Skills Lab

Question 1

Points to touch on during General-ROS questioning

Answer 1

Weight changes
Fevers/chills
Problems with sleep
Fatigue
Night sweats
Headaches

Question 2

Systems involved in ROS questioning

Answer 2

Skin
HEENT/Neck
Respiratory
Cardiovascular
Gastrointestinal
Peripheral vascular
Urinary
Musculoskeletal
Psychiatric
Neurologic

Question 3

BP Questions prior to starting vitals

Answer 3

Before I take your BP…
Have you had any caffeine or nicotine within the last 30 minutes or so?
Have you exercised today?
Do you know what your BP is normally?
Do you take any medications, even over the counter?

Question 4

Points to discuss during Social History questioning

Answer 4

Alcohol
Tobacco
Recreational drugs
Employment
Diet
Exercise
Living situation
Sexual history
Marital status
Children

Question 5

7-Attributes of a symptom

Answer 5

Prompt with open-ended question first!
Location
Quality
Severity
Timing
Setting
Exacerbating factors
Associated symptoms

Question 6

Skin question

Answer 6

Any changes in your skin hair or nails?

Question 7

HEENT/Neck questions

Answer 7

Any changes in vision?

Any stiffness of the neck?

Question 8

Respiratory question

Answer 8

Any shortness of breath or changes in breathing patterns?

Question 9

Cardiovascular question

Answer 9

Have you noticed any changes in your heart beat or pain in your chest?

Question 10

Gastrointestinal question

Answer 10

Have you had any problems with bowel movements, your stomach hurting, or any nausea or vomiting?

Question 11

Peripheral vascular questions

Answer 11

Have you noticed any swelling in your ankles? Any changes in temperature?

Question 12

Why do we ask the questions that we ask when reviewing the peripheral vascular system during our ROS?

Answer 12

We are looking for signs of clots:

• Swelling may be present
• A venous clot will be warm
• A arterial clot will be cold

Question 13

Urinary questions

Answer 13

Have you experienced any difficulty in urination? Any pain, color change, or change in odor?

Question 14

Musculoskeletal questions

Answer 14

Do you have any problems with pain in your joints or muscle weakness?

Question 15

Psychiatric questions

Answer 15

Have you noticed any changes in your mood or experienced any undue anxiety?

Question 16

Neurologic question

Answer 16

Do you feel any numbness or weakness?

Question 17

Questions for the 7-Attributes

Answer 17

Open with open-ended question: Can you tell me a little more about ( )? Then fill in the gaps:
Can you show me where you typically experience this?
Can describe what it is like to me a little differently?
How bad would you say it is on a scale from 1-10?
Can you tell me about when it starts, how long it lasts, and so on?
Are there any other circumstances that you feel bring it on?
Are there any other symptoms that you notice come along with it?

Question 18

Questions for General-ROS

Answer 18

Have you had any recent changes in weight that weren’t intentional?
Have you recently experience any of the following symptoms: fever or chills, problems sleeping, fatigue, night sweats, or headaches?

Question 19

Questions for Social History

Answer 19

Can you tell me about your use of alcohol, nicotine, or recreational drugs?
Do you currently hold a job?
Would you say that you eat a well-balanced or generally healthy diet?
Do you exercise, or participate in anything strenuous regularly?
Can you describe your current living situation?
* In order to get a complete picture of your health, I need to ask a personal question, if you are okay with it… Have you had sexual relations or intercourse with someone within the last 6-months?
- Does your sexual activity include men, women, or both?
- Do you use protection?
Are you currently married or single?
Do you have any children?

Question 20

Components of the Closeout

Answer 20

Intro
- Knock, Introduce, Wash

Interview

• Open-ended Q’s
• 7-Attributes
• Past Medical/Surgical Hx
• Social History
• Family History
• Meds and Allergies (HOW)
• General ROS
• ROS
• BP Questions

Vitals

• BP
• Pulse Oximeter
• Respiratory Rate
• Pulse
• Temperature

Professionalism
- Dress, empathy, confidence, reflection.