Exam 1

Question 1

nonverbal communication

Answer 1

body language is important; gestures, facial expression, affect, posture, eye contact

Question 2

proxemics

Answer 2

study of distance zones between people during communication

Question 3

Validating

Answer 3

restating the words as you heard them

Question 4

reflection

Answer 4

repeating what the person said or describing the persons implied feelings

Question 5

clarifying

Answer 5

trying to understand what was said

Question 6

directing/focusing

Answer 6

asking for elaboration on a topic

Question 7

sequencing

Answer 7

making sure you understand the steps in a process

Question 8

general leads

Answer 8

encouraging the patient to continue talking

Question 9

silence

Answer 9

therapeutic listening: maintaining eye contact, not being closed off, eye level

Question 10

interview guidelines

Answer 10

begin with open-ended questions, use closed ended questions to seek info and clarification

Question 11

communicating with children

Answer 11

responsive to nonverbal communication, talk at eye level, be gentle/calm, use understandable language, structured play

Question 12

communicating with critically ill patients

Answer 12

assume they can hear you, state what you are doing (be clear direct ad simple), provide cues about day/time (help to avoid delirium), nonverbal communication is particularly meaningful, keep call bell within reach

Question 13

communicating with older adults

Answer 13

dont assume they can hear everything said, dont assume they can see all body actions, be gentle and calm, restate and clarify, use understandable language, talk normally but clearly

Question 14

communicating with hearing impaired

Answer 14

orient pt to your presence, face pt while talking to them, talk clearly not loudly, dont chew gum/eat while talking, increase non-verbal cues, write/communicate in another format, ensure hearing aid devices on and working

Question 15

somatic sensory

Answer 15

body sense; afferent: touch, pressure, temperature, vibration of body, muscles stretching, balance

Question 16

visceral sensory

Answer 16

organ senses; afferent; stretch, pain, temperature in organs, nausea, hunger, cramps, smooth muscles

Question 17

somatic motor

Answer 17

body movement; efferent; voluntary contraction of skeletal muscles

Question 18

visceral motor

Answer 18

organ movement; efferent; contraction of smooth muscle, glands, and organs

Question 19

afferent nerve

Answer 19

neurons send signals from the senses, skin, muscles, and internal organs to CNS

Question 20

efferent nerves

Answer 20

neurons that transmit commands from the CNS to the muscles, glands, and organs

Question 21

sensory cranial nerves (afferent)

Answer 21

I olfactory, II optic nerve, VIII vestibulocochlear nerve

Question 22

motor cranial nerve (efferent)

Answer 22

III oculomotor nerve, IV trochlear nerve, VI abducent nerve, XI accessory nerve, XII hypoglossal nerve

Question 23

mixed nerves (sensory and motor)

Answer 23

V trigeminal nerve, VII facial nerve, IX glossopharyngeal nerve, X vagus nerve

Question 24

I. olfactory nerve

Answer 24

modality- special sensory; function- smell

Question 25

II. optic nerve

Answer 25

Afferent: transmits visual info from the retina to brain

Question 26

III. oculomotor nerve

Answer 26

efferent: innervates majority of the extra-ocular muscles; move eyeball and upper eyelid; somatic motor- eye movement and visceral motor- pupil dilation

Question 27

IV. trochlear nerve

Answer 27

efferent: innervates superior oblique muscle; turns eye down and inward

Question 28

V. trigeminal nerve

Answer 28

mixed: sensory and motor; sensation in the face and motor function such as biting/chewing; largest of the cranial nerves

Question 29

VI. Abducens nerve

Answer 29

efferent: controls movement of lateral rectus which is responsible for outward gaze; damage to this nerve would cause double vision (diplopia)

Question 30

VII. facial nerve

Answer 30

mixed: controls muscle of facial expression and sensory taste sensation

Question 31

VIII. vestibulocochlear

Answer 31

afferent: transmits sound and equilibrium (balance) from inner ear to brain

Question 32

IX. glossopharyngeal nerve

Answer 32

mixed: sensory- innervates oropharynx, carotid body and sinus, posterior 1/3 of tongue, middle ear cavity, eustachian tube, special sensory- provides tastes to posterior 1/3 of tongue, parasympathetic- provides parasympathetic innervation to parotid gland, motor- innervates stylopharyngeus muscle of pharynx

Question 33

X. vagus nerve

Answer 33

mixed: sensory- innervates skin of acoustic meatus and internal surfaces of laryngopharynx and larynx; provides visceral sensation to hear and abdominal viscera, special sensory- provides taste sensation to epiglottis and root of tongue, motor- provides motor innervation to majority of the muscles of the pharynx, soft palate, and larynx, parasympathetic- innervates smooth muscle of the trachea, bronchi, and GI tract and regulates heart rhythm

Question 34

XI. accessory nerve

Answer 34

efferent: supplies motor function to sternocleidomastoid and trapezius muscles

Question 35

XII. hypoglossal nerve

Answer 35

efferent: motor control of the extrinsic muscles of tongue

Question 36

general cardiovascuar exam guidelines

Answer 36

pt must be in gown and undressed, tangential lighting (allows pulsations and movements to be visible), room must be quiet, stethoscope and room must be warm, general sequence is inspection palpation auscultation

Question 37

precordium

Answer 37

portion of body over the hear and lower thorax

Question 38

Inspection

Answer 38

precordium: check for any pulsation, masses, edema; neck: check for jugular vein distention (pt at 45 degree angle)

Question 39

JVD

Answer 39

indicative of heart or circulatory issue

Question 40

palpation

Answer 40

precordium; feeling for any pulsations, vibrations, masses, swelling (should not feel any pulses or vibrations); heart: notice size, duration, force or pulse at PMI; palpate carotid arteries (one at a time), palpate rest of the pulse for adequacy of circulation, check cap. refill (<3sec)

Question 41

if cannot feel PMI…

Answer 41

turn pt onto left lateral side to allow heart to rest up against thoracic wall

Question 42

auscultate

Answer 42

apical area for 1 minute to determine pulse rate, rhythm (reg. or irreg.); auscultate each of 5 areas for rate, rhythm (reg. or irreg.), S1 (lub), S2 (dub), S3/S4, or extra heart sounds

Question 43

S3 heart sound

Answer 43

blood flow into the ventricles; can be normal finding in children

Question 44

S4 heart sound

Answer 44

atrial contraction

Question 45

heart murmurs

Answer 45

abnormalities that can be asymptomatic or symptomatic and are created by turbulent blood flow

Question 46

Palpable pulses

Answer 46

Temporal, tympanic, carotid, apical, brachial, radial, ulnar, femoral/groin, popliteal, dorsalis pedis, posterior tibialis

Question 47

5 auscultative heart locations

Answer 47

Aortic- 2nd intercostal RSB, Pulmonic- 2nd intercostal LSB, Erb’s point- 3rd intercostal LST, tricuspid- 4th intercostal LSB, mitral (apical)- 5th intercostal mid clavicular