NU 673 Bates Chapter 4 study guide

A 54‐year‐old diplomat working at the United Nations reports occasional chest pain and a sense of tightness in his chest when particularly stressed over work deadlines. The patient is 6 feet 4 inches tall. He has a temperature of 98.6ºF and blood pressure of 140/78. He has a cut over one eye that he says is "from shaving."Which of the following represents subjective information about this patient? a) Blood pressure of 140/78 b) Employment at the United Nations c) Temperature of 98.6ºF d) Cut over eye from shaving e) Height of 6 feet 4 inches d) Cut over eye from shaving Subjective information is any information that the patient reports but that is not directly observable or measurable. In this case, the cut is observable but the manner in which the cut was sustained is not. Shaving injuries are not usually seen above an eye, so this part of the patient's report could be explored further. Temperature, blood pressure, and height are incorrect because these were measured by the clinician. Employment at the United Nations is incorrect because, although this was not measured by the clinician, it is a fact that can be verified objectively. A physician assistant (PA) has had a long day and has seen many patients. The last patient of the day is an 80‐year‐old woman brought to the office by her 35‐year‐old granddaughter. This is the patient's first visit to the office. As part of the patient's past history, the PA obtains information about childhood illnesses and adult illnesses and then moves on to inquire about the family history. Which important area of the past history has she omitted? a) Allergies b) Medications c) Immunizations d) Chief complaint e) Social history c) Immunizations It is important to understand the three components of the past history: childhood illnesses, adult illnesses, and health maintenance behaviors including immunizations and screening tests. Understanding what conditions the patient is protected against is important for understanding the possible causes of the present illness. The patient's chief complaint(s) are, of course, highly significant, but they are not part of the past history. Allergies and medications also are relevant, but are part of the present illness, not the past history. Social history is its own category of investigation. Upgrade to remove ads Only $1/month A 39‐year‐old nurse who is a well‐established patient complains of irregular menstrual periods and pelvic pain. She says that she is having trouble sleeping and asks whether she could be given a "sleeping pill." The patient also says she is thinking of leaving her job. What is the best "next step" in caring for this patient? a) Ask about recent travel destinations. b) Obtain a urine sample for testing. c) Obtain a more complete description of problems. d) Perform a pelvic examination. e) Obtain blood for testing. c) Obtain a more complete description of problems. It is critical to thoroughly understand the patient's problem in order to narrow the focus of the examination. This is particularly true when symptoms are reported in multiple body systems, as in this case. To the extent possible, the seven attributes of each symptom should be explored. Although it may be necessary to perform a pelvic examination, the exam will yield more information if the clinician has determined, for example, the patient's pregnancy history. The clinician may need to obtain a urine sample for testing later but should have a possible diagnosis in mind when doing so. A similar argument applies regarding obtaining blood for testing—testing for what? Recent travel destinations should be elicited if there is a suspicion that an infectious agent was acquired somewhere else, but more information is needed to determine whether this would be a realistic suspicion. One important examination technique involves using the third fingers of each hand to determine the health of internal organs. What is the name of this technique? a) Inspection b) Listening c) Auscultation d) Percus