NUR-634 Advanced Physical Assessment
Midterm Study Guide
ABCD-EFG - ANS -method used to screen moles for melanomas
-if >2 present risk of melanoma increases and biopsy should be considered
-Asymmetry, Border irregularity, Color Variations, Diameter >6mm, Evolving
-EFG added to help detect aggressive nodular melanomas (Elevated, Firm to palpation,
growing progressively)
\Actinic Keratosis - ANS -a rough, scaly patch on your skin that develops from years of
exposure to the sun. It's most commonly found on your face, lips, ears, back of your
hands, forearms, scalp or neck.
-precancerous skin growth
\Angry Challenging Patient Intervention - ANS -acknowledge any involvement you may
have in their anger and make amends
-avoid reinforcing criticism of other clinicians
-validate their feelings without agreeing with their reasons
-ensure a safe environment, alert staff/security
-stay calm and avoid being confrontational
-keep a relaxed and nonthreatening posture
\Appendicitis - ANS -acute inflammation of the appendix with distention or obstruction
-s/s: poorly localized periumbilical pain that migrates to the RLQ, cramping steady then
more severe, anorexia, nausea, vomiting, low fever
\Assessment - ANS -the clinical reasoning process that interprets the patient's history
and physical examination, singles out identified problems, and movement from each
problems to its action plan
\Asthma - ANS -A chronic allergic disorder characterized by episodes of severe breathing
difficulty, coughing, and wheezing.
-s/s: cough at times with thick mucoid sputum esp. near end of attack, episodic wheezing
and dyspnea, cough may occur alone, often with a hx of allergies, resonant to diffusely
hyper resonant percussion, decreased tactile fremitus, crackles/wheezes
\Atopic Dermatosis - ANS -a condition that makes your skin red and itchy. It's common in
children but can occur at any age. Atopic dermatitis is long lasting (chronic) and tends to
flare periodically. It may be accompanied by asthma or hay fever.
\Attributes of a Symptom - ANS -seven attributes
-OPQRST & Associated manifestations (anything else accompanying it)
-onset, provocative/palliative, quality, region/radiation, severity, timing
\Basal Cell Carcinoma - ANS -Most common and least severe type of skin cancer; often
characterized by light or pearly nodules.
-superficial has a pink patch that does not heal and may have focal scaling
-nodular has a pink papule, pearly appearance overlying telangiectasis, focal
pigmentation, central depression
, -ulcerated is non healing resulting in a rolled border
\Bronchitis - ANS -inflammation of the bronchi
-acute s/s: cough that may be dry or productive, may have retrosternal discomfort
-chronic s/s: chronic cough, sputum mucoid to purulent, may be blood streaked or even
bloody, often with recurrent wheezing and dyspnea, and prolonged hx of tobacco abuse,
resonant percussion, normal tactile fremitus,possible scattered coarse crackles,
wheezing or rhonchi in early inspiration and expiration
\Cholecystitis - ANS -Inflammation of the gallbladder from obstruction of the cyst duct by
gallstones
-s/s: RUQ/epigastrum pain that may radiate to the right shoulder or inter scapular area,
anorexia, nausea, vomiting, fever
\chronic obstructive pulmonary disease (COPD) - ANS -A slow process of dilation and
disruption of the airways and alveoli caused by chronic bronchial obstruction.
-s/s: slow progressive dyspnea, relatively mild cough later with scant mucoid sputum,
diffuse hyperresonant percussion, decreased tactile femitus, decreased or absent breath
sounds
\CN I - ANS -Olfactory nerve: sensory, controls sense of smell
\CN II - ANS -Optic nerve: sensory, located in and behind the eyes, controls central and
peripheral vision
\CN III - ANS -Oculomotor nerve: motor, in and behind the eyes controls pupillary
constriction
\CN IV - ANS -Tochlear nerve: motor, moves eyes down and toward tip of the nose
\CN IX - ANS -Glossopharyngeal nerve: sensory/motor, innervate tongue and throat
(pharynx/larynx) check together with CN X
\CN V - ANS -Trigeminal nerve: motor/sensory, covers most of the face involving
forehead, cheek, jaw, check for sensation with soft and dull object, assess jaw opening
and closing strength
\CN VI - ANS -Abducens nerve: motor, controls eye movement to the sides, six cardinal
fields of gaze
\CN VII - ANS -Facial nerve: sensory/motor, controls facial movements and expression
\CN VIII - ANS -Auditory nerve (vestibulocochlear): sensory, located in the ears controls
hearing
\CN X - ANS -Vagus nerve: sensory/motor, innervate tongue and throat (pharynx/larynx)
check together with CN X
\CN XI - ANS -Spinal Accessory nerve: motor, control neck and shoulder movement
\CN XII - ANS -Hypoglossal nerve: motor, innervates the tongue, stick out tongue,
dysphagia
\Confusing Challenging Patient Intervention - ANS -guide questions, ask for clarification,
and summarize
-watch for underlying issue if there is interference with communication
-when there are multiple symptoms focus on context of the symptoms emphasizing the
patients perspective
-consider delirium or intoxication
Midterm Study Guide
ABCD-EFG - ANS -method used to screen moles for melanomas
-if >2 present risk of melanoma increases and biopsy should be considered
-Asymmetry, Border irregularity, Color Variations, Diameter >6mm, Evolving
-EFG added to help detect aggressive nodular melanomas (Elevated, Firm to palpation,
growing progressively)
\Actinic Keratosis - ANS -a rough, scaly patch on your skin that develops from years of
exposure to the sun. It's most commonly found on your face, lips, ears, back of your
hands, forearms, scalp or neck.
-precancerous skin growth
\Angry Challenging Patient Intervention - ANS -acknowledge any involvement you may
have in their anger and make amends
-avoid reinforcing criticism of other clinicians
-validate their feelings without agreeing with their reasons
-ensure a safe environment, alert staff/security
-stay calm and avoid being confrontational
-keep a relaxed and nonthreatening posture
\Appendicitis - ANS -acute inflammation of the appendix with distention or obstruction
-s/s: poorly localized periumbilical pain that migrates to the RLQ, cramping steady then
more severe, anorexia, nausea, vomiting, low fever
\Assessment - ANS -the clinical reasoning process that interprets the patient's history
and physical examination, singles out identified problems, and movement from each
problems to its action plan
\Asthma - ANS -A chronic allergic disorder characterized by episodes of severe breathing
difficulty, coughing, and wheezing.
-s/s: cough at times with thick mucoid sputum esp. near end of attack, episodic wheezing
and dyspnea, cough may occur alone, often with a hx of allergies, resonant to diffusely
hyper resonant percussion, decreased tactile fremitus, crackles/wheezes
\Atopic Dermatosis - ANS -a condition that makes your skin red and itchy. It's common in
children but can occur at any age. Atopic dermatitis is long lasting (chronic) and tends to
flare periodically. It may be accompanied by asthma or hay fever.
\Attributes of a Symptom - ANS -seven attributes
-OPQRST & Associated manifestations (anything else accompanying it)
-onset, provocative/palliative, quality, region/radiation, severity, timing
\Basal Cell Carcinoma - ANS -Most common and least severe type of skin cancer; often
characterized by light or pearly nodules.
-superficial has a pink patch that does not heal and may have focal scaling
-nodular has a pink papule, pearly appearance overlying telangiectasis, focal
pigmentation, central depression
, -ulcerated is non healing resulting in a rolled border
\Bronchitis - ANS -inflammation of the bronchi
-acute s/s: cough that may be dry or productive, may have retrosternal discomfort
-chronic s/s: chronic cough, sputum mucoid to purulent, may be blood streaked or even
bloody, often with recurrent wheezing and dyspnea, and prolonged hx of tobacco abuse,
resonant percussion, normal tactile fremitus,possible scattered coarse crackles,
wheezing or rhonchi in early inspiration and expiration
\Cholecystitis - ANS -Inflammation of the gallbladder from obstruction of the cyst duct by
gallstones
-s/s: RUQ/epigastrum pain that may radiate to the right shoulder or inter scapular area,
anorexia, nausea, vomiting, fever
\chronic obstructive pulmonary disease (COPD) - ANS -A slow process of dilation and
disruption of the airways and alveoli caused by chronic bronchial obstruction.
-s/s: slow progressive dyspnea, relatively mild cough later with scant mucoid sputum,
diffuse hyperresonant percussion, decreased tactile femitus, decreased or absent breath
sounds
\CN I - ANS -Olfactory nerve: sensory, controls sense of smell
\CN II - ANS -Optic nerve: sensory, located in and behind the eyes, controls central and
peripheral vision
\CN III - ANS -Oculomotor nerve: motor, in and behind the eyes controls pupillary
constriction
\CN IV - ANS -Tochlear nerve: motor, moves eyes down and toward tip of the nose
\CN IX - ANS -Glossopharyngeal nerve: sensory/motor, innervate tongue and throat
(pharynx/larynx) check together with CN X
\CN V - ANS -Trigeminal nerve: motor/sensory, covers most of the face involving
forehead, cheek, jaw, check for sensation with soft and dull object, assess jaw opening
and closing strength
\CN VI - ANS -Abducens nerve: motor, controls eye movement to the sides, six cardinal
fields of gaze
\CN VII - ANS -Facial nerve: sensory/motor, controls facial movements and expression
\CN VIII - ANS -Auditory nerve (vestibulocochlear): sensory, located in the ears controls
hearing
\CN X - ANS -Vagus nerve: sensory/motor, innervate tongue and throat (pharynx/larynx)
check together with CN X
\CN XI - ANS -Spinal Accessory nerve: motor, control neck and shoulder movement
\CN XII - ANS -Hypoglossal nerve: motor, innervates the tongue, stick out tongue,
dysphagia
\Confusing Challenging Patient Intervention - ANS -guide questions, ask for clarification,
and summarize
-watch for underlying issue if there is interference with communication
-when there are multiple symptoms focus on context of the symptoms emphasizing the
patients perspective
-consider delirium or intoxication
