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1
The absence of a language barrier does not preclude a cultrual barrier, and you will likely need?
cultural translation
2
Professional dress and grooming go a long way towards establising a first good impression with the patient?
True
3
Below are part of the Cultural Assessment Guide: The Many Aspects of Understanding except?
Gender-based practices
4
Term used to describe a person's internal sense of self and how they fit into the world from the perspective of gender.
Gender identity
5
Term describing a person's sexual, romantic, emotional, or physical attraction towards other people.
Sexual orientation
6
Identify from the RESPECT model: -Connect on a social level -See the patient's point of view -Consciously suspend judgement -Recognize and avoid making assumptions
Rapport
7
Identify from the RESPECT model: -Remember the patient has come to you for help -Seek out and understand the patient's rationale for his/her behaviors and illness -Verbally acknowledge and legitimize the patient's feelings
Empathy
8
Identify from the RESPECT model: -Ask about and understand the barriers to care and compliance -Help the patient overcome barriers; Involve family members if appropriate -Reassure the patient you are and will be available to help
Support
9
Identify from the RESPECT model: -Be flexible -Negotiate roles when necessary -Stress that you are working together to address health problems
Partnership
10
Identify from the RESPECT model: -Check often for understanding -Use verbal clarification techniques
Explanations
11
Identify from the RESPECT model: -Respect the patient's cultural beliefs -Understand that the patient's views of you may be defined by ethnic and cultural sterotypes -Be aware of your own cultural biases and preconceptions -Know your limitations in addressing health issues across cultures -Understand your personal style and recognize when it may not be working with a given patient
Cultural competence
12
What is a question to avoid asking your patinet in order to enhance patient reponse?
It seems to me that this bothered you a lot didn't it?
13
During moments of tension there may be periods of silence. How would the provider move the coversation along?
Asking open-ended questions or a mild nudge
14
This is always what the patients says it is and is subjective data
Review of Systems (ROS)
15
How is the Chief Complaint (CC) documented?
In quotation marks
16
What is the difference between a screening and an assessment interview?
Screening is to find out if a problem exists. The assessment continues after a positive screen.
17
What is unique about the outline of history?
It offers a guide derived from multiple sources to meet the needs of your patient
18
What is the best question to ask patients to determine how they define themselves?
How do you see yourself?
19
List the 5 Ps of Sexual History
-Partners -Practices -Protection from STIs -Past history of STIs -Prevention of pregnancy
20
Evidence suggests that the risk of DMII and CV disease could be reduced in childhood by?
Taking a family history
21
Starting at what age are children considered good historians?
Age 7
22
When assessing a child with their parent present what action would decrease patient trust and rapport?
Grabbing the child from the parent and putting them on the exam table
23
Which of the following is not considered part of the functional assessment?
Patient Safety
24
Makes you as thoroughly familiar with the patient as possible. Most often, this history is recorded the first time you see the patient.
Complete history
25
Is taken when the problem is acute, possibly life-threatening, requiring immediate attention so that only the need of the moment is given full attention.
Problem history
26
Side-lying position with legs extended or flexed. Used to assess heart, spleen, and rectum.
Lateral recumbent
27
Used for pelvic exams. Supine with knees bent and feet in stirrups with buttocks at edge of table.
Lithotomy
28
When shaking a patient's hands, how much pressure should be applied?
The same pressure as the patient squeezes with
29
Of the 5 percussion sounds which one is the loudest?
Tympany
30
It is OKAY to come across unexpected findings. This may reflect a change in the patient's condition or?
A learning opportunity
31
List the components of EBP
Best evidence, Patient preference, Clinical expertise, Medical decision making
32
Choose the example that is a "Red Herring"
A patient with swollen cervical nodes and fever owns a cat, which had claws, but the patient did not have cat scratch fever. This delayed the diagnosis of non-Hodgkin lymphoma.
33
Do good for the patient
Beneficence
34
Do no harm to the patient
Nonmaleficence
35
Consider appropriate use of resources with concern for the greater good of the larger community
Utilitarianism
36
Recognize the balance between autonomy and competing interests of the family and community
Fairness and justice
37
Our dutiful responsibilities for offering care are established by tradition and in cultural contexts
Deontologic Imperatives
38
-The probability of those findings being associated with that diagnosis -The prevalence of both that particular diagnosis and that combination of findings in the community you are serving
Bayes Theorem
39
What are approved abbreviations?
Unit
40
What are approved abbreviations?
every other day
41
What does SOAP stand for?
S = subjective data O = objective data A = assessment P = plan
42
What are the components of the Problem-Oriented Health Record (POHR)?
1. Comprehesive health history 2. Complete physical examination 3. Problem list 4. Assessment and plan 5. Baseline and problem-directed laboratory and radiologic imaging studies 6. Progress notes
43
How long do you count for when assessing an apical pulse?
60 sec
44
How do you measure the respiratory rate?
count 30 sec x2
45
What blood pressure is considered Stage I HTN?
130-139/80-89
46
What blood pressure is considered Stage II HTN?
>/= 140/90
47
List the physical examination components
1. physical appearance 2. cognitive abilites 3. speech and language 4. emotional stability
48
When it is difficult or impossible to elicit a social smile in an infant who appears ill, be concerned about?
A neurologic condition or infection
49
Expressive language milestones: uses 2 to 3 word sentences
24-36 mos
50
Expressive language milestone: says sounds correctly except l, s, r, v, z, ch, sh, th, and uses detailed sentences and tells stories
48-60 mos
51
When performing a functional assessment related to mental health and ADL, all of the following should be assessed except?
ability to socialize with friends and family
52
How to you assess skeletal muscle mass?
Measuring the mid-arm circumference
53
How do you calcuate BMI?
(weight lbs/(height inches^2)) x 703
54
What BMI is considered underweight?
under 18.5
55
What BMI is considered overweight?
25 - 29.9
56
What Tanner Stage is associated with pre-adolescence in women?
Tanner Stage 1
57
What Tanner Stage is considered the adult stage in males?
Tanner Stage 5
58
Most pregnant patients have some degree of increased pigmentation called?
Colasma
59
Terminal hair can turn into vellus hair, but men can have terminal hair in ____ and ___?
ears and nares
60
What Asian practice is often confused physical abuse?
Cupping
61
This skin condition is r/t hormones in dark skin pregnant patients
Melasma
62
Tend to be large usually > 5 mm with fla component, brown in color, and shape can be round, oval, or irregular
Atypical nevi
63
Boarder is irregular, tend to be larger than 6mm, with wide color variation
Melanoma
64
How do you assess skin turgor?
with palmar surface of hand and pinch sternum and forearms
65
What type of skin lesion is herpes zoster?
Vesicle
66
What equipment do you use to look at cafe a lait spots?
Woods Lamp
67
Be suspicious what disease if you find six or more cafe au lait spots that are greater than 5mm in diameter?
Neurofibromatosis
68
How do you distinguish a nail injury from pseudomonas of the nail?
While both are black, pseudomonas is painless whereas nail injury is painful
69
How many degress is a normal nail base?
160
70
Assoicated with a variety of respiratory, CV diseases, cirrhosis, colitis, and thyroid disease
Clubbing
71
Flat, evenly pigmented spots varying in color from light brown to dark brown or black in darker skin; larger than 5 mm, associated with neurofiromatosis
Cafe au lait macules
72
These hyperpigmentaiton "Mongolian Spots" are often mistaken for physical abuse in children that usually affect?
Dark skinned
73
How do you assess skin turgor in infants?
Pinch abdomen
74
Known as the "mask of pregnancy"
Melasma
75
Why is skin turgor not a good indicator of hydrartion status in older adults?
Becasue it is a common finding
76
When assessing the ABCDEs for a melanoma, what does it stand for?
Asymmetry, Borders, Color, Diameter, Evolution
77
What size do you worry for a melanoma?
> 6 mm
78
Known as "Dew on a Rose Petal"
Chicken Pox
79
Injuries to soft tissue non-uniform worry about?
Abuse
80
Enlarged lymph nodes
Lymphadenopathy
81
Inflamed and enlarged lymph nodes
Lymphadenitis
82
Inflammation of the lymphatics that drain an area of infection; tender erythematous streaks extend proximally from the infected area; regional nodes may also be tender
Lymphangitis
83
Edematous swelling due to excess accumulation of lymph fluid in tissues caused by inadequate lymph drainage
Lymphedema
84
Congenital malformation of dilated lymphatics
Lymphangioma
85
Small non-tender nodes that feel like BBs under skin
Shotty
86
Wavelike motion that is felt when the node is palpated
Fluctuant
87
Group of nodes that feel connected and seem to move as a unit
Matted
88
A hard, fixed, painless node suggests?
Malignancy
89
The more tender a node is the more likely it is?
Inflammation
90
This type of palpable node on the left is associated with thoracic and abdominal malignancy
Supraclavicular
91
Slow progression on nodal enlargment suggests?
Benign process
92
A submandibular lymph node < 1cm and inguinal lymph node < 2 cm are considered?
Normal
93
The thyroid gland moves with _____; subcutanteous fat that mimics a _____ does not.
swallowing; goiter
94
At about age 45, a progressive weakinging of accomodation causes?
presbyopia
95
Term for unequal pupils
Anisocoria
96
Enlarged lacrimal apparatus could suggest?
Tumor or Sjorgrens
97
What cranial nerves control extraocular movements?
CN III, IV, and VI
98
The fundus (retina) appears as a ______ or _____ background and can vary in pigment with the patients skin color.
yellow or reddish
99
Associated with AV nicking and copper wiring
HTN
100
Initial sign is leukocoria, a white reflex (cat's eye) rather than red reflex. White pupils on photographs.
Retinoblastoma