ANSWERS
7 Variables of a Symptom Analysis correct answer Timing
Location
Quality
Quantity/severity Setting
Aggravating/alleviating factors
Associated factors
Abdomen order of examination correct answer Inspection
Auscultation
Percuss
Palpation
Adolescents correct answer Respect need for confidentiality
Respect impending adult status
Do not force conversation
Establish an alliance
Be flexible in approach
Factors impacting history taking Self-esteem, acceptance by peers, tension with
parents
Cover issues of special concern (Hint: Use mnemonic HEEADSSS or PACES to zero
in on issues)
Anthropometrics correct answer Procedures for accurately measuring:
,Height Weight Triceps skinfold
**Mid Arm - skeletal mass
Table of norms for relevant age and gender groups
These measurements are useful in assessing patients' nutritional status and risk
for disease.
Body mass index (BMI) healthy 18.5-24.9
Formula used to assess nutritional status and total body fat
Waist circumference
Large waist circumference often associated with increased risk for type 2
diabetes, dyslipidemia, hypertension, and cardiovascular disease
Monitoring over time may aid in predicting disease risk for cardiovascular and
obesity-related diseases.
Approaching Sensitive Issues correct answer • Ensure privacy.
• Be direct and firm.
• Do not apologize for broaching the issue.
• Do not preach.
• Use language that is understandable.
• Do not push too hard.
Assign a probability correct answer • Cluster and Trend
• How likely is this?
,• Time of year?
• Other family members?
• Previous symptom?
Associated factors correct answer Anything else that happens with the CC
Auscultation correct answer • Sense of hearing
• Stethoscope on bare skin (no fabric)
- High pitch sounds (diaphragm)
- Low pitch sounds (bell)
• Quiet environment
• Listen to characteristics of the sound
- Intensity - Duration - Pitch - Quality
Autonomy correct answer Patient's self-determination
Barriers to communication correct answer Curiosity about you
Anxiety
Silence
Depression
Crying
Physical intimacy
Emotional intimacy
Seduction
, Anger
Avoidance
Financial considerations
Basic Rules for Building the History correct answer • Introduce yourself
• Address patient properly
• Be courteous
• Make eye contact
• Do not overtire patient
• Do not be judgmental
• Be flexible
Avoid medical jargon
• Take notes sparingly
• Avoid leading questions
• Start with general concerns, then move to specific descriptions.
• Clarify responses with where, when, what, how, and why questions.
• Verify and summarize what you have heard
Beneficence correct answer Do good for the patient
BMI-Body Mass Index correct answer Using Kilograms and centimeters: Weight (in
Kg) ÷ Height (meters} 2
Using Pounds [Weight ( in pounds) × Height (inches) 2 ] x 703