NR509 physical assessment Questions
and Answers (100% Correct Answers)
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The nurse practitioner (NP) is completing a comprehensive
assessment of Anita, a new client in a primary care facility.
Which assessment finding(s) reported by Anita are related to
social determinants of health? Select all that apply. Ans:
occasionally running out of food, being discriminated against
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in the workplace, has a great amount of smog in their
community, having difficulty making the rent payment
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Focused assessment: Ans: - addresses focused concerns or
symptoms
-used for established clients during routine or urgent care
visits
- 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
comprehensive assessment: Ans: - used for new clients
-provides personalized information about the client
-strengthens the clinician-client relationship
-provides a baseline for future assessments
, 2
-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 Ans: Subjective data includes symptoms that
the client describes such as a sore throat, headache, or pain. It
also includes the client's feelings, perceptions, and concerns
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objective data Ans: Objective data includes the physical
examination findings or signs observed. Information obtained
from the client during any part of the health history is
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considered subjective data. All physical examinations,
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laboratory information, and test data are considered objective
data
initial encounter Ans: -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)
-identify the c/o
-open-ended approach for client's story
, 3
-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
Basic Interviewing Skills Ans: -active listening-closely
attending to what the pt is communicating, connect to pt's
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emotional state, use verbal and nonverbal skills
-empathy- the capacity to identify with the pt and feel the pt's
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pain as your own
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-guided questioning- allows for interviewer to facilitate full
communications
-validating- affirm legitimacy of pt's emotional experience
-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
, 4
-people first language --> ex. patient with diabetes instead of
diabetic
history of present illness Ans: 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 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
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used to guide in gathering information about the chief
complaint.
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personal and social history Ans: The Five P's:
-partners
-practices
-protection from STIs
-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 related symptom attribute Ans:
onset, location, duration, characteristics, aggravating factors,
relieving factors, treatments, severity of symptoms
pack-year cig calculations Ans: A pack-year calculation is used
to measure a person's exposure to tobacco and assess their