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Questions and Answers
What is the primary purpose of percussion during an abdominal assessment?
What is the primary purpose of percussion during an abdominal assessment?
Which of the following describes normal bowel sounds during auscultation?
Which of the following describes normal bowel sounds during auscultation?
Which action should be performed first during the abdominal assessment?
Which action should be performed first during the abdominal assessment?
What is one of the purposes of light palpation during an abdominal assessment?
What is one of the purposes of light palpation during an abdominal assessment?
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What sound is produced during percussion that indicates normal findings?
What sound is produced during percussion that indicates normal findings?
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Which aspect of the mental status exam assesses whether a patient is aware of their name and the names of familiar individuals?
Which aspect of the mental status exam assesses whether a patient is aware of their name and the names of familiar individuals?
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What does the assessment of a patient's posture and motor behavior help to determine?
What does the assessment of a patient's posture and motor behavior help to determine?
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Which component is NOT part of the neurological examination for determining a patient's alert and oriented status?
Which component is NOT part of the neurological examination for determining a patient's alert and oriented status?
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What does the presence of bruits indicate?
What does the presence of bruits indicate?
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What is considered when assessing a patient's speech characteristics in the mental status exam?
What is considered when assessing a patient's speech characteristics in the mental status exam?
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Which observation would be a sign of facial immobility during a mental status examination?
Which observation would be a sign of facial immobility during a mental status examination?
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Which of the following characteristics is NOT true about splenomegaly?
Which of the following characteristics is NOT true about splenomegaly?
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How should you assess for bruits during an abdominal exam?
How should you assess for bruits during an abdominal exam?
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During the mental status exam, if a patient knows the current location but cannot recall the time, what should that indicate?
During the mental status exam, if a patient knows the current location but cannot recall the time, what should that indicate?
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What would indicate appropriate grooming and dress during a mental status assessment?
What would indicate appropriate grooming and dress during a mental status assessment?
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Which of the following abdominal structures is typically non-palpable?
Which of the following abdominal structures is typically non-palpable?
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What aspect should be evaluated if a patient exhibits anxious fidgeting during the assessment?
What aspect should be evaluated if a patient exhibits anxious fidgeting during the assessment?
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What type of abdominal pain tends to be difficult to localize?
What type of abdominal pain tends to be difficult to localize?
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What is the hallmark finding of guarding during a physical exam?
What is the hallmark finding of guarding during a physical exam?
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What should you NOT do if bruits are heard during auscultation of the abdomen?
What should you NOT do if bruits are heard during auscultation of the abdomen?
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Which abdominal organ is regularly assessed for enlargement by palpation below the 12th rib?
Which abdominal organ is regularly assessed for enlargement by palpation below the 12th rib?
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Rebound tenderness may be suggestive of which condition?
Rebound tenderness may be suggestive of which condition?
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What is the usual size range for a normal liver?
What is the usual size range for a normal liver?
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What is the normal range of bowel sounds heard during auscultation of the abdomen?
What is the normal range of bowel sounds heard during auscultation of the abdomen?
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Which percussion sound is typically expected when assessing a healthy abdomen?
Which percussion sound is typically expected when assessing a healthy abdomen?
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During light palpation, what is NOT a sign that should be assessed?
During light palpation, what is NOT a sign that should be assessed?
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What is the purpose of performing auscultation before palpation during an abdominal assessment?
What is the purpose of performing auscultation before palpation during an abdominal assessment?
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If dullness is heard during percussion, what might this indicate about the underlying structures?
If dullness is heard during percussion, what might this indicate about the underlying structures?
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Which of the following components is part of the screening neurological examination for determining a patient's alertness?
Which of the following components is part of the screening neurological examination for determining a patient's alertness?
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What aspect of the mental status examination does the evaluation of a patient's grooming and hygiene primarily assess?
What aspect of the mental status examination does the evaluation of a patient's grooming and hygiene primarily assess?
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When assessing a patient’s alertness, which of the following correctly evaluates the time component?
When assessing a patient’s alertness, which of the following correctly evaluates the time component?
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Which characteristic of speech might indicate a patient is experiencing a significant mental health issue?
Which characteristic of speech might indicate a patient is experiencing a significant mental health issue?
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In assessing a patient's facial expression during a mental status examination, which of the following would suggest a potential issue?
In assessing a patient's facial expression during a mental status examination, which of the following would suggest a potential issue?
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Where is the location in which a patient needs to be oriented to evaluate their situational understanding?
Where is the location in which a patient needs to be oriented to evaluate their situational understanding?
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If a patient's speech is described as 'fast and loud,' what might this indicate regarding their mental status?
If a patient's speech is described as 'fast and loud,' what might this indicate regarding their mental status?
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What does assessing a patient's tense posture and anxious fidgeting primarily help identify?
What does assessing a patient's tense posture and anxious fidgeting primarily help identify?
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What is the typical reason for auscultating before palpating during an abdominal examination?
What is the typical reason for auscultating before palpating during an abdominal examination?
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Which abdominal area is assessed for splenomegaly during clinical examination?
Which abdominal area is assessed for splenomegaly during clinical examination?
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What characteristic feature differentiates parietal pain from visceral pain?
What characteristic feature differentiates parietal pain from visceral pain?
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What does the presence of rigidity during an abdominal assessment suggest?
What does the presence of rigidity during an abdominal assessment suggest?
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How does rebound tenderness present in a clinical examination?
How does rebound tenderness present in a clinical examination?
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What finding may suggest aortic aneurysm when auscultating the abdomen?
What finding may suggest aortic aneurysm when auscultating the abdomen?
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In which scenario would you suspect splenomegaly during an abdominal assessment?
In which scenario would you suspect splenomegaly during an abdominal assessment?
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What action should be avoided if bruits are heard during abdominal auscultation?
What action should be avoided if bruits are heard during abdominal auscultation?
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Which characteristic is true regarding the normal size of the abdominal aorta?
Which characteristic is true regarding the normal size of the abdominal aorta?
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Which condition is most likely associated with parietal abdominal pain?
Which condition is most likely associated with parietal abdominal pain?
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Study Notes
GEPN Health Assessment Final Exam Review
- The exam has 75 questions in total
- Neurological questions: 30
- Abdominal questions: 30
- Integumentary (skin) questions: 15
Neurological Exam Components
- Mental status
- Cranial nerves
- Sensory system
- Motor system
Neurological Exam: Determining Alert and Oriented Status
- Person: Does the patient know their name and those of relatives or familiar healthcare staff?
- Place: Does the patient know where they are (clinic/hospital name, city, state)?
- Time: Does the patient know the time of day, day of the week, month, season, and year?
- Situation: Does the patient know what is happening and why they are there?
Mental Status Exam Components: Appearance and Behavior
- Posture and motor behavior: Assessing for tense posture, restlessness, and anxious fidgeting
- Dress, grooming, and personal hygiene: Is the clothing appropriate for the weather and is the patient's personal hygiene appropriate?
- Facial expression: Appropriate to topics being discussed, assessing for anxiety, depression, apathy, anger, elation, or facial immobility
- Speech and language:
- Quantity: Assessing how talkative the patient is, compared to baseline
- Rate: How fast or slow is the speech?
- Loudness: Is the speech loud or soft?
- Articulation: Assessing the clarity and distinctness of words
- Fluency: Assessing the rate, flow, and melody of speech
- Aphasia: Impaired comprehension with fluent speech, or preserved comprehension but slow, nonfluent speech
Mental Status Exam Components: Mood and Cognition
- Mood: Asking about the patient's usual mood and how it has changed -Assess for sadness, contentment, joy, euphoria, elation, anger, rage, anxiety, detachment, or indifference
- Thoughts and perceptions: Assessing the logic, relevance, organization, and coherence of thought processes, listening for speech patterns, and assessing thought content
- Cognitive function:
- Orientation: Alert and oriented status
- Attention: Concentration ability
- Remote memory: Past events, birthdays, school names
- Recent memory: Current day, weather
- New learning ability: four unrelated words, recall in 3-5 minutes
Glasgow Coma Scale
- A reliable assessment tool for level of consciousness, particularly after brain injury.
- Three sections: eye opening, verbal response, and motor response.
- Scores range from 3 (most severe) to 15 (least severe). Decreasing scores after head injury relate to higher mortality.
Cranial Nerves
- 12 pairs numbered based on how they arise from nuclei
- (M) = Motor, (S) = Sensory, (B) = Both
- mnemonic for the order and function is "On Old Olympus' Towering Top, A Finn And German Viewed A Hop"
Deep Tendon Reflexes: Grading
- 4+ (Very brisk, hyperactive with clonus)
- 3+ (Brisk)
- 2+ (Normal)
- 1+ (Diminished/hyporeflexia)
- 0 (Absent/areflexia)
NINDS Scale for Tendon Reflex Assessment
- Scoring for tendon reflexes, grading scale from 0 to 4 (absent to enhanced).
- Description of different scores, including those with clonus(involuntary rhythmic oscillations) noted in the reflex
Deep Tendon Reflexes
- Biceps (C5/C6)
- Brachioradialis (C6)
- Triceps (C7)
- Patellar (L4)
- Achilles (S1)
Hyporeflexia
- Decreased/absent reflex response in muscles
- Cause potentially stemming from lower motor neurons or CNS disorders (spinal cord injuries, muscular atrophy, Guillain-Barre, ALS, and hypothyroidism)
- Symptoms include gradual onset, increasing muscle weakness, difficulty holding objects, difficulties walking or standing, muscle atrophy, and dependance on cause.
Cerebral Vascular Accidents (Strokes)
- Use the mnemonic "BE FAST" to remember common symptoms:
- Balance: Loss of balance, headache, or dizziness
- Eyes: Sudden changes in vision (loss or double vision)
- Face: Does one side of face droop?
- Arm: Weakness in arm, especially on one side.
- Speech: Difficulty speaking
- Time: Time to call emergency services
Stroke Risk Factors
- High blood pressure
- High cholesterol
- Diabetes
- Smoking
- Alcohol use
- High stress levels
- Heart disease
- Obesity and lack of exercise.
Traumatic Brain Injuries:
- Concussion
- Contusion
- Coup Contrecoup
- Diffuse Axonal Injury
Pressure Injuries
- Contributing Factors: Advanced age, moisture, friction, shear, poor skin hygiene, diabetes, medication use, and decreased sensory perception
- common locations: Sacrum, heels, hips, coccyx, elbows.
Staging of Pressure Injuries
- Stage 1: Skin is intact with non-blanchable redness
- Stage 2: Partial thickness loss.
- Stage 3: Full thickness loss, adipose tissue exposed.
- Stage 4: Full thickness loss with exposed bone, tendon, or muscle.
- Unstageable: Base of wound obscured by slough or eschar.
- Deep tissue injury: May appear as skin ulcer, but involves deeper tissue and can appear as purple or maroon discoloration.
Assessment of Pressure Injuries
- Size, drainage, presence of sutures, lines, odor, color, and location
- Measurements: Length, width, and depth
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Description
Prepare for your GEPN Health Assessment final exam with this comprehensive review. The quiz covers critical areas such as neurological, abdominal, and integumentary assessments. Test your knowledge on components of mental status exams and different neurological assessment criteria.
