Question 1 What finding is unique to the documentation of a physical examination of an infant? Fontanel sizes Liver span Prostate size Thyroid position Question 2 Nasal symptoms that imply an allergic response include: purulent nasal drainage. bluish gray turbinates. small, atrophied nasal membranes. firm consistency of turbinates. Question 3 Inspection of the abdomen should begin with the patient supine and the examiner: seated at the patient’s side. standing at the foot of the table. standing at the patient’s left. walking around the table. Question 4 Mr. D. complains of a headache. During the history, he mentions his use of alcohol and illicit drugs. This information would most likely belong in the: chief complaint. past medical history. personal and social history. review of systems. Question 5 Mrs. Kinder is a 39-year-old patient who presents to the office with complaints of an earache. In explaining to the patient about the function of her ears, which ear structure would you tell her is responsible for equalizing atmospheric pressure when swallowing, sneezing, or yawning? Eustachian tube Inner ear Pars flaccida Triangular fossa

Question 1: What finding is unique to the documentation of a physical examination of an infant?

In the documentation of a physical examination of an infant, one unique finding that is important to note is the size of the fontanels. Fontanels are the soft spots found on an infant’s skull where the cranial bones have not yet fully fused. There are two main fontanels: the anterior fontanel, located at the top of the head, and the posterior fontanel, located at the back of the head. These fontanels allow for the growth and expansion of the infant’s brain during the first few months of life.

The size and shape of the fontanels can provide important information about the infant’s development and overall health. Normally, the fontanels should be soft and flat, with a slight pulsation when the infant is crying or straining. The anterior fontanel is typically larger and closes around 18 months of age, while the posterior fontanel is smaller and usually closes within a few months after birth.

Abnormal findings in the fontanels can indicate underlying health issues. For example, if the fontanels are excessively large or bulging, it may suggest increased intracranial pressure, such as from hydrocephalus or meningitis. Conversely, if the fontanels are sunken or depressed, it may indicate dehydration or malnutrition.

Proper documentation of fontanel sizes is essential for monitoring the infant’s growth and development, as well as for identifying any potential abnormalities that may require further evaluation or intervention.

Question 2: Nasal symptoms that imply an allergic response include:

When evaluating nasal symptoms, certain findings may imply an allergic response. These may include:

1. Purulent nasal drainage: Allergy-related nasal discharge is typically clear and watery. The presence of pus or a purulent nasal discharge may suggest a secondary bacterial infection, which can complicate an underlying allergic condition.

2. Bluish-gray turbinates: The turbinates are bony structures within the nasal passages that help to warm and moisten the inhaled air. In the case of an allergic response, the turbinates may appear bluish-gray due to congestion and inflammation. This discoloration is a result of increased blood flow to the nasal tissues.

3. Small, atrophied nasal membranes: Chronic exposure to allergens can cause the nasal membranes to become thin and atrophied. This can lead to nasal dryness, discomfort, and increased susceptibility to infections.

4. Firm consistency of turbinates: Normally, the turbinates should feel soft and pliable. In allergic rhinitis, the turbinates may become swollen, congested, and firm to the touch. This finding is indicative of nasal congestion and inflammation.

It is important to note that these findings are not definitive evidence of an allergic response. Allergic rhinitis is a clinical diagnosis that requires a comprehensive assessment of a patient’s symptoms, medical history, and physical examination findings. Further diagnostic testing, such as allergy testing, may be necessary to confirm the presence of allergies and identify specific triggers.

Question 3: Inspection of the abdomen should begin with the patient supine and the examiner:

During the physical examination of the abdomen, the initial position of the patient and the examiner is crucial for a thorough assessment. The examiner should be standing at the patient’s right side. This position allows for a systematic evaluation of the abdomen from top to bottom, as well as from right to left.

The patient should be lying supine, with the abdomen exposed and relaxed. This position allows for better visualization of abdominal contours, movements, and any potential abnormalities. The patient’s arms should be relaxed at their sides, and the legs should be extended.

Standing on the patient’s right side provides the examiner with a clear view of the abdomen and allows for easy access to perform palpation, percussion, and auscultation. Additionally, it allows the examiner to maintain a comfortable and ergonomic position for performing the examination.

Standing on the patient’s left side or walking around the table can impede the examiner’s ability to visualize the abdomen properly and may lead to a less comprehensive assessment. Therefore, starting the abdominal inspection with the patient supine and the examiner standing on the right side is the recommended approach for a thorough examination.