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Physical Assessment
When is physical assessment preformed?
What is a peak flow test?
Physical Assessment
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Physical Assessment
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1
What is a peak flow test?
measures the lungs
measures the inspiratory effort
measures the amount of air exhaled /c force
measures the chest expansion
2
When is physical assessment preformed?
On admission
After they are discharged from the hospital
When patient condition changes
Anytime things don't feel right
3
Avoid using what kind of punctuation at the end of sentences/
!!
" "
periods
commas
4
What is the assessment that regards specific body systems and specific problems?
listening assessment
focused assessment
initial head-to-toe
comprehensive assessment
5
What do nurses commonly call their additional notes?
Doctors notes
Reminders
Pocket-brains
Assets
6
What is anisocoria?
one pupil is bigger than the other
both pupils are pinpoint
both eyes are grey
pupils are both dilated
7
What is the tool=summary of patient care & requires continual updating by nursing staff?
Incident Report
Variance Report
Kardex
Narrative Charting
8
What are the six assessment techniques that a nurse uses?
Interview, Invite, Palpate, Percuss, Auscultate, Olfaction
Interview, Inspect,Palpate, Percuss, Access, Olfaction
Interview, Inspect,Palpate, Percuss, Auscultate, Observe
Interview, Inspect,Palpate, Percuss, Auscultate, Olfaction
9
COPD patients keep their oxygen level at 4L/NC
False
True
10
What type of oxygen delivery device delivers oxygen into the nares &allows patients easily eat?
Partial Rebreathing Mask
Simple face mask
Venturi mask
Nasal Cannula
11
What is the best way to establish rapport during communication?
Giving them everything they ask for
Staring them in the eyes
Taking their kids to day care for them
Demonstrate active listening
12
What does the acronym DAR stand for?
Data, Active, Reasoning
Data, Active, Reactive
Data, Action, Response
Data, Action, Reactive
13
What is a late sign of Hypoxia and hypoxemia?
irritability
pulmonary embolus
muscular retractions
atelectasis
14
How far should you depress the tissue to DEEP palpate?
3-4 cm
6-7 cm
1-2 cm
4-5 cm
15
What is a med delivery system that contains an air compressor& a mask or handheld mouthpiece?
Inhalation
Incentive Spirometry
Nebulizer
Tension Pneumothorax
16
What do you call drooping of the eyes?
Ptosis
Petechia
Aniscocoria
Alopecia
17
Which patient condition can you palpate the abdomen?
organ transplant
Wilms' tumor
AAA- abdominal aortic aneurysm
heart valve replacement
18
What subjective terms should you not use when charting?
All of the above
Poor
Normal
Strange
19
Proper Stethoscope use:
point ear pieces toward nose
clean the chest piece between patients
store in the refrigerator
clean the ear pieces between staff
20
When documenting, most hospitals require that you make an entry at least every _ hour(s).
2
1
4
3
21
What should be done if a page of the chart is damaged and rewritten:
Keep it in the chart
Shred it once it’s been recopied
Place it in the damaged record file
Staple it to the original
22
What is the glascow coma scale involve?
verbal response
cognitive response
Eye response
motor response
23
What is the correct way to document medication dosages?
.2300 mL
<100 mL
0.15 mL
00.9874 mL
24
What is a lighted instrument used to inspect the lining of the nose called?
Stethoscope
Ophthalmoscope
Otoscope
BP cuff
25
What is Candida albicans?
yeast fungus
jaundice
furry tongue
diarrhea
26
How many quadrants are in the abdomen?
2
3
4
6
27
What term is used when the pathway is unblocked and air is moving freely?
Patent airway
Expiration
Airway access
Inspiration
28
What are abnormally deep and rapid respirations are called?
Kussmaul's
Biot's
Auscultation
Tachypnea
29
What abbreviation should NOT be used in documentation?
international unit
mL
cc
P.O.
30
You should put a line after you are finished writing and then sign your name and credentials.
False
True
31
The dropping of oxygen levels in the blood below normal range, what is this referred to as?
Hypoxemia
Atelectasis
Crepitus
Air hunger
32
What are the spheres of orientation?
Situation
Person
Time
Place
33
Dried mucus or food caked on the lips and teeth is termed?
Rales
Halitosis
Sordes
Cheilitis
34
What is kyphosis?
exaggerated lumbar curve
contractured arms
lateral spine curve
stooped posture
35
What does HIPAA stand for?
Having Insurance Portability and Accountability
Having Integrity Plasma And Accountability
Health Integrity Place And Act
Health Insurance Portability and Accountability Act
36
What kind of report do you need to fill out when anything out of the ordinary happens?
Variance Report
Incident Report
Kardex
Both 1 and 4
37
When charting avoid leaving blank lines.
False
True
Sometimes
38
Which of these is a sign?
Stomach cramps
BP of 112/80
Chest pain
Headache
39
When a pt is having difficulty moving air in and out of the lungs, what is this referred to as?
Cyanosis
Dyspnea
Pleural effusion
Sputum
40
Which assessment technique involves striking the body parts /c the tips of your fingers?
percussion
ausculation
inspection
olfaction
41
Which document mistakes carry increased risks? Select all that apply.
Failure to document assessment findings
Failure to document pertinent medical history
Failure to document patient’s last meal
Writing in red ink
42
Continuous melodious, musical, or whistling sounds called?
Rhonchi
Stridor
Rales
Wheezing
43
What is 6pm in military time?
0600
1800
1730
1600
44
What is bad breath commonly referred to as?
Halitosis
Flatulence
Bad breath
Stank breath
45
What will you make on the exam tomorrow?
B
D
C
A
46
What are two things you are not supposed to document?
Assumptions
Vital Signs
Skin integrity
Cap Refill
47
What does the acronym TORB stand for?
Teach others real basics
Take out real bread
Telephone order read back
To own right bearment
48
Which data is subjective?
emesis
nausea
rash
lesion 1cm x 3 cm
49
How much urine should the kidneys produce?
1000mL every hour
2 liters every 4 hours
varies
at least 30 mL every hour
