Final Practicum Exam Sequence

Bedside Head to Toe Exam Sequence

1. General Survey (sitting)

Appearance

Gait, posture & position comfortably erect

Dress, grooming, & hygiene

Nutritional status

Behavior

Level of consciousness

Facial expression, mood & affect

Cognition

Orientation to person, place, & time (& situation as applicable)2. Pupillary assessment (Neurologic - sitting)

Pupils equal, round, react to light with accommodation (PERRLA)

3. Respiratory (Chest - sitting)

Character of respiration (anterior)

Auscultation of breath sounds (posterior)

4. Upper Extremities (Peripheral vascular & musculoskeletal sitting)

Palpate radial pulses bilaterally

Bilaterally assess color, temperature, moisture, & capillary refill

Muscle tone & strength bilateral hand grasps

5. Cardiac (Heart supine)

Auscultate apical heart rate one full minute

Auscultate cardiac landmarks (diaphragm & bell)

6. Gastrointestinal (Abdomen supine)

Describe contour, symmetry of abdomen

Auscultate bowel sounds in all 4 quadrants

Percuss abdomen in all 4 quadrants

Light & deep palpation in all 4 quadrants

7. Lower Extremities (Peripheral vascular & musculoskeletal supine)

Palpate dorsalis pedis & posterior tibial pulses bilaterally

Bilaterally assess color, temperature, & moisture

Bilaterally check capillary refill & pretibial edema

Muscle tone & strength bilateral plantar flexion against resistance

NOTE: Assess IVs, saline locks, dressings, etc. in appropriate locations above if present.