NUR 505 Module 1
Advanced Health
Assessment Study Guide
Chapter 1
• What is the difference between subjective and objective data? What is included under
each of these when obtaining history and physical exam?
o What is the ROS? What purpose does it serve? What do you document in each
body system included in the ROS?
o
• Review specialty populations (Peds, Pregnancy, and elderly). What are some specific
differences when taking histories and performing physical exams in these populations?
o What approaches are different with a pediatric child exam? How do you earn
the child’s trust and make them comfortable? What about considering
developmental stages of pediatric patients?
• There are several screening tools that you need to be familiar with:
o CAGE- The CAGE questionnaire was developed in 1984 and uses by Dr. John
Ewing, and it includes four interview questions designed to help screen for
alcoholism. The CAGE acronym helps practitioners quickly recall the main
concepts of the four questions (Cutting down, Annoyance by criticism, Guilty
feeling, Eye-openers). Probing questions may be asked as follow-up questions to
the CAGE questionnaire.
You ask the patient these questions:
“Have you ever felt like cutting down on your alcohol intake?”
“Do you get annoyed if your friends and family tell you drink too much?”
“Do you ever feel guilty about how much you drink?’
“Have you ever had to take a drink early in the morning?”
If they answer YES to any of these questions you might have to investigate further for
possible alcoholism.
o HITS
HITS is a brief screening tool for domestic violence: HITS
Verbal abuse is as intense a problem as physical violence. Hits stands for HURT,
INSULT, THREATEN, OR SCREAM. The wording of the question is,
“In the past year how often did your partner:
Hurt you physically?”
Insult or talk down to you?”
Threaten you with physical harm?”
Scream or curse at you?”
o PVS- Partner Violence Screen (PVS)
, This is an intimate partner violence screening. This should be used to screen all female
patients routinely. It is often done in an emergency setting when a patient is seeking
help. Presentation of patient’s who might have had intimate partner violence include
injuries that are inconsistent with the explanation provided by the client, frequent
medical visits with multiple somatic complaints like fatigue, sexual dysfunction, chronic
pelvic pain, headache, chest pain, GI complaints. The perpetrator often comes with the
victim and won’t leave the victim unattended. They are often overly attentive and
answer questions for the client. Won’t let the client speak for themselves.
“Have you ever been kicked, punched, or otherwise hurt by someone within the last
year?”
“Do you feel safe in your current relationship?”
“Is there a partner from a previous relationship who is making you feel unsafe now?”
A positive response to any one of these questions constitutes a positive screen.
Positive answers require drawings and accurate documentation. If possible,
photographs or preservation of any tangible evidence.
Patient safety must be insured, consider referral to social workers or mental health
professionals.
If patients have positive questions to this you want to ask some questions to determine
safety
-Are you afraid to go home?
-Are there guns and knives at home?
-Is there alcohol or other drugs that might be contributing to this problem?
-Has it gotten worse lately? Are there children involved?
o FICA
FICA is a Spirituality screening
FAITH, belief, meaning
• What is your spiritual or religious heritage? Is the Bible, the Quran, or similar writings
important to you? Do these beliefs help you cope with stress?
IMPORTANCE AND INFLUENCE
• How have these beliefs influenced how you handle stress? To what extent?
COMMUNITY
• Do you belong to a formal spiritual or religious community? Does this community
support you? In what way? Is there anyone there with whom you would like to talk?
ADDRESS/ACTION IN CARE
• How do your religious beliefs affect your healthcare decisions (e.g., choice of birth
control)? How would you like me to support you in this regard when your health is
involved?
*More information in FICA are located in blackboard.
• Review how to take a sexual health history. This is addressed in the PPT as well as a link
to the CDC document. What are the 5 Ps of a sexual history? What are examples of
questions that you would ask under each “P”?
Advanced Health
Assessment Study Guide
Chapter 1
• What is the difference between subjective and objective data? What is included under
each of these when obtaining history and physical exam?
o What is the ROS? What purpose does it serve? What do you document in each
body system included in the ROS?
o
• Review specialty populations (Peds, Pregnancy, and elderly). What are some specific
differences when taking histories and performing physical exams in these populations?
o What approaches are different with a pediatric child exam? How do you earn
the child’s trust and make them comfortable? What about considering
developmental stages of pediatric patients?
• There are several screening tools that you need to be familiar with:
o CAGE- The CAGE questionnaire was developed in 1984 and uses by Dr. John
Ewing, and it includes four interview questions designed to help screen for
alcoholism. The CAGE acronym helps practitioners quickly recall the main
concepts of the four questions (Cutting down, Annoyance by criticism, Guilty
feeling, Eye-openers). Probing questions may be asked as follow-up questions to
the CAGE questionnaire.
You ask the patient these questions:
“Have you ever felt like cutting down on your alcohol intake?”
“Do you get annoyed if your friends and family tell you drink too much?”
“Do you ever feel guilty about how much you drink?’
“Have you ever had to take a drink early in the morning?”
If they answer YES to any of these questions you might have to investigate further for
possible alcoholism.
o HITS
HITS is a brief screening tool for domestic violence: HITS
Verbal abuse is as intense a problem as physical violence. Hits stands for HURT,
INSULT, THREATEN, OR SCREAM. The wording of the question is,
“In the past year how often did your partner:
Hurt you physically?”
Insult or talk down to you?”
Threaten you with physical harm?”
Scream or curse at you?”
o PVS- Partner Violence Screen (PVS)
, This is an intimate partner violence screening. This should be used to screen all female
patients routinely. It is often done in an emergency setting when a patient is seeking
help. Presentation of patient’s who might have had intimate partner violence include
injuries that are inconsistent with the explanation provided by the client, frequent
medical visits with multiple somatic complaints like fatigue, sexual dysfunction, chronic
pelvic pain, headache, chest pain, GI complaints. The perpetrator often comes with the
victim and won’t leave the victim unattended. They are often overly attentive and
answer questions for the client. Won’t let the client speak for themselves.
“Have you ever been kicked, punched, or otherwise hurt by someone within the last
year?”
“Do you feel safe in your current relationship?”
“Is there a partner from a previous relationship who is making you feel unsafe now?”
A positive response to any one of these questions constitutes a positive screen.
Positive answers require drawings and accurate documentation. If possible,
photographs or preservation of any tangible evidence.
Patient safety must be insured, consider referral to social workers or mental health
professionals.
If patients have positive questions to this you want to ask some questions to determine
safety
-Are you afraid to go home?
-Are there guns and knives at home?
-Is there alcohol or other drugs that might be contributing to this problem?
-Has it gotten worse lately? Are there children involved?
o FICA
FICA is a Spirituality screening
FAITH, belief, meaning
• What is your spiritual or religious heritage? Is the Bible, the Quran, or similar writings
important to you? Do these beliefs help you cope with stress?
IMPORTANCE AND INFLUENCE
• How have these beliefs influenced how you handle stress? To what extent?
COMMUNITY
• Do you belong to a formal spiritual or religious community? Does this community
support you? In what way? Is there anyone there with whom you would like to talk?
ADDRESS/ACTION IN CARE
• How do your religious beliefs affect your healthcare decisions (e.g., choice of birth
control)? How would you like me to support you in this regard when your health is
involved?
*More information in FICA are located in blackboard.
• Review how to take a sexual health history. This is addressed in the PPT as well as a link
to the CDC document. What are the 5 Ps of a sexual history? What are examples of
questions that you would ask under each “P”?
