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NR509 physical assessment
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NR509 Final Exam NR509 Bates Test Bank - Midterm 2024 RN HESI EXIT E
88 terms 251 terms 160 terms
brit_oldland Preview michelleloftus Preview Ernest_Mugo
The nurse practitioner (NP) is occasionally running out of food, being discriminated against in
completing a comprehensive the workplace, has a great amount of smog in their community,
assessment of Anita, a new client having difficulty making the rent payment
in a primary care facility. Which
assessment finding(s) reported
by Anita are related to social
determinants of health? Select
all that apply.
- addresses focused concerns or symptoms
-used for established clients during routine or urgent care visits
Focused assessment: - health history and physical exams are focused on the problem
-Includes: brief history of present illness, only the system related
to the problem in the ROS
- used for new clients
-provides personalized information about the client
-strengthens the clinician-client relationship
-provides a baseline for future assessments
comprehensive assessment:
-provides an opportunity for health promotion education and
counseling
includes: extended history of the present illness, at least two area
of PMhx, family hx, social hx, at least 10 ROS
Subjective data includes symptoms that the client describes such
subjective data as a sore throat, headache, or pain. It also includes the client's
feelings, perceptions, and concerns
Objective data includes the physical examination findings or
signs observed. Information obtained from the client during any
objective data part of the health history is considered subjective data. All
physical examinations, laboratory information, and test data are
considered objective data
, -review the clinical record
-ensure the client is comfortable
-clarify the goals/agenda for the encounter
-establish rapport
-identify client's preferred title, name, and gender pronouns
-use "people first" language (i.e. hearing loss, wheelchair)
initial encounter -identify the c/o
-open-ended approach for client's story
-gather information about the client's perspective of the illness
using the FIFE (feelings, ideas, function, expectations)
-conduct health history interview
-gather information about PMHx, meds, allergies, family,
personal and social, ROS
"How would you describe your
sexual identity?"
"How would you describe your
gender identity?"
"What is the sex on your original
birth certificate?"
-active listening-closely attending to what the pt is
communicating, connect to pt's emotional state, use verbal and
nonverbal skills
-empathy- the capacity to identify with the pt and feel the pt's
pain as your own
-guided questioning- allows for interviewer to facilitate full
communications
-validating- affirm legitimacy of pt's emotional experience
Basic Interviewing Skills -empowerment; encourage pt to ask questions
-partnering; express your commitment to ongoing relationship
-transitioning; inform your pt when you are changing directions
-reassuring; help the pt feel that their problems have been heard
- summarizing; giving a summary of the pt's story to
communicate that you have been carefully listening
-nonverbal communication
-people first language --> ex. patient with diabetes instead of
diabetic
The history of the present illness is a concise, clear, and
chronological description of the chief complaint which
prompted the client's visit. A symptom analysis guided by the
mnemonic OLD CARTS will reveal information regarding the
history of present illness onset, location, duration, characteristics, aggravating factors,
relieving factors, treatments, and severity of the symptoms. There
are other mnemonics and variations of OLD CARTS that may also
be used to guide in gathering information about the chief
complaint.
The Five P's:
-partners
-practices
-protection from STIs
personal and social history
-Past hx of STIs
-Pregnancy plans
-Plus-- assess for trauma, violence, sexual health concerns,
provide support for sexual orientation and gender identity
, assessment questions with the onset, location, duration, characteristics, aggravating factors,
related symptom attribute relieving factors, treatments, severity of symptoms
A pack-year calculation is used to measure a person's exposure
to tobacco and assess their risk of developing lung cancer or
other diseases related to tobacco use. The pack year is
calculated by multiplying the number of packs of cigarettes (1
pack-year cig calculations pack=20 cigarettes) smoked per day by the number of years the
person has smoked. The U.S. Preventive Services Task Force Links
to an external site.(2021) recommends health care providers ask
all adults about tobacco use, advise them to stop, and provide
interventions for smoking cessation
-Social determinants of health are the conditions in the
environments where people are born, live, and work that affects
health, well-being, and quality of life
social determinants of health
- examples: economic stability, education access and quality,
healthcare access and quality, neighborhood and built
environment, social and community context
If indicated and not done during the interview, assess the client's
orientation, mood, thought process, thought content, abnormal
mental status exam perceptions, insight and judgment, memory and attention,
information and vocabulary, calculating abilities, abstract
thinking, and constructional ability.
The NP performs a mental status flight of ideas, mismatched/unseasonal clothing, recalls 1/3 items
examination. Which of the in the exam, erratic speech
following are positive findings?
Select all that apply
Do you have any current problems or history of diseases or
issues with your skin, hair, or nails?
Do you have any allergies to drugs, plants, or animals?
Do you have any birthmarks or tattoos?
Tell me about any changes in skin color or moisture.
Tell me about any changes in moles such as color, size, shape,
skin, hair, nails
sudden appearance of tenderness, bleeding, or itching.
Do you have any bruises, sores, rashes, or itching?
Tell me about any changes in hair color, amount, or texture.
Tell me about any changes in nail color, shape, or density.
Tell me about your current lifestyle including typical diet,
smoking, sun exposure, occupation, and hobbies
Dario, a 23-year-old, presents temperature, pain, change in soap, sexual hx, itching
for evaluation of a new rash on
the inner thighs with onset three
days ago. What additional
assessment data should the FNP
collect? Select all that apply.
Epidermal skin cancer
Slow progression without pain
Occurs in sun-exposed areas
Basal Cell Carcinoma
Often on face
May ooze, crust, or bleed
Refer to dermatology
NR509 physical assessment
Save
Students also studied
Flashcard sets Study guides
NR509 Final Exam NR509 Bates Test Bank - Midterm 2024 RN HESI EXIT E
88 terms 251 terms 160 terms
brit_oldland Preview michelleloftus Preview Ernest_Mugo
The nurse practitioner (NP) is occasionally running out of food, being discriminated against in
completing a comprehensive the workplace, has a great amount of smog in their community,
assessment of Anita, a new client having difficulty making the rent payment
in a primary care facility. Which
assessment finding(s) reported
by Anita are related to social
determinants of health? Select
all that apply.
- addresses focused concerns or symptoms
-used for established clients during routine or urgent care visits
Focused assessment: - health history and physical exams are focused on the problem
-Includes: brief history of present illness, only the system related
to the problem in the ROS
- used for new clients
-provides personalized information about the client
-strengthens the clinician-client relationship
-provides a baseline for future assessments
comprehensive assessment:
-provides an opportunity for health promotion education and
counseling
includes: extended history of the present illness, at least two area
of PMhx, family hx, social hx, at least 10 ROS
Subjective data includes symptoms that the client describes such
subjective data as a sore throat, headache, or pain. It also includes the client's
feelings, perceptions, and concerns
Objective data includes the physical examination findings or
signs observed. Information obtained from the client during any
objective data part of the health history is considered subjective data. All
physical examinations, laboratory information, and test data are
considered objective data
, -review the clinical record
-ensure the client is comfortable
-clarify the goals/agenda for the encounter
-establish rapport
-identify client's preferred title, name, and gender pronouns
-use "people first" language (i.e. hearing loss, wheelchair)
initial encounter -identify the c/o
-open-ended approach for client's story
-gather information about the client's perspective of the illness
using the FIFE (feelings, ideas, function, expectations)
-conduct health history interview
-gather information about PMHx, meds, allergies, family,
personal and social, ROS
"How would you describe your
sexual identity?"
"How would you describe your
gender identity?"
"What is the sex on your original
birth certificate?"
-active listening-closely attending to what the pt is
communicating, connect to pt's emotional state, use verbal and
nonverbal skills
-empathy- the capacity to identify with the pt and feel the pt's
pain as your own
-guided questioning- allows for interviewer to facilitate full
communications
-validating- affirm legitimacy of pt's emotional experience
Basic Interviewing Skills -empowerment; encourage pt to ask questions
-partnering; express your commitment to ongoing relationship
-transitioning; inform your pt when you are changing directions
-reassuring; help the pt feel that their problems have been heard
- summarizing; giving a summary of the pt's story to
communicate that you have been carefully listening
-nonverbal communication
-people first language --> ex. patient with diabetes instead of
diabetic
The history of the present illness is a concise, clear, and
chronological description of the chief complaint which
prompted the client's visit. A symptom analysis guided by the
mnemonic OLD CARTS will reveal information regarding the
history of present illness onset, location, duration, characteristics, aggravating factors,
relieving factors, treatments, and severity of the symptoms. There
are other mnemonics and variations of OLD CARTS that may also
be used to guide in gathering information about the chief
complaint.
The Five P's:
-partners
-practices
-protection from STIs
personal and social history
-Past hx of STIs
-Pregnancy plans
-Plus-- assess for trauma, violence, sexual health concerns,
provide support for sexual orientation and gender identity
, assessment questions with the onset, location, duration, characteristics, aggravating factors,
related symptom attribute relieving factors, treatments, severity of symptoms
A pack-year calculation is used to measure a person's exposure
to tobacco and assess their risk of developing lung cancer or
other diseases related to tobacco use. The pack year is
calculated by multiplying the number of packs of cigarettes (1
pack-year cig calculations pack=20 cigarettes) smoked per day by the number of years the
person has smoked. The U.S. Preventive Services Task Force Links
to an external site.(2021) recommends health care providers ask
all adults about tobacco use, advise them to stop, and provide
interventions for smoking cessation
-Social determinants of health are the conditions in the
environments where people are born, live, and work that affects
health, well-being, and quality of life
social determinants of health
- examples: economic stability, education access and quality,
healthcare access and quality, neighborhood and built
environment, social and community context
If indicated and not done during the interview, assess the client's
orientation, mood, thought process, thought content, abnormal
mental status exam perceptions, insight and judgment, memory and attention,
information and vocabulary, calculating abilities, abstract
thinking, and constructional ability.
The NP performs a mental status flight of ideas, mismatched/unseasonal clothing, recalls 1/3 items
examination. Which of the in the exam, erratic speech
following are positive findings?
Select all that apply
Do you have any current problems or history of diseases or
issues with your skin, hair, or nails?
Do you have any allergies to drugs, plants, or animals?
Do you have any birthmarks or tattoos?
Tell me about any changes in skin color or moisture.
Tell me about any changes in moles such as color, size, shape,
skin, hair, nails
sudden appearance of tenderness, bleeding, or itching.
Do you have any bruises, sores, rashes, or itching?
Tell me about any changes in hair color, amount, or texture.
Tell me about any changes in nail color, shape, or density.
Tell me about your current lifestyle including typical diet,
smoking, sun exposure, occupation, and hobbies
Dario, a 23-year-old, presents temperature, pain, change in soap, sexual hx, itching
for evaluation of a new rash on
the inner thighs with onset three
days ago. What additional
assessment data should the FNP
collect? Select all that apply.
Epidermal skin cancer
Slow progression without pain
Occurs in sun-exposed areas
Basal Cell Carcinoma
Often on face
May ooze, crust, or bleed
Refer to dermatology
