FNP Student Skills Check Off

At Loyola, the Advanced Health Assessment (AHA) courses are the first steps in becoming acclimated to
the role of Primary Nurse Practitioner.

In preparation for their new role, FNP students are required to go through different Advanced Health
Assessment stations, where they will learn new assessment skills, such as how to use an otoscope and
ophthalmoscope. Students will also have their RN Head to Toe Assessment skills verified and will be
required to successfully complete a Head to Toe exam on a partner in order to begin clinicals. The
following pages contain a sample of the grading criteria.

Please practice and come prepared to complete the Head to Toe exam without prompting or note
cards.

Students who are not successful will be given one (1) additional opportunity to demonstrate proficiency.

Tools to Bring: Dates & Times:

• Stethoscope Students will receive an email containing meeting
• Penlight dates at the time of registration. Dates will also
• Reflex Hammer be posted to the School of Nursing Resources
webpage.

What to Wear: Required Textbooks:

Loose, comfortable clothing. Students will be Students will receive an email containing
conducting physical exams on one another. textbook(s) required for Advanced Health
Assessment at the time of registration.

If you have any questions, please contact Jennifer Brackett, the DNP/MSN Administrative Assistant, at brackett@loyno.edu.
 Loyola University New Orleans
College of Nursing and Health
BSN DNP, MSN-FNP, and MSN-NE Program
RN PHYSICAL EXAM REQUIREMENTS

Student’s name: ____________________________ Grade:_______________

Evaluator:_________________________________ Date:________________

Students will complete a physical assessment on a fellow student, meeting all of the objective
points indicated on this Physical Exam Performance Checklist. Please wear comfortable, loose
clothing as you will examine a fellow student. Student is expected to complete the exam in a
strictly timed 30 minute period.

You will need a stethoscope, penlight, and reflex hammer to complete the physical exam.

Students Approach to Patient

Yes No Comments
Logical Exam Sequence (-2)

Initiated / Ended Exam well (-1)

Explained exam to patient (-1)

Assembled proper equipment (-1)

Provided for privacy (-1)

Professional, and mature (-2)

Used correct terminology and pronunciation (-2)

Students may lose up to 10 points for

inappropriate demeanor and behavior

PROCEDURE Yes No Points

THORACIC Inspect anterior, posterior, lateral, chest wall 1.0

THORACI
CARDIAC

Respiratory rate, rhythm, and effort (retractions, use of 1.0

&

accessory muscles)
Palpate for chest wall (for tenderness, lesions) 2.0
 Thoracic expansion (anterior/posterior) 1.0
Percussion (anterior, posterior, and lateral) from apex to 2.0
base (note resonance, hyperresonance, dullness)
Auscultation of breath sounds from apex to bases 2.0
(posterior, anterior, lateral-sitting)
CARDIAC & Inspection of the precordium. Describes 6 areas of 3.0
CIRCULATION assessment (aortic, pulmonic, Erb's, Tricuspid, Mitral,
epigastric)
Palpation of precordium for any heave, thrill, PMI, 2.0
pulsations.
Auscultation of the heart (supine, left lateral, sitting 2.0
position with diaphragm and bell)
Inspection, palpation and auscultation of carotids. 2.0
Location of palpable pulses (radial, brachial, dorsalis, 2.0
posterior tibia, popliteal).
SUBTOTAL CARDIAC & THORACIC WORTH 20 POINTS 20

GENERAL Inspect & Palpate skin (turgor, texture, temperature) 1.0

OVERVIEW AND Hair - inspect 1.0
SKIN
Nails - inspect and palpate (clubbing, cap refill) 2.0

HEAD & NECK Palpate head and scalp, including sinuses and TMJ 2.0
HEAD, EARS, EYES, NOSE, THROAT (HEENT)

Palpate and auscultate temporal arteries; Inspect neck and 2.0

neck veins
Palpate Neck: 2.0
• Trachea
• Thyroid
• Lymph nodes (all sets in neck - state which ones)
EYES Inspection of eyebrows, eyelids, orbital area, eyelashes, 1.0
lacrimal gland
Palpation of orbital area (sclera, conjunctiva) 1.0
Direct and Consensual Response 2.0
Inspection and palpation of ear & functional hearing 2.0
EARS
NOSE Inspect external nose & internal nares 2.0

MOUTH Inspect lips, teeth, buccal mucosa, tongue, floor of mouth 2.0

SUBTOTAL HEENT WORTH 20 POINTS 20.0

ABDOMEN Inspection of the abdomen (supine position, pillow under 3.0

head, arms at side, empty bladder)
 Auscultation of all quadrants: 3.0
bowel sounds, aortic, iliac, femoral, and renal arteries.
Percussion of abdomen in 4 quadrants 2.0
Percussion of liver span at MCL 3.0
Percussion of splenic dullness 2.0
Light & Deep palpation of 4 quadrants 2.0
CVA and rebound tenderness 3.0
Palpate aortic pulsation 2.0

SUBTOTAL ABDOMEN WORTH 20 POINTS 20.0

OVERVIEW Inspect joints and muscles 1.0

ROM Neck - Flexion, extension, lateral bending and rotation 2.0

(Assessment of head and neck may be done with head
and neck exam.)
Shoulder - Adduction, abduction, internal rotation, and 2.0
external rotation
MUSCULOSKELETAL

Elbow - Flexion and extension, supination pronation 2.0

Wrist - Flexion and extension, ulnar and radial deviation 2.0
Fingers - Flexion and extension, adduction and abduction 2.0
Hip - Internal and external rotation, flexion, extension, 2.0
adduction and abduction
Knee – Flexion and extension 2.0
Ankle - Plantar and dorsiflexion 1.0
Vertebral column - Flexion, extension, rotation, and 2.0
lateral bending
STRENGTH Neck, Shoulder, Elbow, Hands, Hips, 2.0
Knees, Ankle
SUBTOTAL 4 MUSCULOSKELETAL WORTH 20 POINTS 20.0

OVERVIEW Cognitive abilities (memory) 1.0

NEUROLOGICAL

Judgment, abstraction 1.0

CRANIAL Fields of peripheral vision CN II - Optic 2.0

NERVES Pupil condition and response to light and accommodation
CN II (Optic), and III (Oculomotor)
Extra ocular movement (six cardinal fields) CN III 2.0
(Occulomotor), IV (Trochlear), and VI (Abducens)
Assess CN V - Trigeminal- Motor and Sensory
 Assess CN VII – Facial - Motor only 2.0
whisper test) CN VIII - Acoustic
Observe movements of soft palate – 2.0
CN IX (Glossopharyngeal) and X (Vagus)
Assess CN XI - Spinal accessory 2.0
Inspect tongue for movement - CN XII - Hypoglossal
REFLEXES Upper extremities (biceps, triceps, brachioradialis) 1.5
(DTRS) Lower extremities (patellar, Achilles, Babinski, clonus) 1.5
Sensation (light touch) using LE and UE 1.0
CEREBELLAR Coordination (finger to nose, nose to finger, alternating, 1.0
rapid hand patting)
Pronator drift 1.0
Gait: Tandem walking 2.0

SUBTOTAL NEUROLOGIC SYSTEM WORTH 20 POINTS 20.0

CARDIAC AND THORACIC Worth 20 points
HEENT Worth 20 points
ABDOMEN Worth 20 points
MUSCULOSKELETAL Worth 20 points
NEUROLOGICAL Worth 20 points

TOTAL Total possible points = 100

 Loyola University New Orleans
College of Nursing and Health—School of Nursing

Practicum This checklist provides a guide for

minimum competencies required in the
Skills Checklist program
Students should demonstrate skills & provided rationale 812 830 845 855 Spring
for choice of exam/test during their clinical rotation and AHA Primary Primary Primary Intensive
during the site visit with FNP faculty Prac Care Peds Care of care of
Course faculty will be responsible for making the final determination Prac Adults Adults &
regarding course grade after conducting the site visit and consulting Prac Women
with the preceptor. Prac

Grading Key
O= observed but not competent
C= observed & competent in skill
Complete Head-to-toe History and Physical *
Exam (Annual Adult Wellness/Preventive
Exam)
Episodic History and Physical Exam * * * *
Complete HEENT Exam * * * *
Complete Cardiovascular Exam * * * *
Inspection (pulsations, lifts, heaves, retractions,
skin lesions, venous distention, surgical scars,
tattoos, JVD)

Palpation (precordium, apical pulse, pulsations,

lifts, heaves, retractions)

Pulses (Apical, radial, femoral, temporal, carotid,

brachial, radial, popliteal, posterior tibial, dorsalis
pedis)

Peripheral lymph nodes

Evaluation of Edema
Auscultation for bruits
Heart Sounds (aortic, pulmonic, Erb’s Point,
Tricuspid, Mitral)
Identification of Heart Murmur
Complete Respiratory Exam * * * *
Inspection
Auscultation
Palpation
Percussion

1
 Loyola University New Orleans
College of Nursing and Health—School of Nursing

Complete Neurologic Exam including: * *

Mental Status (mood, affect, thought processes,
cognitive functions)
Cranial Nerve Exam I-XII
Cerebellar Exam Coordination/Cerebellar Function
(alternating hands movements, touch thumb to
each finger, finger to examiner’s finger bilat, touch
nose with index finger, pronator drift, heel to shin)
Proprioception (Romberg test, stand on one foot,
walk, heel-toe walk, walk on toes, walk on heels)
Motor Exam (Hand grips and strength testing)
Sensory Exam
Pain (Sharpness/Dullness)
Vibratory Sensation
Position of joints
Stereognosis
Two point discrimination
Deep Tendon Reflexes (UE & LE)
Plantar bilateral
Clonus (present or absent)
NURS NURS NURS NURS Spring
812 830 845 855 Intensive

Complete Gastrointestinal Exam * * * *

Inspection (striae, Cullen sign, distention, hernias,
masses)
Auscultation (bruits, renal, aorta, iliac femoral)
Percussion (liver span, spleen, gastric bubble, CVA
tenderness)
Palpation (Murphy’s sign, McBurney’s point,
iliopsoas muscle test, obturator muscle test,
abdominal reflexes, rebound tenderness,
ballottement)
Complete Musculoskeletal Exam (upper *
extremities) Temporalmandibular joint, cervical
spine, thoracic, lumbar spine, shoulder, elbow,
wrist/hand assessment
Spurling’s Test, Apley Scratch Test, Painful Arc
Test, Apprehension Sign, Hawkins test, Identify the
Snuff Box, Finkelstein’s Test, Phalen’s Test, Tinel
Test, ROM, muscle tone
Complete Musculoskeletal Exam (lower *
extremities)
Hip, knee, ankle, foot
Trendelenburg Test, Anterior/Posterior Drawer
Sign, McMurray Maneuver, Lachman Test,
Anterior/Posterior Drawer Test, Talar Tilt Test,
Thomas Test, Straight Leg Raise/Crossed Straight

2
 Loyola University New Orleans
College of Nursing and Health—School of Nursing

Leg Raise, Bulge sign, Ballottement test, ROM,

muscle tone/strength
N 812 N 830 N 845 N 855 Spring
Intensive
Pediatric PE Infant (review with parent/pt *
guardian-growth charts and developmental
screening)
Pediatric PE Toddler (review with parent/pt *
guardian-growth charts and developmental
screening)
Pediatric PE Child (review with parent/pt *
guardian-growth charts and developmental
screening)
Pediatric PE Adolescent (review with parent/pt * * * *
guardian-growth charts and developmental
screening)
Pre-participation physical *
Laboratory Evaluation (includes interpretation):
CBC
CMP
Lipid panel
Thyroid panel
Hepatic function panel
UA and Culture
Breast exam *
Pelvic Exam *
Prostate Exam *
Testicular Exam *
Basic Chest X-ray Interpretation lecture *
Basic EKG interpretation lecture *
Basic Suturing *
Basic Splinting & Extremity X-rays *
Additional Skills
NURS NURS NURS 845 NURS
812 830 855
Saline wet mount
Potassium hydroxide (KOH) prep
Woods lamp
Pulmonary function tests (evaluate)
Peak flow (obtain from patient during encounter)
Spirometry
Routine eye exam- Snellen chart
Routine eye exam-Rosenbaum
Fluorescein staining of eyes
Tonometry
Tymapnometry tests
Audiometry
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 Loyola University New Orleans
College of Nursing and Health—School of Nursing

Developmental screenings *
Growth charts *
Pap smears
Portable Doppler (please identify purpose for
Doppler evaluation)
Suturing
Incision and drainage
Dermabond
Staple removal
Chemical cautery/liquid nitrogen
Cerumen removal
Ring removal (removal of ring from finger)
Cognitive testing
Mini mental exam
PHQ2 and PHQ9
GAD-7
Screening for ETOH use
Screening for Intimate Partner Violence