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NSG 316 Exam 1 Guide/185 Q’s and A’s
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NSG 316 Exam 1 Guide/185 Q’s and A’s
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NSG 316 Exam 1 Guide/185 Q’s and A’sWhen does the general survey begin? - -The moment you first encounter the
person
-What does the general survey focus on/ consider? - -physical appearance,
body structure, mobility, behavior
PBMB
-is PBMB subjective or objective? why? - -Objective, because you are
observing them and they are not verbally telling you.
-What do you look for in physical appearance? - -age- appears to be stated
age
sex- appropriate developmental stage for age
LOC- alert/ orients & responds to Questions
Skin color- appropriate for genetic background
facial features- symmetric
no signs of acute distress
-What do you look for in Body Structure? - --stature- height in normal rage
for age and heritage
-nutrition- even body weight distribution
-symmetry- body is bilateral
-posture- stands comfortably and appropriate for age
-position- sits comfortable in chair
-body build/ contour: arms span equals height
-Obvious deformities- congenital or squired defects
-What to look for in Mobility? - -- gait
-foot placement- agitate, smooth walking, well balanced
-no involuntary movements
-What to look for in behavior? - --facial expression- and sign of pain /
distress, expressions are appropriate tot he situation
-mood & affect- comfortable and cooperative with examiner
-speech- even tased, clear, articulate, communicates in the same language
as the interviewee's
- dress- appropriate for climate, clean
-perosnal hygiene- well groomed and clean
-What is subjective data? - -Data that only the subject or "patient" can feel
and will tell you. during taking of history
-IS subjective data signs or symptoms? - -symptoms
, -What is objective data? - -What you observe and can measure when
inspecting, percussing, palpating, and ausculating during the physical
-Is objective data the signs or symptoms? - -signs
-What is a data base? - -subjective + objective + patient records + lab
studies
-What is the Complete total health database - -complete health history +
full physical exam
current + past health state for a base line
-What is the Episodic or problem centered database - -"mini" database
one body system/ one probable/ one cue complex
hx and exam followed after
for short term/ limited problems
-What is a follow-up database? - -"after the fact"
status of the problem being evaluated at a regular or appropriate time
is problem getting better or worse
id coping strategies
-What is Emergency database? - -Fast collection of data
usually only for lifesaving measures
rapid and comprehensive
- what did you take? How long ago? Who much?
-Nursing process - -assessment, diagnosis, outcome identification, planning,
implementation, evaluation
-Assessment: - -review of record, interview, health hx, physical exam,
functional exam, cultural/ spiritual exam, consultation, review of literature
-Diagnosis - -interpreting data, comparing clusters of cue to make
inference, validation on inference, identify related factors, document the
diagnisis
-Outcome identification? - -identifying the expected out acmes of the patent
(individualized)
ensuring realistic and measurable outcomes/goals
short term and long term goal criteria
-Planning - -establish goal based on patient care goal
identify relevant intervention
document the plan of care
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