NSER 7110 Exam Questions and Correct Answers (100%
COMPLETE ANSWERS) ALREADY GRADED A+ | 100%
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Chief Complaint/Concern - ANSWER-This is the major reason the patient has come to the emergency
department. The chief complaint generally directs the majority of your assessment. The chief complaint
should prompt you to start thinking about what may be causing the problem.
History of the Present Illness (HPI) - ANSWER-This includes a description of the course of events since
the onset of symptoms. In order to fully assess the HPI, in adult patients we recommend the use of the
LOTARP mnemonic which, while comprehensive, requires some flexibility, depending on the chief
complaint.
Past Health History - ANSWER-The past health history may be lengthy. You will become adept at
deciding which information is important (as it relates to presenting complaint) and which information is
not relevant (has no relationship to presenting complaint). Data you will consider under this heading
include: childhood illnesses, immunizations, allergies, medications, medical/surgical history, and recent
travel.
Personal History - ANSWER-This component of the subjective history includes information pertinent to a
patient's personal health. Some data may overlap with information collected previously under the past
health category. Data included in this category include: substance use/misuse, smoking, and a history of
interpersonal violence. It is standard practice to include this personal health history on all patients who
present to EDs, regardless of their chief complaint.
Family History - ANSWER-The family history contains information about illnesses which have familial
tendencies such as heart disease and asthma. We are concerned about chronic disease and cancer
occurrence in first degree relatives. An additional part of this history may include asking if anyone else in
the family is ill.
Drawing on your previous knowledge and experience, identify what information you would consider to
be the most important for McDermott and why. Consider a list of questions you would ask McDermott
to complete her subjective history.
Components of Pediatric Psychiatric: - ANSWER-Chief Complaint:
- reason for the child's ED visit
- duration of complaint
,Immunizations
- current completion of scheduled immunization
Isolation
- exposure to communicable diseases (chicken pox, measels, etc) or consideration of isolation based on
chief complaint
Allergies
- reactions to medication, foods, products (e.g. latex) or environmental allergens
Medications
- current medications (prescription and over-the-counter)
Past History
- prior illnesses, injuries, hospitalizations, surgeries
- chronic physical or psychiatric illness
- prenatal and birth history for infants
Parent's perception
- caregiver's concerns and observations of the child's condition
Events surrounding illness:
- length of illness
- exposure to others with similar symptoms
- treatment prior to ED visits
- Mechanism of injury, if applicable
Diet:
,- changes in eating patterns and/or fluid intake
- last meal or fluid intake
- regular diet
- Special diet
Diapers:
- frequency or change in frequency of urination/bowel movements
- time of last void/bowel movements
- Change in odor or color of urine
- change in color or consistency of bowel movements
Symptoms associated with illness:
- review of systems (ROS) to identify symptoms and progression of symptoms
Hypothesis - ANSWER-What else does the patient complain of?
What other systems may be involved?
What symptoms does the patient deny? (pertinent negatives)
Secondary assessment - GI, GU, GYNE, MSK - ANSWER-GI - some common symptoms that span the
spectrum such as nausea, vomiting, diarrhea, and in the case of an abdominal infection, fever and chills
GU - Common symptoms such as complaints of urinary frequency and burning
GYNE - abnormal vaginal discharge or abnormal periods
MSK - Trauma should be considered as a cause of abdominal pain. This includes assults or heavy lifting.
, Objective Assessment - head to toe - ANSWER-- affect/attitude
- behaviour
- level of consciousness
- hygiene
- incontinence
- odors
- pain and anxiety or level of distress
- posture
- speech pattern and articulation
Objective assessment - head and/or neck - ANSWER-- inspect and palpate scalp for wounds,
hematomas, bleeding, or painful areas, nose and ears for blood or other drainage, mouth and tounge,
facial symmetry and facial bones, trachea for tracheal position, and cervical spine for pain or tenderness.
- Assess pupillary reaction including direct response and consensual reaction; test extraocular
movements (EOMS)
Objective assessment - Chest - ANSWER-- inspect for signs of trauma, brusiing, expansion/retraction,
symmetry, work of breathing, accessory muscle use, paradoxical movement.
- Palpate clavicles, sternum, and lateral chest wall deformities, pain or crepitus, and/or subcutaneous
emphysema
- Auscultate breath sounds anteriorly or posteriorly, apices and bases bi-laterally; determine presence of
breath sounds and presence of any adventitious sounds, apex rate, regularity, clarity, and presence of
extra heart sounds.
Objective assessment - Abdomen - ANSWER-- Inspect for abdominal distension or asymmetry, for signs
of trauma or bruising, for peristalsis, pulsations, genitalia bleeding, bruising, or incontinence.
- Auscultate RLQ for bowel sounds (present or absent).
COMPLETE ANSWERS) ALREADY GRADED A+ | 100%
satisfaction guaranteed
Chief Complaint/Concern - ANSWER-This is the major reason the patient has come to the emergency
department. The chief complaint generally directs the majority of your assessment. The chief complaint
should prompt you to start thinking about what may be causing the problem.
History of the Present Illness (HPI) - ANSWER-This includes a description of the course of events since
the onset of symptoms. In order to fully assess the HPI, in adult patients we recommend the use of the
LOTARP mnemonic which, while comprehensive, requires some flexibility, depending on the chief
complaint.
Past Health History - ANSWER-The past health history may be lengthy. You will become adept at
deciding which information is important (as it relates to presenting complaint) and which information is
not relevant (has no relationship to presenting complaint). Data you will consider under this heading
include: childhood illnesses, immunizations, allergies, medications, medical/surgical history, and recent
travel.
Personal History - ANSWER-This component of the subjective history includes information pertinent to a
patient's personal health. Some data may overlap with information collected previously under the past
health category. Data included in this category include: substance use/misuse, smoking, and a history of
interpersonal violence. It is standard practice to include this personal health history on all patients who
present to EDs, regardless of their chief complaint.
Family History - ANSWER-The family history contains information about illnesses which have familial
tendencies such as heart disease and asthma. We are concerned about chronic disease and cancer
occurrence in first degree relatives. An additional part of this history may include asking if anyone else in
the family is ill.
Drawing on your previous knowledge and experience, identify what information you would consider to
be the most important for McDermott and why. Consider a list of questions you would ask McDermott
to complete her subjective history.
Components of Pediatric Psychiatric: - ANSWER-Chief Complaint:
- reason for the child's ED visit
- duration of complaint
,Immunizations
- current completion of scheduled immunization
Isolation
- exposure to communicable diseases (chicken pox, measels, etc) or consideration of isolation based on
chief complaint
Allergies
- reactions to medication, foods, products (e.g. latex) or environmental allergens
Medications
- current medications (prescription and over-the-counter)
Past History
- prior illnesses, injuries, hospitalizations, surgeries
- chronic physical or psychiatric illness
- prenatal and birth history for infants
Parent's perception
- caregiver's concerns and observations of the child's condition
Events surrounding illness:
- length of illness
- exposure to others with similar symptoms
- treatment prior to ED visits
- Mechanism of injury, if applicable
Diet:
,- changes in eating patterns and/or fluid intake
- last meal or fluid intake
- regular diet
- Special diet
Diapers:
- frequency or change in frequency of urination/bowel movements
- time of last void/bowel movements
- Change in odor or color of urine
- change in color or consistency of bowel movements
Symptoms associated with illness:
- review of systems (ROS) to identify symptoms and progression of symptoms
Hypothesis - ANSWER-What else does the patient complain of?
What other systems may be involved?
What symptoms does the patient deny? (pertinent negatives)
Secondary assessment - GI, GU, GYNE, MSK - ANSWER-GI - some common symptoms that span the
spectrum such as nausea, vomiting, diarrhea, and in the case of an abdominal infection, fever and chills
GU - Common symptoms such as complaints of urinary frequency and burning
GYNE - abnormal vaginal discharge or abnormal periods
MSK - Trauma should be considered as a cause of abdominal pain. This includes assults or heavy lifting.
, Objective Assessment - head to toe - ANSWER-- affect/attitude
- behaviour
- level of consciousness
- hygiene
- incontinence
- odors
- pain and anxiety or level of distress
- posture
- speech pattern and articulation
Objective assessment - head and/or neck - ANSWER-- inspect and palpate scalp for wounds,
hematomas, bleeding, or painful areas, nose and ears for blood or other drainage, mouth and tounge,
facial symmetry and facial bones, trachea for tracheal position, and cervical spine for pain or tenderness.
- Assess pupillary reaction including direct response and consensual reaction; test extraocular
movements (EOMS)
Objective assessment - Chest - ANSWER-- inspect for signs of trauma, brusiing, expansion/retraction,
symmetry, work of breathing, accessory muscle use, paradoxical movement.
- Palpate clavicles, sternum, and lateral chest wall deformities, pain or crepitus, and/or subcutaneous
emphysema
- Auscultate breath sounds anteriorly or posteriorly, apices and bases bi-laterally; determine presence of
breath sounds and presence of any adventitious sounds, apex rate, regularity, clarity, and presence of
extra heart sounds.
Objective assessment - Abdomen - ANSWER-- Inspect for abdominal distension or asymmetry, for signs
of trauma or bruising, for peristalsis, pulsations, genitalia bleeding, bruising, or incontinence.
- Auscultate RLQ for bowel sounds (present or absent).
