NURS 2092 HEALTH ASSESSMENT MIDTERM EXAM STUDY GUIDE 2026

NURS 2092 HEALTH ASSESSMENT MIDTERM EXAM STUDY GUIDE 2026 Health History - -The purpose of a health history is to provide a database of subjective information about the patient's past and current health history. Reliable Patient Responses - -The patient provided consistent information and therefore is reliable. Abdominal Pain Inquiry - -The nurse's best response is, 'Can you point to where it hurts?' Excruciating Pain Assessment - -The nurse's appropriate response is, 'How would you say the pain affects your ability to do your daily activities?' Penicillin Allergy Inquiry - -The nurse's best response is, 'Describe what happens (or the reaction) to you when you take Penicillin.' Family History Importance - -Important diseases or problems about which the patient should be specifically asked include mental illness. Review of Systems - -The review of systems provides information regarding health promotion practices and helps to evaluate the past and present health state of each body system. Subjective Data Example - -Patient denies any color change. Testicular Self-Examinations Inquiry - -The appropriate question to assess health promotion activities is, 'Do you perform testicular self-examinations?' Functional Assessment - -A functional assessment includes the activities of daily living and the person's ability to take care of their needs. Alcohol Interaction Concern - -Alcohol can interact with all medications and make some diseases worse. Genogram Description - -A graphic family tree that uses symbols to depict the gender, relationship, and age of immediate family, usually 3 generations. Health History for Elderly - -Current health promotion activities would be most useful when obtaining health history on an 87-year-old woman. NURS 2092 NURS 2092 Medication Memory in Elderly - -A 90-year-old patient tells the nurse that he cannot remember the names of the medication he is taking or why he is taking them. Functional Assessment Components - -This could include data on lifestyle and type of living environment, self-esteem, activity/exercise, sleep/rest, nutrition/elimination, interpersonal relationships/resources, spiritual resources, coping and stress management, personal habits, environmental hazards, violence questions, and occupational health questions. Coping with a Cast - -Appropriate questions would include how they transfer to bed, another chair, bathing technique, and coping with the situation. Family Health History - -Genograms also highlight the health of close family members and details such as communicable disease, environmental hazards, tobacco use, and alcohol use. Health Promotion Evaluation - -The information helps to evaluate health promotion and teaching opportunities. Patient's Pain Inquiry - -The nurse should ask about the patient's pain and its impact on daily activities. Patient's Reaction to Allergens - -The nurse should inquire about the specific reactions the patient has to allergens. Importance of Family History - -Family history is crucial for understanding potential health risks. Subjective Data Collection - -Subjective data is obtained through patient reports and experiences. Elderly Patient Assessment - -Assessing current health promotion activities is vital for elderly patients. 90-year-old patient - -Cannot remember the names of the medication he is taking or why he is taking them. Functional assessment question - -Are you able to dress yourself? Description of symptom setting - -This pain happens every time I sit down to use the computer. Breast examination importance - -Examining the upper outer quadrant of the breast is especially important because this is the location for most breast tumors. NURS 2092 NURS 2092 Assessment of woman's lymph system - -Assess central, lateral, pectoral, and subscapular nodes. Breast sagging explanation - -After menopause, the glandular and fat tissue atrophies, causing breast size and elasticity to diminish, resulting in sagging breasts. Bilateral gynecomastia - -This is the result of hormonal changes (testosterone) and recommend a visit to their provider. Response to breast pain - -Seek more specific information about the pain, such as: When did you first notice it? Is the pain localized or all over? Is it painful to touch? Is the pain in relation to your menstrual cycle? Is the pain associated with activity or exercise? Crusty, itchy rash on breast - -Important questions include: Where did the rash first appear- on the nipple, areola, or the surrounding skin? When did you first notice this? Breast self-examinations (BSEs) - -Breast self-exams may detect lumps that appear between mammograms. Risk factors for breast cancer - -History of breast cancer - family history—first-degree relative, medications such as estrogen and progestin combined, certain tumor suppressor genes called BRCA1 and BRCA2 (inherited mutation), age. Breast asymmetry - -Asymmetry is not unusual, but the nurse should verify that this change is not new. Inverted left nipple - -Whether the inversion is a recent change should be determined. Nipple and skin retraction screening - -Have the woman slowly lift her arms above her head, and note any retraction or lag in movement. Breast palpation position - -The position most likely to make significant lumps more distinct during breast palpation. Supine with the arms raised over the head - -Correct Answer-Supine with the arms raised over the head Best time to perform a BSE - -The best time to perform a BSE is 4 to 7 days after the first day of the menstrual period. BSE on a monthly basis - -BSE on a monthly basis will help you become familiar with your own breasts and feel their normal variations. Atrophy of glandular tissue - -The decrease in hormones after menopause causes atrophy of the glandular tissue in the breast and is a normal process of aging. NURS 2092 NURS 2092 Breast lump evaluation - -Because of the change in consistency of the lump, it should be further evaluated by the physician. Best time for postmenopausal women to perform BSEs - -On the same day every month. Examine breast shortly after menstrual period - -Examine your breast shortly after your menstrual period each month. Peau d'orange - -Lymphatic obstruction causes edema, which thickens the skin and exaggerates the hair follicles; this creates a pigskin or orange peel look. Could be an indication of cancer. Dullness - -A high-pitched muffled thud sound obtained by percussing over relatively dense organs such as liver or spleen, distended bladder, mass of adipose tissue. Tympany - -A high-pitched musical and drum like note obtained by percussing the surface of a large air-containing space, such as the abdomen. Resonance - -A low-pitched, clear, hollow note obtained by percussing over normal lung tissue. Hyperresonance - -A low-booming note obtained by percussing over the adult lungs that have increased air such as with a patient who has emphysema, present with distended abdomen. Sigmoid colon - -Structure located in the left lower quadrant of the abdomen. Aneurysm - -Defect or sec formed by dilation in artery wall due to atherosclerosis, trauma, or congenital defect (aortic aneurysm). Dysphasia - -Difficulty swallowing. Anorexia - -Loss of appetite. Ascites - -Abnormal accumulation of serous fluid within the peritoneal cavity, associated with heart failure, cirrhosis, cancer or portal hypertension. Bruit - -Blowing, swooshing sound heard through a stethoscope when an artery is partially occluded. Hepatomegaly - -Abnormally enlarged liver. Paralytic ileus - -Complete absence of peristaltic movement that may follow abdominal surgery or complete bowel obstruction. NURS 2092 NURS 2092 Peritonitis - -Inflammation of the peritoneum. Assessing a distended bladder - -Percuss and palpate the midline area above the suprapubic bone. Change in gastrointestinal system of aging adult - -Decreased gastric acid secretion. Hypoactive bowel sounds - -A potential cause of hypoactive bowel sounds is peritonitis. Auscultation - -Auscultation prevents distortion of bowel sounds that might occur after percussion and palpation. Abdominal borborygmi - -Hyperactive bowel sounds Percussion notes - -Tympany, hyperresonance, and dullness. Causes of Abdominal Distention - -Obesity, Ascites, Air or Gas, Ovarian cyst, Pregnancy, Tumor Silent bowel sounds - -The nurse should listen for at least 5 minutes. Assessment technique for right lower quadrant pain - -Examine the tender area first. Rationale for auscultation before palpation or percussion - -Percussion and palpation may increase peristalsis, which gives a false interpretation of bowel sounds. Specific questions for abdominal pain - -Describe the pain, is it in one spot, or does it move around, have the patient point to the area, when did it start, how long have you had the pain, is it constant or does it come and go, does it occur before a meal or after meals, describe the pain is it a cramping, burning, dull, stabbing, or aching pain, are there any changes associated with meals does the pain become worse or better, what have you tried to relieve the pain, what makes the pain worse, is the pain associated with your menstrual cycle. Right Upper Quadrant Organs - -Liver, Gallbladder, Duodenum, Head of Pancreas, Right Kidney and adrenal gland, Hepatic flexure of colon, Part of ascending and transverse colon. Left Upper Quadrant Organs - -Stomach, spleen, left lobe of liver, Body of Pancreas, Left kidney and adrenal, splenic flexure of colon, part of transverse and descending colon. Right Lower Quadrant Organs - -Cecum, Appendix, Right ovary and tube, Right ureter, Right spermatic cord. NURS 2092 NURS 2092 Left Lower Quadrant Organs - -Part of descending colon, Sigmoid colon, Left ovary and tube, left ureter, left spermatic cord. Midline Organs - -Aorta, Uterus, Bladder. Specific questions for nausea and vomiting - -How often, how much come up, color, odor, bloody, pain associated, any diarrhea, fever, chills, what did you eat in the last 24 hours, where, is there anyone else in the family with the same symptoms? Functional units of the musculoskeletal system - -Joints. Ligaments - -Fibrous bands running directly from one bone to another that strengthen the joint and help prevent movement in undesirable directions. Circumduction - -To jump rope, the shoulder has to be capable of. Temporomandibular joint - -Articulation of the mandible and temporal bone. Palpation of the temporomandibular joint - -Anterior to the tragus. Aging and height - -With aging, the vertebral column shortens. Preventing osteoporosis - -Perform physical activity, such as fast walking. Signs of crepitation - -A patient states, 'I can hear a crunching or grating sound when I kneel.' Rotator cuff lesions - -A patient is unable to abduct his arm because of pain and muscle spasms. Lateral tilting during examination - -During an examination, the nurse notices that the patient has lateral tilting when asked to bend forward from the waist. Herniated nucleus pulposus - -The condition suspected when a patient complains of pain going down the buttock into the leg. Changes with an aging adult - -After 40, loss of bone matrix occurs more rapidly than new bone formation; postural changes occur with decreased height; decreased height is due to shortening of the vertebral column; may see kyphosis; distribution of subcutaneous fat changes; tendency to gain weight; loss of muscle mass; may see a shuffling pattern when walking. Osteoporosis - -A condition where bones become weak and more likely to break due to the opposite of bone tissue replacement occurring as we age. NURS 2092 NURS 2092 Steps to bone health and osteoporosis prevention - -Diet includes low fat milk products with vitamin D, fish packed in bones, leafy green vegetables; exercise includes weight bearing at least 3 times a week; lifestyle changes include avoiding smoking and excessive alcohol, seeking help for depression; supplements as directed. Rheumatoid Arthritis - -A chronic, systemic inflammatory disease of the joints characterized by inflammation of the synovial membrane, leading to thickening, fibrosis, and bony ankylosis. Osteoarthritis - -A non-inflammatory localized, progressive disorder involving deterioration of articular cartilage and subchondral bone, commonly affecting hands, knees, hips, and spine. Adduction - -Movement of a body part toward the body's midline. Abduction - -Movement of a body part away from the body's midline. Flexion - -Movement that decreases the angle between a segment and its proximal segment. Extension - -A straightening movement that increases the angle between body parts. Central nervous system - -One of the two parts of the nervous system. Peripheral nervous system - -One of the two parts of the nervous system. Frontal lobe - -Associated with personality, ability to understand, crying easily, and becoming angry. Cerebellum - -The area of the brain related to balance and coordination. Dizziness upon standing - -A condition described by a 70-year-old woman who feels 'really dizzy' when getting up in the morning or after sitting. Vertigo - -A sensation where the room feels like it is spinning around. Aura - -A sensation experienced before a seizure. Aura - -A subjective sensation that precedes a seizure; may be auditory, visual or motor. Positive Romberg Sign - -Documented finding when a patient sways and moves his feet farther apart while standing with feet together and arms at his side with eyes closed. Mental Status Assessment - -Before testing, the nurse would assess the patient's mental status and ability to follow directions. NURS 2092 NURS 2092 Ominous Sign - -A very concerning finding that may indicate brainstem injury, characterized by specific responses to pain. Syncope - -A sudden loss of strength, a temporary loss of consciousness (a faint) caused by a lack of cerebral blood flow. Vertigo - -A rotational spinning caused by neurological disease in the vestibular apparatus of the ear or the vestibular nuclei in the brainstem. Seizure - -Characterized by altered or loss of consciousness, involuntary muscle movements, and sensory disturbances. Tremors - -An involuntary shaking. Paralysis - -Decreased or loss of motor power caused by a problem with motor nerve or muscle fibers. Stroke or Cerebrovascular Accident (CVA) - -Blood flow is interrupted to a part of the brain; the most common type is an ischemic stroke (when a blood clot blocks a blood vessel in the brain) and less common is a hemorrhagic stroke (a blood vessel in the brain ruptures and causes bleeding). Common Symptoms of a Stroke - -Weakness or numbness in the face, arms, or legs, especially when it is on one side of the body; confusion, trouble speaking or understanding; changes in vision such as blurry vision or partial complete loss of vision in one or both eyes; trouble walking, dizziness, loss of balance, or coordination; severe headache with no reason or explanation. Paresis - -Weakness of muscles rather than paralysis. Paraplegia - -Symmetric paralysis of both lower extremities. Quadriplegia - -Paralysis of all four extremities. Hemiplegia - -Paralysis of one side of the body. Symptoms of Meningeal Inflammation - -Sudden fever, stiff neck, severe headache different than normal, nausea and vomiting, seizures, sleepiness, sensitivity to light. Cranial Nerve 7 - -Facial nerve; damage may cause asymmetric palpebral fissures. Cranial Nerve 11 - -Accessory nerve; suspected damage may be assessed by asking the patient to shrug her shoulders against resistance. NURS 2092 NURS 2092 Thyroid Nodule - -A lump in the front of the neck below the 'Adam's apple' that is mobile and not hard may not be cancerous. Accessible Lymph Nodes - -Four areas of the body where lymph nodes are accessible: head and neck, arms, inguinal area, and axillae. Facial Bone Changes - -More noticeable facial bones are probably due to a combination of factors related to aging, such as decreased elasticity, subcutaneous fat, and moisture in her skin. Parotid gland - -An inflammation of the parotid gland is suspected when there is swelling below the angle of the jaw. Bruit - -A bruit is a soft, whooshing, pulsatile sound that is heard best with the bell of the stethoscope. CVA or stroke - -A patient with paralysis on one side of the mouth, unable to raise an eyebrow or whistle, may have a CVA or stroke. Firm but freely movable - -Acutely infected lymph nodes would be firm but freely movable. Nonpalpable - -Most lymph nodes in healthy adults are normally nonpalpable. Palpate lymph nodes - -The best way to palpate the lymph nodes in the neck is using gentle pressure, palpate with both hands to compare the two sides. Visual accommodation - -Visual accommodation is pupillary constriction when looking at a near object. Pupillary light reflex - -A normal pupillary light reflex indicates that constriction of both pupils occurs in response to bright light. 20/30 vision - -A vision recorded as 20/30 indicates that the patient can read at 20 feet what a person with normal vision can read at 30 feet. Ptosis - -To check for ptosis of one eye, observe the distance between the palpebral fissures. Macular degeneration - -Loss of central vision with normal peripheral vision suggests macular degeneration. Eye injury emergency symptoms - -Loss of vision would prompt an emergency situation in the case of an eye injury. NURS 2092 NURS 2092 Sclera color variations - -In dark-skinned people, small brown merciless (freckles) may be seen on the sclera. Extraocular muscles - -Extraocular muscles are controlled by cranial nerves 3, 4, and 6. Chronic Open-Angle Glaucoma - -Chronic Open-Angle Glaucoma is characterized by increased intraocular pressure that leads to peripheral vision loss. Macular Degeneration - -Macular Degeneration involves the breakdown of cells in the Macula or the Retina that leads to loss of central vision. Cataracts - -Cataracts result from lens opacity due to a clumping of protein in the lens. Presbyopia - -Presbyopia is the loss of lens elasticity, decreasing the lens's ability to change shape for near vision. Intracranial pressure - -A fully dilated and nonreactive right pupil, with a reactive left pupil, suggests an increase in intracranial pressure. Smokeless tobacco (SLT) - -Smokeless tobacco (SLT) contains cancer-producing chemicals, such as nitrosamines, that increase the risk of oral cancers (pharynx, larynx, and esophagus). Early signs of oral cancer - -Should be discussed, along with effects of SLT use. SLT - -Smokeless tobacco that can be detrimental to health. Types of SLT - -Chewing tobacco and snuff are the two most commonly used types in the United States. Largest group of SLT users - -American Indian/Alaskan Native children. Pain - -An early sign of oral cancer. Ciliated mucous membrane purpose - -Filters out dust and bacteria. Parotid gland - -The largest salivary gland located in the cheek in front of the ear. Expected finding in 80-year-old patient - -Decreased ability to identify odors. Xerostomia - -Dry mouth, a side effect of many drugs. Questions for adult health history - -Include inquiries about dryness in the mouth, medications, ability to chew food, dental care, and changes in taste or smell. NURS 2092 NURS 2092 Controlling a nosebleed - -Remain calm, sit up straight, lean head forward, pinch nostrils for about 10 minutes. Pale, gray, and swollen nasal mucosa - -Indicates possible allergies. Dry mucosa and deep vertical fissures in the tongue - -Reflective of dehydration. 1-cm ulceration on lower lip - -Important to assess when the patient first noticed the lesion. Candidiasis - -An abnormality found in a patient with raw and red buccal mucosa after chemotherapy. Black, hairy tongue - -A fungal infection caused by antibiotics. Changes in sense of smell - -Possible causes include cigarette smoking, chronic allergies, and aging. Functions of the middle ear - -(1) Conducts sound vibrations, (2) Protects inner ear from loud sounds, (3) Allows equalization of air pressure. Pathway of hearing - -The normal pathway of hearing is known as air conduction (AC) and is the most efficient. Bone conduction (BC) - -An alternate route of hearing where the bones of the skull vibrate and these vibrations are transmitted directly to the inner ear and to cranial nerve VIII. Conductive hearing loss - -Involves a mechanical dysfunction of the external or middle ear and is considered a partial loss because the person is able to hear if the sound amplitude is increased enough to reach the nerve elements in the inner ear. Sensorineural hearing loss - -Indicates pathology of the inner ear, cranial nerve VIII, or the auditory areas of the brain where a simple increase in amplitude may not enable the person to hear. Mixed loss - -A combination of both conductive and sensorineural hearing loss in the same ear. Cerumen - -Purpose of cerumen is to protect and lubricate the ear. Eustachian tube - -Helps equalize air pressure on both sides of the tympanic membrane. Air conduction - -Normal pathway for hearing. NURS 2092 NURS 2092 High-tone frequency loss - -A common finding in ear examination of an 80-year-old patient. Otitis externa prevention - -Use rubbing alcohol or 2% acetic acid teardrops after every swim. Tinnitus - -'Buzzing sound' in the ear. Aging and hearing loss - -Progression of hearing loss is slow; the aging person may find it harder to hear consonants than vowels, sounds may be garbled and difficult to localize. Anal canal - -Is the outlet for the gastrointestinal tract. Colonoscopy - -A test that allows the physician to look at the inner lining of the large intestines, with a thin flexible tube. Benign prostatic hypertrophy (BPH) - -The enlargement of the prostate is caused by hormonal changes, and not cancer. Symptoms of BPH - -May include urinary frequency, urgency, hesitancy, straining to urinate, weak stream, intermittent stream, or sensation of not emptying. Hemorrhoids - -A problem to assess for in a patient complaining of 'pain in my bottom when I have a bowel movement.' Colonoscopy frequency - -Need for a colonoscopy every 10 years for early detection measures for colon cancer. Rectal exam position - -A woman should be in the left lateral decubitus position for a rectal exam. Thrombosed hemorrhoid - -Pigmentation of anus is darker than the surrounding skin, the anal opening is closed, and a skin sac that is shiny and blue is noted, with pain during bowel movements and occasional blood spots. Anal fistula - -An abnormal passage from inner anus or rectum out to the skin surrounding the anus, may occur from chronic GI inflammation or local abscess. Rectal prolapse - -Protrusion of the rectal mucous membrane through the anus. Rectal polyp - -Protruding growth from the rectal mucous membrane. Rectal fissure - -Longitudinal tear in the superficial mucosa at the anal margin. Rectal prolapse appearance - -Moist, red, doughnut shaped protrusion from the anus. NURS 2092 NURS 2092 Prostatitis symptoms - -Consistent with fever, chills, malaise, urinary frequency, urgency, urethral discharge, and dull aching pain in the perineal and rectal area. High-fiber foods - -Discussed during a health history of a patient who complains of chronic constipation. High-fiber food example - -Broccoli Fecal impaction - -A condition suspected when a patient has hard feces in the rectum, feels 'full', has a distended abdomen, and has not had a bowel movement for several days. Human Papilloma Virus (HPV) - -A sexually transmitted disease that may clear on its own but for those that don't clear can lead to cervical cancer. CDC's recommendation for HPV vaccine - -Girls or boys starting at age 11 or 12 years old with a series of 3 injections with a 6-month period. HPV vaccine recommendation before sexual activity - -True HPV virus lingering in cervix - -True, it can cause changes that may lead to cervical cancer. Changes associated with menopause - -Aging of the cells in the reproductive tract. Menopause changes - -Uterine and ovarian atrophy, along with a thinning of the vaginal epithelium. Premenstrual Syndrome - -Refers to physical and emotional symptoms that occur in the one to two weeks before a woman's period. Menarche - -Onset of first menses, usually occurring between 11 and 13 years of age. Menopause - -Cessation of menses, usually occurring around 48 to 51 years of age. Menstrual cycle - -Changes that occur naturally in a woman's body to prepare it for pregnancy. Dysmenorrhea - -Abnormal cramping and pain associated with menstruation. Annual gynecologic examination start - -Menstrual history, generally nonthreatening. Perimenopausal indication - -Patient notices sweating a lot more than used to, especially at night. NURS 2092 NURS 2092 Hormone replacement therapy (HRT) side effects - -Includes fluid retention, breast tenderness, and vaginal bleeding. Vaginal discharge inquiry - -The nurse's appropriate response is to ask, 'What color is it?' Post-UTI inquiry - -The nurse should ask, 'Have you noticed any unusual vaginal discharge or itching?' Introducing sexual relationships topic - -Women often have questions about their sexual relationship and how it affects their health. Do you have any questions? Oral contraceptives health history question - -If you smoke, how many cigarettes do you smoke per day? STI risk assessment question - -Do you use a condom with each episode of sexual intercourse? Postmenopausal health history - -The nurse should ask if she has ever had vaginal bleeding. Lithotomy position - -The position a patient will be in during the examination portion of a visit. Elevate her head and shoulders - -To maintain eye contact and make the position more comfortable for the patient. Papanicolaou (Pap) smear instructions - -Avoid intervenes, inserting anything into the vagina or douching within 24 hours of your appointment. Candidiasis - -A condition characterized by erythematous and edematous vulva and vagina with thick, white, curdlike discharge and intense pruritus. Herpes simplex virus type 2 - -The most likely cause of clusters of small, shallow vesicles with surrounding erythema on the labia in a patient with vulvar pain, dysuria, and fever. Pelvic inflammatory disease - -A condition suggested by rigid, boardlike lower abdominal musculature and severe pain during vaginal examination. Pap test frequency after age 30 - -If you have three consecutive normal Pap tests, then you may be screened every 2 to 3 years. Atrophic vaginitis problems - -Itching, dryness, burning sensation, dyspareunia, mucoid discharge with noticeable blood. NURS 2092 NURS 2092 Questions for elderly female patient - -When did it start, amount, color, taking any medications, history of any cancer in the family, past surgeries, any abdominal pain. Changes associated with menopause - -True; they occur because the cells in the reproductive tract are aging. Normal findings in genital examination - -Deeply pigmented, wrinkled scrotal skin with large sebaceous follicles in a 25-year-old man. Inguinal hernia - -Herniation of bowel (usually small intestine) through a weak area in the lower abdominal wall. Types of inguinal hernias - -Indirect inguinal hernias are congenital defects, while direct inguinal hernias occur due to muscle weakness in male adults. Dysuria - -Burning and pain during urination. Stress Incontinence - -Involuntary urine loss with physical strain, sneezing, or coughing due to weakness of pelvic floor. Questions for genitourinary history from older man - -Frequency, urgency, nocturia, dysuria, hesitancy, straining, color, difficulty controlling urine, accidental urination when sneezing, laughing, coughing or bearing down, any history of kidney disease, prostate problems. Erection during genital examination - -A normal physiological response that may occur in male patients. Hypospadias - -When performing a genitourinary assessment, the nurse notices that the urethral meatus is ventrally positioned. Testicular Cancer Risk - -Men with a history of cryptorchidism are at the greatest risk for the development of testicular cancer. Testicular Self-Examination - -"If you notice an enlarged testicle or a painless lump, call your health care provider." Normal Changes in Aging Men - -Decrease in the size of the penis. Genital Warts - -Multiple soft, moist, painless papules in the shape of cauliflower-like patches scattered across the shaft of the penis. Epididymitis - -A 55-year-old man is experiencing severe pain of sudden onset in the scrotal area, somewhat relieved by elevation, with an enlarged, red scrotum that is very tender to palpation. NURS 2092 NURS 2092 Direct Inguinal Hernia - -A painless round swelling close to the pubis in the area of the internal inguinal ring that is easily reduced when the individual is supine. Priapism - -Prolonged, painful erection of the penis without sexual stimulation. Phimosis - -A male patient's foreskin is fixed and tight and will not retract over the glans. Prostate Cancer Screening - -Blood test for prostate-specific antigen (PSA) and digital rectal examination. Activity of Daily Living - -Tasks that are necessary for self-care, such as eating/feeding, bathing, grooming, toileting, walking, and transferring. Advanced Activities of Daily Living - -Activities that an older adult performs as a family member or as a member of society or community, including occupational and recreational activities. Caregiver Assessment - -Assessment of the health and well-being of an individual's caregiver. Caregiver Burden - -The perceived strain by the person who cares for an older, chronically ill, or disabled person. Domains of Cognition - -Domains included in mental status assessments, such as attention, memory, orientation, language, visuospatial skills, and higher cognitive functions. Environment Assessment - -Assessment of an individual's home environment and community systems, including hazards at home. Functional Ability - -The ability of a person to perform activities necessary to live in modern society; may include driving, using the telephone, or performing personal tasks such as baking or toileting. Functional Assessment - -A systematic assessment that includes assessment of an individual's activities of daily living, instrumental activities of daily living, and mobility. Functional Status - -A person's actual performance of activities and tasks associated with current life roles. Geriatric Assessment - -Multidimensional assessment; physical examination and assessments of mental status, functional status, social and economical status, pain, and physical environment safety. NURS 2092 NURS 2092 Home Care - -Supportive services provided in the home: skilled nursing care, primary care, therapy (physical, occupational, speech), social work, nutrition, case management, ADL assistance, durable medical equipment. Instrumental Activities of Daily Living - -Functional abilities necessary for independent community living, such as, shopping, meal preparation, housekeeping, laundry, managing finances, taking medications, and using transportation. Katz Index of Independence in Activities of Daily Living - -An instrument used to measure physical function in older adults and the chronically ill. Lawton Instrumental Activities of Daily Living - -An instrument used to measure an individual's ability to perform instrumental activities of daily living; may assist in assessing one's ability to live independently. Physical Performance Measures - -Tests that measure balance, gait, motor coordination, and endurance. Social Domain - -The domain that focuses on an individual's relationships within family, social groups, and the community. Social Networks - -Informal supports accessed by older adults, such as family members and close friends, neighbors, church societies, neighborhood groups, and senior centers. Spiritual Assessment - -Assessment of the individual's spiritual health. Functional Status - -An older adult's functional status may vary from independence to disability. Delirium - -An acute change in cognition experienced by an older person. Assessment of the Social Domain - -Includes family relationships. Cognitive Impairment Assessment Technique - -Ask simple questions that have yes or no answers. Up and Go Test - -The best test for assessing whether an older individual is able to go outside alone safely. Self-Report of Pain in Cognitive Impairment - -Older adults with cognitive impairment can provide a self-report of pain. Caregiver Strain Index - -An appropriate use would be a wife who has cared for her husband for the past 4 years at home. NURS 2092 NURS 2092 Formal Social Support Network - -A home health care agency that provides weekly blood pressure screenings at the church luncheon. Spiritual Assessment - -Use open-ended questions to help the patient understand potential coping mechanisms. Functional Assessment - -Observe the patient's ability to perform the tasks. Lawton IADL Instrument - -It is designed as a self-report measure of performance rather than ability. Advanced Activities of Daily Living - -Recreational activities. Disadvantage of Assessment Instruments - -Self or proxy report of functional activities. Acculturation - -Process of social and psychological exchanges with encounters between persons of different cultures, resulting in changes in either group. Cultural and Linguistic Competence - -A set of congruent behaviors, attitudes and policies that come together in a system among professionals that enables work in cross cultural situations. Culture - -The nonphysical attributes of a person-the thoughts, communications, actions, beliefs, values, and institutions of racial, ethnic, religious, or social groups. Cultural Care - -Professional health care that is culturally sensitive, appropriate, and competent. Ethnicity - -A social group within the social system that claims to possess variable traits such as common geographic origin, migratory status, and religion. Ethnocentrism - -Tendency to view your own life as the most desirable, acceptable, or best and to act superior to another culture's way of life. Folk Healer - -Lay healer in the person's culture apart from the biomedical or scientific health care system. Health or Illness - -The balance or imbalance of the person, both within one's being (physical, mental, and/or spiritual) and in the outside world (natural, communal, and/or metaphysical). Religion - -The belief in a divine subhuman power or powers to be obeyed and worshiped as the creator and ruler of the universe and a system of beliefs, practices, and ethical values. NURS 2092 NURS 2092 Socialization - -The process of being raised within a culture and acquiring the characteristics of that group. Spirituality - -A person's personal effort to find purpose and meaning in life. Title VI of the Civil Rights Act of 1964 - -A federal law that mandates that when people with limited English proficiency (LEP) seek health care settings such as hospitals, nursing homes, clinics, daycare centers, and mental health centers, services cannot be denied to them. Values - -A desirable or undesirable state of affairs and a universal feature of all cultures. Religion Definition - -An organized system of beliefs concerning the cause, nature, and purpose of the universe. Cultural care nursing - -The following of established rituals, especially in conjunction with health seeking behaviors. Demographic change - -The major factor contributing to the need for cultural care nursing. Culturally competent nurse - -A nurse who understands the cultural context of the patient's situation. Linguistic competence barrier - -Providing the patient with a paper and pencil so he or she can write down the questions that you are going to ask. Hot and cold imbalance illness - -A concept of illness described by Hispanic-American heritage. Amulet protection belief - -The belief that the amulet is protective against the evil eye. Difference between religion and spirituality - -Religion is characterized by identification of a higher being shaping one's destiny while spirituality reflects the individual's perception of one's life having worth or meaning. First step to cultural competency - -Understand your own heritage and its basis in cultural values. Cultural background and pain - -The cultural background of the patient is important in a nurse's assessment of that patient's pain. Priority influence on health status - -Poverty. NURS 2092 NURS 2092 Initiating assessment of cultural beliefs - -What cultural or spiritual beliefs are important to you. Ethnocentrism - -The tendency to view your own way of life as the most desirable. Cultural assessment category - -Health-related beliefs. Health belief practice of American Indian heritage - -Eating compatible foods in one's diet. Magicoreligious causation of illness - -Belief in the struggle between good and evil is reflected in the regulation of health and illness. Auscultatory gap - -A brief period when Korotkoff sounds disappear during auscultation of blood pressure; common with hypertension. Bradycardia - -Heart rate fewer than 50 or 60 beats per minute in the adult (depending on agency). Sphygmomanometer - -Instrument for measuring arterial blood pressure. Stroke Volume - -Amount of blood pumped out of the heart with each heartbeat. Tachycardia - -Heart rate greater than 95 beats per minute in the adult. General survey areas - -Physical appearance, body structure, mobility, and behavior. Gait assessment expectation - -Gait is as wide as the shoulder width. Horizontal measuring board - -Use a horizontal measuring board to assess the height of a child. Head circumference vs. chest circumference - -The newborn's head will be 2 cm larger than the chest circumference, but between 6 months and 2 years, they will be about the same. Changes in height and weight during the 80's and 90's - -Both height and weight decrease. Temperature interpretation - -It cannot be evaluated without knowledge of the person's age. Accurate pulse assessment - -Begin counting with zero; count for 30 seconds. Normal pulse recording - -This would be recorded as 2+. NURS 2092 NURS 2092 Accurate respiration assessment - -Count for 30 seconds after pulse assessment. Pulse pressure - -The difference between the systolic and diastolic pressure. Coarctation of the aorta assessment finding - -The pressure is lower than in the arm. Mean arterial pressure - -Diastolic pressure plus one third of the pulse pressure. Blood pressure cuff size importance - -Using a cuff that is too narrow will give a false reading. Fainting episodes examination procedure - -Record the blood pressure in the lying, sitting, and standing positions. Vital sign measurements in aging adults - -An increased respiratory rate and a shallower inspiratory phase are possible findings. Android Obesity - -Excess body fat that is placed predominantly within the abdomen and upper body, as opposed to the hips and thighs. Anthropometry - -Measurement of the body (height, weight, circumferences, skin fold thickness). Body Mass Index (BMI) - -Weight in kilograms divided by height in meters squared; value of 30 or more is indicative of obesity; value less than 18.5 is indicative of under nutrition. Diet History - -A detailed record of dietary intake obtainable from 24 hour recalls, food frequency questionnaires, food diaries, and similar sources. Kwashiorkor - -Primarily a protein deficiency characterized by edema, growth failure, and muscle wasting. Malnutrition - -May mean any nutrition disorder but usually refers to long term nutritional inadequacies or excesses. Marasmic Kwashiorkor - -Combination of chronic energy deficit and chronic or acute protein deficiency. Marasmus - -Results from energy and protein deficiency, manifesting with significant loss of body weight, skeletal muscle, and adipose tissue mass, but with serum protein concentrations relatively intact. Nutritional Monitoring - -Assessment of dietary or nutritional status at intermittent times with the aim of detecting changes in the dietary or nutritional status of a population. NURS 2092 NURS 2092 Nutrition Screening - -A process used to identify individuals at nutritional risk or with nutritional problems. Obesity - -Excessive accumulation of body fat; usually defined as 20% above desirable weight or body mass index of 30.0-39.9. Protein Calorie Malnutrition (PCM) - -Inadequate consumption of protein and energy, resulting in gradual body wasting and increased susceptibility to infection. Recommended Dietary Allowance (RDA) - -Levels of intake of essential nutrients considered to be adequate to meet the nutritional needs of almost all healthy persons. Sarcopenic Obesity - -Combined loss of muscle mass with weight gain occurring in old age. Skinfold Thickness - -Double fold of skin and underlying subcutaneous tissue that is measured with skinfold calipers at various body sites. Waist-to-hip Ratio (WHR) - -Waist or abdominal circumference divided by the hip or gluteal circumference; method for assessing fat distribution. Nutritional Status - -The balance between nutrition intake and nutrient requirements. Weight Gain Parameters for Pregnancy - -The recommendation depends on the BMI of the mother at the start of the pregnancy. Normal Change with Aging - -Decrease in height. Nutritional Status Screening Data - -Weight and nutrition intake history. 24-hour Recall of Dietary Intake - -As a questionnaire or interview of everything eaten within the last 24 hours. Nutritional Deficiency Suspected - -Mary, a 15 year old, has come for a school physical. During the interview, you learn that menarche has not occurred. The BMI is 17.1. Lowest Risk for Nutritional Status Alteration - -65 year old widower who visits a senior center with a meal program 5 days per week. Height Measurement in Long-term Care - -Measure arm span. Nutrition Risk Assessment Finding - -BMI = 19kg/m(2). Marasmus Characterization - -Low weight for height. Obesity BMI Category - -30.0-39.9 kg/m(2). NURS 2092 Medication Use in Nutritional Assessment - -Many drugs can interact with nutrients and impair their digestion, absorption, metabolism, or uptake. Alopecia - -Baldness; Hair loss. Annular - -Circular shape to skin lesion. Bulla - -Elevated cavity containing free fluid larger than 1cm in diameter. Confluent - -Skin lesions that run together. Crust - -Thick, dried-out exudate left on skin when vesicles or pustules burst or dry up. Cyanosis - -Dusky blue color to skin or mucous membranes as a result of increased amount of non oxygenated hemoglobin. Erosion - -Scooped-out shallow depressions of skin. Erythema - -Intense redness of the skin due to excess blood in dilated superficial capillaries, as in fever or inflammation. Excoriation - -Self-inflicted abrasion on skin due to scratching. Fissure - -Linear crack in skin extending into the dermis. Furuncle - -Boil; suppurative inflammatory skin lesion due to infected hair follicle. Hemangioma - -Skin lesion due to benign proliferation of blood vessels in the dermis. Iris - -Target shape of skin lesion. Jaundice - -Yellow color to skin, palate, and sclera due to excess bilirubin in the blood. Keloid - -Hypertrophic scar, elevated beyond site of the original injury. Lichenification - -Tightly packed set of papules that thickens skin; caused by prolonged intense scratching. Lipoma - -Benign fatty tumor. Maceration - -Softening of the tissue by soaking. Macule - -Flat skin lesion with only a color change. Nevus - -Mole; circumscribed skin lesion due to excess melanocytes. NURS 2092 NURS 2092 Pallor - -Excessively pale, whitish pink color to lightly pigmented skin. Papule - -Palpable skin lesion smaller than 1cm in diameter. Plaque - -Skin lesion in which papules coalesce or come together. Pruritus - -Itching. Purpura - -Red-purple skin lesion due to blood in tissues from breaks in blood vessels. Pustule - -Elevated cavity containing thick, turbid fluid. Scale - -Compact desiccated flakes of skin from shedding of dead skin cells. Telangiectasia - -Skin lesion due to permanently enlarged and dilated blood vessels that are visible. Ulcer - -Sloughing of necrotic inflammatory tissue that causes a deep depression in skin, extending into dermis. Vesicle - -Elevated cavity containing free fluid up to 1cm in diameter. Wheal - -Raised red skin lesion due to interstitial fluid. Zosteriform - -Linear shape of skin lesion along a nerve route. Eccrine glands secretion - -Dilute saline solution. Early jaundice assessment - -Sclera and hard palate. Skin temperature check - -Dorsal surface of hand. Skin turgor assessment - -Dehydration. Lesion documentation - -Dark brown raised lesion, with irregular border, on dorsum of right foot, 3cm in size, with no drainage. Normal nail bed angle - -160 degrees. Capillary refill normal finding - - 1 second. Sun exposure macules response - -These are the result of sun exposure and do not require treatment. Thin shiny skin - -Atrophy. NURS 2092 NURS 2092 Flattened nail angle - -Described as clubbing. Annular lesion - -A configuration of individual lesions arranged in circles or arcs, as occurs with ringworm. ABCDE rule 'A' - -Asymmetry. Melanoma risk factor - -Skin that freckles or burns before tanning. Herpes zoster infection - -Lesion only on one side of the body; does not cross the midline. Basal cell layer - -Epidermis. Subcutaneous layer function - -Aids protection by cushioning. Collagen - -Dermis. Adipose tissue - -Subcutaneous tissue. Uniformly thin skin - -Epidermis. Stratum corneum - -Epidermis. Elastic tissue - -Dermis. Pallor - -Absence of red-pink tones from the oxygenated hemoglobin in blood. Erythema - -Intense redness of the skin due to excess blood in the dilated superficial capillaries. Cyanosis - -Bluish mottled color that signifies decreased perfusion. Jaundice - -Increase in bilirubin in the blood causing a yellow color in the skin. Erythema toxicum - -Tiny, punctate red macules and papules on the cheeks, trunk, chest, back, and buttocks. Harlequin - -Lower half of body turns red, upper half blanches. Cutis marmorata - -Transient mottling on trunk and extremities. Acrocyanosis - -Bluish color around the lips, hands, fingernails, feet, and toenails. Cafe au lait spot - -Large round or oval patch of light brown usually presented at birth. NURS 2092 NURS 2092 NURS 2092 Physiologic jaundice - -Yellowing of skin, sclera, and mucous membranes due to increased numbers of red blood cells hemolyzed after birth. Carotene effect - -Yellow-orange color in light skinned persons from large amounts of foods containing carotene. Carotenemia - -Correct Answer-Carotenemia Abduction - -Correct Answer-Moving a body part away from an axis or the midline Adduction - -Correct Answer-Moving a body part toward the center or toward the midline Ankylosis - -Correct Answer-Immobility, consolidation, and fixation of a joint because of disease, injury, or surgery; most often due to chronic rheumatoid arthritis Ataxia - -Correct Answer-Inability to perform coordinated movements Bursa - -Correct Answer-Enclosed sac filled with viscous fluid located in joint areas of potential friction Circumduction - -Correct Answer-Moving the arm in a circle around the shoulder. Crepitation - -Correct Answer-Dry crackling sound or sensation due to grating of the ends of damaged bone. Dorsal - -Correct Answer-Directed toward or located on the surface Dupuytren contracture - -Correct Answer-Flexion contracture of the fingers due to chronic hyperplasia of the palmar fascia Eversion - -Correct Answer-Moving the sole of the foot outward at the ankle Extension - -Correct Answer-Straightening a limb at a joint Flexion - -Correct Answer-Bending a limb at the joint Ganglion - -Correct Answer-Round, cystic, nontender nodule overlying a tendon sheath or joint capsule, usually on dorsum of wrist Hallux valgus - -Correct Answer-Lateral or outward deviation of the great toe Inversion - -Correct Answer-Moving of the sole of the foot inward at the ankle Kyphosis - -Correct Answer-Outward or convex curvature of the thoracic spine; hunchback NURS 2092 NURS 2092 Ligament - -Correct Answer-Fibrous band running directly from one bone to another bone that strengthens the joint Lordosis - -Correct Answer-Inward or concave curvature of the lumbar spine Nucleus pulposus - -Correct Answer-Center of the intervertebral disc Olecranon process - -Correct Answer-Bony projection of the ulna at the elbow Patella - -Correct Answer-Kneecap Plantar - -Correct Answer-Refers to the surface of the sole of the foot Pronation - -Correct Answer-Turning the forearm so that the palm side is down Protraction - -Correct Answer-Moving a body part forward and parallel to the ground Range of motion (ROM) - -Correct Answer-Extent of movement of a joint Retraction - -Correct Answer-Moving a body part backward and parallel to the ground Rheumatoid arthritis - -Correct Answer-Chronic systemic inflammatory disease of the joints and surrounding connective tissue Sciatics - -Correct Answer-Nerve pain along the course of the sciatic nerve that travels down from the back or thigh through the leg and into the foot Scoliosis - -Correct Answer-S-shaped curvature of the thoracic spine Supination - -Correct Answer-Turning the forearm so that the palm is up Talipes equinovarus - -Correct Answer-Congenital deformity of the foot in which it is planter flexed and inverted (clubfoot) Tendon - -Correct Answer-Strong fibrous cord that attaches a skeletal muscle to a bone Torticollis - -Correct Answer-Wryneck; contraction of the cervical neck muscles, producing torsion of the neck Flex, extend, abduct, and rotate - -Correct Answer-During the assessment of the spine, the patient would be asked to? Radius and ulna - -Correct Answer-Pronation and supination of the hand and forearm are the result of the articulation of the? NURS 2092 NURS 2092 Anterior and posterior cruciate ligaments - -Correct Answer-Anterior and posterior stability are provided to the knee joint by the? Kyphosis - -Correct Answer-A common age related change in the curvature of the spinal column? Forward flexion, internal rotation, abduction, and external rotation - -Correct Answer Examination of the shoulder includes 4 motions, they are? Swelling in the suprapatellar pouch - -Correct Answer-The bulge sign is a test for? Within 1cm of each other - -Correct Answer-The examiner measures a patient's legs for length discrepancy, which is a normal finding? Lordosis - -Correct Answer-A common finding for a 2 year old child comes in the clinic for a health examination. Carpel Tunnel Syndrome - -Correct Answer-A positive Phalen test and Tinel sign are found in a patient with? Correct Answer - -Gently lifting and abducting the infant's flexed knees while palpating the greater trochanter with the fingers Hematopoiesis - -Takes place in the bone marrow Ligaments - -Fibrous bands running directly from one bone to another that strengthen the joint and help prevent movement in undesirable directions Flexion - -Bending a limb at a joint Extension - -Straightening a limb or joint Abduction - -Moving a limb away from the midline of the body Adduction - -Moving a limb toward the midline of the body Pronation - -Turning the forearm so that the palm is down Supination - -Turning the forearm so that the palm is up Circumduction - -Moving the arm in a circle around the shoulder Inversion - -Moving the sole of the foot inward at the ankle Eversion - -Moving the sole of the foot outward at the ankle NURS 2092 Rotation - -Moving the head around a central axis Protraction - -Moving a body part forward and parallel to the ground Retraction - -Moving a body part backward and parallel to the ground Elevation - -Raising a body part Depression - -Lowering a body part Alveoli - -Functional units of the lung; the thin walled chambers surrounded by networks of capillaries that are the site of respiratory exchange of carbon dioxide and oxygen Angle of Louis - -Manubriosternal angle, the articulation of the manubrium of the body of the sternum, continuous with the second rib Apnea - -Cessation of breathing Asthma - -An abnormal respiratory condition associated with allergic hypersensitivity to certain inhaled allergens, characterized by inflammation, bronchospasm, wheezing and dyspnea Atelectasis - -An abnormal respiratory condition characterized by collapsed, shrunken, deflated sections of the alveoli Bradypnea - -Slow breathing, fewer than 10 breaths per minute, regular rate Bronchiole - -One of the smaller respiratory passageways into which the segmental bronchi divide