Holistic Health Assessment: Final Physical Examination Questions And Answers
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Course
Holistic Health Assessment
Institution
Holistic Health Assessment
Introduce self, wash hands, provide privacy - ANS -Wash hands
-Hello, My name is Shannon and I am the nurse that is going to be conducting your physical assessment today
-Shake hands with the client
-Just to let you know everything discussed today during the assessment will remain private con...
Holistic Health Assessment: Final
Physical Examination Questions And
Answers
Introduce self, wash hands, provide privacy - ANS -Wash hands
-Hello, My name is Shannon and I am the nurse that is going to be conducting your physical
assessment today
-Shake hands with the client
-Just to let you know everything discussed today during the assessment will remain private
confidential
Mobility/assess gait - ANS -As you walked in today, I noticed that your gait was even and
steady with a shoulder-length distance between steps.
-Your arms swung at your sides as you walked opposite of your legs, which is a normal finding
-Walk is smooth, even and well balanced
Posture/Position/Breathing effort - ANS -The patient appears comfortably erect.
-The patient sits on the exam table with arms relaxed (LOCATION) and head turned toward the
examiner.
-Breathing appears to be relaxed, automatic, and silent with no effort
Physical Appearance and Personal Hygiene - ANS -The patient appears clean and groomed.
-Hair is need and clean
-Nails are clean
-The patient appears to be stated age
Skin Color - ANS -Color of skin is even with darker pigmentation due to central american
descent.
-Skin is in tact with no obvious masses or lesions
Orientation and LoC - ANS -Im going to ask you a couple of questions that may seem silly, but
they are just part of the assessment of your level of consciousness and orientation
-Can you tell me your name?
-Can you tell me where you are?
-Can you tell me what day of the week it is?
-By answering all of these questions correctly, the patient is alert and oriented to person, place
and time.
, -The patient is awake,
Facial Expression - ANS -Facial expressions are appropriate to the situation and changes
appropriately with the topic
-Patient maintains eye contact with the examiner
Ability to hear and speak - ANS -The patient maintaining eye contact with the examiner and
answering questions appropriately shows that she can hear to a full extent
-The patient is able to respond during conversation, showing that her ability is in tact
Mood and Affect - ANS -The patient appears comfortable and cooperative with the examiner,
she interacts pleasantly
Overt Signs of Discomfort and Anxiety - ANS -The patient is not exhibiting any overt signs of
discomfort or anxiety
Inspect the skull and scalp for contour and hair distribution, - ANS -Looking at the skull, I see it
is normocephalic in shape with even hair distribution in eye brows and eye lashes.
-Inspect the scalp
-As I inspect the scalp, I see that there is even hair distribution and a paler skin tone, there are
no masses or lesions
Inspect skin color and lesions - ANS The skin on the skull is tan with a few papules. (macule?)
Inspect facial features and symmetry - ANS -Eyes, nasolabial folds, and sides of mouth are all
symmetrical
Cranial Nerve Number 7 (Facial Nerve) - ANS -Please raise your eyebrows for me
-Please show me your teeth
-Please puff out your cheeks (tap to get air out) Air escapes equally from both sides
-Move your forehead around for me
-Move your mouth
-The patient is able to perform all of these tasks, showing me that Cranial Nerve 7 is in tact
Cranial Nerve 5 (Trigeminal) - ANS -Palpate the Temporal Muscles
-Please clench your teeth for me
-Palpate the Masseter Muscles
-Please clench your teeth for me
-Both the Temporal Muscles and Masseter muscles contracted bilaterally, showing me that
Cranial Nerve 5 is in tact
Temporal Pulses - ANS -Palpate Temporal Pulses
-Temporal pulses are a 2+ grade bilaterally
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