Adult Head-to-Toe Examination

Which element of the assessment should be performed with the patient seated and wearing a gown? Percussion of the posterior chest Inspection of facial symmetry Auscultation of heart and lungs Palpation of axillary lymph nodes

-Inspection of facial symmetry Inspection of facial symmetry should be performed after the patient has been assisted onto the examination table in the seated position.

Which examination component should be performed while the adult patient is supine with the legs exposed? Palpation of breast tissue Palpation of popliteal pulse Palpation for inguinal hernia Palpation for aortic pulsation

-Palpation of popliteal pulse Palpation of the popliteal pulse should be performed while the adult patient is supine with the legs exposed.

Which elements should be performed after light palpation of all quadrants of the abdomen in the adult patient? Percussion of all quadrants Auscultation for bowel sounds Deep palpation of all quadrants Inspection of abdominal contour

- Deep palpation of all quadrants Deep palpation is the element of the abdominal assessment that should be performed after light palpation of all quadrants; deep palpation should be done last because it is the maneuver most likely to cause discomfort or pain.

On which elements should the nurse focus when performing the physical examination component of the functional assessment? Select all that apply. Determining caregiver's abilities Evaluating coordination and gait Assessing for dyspnea with exertion Asking about use of a cane or walker Measuring blood pressure while the patient is seated and standing

- Evaluating coordination and gait - Assessing for dyspnea with exertion - Measuring blood pressure while the patient is seated and standing

Palpation of the thyroid and cervical lymph nodes is included in examination of which part of the body? Eyes Neck Mouth Pharynx

- Neck Palpation of the thyroid and cervical lymph nodes is included in examination of the neck.

Observing the patient's gait and testing balance are included in which element of the adult head-to-toe examination with patient standing? Spinal Abdominal Neurologic Musculoskeletal

- Neurologic Observing the patient's gait and testing balance are included in the neurologic element of the adult head-to-toe examination with the patient standing.

Which element is performed after inspection and palpation of the patient's spine while the patient is standing? Test abdominal reflexes Palpate axillary lymph nodes Assess radial and brachial pulses Observe the patient walk heel to toe

- Observe the patient walk heel to toe Observing the patient walk heel to toe is the next element that should be performed after inspection and palpation of the patient's spine.

Which element of the assessment should be performed after assessment of the patient's back, posterior chest, and lungs? Weber test Palpation of apical pulse Palpation of posterior chest Inspection of spine and scapula

- Palpation of apical pulse After assessment of the patient's back, posterior chest, and lungs has been performed, the nurse should move to the front of the patient to begin examining the left side of the chest, which includes palpating the apical pulse.

Which element of the functional assessment should be included during the review of systems? Blood pressure Ability to bathe Neurologic function Signs of dementia

- Signs of dementia Assessing for signs of dementia is an element that should be included in the review of systems.

The assessment of financial resources and health insurance is included in which element of the functional examination? Social situation Review of systems Physical examination Activities of daily living

- Social situation The assessment of financial resources and health insurance is included in the social situation element of the functional examination.

The healthcare provider palpates the prostate gland and seminal vesicles with the patient standing as part of which element of the examination? Spinal Rectal Neurologic Abdominal/Genital

-Abdominal/Genital Palpating the prostate gland and seminal vesicles is included in the examination of the abdomen/genitalia with the patient standing.

Place the examination components in order for the adult patient who is supine.

To assess an adult patient who is in the supine position, the nurse should start at the head and work down, keeping in mind the fact that the abdomen should be inspected before being percussed. The correct order for a head-to-toe assessment while the patient is lying down is as follows: auscultate the heart, inspect the abdomen, percuss the liver border, and finally, palpate for pedal edema.