Interview and Communication Skills for Healthcare Professionals: A Comprehensive Guide, Exams of Nursing

Download Interview and Communication Skills for Healthcare Professionals: A Comprehensive Guide and more Exams Nursing in PDF only on Docsity! Liberty University NURS 210 Test 1 Exam Questions with Verified Solutions. General appearance to look for in a pt. #1 - ANS Apparent state of health General appearance to look for in a pt. #2 - ANS LOC General appearance to look for in a pt. #3 - ANS Facial Expression General appearance to look for in a pt. #4 - ANS Posture, gait, motor activity and speech General appearance to look for in a pt. #5 - ANS Odor of body/breath General appearance to look for in a pt. #6 - ANS Skin color and obvious lesions General appearance to look for in a pt. #7 - ANS Dress, grooming, and personal hygiene OLD CART - ANS Onset Location Duration Characteristics Associated manifestations Relieving factors Treatment FIFE - ANS Feelings Ideas Function (what can't you do now that you could before) Expectations Phases of interview - ANS pre-interview, introduction, working, termination Pre-interview - ANS Plan: self-reflection, review pt. record, set interview goals, review own clinical behavior/appearance Introduction - ANS put the patient at ease and establish trust (greet pt. and est. rapport) est. agenda for interview Working - ANS obtain pt. info (invite pt. story--ID/respond to emotional cues) (expand/clarify pt. story) (generate and test diagnostic hypotheses) (Negotiate a plan further evil, treatment, education and self-management support and prevention) Termination - ANS summarize important points, discuss plan of care Techniques of a skilled interview - ANS Active listening, guided questioning, nonverbal communication, empathetic responses, validation, reassurance, summarizing, transitions, empowering the pt. P a g e 1 | 11 Guided questioning - ANS Helps to continue the patient's story -moving from open-ended to focused questions -using questions that elicit a graded response -asking a series of questions, ONE at a time -clarifying what the patient means -encouraging with continuers -using echoing -avoid leading questions (has your pain been improving? You don't have any blood in your stool, do you?) (General-->specific) The silent pt. - ANS Reasons: to collect thoughts, remember details, or decide whether you could be trusted with info. (appear attentive--watch for nonverbal cues, encourage to continue when appropriate, silence may be a part of culture, maybe you're asking too many short-answer questions in rapid succession, did you offend patient, did you fail to recognize an overwhelming symptom (pain, nausea, dyspnea)) Quantifying Q's - ANS When For how long How many How often Rate (your pain) Interview basics: open with - ANS What How Tell me about Describe INTERPRETER - ANS Introduction Note goals Transparency Ethics Respect beliefs Patient focus Retain control Explain Thanks Advance Directive - ANS A person makes provision for health care decisions in event that pt. becomes unable to make those decisions (this includes CPR, artificial feeding/hydration, and antibiotics) Dying pt. - ANS Rarely want to talk about their illnesses Give them opportunities to talk/listen Smile, touch, inquiring about a family member, comment on day’s events, gentle humor Avoid false reassurance P a g e 2 | 11 Tangential Lighting - ANS optimal for inspecting structures such as the jugular venous pulse, thyroid gland, and the apical impulse of the heart (pulse over the apex of the heart) Melanoma - ANS black tumor Pigment-producing melanocytes Lethal--causing 70% of skin cancer deaths Basal Cell carcinoma - ANS Basal level of epidermis Accounts for most skin cancers Sun-exposed areas Pearly white/translucent Grow slow, rarely metastasize Squamous cell carcinoma - ANS arise in upper layer of epidermis Crusty and scaly Red, inflamed, ulcerated Local warmth means - ANS inflammation or cellulitis Dry skin - ANS Hypothyroidism Dehydration - ANS Dry mucous membranes, cracked lips, dry skin, and lack of tears Jaundice suggests - ANS liver disease or Excessive hemolysis of RBCs Cyanosis in congestive heart failure - ANS usually peripheral, reflecting low blood flow; venous obstruction may cause peripheral cyanosis Central cyanosis - ANS advanced lung disease, congenital heart disease, and hemoglobinopathies Pallor results from - ANS decreased redness in anemia and decreased blood flow, as occurs in fainting or arterial insufficiency. The nursing process steps - ANS Assessment Diagnosis Planning Implementation Evaluation How one thinks solves problems and makes decisions - ANS developmental level Environmental influences - ANS favorable conditions to promote health Spiritual influences - ANS living peacefully, morally, and ethically Cultural influences - ANS favorable connections to promote health P a g e 5 | 11 Social well-being - ANS supportive relationships with family and friends Emotional health - ANS Positive outlook and emotions channeled in a healthy manner Physical health - ANS How the body works and adapts Inspection of NEVI (aka moles) - ANS color, shape, size, surface, number, location Size of mole should be - ANS <6 mm (eraser of #2 pencil) Normal number of moles - ANS 10-40 Location of moles - ANS typically above waist, mostly not on breast, butt, or scalp Cyanosis - ANS lack of o2 Pallor - ANS poor circulation Color of skin - ANS jaundice, pallor, cyanosis, erythema, pale and shiny (I lower extremities; smooth and hairless) Unusual Moles ABCD - ANS Asymmetrical (lumpy) Borders (irregular) Color (multicolor or black) Diameter (greater than 6mm) Primary lesion - ANS occurs from some pathological process Secondary lesion - ANS time; results from later evolution of external trauma to primary lesion Vascular lesion examples - ANS Petechial (tiny red dots) Purport (flood of bruising not associated with trauma) Ecchymosis Spider anima (vessels) Venous star Telangiectasia Primary Lesion examples - ANS macule (freckle) Papule (not flat; raised) Patch Plaque Wheal Nodule Tumor Vesicle (small clear fluid-filled lesion) Bulla (blister, can be filled like vesicle) Pustule (zit; raised, small, filled with pus) P a g e 6 | 11 Cyst (nodule filled with liquid or semisolid) Secondary Lesions examples - ANS scale Lichenification Keloid Scar Excoriation (scratched wound) Fissure Erosion Ulcer (compression of skin-->hypoxia of skin tissue death-->stage 1 ulcer) Crust (dried residue of skin exudate) Atrophy Characteristics of lesion to document - ANS size Shape Color Texture Elevation or depression Pedunculation (skin tag; a piece of skin or a stalk) Exudate Café-Au-Laity spot - ANS A slightly but uniformly pigmented macule or patch with a somewhat irregular border Location and distribution - ANS Generalized or localized Region of the body Patterns Discrete or confluent Configuration (shape) - ANS Annular Grouped Linear Aciform Diffuse Palpation of skin - ANS moisture, texture, temp, tenderness, turgor, edema Other skin variations that don't fall into primary or secondary lesions - ANS callus, cutaneous horn, seborrhea, cutaneous tag Inspection and palpation of hair - ANS Distribution Texture Quantity (alopecia or hirsutism) Parasites Clubbing of nails - ANS Smokers; associated with chronic cardiovascular or pulmonary disease; hypertrophy of the tissue baked Special histories - ANS Infants/children (still developing; how was pregnancy) Adolescents P a g e 7 | 11 Mobility and feeding issues Goiter - ANS lack of iodized salt Bell's palsy - ANS viral Three categories of eye testing - ANS Pupils (penlight) Eye movement (various cranial nerves) Vision (Near, distant, peripheral) Assessment tests for eyes - ANS visual acuity (far and near vision) Confrontation test (peripheral) Pupils (reactive, together, consensual?) Accommodation Convergence (cross-eyed) Extra ocular eye muscles Visual Acuity - ANS CN II Optic Nerve Pt. 20ft for smelling chart Cover one eye and have pt. read lines Recorded as fractions: 20/20 (pt. is always numerator) Extra ocular eye muscles - ANS Three CN involved (III-coulometer, IV-trochlear, and VI-abduces) Six Cardinal Fields of gaze (observe for sustained nystagmus--twitching of eye) Corneal light reflex - ANS test for balance of extra ocular muscles Cover-uncover test - ANS only if pt. has corneal light reflex issues Ophthalmoscopy exam - ANS Examine pt. right eye with your right eye vice versa Have pt. look over shoulder at a distant point Direct the light at the pupil 12in away Visualize for ophthalmoscopy exam: - ANS Clarity of lens Red reflex Retina/fundus Optic disc Retinal vessels (A: V 3:5 to 2:3 ratio) Macula Fovea Centralism (where images you see get shot to the brain) You lose depth perception if - ANS you lose sight in one eye Myopia - ANS nearsighted Hyperopia - ANS farsighted Presbyopia - ANS farsighted; impaired vision as a result of aging P a g e 10 | 11 Abnormal in eye to know - ANS Exophthalmos (associated with graves; bulging eyes) Band Keratopathy Corneal Ulcer (Keratitis) Strabismus Cataracts (light reflex) Xanthelasma (fat deposits) Ptosis Bank Keratopathy - ANS Extra lipid deposits in mucous membranes of the eyes; become blind, but can get transplant Strabismus - ANS "lazy eye" pt. who fails corneal light reflex Corneal Ulcer - ANS Damage to cornea itself; covers the iris as a dome Ptosis - ANS affects palpebral fissure; congenital or acquired (depth perception is affected) Cataracts - ANS light reflex; if light can't get in, images can't get in Ectropion - ANS lash line rolls outward; mucous membrane dried out (wet face, dry eye) Entropies - ANS Lash line rolls inward; rubs cornea all the time Hordeolum - ANS style; affects eyelash not eyeball (Do not squeeze) Chalaza - ANS Infects eyelid Conjunctivitis - ANS pink eye (viral or bacterial) Subconjunctival hemorrhage - ANS conjunctive and cornea don't meet; iris not affected Subconjunctival lymphoma - ANS blood under cornea Pterygium - ANS sclera encroaches the iris and covers cornea Corneal circus senile - ANS ring of lipid deposits around eyes; "washed out" look; covers up color of iris Problems with internal eye - ANS Diabetic retinopathy Papilledema (first sign of hypertension; optic disc puffy/swollen; vessels look weird) Glaucomatous cupping (increase pressure; globe filled with pressure) Hemorrhage (if seen in babies concerned about shaken baby syndrome) P a g e 11 | 11