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NUR 614 MODULE 1-3 EXAM 2025/
QUESTIONS AND ANSWERS GRADED A+
One way that a health history for an infant differs from that of an adult is the inclusion of what?
Prenatal information.
Mr. Blakely is a 59-year-old man requiring a routine physical examination. He will be having his visual acuity tested. What equipment is needed for this specific exam?
Snellen eye chart.
Which technique will most likely facilitate the examination of a small frightened girl?
Tell the child a story in order to distract her.
Your patient presents to the office with a chief complaint of shoulder pain that he reports as stabbing. In using the mnemonic OLDCARTS, this is noted as?
Character.
When meeting a patient for the first time make sure to do what?
Introduce yourself (first and last name). ~Acute care nurse practitioner student.~
Head to Toe exam includes what areas? H&P (8)
CHARMING
- Cardiac and Neck.
- HEENT.
- Abdomen.
- Respiratory.
- Musculoskeletal.
- Integumentary.
- Neuro.
- General inspection.
Why is the SOAP note important?
Consistency between all providers.
What is included in the SOAP note?
S. Subjective data. What the pt. tell you. CC, All history, ROS.
Always begin HPI how?
With the age of the patient and their gender, occupation along with their CC and beginning of history of present illness.
AD
This is in chronological order, written in paragraph form in short, concise statements?
HPI. Always the 1st paragraph.
What variables comprise an History of Present Illness (HPI)? Characteristics of the CURRENT symptoms.
OLD CARTS
- Onset (Timing, when did it start, constant or comes and goes).
- Location.
- Duration.
- Character (quality)
- Aggravating/Alleviating Factors (modifying factors)
- Region/Radiation (associated s/s)
- Timing.
- Severity/Scale (1-10)
What is included in the past medical history?
Prenatal information.
Immunization status.
Previous illnesses and injuries.
Surgeries and hospitalizations.
A concise statement that describes the reason the patient presents to the clinic?
CC. In quotes.
Any system that pertains to the patient's chief complaint should be in the HPI. If in HPI, just note in ROS, "see HPI. What should be assessed on every focused SOAP NOTE ROS?
Cardiovascular, Respiratory and Neuro systems regardless of chief complaint.
Example of ROS. Patient states, I have a head cold." What would you document in ROS? Where will the HEENT be documented?
In ROS: See HPI.
HEENT would be documented in HPI.
Respiratory: See HPI.
In the objective vital signs include what for children 2 years of age and younger?
Head circumference with percentitles.
AD
Which one is a symptom and which on is a sign? Pain, tenderness.
Pain is a symptom. Tenderness a sign.
This is the most important part of the interview with a patient. It begins the patient- center portion and continues to the middle of the interview.
HPI.
The T in old carts refers to what? What does it mean?
Temporal factors: frequency of occurrence.
The physical examination is what the patient or what I observe?
Me. Objective.
What is the Apgar Score?
Used in newborns 1-5 minutes of age to provide insight to the baby upon birth.
What is the Ballard Gestation Age Assessment Tool?
Within 36 hours of birth, provides a gestational age.
During a history, the patient indicates he has an uncle and a brother with sickle cell disease. Which of the following is an appropriate method to document this information?
Include it in the family history.
During an interview, the patient describes problems associated with an illness and begin to cry. The best action in this situation is to?
Allow the patient to cry and then resume when the patient is ready.
A young mother brings her infant to the emergency department with a high temperature and dehydration. Which of the following questions could you ask that would demonstrate cultural awareness?
This type of care requires that healthcare providers be sensitive to patient's heritage, sexual orientation, socioeconomic situation, ethnicity, and cultural background?
Culturally competent care.
The deliberate self-examination and in-depth exploration of one's biases, stereotypes, prejudices, assumptions, and "isms" that one holds about individuals and groups who are different from them?
Cultural awareness.
This involves the ability to recognize one's limitations in knowledge and cultural perspective and be open to new perspectives?
Cultural humility.
What is the baseline for assessing the present concern?
Past Medical History.
How many generations should be in the family history pedigree?
Three generations.
When are children dependable reports on aspects of their health?
Age 7 normally.
This type of history is when you are trying to get a "feel" for a situation. It touches on major points without going into detail?
Inventory history.
AD
This type of history is when the problem is acute, and requires immediate attention, possibly life threatening?
Problem (focused) history.
A history designed to chronicle events that have occurred since your last meeting. Complemented by the patient's pervious record.
Interim history.
How do you address depression?
Don't ask the pt. if they are depressed but rather ask about symptoms of depression. Do you feel hopeless?
Why is the open-ended questions best?
The open-ended question gives the patient discretion about the extent of an answer.
Which question seeks specific information?
The direct question.
AD
Which question is the most risky because it may limit the information provided to what the patient thinks you want to know: "It seems to me that this bothered you a lot. Is that true?" "That wasn't very difficult to do, was it?" "That's a horrible- tasting medicine, isn't it?"
The leading question.
What if your patient doesn't understand?
- Facilitate.
- Reflect.
- Clarify.
- Emphasize.
- Confront.
- Interpret.
What process is all subjective? What the patient tells us.
- CC
- HPI
- Past medical history.
- Family history.
- Social history.
- Review of Systems.
This is a concise statement that describes the reason the patient presents to the clinic. In quotes.
Chief Complaint.
These questions are good to ask for any system reviewed?
General constitutional symptoms: pain, fever, chills, malaise, fatigue, night sweats, sleep patterns, weight changes.
This is an umbrella term for persons whose gender identify is different than their sex at birth?
Transgender.
A persons gender does not determine their what?
Sexual orientation.
Concluding questions might include?
"Is there anything else you want to let me know?"
"What questions or concerns do you have for me?"
One in four American adults have what?
A disability.
Violence or traumatic childhood events affect what factors as an adult?
Brain development
Immune system
DNA
3* more risk of heart, and lung cancer.
Hormonal system.
Expected to live 20 fever years.
The biggest challenge when assessing an adolescents is?
They don't like to talk much.
What are the screening tools for adolescent issues?
- HEEADSSS
- PACES
- CRAFFT
What three things should we focus on with pregnant women?
- Obstetric hx. (pervious pregnancies)
- Menstrual hx.
Inspect: Look
Palpation: Touch
Percussion: Tap
Auscultation: Listen
What is different in the process of assessing the abdomen?
Auscultation then Palpation.
Listen before you touch because it can move things around if you do the opposite.
Palpation assess through the sense of?
Touch.
How do we palpate the position, texture, size, consistency, fluid, crepitus, mass or structure?
Palmar surface of finger's and finger pads.
How do we palpate vibrations? 99 voice it.
Side of hand, ulnar surface of hand and fingers.
How do we palpate temperature?
Dorsal surface of hand.
What percussed sound is loud sounds like a drum and can be found where?
Tympanic, belly air.
What percussed sound is soft, thud like? Where is it found?
Dull. Organs like the liver.
A flat percussed sound is soft and found over what?
Muscles.
This instrument measures pressure in the ear?
Tympanometer.
This is used on an otoscope. Air is blown into the ear drum to check for mobility and motility?
