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Nurs 252 Final Review Questions and Complete Solutions
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  • NUR 252

Priority levels 1. Immediate (emergency, life threatening) 2. Second level (urgent, must be addressed to prevent further deterioration) 3. Third level (important to patient health) 4. Collaborative problems ( interprofessional team, ex. substance abuse) Arranging the physical setting - Minimize in...

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  • September 5, 2024
  • 33
  • 2024/2025
  • Exam (elaborations)
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  • nurs 252 final review questions and complete solut
  • priority levels 1 immediate emergency life thr
  • arranging the physical setting minimize interru

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  • NUR 252
  • NUR 252

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Nurs 252 Final Review Questions and
Complete Solutions
Priority levels ✅1. Immediate (emergency, life threatening)
2. Second level (urgent, must be addressed to prevent further deterioration)
3. Third level (important to patient health)
4. Collaborative problems ( interprofessional team, ex. substance abuse)

Arranging the physical setting ✅- Minimize interruptions and establish rapport
-Leave enough distance, and allow for personal space
-Equal seating

Patient introduction ✅1. wash hands
2. NOD (name, occupation, duty)
3. Purpose of assessment

Motivational Interviewing principles ✅-Open ended questions
-Make affirmations
-use reflections
-Summarize

Empathy ✅-Recognition and acceptance of patient's feelings

Barriers to professional therapeutic communication ✅-Failing to listen
-Giving personal opinions, approving or disapproving statements
-Changing the subject
-False reassurance
-Interrupting
-Overusing professional jargon
-Talking too much
-"why" questions

General Survey ✅-Age
-Level of alertness
-Body size and shape
-Non-verbal communication
-Symmetrical comparison

Palpation ✅Touch to assess
-Temperature
-Moisture
-Texture

,-Vibration
-Pulsation
-Rigidity
-Crepitus
-Presence of lumps or masses
-Presence of tenderness or pain

Finger pads- palpation regions ✅-Used to assess texture, moisture, and contour

Fingertips/pads (palpation) ✅-Used to assess pulsatility, fluid content of tissues,
elasticity and turgor, and vascularity

Dorsum of hand (palpation) ✅-Used to assess temperature

Ulnar surface of hand (palpation) ✅-Used to assess temperature and vibration

Light palpation ✅- Communicate for patient comfort, use warm hands and go from non
tender areas to tender areas
-Use Intermittent circular motions with Dominant hand
-Finger pads sense movement of patient's skin and tissue

Deep palpation ✅-Risk of injuring patient, up to discretion of nurse within their scope of
practice
-3-4 cm below skin surface
-Extended fingers of non dominant hand over dominant hand for extra pressure

Percussion ✅-Tapping on body surfaces to create sound
-Helps determine location, size and density of organs
-Detects abnormal mass
-Elicits pain on inflamed area
-Deep tendon reflex

Direct percussion ✅-Tap directly on skin
-Maxillary sinuses

Indirect percussion ✅-Tap middle finger of dominant hand over middle finger of non-
dominant hand placed on a body surface
-Tap twice only, using a quick and forceful wrist action

Percussion sounds ✅1) Flatness
2) Dullness
3) Resonance
4) Tympanic

Auscultation ✅-Ear pieces facing nose

,-Use the diaphragm and bell
-Warm the stethoscope and sanitize
-Hair and friction can produce artifact sounds
-Do not auscultate through clothes

Diaphragm of stethoscope ✅-Flat endpiece of the stethoscope used for hearing
relatively high-pitched heart sounds
-Lung and Heart sounds

Bell of stethoscope ✅-Cup-shaped endpiece used for soft, low-pitched heart sounds
-Heart murmurs

Infants developmental considerations for assessment ✅-Trust the parent
-Prefer warmth
-Perform least distressing assessments first
-Lung, heart and abdominal sounds first if sleeping

Toddlers developmental considerations for assessment ✅-Can have parental
assistance with positioning
-Least distressing assessments first
-Use games/toys
-Praise cooperative children

Preschool developmental considerations for assessment ✅-They have initiative
-Prefer a parental presence
-Can be cooperative, have increasing communication skills
-Still need games/toys
-Least distressing assessments first

School age children developmental considerations of assessment ✅-Industry
-Seek approval, feelings of accomplishment
-Can have small talk about interests
-Perform a head to toe assessment

Adolescents developmental considerations for assessment ✅- Struggle with self-
identity
-Strong awareness of body image
-Educate for self-care
-head to toe assessment

Older adult developmental considerations for assessment ✅-Seated or supine
-Slower pace of examination
-Discriminate between sensory loss and confusion
-Head to toe examination

, Skin function ✅-Protection
-Barrier for penetration
-Perception
-Thermoregulation
-Identification (self-image
-Communication (blushing, blanching)
-Wound repair
-Absorption and secretion
-Vitamin D production

Skin layers ✅1. Epidermis
2. Dermis
3. Hypodermis/subcutaneous layer-has adipose tissue, energy stores, cushioning,
insulation for temp control

Skin colour and tone ✅1. Melanin-brown pigmentation
2. Carotene-yellow/orange
3. Vascular bed- red/purple
-Varies with genetics and health state (edema, fever)

Glands in the skin ✅-Sebaceous glands (open into hair follicles)
-Sweat glands (thermoregulation)
-Eccrine and apocrine glands

Hair ✅-Made of keratin
-Cyclical growth, active and resting phases
-Vellus hair (fine, covers most of the body)
-Terminal hair (dark, thick)

Nail plate, folds and cuticle ✅-Made of keratin
-Pink colour indicates highly vascular epithelial cells
-Lunula is the white semilunar area at proximal end of nail
-Nail fold overlaps posterior and lateral borders
-The cuticle protects nail matrix

Puritis ✅-Intense itching

Things to look for in a skin assessment ✅-Previous history of skin disease
-Changes in pigmentation
-Changes in mole (ABCDE)
-Excessive dryness or moisture
-Puritis
-Excessive bruising

Things to look for in a hair and nails assessment ✅-Hair loss

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