Question

Review of Systems (ROS) Normal response vs abnormal response to DTR (deep tendon reflexes). Reason why the musculoskeletal system shortens in the elderly/older adult Priority nursing Focused vs Problem-centered Data collection Phases of the interview Objective data vs. subjective data Signs of right sided heart failure vs left sided heart failure Male genitourinary system i.e. hyper/hypospadias Why do we auscultate the abdomen before palpation and percussion? Why would stool appear pale and clay-like? What information can be obtained from deep palpation of the abdomen? Pressure in the arteries vs vein (higher vs lower) What kind of pitch are bruits (low or high?) in the thyroid and carotid artery Hernias Cranial nerves tests when 1) patient stick tongue out, b) patient says "ahh" Purpose of the MMSE (mini mental state examination) What do we assess in Increased intercranial pressure? Think LOC, Glascow coma scale + 3 other things. Which disease is "pill rolling" movement associated with? Which part of the brain controls balance? RAM Normal bicep reflex Define osteoporosis

Answer 1

1. Deep tendon reflexes

Normal - Is +2 ie it is adequately Elicited.

Abnormal - 0 is no response, 1 is hypoactive, 3 is Hyperactive, 4 is Hyperactive with clonus and 5 is Sustained clonus.

2. Musculoskeletal system shortens with increasing age due to three reason a. Muscle fibre reduce in number and shrink in size,. b. Muscle tissue is replaced by tough fibrous tissue. c. Changes in nervous tissue leading to Reduced muscle tone and Inability to contract.

3. Focussed data collection vs problem Centered data collection.

Focused assessment mainly deals with the system type on which focus to laid upon so as to assess the patient, whereas problem centered data collection mainly deals with behavioural problem related assessment which helps in much comprehensive assessment.

4. Phases of interview - Phases of interview in nursing included Preparatory phase, orientation phase, working phase and termination phase.

5. Subjective data vs objective data

Subjective data is data that is being conveyed by patient or primary care giver(Incase of inability by patient) about signs that are felt by the patient as an individual. It can vary from one patient to another in varying intensity and description. Eg. Pain is the subjective data.

Objective data is data that can be seen, measured and doesn't vary And is constant among everyone. Various scales, laboratory investigation reports, instruments all give objective data.

6. Right sided heart failure vs left sided heart failure

Heart failure mainly implies on the inability of the ventricles to contract. Type of heart failure mainly depends which are is unable to contract leading to pressure to the adjoining structure. Right sided heart failure Exerts pressure on the right atrium and subsequently affecting by increased pressure in liver leading to swelling, hepatomegaly, Ascites, pulmonary venous hypertension etc.left sided heart failure exerts pressure on the pulmonary system leading to Puulmonaaru congestion, exertional dyspnea etc

7. Why auscultate before palpation or percussion of abdomen?

Manipulation on abdomen can make the abdominal muscles rigid and it can also activate the bowel sounds abnormally leading to diminished and false reading.

8 hernias

Hernia is caused due to loosening of the muscle that covers the particulars area. There are various types according to congenital or due to instrumentation. Types are 1. Inguinal hernia, 2. Umbilical hernia 3. Incisional hernia