Adult Health History

Question 1

Seven attributes of a symptom

Answer 1

Location, quality, quantity or severity, timing including onset duration and frequency, Setting in which it occurs, factors that aggravate or relieve the symptoms, associated manifestation

Question 2

Components of the adult health history

Answer 2

identifying data, reliability, cheif complaints, present illness, past hx, social HX, family hx, ROS

Question 3

Components of present illness description

Answer 3

Attributes of symptoms, relevant info (risk factors), pt response to symptoms, meds, allergies, tobacco use, etoh and drug use

Question 4

Skilled interviewing techniques

Answer 4

Active listening, empathic responses, guided questioning, nonverbal comm, validation, reassurance, partnering, summarization, transitions, empowering the patient

Question 5

Exploring the patient perspective 4 qualities

Answer 5

1) pt feelings re the problem
2) pt ideas about the nature and cause of the problem
3) effect of problem on patients life and function
4) pt expectations about the illness, the clinician, or of health care

Question 6

NURSE mnemonic

Answer 6

Name, Understand / legitimize, Respect, Support, Explore

Question 7

Seven attributes of a symptom

Answer 7

Location, quality, quantity or severity, timing, onset, exacerbating / remitting factors, associated manifestations

Question 8

OPQRST mnemonic

Answer 8

Onset, palliating / provoking factors, quality, radiation, site, timing

Question 9

How is weight loss defined?

Answer 9

A loss of 5% or more of usual body weight over six months

Question 10

Signs of malnutrition

Answer 10

Weakness, easy fatigability, cold intolerance, flaky dermatitis, ankle swelling

Question 11

Characteristics of the general appearance assessment

Answer 11

Apparent state of health, level of consciousness, any signs of distress, skin color and obvious lesions, personal hygiene, facial expression, photos of the body your breath, posture and motor activity, height and weight, BMI

Question 12

Optimal size of a blood pressure cuff

Answer 12

Width should be about 40% of the upper arm circumference; length should be about 80% of the upper arm circumference

Question 13

Five steps for measurement and tracking the response to managing chronic pain

Answer 13

measure pain intensity and pain interference.

measure mood

Measure the effect of pain onsleep

Measure risk of Co occurring substance abuse

Measure the opioid dose

Question 14

Headache warning signs

Answer 14

Progressively frequent or severe over a 3 month period
sudden “thunderclap” onset the worst headache of my life
new onset after age 50
aggravated or relieved by changing position
precipitated by Valsalva maneuver or exertion
associated symptoms of fever night sweats or weight loss
presence of immuno deficiency
recent head trauma
change in pattern from past headaches
associated neck stiffness or papilledema

Question 15

Important attributes of a headache (3)

Answer 15

Severity, chronologic pattern, associated symptoms

Question 16

Orthostatic hypotension

Answer 16

A drop in SBP of more than 20 or a drop in DBP of more than 10 within three minutes of standing

Question 17

Risk factors for melanoma

Answer 17

Personal or family history of melanoma, More than usual common moles, atypical or large moles, red or light hair, freckles, UV radiation exposure, severe blistering sunburns in childhood, immuno suppressed, history of nonmelanoma skin cancer, solar lentigines

Question 18

breathing patterns that are typical of a CNS lesion

Answer 18

Cheyne-Stokes, biot, apneustic