ANCC PMHNP EXAM PREP CHPT 6 Advanced
Health and Physical Assessment (Physical,
Neurological, Laboratory, Immunizations)-Q&A
Save
Terms in this set (75)
To be able to detect underlying medical problems
To be familiar with a screening neurological exam and
PHYSICAL EXAM to be able to rule out neurological problems that may
Reasons to be familiar manifest as symptoms of a psychiatric problem
with the physical exam in
psychiatry: To be able to differentiate normal and abnormal signs
and symptoms
To know when to refer
Grade reflexes and note symmetry between right and
left sides.
NEUROLOGICAL EXAM
Reflexes (biceps, triceps, Check primitive reflexes in infants (head lag, flexion,
brachioradialis, patellar, rooting, grasping, Moro, glabellar, Babinski).
Achilles, plantar)
A positive Babinski (fanning of toes and dorsiflexion of
the great toe) is normal ininfants up to age 2 years.
, Olfactory: 1st (On)
* Test sense of smell and ensure patency of the nasal
passages.
* Have the client close eyes and test each nostril
separately while other is occluded, asking the client to
identify familiar odors.
Optic: 2nd (Old)
* Test vision using Snellen chart or other suitable chart
depending on the client's acuity and ability to
cooperate.
* Examine the inner aspect of the eyes with the
ophthalmoscope.
* Test peripheral vision using the confrontation test.
Oculomotor: 3rd (Olympus')
* This is the motor nerve to the five extrinsic eye
muscles. Test together with cranial nerve 4 (trochlear)
and cranial nerve 6 (abducens; see below).
* Test the extraocular movements (EOMs).
* Check the equality of pupils, their reaction to light,
and their ability to accommodate.
* Test the corneal light reflex (when shining a light at
the bridge of the nose, the light should appear
NEUROLOGICAL EXAM symmetrically in both eyes).
Cranial nerves (mnemonic
italicized in parentheses) Trochlear: 4th (Towering)
(On Old Olympus * Use the same process as cranial nerve 3
Towering Top, A Finn And (oculomotor) and cranial nerve 6 (abducens).
German Viewed Some
Hops) Trigeminal: 5th (Motor division; Top)
* Palpate the masseter muscles with the fingertips
while the client clenches his or her teeth.
* Look for disparity in tension between the two
muscles, which can indicate paralysis on the weak
side.
* Look for tremor of the lips, involuntary chewing
,movements, and spasm of the masticatory muscles.
Trigeminal: 5th (Sensory division)
* Test tactile perception of the facial skin by touching
with a wisp of cotton.
* Test corneal reflex with wisp of cotton.
* Test superficial pain of the skin and mucosa with
pinpricks.
* Test the sense of touch in the oral mucosa.
Abducens: 6th (A)
* Use the same process as for cranial nerves 3
(oculomotor) and 4 (trochlear).
Facial: 7th (Motor division; Finn)
* Inspect the face in repose for evidence of flaccid
paralysis.
* Test by askin
, * Equilibrium: Check by administering the Romberg
test: have the client stand up straight with feet
together, arms by sides, and eyes closed. Only slight
swaying would be normal, and the client will be able
to sustain this pose for approximately 5 seconds.
More than slight swaying suggests cerebellar ataxia or
vestibular dysfunction.
NEUROLOGICAL EXAM * Diadochokinesia: Ability to perform rapid alternating
Coordination and fine- movements (such as patting knees alternating palm
motor skills and back of hands, touching thumb to each finger);
the client should be able to smoothly execute these
movements and maintain the rhythm.
*Dyssynergia: Finger-to-nose test, heel-to-knee test
* Handwriting
* Gait: Observe client walking.
Health and Physical Assessment (Physical,
Neurological, Laboratory, Immunizations)-Q&A
Save
Terms in this set (75)
To be able to detect underlying medical problems
To be familiar with a screening neurological exam and
PHYSICAL EXAM to be able to rule out neurological problems that may
Reasons to be familiar manifest as symptoms of a psychiatric problem
with the physical exam in
psychiatry: To be able to differentiate normal and abnormal signs
and symptoms
To know when to refer
Grade reflexes and note symmetry between right and
left sides.
NEUROLOGICAL EXAM
Reflexes (biceps, triceps, Check primitive reflexes in infants (head lag, flexion,
brachioradialis, patellar, rooting, grasping, Moro, glabellar, Babinski).
Achilles, plantar)
A positive Babinski (fanning of toes and dorsiflexion of
the great toe) is normal ininfants up to age 2 years.
, Olfactory: 1st (On)
* Test sense of smell and ensure patency of the nasal
passages.
* Have the client close eyes and test each nostril
separately while other is occluded, asking the client to
identify familiar odors.
Optic: 2nd (Old)
* Test vision using Snellen chart or other suitable chart
depending on the client's acuity and ability to
cooperate.
* Examine the inner aspect of the eyes with the
ophthalmoscope.
* Test peripheral vision using the confrontation test.
Oculomotor: 3rd (Olympus')
* This is the motor nerve to the five extrinsic eye
muscles. Test together with cranial nerve 4 (trochlear)
and cranial nerve 6 (abducens; see below).
* Test the extraocular movements (EOMs).
* Check the equality of pupils, their reaction to light,
and their ability to accommodate.
* Test the corneal light reflex (when shining a light at
the bridge of the nose, the light should appear
NEUROLOGICAL EXAM symmetrically in both eyes).
Cranial nerves (mnemonic
italicized in parentheses) Trochlear: 4th (Towering)
(On Old Olympus * Use the same process as cranial nerve 3
Towering Top, A Finn And (oculomotor) and cranial nerve 6 (abducens).
German Viewed Some
Hops) Trigeminal: 5th (Motor division; Top)
* Palpate the masseter muscles with the fingertips
while the client clenches his or her teeth.
* Look for disparity in tension between the two
muscles, which can indicate paralysis on the weak
side.
* Look for tremor of the lips, involuntary chewing
,movements, and spasm of the masticatory muscles.
Trigeminal: 5th (Sensory division)
* Test tactile perception of the facial skin by touching
with a wisp of cotton.
* Test corneal reflex with wisp of cotton.
* Test superficial pain of the skin and mucosa with
pinpricks.
* Test the sense of touch in the oral mucosa.
Abducens: 6th (A)
* Use the same process as for cranial nerves 3
(oculomotor) and 4 (trochlear).
Facial: 7th (Motor division; Finn)
* Inspect the face in repose for evidence of flaccid
paralysis.
* Test by askin
, * Equilibrium: Check by administering the Romberg
test: have the client stand up straight with feet
together, arms by sides, and eyes closed. Only slight
swaying would be normal, and the client will be able
to sustain this pose for approximately 5 seconds.
More than slight swaying suggests cerebellar ataxia or
vestibular dysfunction.
NEUROLOGICAL EXAM * Diadochokinesia: Ability to perform rapid alternating
Coordination and fine- movements (such as patting knees alternating palm
motor skills and back of hands, touching thumb to each finger);
the client should be able to smoothly execute these
movements and maintain the rhythm.
*Dyssynergia: Finger-to-nose test, heel-to-knee test
* Handwriting
* Gait: Observe client walking.
