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NUR 643E ADVANCED HEALTH ASSESSMENT FINAL EXAM
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NUR 643E ADVANCED HEALTH ASSESSMENT FINAL EXAM
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NUR 643E ADVANCED HEALTH ASSESSMENT FINAL EXAMWhat are the parts of the large intestine? - ANSWER Cecum
Asending colon
Transverse colon
Descending colon (sigmoid, rectum, anal)
In what part of the digestive system are fats and proteins broken down? - ANSWER
The stomach - uses HCL and enzymes
What lines the surface of the small intestine to help absorb nutrients? - ANSWER Villi
What are the parts of the small intestine? - ANSWER duodenum, jejunum, ileum
What are the parts of the stomach? - ANSWER The fundus, antrum and the body
What is peristalsis? - ANSWER The sequential autonomic muscular contractions that move nutrients along the digestive tract
What part of the digestive system is responsible absorbing water, lubricating contents, and putrefaction? - ANSWER Large intestine
What is putrefaction? - ANSWER Changes produced by action of bacteria and microorganisms to decompose undigested food, unabsorbed animo acids, cell debris, and dead bacteria
What is the function of the gallbladder? - ANSWER Concentrates and stores bile
What abdominal organ has both exocrine and endocrine functions? What are the functions? - ANSWER Exocrine - produces digestive enzymes Endocrine - produces insulin
What is the function of the spleen? - ANSWER Filter blood and help fight infections
What abdominal organ(s) is located in the retroperitoneum? - ANSWER Kidneys
What part of the social history do you always want to make sure you ask about when
assessing and abdominal complaint? - ANSWER Alcohol use/abuse When you are palpating your patient's abdomen where do you want to look for clues to the severity of their pain? - ANSWER Their face
What is pyrosis? - ANSWER Heartburn
What type of disease is IBS, generally? - ANSWER Functional
45 y/o female presents to your office complaining of achey, burning epigastric pain, especially after she eats. Your cardiac workup is negative. What is high on your differential? What lifestyle modifications do you suggest? - ANSWER GERD Stay sitting up after eating Wait a few hours after eating to go to sleep
Avoid spicy foods, chocolate, caffeine, acidic foods, etc
Your patient comes in with loss of appetite for the last few weeks. What chronic medical disease do you want to keep on your differential? - ANSWER Malignancy
Proton pump inhibitors can increase the risk of what infectious disease? - ANSWER
C. dif
When you are working up a patient with a chief complaint of nausea what do you want to ask them? - ANSWER Pregnant?
When nauseous?
Have you taken anything?
Vomiting?
Relationship to food? Bowel changes?
Taking medications? PMS?
Your patient presents to your office - ANSWER What does projectile vomiting in an adult make you think? - ANSWER Increased intracranial pressure
You are seeing a patient in your office and he tells you he has been having long, skinny stools. What are you worried about? - ANSWER Intestinal obstruction Malignancy?
What does fatty stool indicate? - ANSWER Malabsorption
What do clay colored stools indicate? - ANSWER Hepatobiliary obstruction
What common medications can cause constipation? - ANSWER 5-HT3 receptor antagonists (Ondansetron); Antacids; Anticholinergics; Antidepressants; Antihistamines; Anticonvulsants; CCB; Clonidine; Calcium supplements; Diuretics; Iron supplements; Levodopa; Narcotics; NSAIDs; Psychotropics; Sympathomimetics What are you worried about in older, younger, and immunocompromised patients with diarrhea? - ANSWER Dehydration --> electrolyte imbalances
What is dysuria? - ANSWER Painful or difficult urination
What do you want to warn your patient of before starting him on a laxative? - ANSWER Can develop a dependency due to decreased intestinal tone
Your patient tells you he has been having dark tarry stools. What medication do you want to ask about? - ANSWER Iron supplement
What is familial mediterranean fever? - ANSWER Inherited condition characterized by recurrent episodes of painful inflammation in the abdomen, chest, or joints
When you are prepping your patient for an abdominal exam what do you want to tell them to do? - ANSWER Empty their bladder
When you are performing an abdominal exam where do you want to stand in relation
to your patient? - ANSWER On the patient's right side
What are the nine regions of the abdomen? - ANSWER Right hypochondriac, epigastric, left hypochondriac, right lumbar, umbilical, left lumbar, right inguinal, hypogastric, left inguinal
What hypothetical lines divide up the nine regions of the abdomen? - ANSWER Two horizontal lines - across edge of costal margin and edge of iliac crest Two vertical lines - run bilaterally form midclavicular lines to middle of Poupart ligament (inguinal ligament)
Which kidney is lower and why? - ANSWER The right kidney is lower in the abdominal cavity because of the amount of space the liver occupies.
You are performing an abdominal exam as part of a well visit. What are you inspecting for? - ANSWER Contour of abdomen + peristalsis
Skin - scars, color, rashes, lesions, striae, dilated veins Umbilicus
Asymmetries, masses, hernias
Aortic pulsations
Your colleague thinks she found a mass during her abdominal exam and wants you to double check. She tells you to raise the head of the bed. Why? - ANSWER Mass within the abdominal wall is more prominent when the head is raised
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