Maryville University Advanced Health Assessment
Exam3, 271Questions and Answers (Latest Update
2024/2025) GRADED A+
Screening exam for mental status - CORRECT ANSWERS -Screen for appearance and
behavior (grooming, emotional status, body language)
-Emotional stability (moods & feelings, thought processes)
-Cognitive abilities (state of consciousness, memory, attention span, judgement)
-Speech & language (voice quality, articulation, comprehension, coherence, aphasia)
Delerium - CORRECT ANSWERS sudden, reversible, lasts hours to days, altered
consciousness, mood swings, illogical flow of ideas, hallucinations, delusions, associated with
acute events
Dementia - CORRECT ANSWERS insidious, persistent, struggles to find words,
depressed/apathetic, delusions but no hallucinations, related to structural disease of the brain
Expressive aphasia - CORRECT ANSWERS knows what they want to say but can't
articulate properly, reading comprehension intact, impaired writing
Receptive aphasia - CORRECT ANSWERS can hear words but can't relate, uses words
inappropriately/incomprehensible, impaired reading and writing
Global aphasia (both) - CORRECT ANSWERS Only knows ones name or few select words,
no spontaneous speech or very limited, severely impaired reading and writing
Risk factors for suicidal ideations - CORRECT ANSWERS -Social isolation (living alone,
divorced, widowed)
-Mental health disorder (depression)
-Terminal health condition
-Family hx
,-Personal losses or challenges (unemployment, legal problems)
-Plan for suicide or previous attempt
-Alcohol or substance abuse
-Access to firearms or other self harm
Depression - CORRECT ANSWERS Sudden or insidious, longer than 2 weeks, no impaired
consciousness, impaired concentration/memory/thought processes, insomnia or too much
sleep, fatigue, anxiety, slowed speech, homeless, loss of interest of pleasure, associated with
grief or stressful life event
Abdominal pain HPI questions - CORRECT ANSWERS -Onset: when, sudden vs gradual
-Location: of onset, change? radiates, superficial or deep
-Duration: persistent, recurrent, intermittent
-Character: dull, sharp, burning, gnawing, stabbing, cramping, aching, colicky, also stool/urine
characteristics
-Aggravating factors: medications?
-Relieving factors: medications, home remedies
-Temporal factors: related to menses, intercourse, urination, defecation, inspiration, change in
body position, food/alcohol, stress, time of day, trauma?
-Associated symptoms: vomiting, diarrhea, constipation, flatus, belching, jaundice, abdominal
girth, weight loss or gain
Abdominal: inspection - surface characteristics - CORRECT ANSWERS -Normal: pink,
venous return above the umbilicus should be toward the head; below the umbilicus should be
toward the feet
-Abnormal: Jaundice, cyanosis, taut, bruises, redness, Cullen sign, striae, tumors, masses,
ascstes, nodules (Sister Mary Joseph a pearl-like, enlarged and sometimes painful umbilical
nodule can indicate abd malignancy), lesions
Abdominal: inspection: Contour - CORRECT ANSWERS -Normal: flat, rounded, or scaphoid,
umbilicus centrally located, symmetric
-Abnormal: distention, bulges, umbilicus inflammation/bulging, masses, hernias, diastasis recti
,Abdominal: Inspection: Movement - CORRECT ANSWERS -Normal: Smooth, even
movement with respiration
-Abnormal: limited motion on respiration (peritonitis), peristalsis (obstruction), marked pulsations
(aortic aneurysm)
Abdominal: Auscultation: Bowel sounds & bruits - CORRECT ANSWERS -Normal: 5-35
clicks/gurgles/min
-Abnormal: loud prolonged gurgles (borborygmi), increased BS (gastroenteritis, intestinal
obstruction, hunger), high-pitched tinkling (intestinal fluid & air under pressure aka early
obstruction), decreased BS (peritonitis, paralytic ileus), absent bowel sounds = inability to hear
after 5 min (abdominal pain/rigidity—surgical emergency), bruits, friction rubs, venous hum
Abdominal: Percussion - CORRECT ANSWERS -Normal: Overall tympany & dullness, liver
span 6-12cm, splenic dullness 6th-9th rib, tympany gastric bubble
-Abnormal: organ enlargement, CVA tenderness
Abdominal: Palpation - CORRECT ANSWERS -Normal: smooth, soft, without resistance or
tenderness, spleen, kidneys, and healthy gallbladder are not palpable, liver palpable at costal
margin (firm, smooth, even, nontender)
-Abnormal: Palpable tender gallbladder = cholecystits, common bile duct obstruction =
nontender enlarged gallbladder, any masses, guarding, pain, bulges, nodules, granulation
How to assess for McBurney's point - CORRECT ANSWERS Lower right quadrant
Palpation of the kidney - CORRECT ANSWERS Right kidney is more often felt than the left.
One hand on flank, one hand on costal margin. As patient inhales deeply, lift the flank and
palpate deeply
Palpation of liver - CORRECT ANSWERS 6-12 cm liver span
Conditions for acute abdominal pain - CORRECT ANSWERS appendicitis, peritonitis,
cholecystitis, pancreatitis, salpingitis, PID, diverticulitis, perforated gastric/duodenal ulcer,
intestinal obstruction, volvulus, leaking abdominal aneurysm, biliary stones, renal calculi, extopic
pregnancy, ruptured ovarian cyst, splenic rupture
, Conditions for chronic abdominal pain - CORRECT ANSWERS IBS, lactose intolerance,
diverticular disease, constipation, uterine fibroids, hernia, GERD, peptic ulcer, gastritis
Aarons sign - CORRECT ANSWERS palpation of McBurneys causes heart or stomach pain
= appendicitis
Ballance sign - CORRECT ANSWERS dullness to percussion of flank that disappears w/
change of position= peritoneal irritation
Blumberg sign - CORRECT ANSWERS Rebound tenderness = appendicitis, peritoneal
irritation
Cullen sign - CORRECT ANSWERS Eccymosis around umbilicus = hemoperitoneum,
pancreatitis, ectopic pregnancy
Dance sign - CORRECT ANSWERS absence of BS in RLQ = intussusception
Grey Turner sign - CORRECT ANSWERS Ecchymosis of flanks = hemoperitoneum,
pancreatitis
Kehr sign - CORRECT ANSWERS Abdominal pain radiating to left shoulder = spleen
rupture, renal caliculi, ectopic pregnancy
Markle sign - CORRECT ANSWERS raises on toes and comes down on heels (jarring body)
causing abdominal pain = peritoneal irritation, appendicitis
McBurney sign - CORRECT ANSWERS raises on toes and comes down on heels (jarring
body) causing abdominal pain = peritoneal irritation, appendicitis
Murphy sign - CORRECT ANSWERS cessation of inspiration on gallbladder palpation =
cholecystitis
Romberg-Howship sign - CORRECT ANSWERS pain down medial aspect of thigh to knees
= strangulated obturator hernia
