NURS6521N–ADVANCEDNURSI
NGFi
nalExam
St
udyGui
de
Hi
st
oryt
aki
ng/
symp
toma
nal
ysi
s–c
omp
one
ntsofah
eal
thh
ist
ory(
wha
tisi
nea
ch
c
omp
one
nt,
fore
x.Pa
stme
dic
alh
ist
ory
);s
ubj
ect
iv
evsob
jec
ti
ved
ata
;ex
amp
lesofop
en
a
ndc
los
ede
nde
dqu
est
ion
s;h
ist
oryf
ir
st;
sig
nsv
ssy
mpt
oms
;he
alt
hpr
omot
ionl
eve
ls
Th
era
peu
ticc
ommu
nic
ati
on:
exa
mpl
esofe
ffe
cti
vea
ndi
nef
fec
ti
ve
(
bar
ri
ers
)te
chn
iqu
ese
.g.
cla
rif
ica
tion
,se
que
nci
ng,
ref
lec
ti
on,
b
lami
ng,
etc
.;qu
est
ion
s;p
rep
ari
ngf
ori
nte
rvi
ews
Cu
ltur
alass
essment
:cul
tur
all
yc ompet
entcar
e;r
eli
gi
onvsspi
ri
tua
li
ty
;
Nur
singpr
ocesss
teps
Gen
eralsu
rvey–whati
sincl
u d
ed ?
Vi
tal
sign
s:BP–p r
opermethod,fi
ndi
ngsifn
otdonepr
oper
ly
;
n
orma
lra
nge
s-a
dul
ts
;te
rmi
nol
ogyu
sed
,e.
g.b
rad
yca
rdi
a,
t
ach
ypn
ea,
etc
.
Pa
inasse
s s
mentt
ech
nique
s;4c
las
sic
altec
hn i
que
sofas
ses
sme
nt
Nut
ri
ti
on:Di
eta
rya
ssess
me n
tmet
hodsfa
stestvsmos
t
c
omp
reh
ens
ivev
sfr
equ
enc
y;a
bnor
mal
eat
ingp
att
ern
s,f
or
e
xamp
le,
anor
exi
a.
Sk
in:
mea
sur
eme
nt;
sta
gin
gofd
ecu
bit
usu
lce
rs,
pri
mar
ysk
inl
esi
onsl
i
ke
n
odu
les
,pu
stu
les
,et
c.;
commons
kinl
esi
ons
,fore
x.Ps
ori
asi
s,c
ont
act
d
erma
tit
is
;si
gnsofma
li
gna
nts
kinl
esi
ons
;col
ord
iff
ere
nce
sse
eni
n
d
arks
kin
nedi
ndi
vi
dua
ls;
les
ionc
onf
igu
rat
ion
s,l
i
kea
nnu
lar
,pe
tec
hia
e,
l
i
nea
r,e
tc.
;
HE
ENT:
eyee
xami
nat
iont
ech
niqu
es;
PERRL
A;h
ear
ingt
est
s;l
ymp
hnod
es;
prob
lemss
een
i
nhe
ad,
ear
s,e
yes
,nos
e,a
ndt
hroa
t,e
x.c
ata
rac
ts,
ton
sil
l
it
is
,gl
auc
oma
Th
ora
x/Re
spi
rat
orya
sse
ssme
nt–a
usc
ult
ati
on,
pal
pat
ion
;nor
mal
s
oun
dsa
ndl
oca
tion
s;a
bnor
mal
sou
nds&wh
eny
oumi
ghth
ear
, t
hem;
prop
erme
thodo
fau
scu
lta
tion
;me
thod
s-e
.g.
voi
ces
oun
ds
s
ucha
seg
oph
ony
,th
ora
cice
xpa
nsi
on,
etc
.;c
hes
tsh
ape
s;
r
esp
ira
tor
yvoc
abu
lar
y
He
art
:ca
rdi
acc
ycl
e;a
usc
ult
ati
ons
it
es;
wha
tca
use
sth
ehe
art
s
oun
ds;
useofa
pic
alp
uls
e;b
rui
tvsmu
rmu
r
Br
easts
:Ri
skf
act
orsf
orcanc
er
Abdomen–met
hodsandor
derofa
sse
ssme
nt,
ana
tomy
,ex
pec
ted
f
ind
ing
s;c
olonc
anc
err
is
kfa
ctor
s
GU:t
est
icu
larc
ance
r;ass
ess
ing
Pul
ses-
wherear
ethey
,howdoyoud
ocu
men
tin
for
mat
iona
bou
tth
em,
i
ncl
udi
ngr
ate
,amp
li
tud
e,r
hyt
hm;
per
iph
era
lva
scu
lara
sse
ssme
nt,
e
dema–a
ppe
ara
nce
,sc
ale
;ar
ter
ial
vsv
enou
sin
suf
fi
ci
enc
y
Mu
scu
los
kel
et
al–r
ang
eofmot
iont
ech
niqu
es;
poi
ntsf
orc
omp
ari
son
;
os
teop
oros
isr
is
kfa
ctor
s;s
pin
ala
sse
ssme
ntf
ind
ing
s;t
est
ingv
ari
ousj
oi
nts
i
ncl
udi
ngj
aw;
typ
esoff
rac
tur
es;
ost
eoa
rth
rit
isr
is
kfa
ctor
s;p
rob
lemss
uch
a
srh
euma
toi
dar
thr
it
is
,gou
t,e
tc.
;mov
eme
ntsl
i
kea
bdu
cti
on/
add
uct
ion
,
f
lex
ion
/ex
ten
sion
,Ne
uro–Gl
asg
owc
omas
cal
e;r
efl
exe
s;c
ran
ial
ner
ves–h
owd
oyo
u
t
este
achon
e;t
est
ingf
orc
ere
bel
l
arf
unc
ti
on;
tes
tss
ucha
s
g
rap
hes
the
sia
,pos
it
ions
ens
e,s
ter
eog
nos
is,
etc
.,p
artoft
heb
rai
n
b
ein
gte
ste
d?h
ead
ach
ety
pes
;
Ge
ria
tri
cs:
fun
cti
ona
las
ses
sme
nt-
wha
tisi
t,
wha
tisb
ein
gte
ste
d,b
est
a
ppr
oac
htot
est
ing
;ca
reg
ive
rcon
cer
ns/
bur
nou
t;I
ADL
s,ADL
s;
d
isa
bil
i
tyc
onc
ern
s;e
xpe
cte
dch
ang
esi
nth
eel
der
ly
;fa
llr
is
k
f
act
ors
Pe
dia
tri
cs–b
estme
thod
sfora
sse
ssi
ng;
pai
nas
ses
sme
nt
, St
epsoft
hen
urs
ingp
roc
ess
:
As
ses
sme
nt
Di
agn
osi
s
Ou
tcome
i
den
tif
ica
tion
Pl
ann
ing
I
mpl
eme
nta
ti
onEv
alu
ati
on
Nu
rsi
ngp
roc
ess–As
ses
sme
nt:
Col
l
ect
ingofd
ataf
rom
mu
lti
pl
esou
rce
sre
vie
wof
c
li
ni
cal
rec
ord
h
eal
thh
ist
ory
p
hys
ica
lex
ami
nat
ion
f
unc
ti
ona
las
ses
sme
nt
c
ult
ura
lan
dsp
iri
tua
las
ses
sme
nt
As
ses
sme
nt–t
hes
tar
ti
ngp
oin
t:
s
ub j
ect
ivedat
a–wh a
tpati
ents
aysabou
tthemsel
vesdur
ingh
ist
ory
t
aking.
Obje
ctiv
edata–obse
rvedwheni
nspe
cti
ng,p
ercuss
ing
,
p
alp
ati
ng,
anda
usc
ult
ati
ngp
ati
entd
uri
ngp
hys
ica
lex
ami
nat
ion
.
Nu
rsi
ngp
roc
ess
-di
agn
osi
s:
Cl
ust
erd
atat
hats
eemt
obea
ssoc
iat
ed
i
nsomewa
yVa
li
dat
eda
ta,
con
fir
m
a
ccu
rac
y
NGFi
nalExam
St
udyGui
de
Hi
st
oryt
aki
ng/
symp
toma
nal
ysi
s–c
omp
one
ntsofah
eal
thh
ist
ory(
wha
tisi
nea
ch
c
omp
one
nt,
fore
x.Pa
stme
dic
alh
ist
ory
);s
ubj
ect
iv
evsob
jec
ti
ved
ata
;ex
amp
lesofop
en
a
ndc
los
ede
nde
dqu
est
ion
s;h
ist
oryf
ir
st;
sig
nsv
ssy
mpt
oms
;he
alt
hpr
omot
ionl
eve
ls
Th
era
peu
ticc
ommu
nic
ati
on:
exa
mpl
esofe
ffe
cti
vea
ndi
nef
fec
ti
ve
(
bar
ri
ers
)te
chn
iqu
ese
.g.
cla
rif
ica
tion
,se
que
nci
ng,
ref
lec
ti
on,
b
lami
ng,
etc
.;qu
est
ion
s;p
rep
ari
ngf
ori
nte
rvi
ews
Cu
ltur
alass
essment
:cul
tur
all
yc ompet
entcar
e;r
eli
gi
onvsspi
ri
tua
li
ty
;
Nur
singpr
ocesss
teps
Gen
eralsu
rvey–whati
sincl
u d
ed ?
Vi
tal
sign
s:BP–p r
opermethod,fi
ndi
ngsifn
otdonepr
oper
ly
;
n
orma
lra
nge
s-a
dul
ts
;te
rmi
nol
ogyu
sed
,e.
g.b
rad
yca
rdi
a,
t
ach
ypn
ea,
etc
.
Pa
inasse
s s
mentt
ech
nique
s;4c
las
sic
altec
hn i
que
sofas
ses
sme
nt
Nut
ri
ti
on:Di
eta
rya
ssess
me n
tmet
hodsfa
stestvsmos
t
c
omp
reh
ens
ivev
sfr
equ
enc
y;a
bnor
mal
eat
ingp
att
ern
s,f
or
e
xamp
le,
anor
exi
a.
Sk
in:
mea
sur
eme
nt;
sta
gin
gofd
ecu
bit
usu
lce
rs,
pri
mar
ysk
inl
esi
onsl
i
ke
n
odu
les
,pu
stu
les
,et
c.;
commons
kinl
esi
ons
,fore
x.Ps
ori
asi
s,c
ont
act
d
erma
tit
is
;si
gnsofma
li
gna
nts
kinl
esi
ons
;col
ord
iff
ere
nce
sse
eni
n
d
arks
kin
nedi
ndi
vi
dua
ls;
les
ionc
onf
igu
rat
ion
s,l
i
kea
nnu
lar
,pe
tec
hia
e,
l
i
nea
r,e
tc.
;
HE
ENT:
eyee
xami
nat
iont
ech
niqu
es;
PERRL
A;h
ear
ingt
est
s;l
ymp
hnod
es;
prob
lemss
een
i
nhe
ad,
ear
s,e
yes
,nos
e,a
ndt
hroa
t,e
x.c
ata
rac
ts,
ton
sil
l
it
is
,gl
auc
oma
Th
ora
x/Re
spi
rat
orya
sse
ssme
nt–a
usc
ult
ati
on,
pal
pat
ion
;nor
mal
s
oun
dsa
ndl
oca
tion
s;a
bnor
mal
sou
nds&wh
eny
oumi
ghth
ear
, t
hem;
prop
erme
thodo
fau
scu
lta
tion
;me
thod
s-e
.g.
voi
ces
oun
ds
s
ucha
seg
oph
ony
,th
ora
cice
xpa
nsi
on,
etc
.;c
hes
tsh
ape
s;
r
esp
ira
tor
yvoc
abu
lar
y
He
art
:ca
rdi
acc
ycl
e;a
usc
ult
ati
ons
it
es;
wha
tca
use
sth
ehe
art
s
oun
ds;
useofa
pic
alp
uls
e;b
rui
tvsmu
rmu
r
Br
easts
:Ri
skf
act
orsf
orcanc
er
Abdomen–met
hodsandor
derofa
sse
ssme
nt,
ana
tomy
,ex
pec
ted
f
ind
ing
s;c
olonc
anc
err
is
kfa
ctor
s
GU:t
est
icu
larc
ance
r;ass
ess
ing
Pul
ses-
wherear
ethey
,howdoyoud
ocu
men
tin
for
mat
iona
bou
tth
em,
i
ncl
udi
ngr
ate
,amp
li
tud
e,r
hyt
hm;
per
iph
era
lva
scu
lara
sse
ssme
nt,
e
dema–a
ppe
ara
nce
,sc
ale
;ar
ter
ial
vsv
enou
sin
suf
fi
ci
enc
y
Mu
scu
los
kel
et
al–r
ang
eofmot
iont
ech
niqu
es;
poi
ntsf
orc
omp
ari
son
;
os
teop
oros
isr
is
kfa
ctor
s;s
pin
ala
sse
ssme
ntf
ind
ing
s;t
est
ingv
ari
ousj
oi
nts
i
ncl
udi
ngj
aw;
typ
esoff
rac
tur
es;
ost
eoa
rth
rit
isr
is
kfa
ctor
s;p
rob
lemss
uch
a
srh
euma
toi
dar
thr
it
is
,gou
t,e
tc.
;mov
eme
ntsl
i
kea
bdu
cti
on/
add
uct
ion
,
f
lex
ion
/ex
ten
sion
,Ne
uro–Gl
asg
owc
omas
cal
e;r
efl
exe
s;c
ran
ial
ner
ves–h
owd
oyo
u
t
este
achon
e;t
est
ingf
orc
ere
bel
l
arf
unc
ti
on;
tes
tss
ucha
s
g
rap
hes
the
sia
,pos
it
ions
ens
e,s
ter
eog
nos
is,
etc
.,p
artoft
heb
rai
n
b
ein
gte
ste
d?h
ead
ach
ety
pes
;
Ge
ria
tri
cs:
fun
cti
ona
las
ses
sme
nt-
wha
tisi
t,
wha
tisb
ein
gte
ste
d,b
est
a
ppr
oac
htot
est
ing
;ca
reg
ive
rcon
cer
ns/
bur
nou
t;I
ADL
s,ADL
s;
d
isa
bil
i
tyc
onc
ern
s;e
xpe
cte
dch
ang
esi
nth
eel
der
ly
;fa
llr
is
k
f
act
ors
Pe
dia
tri
cs–b
estme
thod
sfora
sse
ssi
ng;
pai
nas
ses
sme
nt
, St
epsoft
hen
urs
ingp
roc
ess
:
As
ses
sme
nt
Di
agn
osi
s
Ou
tcome
i
den
tif
ica
tion
Pl
ann
ing
I
mpl
eme
nta
ti
onEv
alu
ati
on
Nu
rsi
ngp
roc
ess–As
ses
sme
nt:
Col
l
ect
ingofd
ataf
rom
mu
lti
pl
esou
rce
sre
vie
wof
c
li
ni
cal
rec
ord
h
eal
thh
ist
ory
p
hys
ica
lex
ami
nat
ion
f
unc
ti
ona
las
ses
sme
nt
c
ult
ura
lan
dsp
iri
tua
las
ses
sme
nt
As
ses
sme
nt–t
hes
tar
ti
ngp
oin
t:
s
ub j
ect
ivedat
a–wh a
tpati
ents
aysabou
tthemsel
vesdur
ingh
ist
ory
t
aking.
Obje
ctiv
edata–obse
rvedwheni
nspe
cti
ng,p
ercuss
ing
,
p
alp
ati
ng,
anda
usc
ult
ati
ngp
ati
entd
uri
ngp
hys
ica
lex
ami
nat
ion
.
Nu
rsi
ngp
roc
ess
-di
agn
osi
s:
Cl
ust
erd
atat
hats
eemt
obea
ssoc
iat
ed
i
nsomewa
yVa
li
dat
eda
ta,
con
fir
m
a
ccu
rac
y
