Shadow health respiratory assessment transcript
Shadow health respiratory assessment transcript Pre Brief
Tina had an asthma episode 2 days ago. At that time she used her albuterol inhaler and her symptoms decreased although they did not completely resolve. Since that incident she notes that she has had ten episodes of wheezing and has shortness of breath approximately every four hours. Tina presents with continued shortness of breath and wheezing. Be sure to ask pertinent questions during the interview about related body systems. This case study will provide the opportunity to carefully assess lung sounds during the physical examination. Be sure to appropriately document your findings using correct medical terminology.
Reason for visit: Patient presents complaining of a recent asthma episode that is not fully resolved.
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Hello my name sara an FNP student and I will be interviewing you today.
Hey.
Can you please state your name for me?
Tina Jones.
Your date of birth?
February 17th.
Year of birth please? (Clarified to What year were you born.)
I was born in . . . [Ms. Jones reports correct birth year.] [AUDIO
COMING SOON]
How old are you ms. Jones? (Clarified to how old are you.)
I’m 28.
What brings you in today?
I came in because I’ve been having breathing problems, and my
inhaler just isn’t working the way it normally does.
Why did you XXX
I XXX normally does.
BRIAN FOSTER CHEST PAIN SHADOW HEALTH ASSESSMENT
I’m XXX.
XXX that. Shadow health respiratory assessment transcript.
What XXX?
Well. . . I’ve hadxxxx since I was really little, though for a while
there it wasn’t really much of a problem. And I have xxxx,
too.
What XXX?
It’s XXX.
ESTHER PARK ABDOMINAL PAIN SHADOW HEALTH
How XXX?
I’ve XXX.
XXX start?
I don’t know if I’d call it an asthma attack, but XXX house. She has cats, and I’m
allergic, so I’m used to it being a problem there, but usually the
inhaler fixes it. . . it doesn’t feel totally under control, though.
I’m sorry you’re having difficulty with your breathing problems.
Thanks.
How XXX problems?
My breathing’s been acting up off and on for the past two days.
How XXX?
DANNY RIVERA SHADOW HEALTH PEDIATRIC PHYSICAL ASSESSMENT
Maybe XXX? It’s a lot.
And how XXX? (Clarified to
how long does an episode last.)
I haven’t had a XXX normal. .
. that’s not what’s been happening recently, though.
How xxxx?
I haven’t had a xxx, but usually once I use xxx
it only takes a minute or two for my xxxck to normal. .
. that’s not what’s been happening recently, though.
How manyxxxx
Well. . . it’s kind of hard to count because my breathing’s been at
least a little bad most of the past two days, but it’s really acted up,
like with wheezing and everything, probably every four hours or so–
like five times each day.
Is your ?
My
How xxx.)
My asthma used to be really scary. I haven’t had a full attack in
years, and if you had asked me before this I would have said my
asthma wasn’t that bad anymore, but the last couple days I’ve had a
lot of trouble breathing.
How xxx?
My asthma used to be really scary. I haven’t had a full attack in
years, and if you had asked me before this I would have said my
asthma wasn’t that bad anymore, but the last couple days I’ve had a
lot of trouble breathing.
Is there xxx?
There usually xxxx. . . I
guess I try to avoid things that make my breathing worse, but that’s
about it. The past couple days, though, it’s been hard to do anything.
Do you wheeze during an asthma exacerbation?
During a full attack, I would wheeze a lot, like I couldn’t breathe at all,
but until the past couple days, I would usually just wheeze a little
when I had breathing problems.
Are you having any chest tightness? Shadow health respiratory assessment transcript.
It’s not so bad right this second, but it’s been pretty tight lately, like I
can’t take in air.
Have you xxx?
I’ve been xxxxa lot, yeah.
How long have you had the xxxx?
Since my asthma acted up two days ago.
How would you describe the xxx?
Um. . . I guess I’d describe it asxxx.
What makes your xxxbetter?
Drinking some water helps a little, as long as the water isn’t too cold.
Have you tried txxx your xxx?
I haven’txxx.
Is your xxx?
It has been the past cxxx, yeah.
Does lxxx worse?
Just recently lying on my back has definitely made my breathing
worse.
To try to help your breathing you may want to elevate your head with
two pillows.
OK, I understand.
Inspected anterior chest wall
Inspected anterior chest wall
Inspected left side chest wall
Inspected anterior chest wall
Inspected right side chest wall
Inspected anterior chest wall
Palpated chest expansion: Both sides rise symmetrically
Palpated fremitus in anterior upper chest wall: Equal bilaterally,
expected vibration
Ninety-nine.
Palpated fremitus in anterior lower chest wall: Equal bilaterally,
expected vibration
Ninety-nine.
Palpated fremitus in posterior upper chest wall: Equal bilaterally,
expected vibration
Ninety-nine.
Palpated fremitus in posterior middle chest wall: Equal bilaterally,
expected vibration
Ninety-nine.
Palpated fremitus in posterior lower chest wall: Equal bilaterally,
expected vibration
Ninety-nine.
Percussed anterior left upper lobe
Percussed anterior right upper lobe
Percussed anterior left mid-chest (upper lobe)
Percussed anterior right middle lobe
Percussed anterior left lower lobe
Percussed anterior right lower lobe
Percussed posterior right upper lobe
Percussed posterior left upper lobe
Percussed posterior right mid-back (lower lobe)
Percussed posterior left mid-back (lower lobe)
Percussed posterior right lower lobe
Percussed posterior left lower lobe. Shadow health respiratory assessment transcript.
Percussed posterior left lower lobe on side
Percussed posterior left lower lobe near spine
Percussed posterior right lower lobe near spine
Percussed posterior right lower lobe on side
Auscultated breath sounds in anterior left upper lobe
Auscultated breath sounds in anterior right upper lobe
Auscultated breath sounds in anterior right middle lobe
Auscultated breath sounds in anterior left mid-chest (upper lobe)
Auscultated breath sounds in anterior left lower lobe
Auscultated breath sounds in anterior right lower lobe
Auscultated breath sounds in posterior right upper lobe
Auscultated breath sounds in posterior left upper lobe
Auscultated breath sounds in posterior left mid-back (lower lobe)
Auscultated breath sounds in posterior right mid-back (lower lobe)
Auscultated breath sounds in posterior right lower lobe
Auscultated breath sounds in posterior left lower lobe
Auscultated breath sounds in posterior left lower lobe on side
Auscultated breath sounds in posterior left lower lobe near spine
Auscultated breath sounds in posterior right lower lobe near spine
Auscultated breath sounds in posterior right lower lobe on side
Auscultated voice sounds in anterior left upper lobe
Ninety-nine.
Ninety-nine.
Auscultated voice sounds in anterior right upper lobe
Ninety-nine.
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https://chamberlain.shadowhealth.com/assignment_attempts/3498304 10/23
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Ninety-nine.
Ninety-nine.
Auscultated voice sounds in anterior left upper lobe
Auscultated voice sounds in anterior left mid-chest (upper lobe)
Ninety-nine.
Auscultated xxx
Auscultated xxxx
Ninety-nine.
Auscultated voice sounds in anterior left lower lobe
Ninety-nine.
Ninety-nine.
Ninety-nine.
Auscultated xxxx
Ninety-nine.
Auscultated voice sounds in posterior left upper lobe
Shadow health respiratory assessment transcript
Ninety-nine.
Auscultated voice sounds in posterior right mid-back (lower lobe)
Ninety-nine.
Auscultated voice sounds in posterior left mid-back (lower lobe)
Ninety-nine.
Auscultated voice sounds in posterior right lower lobe
Ninety-nine.
Auscultated voice sounds in posterior left lower lobe
Ninety-nine.
Auscultated voice sounds in posterior left lower lobe on side
Ninety-nine.
Auscultated voice sounds in posterior left lower lobe near spine
Ninety-nine.
Auscultated voice sounds in posterior right lower lobe near spine
Ninety-nine.
Shadow health respiratory assessment transcript
Auscultated voice sounds in posterior right lower lobe on side
Ninety-nine.
Checked pulse xxx
Check pulse xx
Checked xxxx
Checked xxx
Always make sure yourxxxx
Sure, I think I understand what you mean.
Make sure to read all instructions and store as indicated (No
matching questions found.)
Make sure to read all instructions and store as indicated
Alright, thanks for letting me know.
Always shake well before using.
Thanks for telling me.
Also after every complete use you should always rinse out your
mouth with water.
Shadow health respiratory assessment transcript.
That makes sense.
What medications do you take?
My xxx is the only prescription I always have, but I usually don’t
need it everyday, except for recently. . .
When did you last use your xxx?
I had to use it early this morning.
How is your xxx prescribed?
Yes.
How often is your xxx?
Yes.
How many times have you use xxx?
I’ve been needing my xxx about every four hours, I’d say.
How many xxxx 4 hours? (Clarified to how xxxx are you prescribed.)
I’m supposed to just do twoxxx [Nurse confirmed with Pharmacy:
xxx]
How many xxx are you doing?
I’m supposed to just do xxx. [Nurse confirmed with Pharmacy:
xxx]
Make sure to follow thexxx instructions as prescribed
Thanks for telling me.
Are you taking any other medications?
No, all I really use is xxx.
You take any over-the-counter medications?
I take xxx, but not
often.
How much xxxdo you take?
I just take a couple. I usually get them at night from reading–
squinting I guess–and so I take one and go to bed. [Nurse confirmed
with Pharmacyxxx ]
How much xxx do you take for cramps?
I take three at a time. And I’d bet I take it up to three times a day.
[Nurse confirmed with Pharmacy: xxx]
Do you have xxxx?
Yeah, I’mxxx.
Do you have axxx?
No, not that I know of.
When didxxx
This all started at my cousin’s house. Shexxxxalways goes crazy when I’m there.
Does being around dust trigger asthma?
Yeah, being around a lot of dust, especially hanging out in a really
dusty house, can make my asthma act up.
Sorry to hear that about your asthma
Thanks for understanding.
Does cxxxa?
Only when I’m in a rush and have to hurry up them.
Do you have xxxx? (Clarified to do you have
seasonal allergies.)
A little while ago, I had some seasonal allergies, but it didn’t really
bother my asthma, and it’s better now.
Does xxxe?
Well. . . sometimes when txxx often.
Do you xxx?
I used to go to Dr. Dewitt, but she moved her practice recently.
Luckily she’s still been able to call in refills of my inhaler, but I haven’t
actually been in to see her in about two years.
Since you have asthma it is important to follow up on a regular basis
with your asthma specialist
Alright, thanks for letting me know.
How xxx?
I’ve had xxxle.
How xxxx?
My xxx.
Have you everxxx?
I xxx?
I used to go to thexxxt not since I
was sixteen.
Have yoxxx?
You mean like, did they ever have to put me on a breathing machine?
No, I haven’t had an asthma attack that serious.
Do you use a xxx?
Not really. . .
Do you cxxx?
I’ve heard of that, but no, I don’t do it.
Do you use xxx
No, but I have before.
We may cxxx
That makes sense.
Also a way to track your asthma symptoms and episodes. (No
matching questions found.)
Also a way to track your s and episodes.
OK, I understand.
BUY A PLAGIARISM-FREE PAPER HERE
Sending you home with a peak flow meter and document regularly.
I’ve heard of that, but no, I don’t do it.
We will also teach you how to use nebulizer at home.
Sure, I think I understand what you mean.
How often do you change your sheets?
I change my bedding once a week, I’d say.
5/11/2018 Respiratory | Completed | Shadow Health
https://chamberlain.shadowhealth.com/assignment_attempts/3498304 18/23
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Do you have pets at home?
No. . . I’m too busy to take care of a dog, and I can’t have cats
because of my allergies.
Does ?
No, nobody at home .
If exposed to secondhand smoke it is definitely a Asthma trigger.
Alright, thanks for letting me know.
Have you ever had eczema?
No, I don’t have that kind of skin problem.
history of sinus problems? (Clarified to do you have a history of sinus
problems?.)
I don’t really have a problem with my sinuses.
Do you have xxx?
I don’t know what that is, so I guess probably not?
Have you ever been xxx
Have you xxx?
Shadow health respiratory assessment transcript
No, I’ve never done that. I think it’s gross.
I’m glad you think that
Thanks for understanding.
Smoking is a known trigger for asthma
OK, I understand.
Have you xxx
Well, I used to xx. . . but I don’t do that anymore.
When was the xxx?
I haven’t sxxx.
Have you ever experimented with xxxx?
No, no way. That’s a nasty thing to do.
Have you been sick recently?
No, I’m usually healthy.
Have you had any xxx?
No, I haven’t had a xxx.
5/11/2018 Respiratory | Completed | Shadow Health
https://chamberlain.shadowhealth.com/assignment_attempts/3498304 21/23
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Have you had any nausea or vomiting?
I haven’t had thrown up, or even had an upset stomach, in a long
time.
Have you had chills?
No, I haven’t.
Are you fatigued?
I feel tired, yeah, probably because I haven’t been able to sleep very
well.
Do you have any xx?
I don’t getxxx, but sometimes I wake up hot and have to kick off
my xxx.
Sometimexxxybe an indication of being sick
That makes sense.
Have you been cxxx anything?
No, nothing’s coming up.
Have you had any problemsxxx?
Nope.
Do you have any nasal drainage?
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https://chamberlain.shadowhealth.com/assignment_attempts/3498304 22/23
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No, my nose has been fine.
Has anyone been sick at home?
No, no one at home has been sick.
Does anyone in your family have asthma?
It’s just me and my baby sister that have asthma, but she really
doesn’t have problems with it.
Does anyone in your family have allergies?
My sister has hay fever, I think, and it sometimes makes her asthma
get pretty bad.
Does anyone in your family have eczema?
No. . .
Do you have a family history of sinus problems?
I don’t think anyone in the family has sinus problems.
Are you in any pain right now?
It doesn’t hurt. . . it’s just hard to breathe, but there’s no pain.
Is there pain when you wheeze? (No matching questions found.)
are you in pain when you wheeze?
5/11/2018 Respiratory | Completed | Shadow Health
https://chamberlain.shadowhealth.com/assignment_attempts/3498304 23/23
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Right now it doesn’t sound too bad, but I’ve definitely been
wheezing the past couple days.
Any changes in your appetite?
I wouldn’t say it’s changed recently, but I do feel hungry a lot.
When was your last chest x-ray?
The last time I went to the hospital for an asthma attack, when I was
still in high school, they did a chest x-ray.
Comments
If your instructor provides individual feedback on this assignment, it will appear here.
shadow health respiratory transcript
APPROACH
Overview
| Transcript
| Subjective Data Collection
| Objective Data Collection
| Education & Empathy
| Documentation / Electronic Health Record
| Student Pre-Survey
| Lifespan Activity
| Review Questions
| Self-Reflection Activity
SAMPLE Shadow Health Respiratory Assessment
Model Documentation
Subjective
Social History: She is not aware of any environmental exposures or irritants at her job or home……
Review of Systems:
General: Denies changes in…
Nose/Sinuses:
Gastrointestinal:
Respiratory:
Objective
General: Ms. Jones is a pleasant….
Respiratory: Chest expansion is….
Assessment
Mild-persistent….
Plan
Diagnostics
Obtain office….
Education
Encourage Ms. Jones to continue t….
Referral/Consultation
Refer to…..
Follow-up Planning
Order ….
Instruct Ms. Jones …..
Revisit….
Tina’s second cousin was diagnosed with asthma at age 5. What would be included in your treatment plan? What factors might concern you related to compliance?
The treatment plan for this child would be to….
Consider that Tina’s uncle is now 68 years old and has smoked heavily every day since he was fifteen. What would you expect to find in his respiratory assessment? How would this affect your oxygenation goals for this patient?
Common significant deviations of the chest for older adults include xxxx (Hogstel & Curry, 2005). xxxx become thinner, more rigid, and change shape, and muscles may become weakened. This results in a lower oxygen level with less carbon dioxide removed from the body, and decreased ability to cough. xxxx causes decreased xxx height. xxx also causes thexxxto lose their shape causing shortness of xxx. Due to diminishedxxxwith decreased sensitivity, large amounts of particles that are more difficult to expectorate can collect in the xxx. In addition, the xxxx is less sensitive to xxxx and xxx and higher residual volume. As a result of these changes, xxx are at increased risk for xxxx and xxxx (Minaker, 2011; Sharma & Goodwin, 2006). Shadow health respiratory assessment transcript.
In the respiratory assessment of this patient, I expect to find xxx, increased xxxx of the xxx, diminished chest expansion, and xxxx. The weakened muscles will result in xxx levels and lower xxxx leading to decreased xxxx capacity. xxx will also will also lose their shape leading toxxx. Therefore, x goals will hxave to take in cognizance these realities and advise the patient accordingly. Consequently, efforts to increase exercise tolerance, treat complication, and relieve symptoms will be initiated.
If Tina had mentioned that she was just diagnosed with pneumonia, what would you have expected to find during percussion?
If the results of Tina’s pulse oximetry had been 97%, which of the following would have been true?
Suppose that, during your lung exam on Tina, you had heard bronchial breath sounds in the left lower lung posteriorly. What would you have suspected based on this finding?
Suppose that while auscultating, you assessed a few scattered expiratory wheezes. Why would this be an expected finding for a patient with Tina’s history
When you observe a patient like Tina throughout an exam, there are many ways to determine whether a patient is experiencing respiratory distress. Identify one indicator of respiratory distress that can be assessed through observation alone.
Describe how you would assess Tina for dyspnea
Dyspnea can be assessed both……
Explicitly describe the tasks you undertook to complete this exam.
The examination…..
Explain the clinical reasoning behind your decisions and tasks.
Identify how your performance could be improved and how you can apply “lessons learned” within the assignment to your professional practice Shadow health respiratory assessment transcript.
My performance could be improved by seeking more history from the patient…..
NR 509 Week 1 Shadow Health History Assignment
Pre-brief
Obtaining an accurate history is the critical first step in determining the etiology of a patient’s problem. A large percentage of the time, you will actually be able to make a diagnosis based on the history alone. The value of the history, of course, will depend on your ability to elicit relevant information. Your sense of what constitutes important data will grow exponentially as you practice your interviewing skills and through increased exposure to patients and illness…………………… Interviewing patients is an art and should remain an essential skill for successful practice.
In this activity, you will interview Tina Jones to collect data to assess Ms. Jones’ condition. You will also have the opportunity to educate and empathize with Tina to engage in effective therapeutic communication; create a problem listusing evidence from the data you collected; prioritize the identified problems to differentiate immediate from non-immediate care; plan how to best address the most important concern with further assessment, interventions, and patient education; and compare your documentation to model documentation.
Ms. Jones is a pleasant, 28-year-old obese African American single woman who presents to establish care and with a recent right foot injury. She is the primary source of the history. Ms. Jones offers information freely and without contradiction. Her speech is clear and coherent and she maintains eye contact throughout the interview.
Reason for visit: Patient presents for an initial primary care visit today complaining of an infected foot wound.
| Overview
| Transcript
| Subjective Data Collection
| Objective Data Collection
| Education & Empathy
| Documentation / Electronic Health Record
| Information Processing
| Lab Pass: Certificate of Completion
NR 509 Week 2 Alternate Writing Assignment: Respiratory Summer 2018
Purpose
As a family nurse practitioner, you must possess excellent physical assessment skills. This alternative writing assignment mirrors the discussion content of the debriefing session and will allow the student to expand their knowledge of physical health assessment principles specific to the advanced practice role. Shadow health respiratory assessment transcript.
Course Outcomes
This assignment is guided by the following Course Outcomes (COs):
Apply advanced practice nursing knowledge to collecting health history information and physical examination findings for various patient populations. (PO 1, 2)
Differentiate normal and abnormal health history and physical examination findings. (PO 1, 2)
Adapt health history and physical examination skills to the developmental, gender-related, age-specific, and special population needs of the individual patient. (PO 1, 2)
The purposes of this assignment are to: (a) identify and articulate advanced assessment health history and physical examination techniques which are relevant to a focused body system (CO 1), (b) differentiate normal and abnormal findings with regard to a disease or condition that impacts the body system (CO 2), and (c) adapt advanced assessment skills if necessary to suit the needs of specific patient populations (CO 4).
NOTE: You are to complete this alternative writing assignment ONLY if you had not participated or do not plan to participate in a debriefing session for the given week.
Due Date: This alternative written assignment is due no later than the Sunday of the week in which you did not attend the weekly debriefing session. The standard MSN Participation Late Assignment policy applies to this assignment.
Preparing the Paper:
Select a focused body system from the weekly lesson which corresponds with the week of the written assignment.
Carefully read and review the selected body system in your course textbooks.
Incorporate at least onescholarly peer-reviewed journal article that relates to the body system. It may be useful to identify an article that relates to a disease that impacts the body system.
The paper must clearly articulate the relevance of advanced physical assessment skills, techniques, application of advanced practice knowledge, and assessment modification (when necessary) to accommodate for specific patient populations.
Provide concluding statements that should summarize key points of the overall assignment content.
In-text citations and reference page(s) must be written using proper APA format (6thedition).
NR 509 Week 2 Quiz
A mother brings her two month old daughter in for an examination says “my daughter rolled over against the wall and now I have noticed that she has the spot soft on the top of her head, is there something terribly wrong?” The FNP‘s best response would be:
During percussion the FNP knows that a dull percussion note elicited over a lung lobe. This most likely results from:
The patient is unable to differentiate between sharp and dull stimulation to both sides of her face. The FNP suspects Damage to:
When examining the face, the FNP is aware that the two pairs of salivary gland‘s that are accessible to examination are the _____ glands
A patient comes to the clinic complaining of neck and shoulder pain and is unable to turn her head. The FNP suspects damage to cranial nerve ____ and proceeds with the examination by____
When examining a patient’s cranial nerve function, the FNP remembers that the muscles in the neck that are innervated by CN XI are the:
The patient’s laboratory data reveal an elevated thyroxine level. The FNP would proceed with an examination of the _____ gland Shadow health respiratory assessment transcript.
A patient says that she has recently noticed a lump in the front of her neck below her “Adams apple” that seems to be getting bigger. During the assessment, the finding that leaves the FNP to suspect that this may not be a cancerous thyroid nodule is that the lump:
The FNP notices that the patient’s submental lymph nodes are enlarged. In an effort to identify the cause of the node enlargement, the FNP would assess the patient’s:
The FNP is aware that the four areas in the body were lymph nodes accessible are the:
A 52-year-old patient describes the presence of occasional floaters or spots moving in front of his eyes. The FNP should know that floaters are usually not significant and are caused by:
The FNP is preparing to assess the visual acuity of a 16-year-old patient. How should the FNP proceed?
A patient’s vision is recorded as 20/30 when the Snellen eye chart is used. The FNP interprets these results to indicate that:
A patient is unable to read even the largest letters on the Snellen chart. The FNP should take which action next:
A patient’s vision is reported as 20/80 in each eye. The FNP interprets this finding to mean that
When performing the corneal light reflex assessment, the FNP notes that the light is reflected at 2 o’clock in each eye. The FNP should
The FNP is performing the diagnostic positions test. Normal findings would be which of these results?
During an assessment of the sclera of an African-American patient, the FNP would consider which of these an expected finding?
A 60-year-old man is at the clinic for an examination. The FNP suspects that he has ptosis of one eye. How should the FNP check for this?
The FNP is doing an assessment on a 21-year-old patient and notices that his nasal mucosa appears pale gray and swollen. What would be the most appropriate question to ask the patient?
The FNP is palpating the sinus areas. If the findings are normal, then the patient should report which sensation?
During an oral assessment of a 30-year-old African-American patient, the FNP notices bluish lips and a dark line along the gingival margin. What would the FNP do in response to these findings
During an assessment of a 20-year-old patient with a three day history of nausea and vomiting the FNP notices dry mucous and deep vertical fissures on the tongue. These findings are reflective of:
The FNP is reviewing the technique of palpating for tactile fremitus with a new graduate. Which statement by the graduate FNP reflects a correct understanding of tactile fremitus?
The FNP student is reviewing physical assessment findings of the HEENT system associated with pregnancy. Which statement by the graduate FNP reflects a correct understanding of expected HEENT changes associated with pregnancy? During pregnancy:
NR 509 Week 2 Quiz Review – (Jarvis 8,9,13,14,15,16,18), (Swartz 4,6,7,8,9,10)
NR 509 Week 2 Quiz
A mother brings her two month old daughter in for an examination says “my daughter rolled over against the wall and now I have noticed that she has the spot soft on the top of her head, is there something terribly wrong?” The FNP‘s best response would be:
During percussion the FNP knows that a dull percussion note elicited over a lung lobe. This most likely results from:
The patient is unable to differentiate between sharp and dull stimulation to both sides of her face. The FNP suspects Damage to:
When examining the face, the FNP is aware that the two pairs of salivary gland‘s that are accessible to examination are the _____ glands
A patient comes to the clinic complaining of neck and shoulder pain and is unable to turn her head. The FNP suspects damage to cranial nerve ____ and proceeds with the examination by____
When examining a patient’s cranial nerve function, the FNP remembers that the muscles in the neck that are innervated by CN XI are the:
The patient’s laboratory data reveal an elevated thyroxine level. The FNP would proceed with an examination of the _____ gland
A patient says that she has recently noticed a lump in the front of her neck below her “Adams apple” that seems to be getting bigger. During the assessment, the finding that leaves the FNP to suspect that this may not be a cancerous thyroid nodule is that the lump:
The FNP notices that the patient’s submental lymph nodes are enlarged. In an effort to identify the cause of the node enlargement, the FNP would assess the patient’s:
The FNP is aware that the four areas in the body were lymph nodes accessible are the:
A 52-year-old patient describes the presence of occasional floaters or spots moving in front of his eyes. The FNP should know that floaters are usually not significant and are caused by:
The FNP is preparing to assess the visual acuity of a 16-year-old patient. How should the FNP proceed?
A patient’s vision is recorded as 20/30 when the Snellen eye chart is used. The FNP interprets these results to indicate that:
A patient is unable to read even the largest letters on the Snellen chart. The FNP should take which action next:
A patient’s vision is reported as 20/80 in each eye. The FNP interprets this finding to mean that
When performing the corneal light reflex assessment, the FNP notes that the light is reflected at 2 o’clock in each eye. The FNP should
The FNP is performing the diagnostic positions test. Normal findings would be which of these results?
During an assessment of the sclera of an African-American patient, the FNP would consider which of these an expected finding?
A 60-year-old man is at the clinic for an examination. The FNP suspects that he has ptosis of one eye. How should the FNP check for this?
The FNP is doing an assessment on a 21-year-old patient and notices that his nasal mucosa appears pale gray and swollen. What would be the most appropriate question to ask the patient?
The FNP is palpating the sinus areas. If the findings are normal, then the patient should report which sensation?
During an oral assessment of a 30-year-old African-American patient, the FNP notices bluish lips and a dark line along the gingival margin. What would the FNP do in response to these findings
During an assessment of a 20-year-old patient with a three day history of nausea and vomiting the FNP notices dry mucous and deep vertical fissures on the tongue. These findings are reflective of: Shadow health respiratory assessment transcript.
The FNP is reviewing the technique of palpating for tactile fremitus with a new graduate. Which statement by the graduate FNP reflects a correct understanding of tactile fremitus?
The FNP student is reviewing physical assessment findings of the HEENT system associated with pregnancy. Which statement by the graduate FNP reflects a correct understanding of expected HEENT changes associated with pregnancy? During pregnancy:
Identifying and Reliability:
Ms. Jones is an obese 28-y
