NUR 6512 MIDTERM AND FINAL EXAMS (3 VERSIONS) WITH
COMPLETE SOLUTIONS
What soothes or aggravates the problem?
SOAP Notes - S Subjective data—the
... [Show More] information, including the absence or presence
of pertinent symptoms, that the patient tells you
O Objective data—your direct observations from what you see, hear, smell, and touch
and from diagnostic test results
A Assessment—your interpretations and conclusions, your rationale, the diagnostic
possibilities, and present and anticipated problems
P Plan—diagnostic testing, therapeutic modalities, need for consultants, and rationale
for these decisions
Ethical Considerations - • Autonomy: The patient's need for self-determination.
Autonomy suggests that choices exist, and a patient may choose between
alternatives. Uncertainty exists when the patient is a child or is cognitively impaired.
Parents, guardians, family, or other significant persons should then be included, and
the boundaries of that participation must be clearly set. In some cases, the
boundaries are established by an advance directive from the patient. Competency is
not always easily determined, and there may be disagreement. Both the mental status
examination (see Chapter 7) and consultation with individuals who know the person
well can assist.
• Beneficence: Do good for the patient. This may be too eagerly pursued and may
result in a paternalism that might preclude autonomy of the patient. However,
paternalism may have some benefit when used with constraint and respect for
autonomy.
• Nonmaleficence: Do no harm to the patient.
• Utilitarianism: Consider appropriate use of resources with concern for the greater
good of the larger community. Choose wisely.
• Fairness and justice: Recognize the balance between autonomy and competing
interests of the family and community.
• Deontologic imperatives: Our dutiful responsibilities for offering care are
established by tradition and in cultural contexts. Because cultures vary, these may
not be universally binding for all patients. Ethical principles can come into conflict in
any given circumstance.
Cultural Awareness and Diversity - The stereotype, a fixed image of any group that
denies the potential of originality or individuality within the group, must be rejected.
When this occurs, the beliefs and feelings (prejudices) come to mind about what
members of that particular group are like.
Socioeconomic, spiritual, and lifestyle factors affecting diverse populations - Chapter
2: Cultural Competency
Functional Assessments - Functional assessments are an attempt to understand a
patient's ability to achieve the basic activities of daily living. This assessment should
be made for all older adults and for any person limited by disease or disability, acute
or chronic.
Growth, Development and Measurements in Children and Adults - • Standing height
• Weight
• Calculate the BMI (lbs/inches x 703)
• Waist circumference
• Calculate waist-height ratio and waist-to-hip circumference ratio
Infants: Head/Chest circumference
Communication techniques used to obtain a patient's health history - Courtesy,
Comfort, Connection, Confirmation
Courtesy Communication Technique - • Knock before entering a room.
• Address, first, the patient formally (e.g., Miss, Ms., Mrs., Mr.) It is all right to shake
hands.
• Meet and acknowledge others in the room and establish their roles and degree of
participation.
• Learn their names.
• Ensure confidentiality.
• Be in the room, sitting, with no effort to reach too soon for the doorknob.
• If taking notes, take notes sparingly; note key words as reminders but do not let
note-taking distract from your observing and listening.
• If typing in the electronic medical record, type briefly and maintain eye contact with
patient, if possible.
• Respect the need for modesty.
• Allow the patient time to be dressed and comfortably settled after the examination.
Follow-up discussion with the patient still "on the table" is often discomfiting. [Show Less]