1
NR 509 Final Study Guide
Chapter 1 - Foundations for Clinical Proficiency
-Know what should be listed under adult illnesses in health history (p.10)
Medical, Surgical, OBGYN, Psychiatric
-Know what is listed under present illness (p.9)
Problems prompting the patients visit, including the onset of the problem, the setting in which it developed, its manifestations, and any
treatments to date
-Know what makes up the health history (subjective) (p.7)
Identifying data and source of the history; reliability
Chief complaint(s)
Present Illness
Past history
Family history
Personal and social history
Review of Systems
-Know how to prioritize patient complaints (p.37)
List most active & serious problems first and their date of onset
Problems can be symptoms, signs, past health events such as a hospital admission or surgery or diagnoses
-Be able to figure out what is missing in an HPI (p.9)
O.L.D.C.A.R.T
-Know what subjective information is (p.6)
What patient tells you
-Know what objective information is (p.6)
Examination findings, vital signs, laboratory data
-Know the c-sections should be listed in surgeries (p.10)
Surgical history- make sure you include date, indication, type of surgery.
-Subjective info (ROS) (p.12)
Goes under the review of systems
Chapter 2 - Evaluating Clinical Evidence
Evaluating Clinical Evidence
Critical Thinking and Clinical Reasoning
Differential Diagnoses
Pathological and Physiological Processes
Problem List
Problem Prioritization
Chapter 3 - Interviewing and the Health History
-Know how to get a patient to open up when they seem upset (p.72)
Effective reassurance-identifying and acknowledging patients feelings
Meaningful reassurance-deal openly with concerns
Validate the legitimacy of his or her emotional experience
Moving closer or making physical contact
-Know that you need permission of the patient to carry out the visit if someone is in the room (p.75)
Whenever visitors are present, you are obligated to maintain the patients confidentiality
-Know how to make a pelvic exam less intimidating (p.76)
Avoid interviewing patient when she is already positioned for a pelvic exam
-Know that if a patient returns from a country with malaria you still need to be selective of which patients you screen for malaria
(p.66) Review page
-Where to sit when interpreter in the room (p.90)
Arrange seating so that you have eye contact with the patient, have the interpreter sit close or behind you (keeps you from turning your
head back and forth)
-Know the order of meeting a patient and conducting an interview (p.73)
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Chapter 4 - Beginning the Physical Examination: General Survey, Vital Signs, and Pain
-Know what can cause falsely high BP (p.127)
Cuff too small BP will read high; cuff too large BP will read low on small arm and high on large arm
Brachial artery below heart, BP will be higher, if brachial artery is above heart, reading will be lower
-Know what is included in constitutional symptoms (p.112)
Fatigue, weakness, fever/chills, night sweats, weight changes or pain
-BMI interpretation (p.122)
The BMI incorporates estimated but more accurate measures of body fat than weight alone
Chapter 6 - The Skin, Hair, and Nails
-Know that cherry angiomas are benign (p.196 & 205)
Benign tumors that result from overgrowth of capillaries
-Know risk factors of melanoma (p.177)
-Know what acanthosis nigricans can clue into (p.207)
Diabetes
-Know labs to check with vitiligo (p.191)
Thyroid panel/CBC
-Know how psoriasis presents (p.192)
Scattered erythematous; raised on skin, over 1 cm; plaque- Raised papule- rough, dry, silver, grey. Found most often over joints.
-Know what onychomycosis looks like (p.212)
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NR 509 Final Study Guide
-Pityriasis Rosea (p.193)- herald spot w/bullseye like papule with branches emanating from it, occur on back, chest. Red, raised.
-Herpes Zoster (p.193)
-Systemic lupus Erythematosus (p.208)
Malar erythema (mid cheeks, spans bridge of nose), relative sparing of nasolabial folds, periungual erythema, interphalangeal
erythema
-Tinea (p.176, 183, 210)
Hair breaks along the shaft; dry and fine; fungal infection; Ringworm. Tinea Veriscolor: smooth, non-blanching lesion.
-Lyme Disease
Rash, often in Red Bullseye pattern (erythema migrans); caused by tick bite. A/W flu-like symptoms, fever, HA, fatigue
-Cellulitis (p.213)
Inspect ulcers for signs of infection
Chapter 7 - The Head and Neck
-Know how retinal detachment presents (p.217)
Sudden, painless, unilateral vision loss
-Know what cranial nerve you're assessing when checking lateral gaze (p.237)
Cranial nerve VI (6) Abducens
-Know what conditions do not have red reflexes (p.239)
Cataracts, detached retina, the vitreous, artificial eye or retinoblastoma in children
-Know how optic neuritis presents (p.217)
Sudden vision loss, unilateral, painful; associated with multiple sclerosis
-Know what yellow sclera indicates (p.234)
Jaundice
-Know how otosclerosis presents with Weber and Rinne test (p.289)
Conductive loss of hearing
NR 509 Final Study Guide
Chapter 1 - Foundations for Clinical Proficiency
-Know what should be listed under adult illnesses in health history (p.10)
Medical, Surgical, OBGYN, Psychiatric
-Know what is listed under present illness (p.9)
Problems prompting the patients visit, including the onset of the problem, the setting in which it developed, its manifestations, and any
treatments to date
-Know what makes up the health history (subjective) (p.7)
Identifying data and source of the history; reliability
Chief complaint(s)
Present Illness
Past history
Family history
Personal and social history
Review of Systems
-Know how to prioritize patient complaints (p.37)
List most active & serious problems first and their date of onset
Problems can be symptoms, signs, past health events such as a hospital admission or surgery or diagnoses
-Be able to figure out what is missing in an HPI (p.9)
O.L.D.C.A.R.T
-Know what subjective information is (p.6)
What patient tells you
-Know what objective information is (p.6)
Examination findings, vital signs, laboratory data
-Know the c-sections should be listed in surgeries (p.10)
Surgical history- make sure you include date, indication, type of surgery.
-Subjective info (ROS) (p.12)
Goes under the review of systems
Chapter 2 - Evaluating Clinical Evidence
Evaluating Clinical Evidence
Critical Thinking and Clinical Reasoning
Differential Diagnoses
Pathological and Physiological Processes
Problem List
Problem Prioritization
Chapter 3 - Interviewing and the Health History
-Know how to get a patient to open up when they seem upset (p.72)
Effective reassurance-identifying and acknowledging patients feelings
Meaningful reassurance-deal openly with concerns
Validate the legitimacy of his or her emotional experience
Moving closer or making physical contact
-Know that you need permission of the patient to carry out the visit if someone is in the room (p.75)
Whenever visitors are present, you are obligated to maintain the patients confidentiality
-Know how to make a pelvic exam less intimidating (p.76)
Avoid interviewing patient when she is already positioned for a pelvic exam
-Know that if a patient returns from a country with malaria you still need to be selective of which patients you screen for malaria
(p.66) Review page
-Where to sit when interpreter in the room (p.90)
Arrange seating so that you have eye contact with the patient, have the interpreter sit close or behind you (keeps you from turning your
head back and forth)
-Know the order of meeting a patient and conducting an interview (p.73)
,2
Chapter 4 - Beginning the Physical Examination: General Survey, Vital Signs, and Pain
-Know what can cause falsely high BP (p.127)
Cuff too small BP will read high; cuff too large BP will read low on small arm and high on large arm
Brachial artery below heart, BP will be higher, if brachial artery is above heart, reading will be lower
-Know what is included in constitutional symptoms (p.112)
Fatigue, weakness, fever/chills, night sweats, weight changes or pain
-BMI interpretation (p.122)
The BMI incorporates estimated but more accurate measures of body fat than weight alone
Chapter 6 - The Skin, Hair, and Nails
-Know that cherry angiomas are benign (p.196 & 205)
Benign tumors that result from overgrowth of capillaries
-Know risk factors of melanoma (p.177)
-Know what acanthosis nigricans can clue into (p.207)
Diabetes
-Know labs to check with vitiligo (p.191)
Thyroid panel/CBC
-Know how psoriasis presents (p.192)
Scattered erythematous; raised on skin, over 1 cm; plaque- Raised papule- rough, dry, silver, grey. Found most often over joints.
-Know what onychomycosis looks like (p.212)
, 3
NR 509 Final Study Guide
-Pityriasis Rosea (p.193)- herald spot w/bullseye like papule with branches emanating from it, occur on back, chest. Red, raised.
-Herpes Zoster (p.193)
-Systemic lupus Erythematosus (p.208)
Malar erythema (mid cheeks, spans bridge of nose), relative sparing of nasolabial folds, periungual erythema, interphalangeal
erythema
-Tinea (p.176, 183, 210)
Hair breaks along the shaft; dry and fine; fungal infection; Ringworm. Tinea Veriscolor: smooth, non-blanching lesion.
-Lyme Disease
Rash, often in Red Bullseye pattern (erythema migrans); caused by tick bite. A/W flu-like symptoms, fever, HA, fatigue
-Cellulitis (p.213)
Inspect ulcers for signs of infection
Chapter 7 - The Head and Neck
-Know how retinal detachment presents (p.217)
Sudden, painless, unilateral vision loss
-Know what cranial nerve you're assessing when checking lateral gaze (p.237)
Cranial nerve VI (6) Abducens
-Know what conditions do not have red reflexes (p.239)
Cataracts, detached retina, the vitreous, artificial eye or retinoblastoma in children
-Know how optic neuritis presents (p.217)
Sudden vision loss, unilateral, painful; associated with multiple sclerosis
-Know what yellow sclera indicates (p.234)
Jaundice
-Know how otosclerosis presents with Weber and Rinne test (p.289)
Conductive loss of hearing
