Exam 1

Question 1

Define “level of consciousness (LOC)”

Answer 1

the state of arousability, behavior and response to stimuli

Question 2

list the levels of stimuli used to test LOC in order

Answer 2

1. start with verbal stimuli
2. next, light touch
3. painful or noxious stimuli

Question 3

list two examples of painful stimuli that can be used to test LOC

Answer 3

1. rub fish of the sternum

2. push fingers under patients clavicle

Question 4

list the three general categories of nutritional status

Answer 4

1. well nourished
2. malnourished
3. over nourished (obese)

Question 5

list 4 signs a patient is experiencing somatic pain

Answer 5

1. the pain is sharp and well localized
2. they are guarding the painful area
3. hesitant and purposeful movement to prevent triggering pain
4. facial grimacing

Question 6

list 2 signs a patient is experiencing cardiac pain

Answer 6

1. pain is diffuse/vague (described as pressure or heaviness)
2. possible nausea, vomiting or sweating (due to parasympathetic discharge)

Question 7

how many cm are in an inch?

Answer 7

1 cm = 0.393701 in

centimeters x 0.3937 = inches

Question 8

how many pounds are in a kg?

Answer 8

1 kg = 2.2 lbs

Question 9

list 2 ways to calculate BMI?

Answer 9

BMI = (wight in Kg) / (height in m^2)

OR

BMI = (weight in lbs) / (height in in^2) x 703

Question 10

what is the normal body temperature?

Answer 10

98.6

Question 11

how does core temperature and axillary temperature relate to oral temperature?

Answer 11

core temp = 1 degree higher than oral

axillary temp = one degree lower than oral

Question 12

what artery is most commonly palpated to take a pulse in adults? in children?

what part of the hand should you use?

Answer 12

the radial artery in adults, brachial or femoral in children

the pads of your finders (not thumb), not the tips

Question 13

how do you calculate pulse rate?

what about respiratory rate?

Answer 13

count the number of beats in 15 seconds and multiply by 4

count number of breaths in 30 seconds and multiply by 2 (don’t tell patient you testing breath)

Question 14

list 4 possible heart rhythms

Answer 14

1. regular
2. regularly irregular
3. irregularly irregular
4. dead

Question 15

list 3 ways to describe the character of a pulse

Answer 15

1. strong (healthy)
2. weak
3. bounding (too strong)

Question 16

what is the normal healthy breathing rate (eupnea)

whats considered healthy shallow breaths or deep?

Answer 16

12 to 20 BPM

shallow is healthy

Question 17

list 7 patterns of breathing

what conditions most likely cause these?

Answer 17

1. apneustic - brainstem dammage
2. obstructive - asthma or COPD
3. restrictive - restrictive lung disease
4. hyperpnea (kussmaul) - diabetic acidosis
5. sighing - normal if occasional
6. cheyna-stokes - patient near death
7. ataxic - meningitis or any intracranial pressure

Question 18

what is the Auscultatory gap?

Answer 18

a period of diminished sound in patients with high blood pressure(?) It can lead to an incorrect measurement of blood pressure

Question 19

what change in blood pressure would be diagnostic foe orthostatic hypotension

Answer 19

10 mm Hg