Chapter 4 Highlights

Question 1

It is advised in most situations to assess one system ___ and ___the area of complaint

Answer 1

above and below

Based on the regional-interdependence model of musculoskeletal impairments

Question 2

ABCDE method of quick assessement

Answer 2

(airway, breathing, circulation, disability, exposure)

Question 3

A common strategy for history taking in the trauma unit

Answer 3

AMPLE:
•	Allergies
•	Medications
•	Past medical history
•	Last meal
•	Events of injury

Question 4

Parts of the assessment of mental status:

3 things

Answer 4

o Level of consciousness
o Orientation
o Ability to communicate

Question 5

Delirium due to hospitalization=

Answer 5

iatrogenic delirium
the likelihood of delirium associated with hospitalization is much higher with hip fractures and hip and knee joint replacements

Question 6

Confusion assessment method (CAM)

Answer 6

• Assess hospitalized individuals for delirium

* Just identifies the presence of delirium, not the severity

Question 7

Is confusion a normal part of the aging process?

Answer 7

• Confusion is not a normal change with aging and must be reported and documented

Question 8

fruity breath odor→

Answer 8

diabetic ketoacidosis

Question 9

Paradoxic pulse=

Answer 9

Pulse amplitude that fades with inspiration and strengthens with expiration

Question 10

Resting pulse pressure consistently greater than 60-80 mmHg is a yellow flag→ risk factor for ________

Answer 10

arterial fibrillation

Question 11

Excessive morning BP increase is a predictor of stroke in older adults with known hypertension→

Answer 11

red flag sign

Question 12

most common visceral system causing pruritis.

Answer 12

Hepatic system

Question 13

ABCDEs to assess a skin lesion for cancer:

Answer 13

A – Asymmetry 
B – Border (uneven, not round)
C – Color (multiple colors)
D – Diameter (>1/4 in, pencil eraser)
E – Evolving

Question 14

May be the sign of a silent MI, or may have a known history of MI; common in cardiac care

Answer 14

Splinter hemorrhages

Question 15

enlargement of one of the supraclavicular lymph nodes in the presence of primary carcinoma of thoracic or abdominal organs→more common on left side

Answer 15

Virchow’s node

Question 16

Reflexes: DTRs grading system which is similar to pulse grading system

Answer 16

• 0=absent; no response
• 1+=low normal; decreased; slight muscle contraction
• 2+=normal; visible muscle twitch producing movement of arm/leg
• 3+=more brisk than normal, increased or exaggerated; may not indicate disease
• 4+=hyperactive; very brisk; clonus; spinal cord disorder suspected

Question 17

normal ABI values

Answer 17

(normal=.91-1.3)

Question 18

Autar scale scoring:

Answer 18

less than 6=no risk, 7-10= low risk (less than 10%), 11-14= moderate risk (11-40%), greater than 15=high risk.

Question 19

Wells’ scoring(clinical decision rule for DVT): -

Answer 19

-2-0: low probability(3%), 1-2: moderate probability(17%), 3+ high probability(75%)

Question 20

push on LLQ to stretch peritoneal lining and + if pain felt on RLQ.

Answer 20

Rovsing sign (appendicitis)