Exam (elaborations)
2024 NR 509 MIDTERM EXAM WITH CORRECT ANSWERS
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2024 NR 509 MIDTERM EXAM WITH CORRECT ANSWERS
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2024 NR 509 MIDTERM EXAMWITH CORRECT ANSWERS
Active listening - CORRECT-ANSWERS-closely attending to what the patient is
communicating
-connecting to the patient's emotional state
-verbal and nonverbal skills
Testing CN XI, spinal accessory nerve - CORRECT-ANSWERSShoulder shrug
-Put your hands on pt shoulder and ask them to shrug against your hands-
asses for strength and contraction of trapezii. Weakness noted with atrophy
and points to a peripheral nerve disorder.
Causes of vasovagal syncope - CORRECT-ANSWERS-Reflex withdrawal of
sympathetic tone and increased vagal tone causing a drop in BP and HR.
-Usually precipitated by strong emotions such as fear or pain, prolonged
standing or hot humid environment.
-Predisposing factors - fatigue, hunger, dehydration, diuretics, vasodilators
Empathic responses - CORRECT-ANSWERScapacity to identify with the
patient and feel the patient's pain as your own, then respond in a supportive
manner
The decreased sense of smell is normal in elderly patients, head trauma,
smoking, cocaine use and Parkinson's d/e. Which cranial nerve? - CORRECT-
ANSWERSOlfactory CN I
Usually precipitated by strong emotions such as fear or pain, prolonged
standing or hot humid environment. - CORRECT-ANSWERSvasovagal syncope
rarely palpable, soft bi-phasic undulating quality (usually with 2 elevations
and characteristic inward deflection), pulsations eliminated by light pressure
on the vein just above the sternal end of the clavicle, height of pulsation
changes with position (normally dropping as the patient becomes more
upright), height of pulsations usually falls with inspiration - CORRECT-
ANSWERSjugular
, palpable, a more vigorous thrust with a single outward component,
pulsations not eliminated by pressure on veins at sternal end of clavicle,
height of pulsations unchanged by position, height of pulsations not affected
by inspiration - CORRECT-ANSWERSCarotid
cricoid cartilage - CORRECT-ANSWERSthe ring-shaped structure that forms
the lower portion of the larynx
the apical pulse or point of maximal impulse (PMI)- best palpated with the
patient lying supine in the left lateral decubitus position which displaces the
apical pulse to the left.
Locate the interspaces, usually the 5th or 4th which give the vertical location
and the distance in cm from the midclavicular line which gives the horizontal
location. - CORRECT-ANSWERSLeft ventricular area
auscultating aortic regurgitation - CORRECT-ANSWERSAsk the patient to sit
up, lean forward, exhale completely, and briefly stop breathing after
expiration.
Press the diaphragm on your stethoscope on the chest and listen along the
left sternal border and at the apex, pause periodically so the patient may
breathe
You may miss the soft diastolic decrescendo unless you listen at this position
what valve you are listening to when you listen to the apex of the heart -
CORRECT-ANSWERSmitral
how to listen to apex of heart - CORRECT-ANSWERSHave the patient roll onto
left lateral decubitus position which brings the left ventricle closer to the
chest wall
Place bell of your stethoscope lightly on the apical impulse à S3 & S4, mitral
murmurs & mitral stenosis
Dysarthria - CORRECT-ANSWERSslurred speech
Guided questioning - CORRECT-ANSWERSHelps to continue the patients story
-moving from open ended to focused questions
-using questions that elicit a graded response
-asking a series of questions, ONE at a time
-clarifying what the patient means
-encouraging with continuers
-using echoing
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