NR 509 Advanced Physical Assessment Final Exam 2023\/2024<\/p>\n\n\n\n
Delirium
Correct Answer:
acute, worse at night, lasts hours to weeks, disrupted sleep, general illness
and\/or drugs present, disturbed LOC, hesitant\/slow\/rapid\/incoherent speech,
disorganized thought process, immediate and recent memory impaired,
delusions common
Dementia
Correct Answer:
insidious, slowly progressive, lasts months to years, fragmeted sleep,
general illness often absent, LOC usually normal, difficulty finding words,
flat, depressed, recent memory and new learning impaired
Know what an ulcer due to venous insufficiency looks like
Correct Answer:
Usually appears over the medial and sometimes lateral malleolus. Ulcer
contains small, painful granulation tissue and fibrin; necrosis or exposed
tendons are rare. Borders are irregular, flat, or slightly steep. Pain effects
QOL in 75% of patients. Associated findings include edema, reddish
pigmentation and purpura, venous varicosities, the eczematous changes of
stasis dermatitis (redness, scaling, and pruritis), and at times cyanosis of
the foot when dependent. Gangrene is rare.<\/p>\n\n\n\n
Know why venous insufficiency causes edema, swelling, and ulceration
Correct Answer:
It arises from chronic obstruction and incompetent valves in the deep
venous system.
Know the causes of increased jugular venous pressure
Correct Answer:
Highly correlated with both acute and chronic heart failure. Also seen in
tricuspid stenosis, chronic pulmonary hypertension, superior vena cava
obstruction, cardiac tamponade, and constrictive pericarditis.<\/p>\n\n\n\n
Know what a retracted tympanic membrane with effusion looks like
Correct Answer:
amber fluid behind the ear drum is characteristic
Know the signs of ectopic pregnancy
Correct Answer:
range from subacute, approx. 80-89%, to shock from rupture and
intraperitoneal hemorrhage (10-30% of cases).
Most common clinical features: abdominal pain, adnexal tenderness, and
abnormal uterine bleeding. In more than half there is a palpable adnexal
mass that is typically large, fixed, and ill-defined at times with adherent
omentum or small or large bowel. In milder cases, there may be a prior
history of amenorrhea or other symptoms of pregnancy<\/p>\n\n\n\n
Know the signs of prostatitis: acute
Correct Answer:
presents with fever and urinary tract symptoms such as frequency, urgency,
dysuria, incomplete voiding and sometimes low back pain. The gland feels
tender, swollen, “boggy” and warm.<\/p>\n\n\n\n
Know the signs of prostatitis: chronic
Correct Answer:
is associated with recurrent UTI’s, usually from the same organism. Men
may be asymptomatic or have symptoms of dysuria or mild pelvic pain. The
prostate gland may feel normal, without tenderness or swelling.
Know what atopic dermatitis looks like
Correct Answer:
Eczema: erythema, scaling, dry skin, and intense itching<\/p>\n\n\n\n
Know the signs of depression
Correct Answer:
Early signs: low self-esteem, loss of pleasure in daily activities (anhedonia),
sleep disorders and difficulty concentrating or making decisions.
Vulnerable populations: young, female, single, divorced, or separated, or
chronically ill, bereaved, or have other psychiatric disorders, including
substance abuse.<\/p>\n\n\n\n