NR509 Midterm Exam Due
Questions And Verified
Answers 100% Guranteed
Pass
amily history of heart disease
The United States Preventative Services Taskforce (USPSTF, 2021) hypertension screening
guidelines for adults: - correct answer -Adults 18 years or older without known hypertension
• office blood pressure measurement (OBPM)
• obtaining BP outside the clinical setting for diagnostic confirmation before starting tx
A 57-year-old maintenance worker comes to your office for evaluation of pain in his legs. He has
smoked two packs per day since the age of 16, but he is otherwise healthy. You are concerned
that he may have peripheral vascular disease. Which symptom is concerning? - correct answer
Intermittent claudication
Rationale: PAD is an atherosclerotic disease leading to obstruction of peripheral arteries causing
exertional claudication (muscle pain relieved by rest) and atypical leg pain. Untreated it may
progress to ischemic pain at rest. Chest pain and shortness of breath are generally not common
or concerning symptoms of PVD. JVP measurement of 7 cm is normal (6-8 cm).
A 78-year-old female client with a history of hypertension, coronary artery disease, and diabetes
presents to the emergency department with persistent right jaw pain. She states she went to
the dentist earlier, but the examination was normal. There is slight dyspnea when the client
walks to the wheelchair to go to the exam room. As the nurse practitioner (NP) assessing this
,client, what would be the appropriate intervention? - correct answer Evaluate heart rate and
rhythm on cardiac monitor
Rationale: Older adults and female clients do not present with typical chest pain symptoms. Jaw
pain can be the only indicator of an impending cardiac event. This client did have some
exertional dyspnea with mild activity, which can be another indicator of myocardial ischemia.
The appropriate action is to place the client on the cardiac monitor to check rate and rhythm as
well as ordering a 12 lead ECG. Placing the client in the non-emergent waiting area or ordering
an outpatient stress test is not helpful and can potentially delay treatment of acute coronary
syndrome. Cholesterol levels are not going to be helpful immediately.
Focused Assessment - correct answer -Addresses focused concerns or symptoms
-Used for established clients during routine or urgent care visits
-Health history and physical exams are focused on the problem
-Includes:
• brief history of the present illness
• only the system related to the problem in the review of systems
Comprehensive Assessment - correct answer -Used for new clients
-Provides personalized information about the client
-Strengthens the clinician-client relationship
-Provides a baseline for future assessments
-Provides an opportunity for health promotion education and counseling
-Includes:
• extended history of the present illness
• at least two areas of past medical history, family history, and social history
• at least 10 systems in the review of systems
,Subjective data - correct answer includes symptoms that the client describes such as a sore
throat, headache, or pain. It also includes the client's feelings, perceptions, and concerns
Information obtained from the client during any part of the health history
Examples of Subjective Data:
-Lower back pain
-Fatigue
-Stomach cramps
-Immunization history
Objective data - correct answer includes the physical examination findings or signs observed
All physical examinations, laboratory information, and test data
Examples of Objective Data:
-Heart rate
-Blood pressure
-Lung sounds
-Wound appearance
-Ambulation description
-Weight
Clinical Encounter Sequence (detailed) - correct answer Initiate Encounter
-Review the clinical record
-Ensure the client is comfortable
-Clarify the goals/agenda for the encounter; balance provider and client goals
-Establish rapport
-Identify the client's preferred title, name, and gender pronouns
-Use "people first" language (i.e., a person with hearing loss, a person who uses a wheelchair)
, Gather Information
-ID the client's chief complaint or reason for seeking care
-Invite the client's story using an open-ended approach
-Gather information about the client's perspective of the illness using the mnemonic FIFE
-Conduct the health history interview
-Gather information about past medical history, medications and allergies, family history,
personal and social history, and ROS
Perform the Physical Exam
-Conduct the exam based on the information obtained from the health history
-Maintain client's comfort and privacy throughout the exam
Explain and Plan
-Assess and respond to the client's needs for information
-Negotiate and make decisions together
-Utilize teach-back to ensure the client understands the plan
Close the Encounter
-Leave time for the client to ask questions
-Summarize the plans for future evaluation, treatments, and follow up
The general sequence of a clinical encounter is to: - correct answer -initiate the encounter
-gather information
-perform a physical exam
-develop a shared plan
Questions And Verified
Answers 100% Guranteed
Pass
amily history of heart disease
The United States Preventative Services Taskforce (USPSTF, 2021) hypertension screening
guidelines for adults: - correct answer -Adults 18 years or older without known hypertension
• office blood pressure measurement (OBPM)
• obtaining BP outside the clinical setting for diagnostic confirmation before starting tx
A 57-year-old maintenance worker comes to your office for evaluation of pain in his legs. He has
smoked two packs per day since the age of 16, but he is otherwise healthy. You are concerned
that he may have peripheral vascular disease. Which symptom is concerning? - correct answer
Intermittent claudication
Rationale: PAD is an atherosclerotic disease leading to obstruction of peripheral arteries causing
exertional claudication (muscle pain relieved by rest) and atypical leg pain. Untreated it may
progress to ischemic pain at rest. Chest pain and shortness of breath are generally not common
or concerning symptoms of PVD. JVP measurement of 7 cm is normal (6-8 cm).
A 78-year-old female client with a history of hypertension, coronary artery disease, and diabetes
presents to the emergency department with persistent right jaw pain. She states she went to
the dentist earlier, but the examination was normal. There is slight dyspnea when the client
walks to the wheelchair to go to the exam room. As the nurse practitioner (NP) assessing this
,client, what would be the appropriate intervention? - correct answer Evaluate heart rate and
rhythm on cardiac monitor
Rationale: Older adults and female clients do not present with typical chest pain symptoms. Jaw
pain can be the only indicator of an impending cardiac event. This client did have some
exertional dyspnea with mild activity, which can be another indicator of myocardial ischemia.
The appropriate action is to place the client on the cardiac monitor to check rate and rhythm as
well as ordering a 12 lead ECG. Placing the client in the non-emergent waiting area or ordering
an outpatient stress test is not helpful and can potentially delay treatment of acute coronary
syndrome. Cholesterol levels are not going to be helpful immediately.
Focused Assessment - correct answer -Addresses focused concerns or symptoms
-Used for established clients during routine or urgent care visits
-Health history and physical exams are focused on the problem
-Includes:
• brief history of the present illness
• only the system related to the problem in the review of systems
Comprehensive Assessment - correct answer -Used for new clients
-Provides personalized information about the client
-Strengthens the clinician-client relationship
-Provides a baseline for future assessments
-Provides an opportunity for health promotion education and counseling
-Includes:
• extended history of the present illness
• at least two areas of past medical history, family history, and social history
• at least 10 systems in the review of systems
,Subjective data - correct answer includes symptoms that the client describes such as a sore
throat, headache, or pain. It also includes the client's feelings, perceptions, and concerns
Information obtained from the client during any part of the health history
Examples of Subjective Data:
-Lower back pain
-Fatigue
-Stomach cramps
-Immunization history
Objective data - correct answer includes the physical examination findings or signs observed
All physical examinations, laboratory information, and test data
Examples of Objective Data:
-Heart rate
-Blood pressure
-Lung sounds
-Wound appearance
-Ambulation description
-Weight
Clinical Encounter Sequence (detailed) - correct answer Initiate Encounter
-Review the clinical record
-Ensure the client is comfortable
-Clarify the goals/agenda for the encounter; balance provider and client goals
-Establish rapport
-Identify the client's preferred title, name, and gender pronouns
-Use "people first" language (i.e., a person with hearing loss, a person who uses a wheelchair)
, Gather Information
-ID the client's chief complaint or reason for seeking care
-Invite the client's story using an open-ended approach
-Gather information about the client's perspective of the illness using the mnemonic FIFE
-Conduct the health history interview
-Gather information about past medical history, medications and allergies, family history,
personal and social history, and ROS
Perform the Physical Exam
-Conduct the exam based on the information obtained from the health history
-Maintain client's comfort and privacy throughout the exam
Explain and Plan
-Assess and respond to the client's needs for information
-Negotiate and make decisions together
-Utilize teach-back to ensure the client understands the plan
Close the Encounter
-Leave time for the client to ask questions
-Summarize the plans for future evaluation, treatments, and follow up
The general sequence of a clinical encounter is to: - correct answer -initiate the encounter
-gather information
-perform a physical exam
-develop a shared plan
