Nur-634 Advanced Physical
Assessment Midterm Study Guide
Exam Newest Actual Exam Complete
All Questions And Correct Detailed
Answers (Verified Answers) |Already
Graded A+
Subjective Data - ✔✔✔ANSWER--symptoms from the client's point of view
and include: feelings, perceptions, and concerns
-what the patient tells you
,Objective Data - ✔✔✔ANSWER--what the health professional observes by
inspecting, palpating, percussing, and auscultating during the physical examination
-observed signs
Assessment - ✔✔✔ANSWER--the clinical reasoning process that interprets
the patient's history and physical examination, singles out identified problems, and
movement from each problems to its action plan
Plan - ✔✔✔ANSWER--incorporates patient education, changes in
medications, needed tests, referrals to other clinicians, and return visits for
counseling and support
-requires good interpersonal skills and sensitivity to the patients goals, economic
means, competing responsibilities, and family struggles/dynamics
Percussion - ✔✔✔ANSWER--a diagnostic procedure designed to determine
the density of a body part by the sound produced by tapping the surface with the
fingers
-use of the striking or plexor finger (usually the 3rd) to deliver a rapid tap or blow
against the distal pleximeter finger (usually the distal 3rd finger of the left hand
laid against the surface) to evoke a sound wave
-the 5 sounds are resonant, flat, dull, hyper resonant, and tympanic
-Resonant sounds are low pitched, hollow sounds heard over normal lung tissue.
-Flat are normally heard over solid areas such as bones. thigh
-Dull or thudlike sounds are normally heard over dense areas such as the heart or
liver. Dullness replaces resonance when fluid or solid tissue replaces air-containing
lung tissues, such as occurs with pneumonia, pleural effusions, or tumors.
, -Hyperresonant sounds that are louder and lower pitched than resonant sounds are
normally heard when percussing the chests of children and very thin adults.
Hyperresonant sounds may also be heard when percussing lungs hyperinflated with
air, such as may occur in patients with COPD, or patients having an acute
asthmatic attack. An area of hyperresonance on one side of the chest may indicate a
pneumothorax.
-Tympanic sounds are hollow, high, drumlike sounds. Tympany is normally heard
over the stomach, but is not a normal chest sound. Tympanic sounds heard over the
chest indicate excessive air in the chest, such as may occur with pneumothorax.
Attributes of a Symptom - ✔✔✔ANSWER--seven attributes
-OPQRST & Associated manifestations (anything else accompanying it)
-onset, provocative/palliative, quality, region/radiation, severity, timing
Talkative Challenging Patient Intervention - ✔✔✔ANSWER--give 5-10
minutes uninterrupted
-focus on and ask questions to what seems most important to patient
-summarize concerns and focus on #1 concern today
-avoid impatience
Angry Challenging Patient Intervention - ✔✔✔ANSWER--acknowledge any
involvement you may have in their anger and make amends
-avoid reinforcing criticism of other clinicians
-validate their feelings without agreeing with their reasons
-ensure a safe environment, alert staff/security
-stay calm and avoid being confrontational
Assessment Midterm Study Guide
Exam Newest Actual Exam Complete
All Questions And Correct Detailed
Answers (Verified Answers) |Already
Graded A+
Subjective Data - ✔✔✔ANSWER--symptoms from the client's point of view
and include: feelings, perceptions, and concerns
-what the patient tells you
,Objective Data - ✔✔✔ANSWER--what the health professional observes by
inspecting, palpating, percussing, and auscultating during the physical examination
-observed signs
Assessment - ✔✔✔ANSWER--the clinical reasoning process that interprets
the patient's history and physical examination, singles out identified problems, and
movement from each problems to its action plan
Plan - ✔✔✔ANSWER--incorporates patient education, changes in
medications, needed tests, referrals to other clinicians, and return visits for
counseling and support
-requires good interpersonal skills and sensitivity to the patients goals, economic
means, competing responsibilities, and family struggles/dynamics
Percussion - ✔✔✔ANSWER--a diagnostic procedure designed to determine
the density of a body part by the sound produced by tapping the surface with the
fingers
-use of the striking or plexor finger (usually the 3rd) to deliver a rapid tap or blow
against the distal pleximeter finger (usually the distal 3rd finger of the left hand
laid against the surface) to evoke a sound wave
-the 5 sounds are resonant, flat, dull, hyper resonant, and tympanic
-Resonant sounds are low pitched, hollow sounds heard over normal lung tissue.
-Flat are normally heard over solid areas such as bones. thigh
-Dull or thudlike sounds are normally heard over dense areas such as the heart or
liver. Dullness replaces resonance when fluid or solid tissue replaces air-containing
lung tissues, such as occurs with pneumonia, pleural effusions, or tumors.
, -Hyperresonant sounds that are louder and lower pitched than resonant sounds are
normally heard when percussing the chests of children and very thin adults.
Hyperresonant sounds may also be heard when percussing lungs hyperinflated with
air, such as may occur in patients with COPD, or patients having an acute
asthmatic attack. An area of hyperresonance on one side of the chest may indicate a
pneumothorax.
-Tympanic sounds are hollow, high, drumlike sounds. Tympany is normally heard
over the stomach, but is not a normal chest sound. Tympanic sounds heard over the
chest indicate excessive air in the chest, such as may occur with pneumothorax.
Attributes of a Symptom - ✔✔✔ANSWER--seven attributes
-OPQRST & Associated manifestations (anything else accompanying it)
-onset, provocative/palliative, quality, region/radiation, severity, timing
Talkative Challenging Patient Intervention - ✔✔✔ANSWER--give 5-10
minutes uninterrupted
-focus on and ask questions to what seems most important to patient
-summarize concerns and focus on #1 concern today
-avoid impatience
Angry Challenging Patient Intervention - ✔✔✔ANSWER--acknowledge any
involvement you may have in their anger and make amends
-avoid reinforcing criticism of other clinicians
-validate their feelings without agreeing with their reasons
-ensure a safe environment, alert staff/security
-stay calm and avoid being confrontational
