NIU NURS 304 Final Exam Questions & Answers

How do you screen for substance abuse? (drinking) - Answers Make sure the setting is private, confidential, and nonfonfrontational. Be open like "Do you sometimes drink beer, wine, or other alcoholic beverages?" and if yes, then how many times in the past year have you had five or more drinks a day? (4 for women) "How many times a week do you have a drink? On a typical drinking day how much do you drink?" The AUDIT test helps detect less severe drinking problems. (Covers alcohol consumption, drinking behavior or dependence, averse consequences from alcohol) Or you can you CAGE (Cut down(have you ever felt the need to cut down) Annoyed(have people annoyed you by criticizing your drinking) Guilty (have you ever felt guilty about how much you drink) Eye-opener (do you feel like you need a drink right away in the morning?)) How do you screen for substance abuse? Other drugs - Answers Do you sometimes take illicit drugs or street drugs, such as marijuana, cocaine, hallucinogens, narcotics?" If yes, ask, "When was last time you used drugs, and how much did you take that time?" How to help "You are drinking more than is medically safe." Relate to the person's concerns and medical findings, if present: "I strongly recommend that you cut down, or quit, and I'm willing to help." How do you screen for intimate partner violence? - Answers Asking every woman at every health care encounter if she has been abused by a husband, boyfriend, or other intimate partner or ex-partner Ask if they are ever afraid of their partner when they argue, do they ever try to emotionally hurt/abuse you?, do they try and control you? Who you see, where you go, etc. Have you ever been hit? and forceful sex when you did not want to participate? With any yes say, thank you for sharing, can you tell me about the last time. Ask if they think they are safe, if they need a way to get out. They may be in denial and think it's not a problem or they may be afraid to leave. Make sure that they know the abuse is not their fault! What should you teach a patient about breast self-examination? - Answers To do them once a mouth 5-7 days after the start of your period. Stress that self exam will help the woman to familiarize themselves with their breasts and any variability . Men have to do the exams too How to: stand in front of mirror before/after shower. Palpate in the shower, start by the armpit and feel your way down and up across the breast to the chest. (should feel smooth, firm, elastic). Have them sit forward, with the breast in one hand, and palpate from the top Tail of spence is where most of the cancer is. What are some general tips for assessment? - Answers ensure privacy, ask open ended questions, other little things What would you find on assessment of someone with asthma? - Answers Asthma is the constriction of the airways so they might have an inspiratory wheeze or crackles What is the pathophysiology of pneumonia? What would you find of assessment? - Answers It is an overload of fluid and mucus that the patient can't cough up so it just leads to a lot of congestion and they can't breathe right. could percuss a dull sound What is the pathophysiology of atelectasis? - Answers collapsed atelecti, cough and deep breathing will help them to open back up. If they are collapsed breath sounds will be decreased or absent What is the pathophysiology of heart failure? What would you find on assessment? - Answers Heart doesn't pump=blood backs up. Could back up into the lungs= crackles in the lungs What developmental considerations should you think about during assessment of the respiratory system? - Answers Infants/Children- Infants are nose breathers until the age of 3 months, Count respirations for a full minute, Watch for grunting, nasal flaring, & retracting as evidence of respiratory distress Older adult- Increased Anterior-Posterior diameter, Kyphosis common, Chest expansion may be decreased (muscle strength declines after 50 and continues into 70's, elastic properties decrease...making lungs lose tendency to collapse and recoil) Decreased number of alveoli Results in decreased O2 exchange What are some adventitious breath sounds? - Answers Pleural Friction Rub low pitch, grating, heard on inspiration and expiration, i.e. pleuritis