EVC Competency-Based Assessment Exam 2026/2027 | Challenge Test | Latest Questions with Verified Answers | Grade A

EVC Competency-Based Assessment Exam 2026/2027 | Challenge Test | Latest Questions with Verified Answers | Grade A Q: Describe the conceptual framework of the EVC nursing curriculum? Answer The conceptual framework of the EVC nursing curriculum is an adaptation of the "Client Needs Model", a comprehensive framework for identifying nursing actions and competencies necessary for client care in a variety of settings an throughout the life span. Q: Framework includes 5 key concepts? Answer safe and effective care environment health promotion and maintenance physiological integrity Psychosocial integrity professional role of the nurse. Q: What ties the key concepts to the program? Answer Critical thinking, nursing process, cultural sensitivity, and caring are the processes that integrate the key concepts throughout the curriculum. Q: What are the nursing policies and procedures outlined in the nursing student handbook? Answer They are based on state regulations (Board of Registered Nursing), EVCSJCCD policies, ANA, and health care regulations. Joint commission on accreditation of hospitals and healthcare organizations (JCAHO). Q: Discuss the roles of the Associate Degree Graduate RN including Answer HIPAA/confidentiality and reporting abuse. The roles of the Associate Degree Graduate RN are autonomy/accountability, caregiver, advocate, educator, communicator, and manager. Coordinates with other members of the health care team in the management of care for clients, can administer oral medications, injections, and peripheral intravenous medications, considered a supervisor. Q: HIPAA Answer HIPPA confidentiality states that any patients protected health information can only be shared with those assisting in care for the patient and any personal information should be protected and not be in public view. Patient's status can only be discussed upon permission of the patient. Clients have the right to have their medical records amended. Restrictions on the use of protected health information. Certain family members may not be told rethe diagnosis. May be provided with a list of individuals or companies that received this info. Any violation of HIPAA should be reported to the correct personnel and action steps are to be taken. Q: Analyze the concepts of physical safety within the health care setting. Answer security, transmission of pathogens, and physical hazards in the health care setting. Students will demonstrate patterns of professional behaviors which follow the legal and ethical codes of nursing; promote the actual or potential well-being of clients, health care workers, and self in the biological, psychological, sociological, and cultural realms; demonstrate accountability in preparation, documentation, and continuity of care; and show respect for the human rights of individuals. Q: What are the physiological implications of vital signs? Answer Reflect an individuals health status. Regulated by homeostatic mechanisms. Vital sign readings may indicate the need for intervention. Changes may indicate an alteration in health status, vital signs are not interpreted in isolation but analyzed in relationship to client's condition and present status. Q: Discuss the appropriate nursing care for alterations in vital signs. Answer The appropriate nursing care would be identify and note specific alteration in vital signs. Determine which action steps to take whether to reduce patient's temperature, address patient's diet regarding high blood pressure. reflect an individual's health status, Regulated via homeostatic mechanisms.Vital sign readings may indicate the need for medication. Changes may indicate an alternation in health status. Vital signs are not interpreted in isolation but analyzed in relationship to the client's condition and present status Nursing Process: Assessment, Diagnosis, Planning, Intervention, Evaluation. Q: Discuss the evaluation of pulse sites Answer Amplitude: volume of blood ejected against arterial wall • Equality and strength • Apical • Assess and compare all pulse sites • Compare right & left simultaneously • Except carotid • Palpate for strength and equality • 4+ -bounding • 3+ -full strength • 2+ - normal, expected • 1+ - diminished, barely palpable • 0- absent Q: Assessing pulse deficit between Answer Pulse deficit: btwn. 30-50 normal o Difference btwn the radial & apical pulse when they are taken simultaneously By 2 DIFF. people Q: ANALYZE CLINICAL IMPLICATIONS OF STRESS. Answer Client's emotional status can affect their vital signs - Important to appear calm when approaching client - Vital signs may need to be reassessed when client is more relaxed for increased accuracy - Pituitary gland - release cortisol- high blood pressure Q: what is stress? Answer o Fight-or-flight response o Neuro-physiological responses: Medulla oblongata Reticular formation Pituitary gland o Increased mental activity o Dilated pupils o Bronchial dilation, increased respiratory rate o Increased 3 rate, o Increased cardiac output o Increased glucose o Increased fatty acids o Increased arterial b/p o Increased blood flow to skeletal muscles types of stress Answer Chronic: Occurs in stable conditions & results from stressful roles Acute: Time-limited events that threaten a person for a relatively brief period Post traumatic stress disorder: An acute stress disorder that begins when person experiences, witnesses, or is confronted May include flashbacks = recurrent & intrusive recollections of event Developmental: Developmental crises occur as a person moves through the stages of life Situational: External sources such as job change, motor vehicle crash, death, severe illness provoke Adventitious: Major natural or man-made disaster or a crime of violence/ traumatic event, situational crises Identify the purpose of a physical assessment: Answer Gathering a health history requires that you communicate with the patient. Physical assessment findings determine the individualized plan of care. While managing patient problems, you will use physical assessment skills to assess the status of your patient's health. Nurses can revise the care plan to ensure that the patient's problems are addressed. During the evaluation phase, nurses can revise, amend, or discontinue nursing interventions as patients achieve their outcomes and/or goals. Gather baseline data about patient's health. Identify health issues, Make clinical decisions about a patient's changing health status and management. Evaluate the outcomes of care. Differentiate the components of the head to toe assessment: The four techniques used in a physical examination are inspection, palpation, percussion, and auscultation. Describe the appropriate use and techniques of inspection Inspection: systematic observation of entire body, as well as each body system. Using visual, auditory, olfactory information to describe. Examines, color, shape, symmetry, and position of body parts. All body parts compared bilaterally. Needs good lighting, also environment conducive to proper examination. Palpation Palpation: is a technique of using touch to gather info about temperature, turgor, texture, moisture, size and shape and consistency, location, and tenderness of organ or body part. Palpation can be light, ½ inch- or deep 1 inch. Patient should be provided with privacy and should have warm hands and short nails.. any areas of tenderness should be palpated last. During palpation assess, consistency of tissue, alignment and intactness of structures, symmetry of body parts and movements, and transmission of fine vibrations. percussion Precussion: involves striking one object with another to create sound as a means of assessing the location, size and density of underlying tissue. Auscultation Auscultation: involves listening to sounds produced by the body using a stethoscope. Auscultation is performed for the purpose of examining the circulatory system, respiratory system and GI system. Sounds must be isolated for proper identification and evaluation. Stethoscope has diaphragm for high pitch sounds and a bell for low pitched sounds. For sounds that should be noted: pitch, loudness, quality, duration Describe the process of a head to toe assessment general- appearance, behavior, posture, gait, hygiene, speech, mental status, height and weight, hearing, visual acuity, vital signs, and nutrition. Head and neck assess skull size, shape, symmetry, as well as hair and scalp. Palpate for masses on scalp, ears, face, throat, and neck. (make sure to be aware of cultural sensitivities) Palpate sinuses for tenderness and masses EYES Inspect eyes: sclera and conjunctiva. Assess pupil responses by using PERRLApuplis equal, round, reactive to light, and accommodation Assess convergence eyes shift from far object to near object, pupils constrict. Corneal light reflex. When examining the eyes, you will assess size, shape, structure, visual acuity, visual fields, conjunctiva, sclera, cornea, pupil, and iris. •Nystagmus, an involuntary, rhythmical oscillation of the eyes, occurs as a result of local injury to eye muscles and supporting structures, or may follow a disorder of the cranial nerves innervating the muscles. •The presence of redness in the conjunctiva indicates an allergic or infectious conjunctivitis. •A thin white ring along the margin of the iris, called an arcus senilis, is common with aging but is abnormal in anyone younger than age 40. •The photo at the bottom shows the six directions of gaze. Direct patient to follow finger movement through each gaze. mouth, nose Inspect mouth and teeth. Test rise in uvula and gag reflex. Assess sense of smell and taste. Ears When examining the eyes, you will assess size, shape, structure, visual acuity, visual fields, conjunctiva, sclera, cornea, pupil, and iris. •Nystagmus, an involuntary, rhythmical oscillation of the eyes, occurs as a result of local injury to eye muscles and supporting structures, or may follow a disorder of the cranial nerves innervating the muscles. •The presence of redness in the conjunctiva indicates an allergic or infectious conjunctivitis. •A thin white ring along the margin of the iris, called an arcus senilis, is common with aging but is abnormal in anyone younger than age 40. •The photo at the bottom shows the six directions of gaze. Direct patient to follow finger movement through each gaze. Upper extremeties Inspect skin, test capillary refill, palpate peripheral pulses, rate muscle strength, assess ROM, and check deep tendon reflexes Integumentary The integumentary system refers to the skin, hair, scalp, and nails. Observe for cyanosis (bluish discoloration) of the lips, nail beds, palpebral conjunctivae, and palms. The best site to inspect for jaundice (yellow-orange discoloration) is the patient's sclera. You can see normal reactive hyperemia, or redness, most often in regions exposed to pressure such as the sacrum, heels, and greater trochanter. Inspect for any patches or areas of skin color variation. Localized skin changes such as pallor or erythema (red discoloration) indicate circulatory changes. For example, an area of erythema is caused by localized vasodilation resulting from sunburn, inflammation, or fever. Texture refers to the character of the surface of the skin and how the deeper layers feel. By palpating lightly with the fingertips, you determine whether the patient's skin is smooth or rough, thin or thick, tight or supple, and indurated (hardened) or soft. Edema Inspect edematous areas for location, color, and shape. The formation of edema separates the surface of the skin from pigmented and vascular layers, masking skin color. Edematous skin also appears stretched and shiny. Palpate edematous areas to determine mobility, consistency, and tenderness. When pressure from the examiner's fingers leaves an indentation in the edematous area, this is called pitting edema. To assess the degree of pitting edema (shown), press the edematous area firmly with the thumb for several seconds, and release. The depth of pitting, recorded in millimeters, determines the degree of edema. For example, 1+ edema equals a 2-mm depth, 2+ edema equals a 4-mm depth, 3+ equals 6 mm, and 4+ equals 8 mm. ABCD Asymmetry—look for an uneven shape Border irregularity—look for edges that are blurred, notched, or ragged Color—look for pigmentation that is not uniform; variegated areas of blue, black, and brown and areas of pink, white, gray, blue, or red are abnormal Diameter—look for areas greater than the size of a typical pencil eraser HEART Auscultation of the heart detects normal heart sounds, extra heart sounds, and murmurs. •Failure of the heart to beat at regular successive intervals is a dysrhythmia. Some dysrhythmias are life threatening. •Assess for extra heart sounds at each auscultatory site. Use the bell of the stethoscope and listen for low-pitched extra heart sounds such as S3 and S4 gallops, clicks, and rubs. Auscultate over all anatomical areas. S3, or a ventricular gallop, occurs after S2. •S4, or an atrial gallop, occurs just before S1, or ventricular systole. •The final portion of the examination includes assessment for heart murmurs. Murmurs are sustained swishing or blowing sounds heard at the beginning, middle, or end of the systolic or diastolic phase. Intensity is recorded using grades 1 through 6. Murmurs can vary in pitch and quality Posterior thorax Inspect spine for alignment, assess anteroposterior to lateral diameter: chest diameter. Assess thoracic expansion. Assess for tactile fremitus- Fremitus refers to vibratory tremors that can be felt through the chest by palpation. To assess for tactile fremitus, ask the patient to say "99" or "blue moon". While the patient is speaking, palpate the chest from one side to the other. Auscultate breath sounds, heart sounds and inspect jugular veins, and perform breast exam. LUNGS: •Reduced mental alertness, nasal flaring, somnolence, and cyanosis are examples of assessed signs that indicate oxygenation problems. •Inspect the posterior thorax by observing the shape and symmetry of the chest from the patient's back. •Auscultation assesses movement of air through the tracheobronchial tree and detects mucus or obstructed airways. Normally, air flows through the airways in an unobstructed pattern. Recognizing the sounds created by normal airflow allows you to detect sounds caused by airway obstruction. When listening, follow the same systematic approach that was used for palpation. •Abnormal sounds result from air passing through moisture, mucus, or narrowed airways. They also result from alveoli suddenly reinflating or an inflammation between the pleural linings of the lung. Adventitious sounds often occur superimposed over normal sounds. •Crackles are caused by random, sudden reinflation of groups of alveoli, or disruptive passage of air through small airways, and can be described as fine, medium, or coarse. •Rhonchi are low-pitched, continuous sounds caused by muscular spasm, fluid, or mucus in larger airways; or new growth or external pressure causing turbulence. •Wheezes are high-pitched continuous musical sounds, like a squeak heard continuously during inspiration or expiration. They usually are louder on expiration and often are heard in asthma. •A pleural friction rub has a dry, rubbing or grating quality and is caused by inflamed pleura: parietal pleura rubbing against visceral pleura. •During auscultation, note the location and characteristics of the sounds, and listen for the absence of breath sounds. •Assess the rate and rhythm of breathing (see Chapter 29). •Palpation of the posterior thorax provides further information about a patient's health status. A, Hand position for palpation of posterior thorax excursion. B, As patient inhales, movement of chest excursion separates thumbs.] Excursion indicates if the lungs are expanding equally bilaterally. EXCURSION- not done very often. Abdomen Auscultate for bowel sounds, percuss for masses, and tenderness. Percuss the liver, and palpate kidneys and spleen. Lower extremities inspect skin, palpate peripheral pulses, Asses for homans signdeep vein thrombosis, inspect and palpate joints for swelling, assess for pedal and ankle edema, assess ROM. Differentiate between objective and subjective data objective is something you can observe and measure. Subjective is how the patient feels, what they tell you. Analyze the significance of physical assessment in the nursing process Significance, finds a baseline through assessment, through assessment find diagnosis and then plan and implement interventions and evaluate outcomes of intervention. If outcomes are not met, reassess and start over. Physical assessment finding determine the individualized plan of care. Use physical assessment skills to assess status of your patient and your patients health. Nurses can revise the care plan to ensure the patients problems are addressed. STEPS OF NURSING PROCESS 1. Assessment 2. Diagnosis 3. Planning 4. Implementation 5. Evaluation Identify principles of therapeutic communication Is used to provide care and demonstrate caring, establish relationships, obtain and deliver info effectively, as well assisting with changing behavior. It is the foundation to nurse client relationships. Effective communication is key to ensuring client safety. Identify barriers to effective communication: PAGE 312 ATI The Barriers to effective communication are 1) asking irrelevant personal questions. 2) Offering personal opinions 3) giving advice 4) giving false reassurance 5) minimizing feelings 6) changing the topic 7) asking why questions or asking for explanations 8) offering value judgments. 9) Excessive questioning 10) responding approvingly or disapprovingly. 11) Language Compare and contrast the phases of the Nurse-Client relationship. helping patient, prep, time to plan, history and background. orientation phase: introduce self, expectations, face to face, meeting, make goals, get to know each other. working phase: major portion, vitals signs, therapies, used to accomplish goals, get feedback from patient, when they work together to solve problems. Termination phase: last, discharge, ask them for questions, get summary and end relationship, recommendations.. evaluate care, and continuation of meds etc. page: 24-4 pre interaction phase helping patient, prep, time to plan, history and background. orientation phase introduce self, expectations, face to face, meeting, make goals, get to know each other. working phase major portion, vitals signs, therapies, used to accomplish goals, get feedback from patient, when they work together to solve problems. Termination phase last, discharge, ask them for questions, get summary and end relationship, recommendations.. evaluate care, and continuation of meds etc. page: 24-4 Discuss the role that caring plays in building a nurse client relationship: Swansons 5 key component of what a nurse brings to a patient experience. 1) Knowing 2) being with 3) doing for 4) enabling 5) maintain belief. building relationship: client :nurse When you engage patients in a caring and compassionate manor you learn that the therapeutic game in caring makes enormous contributions to the health and wellbeing of your patients. Through caring, give meaning to illness and help them through it, and collect data from that relationship. Recognize the significance of interviewing in the data collection process. goals and outcomes: specific and measurable. Setting priorities, team work and collaboration. Page 310 ati- determing communication needs. For example, hearing impaired, visual, language. Consider developmental level, children, older people. Enhance communication, by getting on patients level, add playing for children. Recognize if elders need hearing aides, give time.. be slower. Identify any cultural aspects that can alter communication. Define collaboration of the nurse with selected health care team members: the way they communicate and collaborate. Using speech therapists, interpreters, mental health nurse specialist, social worker Illustrate the Registered Nurse's accountability to collaboration Chain of command elements of communication voice tone 38%, physiology 55%, words 7% SBAR Situation, background, assessment and recommendation Hypothalamus located between cerebral hemispheres- controls body temp, senses minor changes in body temp. Anterior hypothalamus controls heat loss. vasodialation occurs when AH becomes overheated, it sends out impulses to reduce body temp. sweating, blood vessels to surface. posterior hypothalamus controls heat production. Vasoconstriction occurs when PH senses low body temp. Vasoconstriction occurs to keep core warm, through shivering. Normal pulse for adult 60-100 BPM Bradycardia 60 tachycardia 100 pyrexia fever, alteration in hypothalamus set point caused by pyrogens. febrile fever greater then 99.5f hyperpyrexia temp over 105.8f hyperthermia disease or trauma induced, anesthesia malignant. hypothermia mild 93.2-96.8f moderate- 86.0-93.2 severe- 86f parasympathetic NS decrease HR beta blockers LOwer HR cardiac output low increased blood pressure cardiac output high decreased blood pressure hypertension 120-139/80-89 IPPA inspection,palpation,percussion, auscultation cachexia very thin, malnutrition occular nerves 3,4,6 bruit swooshing sound in lungs ADPIE (AA) Analyzing, assessment, diagnosis, planning, intervention, evaluation listen to lung sounds 13 spots C,W,M,S color, warmth, movement, sensation- in regard to peripheral arteries borborygmi sounds hunger sounds- bowel sounds Metacommunication Broad term refers to all factors that contribute and influence to communication therapeutic communication are specific responses that encourage the expression of feelings and ideas and convey acceptance and respect. evaluation involves gathering info about client to determine whether client outcomes have been met. implementation organizing resources planning establishing client centered outcomes and establishing priorities of care medicaid Medicaid is for US citizens who are low income and cannot afford health care insurance medicare Medicare is a federal agency that provides health insurance for people over 65, some disabled younger adults and people who need dialysis. Covers hospitals, doctors, prescriptions and some extended benefits. joint commision Joint Commission is an independent not for profit agency that evaluates hospitals and resources to ensure safe practices and standards are upheld. If an organization fails a Joint Commission inspection, their funding may be in jeopardy from DHHS. DHHS DHHS regulates the centers for Medicare and Medicaid and also regulates CDC, NIH, Indian Act, FDA, Family and Children's, Substance Abuse and Mental Health and others.(work together) with joint commission. government programs Workers Comp is for workers injured on the job and provides insurance for those workers. Every legal worker in California is covered if injured at work. OSHA regulates work environments to provide safety for workers. Mental hospitals are often attached to larger hospitals and provide both acute and longterm care. PHS is a broad service that promotes health and protects the general program through various community programs and agencies. ANA American Nurses Association: Scope of practice issues Standards of practice Ethics and legal issues National Council of State Boards of Nursing Organization of all state boards Evergreen Valley Nursing Programs Definition of Nursing "The protection, promotion, and optimization of health and abilities, prevention of illness and injury, alleviation of suffering through the diagnosis and treatment of human response, and advocacy in the care of individuals, families, communities, and populations. (American Nurses Association, 2003)." RN Coordinates with other members of the health care team in the management of care for clients(individuals, families, communities) Can administer oral medications, injections, and peripheral intravenous medications Considered a supervisor - directs activities and is accountable for actions of C.N.A.s L.V.N.s, UAP, etc. Can not prescribe treatments or medications unless in advanced practice Client needs model Safe and effective care Health promotion and Maintenance Psychosocial integrity Physiological Integrity Professional Role of the Nurse client needs model focus: Critical thinking Nursing process Cultural sensitivity Caring Safety Safety is defined as "freedom from psychological and physiological injury" and it is considered a basic human need. factors affecting safety Environment Self Client Prevention as nurses Nursing responsibility : Client's environment Assessment Health care environment Assessment Risk for injury Transmission of Pathogen Reduction Client's Assessment Client's History Following Care Plans Knowledge and Skills dyspnea shortness of breath diaphoresis fever- sweating