Virginia Commonwealth University School of Nursing
NURS261 – Health Assessment for Nursing Practice
S 2023
Study Guide for Midterm
1. What are the different types of health assessments, and when would each be
performed?
Comprehensive: Detailed history + physical exam, onset of primary care, admission to
hospital, or long-term care
Problem-based/Focused: Involves a history + physical exam limited to a specific
problem or complaint, commonly used in a walk-in clinic or emergency room, outpatient
setting
Episodic/Follow up: Following up with a health care provider for a previous problem
identified.
Shift assessment: Hospitalized patients, nurse conducts an assessment each shift, identify
any changes to patient conditions from base line; Focus on condition or problem.
Screening /exam assessment: Exam focused on disease detection; Performed by a
provider in office or health fair.
2. Describe the differences between a comprehensive assessment, screening assessment,
focused assessment, and a follow up assessment.
Comprehensive: Detailed history + physical exam, onset of primary care, admission to
hospital, or long-term care
Screening /exam assessment: short exam focused on disease detection; Performed by a
provider in office or health fair.
Episodic/Follow up: Following up with a health care provider for a previous problem
identified.
Problem-based/Focused: Involves a history + physical exam limited to a specific
problem or complaint, commonly used in a walk-in clinic or emergency room, outpatient
setting.
3. What are the steps in clinical judgement process?
Noticing- Perceptual grasp of situation, recognizing that a situation is or is not
consistent with anticipation or in context of patient’s situation
Interpreting- Uses patterns of reasoning, involves analysis and intuition to gain
an understanding of the situation
Responding- Determine the appropriate actions/interventions to take
Reflecting- *CRITICAL* - Uses what is learned from clinical experience for
future encounters
4. What are the factors in symptom analysis (OLDCARTS)?
Onset- When did symptoms begin? Suddenly, over a period of time, specific date, what
were you doing, anybody else in contact with experience these symptoms?
, Location- Specific area. Describe if it’s vague or generalized. Does it radiate? Where is
the symptom?
Duration- How long does it last? Constant or intermittent? How many times and how
long since you noticed? Is pain worse or the same?
Characteristics- Describe the symptom. How does the symptom feel or look? Stabbing,
dull, aching, throbbing, nagging, sharp, squeezing, itching? Color, texture, composition,
and odor
Aggravating factors- What makes symptoms worse? Is it aggravated by activity,
situation, or body position? Environmental factors? (Smoke, chemicals, etc.)
Related symptoms- Are any other symptoms present? Describe
Treatment- Have you taken/done anything to treat it? What alleviated symptoms? Diet,
changing position, drugs?
Severity- Describe the intensity of symptom. Size, extent, #, amount, scale 0-10,
interrupts activity or sleep?
5. How does the nurse assess pain? What scales can be used?
The nurse assesses pain through the patient; Self-report is the most reliable +
OLDCARTS.
Numeric rating scale- Frequently used, 0-10
FPS-R- Faces pain scale
Clinically aligned pain assessment- For pain more than a number
6. Review Health promotion/protection education for different systems
Health promotion- Motivated by a desire to improve health, well- being (diabetes)
Health protection- Motivated by a desire to remain healthy, avoid illness, early
detection, maintain functioning within the illness/disease constraints
7. Identify infection control procedures to be used when conducting a health
assessment. (i.e. when do you wear gloves, and when don’t you?)
Hand hygiene is the single most important component to reduce infection
transmission
Utilize personal protective equipment, as necessary
Proper management of patient care equipment is essential
Wear gloves when in contact with blood or bodily fluids or when equipment is
contaminated with blood or bodily fluids
8. What are the differences between subjective and objective data?
Objective Data- Signs that can be felt, heard, observed, or measured; Blood pressure,
SOB, rapid pulse
Subjective Data- Symptoms that are perceived and reported by the patient; Headache,
itching
9. What assessment techniques are used to evaluate vital signs?
Temperature:
Use different types of thermometers to assess for temperature; average is 98.6 degrees
Fahrenheit; Normal range is 96.4-99.1 degrees Fahrenheit
NURS261 – Health Assessment for Nursing Practice
S 2023
Study Guide for Midterm
1. What are the different types of health assessments, and when would each be
performed?
Comprehensive: Detailed history + physical exam, onset of primary care, admission to
hospital, or long-term care
Problem-based/Focused: Involves a history + physical exam limited to a specific
problem or complaint, commonly used in a walk-in clinic or emergency room, outpatient
setting
Episodic/Follow up: Following up with a health care provider for a previous problem
identified.
Shift assessment: Hospitalized patients, nurse conducts an assessment each shift, identify
any changes to patient conditions from base line; Focus on condition or problem.
Screening /exam assessment: Exam focused on disease detection; Performed by a
provider in office or health fair.
2. Describe the differences between a comprehensive assessment, screening assessment,
focused assessment, and a follow up assessment.
Comprehensive: Detailed history + physical exam, onset of primary care, admission to
hospital, or long-term care
Screening /exam assessment: short exam focused on disease detection; Performed by a
provider in office or health fair.
Episodic/Follow up: Following up with a health care provider for a previous problem
identified.
Problem-based/Focused: Involves a history + physical exam limited to a specific
problem or complaint, commonly used in a walk-in clinic or emergency room, outpatient
setting.
3. What are the steps in clinical judgement process?
Noticing- Perceptual grasp of situation, recognizing that a situation is or is not
consistent with anticipation or in context of patient’s situation
Interpreting- Uses patterns of reasoning, involves analysis and intuition to gain
an understanding of the situation
Responding- Determine the appropriate actions/interventions to take
Reflecting- *CRITICAL* - Uses what is learned from clinical experience for
future encounters
4. What are the factors in symptom analysis (OLDCARTS)?
Onset- When did symptoms begin? Suddenly, over a period of time, specific date, what
were you doing, anybody else in contact with experience these symptoms?
, Location- Specific area. Describe if it’s vague or generalized. Does it radiate? Where is
the symptom?
Duration- How long does it last? Constant or intermittent? How many times and how
long since you noticed? Is pain worse or the same?
Characteristics- Describe the symptom. How does the symptom feel or look? Stabbing,
dull, aching, throbbing, nagging, sharp, squeezing, itching? Color, texture, composition,
and odor
Aggravating factors- What makes symptoms worse? Is it aggravated by activity,
situation, or body position? Environmental factors? (Smoke, chemicals, etc.)
Related symptoms- Are any other symptoms present? Describe
Treatment- Have you taken/done anything to treat it? What alleviated symptoms? Diet,
changing position, drugs?
Severity- Describe the intensity of symptom. Size, extent, #, amount, scale 0-10,
interrupts activity or sleep?
5. How does the nurse assess pain? What scales can be used?
The nurse assesses pain through the patient; Self-report is the most reliable +
OLDCARTS.
Numeric rating scale- Frequently used, 0-10
FPS-R- Faces pain scale
Clinically aligned pain assessment- For pain more than a number
6. Review Health promotion/protection education for different systems
Health promotion- Motivated by a desire to improve health, well- being (diabetes)
Health protection- Motivated by a desire to remain healthy, avoid illness, early
detection, maintain functioning within the illness/disease constraints
7. Identify infection control procedures to be used when conducting a health
assessment. (i.e. when do you wear gloves, and when don’t you?)
Hand hygiene is the single most important component to reduce infection
transmission
Utilize personal protective equipment, as necessary
Proper management of patient care equipment is essential
Wear gloves when in contact with blood or bodily fluids or when equipment is
contaminated with blood or bodily fluids
8. What are the differences between subjective and objective data?
Objective Data- Signs that can be felt, heard, observed, or measured; Blood pressure,
SOB, rapid pulse
Subjective Data- Symptoms that are perceived and reported by the patient; Headache,
itching
9. What assessment techniques are used to evaluate vital signs?
Temperature:
Use different types of thermometers to assess for temperature; average is 98.6 degrees
Fahrenheit; Normal range is 96.4-99.1 degrees Fahrenheit
