Jarvis Health Assessment Exam 1 Questions and Answers Solved Correctly Rated A+
Observation of patient's general appearance - Answers posture and position of patient
gait/ambulation
gross assessment of nutritional status
body habitus
estimation of psychological status
Apparent state of health - Answers healthy, chronically ill, frail
Level of consciousness - Answers awake, alert, responsive
lethargic (drowsy but will respond)
obtunded (hear you but respond slowly, confused)
Signs of distress - Answers Cardiac - clutching chest, diaphoretic (sweating heavily)
Respiratory - labored breathing, sitting forward, using intercostal muscles for respiration
Pain - wincing, writhing, rigid, protecting painful area
Anxiety and Depression - fidgeting, sweaty palms, poor eye contact, appears disheveled
Height and build - Answers short, tall, slender, stocky, lanky
Weight - Answers cachectic, emaciated, slender, obese, morbidly obese
Facial expression - Answers Eye contact, Level of attention, Facial expression, Affect
Posture, gait and motor activity - Answers antalgic gait due to pain
tripod posture in COPD
involuntary movements as in Parkinson's disease
Tremulousness in alcohol withdrawal
antalgic gait - Answers a gait that develops as a way to avoid pain while walking
Six primary vital signs - Answers BMI, height, weight
Blood pressure
Heart rate (pulse)
,Respiratory rate
Temperature
Pain
Pulse Oximetry (oxygen saturation)
Last menstrual period (LMP)
Height, Weight - Answers measure w/o shoes, heavy clothing
Body Mass Index (BMI) - Answers estimated measure of body fat
Calculation:
BMI = weight (kg) / height (m²)
Target range between 18.5-24.9
Height and Weight Abnormalities - Answers Cushing syndrome
Dwarfism
Turner syndrome
Marfan syndrome
Emaciated/cachexia
Cushing syndrome - Answers Weight gain is hallmark.
There is generalized fat distribution in simple obesity and truncal fat with relatively thin limbs in Cushing
syn- drome and metabolic syndrome.
Dwarfism - Answers short stature due to underproduction of growth hormone
Marfan syndrome - Answers genetic connective tissue disorder that can cause a ruptured aorta
long limbs in proportion to the trunk
Turner syndrome - Answers Short stature
Emaciated/cachexia - Answers cachexia - weakness and wasting of the body due to severe chronic
illness.
emaciated - abnormally thin or weak, especially because of illness or a lack of food.
BMI - what is overweight and obese? - Answers BMI > 25 = overweight
,BMI > 30 = obese
>50% US adults are overweight
~25% of US adults are obese
Medical implications of obesity - Answers Diabetes, metabolic syndrome
Hypertension
Vascular disease
Osteoarthritis
What BMI is considered underweight? and what are the possible causes - Answers BMI < 17 =
underweight
Possible causes:
Eating disorders
Cancer
Wasting syndrome
Hyperthyroidism
BMI >25 or <17
indications for what? - Answers Indication of malnutrition
referral for counseling/education geared at optimal weight and nutrition
How to take a blood pressure reading - Answers Patient seated and relaxed at least 5 min, feet on floor
No smoking, caffeine 30 min prior
Arm resting with antecubital crease at heart level, free of clothing, and supported
BP Assessment values Adult - Answers Normal BP: <120 mm Hg systolic, <80 mm Hg diastolic
Pre-hypertensive: 120-139 mm Hg systolic, 80-89 mm Hg diastolic
requirements of BP cuff - Answers Sphygmomanometer
Center of inflatable bladder at 2.5cm above the antecubital crease in line with brachial artery
Cuff should be tight around arm
, Use appropriate cuff size
Width of bladder 40% of upper arm circumference
Length of bladder 80% upper arm circumference
Korotkoff sounds - Answers low pitch sounds heard while taking the blood pressure
1st sound is systolic blood pressure(SBP)
Last sound is diastolic blood pressure(DBP)
auscultatory gap is associated with atherosclerosis. What is it? - Answers temporary disappearance of
sounds usually heard over the brachial artery, occurring when the cuff pressure is high and is gradually
reduced, with the sounds again heard at a lower level of pressure
a silent interval that may be present between the systolic and the diastolic pressures Deflate the cuff
promptly and completely and wait for 15 to 30 seconds.
An unrecognized auscultatory gap - Answers may lead to serious underestimation of systolic pressure
(150 instead of 200 in the example below) or overestimation of diastolic pressure.
BP findings - taking the average - Answers Wait at least 2 minutes to repeat BP if needed to confirm
findings and average your readings
If >5mmHg difference, check again before averaging readings
BP should be taken both arms at least once - Answers Pressure differences 5-10mmHg btw arms is ok
Pressure differences >10-15mmHg suggests cardiac or arterial problem on lower pressure side
When to medicate for abnormal BP? - Answers Stage 2 with no risk factors medicate, stage one with >
10% ASCVD risk medicate
ASVD = atherosclerotic cardiovascular disease; develops because of a build-up of sticky cholesterol-rich
plaque. over time, this plaque can harden and narrow the arteries.
Orthostatic (postural) hypotension - Answers Measure BP and HR supine, seated, standing
Wait 2-3 mins between positions
Positive if drop in SBP ≥20mmHg, drop in DBP ≥10mmHg or increase in HR >10bpm, or dizziness
pulsus paradoxus - Answers Systolic blood pressure normally falls during quiet inspiration in normal
individuals. Pulsus paradoxus is defined as a fall of systolic blood pressure of >10 mmHg during the
inspiratory phase.
4 components to a pulse - Answers rate
Observation of patient's general appearance - Answers posture and position of patient
gait/ambulation
gross assessment of nutritional status
body habitus
estimation of psychological status
Apparent state of health - Answers healthy, chronically ill, frail
Level of consciousness - Answers awake, alert, responsive
lethargic (drowsy but will respond)
obtunded (hear you but respond slowly, confused)
Signs of distress - Answers Cardiac - clutching chest, diaphoretic (sweating heavily)
Respiratory - labored breathing, sitting forward, using intercostal muscles for respiration
Pain - wincing, writhing, rigid, protecting painful area
Anxiety and Depression - fidgeting, sweaty palms, poor eye contact, appears disheveled
Height and build - Answers short, tall, slender, stocky, lanky
Weight - Answers cachectic, emaciated, slender, obese, morbidly obese
Facial expression - Answers Eye contact, Level of attention, Facial expression, Affect
Posture, gait and motor activity - Answers antalgic gait due to pain
tripod posture in COPD
involuntary movements as in Parkinson's disease
Tremulousness in alcohol withdrawal
antalgic gait - Answers a gait that develops as a way to avoid pain while walking
Six primary vital signs - Answers BMI, height, weight
Blood pressure
Heart rate (pulse)
,Respiratory rate
Temperature
Pain
Pulse Oximetry (oxygen saturation)
Last menstrual period (LMP)
Height, Weight - Answers measure w/o shoes, heavy clothing
Body Mass Index (BMI) - Answers estimated measure of body fat
Calculation:
BMI = weight (kg) / height (m²)
Target range between 18.5-24.9
Height and Weight Abnormalities - Answers Cushing syndrome
Dwarfism
Turner syndrome
Marfan syndrome
Emaciated/cachexia
Cushing syndrome - Answers Weight gain is hallmark.
There is generalized fat distribution in simple obesity and truncal fat with relatively thin limbs in Cushing
syn- drome and metabolic syndrome.
Dwarfism - Answers short stature due to underproduction of growth hormone
Marfan syndrome - Answers genetic connective tissue disorder that can cause a ruptured aorta
long limbs in proportion to the trunk
Turner syndrome - Answers Short stature
Emaciated/cachexia - Answers cachexia - weakness and wasting of the body due to severe chronic
illness.
emaciated - abnormally thin or weak, especially because of illness or a lack of food.
BMI - what is overweight and obese? - Answers BMI > 25 = overweight
,BMI > 30 = obese
>50% US adults are overweight
~25% of US adults are obese
Medical implications of obesity - Answers Diabetes, metabolic syndrome
Hypertension
Vascular disease
Osteoarthritis
What BMI is considered underweight? and what are the possible causes - Answers BMI < 17 =
underweight
Possible causes:
Eating disorders
Cancer
Wasting syndrome
Hyperthyroidism
BMI >25 or <17
indications for what? - Answers Indication of malnutrition
referral for counseling/education geared at optimal weight and nutrition
How to take a blood pressure reading - Answers Patient seated and relaxed at least 5 min, feet on floor
No smoking, caffeine 30 min prior
Arm resting with antecubital crease at heart level, free of clothing, and supported
BP Assessment values Adult - Answers Normal BP: <120 mm Hg systolic, <80 mm Hg diastolic
Pre-hypertensive: 120-139 mm Hg systolic, 80-89 mm Hg diastolic
requirements of BP cuff - Answers Sphygmomanometer
Center of inflatable bladder at 2.5cm above the antecubital crease in line with brachial artery
Cuff should be tight around arm
, Use appropriate cuff size
Width of bladder 40% of upper arm circumference
Length of bladder 80% upper arm circumference
Korotkoff sounds - Answers low pitch sounds heard while taking the blood pressure
1st sound is systolic blood pressure(SBP)
Last sound is diastolic blood pressure(DBP)
auscultatory gap is associated with atherosclerosis. What is it? - Answers temporary disappearance of
sounds usually heard over the brachial artery, occurring when the cuff pressure is high and is gradually
reduced, with the sounds again heard at a lower level of pressure
a silent interval that may be present between the systolic and the diastolic pressures Deflate the cuff
promptly and completely and wait for 15 to 30 seconds.
An unrecognized auscultatory gap - Answers may lead to serious underestimation of systolic pressure
(150 instead of 200 in the example below) or overestimation of diastolic pressure.
BP findings - taking the average - Answers Wait at least 2 minutes to repeat BP if needed to confirm
findings and average your readings
If >5mmHg difference, check again before averaging readings
BP should be taken both arms at least once - Answers Pressure differences 5-10mmHg btw arms is ok
Pressure differences >10-15mmHg suggests cardiac or arterial problem on lower pressure side
When to medicate for abnormal BP? - Answers Stage 2 with no risk factors medicate, stage one with >
10% ASCVD risk medicate
ASVD = atherosclerotic cardiovascular disease; develops because of a build-up of sticky cholesterol-rich
plaque. over time, this plaque can harden and narrow the arteries.
Orthostatic (postural) hypotension - Answers Measure BP and HR supine, seated, standing
Wait 2-3 mins between positions
Positive if drop in SBP ≥20mmHg, drop in DBP ≥10mmHg or increase in HR >10bpm, or dizziness
pulsus paradoxus - Answers Systolic blood pressure normally falls during quiet inspiration in normal
individuals. Pulsus paradoxus is defined as a fall of systolic blood pressure of >10 mmHg during the
inspiratory phase.
4 components to a pulse - Answers rate
