Assessing Neuro and Heent

Question 1

subjective data

Answer 1

health history and interview

Question 2

objective data

Answer 2

physical examination, IPPA

Question 3

purpose of physical examination

Answer 3

gather baseline data, supplement or refute subjective data, identify nursing diagnoses, make clinical decisions about a patient’s changing health status

Question 4

subjective is …

Answer 4

symptoms

Question 5

objective is….

Answer 5

signs (collected by the nurse)

Question 6

inspection

Answer 6

look for symmetry, size, shape and color, abnormality and position; take vital signs, height and weight

Question 7

palpation

Answer 7

start with light palpation, use different parts of hand

Question 8

percussion

Answer 8

tap skin with fingertips to vibrate underlying tissues and organs

Question 9

auscultation

Answer 9

use stethascope

Question 10

reasons for adequate documentation pf assessment

Answer 10

communication with healthcare team, care plan development, insurance audits, legal situations

Question 11

Epistaxis

Answer 11

nose bleeds

Question 12

Rhinitis

Answer 12

nasal inflammation

Question 13

Rhinorrhea

Answer 13

nasal discharge

Question 14

Sinusitis

Answer 14

inflammation of sinuses, pain on cheeks, teeth, and gums

Question 15

deviated septum

Answer 15

ingrown of lower nasal septum

Question 16

Nasal polyp

Answer 16

non-painful overgrowth of nasal mucosa

Question 17

strabismus

Answer 17

crossed eyes

Question 18

anosmia

Answer 18

decrease of loss of smell occurs bilaterally with tobacco smoking, allergies, and cocaine use

Question 19

amblyopia

Answer 19

blindness from strabismus

Question 20

exophthalmos

Answer 20

protruding eyes from hyperthyroidism

Question 21

conjunctivitis

Answer 21

pink eye, inflammation from bacteria

Question 22

hordeolum

Answer 22

stye, localized staph infection of hair follicles

Question 23

subconjunctival hemorrhage

Answer 23

increased IOP, cough, vomiting, strain

Question 24

myopia

Answer 24

nearsightedness, see closer better

Question 25

hyperopia

Answer 25

farsightedness, see distance better

Question 26

astigmatism

Answer 26

refraction of light casues blurred or double vision

Question 27

Head exam

Answer 27

subjective data; headache, injury, dizziness, ROM
objective data: inspect and palpate skin and hair, skull symmetry, size and shape, lymph nodes…

Question 28

CNI

Answer 28

olfactory, sensory , sense of smell

Question 29

CN II

Answer 29

optic, sensory, visual acuity

Question 30

CN III

Answer 30

oculomotor, motor, extraocular eye movements, pupil constriction and dialation, opening the eye

Question 31

CN IV

Answer 31

trochlear, motor, downward and inward eye movemements

Question 32

CN V

Answer 32

Trigeminal, sensory and motor, sensory to skin of face, motor to muscles of jaw,

Question 33

CN VI

Answer 33

abducens, motor, lateral movement of eyeballs

Question 34

CN VII

Answer 34

facial, sensory and motor, facial expression, taste

Question 35

CN VIII

Answer 35

auditory, sensory, hearing

Question 36

CN IX

Answer 36

Glossopharyngeal, sensory and motor, taste and ability to swallow

Question 37

CN X

Answer 37

vagus, sensory and motor, sensation of pharynx, movements of vocal cords, parasymp. innervation to glands of mucous membranes

Question 38

CN XI

Answer 38

spinal accessory, motor, movement of head and shoulders