Exam One - Think Tank

Question 1

Body language and pain

Answer 1

fretful hand movements, restless

Question 2

Comprehensive review of systems

Answer 2

reason for visit, extent of illness

Question 3

NPs handle multiple patient complaints

Answer 3

one at a time and all must be explored/drilled down

Question 4

How do you document lack of communication from a patient?

Answer 4

“pt is not a reliable source”

Question 5

What are you assessing when using a proverb or metaphor ?

Answer 5

abstract reasoning

Question 6

chalazion

Answer 6

focal lesion appears to be inflammatory in nature on the meibomian gland

Question 7

Nutritional assessment in the elderly

Answer 7

MNA - mini nutritional assessment
height/weight
biochemical – albumin & hemoglobin
functional

Question 8

Patch test on a papule that erupted

Answer 8

allergic contact dermatitis

Question 9

Documentation of a specific family members history :

Answer 9

age their family member experienced it/onset

Question 10

Assessment of elderly pt after rehab

Answer 10

functional / ADLs

Question 11

Newborn assessment sequence

Answer 11

1st-head/fontanelles
2nd - extremities
3rd - trunk/abdomen

Question 12

Newborns assessment technique likely to yield most clues

Answer 12

Inspection

Question 13

Valid and reliable pain scale for children

Answer 13

Wong-Baker Pain Scale

Question 14

Description of pain in trigeminal neuralgia

Answer 14

burning, shock-like, sharp-shooting

Question 15

Diverse patient population & health risks

Answer 15

40 y/o +, hypertension, AA or Hispanic - open-angle glaucoma leading cause of blindness

Question 16

patients greatest at risk for suicide

Answer 16

Elderly males

Question 17

Documenting physical assessment finding and the use of abbreviations

Answer 17

should be restricted, could lead to liability/malpractice

Question 18

Use of a family member as a translator

Answer 18

Document skepticism of understanding treatment/diagnosis/meaning.

Question 19

A 4-year-old with no/minimal pain - what would you expect on the Wong-Baker scale

Answer 19

smiling

Question 20

Wong-Baker Pain Scale

Answer 20

for children, rated on a 1-5 scale of smiley/sad face
1-2 no-little pain
3-4 sad face pain
5 extreme pain

Question 21

Diagnostic procedure to rule out fungus

Answer 21

scrape test from active border

Question 22

fluorescein dye and cobalt light is used to confirm what diagnosis

Answer 22

corneal abrasion

Question 23

when patient has severe pain in eye, you can suspect

Answer 23

foreign body

Question 24

What is LEAST important to know? Elbow injury playing tennis
Have you ever had this pain before?
LMC for females
Allergies to food/drugs
Cardiovascular family history

Answer 24

Cardiovascular family history

Question 25

Test to confirm abnormal corneal light reflex

Answer 25

cover/uncover test

Question 26

Priority for someone with major depression

Answer 26

Safety, thoughts of self-harm, harm to others PHQ-9 test

Question 27

Photophobia, eye discomfort in only one eye, no visual change, you can suspect

Answer 27

bacterial conjunctivitis

Question 28

Blepharitis is

Answer 28

thickened, crusted area at lash line and no other eye structures are involved

Question 29

Alterations in things that do not exist, perceived thoughts, internal perceptions that patient believes to be true but is not

Answer 29

hallucinations

Question 30

small raised bump after an injury, friable (bleeds easily), vascular papule

Answer 30

pyogenic granuloma

Question 31

Perceptions of pain

Answer 31

it is what the patient says it is greatly impacted by emotions and quality of sleep can greatly impact perceptions of pain

Question 32

Pain assessment scale for dementia

Answer 32

use a checklist for non-verbal

Question 33

HPI vs PMH

Answer 33

HPI narrative PMH bullets

Question 34

Characteristics leading to believe a skin lesion is a melanoma

Answer 34

ABCDE asymmetry borders irregular color difference diameter evolution

Question 35

what abnormals do you find on African Americans that need further testing

Answer 35

hyperpigmentation Drusen bodies (opthalmic exam)

Question 36

what order do you document assessment

Answer 36

Data is always documented by body systems, with subjective and objective data grouped accordingly

Question 37

a dark-colored skin person will have ___ gums

Answer 37

lighter

Question 38

Assessment of abdominal pain in a child

Answer 38

"point to where it hurts"

Question 39

What do Wood's Lamp colors mean = yellow/green.

Answer 39

it is fungal and it is pseudomonas aeruginosa

Question 40

What is the value of using a pain scale ?

Answer 40

patients response to therapy interventions can be documented. encompasses re-evaluation.

Question 41

How do we notate a chief complaint in a patients medical record?

Answer 41

whatever the patient says in quotes or italics, or parenthesis

Question 42

Smoking brother & dad died last hospital

Answer 42

smoking is social hx bro & dad is family hx last hospital is PMH

Question 43

Pt comes in complaining of chest pain. What is the BEST next question to ask.

Answer 43

Please describe your pain. Open-ended question.

Question 44

Woman, 1 month postpartum, fatigue, loss of appetite, inability to sleep and states " I don't want to go on anymore"

Answer 44

Postpartum depression. Post partum depression differs from "baby blues" because it is longer than 2 weeks.

Question 45

Distinct raised red circular, scaly border on arm of child

Answer 45

tinea corporis

Question 46

Disease process that appears usually on knees, elbows, & face. They are silvery and scaly.

Answer 46

plaque psoriasis

Question 47

JAHCO requires pain assessment when...

Answer 47

every shift, admission, & re-assessment of pain. Must document pain scale.

Question 48

how will you rate a pts LOC? drowsy, but wakes up and answers appropriately, & falls back asleep

Answer 48

lethargy

Question 49

Pain OLDCARTS

Answer 49

Onset Location Duration Character Aggravating Relieving Treatment Severity

Question 50

Focused vs Comprehensive

Answer 50

Comprehensive is everything Focused is on chief complaint. The extent of illness and reason for visit determines if it is focused or comprehensive

Question 51

Providing care to a trans patient

Answer 51

Risk factor indicators for biological gender and for how they identify