Solved Paper: Advance Health Assessment, Session (2008-2010)

WHAT ARE THE FIVE MOST IMPORTANT ASSESSMENTS YOU WILL DO IF YOU
FIND ANY MASSES IN THE ABDOMEN?
If you find any masses in the abdomen a complete physical assessment should be performed.
1. Auscultate for bowel sounds in each quadrant. Listen for bruits or friction rubs, and
check for enlarged veins.
2. Lightly palpate and then deeply palpate the abdomen, assessing any painful or
suspicious areas last. Note the patients position when locate the mass. Some masses can
be detected only with the patient in a supine position; others require a side-lying position.
3. Estimate the size of the mass in centimeters. Determine its shape (round or sausage).
Describe its contour (smooth, rough, sharply defined, nodular, or irregular). Determine
the consistency (doughy, soft, solid, or hard)
4. Percuss the mass. A dull sound indicates a fluid-filled mass; a tympanic sound, an airfilled mass.
5. Determine if the mass moves with hand or in response to respiration (mass free-floating
or attached to intra-abdominal structures)
6. To determine whether the mass is located in the abdominal wall or the abdominal
cavity, ask the patient to lift his head and shoulders off the examination table, thereby
contracting his abdominal muscles. While these muscles are contracted, try to palpate the
mass. If you can, the mass is in the abdominal wall; if you cant, the mass is within the
abdominal cavity.
WRITE DOWN THE NAMES OF CRANIAL NERVES
To remember 12 cranial nerves, mostly following mnemonic is used;
Oh, Oh, Oh, To Touch And Feel A Girl's Very Soft Hands
A common mnemonic for the functions of the first through twelfth nerves, is
"Some Say Marry Money, But My Brother Says Big Business Makes Money"
Cranial Nerves
I Olfactory

V Trigeminal

IX Glossopharyngeal

II Optic

VI Abducens

X Vagus

III Oculomotor

VII Facial

XI Accessory

IV Trochlear

VIII Vestibulocochlear

XII Hypoglossal

WRITE THE PURPOSE OF HEALTH ASSESSMENT

1. To obtain baseline data about the clients functional abilities.
2. To supplement, confirm, or question data obtained in the nursing history.
3. To obtain data that will help the nurse establish nursing diagnoses and plan patient care.
4. To evaluate the appropriateness of the nursing interventions in resolving the patient's
identified pathophysiology problems.
5. To evaluate the physiologic outcome of health care and thus the progress of a clients health
Compiled By: Dileep Kumar (2009-11-Batch)
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Solved Paper: Advance Health Assessment, Session (2008-2010)

6. To establish a relationship before problems happen
DESCRIBE BRIEFLY THE PURPOSE OF HEALTH HISTORY
The health history is a current collection of organized information unique to an individual.
Relevant aspects of the history include biographical, demographic, physical, mental, emotional,
sociocultural, sexual, and spiritual data.
Purpose of health history
The health history aids both individuals and health care providers by supplying essential
information that will assist with diagnosis, treatment decisions, and establishment of trust and
rapport between lay persons and medical professionals. The information also helps determine an
individual's baseline, or what is normal and expected for that person.
FACTORS THAT DISTORT COMMUNICATION
1. Development: language & communication skills develop through various stages such as
infant/toddlers - rely on nonverbal communication
2. Gender: males & females communicate differently such as males use communication to
establish independence & negotiate status within a group, while females use
communication to seek confirmation, minimize differences & establish or reinforce
intimacy
3. Sociocultural Characteristics: culture, education, economic level can influence
communication such as body language, eye contact, and touch are influenced by cultural
beliefs about appropriate communication behavior. education level may affect the extent
of their vocabulary or their ability to access written communication
4. Values and Perceptions: each person has unique personality traits, values, and life
experiences, each will perceive and interpret messages and experiences differently. It is
important for the nurse to be aware of a client's values and to validate or correct
perceptions to avoid creating barriers in the nurse-client relationship
5. Personal Space: The distance people prefer in interactions with others. Middle-class
North Americans use definite distances in various interpersonal relationships, along with
specific voice tones and body language.
1. intimate: touching - 1.5 feet

3. social: 4-12 feet

2. personal: 1.5 -4 feet

4. public 12-15 feet

6. Territoriality: space and things considered as belonging to the individuals self. E.g.
Patient in a hospital often considers their territory as bounded by curtains around the bed
unit or the walls of a private room. Nurses need to obtain permission from clients to
remove, rearrange, or borrow objects in their hospital area.
7. Roles and Relationships: roles & relationships between sender & receiver affect the
content and responses in the communication process. Choice of words, sentence
structure, message content and channel, body language, and tone of voice vary
considerably from role to role. The specific relationship between communicators is
significant (the nurse who meets a pt for the first time communicates differently from the
nurse who has previously developed a relationship with that pt
Compiled By: Dileep Kumar (2009-11-Batch)
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Solved Paper: Advance Health Assessment, Session (2008-2010)

8. Environment: people usually communicate most effectively in a comfortable
environment. Temperature extremes, excessive noise, and a poorly ventilated
environment can all interfere with communication. environmental distraction can impair
and distort communication
9. Congruence: verbal & nonverbal aspects of the message match. This helps the client to
more readily trust the nurse. Helps prevent miscommunication
10. Interpersonal Attitudes: attitudes convey beliefs, thoughts, and feelings about people
and events. Attitudes are communicated convincingly and rapidly to others. Attitudes
such as caring, warmth, respect, and acceptance facilitate communication. condescension,
lack of interest, and coldness inhibit communication
FUNCTIONS OF THE FOLLOWING INSTRUMENTS
a) Tuning fork
To assess a patient's hearing. Lower-pitched ones (usually C-128) are also used to check
vibration sense as part of the examination of the peripheral nervous system
b) Stethoscope
The stethoscope is an instrument used for auscultation, or listening to sounds produced by the
body. It is used primarily to listen to the lungs, heart, and intestinal tract. It is also used to listen
to blood flow in peripheral vessels and the heart sounds of developing fetuses in pregnant
women.
c) Otoscope

The Otoscope facilitates the examination of the ear canal. From the color, shape and general
appearance, a doctor can assess abnormalities. These include otitis externa, exostoses, aspergillus
niger, foreign bodies, perforations and lesions.
d) Ophthalmoscope
An ophthalmoscope enables a physician to examine the interior of the eye to detect abnormalities
or signs of disease on the retina and lens of the eye. It does this by directing a tiny beam of light
through the pupil. The pupil is the black "window" of the eye.
e) Reflex hammer
A reflex hammer is a medical instrument used by physicians to test deep tendon reflexes. Testing
for reflexes is an important part of the neurological physical examination in order to detect
abnormalities in the central or peripheral nervous system. Reflex hammers can also be used for
chest percussion

Compiled By: Dileep Kumar (2009-11-Batch)

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