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WorksheetsPhysical Examination and Respiratory Assessment Worksheet
Total questions: 101
Worksheet time: 51mins
Which of the following lists the four components of a physical examination?
Inspection, palpation, percussion, auscultation
Inspection, diagnosis, treatment, follow-up
History taking, inspection, diagnosis, auscultation
Palpation, percussion, diagnosis, treatment
Why is it important to review the history of present illness before performing a physical examination?
It helps guide the physical examination and focus on relevant findings
It allows the examiner to skip unnecessary steps in the examination
It is required for insurance purposes only
It ensures the patient is comfortable during the examination
Which finding during examination of the head and neck is most likely to indicate respiratory distress?
Nasal flaring
Diaphoresis with no other symptoms
Changes in pupillary size in response to light
Deviated tracheal position
What is the correct method for measuring jugular venous pressure?
Position the patient at a 45-degree angle and observe the height of the jugular vein above the sternal angle
Measure the pulse rate at the neck and compare to the radial pulse
Ask the patient to hold their breath and observe the jugular vein
Palpate the jugular vein while the patient is lying flat
Which term describes a chest configuration where the sternum protrudes outward?
Pectus carinatum
Kyphosis with spinal curvature
Barrel chest with increased diameter
Flail chest with unstable segment
Which breathing pattern is characterized by periods of deep, rapid breathing followed by apnea?
Cheyne-Stokes breathing
Biot’s breathing with irregular rhythm
Kussmaul’s breathing with consistent deep breaths
Apneustic breathing with prolonged inspiration
Which of the following is a primary muscle of inspiration?
Diaphragm
Rectus abdominis with forced exhalation
Trapezius with shoulder movement
Latissimus dorsi with arm adduction
What is the clinical significance of accessory muscle usage during breathing?
Indicates increased work of breathing
Shows normal relaxed respiration
Suggests improved lung compliance
Demonstrates voluntary breath holding
Which term refers to a paradoxical inward movement of the abdomen during inspiration?
Abdominal paradox
Hoover sign with costal margin movement
Peripheral cyanosis with blue extremities
Respiratory alternans with alternating muscle use
What does right sided heart failure indicate?
Something bothering the lungs
Something bothering the stomach
Something bothering the diaphragm
Congested heart failure
What is the difference between peripheral and central cyanosis?
Peripheral cyanosis affects extremities, central cyanosis affects mucous membranes
Peripheral cyanosis affects the lips, central cyanosis affects the fingers
Peripheral cyanosis is always more severe than central cyanosis
Peripheral cyanosis is caused by heart failure, central cyanosis by lung disease
What are the normal sodium values?
120 to 135 mEq/L
Normal 135 to 145 mEq/L
145 to 155 mEq/L
100 to 120 mEq/L
What causes hypernatremia?
Excessive water intake
High sodium due to from loss of water
Low sodium due to dehydration
Low potassium levels
What causes hyponatremia?
Excessive water intake or sodium loss
High sodium from dehydration
Low potassium levels
Low chloride levels
What are the normal potassium values?
2.5 to 3.5 mEq/L
3.5 to 5.0 mEq/L
5.5 to 6.0 mEq/L
4.5 to 6.5 mEq/L
What is hypokalemia?
Low potassium
High potassium
High sodium
Low chloride
What is hyperkalemia?
High potassium
Low sodium
High chloride
Low glucose
What are the normal chloride values?
98 to 107 mEq/L
100 to 120 mEq/L
90 to 100 mEq/L
105 to 115 mEq/L
What is hypochloremia?
Low chloride
High chloride
Low potassium
Low sodium
What is hyperchloremia?
High chloride
Low chloride
Low potassium
High glucose
What is the normal pH range for acid-base balance?
Acid = 7.35–7.45 = Alkaline
Acid = 6.0–7.0 = Alkaline
Acid = 7.0–8.0 = Alkaline
Acid = 7.25–7.55 = Alkaline
What does bicarbonate (HCO3−) play a part in?
Acid-base balance
Glucose regulation
Potassium transport
Water retention
What happens when CO2 is high?
Brings pH ↓, high bicarb level brings pH back up
Brings pH ↑
Reduces bicarb levels
Has no effect
What is metabolic alkalosis?
Elevation
Decrease
Low pH
Low bicarbonate
What is metabolic acidosis?
Decrease
Elevation
High pH
High sodium
What are normal blood sugar levels?
Range from 70 to 99 mg/dL
100 to 120 mg/dL
60 to 90 mg/dL
80 to 110 mg/dL
What is hypoglycemia?
Reduced blood glucose
Elevated blood glucose
High sodium
Low potassium
What is hyperglycemia?
Elevated blood glucose
Reduced blood glucose
Low chloride
High potassium
What is the composition of blood?
Cells (45%) and Plasma (55%)
Plasma (70%) and Cells (30%)
Cells (60%) and Plasma (40%)
Plasma only
What are the three main cell types in blood?
WBC (leukocytes), RBC (erythrocytes), and platelets (thrombocytes)
Plasma, lymph, and hormones
WBC, glucose, and plasma
Enzymes, proteins, and RBC
What major test evaluates hematology and clotting ability?
CBC
BMP
CMP
ECG
What does the CBC determine?
Number of circulating red and white blood cells
Amount of plasma
Blood sugar levels
Hemoglobin type only
What does RBC evaluation check for?
Size and amount of hemoglobin present
Number of white blood cells
Type of plasma proteins
Antibody production
Normal WBC count is:
4.0 – 11.0
2.0 – 5.0
5.0 – 15.0
3.0 – 8.0
Segmented neutrophils normally make up what percentage?
50 – 70
40 – 60
20 – 40
70 – 90
Eosinophils normally make up what percentage?
1 – 3
3 – 5
5 – 7
0 – 2
Basophils normally make up what percentage?
0 – 1
1 – 3
2 – 5
0 – 5
Lymphocytes normally make up what percentage?
20 – 45
10 – 20
30 – 60
50 – 70
Monocytes normally make up what percentage?
2 – 11
5 – 15
0 – 5
10 – 20
Neutrophils perform what function?
Phagocytosis and die; last about 10 days
Fight viruses
Create antibodies
Produce hemoglobin
Eosinophils play a role in:
Allergic reactions
Blood clotting
Oxygen transport
Antibody production
Basophils play a role in:
Allergic reactions
Fighting infections
Transporting oxygen
Platelet formation
Lymphocytes are used to fight against:
Viral, fungal, and tuberculosis infection
Allergic reactions
Oxygen deficiency
Platelet loss
Monocytes are the biggest WBC and convert to:
A macrophage in lungs
A platelet
A neutrophil
A lymphocyte
Leukocytosis is:
Increase in circulating WBC
Decrease in WBC
Increase in RBC
Decrease in platelets
Neutrophilia is:
Increase in leukocytes due to neutrophils
Decrease in RBC
Decrease in platelets
Increase in monocytes
Leukopenia is:
Abnormal decrease in circulating WBC
Increase in WBC
Increase in platelets
Decrease in hemoglobin
Neutropenia is:
A drop in WBC caused by decrease in neutrophils
A rise in RBC
An increase in WBC
A drop in platelets
Bands are:
Immature versions of neutrophils
Mature lymphocytes
Platelet fragments
Plasma cells
If bands increase significantly, what does this indicate?
Body is under stress; this is called a left shift
Infection resolved
Dehydration
Anemia
Eosinophilia/Basophilia occurs with:
Similar disorders that cause eosinophilia
Viral infections
Anemia
Leukemia only
Blasts are:
Immature white blood cells in general
Mature red blood cells
Plasma proteins
Platelets
Where are RBCs produced?
Bone marrow
Liver
Spleen
Lungs
Life span of RBCs:
120 days
60 days
90 days
180 days
Anemia means:
Low RBC count
High RBC count
Low WBC count
High hemoglobin
Hypochromic means:
Not the right amount of hemoglobin
Too many platelets
Low WBC count
High iron
Polycythemia means:
Abnormal increase in number of circulating RBCs
Decrease in RBCs
Decrease in platelets
Decrease in WBCs
Low platelet count is called:
Thrombocytopenia
Leukopenia
Anemia
Neutropenia
Low platelet count causes:
More bleeding
Faster clotting
High hemoglobin
High sodium
Three screening coagulation tests are:
APTT, PT/INR, and Platelet count
Hemoglobin, Hematocrit, and Glucose
Sodium, Potassium, and Chloride
CBC, ABG, and BMP
APTT test is used to:
See clotting
Measure glucose
Detect WBCs
Count RBCs
PT/INR test is used to:
End bleeding
Check cholesterol
Detect infection
Measure blood sugar
What is D-Dimer used for?
Test used for clotting to see breakdown of fibrin clots that form in the vasculature
Measure glucose
Detect anemia
Measure sodium
What are murmurs?
Irregular heartbeats
Blood flowing back through valves
Fluid in lungs
Air trapped in the abdomen
Examination of the abdomen is performed to:
Detect bone fractures
Inspect and palpate for distention
Listen for bowel sounds
Observe skin color
Hepatomegaly refers to:
Enlarged heart
Large liver
Fluid retention in the abdomen
Enlarged spleen
Left heart failure is usually caused from:
Valve damage
Congested Heart Failure
Left side heart failure
High blood pressure
An abnormal collection of fluid in the peritoneal cavity is known as:
Edema
Hemothorax
Ascites
Pericardial effusion
Digital clubbing is a sign of:
Liver disease
Cardiopulmonary disease
Kidney disorder
Skin infection
Peripheral cyanosis refers to discoloration in:
Lips and eyes
Hands and feet
Neck and chest
Abdomen
Pedal edema may be a sign of:
Dehydration
Heart failure
Stroke
Asthma
Pedal edema is common in:
Diabetic patients
Right heart failure and COPD patients
Stroke patients
Pregnant women only
Capillary refill is when color returns and lets us know the status of:
Blood pressure
Circulation
Oxygen intake
Heart rhythm
The three phases of laboratory testing are:
Chemical, Biological, and Statistical
Preanalytical, Analytical, and Post-analytical
Testing, Reviewing, and Storing
Primary, Secondary, and Final
The preanalytical phase includes:
The precautions of making sure everything is right and in order
Running the lab test
The analytical phase involves:
Data recording
Cultural testing performed by laboratory scientists
Reporting and interpretation
Cleaning specimens
The post-analytical phase involves:
Reporting and interpretation of results
Collection of samples
Patient diagnosis
Equipment sterilization
What does TP stand for?
True probability
True positive
Test prediction
Total precision
What does FN stand for?
False neutral
False negative
False normal
Faulty neuron
What does TN stand for?
True normal
True negative
Test negative
Total neutral
What does FP stand for?
False positive
Failed process
Faulty patient
Final procedure
Sensitivity measures:
Frequency of false results
Frequency of positive test results in patients with disease
Frequency of negative results
Rate of lab errors
Specificity measures:
Frequency of negative test results in patients without disease
Frequency of positive test results
Frequency of repeated tests
Number of lab retests
COPD patients often display which feature?
Jaw tension
Lips puckered (whistle type)
Nose flaring
Open-mouth breathing
Kyphosis (hump back) has an abnormal:
Lateral curvature
Anteroposterior curvature
Vertical curvature
Oblique curvature
Scoliosis refers to:
Forward-leaning curvature
Side-to-side curvature of the spine
Barrel chest occurs when
Air is not released every time the patient breathes
The lungs collapse
The chest wall caves in
The ribs become stiff
Vocal fremitus phrase
“Breathe in deeply”
“Ninety-nine”
“One-two-three”
“Hold your breath”
Increased vocal fremitus indicates
Fluid or solid tissue (white)
Air
Gas bubbles
Mucus blockage
Crackles are
Discontinuous abnormal lung sounds
Continuous abnormal lung sounds
Normal lung sounds
High-pitched breath sounds
Wheezes are
Continuous abnormal lung sounds
Discontinuous abnormal lung sounds
Normal vesicular sounds
Absence of breath sounds
Describe Atelectasis on a X-ray
lung volume loss
lung volume gain
Paralized arm
Damaged diaphram
What protect you from radiation
Time
Distance
Shielding
gloves
Hot spots
(PET) Tumors or areas of high metabolic activity
Wifi Connection
Radiation spots disappearing
Ultrasound
Look for pleural fluid (Laying on side and take image)
Lateral Decubitus
Expiratory
Apical Lordoctic
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Expiratory
Front to back
Top Apical region
To see a small Pneumothorax
Pleural fluid
Anterior Posterior(AP)
Front to back
Back to front
Side to side
Side to front
Posteroanterior(PA)
From front of body to back
From back of body to front
From side to side
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dense substance appear light or white i.e..) bones
Radio lucent
Radio Paque
Radio
Lightening imaging
Radio Lucent
Black on X-ray, air like high density substance
White on X-ray, air like low density substance
Black on X-ray, air like low density substance
White on X-ray, air like high density substance
What is needed for Pulmonary embolisms(V/Q) ; look at what areas are being ventilated
MRI
CT scan
Lung perfusion scan
X-ray
