Questions and Answers
What type of pain results from spasms in the intestines and fluctuates in intensity?
Which type of pain is associated with damage or inflammation to sensory nerves?
What is the term for the pain perceived in a part of the body that is not the actual source of the injury?
Which characteristic is NOT a feature of nociceptive pain?
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Which of the following best describes visceral pain?
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What is measured during a pain assessment using OLDCARTS?
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Which of the following is a component of the 'A' in OLDCARTS?
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What kind of pain starts in one area and radiates to another part of the body?
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What is the primary aim of conducting a focused or problem-based health history?
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Which of the following is NOT considered a purpose of health history?
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In a health history assessment, which component addresses the evaluation of day-to-day habits?
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What distinguishes a follow-up health history from an initial health history?
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Which source of health history refers specifically to the individual being assessed?
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During an annual examination, which process is usually conducted?
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Which of the following best describes the role of medications in a health history assessment?
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What type of information is NOT typically included in biographical data during health history taking?
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What does the 'R' in the OPQRST pain assessment acronym stand for?
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Which scale is most commonly used for numeric pain assessment?
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Which pain assessment tool is specifically designed for nonverbal patients in critical care?
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What is the primary focus of the 'S' in OPQRST?
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What does the Iowa Pain Thermometer (IPT) utilize to assess pain levels?
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Which pain assessment tool can also be used for advanced dementia patients?
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How often is the epidermis replaced?
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The Verbal Descriptor Pain Scale (VRS) allows patients to describe their pain using what?
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What is pitting of nails primarily associated with?
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What characterizes splinter hemorrhages in nails?
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Which cranial bone is considered the most important?
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What feature distinguishes spoon nails?
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Which imaging technique provides the most detailed picture of internal body structures?
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What is the primary function of the temporal artery?
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What is a common cause of spoon nails?
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What diagnostic tool is typically ordered for a more detailed picture of brain abnormalities?
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What is a common symptom of exophthalmos?
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Which abnormal finding indicates that a lower eyelid is turned inward?
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What should be assessed to check for symmetry in the palpebral fissures?
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What does the presence of crusting on the eyelashes typically indicate?
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Which finding would be considered normal during an eye examination?
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What characteristic of the eyelids is a sign of ptosis?
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What can presence of yellow, white, or green drainage from the eyelids potentially indicate?
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Which of the following findings would most likely indicate periorbital edema?
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Study Notes
Patient Examination and History
- Annual examinations involve reviewing patient systems from head to toe.
- Focused health histories target specific acute problems or symptoms, common in urgent care or ER settings.
- Follow-up histories assess new developments since the last consultation.
Health History Data Sources
- Primary source: Patient being assessed provides personal health information.
- Secondary source: Relatives, significant others, or medical records offer supplementary data.
Purpose of Health History
- Document past and present health, including medical conditions, hospitalizations, and surgeries.
- Record family health history to identify hereditary issues.
- Uncover psychosocial factors impacting health.
- Determine strengths, weaknesses, teaching needs, and discharge planning requirements.
Components of Health History
- Reason for seeking care.
- Detailed history of present illness.
- Biographical data covering general info about the patient.
- Military history if applicable.
- List medications including prescriptions, OTC, and supplements.
- Immunization status.
- Past medical history overview.
- Family health history.
- Psychosocial assessment focusing on behavioral and environmental factors.
Pain Types and Characteristics
- Colicky pain: Fluctuating in intensity, related to intestinal spasms.
- Nociceptive pain: Caused by damage to sensory nerves, can be somatic (sharp/intense) or visceral (vague/deep).
- Neuropathic pain: Resulting from nerve damage, characterized by sharp, burning sensations, and possible numbness.
- Phantom limb syndrome: Pain perceived in an amputated body part.
Pain Transmission Concepts
- Radiating pain: Originates in one location and spreads to others.
- Referred pain: Felt in a different area from the source of the pain.
Pain Assessment Techniques
- OLDCARTS: Framework for gathering detailed pain information (Onset, Location, Duration, Character, Aggravating/Alleviating factors, Related symptoms, Treatment, Severity).
- OPQRST: Specific pain assessment focusing on Onset, Provocation/Palliation, Quality, Radiation, Severity, Timing.
- Multiple scales used for quantifying pain levels, including numeric, Wong-Baker Faces, Verbal Descriptor, and Iowa Pain Thermometer.
Pain Assessment in Nonverbal Patients
- Critical Care Pain Observation Tool (CPOT): Assesses pain through facial expressions, body movements, and muscle tension.
- Pain Assessment in Advanced Dementia Scale (PAINAD): Evaluates pain in patients with cognitive impairments.
Skin, Hair, and Nails Examination
- Epidermis: Avascular outer skin layer, renews every 3-4 weeks.
- Pitting nails: Indicative of psoriasis, causing various indentations.
- Splinter hemorrhages: Red streaks due to bleeding beneath the nails.
- Spoon nails: Flat or concave nails potentially indicating nutritional or systemic disease.
Head, Face, Mouth, and Neck
- Cranium consists of 8 bones, with the frontal bone being crucial for structure.
- Face comprises 14 bones with the temporal artery as a significant artery with a palpable pulse.
Diagnostic Procedures
- CT scans: Provide detailed imaging for diagnosing strokes or brain injuries with or without contrast.
- MRI: Offers a sensitive imaging modality for internal structures, more detailed than a CT scan.
Normal Findings in Eye Examination
- Symmetrical eyes with complete eyelid closure, clear cornea and lens, equal pupil size, and smooth iris.
- Lacrimal ducts should be clear, and conjunctiva should be pink and moist.
Abnormal Findings in Eye Examination
- Asymmetrical eyes or exophthalmos associated with hyperthyroidism.
- Issues with eyelid closure, such as ectropion (outward turning) or entropion (inward turning).
- Infection-related symptoms, like hordeolum (stye), indicated by redness and inflammation around eyelashes.
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Description
This quiz covers the importance of reviewing patient systems systematically during annual examinations, as well as the focused history obtained in acute care settings. Understanding the distinctions between comprehensive and focused health histories is crucial for healthcare professionals in effectively addressing patient needs.