NR 509 APEA ADVANCED PHYSICAL ASSESSMENT
EXAM
WITH CORRECT ANSWERS LATEST UPDATED
Components of Health History - 1) Demographic information
2) Source of history
3) Chief concern
4) History of present illness
——OLDCARTS
5) Past health history and current health status
6) Family history
7) Social history
8) Health promotion behaviors
9) ROS
——all subjective
Determining the Scope of patient assessment - The patient's symptoms, age, and health
history help determine the scope of the focused examination, as does your knowledge
of disease patterns.
seven attributes of a symptom - 1. Location
2. Quality
3. Quantity or severity
4. Timing (including onset, duration, and frequency)
5. The setting in which it occurs
6. factors that have aggravated or relieved the symptom
7. associated manifestations
subjective data - what the person says about himself or herself during history taking
objective data - information that is seen, heard, felt, or smelled by an observer; signs
Modifying of the clinical interview for various settings - Interviews may vary based on
where the interview is taking place. Ideal situations are a quiet, uninterrupted
environment however the ER setting, home setting, urgent care, nursing home, and
,inpatient setting will differ greatly from information obtained to what can be visualized by
the clinician in the setting. Interruptions are likely during lengthy interview processes.
Watch interviewing during the examination.
Determining the scope of examination - Is the exam going to be focused or
comprehensive? Review chart for information to make the decision on what to focus on
or be prepared to do a comprehensive assessment.
The interview process - Initiating the session
Gathering information
Physical examination
Explanation and planning
Closing the session
These steps are proving structure and building the relationship
interviewing techniques - Nonverbal communication
Empathy
Active listening
Validation
reassurance
partnering
summarize Guided
questioning
Empowerment
Setting the stage for examination - Explaining point for point what the examination will
entail, preparing, privacy, awareness of the setting in which the exam is taking place, do
not assume it is ok to have others in the room, being aware of disabilities.
Establishing Rapport - Earning trust, following through, showing empathy and
compassion, being knowledgeable of the information provided
Gender Pronouns - How a person would like to be referred to. Ex: "She/Her" "He/Him"
"They/Them" etc.
How would you describe your sexual identity
How would you describe your gender identity
What is the sex on your original birth certificate
FIFE model - Feelings
Ideas
Functioning
Expectations
Helps explore the patient's perspective about their health and illness
, Patient-centered medical care - Involving the patient in their care and coming up with a
plan with the provider. Provider must acknowledge their own personal biases while
being aware of what is the safest Sam's most effective plan for the patient
Fundamentals of skilled interviewing - Active listening, empathetic responses, guided
questioning, nonverbal communication, validation, reassurance, partnering,
summarization, transitions, empowering the patient
verbal communication - expressing ideas to others by using spoken words
nonverbal communication - communication using body movements, gestures, and facial
expressions rather than speech
Techniques of Examination - 1. Inspection
2. Palpation
3. Percussion
4. Auscultation
Head to toe assessment - an assessment that organizes the collection of
comprehensive physical data by proceeding through the entire body from head to toe
General survey
Vital signs
-skin
- head, EENT
-neck
-back
-posterior thorax and lungs
-breasts and axillae (ask to lay down)
-anterior chest and lungs
-cardiac
——elevate the HOB for JVD assessment
——- slight left side for mitral stenosis
Then sit and lean forward, aortic regurg
—abdomen. (Supine)
—-Lower extremity's (supine) nervous/skeletal
Then stand up
——-sit down for mental/cranial/motor/reflexes
If needed genital and rectal exams
The clinical reasoning process - Knowledge, Context, Experience
EXAM
WITH CORRECT ANSWERS LATEST UPDATED
Components of Health History - 1) Demographic information
2) Source of history
3) Chief concern
4) History of present illness
——OLDCARTS
5) Past health history and current health status
6) Family history
7) Social history
8) Health promotion behaviors
9) ROS
——all subjective
Determining the Scope of patient assessment - The patient's symptoms, age, and health
history help determine the scope of the focused examination, as does your knowledge
of disease patterns.
seven attributes of a symptom - 1. Location
2. Quality
3. Quantity or severity
4. Timing (including onset, duration, and frequency)
5. The setting in which it occurs
6. factors that have aggravated or relieved the symptom
7. associated manifestations
subjective data - what the person says about himself or herself during history taking
objective data - information that is seen, heard, felt, or smelled by an observer; signs
Modifying of the clinical interview for various settings - Interviews may vary based on
where the interview is taking place. Ideal situations are a quiet, uninterrupted
environment however the ER setting, home setting, urgent care, nursing home, and
,inpatient setting will differ greatly from information obtained to what can be visualized by
the clinician in the setting. Interruptions are likely during lengthy interview processes.
Watch interviewing during the examination.
Determining the scope of examination - Is the exam going to be focused or
comprehensive? Review chart for information to make the decision on what to focus on
or be prepared to do a comprehensive assessment.
The interview process - Initiating the session
Gathering information
Physical examination
Explanation and planning
Closing the session
These steps are proving structure and building the relationship
interviewing techniques - Nonverbal communication
Empathy
Active listening
Validation
reassurance
partnering
summarize Guided
questioning
Empowerment
Setting the stage for examination - Explaining point for point what the examination will
entail, preparing, privacy, awareness of the setting in which the exam is taking place, do
not assume it is ok to have others in the room, being aware of disabilities.
Establishing Rapport - Earning trust, following through, showing empathy and
compassion, being knowledgeable of the information provided
Gender Pronouns - How a person would like to be referred to. Ex: "She/Her" "He/Him"
"They/Them" etc.
How would you describe your sexual identity
How would you describe your gender identity
What is the sex on your original birth certificate
FIFE model - Feelings
Ideas
Functioning
Expectations
Helps explore the patient's perspective about their health and illness
, Patient-centered medical care - Involving the patient in their care and coming up with a
plan with the provider. Provider must acknowledge their own personal biases while
being aware of what is the safest Sam's most effective plan for the patient
Fundamentals of skilled interviewing - Active listening, empathetic responses, guided
questioning, nonverbal communication, validation, reassurance, partnering,
summarization, transitions, empowering the patient
verbal communication - expressing ideas to others by using spoken words
nonverbal communication - communication using body movements, gestures, and facial
expressions rather than speech
Techniques of Examination - 1. Inspection
2. Palpation
3. Percussion
4. Auscultation
Head to toe assessment - an assessment that organizes the collection of
comprehensive physical data by proceeding through the entire body from head to toe
General survey
Vital signs
-skin
- head, EENT
-neck
-back
-posterior thorax and lungs
-breasts and axillae (ask to lay down)
-anterior chest and lungs
-cardiac
——elevate the HOB for JVD assessment
——- slight left side for mitral stenosis
Then sit and lean forward, aortic regurg
—abdomen. (Supine)
—-Lower extremity's (supine) nervous/skeletal
Then stand up
——-sit down for mental/cranial/motor/reflexes
If needed genital and rectal exams
The clinical reasoning process - Knowledge, Context, Experience
