscles and affects facial expressions (smiling,
frowning, closing eyes).

Test motor function. Ask the client to:

• Smile
• Frown and wrinkle forehead
• Show teeth
• Puff out cheeks
• Purse lips
• Raise eyebrows
• Close eyes tightly against resistance
2. Palpation of the posterior thorax Definition: The posterior thorax includes the
vertebral (or spinal) line and the right and left
scapular lines, which extend through the inferior
angle of the scapulae when the arms are at the
client’s side.

Palpate for
tenderness and
sensation.
Palpation may be
performed with one
or both hands. Use
your fingers to
palpate for
tenderness,
warmth, pain, or
other sensations.
Start toward the
midline at the level of the left scapula (over the
apex of the left lung) and move your hand left to
right, comparing findings bilaterally. Move
systematically downward and out to cover the
lateral portions of the lungs at the bases.

Palpate for crepitus. Crepitus, also called

subcutaneous emphysema, is a crackling
sensation (like bones or hairs rubbing against
each other) that occurs when air passes through
fluid or exudate.

Palpate surface characteristics. Put on gloves

and use your fingers to palpate any lesions that
you noticed during inspection. Feel for any
unusual masses.

Palpate for fremitus. Use the ball or ulnar edge

of one hand to assess for fremitus (vibrations of
air in the bronchial tubes transmitted to the chest
wall). As you move your hand to each area, ask
the client to say “ninety-nine.” Assess all areas
for symmetry and intensity of vibration.

3. Define and perform the capillary refill test Definition: capillary refill time—time it takes
for reperfusion to occur after circulation has
been stopped; test for capillary refill involves
pressing on a fingernail firmly enough to stop
 circulation to the digit (signaled by blanching of
the underlying tissue), releasing the pressure,
and measuring the time it takes for color to
return to the tissue; test is used to assess
cardiac output

Assess capillary refill time.

Compress the nailbed until it blanches. Release
the pressure and calculate the time it takes for
color to return. In normal findings, capillary beds
refill (and, therefore, color returns) in 2 seconds
or less

4. Location of abdominal structures by quadrants Right Upper Quadrant (RUQ)

1. Ascending and transverse colon
2. Duodenum
3. Gallbladder
4. Hepatic flexure of colon
5. Liver
6. Pancreas (head)
7. Pylorus (the small bowel—or ileum—
traverses all quadrants)
8. Right adrenal gland
9. Right kidney (upper pole)
10. Right ureter
Right Lower Quadrant (RLQ)
1. Appendix
2. Ascending colon
3. Cecum
4. Right kidney (lower pole)
5. Right ovary and tube
6. Right ureter
7. Right spermatic cord
Left Upper Quadrant (LUQ)
1. Left adrenal gland
2. Left kidney (upper pole)
3. Left ureter
4. Pancreas (body and tail)
5. Spleen
6. Splenic flexure of colon
7. Stomach
8. Transverse descending colon
Left Lower Quadrant (LLQ)
1. Left kidney (lower pole)
2. Left ovary and tube
3. Left ureter
4. Left spermatic cord
5. Descending and sigmoid colon
Midline
1. Bladder
2. Uterus
3. Prostate gland

5. Perform Romberg Test Perform the Romberg test. Ask the client to
stand erect with arms at side and feet together.
Note any unsteadiness or swaying. Then with
the client in the same body position, ask the
client to close the eyes for 20 seconds. Again,
note any imbalance or swaying.

Now ask the client to stand on one foot and to

bend the knee of the leg the client is standing
on. Then ask the client to hop on that foot.
Repeat on the other foot.
7. Palpate lymph nodes Palpate the tonsillar nodes at the
• tonsillar angle of the mandible on the
• submandibular anterior edge of the sternomastoid
• supraclavicular muscle.
• post auricular
Palpate the
submandibular
nodes located on the medial
border of the mandible

Palpate the supraclavicular nodes

by hooking your fingers over the
clavicles and feeling deeply
between the clavicles and the
sternomastoid
Muscles.

Postauricular nodes (behind the

Ears).

8. Palpate the TMJ and perform the ROM for neck
Inspect and palpate the TMJ. Have the client
sit; put your index and middle fingers just
anterior to the external ear opening. Ask the
client to open the mouth as widely as possible.
(The tips of your fingers should drop into the joint
spaces as the mouth opens.)
• Move the jaw from side to side
• Protrude (push out) and retract (pull in) jaw

Test ROM. Ask the client to open the mouth and

move the jaw laterally against resistance. Next,
as the client clenches the teeth, feel for the
contraction of the temporal and masseter
muscles to test the integrity of cranial nerve V
(trigeminal nerve).

9. Palpate the frontal and maxillary sinuses Palpate the frontal

sinuses by using
your thumbs to press
up on the brow on
each side of nose

Palpate the maxillary

sinuses by pressing with
thumbs up on the
maxillary sinuses

10. assessing Cranial nerve X Definition: Sensory motor Carries sensations

from the throat, larynx, heart, lungs, bronchi,
gastrointestinal tract, and abdominal viscera.
Promotes swallowing, talking, and production of
digestive juices.

Test motor function. Ask the client to open

mouth wide and say “ah” while you use a tongue
depressor on the client’s tongue

Test the gag reflex by touching the posterior

pharynx with the tongue depressor.

Check the client’s ability to swallow by

giving the client a drink of water. Also note
the client’s voice quality.
11. Perform the corneal light reflex Perform corneal light reflex test. This
test assesses parallel alignment of the eyes.
Hold a penlight approximately 12 inches from the
client’s face. Shine the light toward the bridge of
the nose while the client stares straight ahead.
Note the light reflected on the corneas.

12. Perform the different position for retraction
and dimpling of breast
Inspect for retraction and dimpling.
During assessment for retraction and dimpling,
the client first (A) raises her arms over her head,
(B) then lowers them and presses them against
the hips, and finally (C) presses the hands
together with the fingers of one hand pointing
opposite to the fingers of the other hand.

13. Assess the motor functions of Cranial Nerve V Definition: V (trigeminal) Sensory motor Carries
sensory impulses of pain, touch, and
temperature from the face to the brain.
Influences clenching and lateral jaw movements
(biting, chewing). Test motor function. Ask the
client to clench the teeth while you palpate the
temporal and masseter muscles for contraction.

14. Perform the Allen test
Perform the Allen test. The Allen test evaluates
patency of the radial or ulnar arteries. It is
implemented when patency is questionable or
before such procedures as a radial artery
puncture. The test begins by assessing ulnar
patency. Have the client rest the hand palm side
up on the examination table and make
a fist. Then use your thumbs to occlude the
radial and ulnar arteries.

A. Occlude radial and ulnar arteries while client

makes a fist.
B. Continue occluding arteries while client
releases fist.
C. Remove pressure on ulnar artery while
observing color return to palm.

15. Perform the ROM for thoracic and lumbar Test ROM of the thoracic and lumbar spine. Ask
spine the client to bend forward and touch the toes
(flexion). Observe for symmetry of the shoulders,
scapula, and hips.

Sit down behind the client, stabilize the client’s

pelvis with your hands, and ask the client to
bend sideways (lateral bending), bend backward
toward you (hyperextension), and twist the
shoulders one way then the other (rotation).

16. Perform the ROM for shoulders, arms, and Test ROM. Ask client to stand with
elbows both arms straight down at the sides. Next, ask
the client to move the arms forward (flexion),
then backward with elbows straight.

17. Perform the Phalen’s test
18. Assess the radial, ulnar and brachial pulse
Then have the client bring both hands
together overhead, elbows straight, followed by
moving both hands in front of the body past the
midline with elbows straight (this tests adduction
and abduction). In a continuous motion, have the
client bring the hands together behind the head
with
elbows flexed (this tests external rotation) and
behind the back (internal
rotation). Repeat these maneuvers
against resistance.
ELBOW
Test ROM. Ask the client to perform the
following movements to test ROM, flexion,
extension, pronation, and supination.
Flex the elbow and bring the hand to the
forehead. Straighten the elbow.
Then the hold arms out, turn the palm down,
then turn the palm up. Last, have the client
repeat the movements
against your resistance.
Ask the client to rest elbows on a table and place
the backs of both hands against each other while
flexing the wrists 90 degrees with fingers pointed
downward and wrists dangling. Have the client
hold this position for 60 seconds.
Palpate the radial pulse. Gently press the radial
artery against the radius. Note elasticity and
strength.
Palpate the ulnar pulses. Apply pressure with
your first three fingertips to the medial aspects of
the inner wrists. The ulnar pulses are not
routinely assessed because they are
located deeper than the radial pulses and are
difficult to detect. Palpate the ulnar arteries if you
suspect arterial insufficiency (Fig. 22-10,
p. 458).
You can also palpate the brachial pulses
if you suspect arterial insufficiency. Do
this by placing the first three fingertips of
each hand at the client’s right and left medial
antecubital creases. Alternatively, palpate
 the brachial pulse in the groove between the
biceps and triceps (Fig. 22-11).

Total score

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Student’s Signature