Neurological Assessment Quiz

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Questions and Answers

What neurological test assesses the ability to maintain balance and coordination?

Pronation drift test

Romberg test (correct)

EOM test

Whisper test

What factor is likely associated with a decrease in height in elderly patients?

Decreased muscle mass

Increased bone density

Increased joint flexibility

Decreased bone density (correct)

Which cranial nerves are assessed by checking the gag reflex?

9 and 10 (correct)

7 and 8

5 and 6

1 and 2

What might be indicated by a positive straight leg raise test?

Presence of herniated nucleus pulposus Signup and view all the answers

Which assessment tests for upper extremity strength and may indicate a stroke?

Pronation drift test Signup and view all the answers

What would be the expected finding in a patient with severe nystagmus?

Abnormal eye movements Signup and view all the answers

What is a potential consequence of significant cerebral dysfunction evident by the Glasgow Coma Scale score being less than 7?

Severe brain damage or coma Signup and view all the answers

Which aspect of communication is essential when assessing a patient's ability to perform activities of daily living?

Non-verbal cues Signup and view all the answers

What is a common symptom of fluid accumulation in the knee joint?

Popping or clicking sounds Signup and view all the answers

What is the role of the hypothalamus in maintaining homeostasis?

Controls sleep-wake cycles and temperature Signup and view all the answers

What is the recommended action for a patient in their 70s with a cardiac history?

Listen for bruits with a stethoscope Signup and view all the answers

During a respiratory assessment, what indicates the presence of whispered pectoriloquy?

Louder, clearer whispered sounds Signup and view all the answers

In elderly patients, what is a significant change in their arterial health?

More rigid and less flexible arteries Signup and view all the answers

What symptom might suggest a patient is experiencing respiratory distress?

Barrel chest formation Signup and view all the answers

What is an important step to take before examining a patient in a supine position?

Empty the bladder Signup and view all the answers

What is the proper technique for conducting a testicular exam?

Feel each testicle rolling with finger and thumb after a warm bath Signup and view all the answers

What is a common respiratory assessment finding in patients with COPD?

Clubbing of fingers Signup and view all the answers

Which of these assessments indicates immediate focus is needed for the patient?

Hearing crackles or rales through the stethoscope Signup and view all the answers

Which type of skin cell cancer is classified as primary?

Basal cell carcinoma Signup and view all the answers

What is an ineffective assessment technique indicated for examining breast tissue?

Checking for size and symmetry during menstruation Signup and view all the answers

Study Notes

N220 Health Assessment Final Review

Fall 2024 review for N220 Health Assessment

Health Promotion

Questions to ask the patient:
- Sunscreen use
- Diet habits
- Exercise routine
- Smoking history (pack years)
- Alcohol use (ETOH)
- Drug use
- Sexual history
- Vaccination records
- Annual physical exam history

Diagnostic Reasoning

Analyzing health data and drawing conclusions to identify diagnoses
Components of the hypothetico-deductive model:
- Attending to available cues
- Clustering related cues
- Formulating diagnostic hypotheses
- Gathering data relevant to hypotheses
- Evaluating hypotheses with new data
- Critical thinking skills to identify relationships in the data

Transcultural Expression of Illness

Pain expression is culturally influenced
Expectations, manifestations, and management of pain vary across cultures.
Often, pain is perceived as a highly personal experience.
Meaning and significance of the situation influence pain expression.
Silent suffering may be a culturally valued response.

Communication Techniques

Introduction phase: Setting the stage
Working phase: Types of interview questions
Open-ended: "narrative" style
Closed: "short, one or two words"
Closing the interview: Summary

Interview Techniques

Open-ended questions:
- Chief Complaint: "Why I am here"
- History of Present Illness (HPI): Timeline and details of the complaint
- OLD CARTS
- Past Medical History (PMH)
- Family History (FHx)
- Medications
- Allergies
Creating a quiet interview environment:
Important for hearing-impaired individuals
Control external factors
Closed-ended questions:
- "Did you take your medications today?"

Review of Systems

YES/NO Questions: Use system-specific questions
One question above and below the chief complaint
Cover all systems
Complete Health History

Cultural Health Assessment

Preferred language
Health care beliefs
Predominant sick care practices
Geographic origin and CDC consultation during outbreaks
Family role in care, Decision-making practices, Touch practices, Perception of time, Pain reactions, Birth/death rites, Food practices. Immunization Practices

Health History: Putting It All Together

Clustering cues: Group related information
A large amount of information is collected.

Other

Life-threatening situations: Immediate action needed to avoid further deterioration. The patient's family should be involved to support their coping abilities.
Listening for bruits in a 70-year-old with cardiac history. This involves using a stethoscope to listen for abnormal sounds (bruits).
Assessing the apex and pulse rate. The heart rate is checked by listening to the heartbeat at the apex (the point of maximum impulse) and checking for the pulse. The number of heart beats in a minute are recorded
Normal lung sounds:
Vesicular: Soft, relatively low pitch, and heard over most of the lungs
Bronchial: Loud, relatively high pitch, and heard between the scapula and anteriorly
Tracheal: Very loud, relatively high pitch, heard over the trachea in the neck.
Tremor and facial expressions, sunken eyes, and masking of emotions are indicators of illness.
Palpation: Technique for examining the body using hands
Palpation (head and face): Thumb placed under the eyebrow, frontal and maxillary areas are palpated.
Barrel chest and clubbing of fingers. These physical characteristics observed could indicate lung diseases.
COPD: Chronic obstructive pulmonary disease, the patient could be experiencing Respiratory distress.
Health Promotion Teaching (Male):
- Prostate, colorectal, and HPV cancer screening
- PSA (Prostate-Specific Antigen) screening: An effective early screening test for prostate cancer
- Colorectal cancer (CRC) screening: Recommended starting at age 50
- Fecal Immunochemical Test (FIT): Screening test for CRC that should start at age 40.
- HPV vaccination for men under 26
- Testicular exams: How and when to conduct them
Breast self-exam: Perform this a few days after a menstrual cycle to ensure early detection of changes, size, shape, symmetry, skin texture, and nodules.
Joint crepitation: A popping, clicking, or cracking sound in a joint.
Anthropometrics: Assessing height and bone density—a decrease in bone density often occurs in the elderly, causing a decrease in height
Self-Care Ability: Assessing the patient's ability to complete basic self-care tasks.
Activities of Daily Living (ADLs): Analyzing the patient's ability to perform daily tasks (bathing, toileting, eating, dressing, mobility, communicating)
Methods of communication: Finding the most effective way to communicate with patients
Large amount of fluid: Could have fluid around joints or internal organ
Water on the knee: Accumulation of fluid within the knee joint
"Walking pattern" and balance tests assess neurological functions
Motor, cerebellar functions: Coordination check, muscle and tone check, assessing involuntary movements, including tremors and other unusual movements
Self-care abilities: Assess patient's ability to perform actions: rising, walking, climbing, descending, getting objects on the floor, and writing checks.
Shoulder examination: Palpate joints, assess range of motion (ROM), check for crepitation
Sciatic pain from lifting: Indicates possible herniated disc.
Patient presenting with pain while sitting: Pain continuing when sitting is a significant indicator.
Gag reflex: Check for swallowing difficulties and/or gag reflex, which assesses the 9th cranial nerve.
Assessing level of consciousness: Testing the level of a patient's consciousness using the Glasgow Coma Scale
Hypothyroidism: Slow metabolism and thyroid problems can cause symptoms.
Symmetry look at the symmetry of movement when testing muscle strength, and check symmetry of body.
Alternating arm swing A neurological function check involves gently shaking the patient's shoulder to assess level of consciousness.

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Description

Test your knowledge on key neurological assessments and related topics. This quiz covers various tests and their implications, including balance, strength, and reflex assessments. Ideal for students and professionals in healthcare and medical fields.