NUR643E/NUR643
NUR643E Advanced Health Assessment for Nurse Educators
Week 1 c
DQ1 You are working with a nursing learner who is introducing herself to a Native American patient to establish rapport. The nursing learner is trying to make eye contact and puts her hand on the shoulder of the patient to get his attention. What situation could arise with this approach? How would you handle this situation? Defend rationale with references.
DQ2 While completing a health assessment, you notice that there are indications that the patient may have been cutting herself. You inquire about the marks and she indicates that she scratched her wrist when she tried to break her fall. How do you handle this information? How can you incorporate your Christian worldview to help in providing quality care? What are the key elements to accurately obtaining the needed information for effective treatment?
NUR643E/NUR643
NUR643E Advanced Health Assessment for Nurse Educators
Week 2 Discussion
DQ1 As an instructor, you are working with a nursing learner in the second year of a 4-year nursing program. The learner does not perform an ear exam correctly. How would you explain the appropriate technique to examine the ears?
DQ2 You are working the triage desk of the ED. A patient presents with sudden loss of vision of the right eye after a head collision during a volleyball game. What would your assessment include? Identify initial problems and determine if they would warrant emergent intervention.
NUR643E/NUR643
NUR643E Advanced Health Assessment for Nurse Educators
Week 3 Discussion
DQ1 Select one pulmonary, cardiac, peripheral vascular, or lymphatic system disorder. Discuss the clinical characteristics and identify the appropriate laboratory, imaging, and other diagnostic and screening tools that apply to this disorder. Explain why these tests or tools were chosen as appropriate to the conditions. Select different topics from that of your classmates.
DQ2 You are called to the bedside of a critical patient as a rapid response team member. Upon initial inspection the patient is cyanotic, has labored breathing, and is not responding well. Develop an SBAR (situation, background, assessment, recommendation) for this patient. Use references to substantiate your approach to this clinical scenario.
NUR643E/NUR643
NUR643E Advanced Health Assessment for Nurse Educators
Week 4 Discussion
DQ1 As an instructor, you are working with a nursing learner to develop a problem-focused exam involving the musculoskeletal system and extremities. Formulate potential questions to support the learner in soliciting specific information about the patient related to past history, drugs that may adversely affect the musculoskeletal system, family history, psychosocial profile. Provide rationale.
DQ2 The goal of a complete musculoskeletal assessment is to detect risk factors, potential problems, or musculoskeletal dysfunction early and then to plan appropriate interventions, including teaching health promotion and disease prevention, and implement treatment measures. By doing so, you can play a signi?cant role in preventing pain and dysfunction in your patients. Describe a plan to provide patient teaching that incorporates health promotion and disease prevention. Provide rationale.
NUR643E/NUR643
NUR643E Advanced Health Assessment for Nurse Educators
Week 5 Discussion
DQ1 Differentiate between the appearances of skin lesions in relation to cancerous versus noncancerous.
DQ2 A patient presents with abdominal discomfort to the point of being in the fetal position. What questions need to be asked of this patient? What examination techniques would you perform for this patient?
NUR643E/NUR643
NUR643E Advanced Health Assessment for Nurse Educators
Week 6 Discussion
DQ1 A patient is experiencing delirium after the initiation of a new medication. What are questions you want answered as well as physical findings would you be looking for?
DQ2 Choose a special population and detail the approach to history taking and physical examination with the patient and/or family member.
NUR643E/NUR643
NUR643E Advanced Health Assessment for Nurse Educators
Week 7 Discussion
DQ1 A patient presents with heaviness in their chest and diaphoretic. What steps will you take in providing a proper assessment?
DQ2 A patient calls out on the call system and requests pain medication. We know that patients are to rate their pain on a scale. If the pain is unrelated to the admission diagnosis, what steps will you take in providing a proper assessment?
NUR643E/NUR643
NUR643E Advanced Health Assessment for Nurse Educators
Week 8 Discussion
DQ1 You walk into a patient's room and find him unconscious; he does not greet you when you walk in. What are some of your initial assessment techniques that need to be employed and why?
DQ2 You just reviewed the morning laboratory report for a patient in critical care. You noted that the potassium level is 6.5 mEq/L. What are areas you need to be assessing the patient to monitor for complications from hyperkalemia? Explain your approach in a head to toe assessment.
NUR643E/NUR643
NUR643E Advanced Health Assessment for Nurse Educators
Week 1 Topic Reflection
Take a moment to review the details of this assignment below and gather any necessary files. Once you're ready to submit your assignment, move on to Step 2.
Assessment Description
Complete a written reflection (250-350 words) on what you learned during this topic. Include the following in your reflection, considered through the lens of a nurse educator.
Think about an experience you have encountered when viewing or completing the particular assessment.
Describe the steps you took when completing this particular assessment.
Discuss difficulties that could potentially arise or specific questions related to completing this type of assessment.
Include illustrative examples of potential strategies used to overcome the difficulties encountered when completing the particular assessment.
Describe how the Christian worldview and compassion for all play a role in this type of assessment.
APA style is not required, but solid academic writing is expected.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
You are not required to submit this assignment to LopesWrite.
NUR643E/NUR643
NUR643E Advanced Health Assessment for Nurse Educators
Week 2 Topic Reflection
Health Assessment Topic Reflection 2
Assessment Description
Complete a written reflection (250-350 words) on what you learned during this topic. Include the following in your reflection, considered through the lens of a nurse educator.
Think about an experience you have encountered when viewing or completing the particular assessment.
Describe the steps you took when completing this particular assessment.
Discuss difficulties that could potentially arise or specific questions related to completing this type of assessment.
Include illustrative examples of potential strategies used to overcome the difficulties encountered when completing the particular assessment.
Describe how the Christian worldview and compassion for all play a role in this type of assessment.
APA style is not required, but solid academic writing is expected.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
You are not required to submit this assignment to LopesWrite.
NUR643E/NUR643
NUR643E Advanced Health Assessment for Nurse Educators
Week 3 Topic Reflection
Assessment Description
Complete a written reflection (250-350 words) on what you learned during this topic. Include the following in your reflection, considered through the lens of a nurse educator.
Think about an experience you have encountered when viewing or completing the particular assessment.
Describe the steps you took when completing this particular assessment.
Discuss difficulties that could potentially arise or specific questions related to completing this type of assessment.
Include illustrative examples of potential strategies used to overcome the difficulties encountered when completing the particular assessment.
Describe how the Christian worldview and compassion for all play a role in this type of assessment.
APA style is not required, but solid academic writing is expected.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
You are not required to submit this assignment to LopesWrite.
NUR643E/NUR643
NUR643E Advanced Health Assessment for Nurse Educators
Week 4 Topic Reflection
Assessment Description
Complete a written reflection (250-350 words) on what you learned during this topic. Include the following in your reflection, considered through the lens of a nurse educator.
Think about an experience you have encountered when viewing or completing the particular assessment.
Describe the steps you took when completing this particular assessment.
Discuss difficulties that could potentially arise or specific questions related to completing this type of assessment.
Include illustrative examples of potential strategies used to overcome the difficulties encountered when completing the particular assessment.
Describe how the Christian worldview and compassion for all play a role in this type of assessment.
APA style is not required, but solid academic writing is expected.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
You are not required to submit this assignment to LopesWrite.
NUR643E/NUR643
NUR643E Advanced Health Assessment for Nurse Educators
Week 5 Topic Reflection
Assessment Description
Complete a written reflection (250-350 words) on what you learned during this topic. Include the following in your reflection, considered through the lens of a nurse educator.
Think about an experience you have encountered when viewing or completing the particular assessment.
Describe the steps you took when completing this particular assessment.
Discuss difficulties that could potentially arise or specific questions related to completing this type of assessment.
Include illustrative examples of potential strategies used to overcome the difficulties encountered when completing the particular assessment.
Describe how the Christian worldview and compassion for all play a role in this type of assessment.
APA style is not required, but solid academic writing is expected.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
You are not required to submit this assignment to LopesWrite.
NUR643E/NUR643
NUR643E Advanced Health Assessment for Nurse Educators
Week 2 Assignment
SBAR
Assessment Description
Choose an experience from your nursing practice. Using the "SBAR" template, explain the situation in detail, followed with background information. Then explain your immediate assessment and recommendations you have for the provider.
Include the following in the "SBAR" template:
Be sure to include three or four evidence-based references, not older than 5 years.
When giving your recommendation discuss how you would educate the client using evidence-based research and guidelines. How would you deliver your recommendation in various learning environments?
APA style is not required, but solid academic writing is expected.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
You are not required to submit this assignment to LopesWrite.
NUR643E/NUR643
NUR643E Advanced Health Assessment for Nurse Educators
Midterm Exam
• Adam is a very successful 15-year-old student and athlete. His mother brings him in today because he no longer studies, works out, or sees his friends. This has gone on for a month and a half. When you speak with him alone in the room, he states it “would be better if I was not here.” What would you do next?
• Tell him that he has a very promising career in anything he chooses and soon he will feel better.
• Tell him that he needs an antidepressant and it will take about 4 weeks to work.
• Speak with his mother about getting him together more with his friends.
• Assess his suicide risk.
• Mr. Chin is an 82-year-old man who presents to your office for a routine check. On examination, you notice a somewhat high-pitched murmur in the second right intercostal space during systole. It does not radiate and the rest of his examination is normal for his age. Which is true of the most likely cause of this murmur?
• It often increases carotid upstroke.
• It carries with it increased risk for cardiovascular disease.
• It is usually accompanied by an S3 gallop.
• It is found in 10% of otherwise normal elderly patients.
• Mrs. Fletcher complains of numbness of her right hand. On examination, sensation of the volar aspect of the web of the thumb and index finger and the pulp of the middle finger are normal. The pulp of the index finger has decreased sensation. Which of the following is affected?
• Median nerve
• Ulnar nerve
• Radial nerve
• You are assessing a patient for peripheral vascular disease in the arms, secondary to a complaint of increased weakness and a history of coronary artery disease and diabetes. You assess the brachial and radial pulses and note that they are bounding. What does that translate to on a scale of 0 to 3?
• 0
• 3+
• 2+
• 1+
• A 70-year-old retired auto mechanic presents to your office because his neighbor is concerned about his memory. The patient himself admits to misplacing his keys more often and forgets what he is supposed to buy from the grocery store and where he has parked the car. He denies getting lost in familiar places. Upon further questioning, he states that his wife of 40 years died 8 months ago; his three children live in three different states; and he has limited his activities because the people he interacted with were “his wife's friends, not his.” He drinks a six-pack of beer daily; he does not smoke or use illicit drugs. You perform a mini-mental state examination and obtain a total score of 24 out of 28. Based on this information, what is the most likely condition?
• Benign forgetfulness
• Dementia
• Meningitis
• Depression
NUR643E/NUR643
NUR643E Advanced Health Assessment for Nurse Educators
Final Exam
A 32-year-old attorney comes to your office for her second prenatal visit. She has had two previous pregnancies with uneventful prenatal care and vaginal deliveries. Her only problem was that with each pregnancy she gained 50 lbs (23 kg) and had difficulty losing the weight afterward. She has no complaints today. Looking at her chart, you see she is currently 10 weeks pregnant and that her prenatal weight was 130 lbs (59 kg). Her weight today is 134 lbs (60.9 kg). Her height is 5'4", giving her a BMI of 22. Her blood pressure, pulse, and urine tests are unremarkable. The fetal heart tone is difficult to find but is located and is 150. While you give her first trimester education, you tell her how much weight you expect her to gain.
How much weight should this patient gain during pregnancy?
A) Less than 15 pounds (less than 7 kg)
B) 15 to 25 pounds (7 to 11.5 kg)
C) 25 to 35 pounds (11.5 to 16 kg)
D) 30 to 40 pounds (12.5 to 18 kg)
A 21-year-old receptionist comes to your clinic, complaining of frequent diarrhea. She states that the stools are very loose and there is some cramping beforehand. She states this has occurred on and off since she was in high school. She denies any nausea, vomiting, or blood in her stool. Occasionally she has periods of constipation, but that is rare. She thinks the diarrhea is much worse when she is nervous. Her past medical history is not significant. She is single and a junior in college majoring in accounting. She smokes when she drinks alcohol but denies using any illegal drugs. Both of her parents are healthy. Her entire physical examination is unremarkable.
What is most likely the etiology of her diarrhea?
A) Secretory infections
B) Inflammatory infections
C) Irritable bowel syndrome
D) Malabsorption syndrome
Mr. Maxwell has noticed that he is gaining weight and has increasing girth. Which of the following would argue for the presence of ascites?
A) Bilateral flank tympany
B) Dullness which remains despite change in position
C) Dullness centrally when the patient is supine
D) Tympany which changes location with patient position
• A 73-year-old retired accountant presents to your office for her annual examination. She has incontinence of urine when she coughs or sneezes. She takes several medications for control of hypertension and diabetes. You use the DIAPPERS mnemonic to assess the cause of her incontinence. All of the following are items represented by the mnemonic except for:
• Atrophic vaginitis
• Depression
• Pharmaceuticals
• Restricted mobility
A 53?year?old caterer comes to the clinic for a routine examination. She has type 2 diabetes mellitus, which is well controlled on medication. Her history from her last visit reveals that she smoked one pack of cigarettes a day at that time. The 5 As Model is a useful approach to take with trying to help patients to quit smoking. What is the 5 As Model?
a) Affable, associated manifestations, ask, admonish, available
b) Arrange, aggravating factors, action, attitude, able
c) Agitate, assist, alleviating factors, able, action
d) Ask, advise, assess, assist, arrange
e) Admonish, action, available, assess, alleviating factors
A 75?year?old female in generally good health presents to a new primary care provider after she recently moved to a new city. She takes no prescribed medications, but she has been told in the past that her blood pressure was borderline elevated and might require treatment at some time in the future. Which of the following findings during the physical examine is consistent with the normal aging process and not a sign of cardiovascular disease?
a) An unchanged pulse pressure with equal increases in both systolic and diastolic pressures
b) A widened pulse pressure with increased systolic pressure (up to 140) and decreased diastolic pressure
c) A narrowed pulse pressure with increased systolic and diastolic components
d) An isolated increase in systolic blood pressure to >150 mm Hg
e) A drop in systolic pressure of 25 mm Hg when rising from a supine to standing position
