NUR 612 ADVANCED HEALTH ASSESMENT
EXAM 3 MARYVILLE UNIVERSITY|LATEST
UPDATE 2024| ACTUAL EXAM QUESTIONS
WITH CLEARLY EXPLAINED CORRECT
ANSWERS ALL GRADED A+GUARANTEED
SUCCESS!!
Screening exam for mental status - ANSWER-✅-Screen for appearance and behavior
(grooming, emotional status, body language)
-Emotional stability (moods & feelings, thought processes)
-Cognitive abilities (state of consciousness, memory, attention span, judgement)
-Speech & language (voice quality, articulation, comprehension, coherence, aphasia)
Delerium - ANSWER-✅sudden, reversible, lasts hours to days, altered consciousness,
mood swings, illogical flow of ideas, hallucinations, delusions, associated with acute
events
Dementia - ANSWER-✅insidious, persistent, struggles to find words,
depressed/apathetic, delusions but no hallucinations, related to structural disease of
the brain
Expressive aphasia - ANSWER-✅knows what they want to say but can't articulate
properly, reading comprehension intact, impaired writing
Receptive aphasia - ANSWER-✅can hear words but can't relate, uses words
inappropriately/incomprehensible, impaired reading and writing
Global aphasia (both) - ANSWER-✅Only knows ones name or few select words, no
spontaneous speech or very limited, severely impaired reading and writing
Risk factors for suicidal ideations - ANSWER-✅-Social isolation (living alone,
divorced, widowed)
,-Mental health disorder (depression)
-Terminal health condition
-Family hx
-Personal losses or challenges (unemployment, legal problems)
-Plan for suicide or previous attempt
-Alcohol or substance abuse
-Access to firearms or other self harm
Depression - ANSWER-✅Sudden or insidious, longer than 2 weeks, no impaired
consciousness, impaired concentration/memory/thought processes, insomnia or too
much sleep, fatigue, anxiety, slowed speech, homeless, loss of interest of pleasure,
associated with grief or stressful life event
Abdominal pain HPI questions - ANSWER-✅-Onset: when, sudden vs gradual
-Location: of onset, change? radiates, superficial or deep
-Duration: persistent, recurrent, intermittent
-Character: dull, sharp, burning, gnawing, stabbing, cramping, aching, colicky, also
stool/urine characteristics
-Aggravating factors: medications?
-Relieving factors: medications, home remedies
-Temporal factors: related to menses, intercourse, urination, defecation, inspiration,
change in body position, food/alcohol, stress, time of day, trauma?
-Associated symptoms: vomiting, diarrhea, constipation, flatus, belching, jaundice,
abdominal girth, weight loss or gain
Abdominal: inspection - surface characteristics - ANSWER-✅-Normal: pink, venous
return above the umbilicus should be toward the head; below the umbilicus should
be toward the feet
-Abnormal: Jaundice, cyanosis, taut, bruises, redness, Cullen sign, striae, tumors,
masses, ascstes, nodules (Sister Mary Joseph a pearl-like, enlarged and sometimes
painful umbilical nodule can indicate abd malignancy), lesions
Abdominal: inspection: Contour - ANSWER-✅-Normal: flat, rounded, or scaphoid,
umbilicus centrally located, symmetric
-Abnormal: distention, bulges, umbilicus inflammation/bulging, masses, hernias,
diastasis recti
Abdominal: Inspection: Movement - ANSWER-✅-Normal: Smooth, even movement
with respiration
-Abnormal: limited motion on respiration (peritonitis), peristalsis (obstruction),
marked pulsations (aortic aneurysm)
Abdominal: Auscultation: Bowel sounds & bruits - ANSWER-✅-Normal: 5-35
clicks/gurgles/min
-Abnormal: loud prolonged gurgles (borborygmi), increased BS (gastroenteritis,
intestinal obstruction, hunger), high-pitched tinkling (intestinal fluid & air under
pressure aka early obstruction), decreased BS (peritonitis, paralytic ileus), absent
,bowel sounds = inability to hear after 5 min (abdominal pain/rigidity—surgical
emergency), bruits, friction rubs, venous hum
Abdominal: Percussion - ANSWER-✅-Normal: Overall tympany & dullness, liver span
6-12cm, splenic dullness 6th-9th rib, tympany gastric bubble
-Abnormal: organ enlargement, CVA tenderness
Abdominal: Palpation - ANSWER-✅-Normal: smooth, soft, without resistance or
tenderness, spleen, kidneys, and healthy gallbladder are not palpable, liver palpable
at costal margin (firm, smooth, even, nontender)
-Abnormal: Palpable tender gallbladder = cholecystits, common bile duct obstruction
= nontender enlarged gallbladder, any masses, guarding, pain, bulges, nodules,
granulation
How to assess for McBurney's point - ANSWER-✅Lower right quadrant
Palpation of the kidney - ANSWER-✅Right kidney is more often felt than the left.
One hand on flank, one hand on costal margin. As patient inhales deeply, lift the
flank and palpate deeply
Palpation of liver - ANSWER-✅6-12 cm liver span
Conditions for acute abdominal pain - ANSWER-✅appendicitis, peritonitis,
cholecystitis, pancreatitis, salpingitis, PID, diverticulitis, perforated gastric/duodenal
ulcer, intestinal obstruction, volvulus, leaking abdominal aneurysm, biliary stones,
renal calculi, extopic pregnancy, ruptured ovarian cyst, splenic rupture
Conditions for chronic abdominal pain - ANSWER-✅IBS, lactose intolerance,
diverticular disease, constipation, uterine fibroids, hernia, GERD, peptic ulcer,
gastritis
Aarons sign - ANSWER-✅palpation of McBurneys causes heart or stomach pain =
appendicitis
Ballance sign - ANSWER-✅dullness to percussion of flank that disappears w/ change
of position= peritoneal irritation
Blumberg sign - ANSWER-✅Rebound tenderness = appendicitis, peritoneal irritation
Cullen sign - ANSWER-✅Eccymosis around umbilicus = hemoperitoneum,
pancreatitis, ectopic pregnancy
Dance sign - ANSWER-✅absence of BS in RLQ = intussusception
Grey Turner sign - ANSWER-✅Ecchymosis of flanks = hemoperitoneum, pancreatitis
, Kehr sign - ANSWER-✅Abdominal pain radiating to left shoulder = spleen rupture,
renal caliculi, ectopic pregnancy
Markle sign - ANSWER-✅raises on toes and comes down on heels (jarring body)
causing abdominal pain = peritoneal irritation, appendicitis
McBurney sign - ANSWER-✅raises on toes and comes down on heels (jarring body)
causing abdominal pain = peritoneal irritation, appendicitis
Murphy sign - ANSWER-✅cessation of inspiration on gallbladder palpation =
cholecystitis
Romberg-Howship sign - ANSWER-✅pain down medial aspect of thigh to knees =
strangulated obturator hernia
Rovsing sign - ANSWER-✅RLQ pain worse with LLQ palpation = peritoneal irritation,
appendicitis
History for female with female problems - ANSWER-✅o HPI: OLDCARTS
o Review pg. 423
Normal pap smear of cervix - ANSWER-✅Normal: pink, horizontal position (midline),
1-3cm within the vagina, smooth surface, nabothian cysts, discharge (odorless,
creamy or clear, thick, thin, or stringy), os nulliparous = small, round, oval; os of
multiparous = slit, stellate,
Abnormal pap smear and indications - ANSWER-✅-bluish (increased vascularity =
pregnancy)
-patchy areas of redness with irregular borders
-pale = anemia
-deviation (pelvic mass, uterine adhesions, pregnancy), -> 3cm = pelvic/uterine mass,
cervical ectropion
-friable tissue, granular areas, white patchy areas (cervicitis, infection, carcinoma)
-cervical polyps, varied color discharge w/ foul odor indicates bacterial or fungal
infection
-stellate scarring/lacerations (trauma from childbirth)
-trauma from induced abortion or difficult removal of an IUD may change the shape
of the os to a slit
Red flags for sexual abuse - ANSWER-✅o Evidence of general physical abuse or
neglect
o Evidence of trauma and/or scarring in genital area
o Unusual skin color changes in genital or anal area
o STIs
o Anorectal problems (itching, bleeding, etc)
o Genitourinary problems (rash, sore, discharge, pain, UTIs, bleeding)
o Problems with school
