Advanced Health Assessment Exam 2 Blueprint
Some of your content for Exam 2 is split into different segments due to the amount of content. Modules
5, 6 and 7 is a lot to cover in one exam, so you will need to study Module 5, 6 and only the Neurological
portion of Module 7. Musculoskeletal will be on Exam 3.
The blueprint below gives you detailed focus areas that we feel are the most important content (not just
for an exam but for your baseline knowledge in practice to practice safely!). That being said, this exam is
much more "need to know" history and exam information to keep your patients safe clinically and to
educate other nurses/healthcare professionals to practice safely.
If we have suggested you review a ppt, lecture or other lesson--please make sure you do so! Focus on
learning the concepts below, not reading every single page of every single chapter.
Exam 2—See your syllabus for date/details.
Once you open your exam, you will have 90 minutes to complete the exam. Please ensure you begin the
exam no later than 1015pm CST to ensure you have the complete 90 minutes for the exam by the time it
closes at 1159pm CST
Total # of questions: 50
Modules 5-7 (Module 5, 6 and the Neurological System portion of Module 7 only)
Concepts to review:
Pulmonary--Focus your pulmonary review on Dains, not S2D.
Cardiac--S2D text readings (primarily chest pain, hypertension/Syncope) and other key items below
within your modules. You will not be tested over any IHUMAN cases but you will need to review your
Diagnostic approaches to chest pain lessons and Mr. Clayton Womack’s presentation on Pediatric
Cardiology assessment.
S2D text—remember—any sections that refer to how to “treat” or Treatment Headings are not
necessary for study.
Diagnostic testing—this exam will not have heavy focus on diagnostic testing beyond mentioning certain
testing in a scenario—you will not have to interpret EKG results, CXR, Echocardiograms, and you will not
have to “select” testing for any cardiac or pulmonary conditions.
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,Pulmonary and CV (20 questions) Caylene, Teresa, Hannah Thomas, Aurora, Lucy, Erin, Addison,
Sydney
● Differential diagnoses possibilities for presentations of (Dains)
● dyspnea CAYLENE
● hoarseness
● cough
DYSPNEA
Dyspnea- Shortness of breath, subjective sensation of air hunger that results in labored breathing
True dyspnea results from 3 general causes:
1. An increased awareness of normal breathing, such as with hyperventilation
2. As increase in the in the work of breathing, such as in airway obstruction or restricted volume
3. Abnormalities in the ventilatory system, such as in neurologic disorders, diseases of the muscles,
and chest wall abnormalities.
In disease state it is usually a result of pulmonary or cardiac pathology
When eliciting a history determine if this is:
● New-onset acute dyspnea
● Chronic progressive dyspnea
● Chronic recurrent dyspnea
In children younger than 3 years old (who usually cannot express the sensation), caregivers can observe
tachypnea, retractions, stridor, nasal flaring, or feeding difficulty
First, is this an emergency?
Severe Dyspnea is a medical emergency if not treated immediately respiratory failure and death can
occur! Assess adequacy of airway first
Key questions:
● Did this occur suddenly, or has it been developing gradually?
● Over what period of time (hours, days, weeks) has it developed?
● What were you (or the child) doing just before having difficulty breathing?
● Do you (or the child) have other symptoms such as itching or swelling?
Acute dyspnea (sudden shortness of breath) in someone with no previous heart or lung issues can be a
life-threatening condition requiring immediate attention. In children, it's crucial to rule out airway
obstruction, which can be caused by conditions like epiglottitis (inflammation of the epiglottis), croup, or
a foreign body. Symptoms may include:
- Drooling
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,- Hoarseness (dysphonia)
- Difficulty swallowing (dysphagia)
- Respiratory distress with inspiratory stridor (a high-pitched sound when breathing in)
- Anxiety and sitting up straight to assist breathing
Other possible causes of acute dyspnea include:
- Aspiration of a foreign body
- Anaphylaxis
- Pulmonary embolism (PE)
- Pneumonia
- Left ventricular dysfunction
- Status asthmaticus (severe asthma attack)
Prompt assessment of airway and ventilatory status, oxygen, and cardiac monitoring are essential to
address this potentially life-threatening condition.
Is the dyspnea caused by a secondary obstruction in the lower respiratory tract?
Key Questions:
● Have you had a cough or recent cold?
● Do you have a history of asthma
● Is there a family history of asthma?
Is the dyspnea caused by trauma to the chest?
Key Question:
● Have you experienced any trauma to the chest?
Is the dyspnea caused by a Pulmonary Embolus?
Key Questions:
● Have you recently been confined to bed or been sitting for a long period of time?
● Have you had recent surgery?
● Have you recently sustained a fracture?
● Are you taking birth control pills or estrogen?
● Have you had any pain in your legs?
● Do you have a history and or family history of deep vein thrombosis?
● Do you smoke?
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, ● What medications are you taking?
● Are you feeling anxious or scared?
Is the dyspnea related to a preexisting disease?
Key Questions:
● Do you have a history of heart problems, lung problems (asthma), or anemia?
● Do you have any numbness or tingling in your body? Where?
● Have you noticed any other symptoms?
What factors precipitate or aggravate the dyspnea?
Key Questions:
● What activities are associated with SOB?
● Do you take any medication?
● Do you have any known allergies (to trees, dust, pollen, animals)? Have you been exposed to
these recently?
● Is there anything you can do to help yourself feel less SOB, such as sit up, stay indoors, lie down,
or use medication?
Is the dyspnea caused by a neuromuscular problem?
Key Questions:
● Are your immunizations up to date?
● If a child: Has the child eaten honey? Do you live on a farm?
● If a child: Is the child at risk for lead poisoning?
● Do you have a headache, muscle weakness, or other symptoms?
Does the patient have any pertinent risk factors that will point me in the right direction?
Key Questions:
● Do you smoke? Have you ever smoked? Are you regularly exposed to cigarette smoke?
● What type of work do you do?
● Have you had a recent weight gain?
● Have you had eczema?
DIAGNOSTIC REASONING: FOCUSED PHYSICAL EXAM
The severity of the dyspnea almost always correlates to the severity of the condition causing it
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