Health Assessment Exam 1 Focus Points
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Questions and Answers

Which of the following is NOT a characteristic of culture?

  • Learned from birth
  • Shared by all members of a group
  • Static and unchanging (correct)
  • Adapted to specific conditions

    • Ethnicity refers solely to a person's physical characteristics.

    False

    What is the primary difference between subjective and objective data in a patient interview?

    Subjective data is what the patient tells you, while objective data is what you observe or measure.

    The acronym AIDET stands for Acknowledge, Introduce, _____, Explain, Thank You.

    <p>Duration</p> Signup and view all the answers

    When interviewing a toddler, which approach is most effective?

    <p>Providing simple explanations and warnings</p> Signup and view all the answers

    Open-ended questions are designed to elicit only brief, specific answers.

    <p>False</p> Signup and view all the answers

    Match the following communication traps with their descriptions:

    <p>False assurance = Offering promises you cannot keep Unwanted advice = Prescribing solutions without patient input Authority = Using your professional title to intimidate Avoidance language = Evasive wording to minimize discomfort Distancing = Using impersonal language to create distance Professional jargon = Using technical terms the patient may not understand Leading or biased questions = Phrasing questions to suggest a desired answer Talking too much = Dominating the conversation Interrupting = Cutting off the patient's thoughts Why questions = Making the patient feel interrogated</p> Signup and view all the answers

    What is the purpose of a complete health history?

    <p>To gather subjective and objective data, provide a complete picture of the patient's health, and identify areas for health promotion and disease prevention.</p> Signup and view all the answers

    Which of the following is considered a secondary source of patient data?

    <p>Information from the patient's medical chart</p> Signup and view all the answers

    When working with older adults, it is essential to address them by their first name to show respect.

    <p>False</p> Signup and view all the answers

    The conditions in which people are born, live, work, and age that impact their health are known as _____.

    <p>Social Determinants of Health</p> Signup and view all the answers

    Which of the following is NOT an aspect of cultural competence?

    <p>Ignoring cultural differences to avoid bias</p> Signup and view all the answers

    Spirituality and religion are synonymous terms.

    <p>False</p> Signup and view all the answers

    Explain the importance of building rapport with patients.

    <p>Building rapport establishes trust and makes the patient feel comfortable sharing information, leading to more effective care.</p> Signup and view all the answers

    The process of learning cultural norms and values from birth is called _____.

    <p>socialization</p> Signup and view all the answers

    When communicating with adolescents, which approach is most important?

    <p>Respecting their views and feelings</p> Signup and view all the answers

    Which of the following precautions should be used when caring for a patient with tuberculosis?

    <p>Gown, respirator (N95), eye protection, and gloves</p> Signup and view all the answers

    It is important to warm your hands before examining an infant to help them feel more comfortable.

    <p>True</p> Signup and view all the answers

    What is the primary reason for starting a physical exam by examining the patient's hands?

    <p>To ease the patient into being touched during the exam.</p> Signup and view all the answers

    During a physical exam, it is essential to maintain the patient's ______ by using additional drapes.

    <p>privacy</p> Signup and view all the answers

    Match the developmental stage with the appropriate examination considerations:

    <p>Infant = Warm your hands and use brightly colored toys for distraction. Toddler = Make the assessment a game, start with non-threatening areas, and offer choices. Preschool = Use short and simple explanations, let them play with equipment, and don't rush the child. School Age = Show them how to use equipment and comment on how their body works. Adolescent = Do the examination without the caregiver present and communicate with care.</p> Signup and view all the answers

    What is the best time to examine an infant?

    <p>1 or 2 hours after feeding</p> Signup and view all the answers

    It is okay to restrain a toddler during a physical exam if they are uncooperative.

    <p>False</p> Signup and view all the answers

    Preschoolers may view illness as ______ and fear body injury from invasive procedures.

    <p>punishment</p> Signup and view all the answers

    What is a key consideration to keep in mind when examining a school-age child?

    <p>They desire approval from caregivers and teachers.</p> Signup and view all the answers

    Which of the following is a key focus when examining an adolescent?

    <p>Teaching them about health promotion and well-being</p> Signup and view all the answers

    When examining an aging adult, it is important to use physical touch because their other senses may be diminished.

    <p>True</p> Signup and view all the answers

    The general survey is a study of the ______ person, including their general health state and any obvious characteristics.

    <p>whole</p> Signup and view all the answers

    Which of the following is NOT a component of the general survey?

    <p>Neurological function</p> Signup and view all the answers

    Unexplained weight loss can be a sign of a short-term or chronic illness.

    <p>True</p> Signup and view all the answers

    Why is it recommended to measure a patient's weight around the same time of day and wearing the same type of clothing?

    <p>To ensure consistency and accuracy in measurements.</p> Signup and view all the answers

    After obtaining patient measurements, the next step in the nursing process is data ______ and plan formulation.

    <p>collection</p> Signup and view all the answers

    What is the primary purpose of assessment in nursing?

    <p>To make a judgment or diagnosis</p> Signup and view all the answers

    The Clinical Judgment Model supports only expert practitioners in developing clinical judgment skills.

    <p>False</p> Signup and view all the answers

    What are the three levels of priority setting during an assessment?

    <p>1st level: emergent and life-threatening, 2nd level: requiring intervention, 3rd level: important but not urgent.</p> Signup and view all the answers

    A _____ database is the most comprehensive and includes complete health history and physical examination.

    <p>Complete (Total Health)</p> Signup and view all the answers

    Which type of database is used for urgent situations where immediate information is crucial?

    <p>Emergency Database</p> Signup and view all the answers

    Match the clinical judgment level with its description:

    <p>Novice = Needs clear cut rules to guide actions Competent = Sees actions in relation to patient goals Proficient = Understands patient situations as a whole Expert = Has an intuitive grasp of a clinical situation</p> Signup and view all the answers

    Social determinants of health are exclusively medical factors influencing health outcomes.

    <p>False</p> Signup and view all the answers

    List one example of a social determinant of health (SDOH).

    <p>Education level, income, or housing conditions.</p> Signup and view all the answers

    What is the proper technique for taking a child's temperature in children under age 3?

    <p>Pull the ear down and back</p> Signup and view all the answers

    The normal pulse rate for adults is usually faster than that for infants.

    <p>False</p> Signup and view all the answers

    What is the difference between systolic and diastolic pressure known as?

    <p>Pulse pressure</p> Signup and view all the answers

    To measure blood pressure accurately, a patient should rest for ____ minutes before taking a measurement.

    <p>5</p> Signup and view all the answers

    Match the following abnormal vital sign terms with their definitions:

    <p>Bradycardia = Heart Rate less than 60 beats per minute Tachycardia = Heart Rate above 100 beats per minute Tachypnea = Respiratory rate above 25 breaths per minute Bradypnea = Respiratory rate below 12 breaths per minute</p> Signup and view all the answers

    What is the normal range for oxygen saturation (SPO2) readings?

    <p>97% - 99%</p> Signup and view all the answers

    Hypertension is defined as a blood pressure reading of more than 140 mmHg systolic, or 90 mmHg diastolic.

    <p>True</p> Signup and view all the answers

    What device is used to measure blood flow through blood vessels?

    <p>Doppler</p> Signup and view all the answers

    Normal blood pressure is defined as less than ____ mmHg systolic and less than ____ mmHg diastolic.

    <p>120, 80</p> Signup and view all the answers

    Which of the following techniques is the best for assessing pulse rate?

    <p>Counting the pulse for 30 seconds and multiplying by 2</p> Signup and view all the answers

    What is Body Mass Index (BMI) used for?

    <p>To guide patient progress towards a healthy weight</p> Signup and view all the answers

    Excessive abdominal fat is not an important risk factor for diseases like heart disease and type 2 diabetes.

    <p>False</p> Signup and view all the answers

    What measurement is used to assess waist circumference?

    <p>the waist around the iliac crest with a measuring tape</p> Signup and view all the answers

    To calculate BMI in the Imperial System, the formula is _____.

    <p>703 x Weight (in pounds) / Height (in inches)</p> Signup and view all the answers

    Which condition is characterized by excessive fat accumulation in the trunk due to excessive cortisol secretion?

    <p>Cushing Syndrome</p> Signup and view all the answers

    Muscle mass tends to increase in aging adults.

    <p>False</p> Signup and view all the answers

    How should height be recorded for a patient?

    <p>in feet, inches, and centimeters</p> Signup and view all the answers

    Hypopituitary Dwarfism results from a deficiency in _____ hormone in childhood.

    <p>growth</p> Signup and view all the answers

    Match the following conditions to their characteristics:

    <p>Bulimia Nervosa = Binge eating followed by purging Anorexia Nervosa = Severe weight loss in a healthy person Cushing Syndrome = Excessive fat accumulation in the trunk Marfan Syndrome = Tall stature with long fingers and joints</p> Signup and view all the answers

    What technique is considered the most accurate for measuring body temperature?

    <p>Rectal</p> Signup and view all the answers

    Bulimia Nervosa is characterized by severe weight loss.

    <p>False</p> Signup and view all the answers

    At what age should head circumference be measured?

    <p>from newborns to 6 years of age</p> Signup and view all the answers

    The aging adult may experience a decrease in _____ due to postural changes.

    <p>height</p> Signup and view all the answers

    Which of the following is NOT a vital sign?

    <p>Body Mass Index</p> Signup and view all the answers

    What percentage of the population is at risk for developing health problems based on BMI?

    <p>Various factors contribute to the risk, like obesity or malnutrition</p> Signup and view all the answers

    What does the acronym OLDCARTS stand for in health assessments?

    <p>Onset, Location, Duration, Character, Aggravating factors, Relieving factors, Timing, Severity</p> Signup and view all the answers

    Alcohol is the most commonly abused stimulant in the United States.

    <p>False</p> Signup and view all the answers

    What is HEEADSSS and who is it used for?

    <p>HEEADSSS is a method of interviewing for adolescents that assesses the Home, Education, Eating, Activities, Drugs, Sexuality, Suicide/Depression, and Safety.</p> Signup and view all the answers

    The __________ questionnaire helps identify alcohol use disorders by assessing consumption, behavior, and adverse consequences.

    <p>AUDIT</p> Signup and view all the answers

    Match the types of violence with their descriptions:

    <p>Intimate Partner Violence = Abuse or aggression between current or former partners Child Abuse = Neglect or maltreatment of a minor Elder Abuse = Harmful behavior towards older adults Human Trafficking = Exploitation and coercion of individuals for labor or sex</p> Signup and view all the answers

    Which of the following is NOT a reason pills are often misused with alcohol?

    <p>Both substances are always safe when combined</p> Signup and view all the answers

    Marijuana is the most commonly used illicit drug in the United States.

    <p>True</p> Signup and view all the answers

    What is CIWA and what is its purpose?

    <p>CIWA stands for Clinical Institute Withdrawal Assessment, used to assess alcohol withdrawal symptoms.</p> Signup and view all the answers

    The __________ assessment measures a person's self-care ability in areas such as bathing and dressing.

    <p>functional</p> Signup and view all the answers

    What score on the AUDIT indicates low risk for alcohol use?

    <p>0-7</p> Signup and view all the answers

    There is a safe amount of alcohol consumption during pregnancy.

    <p>False</p> Signup and view all the answers

    What are instrumental ADLs?

    <p>Instrumental ADLs are skills needed for independent living, such as managing finances and community participation.</p> Signup and view all the answers

    The __________ questionnaire is quick and asks about four key aspects of alcohol use.

    <p>CAGE</p> Signup and view all the answers

    Match the illicit drug category with its effect:

    <p>Cocaine = Stimulant that boosts energy and euphoria Heroin = Opioid with high risk of addiction Marijuana = Common illicit drug impacting cognition Methamphetamine = Highly addictive stimulant with severe health consequences</p> Signup and view all the answers

    Which of the following is NOT a category of intimate partner violence?

    <p>Financial exploitation</p> Signup and view all the answers

    Child abuse can include emotional abuse.

    <p>True</p> Signup and view all the answers

    What must a mandated reporter do upon suspecting elder abuse?

    <p>Call protective services hotline.</p> Signup and view all the answers

    The HITS screening tool scores each question from 0 (never) to ____ (frequently).

    <p>5</p> Signup and view all the answers

    Match the forms of elder abuse with their descriptions:

    <p>Physical abuse = Inflicting physical pain or injury Financial abuse = Improper use of an elder's funds or resources Neglect = Failing to meet basic needs Psychological abuse = Inflicting emotional distress or fear</p> Signup and view all the answers

    Which of the following factors should be assessed during a physical examination for suspected abuse?

    <p>Nutritional supplements</p> Signup and view all the answers

    A score greater than 10 on the HITS tool indicates no risk of intimate partner violence.

    <p>False</p> Signup and view all the answers

    What is the purpose of inspection during a physical exam?

    <p>To observe the patient's condition and compare body symmetry.</p> Signup and view all the answers

    ____ is the method used to listen to sounds produced by the body during a physical examination.

    <p>Auscultation</p> Signup and view all the answers

    What is the correct action to take when using a stethoscope for auscultation?

    <p>Keep the room warm and quiet.</p> Signup and view all the answers

    Transmission-based precautions are standard precautions applied to all patients.

    <p>False</p> Signup and view all the answers

    What are the two primary techniques used in palpation?

    <p>Light palpation and deep palpation.</p> Signup and view all the answers

    The _______ fork is used for auditory screening and assessment of vibratory sensation.

    <p>tuning</p> Signup and view all the answers

    Match the examination technique with its description:

    <p>Inspection = Visual observation of the patient Palpation = Assessment by touch Percussion = Tapping to assess underlying structures Auscultation = Listening to body sounds</p> Signup and view all the answers

    Study Notes

    Evidence-Based Assessment (Chapter 1)

    • Assessment Data Sources: Assessment collects data on health. Data comes from the patient (subjective) and observation (objective).

    • Nursing Process Steps: Assessment, Diagnosis, Planning, Implementation, Evaluation.

    • Clinical Judgment Model: Clinical judgment improves with experience, progressing from novice (needs rules) to expert (intuitive solutions).

    • Priority Setting in Assessment:

    • Level 1: Emergent and life-threatening issues (airway, breathing).

    • Level 2: Problems leading to deterioration (mental status change, pain).

    • Level 3: Important but less urgent issues (mobility, knowledge).

    • Types of Patient Databases:

    • Complete Database: Comprehensive history and exam (primary care).

    • Focused Database: Limited, short-term problem (all settings).

    • Follow-up Database: Status of previous problems (all settings).

    • Emergency Database: Urgent and rapid collection of critical information.

    Cultural Assessment (Chapter 2)

    • Social Determinants of Health (SDOH): Non-medical factors (where you were born, live, work) that influence health.

    • Cultural Data Collection: Assess individuals, families, & communities on health beliefs and values, and work with their systems for effective care.

    • Culture: Learned, shared, adapted, and dynamic system of attitudes, beliefs, values.

    • Cultural Competence: Requires questions about patient culture to uncover influences on health beliefs.

    • Common Cultural Terms:

    • Race: Self-identification, often a social construct.

    • Ethnicity: Shared traits (origin, religion).

    • Spirituality: Connection to something larger than oneself.

    • Religion: Organized system of beliefs and practices.

    The Interview (Chapter 3)

    • Subjective vs. Objective Data: Subjective = patient-reported, Objective = observed/measured.

    • Successful Patient Interview: Gather accurate information, build trust, teach about health, and build rapport.

    • AIDET: Acknowledge, Introduce, Duration, Explanation, Thank You.

    • Interview Questions: Open-ended (narrative) and closed (specific).

    • Interview Traps: False assurance, advice, authority, avoidance, jargon, leading questions, talking too much, interrupting, "why" questions.

    • Nonverbal Communication: Physical appearance, posture, gestures, facial expressions, voice, touch.

    • Age and Special Needs Considerations: Different approaches for each age group (children, older adults, etc.). Specific strategies needed for children and adolescents depending on age and developmental stage. Needs of patients with special needs must be addressed.

    The Complete Health History (Chapter 4)

    • Purpose of Complete Health History: Collect data, understand past/present health, recognize strengths and support for healthy routines, and evaluate illness patterns.

    • Data Sources: Primary (patient), secondary (family, records).

    • Present & Past Health Status: Present illness details (OLDCARTS, PQRSTU), past illnesses, accidents, hospitalizations, surgeries.

    • Review of Systems & Functional Assessments: Evaluate each body system's health and daily living skills.

    • Age Considerations: Use HEEADSSS (Home, Education, Eating, Activities, Drugs, Sexuality, Suicide/Depression, Safety). Adjust methods for children, adolescents, and older adults to elicit appropriate data.

    Substance Use Assessment (Chapter 6)

    • Alcohol Use & Abuse: Commonly abused substance, interacts negatively with medications (affecting metabolism). Links to cardiovascular issues (hypertension, heart disease).

    • Illicit Drug Use (Opioid Epidemic): Includes various categories (marijuana, cocaine, heroin, hallucinogens). Negative effects, especially for adolescents and pregnant women. Opioid epidemic connects to misuse of prescriptions to heroin.

    • Developmental Considerations: Addiction influenced by genetics, environment. Adolescents more prone to risk-taking, alcohol slows brain development, marijuana can affect brain development. Pregnancy: alcohol harm to fetus. Older adults are challenged with multiple medications.

    • Subjective Data Collection (AUDIT & CAGE): Assess alcohol use, consider AUDIT (alcohol use disorders identification test- total possible score 40), CAGE questionnaire, and look for illicit substance use. Record score to identify risk levels.

    • Objective Data Collection (CIWA): Clinical Institute Withdrawal Assessment (CIWA) used to evaluate the severity of alcohol withdrawal symptoms.

    Family Violence & Human Trafficking (Chapter 7)

    • Types of Violence: Intimate partner, child abuse/neglect, elder abuse/neglect, human trafficking.

    • Subjective Data Collection (HITS): Open-ended questions, use the HITS screening tool (intimate partner violence- scoring system).

    • Objective Data Collection: Thorough head-to-toe examination documenting observable injuries carefully but without speculating on timing.

    • Mandated Reporting: Nurses must report suspected abuse or neglect to appropriate authorities. Appropriate documentation is essential.

    Assessment Techniques & Safety (Chapter 8)

    • Exam Techniques: Inspection (visual), palpation (touch), percussion (tapping), auscultation (listening). Equipment for each technique, like stethoscope, otoscope, etc.

    • Standard Precautions: Hand hygiene, gloves, gowns, correct PPE use for transmission-based precautions.

    • Hand Hygiene: Crucial step in preventing infection transmission, protocols on different occasions like after patient encounter.

    • Personal Protective Equipment (PPE): Transmission-based precautions including contact, droplet, and airborne. Specific PPE for each precaution.

    • Developmental Considerations: Adapt techniques and environment for infants, toddlers, preschoolers, school-aged children, adolescents, and older adults.

    General Survey & Measurement (Chapter 9)

    • General Survey: Observation of physical appearance, body structure, mobility, and behavior.

    • Patient Measurements:

    • Weight: Same time, clothing, scale; consider changes to health status.

    • Height: Standing straight; record in standard units.

    • BMI: Relationship between height and weight; indicator of health risk.

    • Waist Circumference: Measure abdominal fat; important risk factor for chronic disease.

    • BMI Calculation: Formula for both imperial and metric systems.

    • Developmental Considerations:

    • Infants & Children: Note interactions, caregivers, appropriate measurement methods (length for very young).

    • Aging Adult: Observe physical presentation, address potential physical changes, appropriate measurement methods (height changes).

    • Abnormal Findings: Various conditions (dwarfism, gigantism) associated with abnormal height and proportion.

    Vital Signs (Chapter 10)

    • Vital Signs Significance: Objective measurements of body functions, monitor patient health status.

    • Assessment Techniques & Equipment: Temperature (oral, rectal, tympanic, temporal), pulse (rate, rhythm, force), respiration rate, blood pressure (manual, automatic).

    • Blood Pressure: Systolic/diastolic pressure; measures the force against vessel walls, with different methods.

    • Oxygen Saturation (SpO2): Non-invasive measurement; normal range.

    • Abnormal Vital Sign Terms: Bradycardia, tachycardia, tachypnea, bradypnea, hypotension, hypertension, orthostatic changes.

    • Orthostatic Vital Signs: Measure changes in pulse and blood pressure when moving from supine to standing. Observe for significant drops in blood pressure and pulse.

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    Description

    This quiz focuses on important concepts related to cultural competence in healthcare settings. It covers various aspects such as communication techniques, data collection, and the impact of culture on patient care. Test your knowledge on these essential elements for providing effective healthcare.

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