Health final

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  1. A process that involves the use of specific strategies that encourage the pt to express feelings and ideas and that convey acceptance and respect would be:
    Theraputic communication
  2. If a pt comes into the ER with chest pain radiating down his left arm, and diaphoretic, you should first perform a:
    focused health hx
  3. A list of questions you ask a pt about his body functions/problems is called:
    Review of Systems
  4. When performing a physical examination, which operations do you do first
    inspection

    • In order:
    • Inspection
    • palpation
    • percussion
    • auscultation
    • *except in abd, where auscultation is performed right after inspection
  5. You perform a symptom analysis of a pt’s abd pain.  What question would best assess the severity of the pain?
    On a scale of 0 - 10, rate the pain
  6. What heart valve would I be listening to if I placed my stethoscope at the base on the right side?
    Aortic
  7. What sound is caused by turbulent flow in the peripheral arteries?
    Bruits
  8. The PMI is located at the?
    Apex
  9. Pain in the legs with exertion is called?
    Intermittent claudication
  10. While measuring JVP you should elevate your patient’s head to?
    45 degrees
  11. When checking capillary refill, you are assessing?
    Tissue perfusion
  12. A particle that breaks from one place in an artery and goes to another place is called?
    An embolus
  13. The Tricuspid valve is heard best?
    Left lower sternal border
  14. A weakness in an artery is called?
    An aneurysm
  15. The resting time for the heart is called?
    Ventricular diastole
  16. Difficulty breathing is called?
    Dyspnea
  17. An increase in blood pH is called?
    Respiratory alkalosis
  18. The anteroposterior to lateral ratio for someone with a BARREL CHEST is?
    1:1
  19. What is the worst breathing pattern?
    Agonal breathin
  20. When percussing a COPD patient’s lungs, what sound would you hear over the bases?
    Hyperresonance
  21. What is the best for assessing color changes in dark skinned individuals?
    Sclera
  22. What is clubbing caused by
    hypoxia
  23. One of the earliest indicators of increased intracranial pressure is?
    Decreased LOC
  24. Deep Tendon reflexes are specifically associated with which area?
    Spinal cord
  25. The sensation of your surroundings are spinning is?
    Vertigo
  26. When assessing LOC, you should assess
    Arousal and orientation
  27. Which instrument would you use for looking at the tympanic membrane?
    otoscope
  28. Which instrument would you use for looking at the fundus of the eye?
    Ophthalmoscope
  29. Other than tuning your piano, what would you use a tuning fork for in assessing patients?
    Weber and Renne tests
  30. Which reflex is abnormal for an adult?
    Babinski reflex
  31. Alterations in the cardiovascular system can lead to circulatory impairment which can cause?
    Lesions and ulcerations
  32. Increased fluid volume associated with diminishing renal function may result in?
    edema
  33. African Americans have a higher incidence of?
    Pseudofolliculitis
  34. A diabetic patient is more likely to have trauma to the skin because?
    They usually have decreased sensation
  35. Newborn babies appear more pink or red because?
    There is a lack of subQ tissue
  36. If you cannot perform a complete health history of the integumentary system, at least ask
    Have you had any recent changes in your skin, hair or nails?
  37. Patchy, pallid discoloration is?
    Vitiligo
  38. When assessing lesions, the ABCD method means:
    • Asymmetry
    • border
    • color
    • diameter
  39. Mrs. Green age 75, has a stroke with left sided weakness. As you reposition her, you notice a slight reddened area on her sacrum. How would you stage this pressure ulcer?
    Stage 1
  40. The Red Reflex is seen when examining the?
    Retina
  41. A polyp is an
    elongated, rounded projection
  42. Having difficulty seeing things close after aging is called?
    Presbyopia
  43. What is the definition of a cataract?
    • A cloudy, protein build up on the eye causing visual impairment.
    • Often related to aging
  44. The refraction of light rays diffused rather than sharply focused on the retina is called?
    Astigmatism
  45. If a patient’s vision tested 20/40 OU, you would teach the patient?
    You can see at 20 feet what a person with normal vision can see at 40 feet.
  46. When assessing the abdomen, which is the correct sequence?
    Inspection, Auscultation, palpation, percussion
  47. The USDA’s guide for teaching nutrition is called?
    My Plate
  48. Body mass index is an indicator of
    Fat
  49. T or F
    You cannot be obese and malnourished at the same time
    F
  50. the accumulation of fluid in the peritoneal cavity is called
    Ascites
  51. When considering a dx of an upper GI bleed, what color would you expect stools to be
    black
  52. The fluid wave test checks for
    ascites
  53. My grandmother started getting smaller as she got older. She probably had
    Kyphosis
  54. The point at which a painful stimulus is perceived as painful is?
    Pain threshold
  55. An example of a condyloid joint is the?
    Wrist
  56. T or F
    Flexion is decreasing of the joint angle
    T
  57. Which class of medications can increase the risk for osteoporosis?
    steriods
  58. The areola
    Contains glands to lubricate the nipple during breastfeeding
  59. Breast development depends on
    estrogen and progesterone
  60. Menopause is said to occur?
    When a woman has not had a period in a yr
  61. Amenorrhea is
    absent menstrual bleeding
  62. A PAP test screens for
    cervical cancer
  63. Impotence in men is not part of aging and could be attributed to?
    Heart disease or diabetes
  64. Which neurotransmitter is associated with anxiety?
    Gamma-aminobutyric acid (GABA)
  65. Mary age 75 is admitted to the hospital with change in mental status and sudden onset of confusion. This behavior is most associated with?
    Delirium
  66. Which medication is associated with depression?
    beta blockers
  67. Susan age 69, panics when driving on congested highways, feels as if she is “outside her body” as if someone else is driving her car. This is an example of?
    Depersonalization
  68. You are teaching your patient about wound care and she has hyperthyroidism. How might you adapt your teaching plan to meet her needs?
    adjust the temp
  69. Your patient was involved in an automobile accident. You see that he is a Jehovah’s Witness. Which treatment may be against the patient’s wishes?
    blood transfusions
  70. A Christian Scientist may?
    refuse tx
  71. You are performing a complete history and physical assessment. Which approach is best for performing a complete assessment?
    by region
  72. Which approach is best for documenting assessment findings?
    by system
  73. The age range that a child would be considered an adolescent would be?
    no specific age range
  74. Which vision change is frequently seen in adolescence?
    myopia
  75. Which of Erikson’s developmental tasks are for school aged children?
    Industry vs. inferiority
  76. Which of erikson's developmental tasks are for adolescents
    identity vs role diffusion
  77. What immunization should be given to an adolescent before starting college
    meningitis
  78. What common breast problem is seen is adolescent boys are they proceed through puberty?
    Gynecomastia
  79. Gardasil vaccine will protect against which virus
    HPV
  80. Which nursing dx may be most appropriate for most adolescents
    Identity, disturbed personal
  81. T or F
    Heart murmurs are common in young children
    T
  82. Which of the following is one of the key points to remember when obtaining a health history?
    Start with what the patient perceives as the problem
  83. If you wanted to really emphasize a point during a conversation the best help would be to use
    nonverbal language
  84. If you wanted to find out about a patient’s past/present renal function what part of the health history you would use:
    Review of systems
  85. A blood pressure cuff that is too large for the patient’s arm results in a blood pressure:
    too low
  86. The nurse knows, when each step of the Nursing Process is complete, he will have identified:
    A plan which is the basis of nursing care for his patient.
  87. During the “planning” phase of the Nursing Process, the nurse:
    Establishes goals and measurable outcome
  88. Which activities are performed during the assessment phase of the nursing process?
    collecting data
  89. Upon assessing vital signs, you know it is important to:
    Watch for changes in trends from baseline
  90. Which would be the worst place to see cyanosis?
    oral mucosa
  91. While performing a cardiovascular assessment, you palpate a carotic thrill. What sound would you expect to hear when auscultating over the area?
    bruit
  92. If you haven’t just run a 100-meter race, accessory muscle use when breathing would mean:
    increased work of breathing
  93. When teaching a patient to use incentive spirometry you have them
    take a deep slow breath
  94. Which of the following is marked rhythmic waxing and waning of respirations from very deep to very shallow breathing and temporary apnea?
    Cheyne-stokes
  95. You have auscultated your patient’s lungs and hear sounds described as “air bubbling through moisture in the alveoli or from collapsed alveoli popping open.”  A common term for these sounds is:
    crackles
  96. A 68-year-old female developed pulmonary edema following hip surgery. The experience is so frightening to her that when she feels short of breath she begins to hyperventilate. A nursing diagnosis MOST appropriate for her is:
    Ineffective Breathing Pattern related to anxiety
  97. When examining someone for a stroke using the Cincinnati Stroke Scale you know to recognize symptoms quickly you need to act FAST, which stands for:
    Face, Arm, Speech, Time
  98. When testing visual accommodation, which response would be considered normal?
    Constriction and convergence
  99. Which of the following means difficulty swallowing?
    Dysphagia
  100. Of the following patients, who is most likely to need a neurologic assessment?
    An 18-year-old car accident victim who appears sleepy
  101. When giving a bed-bath, you notice that your patient has a 4 cm non-blanching reddened area with a blister on his coccyx. How would you stage this pressure ulcer?
    stage 2
  102. Pinpoint lesions caused by extravasation of blood into the skin would be
    Petechia
  103. You are assigned 4 patients when you come on shift.  After your initial assessments, which patient will be your priority?
    A newly admitted patient with bright red stools
  104. You are assigned 4 patients on your shift.  After your initial assessments, which of the following are you most concerned about?
    79-year-old female with cyanosis and decreased level of consciousness.
  105. .A visual acuity of 20/40 would be consistent with:
    Myopia
  106. You are performing a nutritional assessment. Which of the following conditions would most likely result in primary malnutrition?
    • Kwashiorkor also
    • Anorexia Nervosa was correct
  107. John Spivey, age 75, is scheduled for a hearing exam.  Considering his age, which hearing change might you expect to find?
    Presbycusis
  108. A positive Murphy’s sign would most likely indicate:
    Cholecystitis
  109. What would be an expected finding when assessing eyes in an older adult?
    cataract
  110. Black tarry bowel movements could indicate:
    GI bleed
  111. When inspecting the breast, you are concerned with the following finding:
    Dimpling near the nipple
  112. Your elderly female patient states that she is incontinent of urine every time she coughs. What type of incontinence does she have?
    stress
  113. When performing a pain assessment on a 3-month-old infant who has had heart surgery, the most appropriate pain scale to use would be:
    FLACC Postoperative Pain Tool
  114. When a patient tells her nurse that her pain level is an “8 out of 10,” even though the patient received pain medication just an hour ago, the nurse should:
    Believe the patient and try to make her more comfortable
  115. Which test would I use to check for carpal tunnel syndrome?
    Phalen’s
  116. A health concern for young men would be:
    Testicular cancer
  117. Which factor is not a risk for breast cancer:
    First pregnancy at age 20
  118. The nurse plays music for a child with leukemia who is experiencing pain. Which pain management techniques is this nurse using?
    Distraction
  119. From a psychosocial perspective, Eric Erikson describes that period of adolescence as one of:
    Identity vs. role diffusion
  120. Of the following risk factors; which is not a common risk factor for school aged children?
    Selfish habits
  121. Your patient is 2-years-old, and her mother is wondering about when she will be able to begin potty training.  What would you tell the mother?
    Children become physiologically and psychologically ready for toilet training between 18 and 24 months
  122. It is important to familiarize yourself with your patient’s cultural domain, which of the following is an important area to consider?
    Spiritual beliefs and healthcare practices
  123. An elderly patient, accompanied by his wife, is admitted to the floor and is completely disoriented. The most appropriate initial action for you to do would be:
    Find out his baseline mental status by asking his wife if this is typical behavior for him
  124. A 35 year old woman is admitted for treatment of depression. Which of these symptoms would the nurse be least likely to find in the initial assessment?
    Increased interest in sex
  125. Which of the following would provide environmental hazards for falls?
    Inappropriate assistive device
Author:
jskunz
ID:
313150
Card Set:
Health final
Updated:
2015-12-13 22:05:45
Tags:
health
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Description:
health assess final
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