BAT

Question 1

Box 1

Answer 1

1. SAFETY: (MUST complete ALL items to pass)
   a. Knock on the patient’s door, greet patient. Perform hand hygiene. Introduce yourself. Don gloves.
   b. Verify patient’s identity: name, DOB, MRN. Check with wrist band and chart. – Verbalize findings: do they match or are there discrepancies?
   c. Verify allergies: medication, food, latex, tape & environmental. Check with wrist band and chart. – Verbalize findings: do they match or are there discrepancies?

Question 2

Box 2

Answer 2

a. Vitals provided in chart. Review – Verbalize each VS as normal or abnormal
b. Ask patient if they have pain. If they do, you must OLDCARTS the complaint:
Onset: When did your pain start?
Location: Where is your pain located?
Duration: How long have you had pain?
Characteristics: What does the pain feel like?
Aggravating: What makes the pain worse?
Relieving: What makes the pain better?
Treatments: What treatments have you tried?
Severity: On a scale of 0-10, how severe is your pain?

Question 3

Box 3

Answer 3

3. LEVEL OF CONSCIOUSNESS: (Verbalize ALL findings)

Observe patient’s general appearance: signs of distress?
Both sides of body symmetrical?
A&O x 3 (person, place, time)?

Question 4

Box 4

Answer 4

EQUIPMENT: (Verbalize ALL findings)

a. Oxygen: Check apparatus (cannula or mask) for placement. Any kinks in tubing? Skin breakdown? Flow rate must match provider orders in chart
b. IV lines: Check site for tenderness, erythema, edema. Are there kinks in the tubing? The IV solution hanging should match the prescribed orders
c. Urinary catheter: Check for placement, skin breakdown. Any kinks or loops in tubing? Tubing secured to patient’s leg appropriately? Collection bag hanging on bed frame? Note color, consistency, amount of urine – For check off purposes, no catheter will be present. However, you MUST verbalize “I do not see a urinary catheter, however if I did I would assess the catheter accordingly”

Question 5

Box 5

Answer 5

5. HAIR / SKIN / NAILS: (Verbalize ALL findings)
   a. Inspect: hair, scalp, nails, skin (note skin color, any rashes, lesions or break down?)
   b. Assess: wounds? If so, note: appearance. Drainage? Dressing? Drains?
   c. Palpate: skin turgor, temperature. Any edema in the extremities?
   d. Palpate: capillary refill (1 finger per hand, 1 toe per foot) – Verbalize: “Cap refill <3 seconds in all areas”

Question 6

Box 6

Answer 6

HEENT: (Verbalize ALL findings)

a. Inspect: external ears
b. Inspect: eyes – PERRLA, conjunctiva color, sclera
c. Inspect: nares – color, any drainage?
d. Inspect: mouth, tongue, oropharynx (color, any lesions?)
e. Assess: smile. Ask patient to smile, check for facial symmetry

Question 7

Box 7

Answer 7

RESPIRATORY: (For check off purposes, examine POSTERIORLY only, sitting up)

a. Inspect: accessory muscle use, work of breathing. – Verbalize findings
b. Auscultate: breath sounds using Greek Key pattern from apex to base (MUST be completed on skin, auscultation over gown NOT acceptable)
c. Verbalize – “I would teach patient how to use incentive spirometer and have them demonstrate use

Question 8

Box 8

Answer 8

CARDIAC: (Examine patient ANTERIORLY, leaning forward slightly)

a. Palpate: carotid – one side at a time. Thrills? – Verbalize findings
b. Palpate: pulses (radial and dorsalis pedis) – Verbalize findings
c. Palpate: PMI. Lifts? Heaves? – For check off purposes, you may verbalize: “I would palpate the PMI at the 5th ICS MCL, no lifts or heaves noted”
d. Auscultate: carotid – one side at a time. Bruits? – Verbalize findings
e. Auscultate: heart sounds in all areas with diaphragm and bell. – All locations and positions must be verbalized: aortic /RSB 2nd ICS, pulmonic/LSB 2nd ICS, erbs point/LSB 3rd ICS, tricuspid/LSB 4th ICS, mitral/5th ICS MCL. (MUST be completed on skin, auscultation over gown NOT acceptable. For check off purposes, ONLY mitral area can be verbalized instead of auscultation: “I would auscultate the mitral area over the 5th ICS MCL”. All other areas should be auscultated)
f. Verbalize: rate, rhythm, any extra sounds?

Question 9

Box 9

Answer 9

GI: Examine with patient lying supine (Verbalize ALL findings)

a. Ask patient: “Have you had any nausea, vomiting or diarrhea? Do you have any dietary restrictions? When was your last BM? Was it normal or abnormal?”
b. Inspect: shape, symmetry, any pulsations?
c. Auscultate: bowel sounds in all 4 quadrants with diaphragm.
d. Verbalize: “I would listen for 5 minutes in each quadrant if no sounds were auscultated”
e. Auscultate: aorta with bell – any bruits?
f. Palpate: all 4 quadrants lightly (1 hand approach) and then deeply (2 hand approach) – Any tenderness? Guarding? Masses?

Question 10

Box 10

Answer 10

GU:

a. Ask patient: “Have you been urinating more frequently than your usual? How often do you urinate a day on average? When did you last urinate? Was it normal or abnormal?”
b. Verbalize: “I would monitor intake/output for the patient”

Question 11

Box 11

Answer 11

MS/EXTREMITIES:

a. Ask patient: “Are you experiencing any swelling or numbness or tingling in any of your extremities?”
b. Perform: hand grip test & foot pumps against resistance for strength – Verbalize finding

Question 12

Box 12

Answer 12

FINAL CHECKS: (Verbalize ALL areas)

a. Call light within reach? Verify patient knows how to use call button
b. Bed in down position? Side rails down/up?
c. Verbalize – “is there anything else I can do for you?”
d. Perform hand hygiene. Leave room.