Health Assessment Across the Lifespan
- Chapter 4 Assured success 173
questions and actual answers.
Health Assessment Across the Lifespan
- Chapter 4 Assured success 173
questions and actual answers.
Health assessment is the collection of information about an individuals well being. Info
can come from a variety of sources such as? - ANSWER-Verbal info from person or
family
Physical info through inspection, palpation, and auscultation
Laboratory Testing
It is important to also view the clients _________ during the interview to give you the full
story? - ANSWER-Posture
eye contact
facial expressions
voice
language
use of touch
Gestures
If a client has a hearing deficit how should you sit to speak to them? - ANSWER-Directly
infront, make sure hearing aids are present. If severe have sign-language interpreter
How many metres should you stay apart from a patient when meeting? - ANSWER-1.5-
3 metres
A complete health history includes? - ANSWER-Biographical data
Reason for seeking care
Present health or history of the present illness
Past history
Family history
Review of all systems
Functional assessment or ADLs
If pain - PQRSTU
P: What starts the pain? What makes it worse/better? - ANSWER-Provocative
Q: Neurophatic or nociceptive pain? How does it feel? - ANSWER-Quality of pain
R: Where is the pain? Does it spread? - ANSWER-Region or Radiation
,Health Assessment Across the Lifespan
- Chapter 4 Assured success 173
questions and actual answers.
S: On a scale of 0-10, where 0 is no pain and 10 is the most severe pain you can
imagine. where is your pain? - ANSWER-Severity Scale
T: when did the pain start? how often does it occur and how long does it last? -
ANSWER-Timing
U: what do you think that it means? - ANSWER-Understanding pts perception of
problem
Cultural differences to keep in mind after determining when they arrived, the country or
region they came from and conditions in that location? - ANSWER-blood-product
transfusions
dietary options
need for clergy
necessity of a chaperone
If client is an infant, include details of? - ANSWER-Pre and post natal health and labour
and delivery
Developmental history
What assessment is crucial for adolescents as they can be vulnerable to depression
and suicide? - ANSWER-Psychological
A persons mental status is defined as his or her emotional and cognitive function
assessed through? - ANSWER-Behaviour
By assessing mental status first a nurse can then establish a? - ANSWER-Baseline
Reassessment can monitor any changes
Response to the stress of an illness and feeling of being unwell
What can alter the mental assessment? - ANSWER-Serious health conditions
(Alcoholism, renal failure, diabetes, liver disease, or brain disease)
Various medications
Older adults might have experiences a number of loss and health declines which give
rise to an added risk of? - ANSWER-Depression and despair
The behaviour assessment should include? - ANSWER-Consciousness
Language
Mood Affect
Orientation
, Health Assessment Across the Lifespan
- Chapter 4 Assured success 173
questions and actual answers.
Attention
Memory
Abstract reasoning
Thought process
Thought content
Perceptions
For the average client what are the 4 main headings in mental assessment? -
ANSWER-Appearance
Behaviour
Cognition
Thought process
The PN uses which techniques when objectively assessing a client? - ANSWER-
Inspection
Palpation
Auscultation
Guided by observation of any abnormalities? - ANSWER-Inspection
Touching of the body to assess the skin and underlying organs, as well as any
abnormalities. Can be used to feel texture, temp, moisture, vibration, pulsation, swelling,
rigidity, spasticity, organ location, crepitations, lumps, bumps or lesions or the presence
of pain? - ANSWER-Palpation
Auscultation: The diaphragm is used to listen to? - ANSWER-High-Pitched sounds:
Bowel, resp, heart
Auscultation: The bell is used to listen to? - ANSWER-Low-pitched sounds: Heart
murmurs or bruits
If a clients chest is hairy, wet the hair to avoid mistaking it for? - ANSWER-Crackles
The General Survey: Firstly establish the client? - ANSWER-Airway clear
Breathing
Circulation
The General Survey: Does the client look the correct age? Orientation? sexual
development appropriate for age and gender? Colour and condition of skin? Acute
distress? - ANSWER-Physical appearance
- Chapter 4 Assured success 173
questions and actual answers.
Health Assessment Across the Lifespan
- Chapter 4 Assured success 173
questions and actual answers.
Health assessment is the collection of information about an individuals well being. Info
can come from a variety of sources such as? - ANSWER-Verbal info from person or
family
Physical info through inspection, palpation, and auscultation
Laboratory Testing
It is important to also view the clients _________ during the interview to give you the full
story? - ANSWER-Posture
eye contact
facial expressions
voice
language
use of touch
Gestures
If a client has a hearing deficit how should you sit to speak to them? - ANSWER-Directly
infront, make sure hearing aids are present. If severe have sign-language interpreter
How many metres should you stay apart from a patient when meeting? - ANSWER-1.5-
3 metres
A complete health history includes? - ANSWER-Biographical data
Reason for seeking care
Present health or history of the present illness
Past history
Family history
Review of all systems
Functional assessment or ADLs
If pain - PQRSTU
P: What starts the pain? What makes it worse/better? - ANSWER-Provocative
Q: Neurophatic or nociceptive pain? How does it feel? - ANSWER-Quality of pain
R: Where is the pain? Does it spread? - ANSWER-Region or Radiation
,Health Assessment Across the Lifespan
- Chapter 4 Assured success 173
questions and actual answers.
S: On a scale of 0-10, where 0 is no pain and 10 is the most severe pain you can
imagine. where is your pain? - ANSWER-Severity Scale
T: when did the pain start? how often does it occur and how long does it last? -
ANSWER-Timing
U: what do you think that it means? - ANSWER-Understanding pts perception of
problem
Cultural differences to keep in mind after determining when they arrived, the country or
region they came from and conditions in that location? - ANSWER-blood-product
transfusions
dietary options
need for clergy
necessity of a chaperone
If client is an infant, include details of? - ANSWER-Pre and post natal health and labour
and delivery
Developmental history
What assessment is crucial for adolescents as they can be vulnerable to depression
and suicide? - ANSWER-Psychological
A persons mental status is defined as his or her emotional and cognitive function
assessed through? - ANSWER-Behaviour
By assessing mental status first a nurse can then establish a? - ANSWER-Baseline
Reassessment can monitor any changes
Response to the stress of an illness and feeling of being unwell
What can alter the mental assessment? - ANSWER-Serious health conditions
(Alcoholism, renal failure, diabetes, liver disease, or brain disease)
Various medications
Older adults might have experiences a number of loss and health declines which give
rise to an added risk of? - ANSWER-Depression and despair
The behaviour assessment should include? - ANSWER-Consciousness
Language
Mood Affect
Orientation
, Health Assessment Across the Lifespan
- Chapter 4 Assured success 173
questions and actual answers.
Attention
Memory
Abstract reasoning
Thought process
Thought content
Perceptions
For the average client what are the 4 main headings in mental assessment? -
ANSWER-Appearance
Behaviour
Cognition
Thought process
The PN uses which techniques when objectively assessing a client? - ANSWER-
Inspection
Palpation
Auscultation
Guided by observation of any abnormalities? - ANSWER-Inspection
Touching of the body to assess the skin and underlying organs, as well as any
abnormalities. Can be used to feel texture, temp, moisture, vibration, pulsation, swelling,
rigidity, spasticity, organ location, crepitations, lumps, bumps or lesions or the presence
of pain? - ANSWER-Palpation
Auscultation: The diaphragm is used to listen to? - ANSWER-High-Pitched sounds:
Bowel, resp, heart
Auscultation: The bell is used to listen to? - ANSWER-Low-pitched sounds: Heart
murmurs or bruits
If a clients chest is hairy, wet the hair to avoid mistaking it for? - ANSWER-Crackles
The General Survey: Firstly establish the client? - ANSWER-Airway clear
Breathing
Circulation
The General Survey: Does the client look the correct age? Orientation? sexual
development appropriate for age and gender? Colour and condition of skin? Acute
distress? - ANSWER-Physical appearance
