Exam 2 covers the content from weeks 4-8: chapters 12, 13, 14, 16, 17, 19, 20
Anything we've covered in those weeks is fair content for the test. In other words, the test might
include things not on this guide, but I do try to get most of it here.
Make sure to read questions carefully. NCLEX-style questions sometimes includes words like
"Which one is not....” "All are correct except...” and "The priority intervention...” (which probably
means most of the answers are correct, you just have to pick the best or first thing to do.)
• Give four numbers and have patient repeat back
• Give three number and have patient repeat backwards
• Serial 7s
When prioritizing cares or nursing diagnoses:
1. Safety - the stuff that is life threatening
2. ABCs – For example, altered tissue perfusion is probably a circulation issue. If one of the
other options is impaired gas exchange (an airway or breathing issue), then you probably
need to address it first.
3. Safety - the non-life-threatening (I try to make this plain in the questions.)
4. Pain after that – if your patient in pain is falling out of bed, you have the falling first.
5. Other problems
6. “Risk for” concerns – since these are concerns that not yet problems, they will generally fall
at the end of the priority list (I’m sure there are exceptions to this somewhere, but generally
speaking, that will be the case.)
Health History and Physical Examination are often done together (or sequentially), but are not the
same thing. If a question asks for health history, make sure you do not select items that are actually
physical exam (and vice versa).
Mental status: - While we cover this content with neuro, don't forget it has it's own chapter so there
will be specific mental status questions
● What questions might be used for a mini-mental status exam?
o MMSE: brief test useful in screening for cognitive dysfunction or dementia
o Can use to follow patients over a course of time
o Sample items: orientation, registration, naming, reading
o Questions similar to what we ask on the neuro assessment. Quick google search
shows a variety of styles.
● What areas are assessed in a mini-mental status exam?
o Attention
▪ ability to concentrate or focus over time on 1 task or activity
▪ Impaired attention/consciousness example: pt having difficulty
responding to questions
o Memory
, ▪ The process of registering or recording information and storing/retaining that
information
▪ Short-term: minutes, hours, days
▪ long-term: intervals of years
o Orientation
▪ Personal awareness, place, time (uses memory and attention)
o Perception
▪ Sensory awareness of objects in the environment and their interrelationships
(external stimuli)
▪ Internal stimuli such as dreams or hallucinations
o Thought processes
▪ Logic, coherence, relevance of pt’s thought as it leads to goals or how
people think
o Thought content
▪ what is the patient thinking about, level of insight and judgement
o Insight
▪ awareness hat symptoms or behaviors are normal or abnormal
▪ can they determine if a dream is real or just a dream?
o Judgement
▪ the process of comparing and evaluating alternatives when deciding on a
course of action.
▪ May reflect values that may or may not be based on reality or social
norms
o Affect
▪ observable, usually episodic, feeling or tone expressed through voice, facial
expressions, and demeanor
o Mood
▪ more sustained (less episodic) emotion that may color a person’s view of the
world
▪ mood is to affect as climate is to weather
o Language
▪ Complex symbolic system for expressing, receiving, and
comprehending words.
▪ essential to assessing other mental functions
o Higher cognitive functions
▪ vocabulary, amount of info, abstract thinking, calculations, construction of
objects that have 2 or 3 dimensions
*Other:
o Attention:
▪ Give four numbers and have patient repeat back
▪ Give three number and have patient repeat backwards
▪ Serial 7s
o Memory:
▪ Short-term:
▪ Identify 3 words, tell the patient the words, then have them recall the
words at end of assessment
o Orientation:
▪ Name, place, time (month, date, day of the week), thing