Mod-3 Jan-25

Question 1

Tools of Health Assessment - 5

Answer 1

Inspection
Palpation
Percussion
Auscultation
Your senses - hearing, smell, sight, touch
Move Auscultation up after Inspection On abdomen

Question 2

Why do health assessment - 7

Answer 2

Baseline data
Evaluate step
Screening
Annual check up
New problem
Follow up to a problem
Change in health status

Question 3

CONFHER for culture

Answer 3

Communication - language, literacy, non-verbal
Orientation - how do they identify - cultural, ethnic
Nutrition - 24 hour diet recall, things to eat/avoid
Family - Id as family, head of house?
Health, health belief - What do you think is causing this problem? What do you do to stay healthy?
Education - level, learning style
Religion / spirituality

Question 4

Physical assessment environment - 5

Answer 4

Comfort
Warmth, including hands
Privacy
Standard Precautions
Tell them what to expect, why

Question 5

Integument Inspection notes - when starts, looking for, attributes (7)

Answer 5

When you walk in the door, general survey
Looking for anything out of normal. Is it expected finding?
Site and smell:
Color, size, shape, contour, symmetry, movement, drainage

Question 6

Palpation - 3

Answer 6

Confidence
Intentionality
Appropriate pressure

Question 7

Percussion sounds - 5

Answer 7

Tympany - high pitched (air)
Resonance - loud, low pitched, hollow
Hyperresonance - abnormally loud
Dullness - high pitched, soft (organ, feces)
Flatness - high pitched (muscle/bone)

Question 8

Auscultation - 4

Answer 8

Intensity
Pitch
Duration
Quality

Question 9

Prepare for assessment - 5

Answer 9

Gather appropriate equipment
Wash hands
Introduce self
Identify client - 2 IDs
Explanation of procedure (brief)

Question 10

General Survey - 14

Answer 10

Posture, Appearance, Appears stated age,
Level of consciousness, Skin color, Nutritional status,
Posture and position, Obvious physical deformities,
Mobility (gait, assist device, ROM, no involuntary movements),
Mood and affect, Speech (articulation, pattern, appropriate content),
Native language, Hearing, Personal hygiene

Question 11

Mental Status Exam - 4

Answer 11

Alert and Oriented (A and O) to
Person 1
Place 2
Time 3
Situation 4

Question 12

Skin Assessment - 9

Answer 12

Color, Temperature, Moisture, Thickness, Edema,
Mobility and Turgor (),
Bruising, Scarring, Rashes

Question 13

General Survey vitals - 7

Answer 13

Vital Signs T, P, R, BP
Height
Weight
BMI

Question 14

Tools/equipment used in Integumentary Assessment - 3/2

Answer 14

Senses
Inspection
Palpation

Tape measure, clean gloves

Question 15

Mole description - 5

Answer 15

A - Asymmetry
B - Border
C - Color
D - Diameter
E - Evolving - has it changed?

Question 16

Hair/Scalp, Nails Assessment - 6/4

Answer 16

Distribution, Fullness, Cleanliness, Alopecia, Lesions, Dandruff
Clean/trim, Shape, Thickening/yellowing, Clubbing

Question 17

Edema pitting level - 4

Answer 17

+1 - barely detectable
+2 - 4mm, few seconds to rebound
+3 - 6mm 1-12 seconds to rebound
+4 - 8mm >20 seconds to rebound