HWA PPx 1 Interview, Health History

Question 1

What is an assessment? What is its purpose?

Answer 1

Collection of data about a person’s health state.
Purpose: to make a judgement or diagnosis.

Question 2

What is subjective information?

Answer 2

What the patient says or describes about their condition during history taking.

Question 3

What is objective information?

Answer 3

What you as the healthcare provider can observe (think senses see, hear, touch, smell, etc) during your assessment.

Question 4

What is diagnostic reasoning?

Answer 4

Analyzing all the data and drawing conclusions (differentials) to identify diagnoses

Question 5

What is evidence based practice?

Answer 5

-Guide to healthcare providing patients the most current and best-practice techniques.

Question 6

What are the six phases of nursing process?

Answer 6

1. Assessment
2. Diagnosis
3. Outcome Identification
4. Planning
5. Implementation
6. Evaluation

Question 7

What is part of the assessment process?

Answer 7

-Collection of Data: review of the clinical record, health history, physical exam, functional assessment, risk assessment , review of literature.
- Use evidence-based assessment techniques.
-Document relevant data.

Question 8

What are the 3 priorities? What are their characteristics?

Answer 8

1st Level: Highest priority, urgent, life threatening (MARCH)
2nd Level: Needs attention before decompensating to 1st level.
3rd Level: Lowest priority, long term intervention process.

Question 9

What are the four databases?

Answer 9

1. Complete
2. Focused/Problem-Centered
3. Follow-Up
4. Emergency

Question 10

What is a complete database?

Answer 10

Complete health history and full physical examination. Usually done in primary care settings

Question 11

What is a focused database?

Answer 11

Collect a targeted history and the physical examination is catered to the area(s) of concern. Completed in all settings.

Question 12

What is a follow-up database?

Answer 12

Used to check status of known issue to verify if change has occurred. Completed in all settings.

Question 13

What is an emergency database?

Answer 13

URGENT, RAPID collection of info in conjunction with life-saving measures. Completed history is completed once the patient is stable.

Question 14

What is culture?

Answer 14

Includes attitudes, values, beliefs, norms, and roles
* learned from birth – language acquisition and socialization
* shared by all group members
* adapted to environmental factors
* always changing
* Sub-cultures may share different beliefs, values,
attitudes, norms

Question 15

What is socialization/enculturation?

Answer 15

Raised within a culture and acquiring the norms, values, and behaviors of that group.

Question 16

What is ethnicity?

Answer 16

A social group that may share traits – geographic origin, religion, language, values, traditions.

Question 17

What is acculturation?

Answer 17

Adopting culture and behaviors of the major culture.

Question 18

What is race?

Answer 18

Reflects self-identification and construct of groups of people who share similar physical characteristics.

Question 19

What is FICA? What is it used for?

Answer 19

FICA is a spiritual assessment tool.

F- Faith “Do you have spiritual beliefs, values or practices that help you cope with stress?”

I- Importance/Influence “Do you have specific beliefs that influence your health care decisions?”

C- Community “Are you part of a spiritual or religious community?”

A- Address/Action “How should I address these issues in your health care?”

Question 20

What is an open-ended question?

Answer 20

One where the patient answers in descriptive terms.

Example: Can you describe your pain?

Question 21

What is close-ended question?

Answer 21

Questions that are yes no/one or two-word answers.

Example: “Does this hurt? Can you wiggle your toes?”

Question 22

What is SBAR?

Answer 22

S- Situation?
B- Background
A- Assessment
R- Recommendation

Means of passing down/on patient information.

Question 23

What is OLDCARTS?

Answer 23

O- Onset
L- Location
D- Duration
C- Character
A- Aggravating Factors
R- Relieving Factors
T- Treatment
S- Severity

Question 24

What is an organic mental disorder?

Answer 24

Caused by brain disease of known specific origin – delirium and intoxication.

Question 25

What is a psychiatric mental disorder?

Answer 25

No established etiology – anxiety disorder.

Question 26

What are the 10 traits we assess for mental status (MS)?

Answer 26

1. LOC
2. Language
3. Mood
4. Orientation
5. Attention
6. Memory
7. Abstract Reasoning
8. Thought Process
9. Though Content
10. Perception

Question 27

How do we assess during our mental status exam?

Answer 27

ACBT
A- Appearance
B- Behavior
C- Cognition
T- Thought Process

Question 28

What screening tools do we use for anxiety and depression?

Answer 28

Anxiety - GAD 7
Depression - PHQ 2 (short) PHQ 9 (long)

Question 29

What screening tool do we use for ETOH use?

Answer 29

AUDIT-C

Question 30

How do we assess alcohol use?

Answer 30

C - Cutting Back
A - Annoyed by Critcism
G - Guilty about your drinking
E - Eye Opener (Drink in the morning)