Fundamentals of Nursing Practice · Assessment

Physical Assessment Techniques and General Survey

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In 30 seconds
Why this matters
The college version
Eli explains
Worked example
Key takeaway
Study tools

In 30 seconds

A physical assessment uses four techniques—, , , and —usually in that order, except over the abdomen, where auscultation comes first. The exam opens with a of appearance, behavior, mobility, and distress, and depends on that protects privacy, obtains consent, ensures comfort and positioning, and uses clean with and . (height, weight, BMI) add objective data, and findings are recorded separately from interpretation.

Why this matters

A physical exam touches the body, so it carries legal and ethical weight: the nurse explains the exam, obtains consent, and protects privacy and modesty. Findings are documented factually because the chart is a legal record, and observed findings are kept separate from interpretation. Standard precautions and hand hygiene are required by infection-control standards that vary by institution and jurisdiction. Scope of practice limits the nurse to techniques within their training; abnormal findings are reported for qualified evaluation, not self-diagnosed.

The college version

1. The four techniques and their order

Inspection is systematic looking—observing color, shape, symmetry, and movement. Palpation uses touch for temperature, texture, tenderness, and masses (light before deep). Percussion taps to produce sounds that hint at air, fluid, or solid tissue. Auscultation listens with a stethoscope to heart, lung, and bowel sounds. The standard is inspect, palpate, percuss, auscultate. The reverses the last three—inspect, auscultate, palpate, percuss—because touching first can stimulate the bowels and change their sounds.

2. The general survey

The general survey is the overall first impression formed on meeting the client, before hands-on technique. Appearance includes age, skin color, hygiene, grooming, and visible illness. Behavior includes level of consciousness, mood, speech, and eye contact. Mobility includes posture, gait, and ease of movement. Distress is visible pain or breathing difficulty (grimacing, guarding, labored breathing). The survey guides what the nurse examines more closely.

3. Preparation and objective measurement

Preparation protects the client and the accuracy of the exam. The nurse ensures privacy (curtain, door, screen), obtains consent by explaining what will happen and why, promotes comfort (warm room, empty bladder, pain addressed), and uses proper positioning (sitting, supine, side-lying). The nurse gathers equipment (stethoscope, cuff, thermometer, scale, light, gloves) and performs hand hygiene before and after contact, following standard precautions (treating all body fluids as potentially infectious, using gloves or other PPE as indicated). Anthropometrics—height, weight, and BMI (body mass index)—are objective measurements trended over time. Throughout, the nurse keeps findings (what was observed) separate from interpretation (what it might mean), because only findings are fact.

How it works

Inspection first—look before touching.
Palpation second—feel temperature, texture, tenderness (light before deep).
Percussion third—tap to hear what lies beneath.
Auscultation fourth—listen to heart, lung, bowel sounds.
Exception: over the abdomen, auscultate before palpation and percussion.

Common confusions

Do not confuse	With	Difference
Inspection	Palpation	Looking vs touching
Percussion	Auscultation	Tapping vs listening
Findings	Interpretation	Observed fact vs what it might mean
General survey	Head-to-toe exam	First impression vs detailed exam
BMI	Weight alone	BMI relates weight to height

Memory aids

IPPA for the exam order: Inspection, Palpation, Percussion, Auscultation. Remember "A before P" for the abdomen: auscultate before palpation and percussion.

Quick review

Topic Recap

Four techniques—inspection, palpation, percussion, auscultation—in that order, with auscultation first over the abdomen.
The general survey assesses appearance, behavior, mobility, and distress.
Preparation (privacy, consent, comfort, positioning, equipment) plus hand hygiene and standard precautions make the exam safe and accurate.
Anthropometrics (height, weight, BMI) add objective data; findings are documented separately from interpretation.

Knowledge Check

List the four techniques in the standard order.
What is the abdominal-sequence exception, and why?
Name the four components of the general survey.
What do anthropometrics measure?
Why keep findings separate from interpretation?

Answers and Rationales

Answer: Inspection, palpation, percussion, auscultation. Why: The fixed order prevents one step from distorting the next.
Answer: Auscultate before palpation and percussion over the abdomen. Why: Touching first can stimulate the bowels and change their sounds.
Answer: Appearance, behavior, mobility, distress. Why: These form the first impression guiding the exam.
Answer: Height, weight, and body mass index (BMI). Why: Objective measures trended over time.
Answer: Findings are observable facts; interpretation is judgment needing more data. Why: The chart must record facts accurately.

Eli explains

The same idea, in plain words

Explain it like I’m 10

Think of the four techniques as four ways of "reading" the body, like a detective's senses at a scene: inspection is looking, palpation is touching, percussion is tapping to hear if something is hollow, and auscultation is listening. Each adds a different clue.

The comparison stops being exact because the body is alive and responsive. Tapping the abdomen is nothing like tapping drywall—it reveals organs, air, and fluid—and the order matters. Over the belly, poking and tapping first can stir the bowels and change the sounds, so the nurse listens before touching.

Simple Example

A nurse looking at a wound is inspecting; placing a hand to feel warmth is palpating; tapping the chest is percussing; and listening with a stethoscope is auscultating.

Worked example

Observe: Perform the general survey, noting appearance, behavior, mobility, and distress.
Prepare and protect: Ensure privacy, consent, comfort, positioning, hand hygiene, and standard precautions.
Examine: Apply inspection, palpation, percussion, auscultation in order—and the abdominal exception over the abdomen.
Measure and document: Record anthropometrics and objective findings, keeping findings separate from interpretation.
Communicate and escalate: Share abnormal findings with the team; escalate acute distress or concerning change for qualified evaluation.

Key takeaways

High yield: Standard order: inspect, palpate, percuss, auscultate.
High yield: Over the abdomen, auscultate before palpation and percussion.
High yield: The general survey covers appearance, behavior, mobility, distress.
High yield: Hand hygiene and standard precautions frame every contact.
High yield: Anthropometrics = height, weight, BMI.
High yield: Findings are fact; interpretation is judgment—document separately.
Preparation is not optional—it protects dignity, safety, and accuracy.

Keep learning

Ready to build on this? Continue to the next lesson.

Study toolsYou’ll learn to · Key vocabulary

You’ll learn to

Describe the four examination techniques—inspection, palpation, percussion, auscultation—and their order.
Explain the general survey and its components (appearance, behavior, mobility, distress).
Identify exam preparation steps: privacy, consent, comfort, positioning, equipment, hand hygiene, standard precautions.
Distinguish findings from interpretation, and explain the abdominal-sequence exception and anthropometrics (height, weight, BMI).

Key vocabulary

General survey: Overall first impression
Inspection: Systematic looking
Palpation: Touch for temperature, texture, tenderness
Percussion: Tapping to produce diagnostic sounds
Auscultation: Listening with a stethoscope
Preparation: Privacy, consent, comfort, positioning, equipment
Privacy / consent: Protected space / agreement after explanation
Comfort / positioning: Warmth, empty bladder / correct position
Equipment: Stethoscope, cuff, thermometer, scale, gloves
Hand hygiene: Cleaning hands before and after contact
Standard precautions: Treating all body fluids as infectious
Exam sequence: Inspect, palpate, percuss, auscultate
Abdominal-sequence exception: Auscultate before palpate/percuss
Anthropometrics: Height, weight, BMI
Findings vs interpretation: What is observed vs what it might mean

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