Assessment Final

Question 1

Your patient states that he has an allergy to PCN, what should be your next question?

Answer 1

What is your reaction? How sever is it?

Question 2

Describe how the Chief Complaint is recorded, and given an example.

Answer 2

Subjective statement client gives about why seeking healthcare. “My Head Hurts!”

Question 3

When doing the general survey what are you assessing?

Answer 3

Appearance, breathing pattern, posture, cleanliness, skin pink or warm

Question 4

What information is needed when collecting a medication history?

Answer 4

Dose, reason, time taking it, last time took it, route, and history, name

Question 5

Therapeutic communication –

Answer 5

• active listening – listening then repeating it back
• restatement – help pt to expand on what they are saying or use different words
• reflection – summarizing main parts
• encouraging elaboration – trying to get pt to talk more
• silence – gives pt time to pick the words they want to use
• focusing – narrow down concerns we have about health history
• clarification – ask pt what do they mean
• summarizing
• open ended questions
• eye contact

Question 6

Nontherapeutic communication –

Answer 6

• false reassurance – can’t guarantee anything, every pt is different
• sympathy – takes focus off of pt and put on self
• unwanted advice – “my mother had this done and did this”
• biased questions – “do you use drugs”
• changing the subject – don’t run away from info we feel uncomfortable
• distractions – ex trying to chart while in pts room
• technical or overwhelming language – supposed to teach at a 4th grade level
• interrupting - give pt time to explain
• arms crossed

Question 7

Open-ended questions; when collecting information about weight what would be an appropriate open-ended question to ask your patient?

Answer 7

Have you had any changes in your weight?

Question 8

Describe the difference between subjective and objective data. What are some examples?

Answer 8

Subjective: pain
Objective: anything measurable

Question 9

What are the steps for completing a symptom analysis

Answer 9

OLD CARTS (onset, location, duration, character, associated or aggravating factors, relieving factors, timing, severity)

Question 10

how would you assess severity?

Answer 10

use pain scale

Question 11

3. How would you document your findings for a general survey? For example, you have a patient that appears depressed and does not make direct eye contact during the history Assessment.

Answer 11

Document what you see

Question 12

What are the normal age related changes for our older adult patients?

Answer 12

Decrease perception, decreased mobility (everything goes down except adipose tissue)

Question 13

Name the stage of development according to Erikson.

Answer 13

Integrity vs. Despair. (sense of satisfaction of a life well lived)

Question 14

What is the best position to take a history in the older adult with hearing loss?

Answer 14

If elderly sit in front of pt, slow speech down, make sure they can see your mouth

Question 15

What are some psychosocial factors/ concerns in the older adult?

Answer 15

Life roles and attitudes

Question 16

What is the technique for taking a rectal temperature?

Answer 16

1 ½ adult, 1 child, ½ infant (Approximately 1 degree higher than normal)

Question 17

What range is considered pre-hypertension? **

Answer 17

Pre-hypertension – 120-139 / 80-89
Stage l hypertension – 140-159 / 90-99
Stage 2 hyperstion - >160 / >100

Question 18

Grading of peripheral pulses, what is considered normal and abnormal?

Answer 18

2+ normal

0 absent, 1 diminished, 3 full, 4 strong

Question 19

What is pulse pressure?

Answer 19

The difference between the SBP and the DBP and reflects the stroke volume (normal is 40 mm Hg

Question 20

5. How long should you palpate the radial pulse when assessing rate, how long for the apical pulse

Answer 20

Radial – 30 seconds x 2

Apical – 1 minute

Question 21

When assessing blood pressure what does systolic pressure represent, and what does diastolic pressure indicate?

Answer 21

Systolic – contraction of the left ventricle at the beginning of systole
Diastolic – left ventricle relaxes between beats

Question 22

What are some risk factors for atelectasis?

Answer 22

collapsed section of alveoli from immobility, obstruction, compression, or decreased surfacant) risk factor – immobility

Question 23

Bradypnea -

Answer 23

<12 breaths per minute

Question 24

Tachypnea –

Answer 24

abnormally rapid >20

Question 25

Apnea –

Answer 25

respirations cease for several seconds

Question 26

Hyperventilation –

Answer 26

rate and depth increase (hypocardia can occur) (paniac attack)

Question 27

Hypoventilation –

Answer 27

rate and depth decrease, depth of ventilation = depressed (hypercardia)

Question 28

Biots –

Answer 28

rapid pause rapid pause (brain stem injuries)

Question 29

Kussmauls –

Answer 29

deep when blood sugar is hig

Question 30

Cheyne-strokes -

Answer 30

normal in children and elderly, regular irregular rhythm that cycles from deep and fast to shallow and slow

Question 31

When assessing a patient of darker skin color you note a gray dullness, what does this indicate?

Answer 31

Cyanosis

Question 32

Vesicular sounds

Answer 32

soft airy breeze, inspiration greater then expiration, heard over most of the lung fields

Question 33

Bronchovesicular sounds

Answer 33

– inspiration = expiration, between 2nd intercostal spaces, between scapula

Question 34

Brochial sounds

Answer 34

harsch, coarse sound, over trachea, inspiration less than expiration

Question 35

During percussion what should you hear over most lung fields and what could cause dullness. If you not dullness at T10 this usually indicates what?

Answer 35

The diaphragm

Question 36

How do you assess for fremutis?

Answer 36

99 test

Question 37

Rhochi –

Answer 37

(low pitch) sonorous

Question 38

Wheezing –

Answer 38

musical, sibilant (high pitch)

Question 39

Crackles –

Answer 39

popping

Question 40

Friction rub –

Answer 40

high pitch grating

Question 41

What are the physical symptoms of dyspnea?

Answer 41

SOB, increase rate, use of abdominal muscles, tripod position (definition: labored breathing and breathlessness)