Clinical Assessment Skills Flashcards

During a NZREX clinical examination, you are assessing a patient with acute abdominal pain. What is the correct sequence for abdominal examination?

Answer: Inspection, auscultation, percussion, palpation

The correct sequence for abdominal examination is inspection, auscultation, percussion, then palpation. Auscultation comes before palpation and percussion because palpation can alter bowel sounds, leading to inaccurate findings.

In the NZREX exam, what is the essential first step when approaching any clinical station?

Answer: Introduce yourself, confirm the patient's identity, explain what you intend to do, and obtain consent

In NZREX (and NZ clinical practice), you must always introduce yourself, verify the patient's identity, explain the examination or procedure, and obtain informed consent before proceeding. This reflects NZ consumer rights standards.

When performing a cardiovascular examination in the NZREX, what clinical signs should you specifically check in the hands?

Answer: Clubbing, splinter haemorrhages, Janeway lesions, Osler's nodes, and peripheral cyanosis

In a cardiovascular examination, the hands may reveal important signs: clubbing (cyanotic heart disease), splinter haemorrhages (endocarditis), Janeway lesions (painless, endocarditis), Osler's nodes (painful, endocarditis), and peripheral cyanosis.

During a respiratory examination in the NZREX, what does increased tactile vocal fremitus on one side suggest?

Answer: Consolidation (such as pneumonia) on that side

Increased tactile vocal fremitus occurs when sound is transmitted more efficiently through consolidated (solid) lung tissue, as in pneumonia. Decreased fremitus would suggest pleural effusion or pneumothorax, which block sound transmission.

In the NZREX clinical exam, how should you assess for cerebellar dysfunction?

Answer: Test for dysmetria (finger-nose test), dysdiadochokinesia (rapid alternating movements), intention tremor, gait ataxia, and nystagmus

Cerebellar examination includes testing for dysmetria (finger-nose and heel-shin tests), dysdiadochokinesia (inability to perform rapid alternating movements), intention tremor, gait ataxia (broad-based, unsteady gait), and nystagmus.

When examining a patient's thyroid in the NZREX, what is the correct technique?

Answer: Stand behind the patient, ask them to swallow water, and palpate the thyroid as it moves with swallowing

The thyroid should be examined from behind the patient, using both hands to palpate the gland. Asking the patient to swallow water helps identify the thyroid as it moves upward with the larynx during swallowing.