Primary Care Assessment Exam Review
Course Introduction
Primary Care Assessment provides an in-depth overview of the methods and tools used to evaluate patient health within primary care settings. The course explores core assessment techniques across the lifespan, including patient history-taking, physical examination skills, and the use of diagnostic reasoning to identify common acute and chronic health conditions. Emphasis is placed on integrating evidence-based screening strategies, cultural competence, and interprofessional collaboration to ensure comprehensive and patient-centered assessments. Students will learn to document findings effectively and develop care plans that address the unique needs of diverse populations in primary care environments.
Recommended Textbook
Seidels Guide to Physical Examination 9th Edition by Jane
W. Ball
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26 Chapters
648 Verified Questions
648 Flashcards
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Chapter 1: The History and Interviewing Process
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22 Verified Questions
22 Flashcards
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Sample Questions
Q1) Direct questioning about domestic violence in the home should be:
A) a routine component of history taking with female patients.
B) avoided for fear of offending the woman's partner.
C) conducted only in cases in which there is a history of abuse.
D) used only when the patient is obviously being victimized.
Answer: A
Q2) Ms. A states, "My life is just too painful. It isn't worth it." She appears depressed. Which one of the following statements is the most appropriate caregiver response?
A) "Try to think about the good things in life."
B) "What in life is causing you such pain?"
C) "You can't mean what you're saying."
D) "If you think about it, nothing is worth getting this upset about."
Answer: B
Q3) When are open-ended questions generally most useful?
A) During sensitive area part of the interview
B) After several closed-ended questions have been asked
C) While designing the genogram
D) During the review of systems
Answer: A
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Page 3
Chapter 2: Cultural Competency
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Sample Questions
Q1) As you explain your patient's condition to her husband, you notice that he is leaning toward you and pointedly blinking his eyes. Knowing that he is from England, your most appropriate response to this behavior is to:
A) tell him that you understand his need to be alone.
B) ask whether he has any questions.
C) ask whether he would prefer to speak to the clinician.
D) tell him that it is all right to be angry.
Answer: B
Q2) Which variables can intrude on successful communication? (Select all that apply.)
A) Social class
B) Gender
C) Stereotype
D) Phenotype
E) Age
Answer: A, B, E
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4
Chapter 3: Examination Techniques and Equipment
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Sample Questions
Q1) The dorsal surface of the hand is most often used for the assessment of:
A) crepitus.
B) temperature.
C) texture.
D) vibration.
Answer: B
Q2) Mr. Walters, a 32-year-old patient, tells you that his ears are "stopped up." An objective assessment of this complaint is achieved by using the:
A) tuning fork.
B) reflex hammer.
C) otoscope with pneumatic attachment.
D) tympanometer.
Answer: D
Q3) A scale used to assess patients' weight should be calibrated:
A) only by the manufacturer.
B) by a qualified technician at regularly scheduled intervals.
C) each time it is used.
D) when necessary, with the patient standing on the scale.
Answer: C
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Page 5
Chapter 4: Clinical Reasoning
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Sample Questions
Q1) Mr. Johnson actually has streptococcal pharyngitis; however, the throat culture is initially read as negative. This situation describes a test with a:
A) low sensitivity.
B) high sensitivity.
C) high specificity.
D) low specificity.
Q2) When determining actions for the management plan, the practitioner should first address:
A) problems in the order of their chronologic development.
B) the patient's concern about a particular problem.
C) the patient's social and economic circumstances.
D) the most urgent problem.
Q3) A valid history and physical examination can serve to:
A) create higher healthcare costs.
B) limit the indiscriminate use of diagnostics.
C) threaten patient satisfaction.
D) increase the risk of liability.
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Chapter 5: Documentation
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Sample Questions
Q1) Differential diagnoses belong in the:
A) history.
B) physical examination.
C) assessment.
D) plan.
Q2) Which finding is unique to the documentation of a physical examination of an infant?
A) Fontanel size
B) Liver span
C) Prostate size
D) Thyroid position
Q3) The review of systems is a component of the:
A) physical examination.
B) health history.
C) assessment.
D) past medical-surgical history.
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Page 7
Chapter 6: Vital Signs and Pain Assessment
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Sample Questions
Q1) The pyrexia response is triggered by the production and release of:
A) prostaglandins.
B) endogenous pyrogens.
C) hypothalamic enzymes.
D) thyroid hormones.
Q2) Underestimation of blood pressure will occur if the cuff's width covers:
A) less than half of the upper arm.
B) less than 5 inches of the lower arm.
C) more than two-thirds of the upper arm.
D) more than 4 inches of the lower arm.
Q3) The most frequent cause of serious hypertension in children is:
A) heart disease.
B) liver failure.
C) renal disease.
D) rheumatic fever.
Q4) The fifth vital sign is:
A) pain.
B) orientation.
C) waist-to-hip ratio.
D) body mass index (BMI).
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Chapter 7: Mental Status
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Sample Questions
Q1) Flight of ideas or loosening of associations is associated with:
A) aphasia.
B) dysphonia.
C) multiple sclerosis.
D) psychiatric disorders.
Q2) Which condition is considered progressive rather than reversible?
A) Delirium
B) Dementia
C) Depression
D) Anxiety
Q3) Appropriateness of logic, sequence, cohesion, and relevance to topics are markers for the assessment of:
A) mood and feelings.
B) attention span.
C) thought process and content.
D) abstract reasoning.
Q4) The examiner should be concerned about neurologic competence if a social smile cannot be elicited by the time a child is _________ old.
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Page 9
Chapter 8: Growth, Measurement, and Nutrition
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Sample Questions
Q1) The legs are the fastest growing body part during:
A) early infancy.
B) late infancy.
C) childhood.
D) early adulthood.
Q2) During a preventive healthcare visit, Ms. G, an older patient, states that she is getting shorter. She says that her son mentioned that her change in stature became noticeable to him during his last visit with her. Her posture appears straight and aligned. When addressing Ms. G.'s present concerns, it is most important to inquire about:
A) the number of pregnancies.
B) her parents' heights.
C) a history of scoliosis.
D) her usual height and weight.
Q3) Ms. Davis is a 27-year-old patient with a BMI of 33. Based on her BMI, your diagnosis would be:
A) normal body weight.
B) overweight.
C) obese.
D) extremely obese.
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Chapter 9: Skin, Hair, and Nails
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Sample Questions
Q1) A 17-year-old student complains of a "rash for 3 days." You note pale, erythematous oval plaques over the trunk. They have fine scales and are arranged in a fernlike pattern, with parallel alignment. What is the nurse's next action?
A) Teach infectious control measures.
B) Inquire about another recent skin lesion.
C) Inspect the palms and the soles.
D) Inform the patient that this will resolve within a week.
Q2) Tangential lighting is best used for inspecting skin:
A) color.
B) contour.
C) exudates.
D) symmetry.
Q3) A 5-year-old child presents with discrete vesicles on an erythematous base that began near her scalp and are spreading to the trunk. The child has a low-grade fever and feels tired. What is the nurse's next action?
A) Teach infectious control measures.
B) Inquire about other patterns of physical abuse.
C) Inspect the buccal mucosa for Koplik spots.
D) Inform the parent that this will resolve within a couple of days.
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Page 11
Chapter 10: Lymphatic System
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22 Flashcards
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Sample Questions
Q1) Tender nodes associated with cat scratch disease are usually found in which area?
A) Epitrochlear area
B) Popliteal area
C) Axilla
D) Inguinal area
Q2) A red streak that follows the course of the lymphatic collecting duct is a finding associated with:
A) Hodgkin disease.
B) lymphangitis.
C) lymphedema.
D) lymphoma.
Q3) To palpate the inguinal nodes, you should have the patient:
A) bend over a table and cough.
B) lie supine with knees slightly flexed.
C) lie supine with legs extended.
D) stand and cough vigorously.
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Chapter 11: Head and Neck
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19 Flashcards
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Sample Questions
Q1) Which is the best way to position a patient's neck for palpation of the thyroid?
A) Flexed away from the side being examined
B) Flexed directly forward
C) Flexed toward the side being examined
D) Hyperextended directly backward
Q2) During a head and neck assessment of a neonate, it is important to screen for:
A) the presence of torticollis.
B) signs and symptoms of cerebral palsy.
C) uneven movement of the eyes.
D) unilateral movement of the tongue.
Q3) Nuchal rigidity is most commonly associated with:
A) thyroiditis.
B) meningeal irritation.
C) Down syndrome.
D) cranial nerve V damage.
Q4) Which cranial nerves innervate the face?
A) II and V
B) III and VI
C) V and VII
D) VIII and IX
Page 13
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Chapter 12: Eyes
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Sample Questions
Q1) If a patient has early papilledema, using an ophthalmoscope, the examiner will be able to detect:
A) dilated retinal veins.
B) retinal vein pulsations.
C) sharply defined optic discs.
D) visual defects.
Q2) Ask the patient to look directly at the light of the ophthalmoscope when you are ready to examine the:
A) retina.
B) optic disc.
C) retinal vessels.
D) macula.
Q3) You are attempting to examine the eyes of a newborn. To facilitate eye opening, you would first:
A) dim the room lights.
B) elicit pain.
C) place him in the supine position.
D) shine the penlight in his or her eyes.
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Chapter 13: Ears, Nose, and Throat
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Sample Questions
Q1) When conducting an adult otoscopic examination, you should:
A) position the patient's head leaning toward you.
B) grasp the handle of the otoscope as you would a baseball bat.
C) select the largest speculum that will fit in the canal.
D) ask the patient to keep his or her eyes closed.
Q2) You are using a pneumatic attachment on the otoscope while assessing tympanic membrane movement. You gently squeeze the bulb but see no movement of the membrane. Your next action should be to:
A) remove all cerumen from the canal.
B) change to a larger speculum.
C) squeeze the bulb with more force.
D) insert the speculum to a depth of 2 cm.
Q3) Speech with a monotonous tone and erratic volume may indicate:
A) otitis externa.
B) hearing loss.
C) serous otitis media.
D) sinusitis.
Q4) When you ask the patient to identify smells, you are assessing cranial nerve __.
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Page 15
Chapter 14: Chest and Lungs
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Sample Questions
Q1) The best time to observe and count respirations is while:
A) the patient is answering questions.
B) weighing the patient.
C) palpating the pulse.
D) the patient is sleeping.
Q2) A 44-year-old male patient who complains of a cough has presented to the emergency department. He admits to smoking one pack per day. During your inspection of his chest, the most appropriate lighting source to highlight chest movement is:
A) bright tangential lighting.
B) daylight from a window.
C) flashlight in a dark room.
D) fluorescent ceiling lights.
Q3) As you take vital signs on Mr. Barrow, age 78 years, you note that his respirations are 40 breaths/min. He has been resting, and his mucosa is pink. In regard to Mr. Barrow's respirations, you would:
A) document his rate as normal.
B) do nothing because his color is pink.
C) note that his rate is below normal.
D) report that he has an above-average rate.
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Page 16
Chapter 15: Heart
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Sample Questions
Q1) To hear diastolic heart sounds, you should ask patients to:
A) lie on their back.
B) lie on their left side.
C) lie on their right side.
D) sit up and lean forward.
Q2) Chest pain with an organic cause in a child is most likely the result of:
A) cardiac disease.
B) asthma.
C) esophageal reflux.
D) arthritis.
Q3) In the adult, the apical impulse should be most visible when the patient is in what position?
A) Supine
B) Upright
C) Lithotomy
D) Right lateral recumbent
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Chapter 16: Blood Vessels
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Sample Questions
Q1) Which are risk factors for varicose veins? (Select all that apply.)
A) Gender
B) Alcohol use
C) Lower extremity trauma
D) Increased body mass
E) Hypertension
F) Diabetes
Q2) You are performing a physical examination on a 46-year-old male patient. His examination findings include the following: positive peripheral edema, holosystolic murmur in the tricuspid region, and a pulsatile liver. His diagnosis is:
A) an aortic aneurysm.
B) an arteriovenous fistula.
C) tricuspid stenosis.
D) tricuspid regurgitation.
Q3) In children, coarctation of the aorta should be suspected if you detect:
A) a delay between the radial and femoral pulses.
B) a simultaneous radial and femoral pulse.
C) an absent femoral pulse on the left.
D) bilateral absence of femoral pulses.
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Page 18
Chapter 17: Breasts and Axillae
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Sample Questions
Q1) A firm, transverse ridge of compressed tissue is felt bilaterally along the lower edge of a 40-year-old patient's breast. You should:
A) ask the patient if she has a history of breast cancer.
B) refer the patient to a surgeon.
C) ask the patient to have a mammogram as soon as possible.
D) record the finding in the patient's record.
Q2) A nursing mother complains that her breasts are tender. You assess hard, shiny, and erythemic breasts bilaterally. You should advise the patient to:
A) massage gently and continue nursing.
B) apply warm compresses and stop nursing.
C) monitor her temperature and restrict fluids.
D) sleep wearing a bra and wash her breasts with antibacterial soap.
Q3) Montgomery tubercles are most prominent in the breasts of:
A) adult males.
B) patients with lung disease.
C) pregnant women.
D) pubertal females.
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19
Chapter 18: Abdomen
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Sample Questions
Q1) Your patient is a 48-year-old woman with complaints of severe cramping pain in the abdomen and right flank. Her past medical history includes a history of bladder calculi. You diagnose her with renal calculi at this time. Which of the following symptoms would you expect with her diagnosis? (Select all that apply.)
A) Abdominal pain on palpation
B) Blumberg sign
C) Cullen sign
D) CVA tenderness
E) Fever
F) Grey Turner sign
G) Hematuria
H) Nausea
Q2) Costovertebral angle tenderness should be assessed whenever you suspect that the patient may have:
A) cholecystitis.
B) pancreatitis.
C) pyelonephritis.
D) ulcerative colitis.
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Page 20
Chapter 19: Female Genitalia
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Sample Questions
Q1) What accommodations should be used for the position of a hearing-impaired woman for a pelvic examination?
A) The patient should assume the M or V position.
B) Her legs should be farther apart.
C) The head of the table should be elevated.
D) The lithotomy position with obstetric stirrups should be used.
Q2) Posteriorly, the labia minora meet as two ridges that fuse to form the: A) fourchette.
B) vulva.
C) clitoris.
D) perineum.
Q3) Asking the woman to close the introitus during a pelvic examination is a test for: A) endometriosis.
B) rectocele.
C) cervical polyps.
D) sphincter tone.
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21
Chapter 20: Male Genitalia
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Sample Questions
Q1) A premature infant's scrotum will appear:
A) bifid.
B) loose.
C) ridged.
D) smooth.
Q2) A characteristic related to syphilis or diabetic neuropathy is testicular:
A) dropping, with asymmetry.
B) enlargement.
C) insensitivity to painful stimulation.
D) recession into the abdomen.
Q3) The most common cancer in young men ages 15 to 30 years is:
A) testicular.
B) penile.
C) prostate.
D) anal.
Q4) Inspection of the scrotum should reveal:
A) lightly pigmented skin.
B) two testes per sac.
C) smooth scrotal sacs.
D) the left scrotal sac lower than the right.
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Chapter 21: Anus, Rectum, and Prostate
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Sample Questions
Q1) A lower spinal cord lesion may be indicated by which finding?
A) Lack of an anal wink
B) Rectal prolapse
C) Anal fistula
D) Small flaps of anal skin
Q2) The cervix may be palpated through the:
A) anterior rectal wall.
B) internal umbilical wall.
C) lateral urethral meatus.
D) posterior uterine surface.
Q3) The mother brings her 4-year-old to the clinic because the child complains of perianal itching. As part of your examination you complete a cellulose tape test. The cellulose tape test is used for the detection of:
A) enterobiasis.
B) carcinoma.
C) amebiasis.
D) steatorrhea.
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Chapter 22: Musculoskeletal System
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Sample Questions
Q1) The temporalis and masseter muscles are evaluated by:
A) having the patient shrug his or her shoulders.
B) having the patient clench his or her teeth.
C) asking the patient to fully extend his or her neck.
D) passively opening the patient's jaw.
Q2) The physical assessment technique most frequently used to assess joint symmetry is:
A) inspection.
B) palpation.
C) percussion.
D) the use of joint calipers.
Q3) When the shoulder contour is asymmetric and one shoulder has hollows in the rounding contour, you would suspect:
A) kyphosis.
B) fractured scapula.
C) a dislocated shoulder.
D) muscle wasting.
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24
Chapter 23: Neurologic System
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Sample Questions
Q1) Which area of the brain maintains temperature control?
A) Epithalamus
B) Thalamus
C) Abducens
D) Hypothalamus
Q2) On a scale of 1+ to 4+, which deep tendon reflex score is appropriate for a finding of clonus in a patient?
A) 1+
B) 2+
C) 3+
D) 4+
Q3) When assessing superficial pain, touch, vibration, and position perceptions, you are testing:
A) cerebellar function.
B) emotional status.
C) sensory function.
D) tendon reflexes.
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Page 25
Chapter 24: Sports Participation Evaluation
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Sample Questions
Q1) The checkout station for preparticipation physical evaluation is critical because at this point:
A) all completed forms are distributed.
B) parental signatures are obtained.
C) the relevant history is obtained.
D) the coordination of follow-ups is reviewed.
Q2) Why should the preparticipation sports examination take place well in advance of the planned sports activity? (Select all that apply.)
A) To allow completion of therapy for identified problems
B) Because routine health maintenance needs to be addressed
C) Because it should be 6 weeks prior to the planned sports event
D) To allow completion of follow-up testing
Q3) Your 15-year-old patient is athletic and thin. Radiography of an ankle injury reveals a stress fracture. You should question this patient about her:
A) sleep patterns.
B) salt intake.
C) aerobic workouts.
D) menstrual cycles.
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Chapter 25: Putting it All Together
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Sample Questions
Q1) Palpation of the epitrochlear nodes is part of the:
A) examination of the upper extremities.
B) assessment of the chest and thorax.
C) palpation of the abdomen.
D) examination of the head and neck.
Q2) To inspect the abdominal muscles, ask the:
A) supine patient to raise their head.
B) standing patient to bend forward.
C) prone patient to raise their lower legs.
D) standing patient to stand on tiptoes.
Q3) In crying infants, it is often difficult to:
A) perform tactile fremitus assessments.
B) determine lung expansion.
C) auscultate heart sounds.
D) visualize the pharynx.
Q4) When assessing the abdomen, the examiner needs to expose the patient:
A) from the waist down.
B) from the pubis to the epigastrium.
C) in entirety.
D) at no point during the examination.
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Chapter 26: Emergency or Life-Threatening Situations
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Sample Questions
Q1) Respiratory distress may be evidenced by:
A) retractions of accessory muscles.
B) bradycardia.
C) flushed skin.
D) decreased capillary refill time.
Q2) Until they are stabilized, trauma patients require reevaluation:
A) every 2 minutes.
B) every 5 minutes.
C) every 10 minutes.
D) every hour.
Q3) The Cushing triad includes:
A) tachycardia.
B) irregular respirations.
C) tachypnea.
D) constricted pupils.
Q4) You would complete a Glasgow Coma Scale rating during the:
A) health history.
B) physical examination.
C) primary survey.
D) secondary survey.
28
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