NURS3320 ASSESSMENT FINAL REVIEW QUESTIONS AND CORRECT ANSWERS

NURS3320 ASSESSMENT FINAL
REVIEW QUESTIONS AND CORRECT
ANSWERS
WhatA2isA2aA2comprehensiveA2assessment?A2-A2Ans--
AnA2initialA2comprehensiveA2assessmentA2involvesA2collectionA2ofA2subjectiveA2dataA2abo
utA2theA2client'sA2perceptionA2ofA2hisA2orA2herA2health,A2pastA2healthA2history,A2familyA2hist
ory,A2andA2lifestyleA2andA2healthA2practicesA2(whichA2includesA2informationA2relatedA2toA2t
heA2client'sA2overallA2function)A2asA2wellA2asA2objectiveA2dataA2gatheredA2duringA2aA2step-
by-stepA2physicalA2examination.A2ItA2servesA2asA2aA2baselineA2ofA2dataA2onA2aA2patient.

WhatA2isA2aA2partialA2assessment?A2-A2Ans--
AnA2ongoingA2orA2partialA2assessmentA2ofA2theA2clientA2consistsA2ofA2dataA2collectionA2tha
tA2occursA2afterA2theA2comprehensiveA2databaseA2isA2established.A2ThisA2consistsA2ofA2aA
2mini-
overviewA2ofA2theA2client'sA2bodyA2systemsA2andA2holisticA2healthA2patternsA2asA2aA2follow
-
upA2onA2healthA2status.A2AnyA2problemsA2thatA2wereA2initiallyA2detectedA2inA2theA2client'sA2
bodyA2systemA2orA2holisticA2healthA2patternsA2areA2reassessedA2toA2determineA2anyA2cha
ngesA2(deteriorationA2orA2improvement)A2fromA2theA2baselineA2data.

WhatA2isA2aA2focusedA2assessment?A2-A2Ans--AA2focusedA2orA2problem-
orientedA2assessmentA2doesA2notA2replaceA2theA2comprehensiveA2healthA2assessment.A2I
tA2isA2performedA2whenA2aA2comprehensiveA2databaseA2existsA2forA2aA2clientA2whoA2come
sA2toA2theA2healthA2careA2agencyA2withA2aA2specificA2healthA2concern.A2AA2focusedA2asses
smentA2consistsA2ofA2aA2thoroughA2assessmentA2ofA2aA2particularA2clientA2problemA2andA2
doesA2notA2coverA2areasA2notA2relatedA2toA2theA2problem.

WhatA2isA2anA2emergencyA2assessment?A2-A2Ans--
AnA2emergencyA2assessmentA2isA2aA2veryA2rapidA2assessmentA2performedA2inA2life-
threateningA2situations.A2InA2suchA2situationsA2(choking,A2cardiacA2arrest,A2drowning),A2an
A2immediateA2assessmentA2isA2neededA2toA2provideA2promptA2treatment.A2AnA2exampleA2
ofA2anA2emergencyA2assessmentA2isA2theA2evaluationA2ofA2theA2client'sA2airway,A2breathin
g,A2andA2circulationA2(knownA2asA2theA2ABCs)A2whenA2cardiacA2arrestA2isA2suspected.

WhatA2isA2theA2purposeA2ofA2aA2nursingA2healthA2assessment?A2-A2Ans--
TheA2purposeA2ofA2aA2nursingA2healthA2assessmentA2isA2toA2collectA2holisticA2subjectiveA2
andA2objectiveA2dataA2toA2determineA2aA2client'sA2overallA2levelA2ofA2functioningA2inA2order
A2toA2makeA2aA2professionalA2clinicalA2judgment.A2TheA2nurseA2collectsA2physiologic,A2psy
chological,A2sociocultural,A2developmental,A2andA2spiritualA2dataA2aboutA2theA2client.A2Th
usA2theA2nurseA2performsA2holisticA2dataA2collection.

,WhatA2isA2theA2firstA2stepA2inA2theA2nursingA2process?
A2WhyA2isA2itA2criticalA2toA2theA2restA2ofA2theA2process?A2-A2Ans--
AssessmentA2isA2theA2firstA2andA2mostA2criticalA2stepA2ofA2theA2nursingA2process,A2andA2a
ccuracyA2ofA2assessmentA2dataA2affectsA2allA2otherA2phasesA2ofA2theA2nursingA2process.

WhatA2areA2theA2fourA2stepsA2ofA2theA2healthA2assessment?A2-A2Ans--
1.A2collectingA2subjectiveA2data,A2
2.A2collectingA2objectiveA2data,A2
3.A2validationA2ofA2data,A2andA2
4.A2documentationA2ofA2data.

WhatA2isA2anA2open-endedA2question?A2WhyA2isA2itA2important?A2-A2Ans--Open-
endedA2questionsA2areA2usedA2toA2elicitA2theA2client'sA2feelingsA2andA2perceptions.A2TheyA
2typicallyA2beginA2withA2theA2wordsA2"how"A2orA2"what."A2AnA2exampleA2ofA2thisA2typeA2ofA2
questionA2is:A2"HowA2haveA2youA2beenA2feelingA2lately?"A2AskingA2open-
endedA2questionsA2mayA2helpA2toA2revealA2significantA2dataA2aboutA2theA2client'sA2healthA2
status.

WhatA2isA2aA2closed-endedA2question?A2WhenA2isA2itA2used?A2-A2Ans--UseA2closed-
endedA2questionsA2toA2obtainA2factsA2andA2toA2focusA2onA2specificA2information.A2TheA2cli
entA2canA2respondA2withA2oneA2orA2twoA2words.A2TheA2questionsA2typicallyA2beginA2withA2t
heA2wordsA2"when"A2orA2"did."A2AnA2exampleA2ofA2thisA2typeA2ofA2questionA2is:A2"WhenA2di
dA2yourA2headacheA2start?"A2Closed-
endedA2questionsA2areA2usefulA2inA2keepingA2theA2interviewA2onA2courseA2andA2toA2clarifyA
2statements.


WhatA2isA2subjectiveA2data?A2-A2Ans--
InformationA2elicitedA2orA2verifiedA2onlyA2byA2theA2patient.A2-
BiographicalA2informationA2(name,A2age,A2religion,A2occupation)
-
HistoryA2ofA2presentA2healthA2concern:A2PhysicalA2symptomsA2relatedA2toA2eachA2bodyA2p
artA2orA2systemA2(e.g.,A2eyesA2andA2ears,A2abdomen)
-PersonalA2healthA2history
-FamilyA2history
-
HealthA2andA2lifestyleA2practicesA2(e.g.,A2healthA2practicesA2thatA2putA2theA2clientA2atA2risk,
A2nutrition,A2activity,A2relationships,A2culturalA2beliefsA2orA2practices,A2familyA2structureA2a
ndA2function,A2communityA2environment)

WhatA2isA2objectiveA2data?A2-A2Ans--InformationA2directlyA2observedA2byA2theA2nurse.
-PhysicalA2characteristicsA2(e.g.,A2skinA2color,A2posture)
-BodyA2functionsA2(e.g.,A2heartA2rate,A2respiratoryA2rate)
-AppearanceA2(e.g.,A2dressA2andA2hygiene)
-BehaviorA2(e.g.,A2mood,A2affect)
-MeasurementsA2(e.g.,A2bloodA2pressure,A2temperature,A2height,A2weight)
-ResultsA2ofA2laboratoryA2testingA2(e.g.,A2plateletA2count,A2x-rayA2findings)

,EquipmentA2neededA2forA2allA2examsA2-A2Ans--GownA2andA2gloves

EquipmentA2neededA2forA2vitalA2signsA2-A2Ans--
SphygmomanometerA2andA2stethoscope,A2thermometer,A2watch,A2painA2scale

EquipmentA2neededA2forA2nutritionalA2examA2-A2Ans--
SkinfoldA2calipers,A2platformA2scaleA2withA2heightA2attachment,A2flexibleA2tape,A2skinA2mar
ker

EquipmentA2neededA2forA2skin,A2nail,A2andA2hairA2examA2-A2Ans--
ExamA2light,A2penA2light,A2handA2mirrorA2forA2patient,A2metricA2rulerA2toA2measureA2sizeA2o
fA2lesions,A2magnifyingA2glass,A2Wood'sA2lightA2toA2testA2fungus,A2Braden'sA2scale,A2Press
ureA2UlcerA2ScaleA2forA2HealingA2(PUSH)

EquipmentA2neededA2forA2headA2andA2neckA2examA2-A2Ans--
StethoscopeA2toA2auscultateA2thyroidA2andA2smallA2cupA2ofA2waterA2toA2helpA2clientA2swall
owA2whenA2examiningA2thyroid

EquipmentA2neededA2forA2eyeA2examA2-A2Ans--
PenA2light,A2SnellenA2EA2chart,A2newspaper,A2opaqueA2card,A2andA2Ophthalmoscope

EquipmentA2neededA2forA2earA2examA2-A2Ans--OtoscopeA2andA2tuningA2fork

EquipmentA2neededA2forA2Mouth,A2Throat,A2Nose,A2andA2SinusA2ExaminationA2-A2Ans--
PenA2light,A24x4A2gauze,A2tongueA2depressor,A2andA2otoscope

EquipmentA2neededA2forA2ThoracicA2andA2LungA2ExaminationA2-A2Ans--
Stethoscope,A2metricA2ruler,A2skinA2markingA2pen,

EquipmentA2neededA2forA2HeartA2andA2NeckA2VesselA2ExaminationA2-A2Ans--
StethoscopeA2andA2twoA2metricA2rulersA2toA2measureA2jugularA2venousA2pressure

EquipmentA2neededA2forA2PeripheralA2VascularA2ExaminationA2-A2Ans--
SphygmomanometerA2andA2stethoscope,A2flexibleA2metricA2measuringA2tape,A2tuningA2for
k,A2andA2DopplerA2ultrasound

EquipmentA2neededA2forA2AbdominalA2ExamA2-A2Ans--
Stethoscope,A2flexibleA2measuringA2tape,A2skinA2markingA2pen,A2andA2twoA2smallA2pillows

EquipmentA2neededA2forA2MusculoskeletalA2ExaminationA2-A2Ans--
FlexibleA2measuringA2tape,A2goniometer,

EquipmentA2neededA2forA2NeurologicA2ExaminationA2-A2Ans--
CottonA2tippedA2applicators,A2newspaper,A2Ophthalmoscope,A2flexibleA2tape,A2commonA2
smallA2objectA2likeA2keyA2orA2coin,A2reflexA2hammer,A2cottonA2ball,A2paperA2clip,A2substanc

, esA2toA2smellA2andA2taste,A2SnellenA2EA2chart,A2penA2light,A2tongueA2depressor,A2andA2tuni
ngA2fork.

EquipmentA2neededA2forA2MaleA2GenitaliaA2andA2RectumA2ExaminationA2-A2Ans--
GlovesA2andA2waterA2solubleA2lubricant,A2penA2light,A2occultA2bloodA2specimenA2card

EquipmentA2neededA2forA2FemaleA2GenitaliaA2andA2RectumA2ExaminationA2-A2Ans--
VaginalA2speculumA2andA2water-
solubleA2lubricant,A2BifidA2spatula,A2endocervicalA2broomA2toA2obtainA2endocervicalA2swa
bA2andA2cervicalA2scrapeA2andA2vaginalA2poolA2sample,A2largeA2swabs,A2liquidA2papA2medi
um,A2pHA2paper,A2feminineA2napkins

WhatA2stepsA2areA2takenA2whenA2identifyingA2variousA2skinA2lesions?A2-A2Ans--
IfA2youA2observeA2aA2lesion:
-NoteA2color,A2shape,A2andA2sizeA2ofA2lesion.A2
-ForA2veryA2smallA2lesions,A2useA2aA2magnifyingA2glassA2toA2noteA2theseA2characteristics.
-NoteA2itsA2location,A2distribution,A2andA2configuration.
-MeasureA2theA2lesionA2withA2aA2centimeterA2ruler.

IfA2youA2suspectA2aA2fungus,A2shineA2aA2Wood'sA2lightA2(anA2ultravioletA2lightA2filteredA2thr
oughA2aA2specialA2glass)A2onA2theA2lesion.

PalpateA2skinA2toA2assessA2texture.A2

PalpateA2theA2lesionA2betweenA2theA2thumbA2andA2indexA2fingerA2forA2size,A2mobility,A2con
sistency,A2andA2tenderness.A2ObserveA2forA2drainageA2orA2otherA2characteristics.

WhatA2areA2theA2ABC'sA2ofA2Melanoma?A2-A2Ans--
Asymmetry,A2Borders,A2Color,A2Diameter,A2Elevated

MalignantA2melanomaA2canA2beA2deadlyA2ifA2notA2discoveredA2andA2treatedA2early,A2whic
hA2isA2oneA2reasonA2whyA2professionalA2healthA2assessmentA2andA2skinA2self-
assessmentA2canA2beA2life-savingA2procedures.

MalignantA2melanomaA2isA2usuallyA2evaluatedA2accordingA2toA2theA2mnemonicA2ABCDE:A
2AA2forA2asymmetrical;A2BA2forA2bordersA2thatA2areA2irregularA2(unevenA2orA2notched);A2CA2
forA2colorA2variations;A2DA2forA2diameterA2exceedingA21/8A2toA21/4A2ofA2anA2inch;A2andA2EA2
forA2elevated,A2notA2flat.A2DangerA2signsA2ofA2malignantA2melanomaA2includeA2anyA2ofA2th
eseA2factors.A2However,A2smallerA2areasA2mayA2indicateA2early-
stageA2melanomas.A2OtherA2warningA2signsA2includeA2itching,A2tenderness,A2orA2pain,A2a
ndA2aA2changeA2inA2sizeA2orA2bleedingA2ofA2aA2mole.A2NewA2pigmentationsA2areA2alsoA2wa
rningA2signs.

WhatA2areA2theA2threeA2mostA2commonA2skinA2cancers?A2-A2Ans--
Melanoma,A2basalA2cellA2carcinomaA2(BCC),A2andA2squamousA2cellA2carcinomaA2(SCC).A
2