NZREX Clinical History-Taking & Examination 1

Question 1

When taking a history from a patient presenting with chest pain, which mnemonic is most useful for characterising the pain?

Accepted Answer

SOCRATES

Answer

SOCRATES (Site, Onset, Character, Radiation, Associated symptoms, Timing, Exacerbating/relieving factors, Severity) is the standard mnemonic for characterising pain in clinical history-taking.

Question 2

Which finding on auscultation is most consistent with a pleural effusion?

Accepted Answer

Stony dull percussion with reduced breath sounds

Answer

A pleural effusion produces stony dull percussion note and reduced or absent breath sounds over the effusion due to fluid accumulation in the pleural space.

Question 3

A 45-year-old presents with gradual onset dyspnoea and bilateral pitting oedema to the knees. Which examination finding would most support a diagnosis of congestive heart failure?

Accepted Answer

Elevated JVP with S3 gallop

Answer

Elevated JVP and S3 gallop are classic signs of congestive heart failure, reflecting increased venous pressure and a dilated, poorly compliant ventricle.

Question 4

When examining the abdomen, what is the correct order of examination steps?

Accepted Answer

Inspection, auscultation, percussion, palpation

Answer

The abdomen is examined in the order: inspection, auscultation, percussion, then palpation. Auscultation precedes percussion and palpation to avoid artificially altering bowel sounds.

Question 5

Which of the following best describes the 'shifting dullness' sign in abdominal examination?

Accepted Answer

Dullness that moves to the dependent side when the patient is rolled

Answer

Shifting dullness is elicited by percussing the flanks and then rolling the patient; if ascites is present, the dull area shifts to the dependent side as fluid moves with gravity.

NZREX Practice Test

NZREX Practice Test

NZREX Clinical History-Taking & Examination 1