NR302 Health Assessment Final Exam || Concepts, Questions & Solutions (100% Accurate)
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Course
NR 302 EDAPT
Institution
NR 302 EDAPT
NR302 Health Assessment Final Exam || Concepts, Questions & Solutions (100% Accurate)
NR302 Health Assessment Final Exam || Concepts, Questions & Solutions (100% Accurate)
What are some examples of subjective data? - ANSWER - pain, nausea, dizziness, fatigue
Identify examples of what should ...
, NR302 Health Assessment Final Exam
|| Concepts, Questions & Solutions
(100% Accurate)
What are some examples of subjective data? - ANSWER - pain, nausea, dizziness,
fatigue
Identify examples of what should be documented in the medication reconciliation -
ANSWER - Prescribed and OTC medication and/ or herbal therapy.
Identify and understand each component of PQRSTU and its place within the health
history. - ANSWER - P= Provocative or palliative
Q= Quality or quantity
R= Region or radiation
S= Severity scale 1-10
T= Timing or onset
U= Understand patients perception of problem
what is the purpose of the PQRSTU mnemonic - ANSWER - Purpose of the
mnemonic is to help assess pain or symptoms
Identify how a ROS should be recorded - ANSWER - Evaluation of past and present
state of each body system
Assess that all pertinent(relevant) data relative to each body system have been
noted.
Record either presence or absence of symptoms
NO OBJECTIVE DATA
Limit to patients statements
Include ALL relevant body systems
Define orientation - ANSWER - Person knows own name,age, who examiner is, type
of worker
Time, place, day of the week etc.
Alert - ANSWER - person is alert(aware)
Lethargy - ANSWER - lack of energy or enthusiasm
Coma - ANSWER - state of deep unconsciousness that may be prolonged or
indefinite
Delirium - ANSWER - an acute confusional state, potentially in hospitalized persons.
Characterized by disorientation, disordered thinking, and perceptions (illusions and
hallucinations), defective memory, agitation, inattention.
Objective data - ANSWER - what you as the health professional observe by
inspecting, percussing, palpating, and auscultating during the physical examination
,what are some examples of objective data? - ANSWER - pulse, heart rate, weight,
vital signs
what is the order for the nursing process? - ANSWER - ADOPIE
-Assessment
-Diagnosis
-Outcomes Identification/Planning
-Implementation
-Evaluation
subjective data - ANSWER - what the patient says about himself/herself during
history taking.
Assessment - ANSWER - collect data, health history, functional assessment.
diagnosis - ANSWER - compare clinical findings with normal and abnormal variation
and development of events.
-interpret data
- validate diagnoses
Implementation - ANSWER - perform the nursing actions identified in planning
Evaluation - ANSWER - patients status and effectiveness of nursing interventions.
"evaluation is when you determine if the desired outcome was achieved"
Novice nurse - ANSWER - has no experience with specific patient populations and
uses rules to guide performance.
Competency Nurse - ANSWER - * 2 to 3 years post graduation
* Ability to see actions in the context of arching goals or daily plans for patients
proficient nurse - ANSWER - with additional time and experience you understand a
patient's situation as a whole rather than a list of tasks
Expert nurse - ANSWER - -vault over the steps and arrive at a clinical judgment in
one leap
1st priority - ANSWER - emergent, life threatning and immediate
2nd priority - ANSWER - - next in urgency
-mental status change
- acute pain
- acute urinary elimination problems
, 3rd priority - ANSWER - important to patient's health but can be attended to after
more urgent health problems are addressed.
-mobility problems
- family coping
- anything that can wait.
SBAR communication - ANSWER -
Identify guidelines for recommending vaccines - ANSWER - Correlate with CDC
guidelines (should be kept up to date)- adults need flu vaccine every year + a td or
tdap
Define ABCT and differentiate the components involved within each level (mental
status examination) - ANSWER - A-B-C-T
Appearance
Behavior
Cognition-4w's
Thought process
Identify how to assess a pulse, and normal findings for the rate, rhythm, and force. -
ANSWER - Using pads of the first three fingers, palpate radial pulse at the flexor
aspect of wrist laterally along the radius bone until the strongest pulsation is felt.
Regular pulse = count number of beats in 30 seconds and multiply by 2
rate= regular
rhythm= even regular tempo
force= 2+ normal
How to assess pulse readings - ANSWER - 0- absent
1+ weak and thready
2+ normal
3+ full and bounding
Identify how cardiac output affects blood pressure - ANSWER - If the heart pumps
more blood into the container(blood vessels), the pressure on the container walls
increases.
Cardiac output increase = blood pressure increase
identify vital sign changes in the aging adult with/ temperature - ANSWER -
Temperature: Changes in the body's temperature regulatory mechanism leave aging
adults less likely to have a fever but at greater risk for hypothermia.
- Temperature is less reliable index of the older person's true health state.
- Sweat gland activity is diminished.
identify vital sign changes in the aging adult /Pulse - ANSWER - o Normal range is
60-100 bpm, but rhythm may slightly be irregular.
- Radial artery may feel stiff, rigid, and tortuous in an older person, although this
condition does not necessarily imply vascular disease in heart or brain.
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