Chapter 26

Question 1

What does data collection refer to during a interview?

Answer 1

Obtaining subjective and objective information from clients.

Question 2

During which portion of the health assessment does Subjective data come from?

Answer 2

Health History

Question 3

During which portion of the health assessment does Objective data come from?

Answer 3

Physical examination and diagnostic tests

Question 4

What are two interviewing techniques?

Answer 4

Standardized formats and therapeutic techniques

Question 5

Definition of Standardized format technique?

Answer 5

Framework for obtaining physical, developmental, emotional, intellectual, social, and spiritual information (dimensions) of a client.

Question 6

Definition of Therapeutic techniques (not methods)?

Answer 6

A health assessment that fosters communication and promotes an optimal health assessment/data collection experience.

Question 7

What does therapeutic communication include?

Answer 7

Introduction
What does the client want to be called?
Is the client comfortable? Interpretive services?
Reduce Environmental noise
State purpose of the interview
Obtain health Hx, General survey, & Vitals prior to PE
Note body language
Avoid - Jargon, Advice, False reassurance
Summarize

Question 8

What are the health history components?

Answer 8

Demographics
Source of Hx
Chief complaint (CC)
Hx of present Illness (HPI)
Past Health Hx (PHx) and current Health Status
Family History
Psychosocial History
Health promotion behaviors

Question 9

Methods to practice therapeutic communication techniques?

Answer 9

Active Listening
Open-ended questions - want pt to tell own story
Close-ended questions - used to clarify information
Clarifying (expand on clients statements)
Back channeling (active listening phrases - “go on” or “tell me more”.
Summarizing

Question 10

Is it appropriate to feel or listen through clothing?

Answer 10

No - will obscure findings

Question 11

Additional guidelines for older pts

Answer 11

Allot time for the elderly to move/change position
Allot time for possible extensive Hx
Observe if pt is getting tired
Realize the loss of independence is difficult for pt
Sensory aids available

Question 12

What is the order for look, feeling, listening during exam? And What is the exception?

Answer 12

IPal-PerA (IPPA)

• Inspect
• Palpate
• Percuss
• Auscultate

Exception = Abdomen (IAPer-Pal or IAPP) - avoid altering bowel sounds

Question 13

When should a tender area be palpated - First or last?

Answer 13

Last

Question 14

When is deep palpation performed?

Answer 14

During abdominal examination

Question 15

What sensation is the dorsal surface of the hand most sensitive to?

Answer 15

Temperature

Question 16

What sensation is the palmar surface of the hand and base of fingers most sensitive to?

Answer 16

Vibration

Question 17

What sensation is the fingertips most sensitive to?

Answer 17

Pulsation
Position
Texture
Turgor
Size
Consistency

Question 18

What are the fingers and thumb useful for?

Answer 18

Grasping an organ or mass

Question 19

During percussion, what might quieter sounds indicate?

Answer 19

Denser tissue

Question 20

Describe is direct percussion?

Answer 20

Involves striking the body directly

Question 21

Describe is indirect percussion?

Answer 21

Involves striking your flat hand or finger covering body part you are trying to exam

Question 22

Describe is fist percussion?

Answer 22

Involves lightly tapping areas over kidney, liver, or gallbladder with a fist to elicit tenderness

Question 23

How are auscultation sounds described?

Answer 23

Amplitude/intensity (Loud or soft)
Pitch/Frequency (high or low)
Quality (What it sounds like)

Question 24

What side of a stethoscope is intended for high pitch sounds?

Answer 24

Diaphragm

Question 25

What sounds should be higher in pitch?

Answer 25

Expected heart, bowel, and lung sounds

Question 26

What sounds should be lower in pitch?

Answer 26

Unexpected heart sounds or bruits

Question 27

What side of a stethoscope is intended for low pitch sounds?

Answer 27

Bell

Question 28

How is the Bell or Diaphragm of a stethoscope used?

Answer 28

The Diagraph should be placed firmly

The Bell should be lightly placed

Question 29

What is a general survey?

Answer 29

A written summary of overall health.

Question 30

What is included in a general survey?

Answer 30

Physical appearance
Body Structure
Mobility
Behavior
Vital Signs