Download Traps of Interviewing and Types of Interview Questions and more Exams Nursing in PDF only on Docsity! NUR 2092Final Exams Concepts(A+ rated) Final Exams Concepts(with correct answers) 1. Know the difference between subjective and objective data. (I will scream if you all get these wrong! :)) • Subjective: What a person says about themselves o Example: “My BP was 118/90 yesterday” and pain • Objective: What you observe through measurement, inspection, palpation, percussion, and auscultation o Examples: Meter readings, vital signs, and measurements 2. Barriers to communication. What are they? • The use of jargon • Emotional barriers and taboo • Lack of attention, interest, distractions, or irrelevance to the receiver • Difference in viewpoint • Physical barriers to non-verbal communication • Physical or mental disabilities (Physical: Hearing problems. Mental: Down Syndrome) • Language differences and difficulty understanding unfamiliar accents • Cultural difference. 3. Traps of interviewing-Chapter 3 • Providing false assurance or reassurance • Giving unwanted advice • Using authority • Using avoidance language • Distancing • Using professional jargon • Using leading or bias questions • Talking too much • Interrupting • Using “why” questions 4.Open ended questions vs closed ended questions. Know the difference and when to use them during the interview process. • Open ended: Questions asking for narrative information o When to use them: ▪ Use it to begin the interview ▪ Introduce a new section of questions ▪ Whenever the person introduces a new topic • Closed (direct) questions: Asking for specific information. Elicit a short, one- or two-word answer, a “yes” or “no” or a forced choice. o Used in an emergengy to obtain information quickly 5. Components of a Health History -Chapter 4. Know this Chapter!! • Initial information NUR 2092Final Exams Concepts(A+ rated) • Chief complaint • Past medical history • Family history • Social history • Review of systems • Physical exam 6. General survey and what it consists of. • Initial inspection • Observe posture • Hygeine • Facial expression • Assess breathing • Behaviors • Body language o Appearance o Body Structure and mobility o Behavior 7. Skills requisite of physical exam. Chapter 8. Know the correct order for assessment. (Inspection, palpation etc). Know the different order for abdominal exam. • Order: o Inspect o Palpation o Percussion o Auscultation ▪ Abdomen: • Inspect • Auscultation • Percussion • Palpation 8. Know the normal range of respirations. Above and below that range, what's it called? • Normal Range: 12-20(21) • Dyspnea: Shortness of breath; < 12 • Tachypnea: Abnormally rapid breathing; >21 9. Lung sounds- Know difference between normal vs abnormal and where they are heard. 10. Characteristics of pulse and how to document it. • Rhythm: Normal regular, even tempo o Rating: ▪ Force: • 3+: Full, bounding • 2+: Normal • 1+: Weak, thread • 0: Absent NUR 2092Final Exams Concepts(A+ rated) 27. Cardiac sounds and location of each. • Aortic (Right 2nd intercostal space) • Pulmonic (Left 2nd intercostal space) • Erb’s point (Left 3rd intercostal space) • Tricuspid (Lower Left sternal border 4th intercostal) • Mitral (Left 5th intercostal; medial to midclavicular line) 28. What is the Glascow coma scale? • Scoring system used to describe the level of consciousness in a person following a traumatic brain injury 29. Cerebellar function tests. • Ask the patient to stand up, place feet together, and close their eyes o Normal findings: Able to stand still without any problem maintaining their position o Abnormal function: Swaying, problems maintaining position • Causes: o Cerebellar ataxia (lack of voluntary coordination of muscle movements) o Aging causes changes in the cerebellum which may manifest problems o Tumors in the cerebellum can disrupt function 30. Cranial nerves and their functions and how to test them. • Cranial Nerve 1: Olfactory; Smell (Sensory) • Cranial Nerve 2: Optic; Vision (Sensory) • Cranial Nerve 3: Oculomotor; Motor- Most EOM movement, opening eyelids. Parasympathetic- Pupil constriction, lens shape (Mixed) • Cranial Nerve 4: Trochlear; Down and inward movement of eye (Motor) • Cranial Nerve 5: Trigeminal; Motor- Muscles of mastication, Sensory- Sensation of face and scalp, cornea, mucous membranes of mouth and nose (Mixed) • Cranial Nerve 6: Abducens; Lateral eye movement (Motor) • Cranial Nerve 7: Facial; Motor- facial muscles, close eye, labial speech, close mouth. Sensory- Taste (sweet, salty, sour, and bitter) on anterior two thirds of tongue. Parasympathetic- tear and saliva secretion (Mixed) • Cranial Nerve 8: Acoustic; Hearing and equilibrium (Sensory) • Cranial Nerve 9: Glossopharyngeal; Motor- pharynx (phonation and swallowing), sensory- taste on posterior one third of tongue, pharynx (gag reflex), parasympathetic- parotid gland, carotid reflex (Mixed) • Cranial Nerve 10: Vagus; Motor- Pharynx and larynx (talking and swallowing). Sensory- general sensation from carotid body, carotid sinus, pharynx, viscera. Parasympathetic- carotid reflex (Mixed) • Cranial Nerve 11: Spinal Accessory; Movement of trapezius and sternomastoid muscles (Motor) • Cranial Nerve 12: Hypoglossal; Movement of tongue (Motor) NUR 2092Final Exams Concepts(A+ rated) 31. Testing reflexes and ALL superficial reflexes. 0 No evidence of contraction 1+ Decreased, but still present (hypo-reflexic) 2+ Normal 3+ Super-normal (hyper-reflexic) 4+ Clonus: Repetitive shortening of the muscle after a single stimulation • • Superficial reflex: any withdrawal reflex elicited by noxious or tactile stimulation of the skin, cornea, or mucous membrane, including the corneal, pharyngeal, and cremasteric reflexes. 32. Abdominal exam- What organs are found in each quadrant. • RUQ: o Liver o Gallbladder o Duodenum o R kidney o Adrenal Gland o Head of Pancrease • LUQ: o Stomach o Spleen o L Kidney o Adrenal gland o Body of pancreas • RLQ: o Cecum o Appendix o R ovary and tube o R ureter o R spermatic cord • LLQ: o Part of descending colon o Sigmoid colon o L ovary and tube o L ureter o L spermatic cord 33. Bowel sounds-normal vs abnormal. • High pitched NUR 2092Final Exams Concepts(A+ rated) • Gurgling • Cascading sounds • Occur irregularly anywhere from 5-30 times per minutes o Hyperperistalsis- “Stomach growling” (borborygmus) o Hypoperistalsis- lacking sounds within stomach 34. Pain level assessments and differences in the elderly. • Assessments: o Wong-Baker FACES pain rating scale o 0-10 Numeric Pain Rating Scale • Differences: o It is believed to be a normal part of aging o They do NOT want to be a nuisance o Reporting pain will lead to expensive testing or hospitalization o They are hesitant to take pain meds. 35. Range of motion- active vs passive. • Passive range of motion- Amount of motion at a given joint when the joint is moved by an external force or therapist • Active range of motion- When patient moves their limbs by themselves without assistance 36. Know difference between- Tinnitus, vertigo and otitis media • Tinnitus- Ringing or buzzing in the ears • Vertigo- A sensation of whirling and loss of balance; associated with looking from a great height or caused by disease affecting the inner ear or the vestibular nerve • Otitis media- Inflammation of the ear, usually distinguished as otitis externa (of the passage of the outer ear), otitis media (of the middle ear), and otitis interna (of the inner ear; labyrinthitis) 37. Cataract vs glaucoma vs conjunctivitis. • Cataract- Medical condition in which the lens of the eye becomes progressively opaque, resulting in blurred vision • Glaucoma- condition of increased pressure within the eyeball, causing gradual loss of sight • Conjunctivitis- Inflammation of the conjunctiva of the eye (pink eye) 38. Tests used for visual acuity and the difference tests used for toddlers, adolescents, elderly etc. • Test light perception using the blink reflex; the neonate blinks in response to bright light. The pupillary light reflex also shows that the pupils constrict in response to light. These reflexes indicate that the lower portion of the visual apparatus is intact. But you cannot infer that the infant can see; this requires later observation to show that the brain has received images and can interpret them. • NUR 2092Final Exams Concepts(A+ rated) iv. Lobular carcinoma in situ v. Mammographically dense breasts vi. Personal history of early onset (<40 years) breast cancer vii. Two or more first-degree relatives with breast cancer diagnosed at an early age b. Moderate risk factors i. Personal history of breast cancer (40+ years) ii. High endogenous estrogen or testosterone levels (postmenopausal) iii. High-dose radiation to chest iv. One first-degree relative with breast cancer c. Low risk factors i. Alcohol consumption ii. Ashkenazi Jewish heritage iii. Diethylstilbestrol (DES) exposure iv. Early menarche (<12 years) v. Height (tall) vi. High socioeconomic status vii. Late age at first full-term pregnancy (>30 years) viii. Late menopause (>55 years) ix. Never breastfed a child x. No full-term pregnancies xi. Obesity (postmenopausal)/adult weight gain xii. Personal history of endometrial, ovarian, or colon cancer xiii. Recent and long-term use of menopausal hormone therapy containing estrogen and progestin xiv. Recent oral contraceptive use 2. Location and names of lymph nodes on head and neck. a. Preauricular - in front of the ear b. Posterior auricular (mastoid) - superficial to the mastoid process c. Occipital - at the base of the skull d. Submental - midline, behind the tip of the mandible e. Submandibular - halfway between the angle and the tip of the mandible f. Jugulodigastric (tonsillar) - under the angle of the mandible g. Superficial cervical - overlying the sternomastoid muscle h. Deep cervical - deep under the sternomastoid muscle i. Posterior cervical - in the posterior triangle along the edge of the trapezius muscle j. Supraclavicular - just above and behind the clavicle, at the sternomastoid muscle 3. Carpal tunnel and tests used to determine this. a. Occurs because of the compression of the median nerve. b. Symptoms of carpal tunnel syndrome include pain, burning and numbness, positive findings on Phalen test, positive Tinel sign, and often atrophy of thenar muscles. NUR 2092Final Exams Concepts(A+ rated) c. Phalen test reproduces numbness and burning in a person with carpal tunnel syndrome. i. Ask the person to hold both hands back to back while flexing the wrists 90 degrees. Acute flexion of the wrist for 60 seconds produces no symptoms in the normal hand. 4. Know Eating disorders- Anorexia, Bulimia, Binge eating and Nervosa eating. a. Anorexia i. Intense fear of weight gain ii. Distorted body image iii. Restricted calories with significantly low body mass index iv. Subtypes: 1. Restricting (no consistent bulimic features) 2. Binge eating/purging type (primarily restriction, some bulimic behaviors) b. Bulimia i. Recurrent episodes of uncontrollable binging ii. Inappropriate compensatory behaviors: vomiting, laxatives, diuretics, or exercise iii. Self-image largely influenced by body image c. Binge eating i. Recurrent episodes of uncontrollable binging without compensatory behaviors ii. Binging episodes induce guilt, depression, embarrassment, or disgust d. Nervosa eating i. 5. Assessing urinary elimination status-what comes first, next, last. a. Frequency i. Normal is 5-6 times/day ii. Polyuria – excessive quantity iii. Oliguria – diminished quantity; less than 400 mL/day iv. Nocturia – awakening at night to void v. Dysuria – burning/pain; associated with UTI vi. Anuria – absence of urine b. Color i. Cloudy – associated with UTI ii. Hematuria – presence of blood in urine c. History of urinary disease i. Kidney disease ii. Kidney stones iii. UTI iv. Prostate d. Pain in flank, groin, suprapubic region, or lower back? e. Incontinence? 6. Assessment of liver disorders- jaundice in fair skinned, Asian and Dark skinned individuals. NUR 2092Final Exams Concepts(A+ rated) a. Jaundice in fair skinned i. A yellowish skin color indicates rising amounts of bilirubin in the blood. ii. Light or clay-colored stools and dark golden urine often accompany jaundice in both light- and dark-skinned people. iii. Jaundice occurs with hepatitis, cirrhosis, sickle-cell disease, transfusion reaction, and hemolytic disease of the newborn. iv. Light skinned 1. Increased serum bilirubin, more than 2 to 3 mg/100 mL from liver inflammation or hemolytic disease such as after severe burns, some infections a. Yellow in sclera, hard palate, mucous membranes, then over skin 2. Carotenemia—Increased serum carotene from ingestion of large amounts of carotene-rich foods a. Yellow-orange in forehead, palms and soles, nasolabial folds, but no yellowing in sclera or mucous membranes 3. Uremia—Renal failure causes retained urochrome pigments in the blood a. Orange-green or gray overlying pallor of anemia; may also have ecchymoses and purpura v. Dark skinned 1. Increased serum bilirubin, more than 2 to 3 mg/100 mL from liver inflammation or hemolytic disease such as after severe burns, some infections a. Check sclera for yellow near limbus; do not mistake normal yellowish fatty deposits in the periphery under the eyelids for jaundice; jaundice best noted in junction of hard and soft palate and also palms 2. Carotenemia—Increased serum carotene from ingestion of large amounts of carotene-rich foods a. Yellow-orange tinge in palms and soles 3. Uremia—Renal failure causes retained urochrome pigments in the blood a. Easily masked; rely on laboratory and clinical findings 7. Physical exam finding on patients who suffer from chronic hypoxia from pulmonary disease. a. Wheezing, barrel chest, decreased breath sounds, accessory muscle use, clubbing, paradoxical pulse 8. Gout- what is it? Risk factors in patients? a. Gout is a common chronic arthritis characterized by excess uric acid in the blood and deposits of urate crystals in the joint space. NUR 2092Final Exams Concepts(A+ rated) flexed, a good NUR 2092Final Exams Concepts(A+ rated) deal of power is lost from the fingers, and often the thumb cannot oppose the fingers. d. Osteoarthritis (OA) i. Different from RA, OA is characterized by hard, nontender, noninflammatory nodules, 2 to 3 mm or more. These osteophytes (bony overgrowths) of the distal interphalangeal joints are called Heberden nodes. Those of the proximal interphalangeal joints are called Bouchard nodes and are less common. e. Acute Rheumatoid Arthritis i. Painful swelling and stiffness of joints, with fusiform or spindle- shaped swelling of the soft tissue of proximal interphalangeal joints. Fusiform swelling is usually symmetric, the hands are warm, and the veins are engorged. The inflamed joints have a limited range of motion. f. Polydactyly i. Extra digits are a congenital deformity, usually occurring at the 5th finger or the thumb. Surgical removal is considered for cosmetic appearance. 14. Table 18-3, Configurations of thorax, page 441- focus on these: Pectus Carinatum, Barrel chest, Pectus excavatum and Kyphosis. a. Pectus Carinatum i. A forward protrusion of the sternum, with ribs sloping back at either side and vertical depressions along costochondral junctions (pigeon breast). Less common than pectus excavatum, this minor deformity requires no treatment. If severe, surgery may be indicated. b. Barrel Chest i. Note equal AP-to-transverse diameter and that ribs are horizontal instead of the normal downward slope. This is associated with normal aging and also with chronic emphysema and asthma as a result of hyperinflation of lungs. c. Pectus excavatum i. A markedly sunken sternum and adjacent cartilages (also called funnel breast). Depression begins at second intercostal space, becoming depressed most at junction of xiphoid with body of sternum. More noticeable on inspiration. Congenital, usually not symptomatic. When severe, sternal depression may cause embarrassment and a negative self-concept. Surgery may be indicated. d. Kyphosis i. An exaggerated posterior curvature of the thoracic spine (humpback) that causes significant back pain and limited mobility. NUR 2092Final Exams Concepts(A+ rated) Severe deformities impair cardiopulmonary function. If the neck muscles are