The nurse is teaching the student nurse the sequence for performing the assessment techniques during a physical examination. What is the appropriate order?
Inspection, percussion, palpation, auscultation
Inspection, palpation, percussion, auscultation
Palpation, percussion, inspection, auscultation
Inspection, auscultation, palpation, percussion
The Correct Answer is B
A. Inspection, percussion, palpation, auscultation: This sequence starts with visual inspection, followed by percussion (tapping the body to assess underlying structures), palpation (using the hands to feel for abnormalities), and finally auscultation (listening with a stethoscope to assess sounds such as heart, lung, or bowel sounds). However, palpation is usually performed before percussion.
B. Inspection, palpation, percussion, auscultation: This is the correct sequence for performing a physical examination. It begins with visual inspection, followed by palpation to assess for
tenderness, masses, or other abnormalities, then percussion to evaluate the density of underlying structures, and finally auscultation to listen to internal sounds.
C. Palpation, percussion, inspection, auscultation: This sequence starts with palpation, followed by percussion, then inspection, and finally auscultation. However, inspection is typically performed before palpation in a physical examination.
D. Inspection, auscultation, palpation, percussion: This sequence starts with visual inspection, followed by auscultation, palpation, and percussion. While auscultation often follows inspection, palpation is usually performed before auscultation.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. An anxiety reaction: The toddler's behavior of sitting quietly, sucking her thumb, and turning away from the nurse when approached after her mother leaves the room suggests anxiety. These
behaviors are common signs of distress or discomfort in young children, especially when separated from their primary attachment figure (in this case, the mother).
B. Regression: Regression involves reverting to earlier, more immature behaviors in response to stress or discomfort. While thumb sucking can be considered a form of regression, the behavior observed in this scenario is more indicative of anxiety rather than a broader regression in
developmental milestones.
C. Resentment toward the mother: There is no evidence in the scenario to suggest that the toddler is expressing resentment toward the mother. The behaviors observed are more likely related to
the child's emotional response to separation and hospitalization.
D. Developing autonomy: Developing autonomy typically involves asserting independence and exploring one's environment. The behaviors observed in the scenario are more indicative of anxiety and distress rather than autonomous behavior.
Correct Answer is D
Explanation
A. "I can fit my hand between the baby and the car seat harness."
This statement indicates that the harness may not be properly snug against the infant's body, which could compromise safety.
B. "Our car seat is front-facing in the back seat."
For a 6-month-old infant, the car seat should be rear-facing to provide optimal safety in the event of a crash. Front-facing seats are typically used for older children.
C. "The car seat is rear-facing in the front passenger seat."
Rear-facing car seats should never be placed in the front passenger seat, especially if the car is equipped with airbags. The back seat is the safest location for a car seat.
D. "Our car seat is an infant model and is anchored in the car."
This statement indicates that the parent understands the importance of using an appropriate car seat for the infant's age and size and that the seat is properly installed and secured in the vehicle.
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