REVIEWER FOR HEALTH ASSESSMENT LECTURE

SESSION 1 INTRODUCTION TO HEALTH ASSESSMENT

Health -is a relative state in which a person is able to live to his or her potential and includes the
"7 facets"(PESCSED)
[Link] health - how the body works and adapts
[Link] health - positive outlook and emotions channeled in a healthy manner
[Link] well-being - supportive relationships with family and friends
[Link] influences - favorable connections to promote health
[Link] influences - living peacefully, morally, and ethically
[Link] influences - favorable conditions to promote health
[Link] level - how one thinks, solves problems, and makes decisions

• Health is a sum of these facets and is not solely defined as the absence of disease or eating right, but
rather by the contribution of all dimensions

- Health Assessment -The nursing health assessment entails both a comprehensive health history and a
complete physical examination, which are used to evaluate the health and status of a person.
-The nursing health assessment involves a systematic data collection that provides information to
facilitate a plan to deliver the best care for the patient.
-The first part of health assessment is the health history, which also incorporates the "7 facets". The
nurse asks pertinent questions to gather data from the patient and/or family. Past medical records may
also be used to collect additional information.
• Learning about the patient's physical and psychological issues, social and cultural associations,
environment, developmental level, and spiritual beliefs contribute to the history.
- The second component of the health assessment is the physical examination.
-The nurse uses a structured head-to-toe examination to identify changes in the patient's body systems.

NURSING PROCESS
The NURSING PROCESS (a problem solving process) to identify patient problems; set a goal and develop
an action plan; implement the plan; and evaluate the outcome

•The NURSING PROCESS steps are: ADPIE

[Link]
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• Assessment - it is the first step of the nursing process. It is the subjective and objective data gathered
during the initial health history and physical examination and collected on each patient encounter

Diagnosis has a nursing focus and is based on real or potential health problems or human responses to
health problems. The nurse uses clinical reasoning to formulate diagnoses based on the assessment data
and the patient's problem list.
•Planning is devising the best course of action to address the patient's diagnoses. During planning, the
nurse and patient select goals for each diagnosis in order to alleviate, decrease, or prevent the problems
addressed in the nursing diagnosis.

•Implementation of the interventions can be completed by the patient, the family, or members of the
health care team. The interventions should clearly relate to the nursing diagnosis and the planned goals.

•Evaluation is a continuing process to determine if the goals have been attained. The nursing care plan
is revised based on the patient's condition and whether the goals are realistic or appropriate for the
patient.

SESSION 2 STEPS OF HEALTH ASSESSMENT

Phases of Interview
1. Pre-interview: set the stage for a smooth interview
• Self-Reflection
Self-reflection is a continual part of professional development in clinical work. It brings a deepening
personal awareness to our work with patients, which is one of the most rewarding aspects of patient
care.
• Review patient record
•Set interview goals
• Review own clinical behavior and appearance
2. Introduction: put the patient at ease and establish trust
• Greet the patient and establish rapport
• Establish the agenda for the interview
3. Working: obtain patient information - longest Phase
• Invite the patient's story
• Identify and respond to emotional clues
• Expand and clarify the patient's story
• Generate and test diagnostic hypotheses
• Negotiate a plan, including further evaluation, treatment, education and self-management support
and prevention
THE SEVEN ATTRIBUTES OF A SYMPTOM( OLDCAR)
" Ascess properly
 Onset. When did (does) it start? Setting in which it occurs, including environmental factors,
personal activities, emotional reactions, or other circumstances that may have contributed to
the illness.
 2. Location. Where is it? Does it radiate?
 3. Duration. How long does it last?
Describe scale
 4. Characteristic Symptoms. What is it like? How severe is it? (For pain, ask a rating on a scale of
1 to 10.)
 5. Associated Manifestations. Have you noticed anything else that accompanies it?
 6. Relieving Factors. Is there anything that makes it better or worse? 7. Treatment. What have
you done to treat this? Was it effective?
4. Termination:
Summarize important points
Discuss plan of care
"So, you will take the medicine as we discussed, check your blood glucose daily, and make a follow-up
appointment for 4 weeks. Do you have any questions about this?" Address any related concerns or
questions that the patient raises.

Types of data:

Subjective data- are information from the client's point of view ("symptoms"), including feelings,
perceptions, and concerns obtained through interviews.
Objective data- are observable and measurable data (signs) obtained through observation, physical
examination, and laboratory and diagnostic testing.

COMPREHENSIVE HEALTH HISTORY

Allergies, including specific reactions to each medication, such as rash or nausea, must be recorded.
Allergies to foods, insects, or environmental factors along with the patient's reaction should also be
noted.
Medications, including name, dose/route, and frequency of use, are included. Also list home remedies,
nonprescription drugs, vitamins, mineral or herbal supplements, oral contraceptives, and medicines
borrowed from family members or friends. If the patient is unsure, ask him or her to bring in all
medications to see exactly what is taken.
Childhood illnesses, such as measles, rubella, mumps, whooping cough, chickenpox, rheumatic fever,
scarlet fever, and polio, are included in the Past History. Also included are any chronic childhood
illnesses, such as asthma.
Adult illnesses in each of the following areas:
• Medical: Illnesses such as diabetes, hypertension, hepatitis, asthma, or HIV; hospitalizations
• Surgical: Dates, reasons for surgery, and types of operations or treatments
• Accidents: type, dates, treatment and residual disability of major accidents
• Psychiatric: Illness and time frame, hospitalizations, and treatments
Health Maintenance
Immunizations: Ask whether the patient has received vaccines for tetanus, pertussis, diphtheria, polio,
measles, mumps influenza, varicella, hepatitis B, Haemophilus influenza type B, Neisseria meningitides
meningitis, and pneumococci. Include the dates of original and booster immunizations.
Screening Tests: Such as tuberculin tests, cholesterol tests, stool for occult blood, Pap smears, and
mammograms. Include the results and the dates the tests were performed. Alternatively, screening tests
maybe asked about during and documented in the Review of Systems.
Safety Measures: Seat belts in cars, smoke/carbon monoxide detectors, sports helmets or padding, etc.
Risk Factors:
SESSSION 3: PHYSICAL EXAMINATION

THE COMPREHENSIVE ADULT PHYSICAL EXAMINATION

Beginning the Examination: Setting the Stage
Preparing for the Physical Examination:
 -Reflect on your approach to the patient.
 -Adjust the lighting and the environment.
 -Make the patient comfortable.
 Check your equipment.
 Choose the sequence of examination.

Reflect your Approach to the Patient:

 -Identify yourself as a nursing student.
 -Try to appear calm, organized, and competent.
 -Most patients view the physical examination with some anxiety.
 -Avoid interpreting your findings - If you find anything that is unusual or disturbing, always talk
with your clinical instructor.

Adjust the Lighting and Environment;

 -"Set the stage so that both you and the patient are comfortable.
 -Good lighting and a guiet environment make important contributions to what you see and hear
but may be hard to arrange.
 -Tangential lighting optimal for inspecting structures such as the jugular venous puise, the
thyroid gland, and the apical impulse of the heart.

Make the Patient Comfortable:

 -Showing concern for privacy and patient modesty must be ingrained in your professional
behavior.
 Close nearby doors and draw the curtains in the hospital or examining room before the
examination begins
 -Wash your hands
 -draping the patient - goal is to visualize one area of the body at a time keep the patient
informed, especially when you anticipate embarrassment or discomfort checking vital signs, tell
the patient the results the examination is completed, tell the patient your general impressions
and what to expect next

Protective barriers include:

• gloves, gowns, aprons, masks, and protective eyewear
All health care workers should observe the important precautions for safe injections and prevention of
injury from needle sticks, scalpels, and other sharp instruments and devices.

Make the Patient Comfortable

 Patient Privacy and Comfort:
 Close nearby doors, draw the curtains in the hospital or examining room, wash your hands
thoroughly
 During the examination be aware of the patient's feelings and any discomfort.
Draping the Patient:
 Goal: to visualize one are of the body at a time.
 When patient is sitting, auscultate the lungs with the gown unties in back.
 Breast examination, uncover the right breast and keep the left chest draped.
 Abdominal examination, only the abdomen should be exposed.

Cardinal Techniques of Examination:

Note: abdominal examination, the pattem will be inspection, auscultation, percussion, and palpation

INSPECTION
 Close observation of the details of the patient's appearance, behavior, and movement such as:
facial expression, mood, body build and conditioning, skin conditions such as petechia or ecchymosis,
eye movements, pharyngeal color, symmetry of thorax, height of jugular venous pulsations, abdominal
contour, lower extremity edema, and gait.

PALPATION
 Tactile pressure from the palmar fingers or finger pads to assess areas of skin elevation,
depression, warmth, or tenderness; lymph nodes; pulses; contours and sizes of organs and
masses; and crepitus in the joints Metacarpal/phalangeal joint or ulnar surface of the hand is
used to detect vibration.

PERCUSSION
 Use of the striking or plexor finger, usually the third, to deliver a rapid tap or blow against the
distal pleximeter finger, usually the distal third finger of the left hand lay against the surface of
the chest or abdomen, to evoke a sound wave such as resonance or dullness from the
underlying tissue or organs.
• This sound wave also generates a tactile vibration against the pleximeter finger.

AUSCULTATION
• Use of the diaphragm and bell of the stethoscope to detect the characteristics of heart, lung, and
bowel sounds, including location, timing, duration, pitch, and intensity.
• For the heart this involves sounds from closing of the four valves and flow into the ventricles as well as
murmurs.
Auscultation also permits detection of bruits, i.e., turbulence over arterial vessels.

EQUIPMENT
 -Snellen CHART
Used to measure the visual acuity of the patient
 -STADIOMETER
Measure patients height

 -EAR OTOSCOPE
 -OPTHALMOSCOPE (EYE)
 -SPHYGMOMANOMETER
 -STETHOSCOPE
 -FORGESY KNEE HAMMER
 -PULSE OXIMETER
 -DIGITAL MEASURE SCALE
 TUNING FORK

SESSION 4 PHYSICAL EXAMINATION OF A PEDIATRIC PATIENT
Collecting Subjective Data
Information spoken by the child or family is called subjective data.
Conducting the Client Interview
 Most subjective data are collected through interviewing the family caregiver and the child.
Why interview? The interview helps establish relationships between the nurse, the child, and the family.
 Listen and communicate. Listening and using appropriate communication techniques help
promote a good interview.
 Introduce and explain your purpose. The nurse should be introduced to the child and caregiver
and the purpose of the interview stated.
 Establish rapport. Calm, reassuring manner is important to establish trust and comfort; the
caregiver and the nurse should be comfortably seated, and the child should be included in the
interview process.

Interviewing Family Caregivers

The family caregiver provides most of the information needed in caring for the child, especially the
infant or toddler.
 Ask questions and note them. Rather than simply asking the caregiver to fill out a form, the
nurse may ask the questions and write down the answers; this process gives the opportunity to
observe the reactions of the child and the caregiver as they interact with each other and answer
the questions.
 Avoid being judgmental. The nurse must be non-judgmental, being careful not to indicate
disapproval by verbal or nonverbal responses.

Interviewing the Child

It is important that the preschool child and the older child be included in the interview.
 Be ago-appropriate. Use age-appropriate toys and questions when talking with the child.
 Establish rapport. Showing interest in child and in what he or she says helps both the child and
caregiver to listen the table: by being honest when answering the child questions, the nurse
establishes trust with child


Interviewing the Adolescent

• Adolescents can provide information about themselves.
Interview in private. Interviewing them in private often encourages them to share information that they
might not contribute in front of their caregivers.
Obtaining a Client History
When a child is brought to any health care setting, it is important to gather information regarding the
child's current condition, as well as medical history.
• Biographical data. The nurse obtains identifying information about the child, including the child's
name, address, and phone number, as well as information about the caregiver; a questionnaire often is
used to gather information, such as the child's nickname, feeding habits, food likes and dislikes,
allergies, sleeping schedule, and toilet-training status.
• Chief Complaint. The reason for the child's visit to the healthcare setting is called the chief complaint;
to best care for the child, it is important to get the complete explanation of what brought the child to
the healthcare
setting.
• History of present health concern. To help the nurse discover the child's needs, the nurse elicits
information about the current situation, including the child's symptoms, when they began, how long the
symptoms have been present, a description of the symptoms, their intensity and frequency, and
treatments to this time.
• Health history. Information about the mother's pregnancy and prenatal history are included in
obtaining a health history for the child; other areas the nurse asks questions about include common
childhood, serious, or chronic illnesses; immunizations and health maintenance; feeding and nutrition;
as well as hospitalizations and injuries.
 Family health history. The caregiver can usually provide information regarding family health
history; the nurse uses this information to do preventive teaching with the child and family.
• Review of systems for current health problem. While the nurse is collecting subjective data, the
caregiver or child is asked questions about each body system; the body system involved in the chief
complaint is reviewed in detail.
• Allergies, medications, and substance abuse. Allergic reactions to any foods, medications, or any other
known allergies should be discussed to prevent the child being given any medications or substances that
might cause an allergic reaction; medications the child is taking or has taken, whether prescribed by a
care provider or over the counter, are recorded; it is important, especially in the adolescent, to assess
the use of substances such as tobacco, alcohol, or illegal drugs
• Lifestyle. School history includes information regarding the child's current grade level and academic
performance, as well as behavior seen at school; social history offers information about the
environment that the child lives in, including the home setting, parents' occupations, siblings, family
pets, religious affiliations, and economic factors; personal history relates to data collected about such
things as the child's hygiene and sleeping and elimination patterns; nutrition history of the child offers
information regarding eating habits and preferences, as well as nutrition concerns that might indicate
illness.
 Developmental level. Gathering information about the child's developmental level is done by
asking questions directly related to growth and development milestone; knowing normal
development patterns will help the nurse determine if there are concerns that should be further
assessed regarding the child's development.
Collecting Objective Data
• Objective data in nursing is part of the health assessment that involves the collection of information
through observations. The collection of objective data includes the nurse doing a baseline measurement
of the child's height, weight, blood pressure, temperature, pulse, and respiration.
• General Status
The nurse uses knowledge of normal growth and development to note if the child appears to fit the
characteristics of the stated age.
• Observing general appearance. The infant or child's face should be symmetrical; observe for
nutritional status, hygiene, mental alertness, and body posture and movements; examine the skin for
color, lesions, bruises, scars, and birthmarks; observe hair texture, thickness, and distribution.
Nothing psychological status and behavior.
• Observation of behavior should include factors that influenced the behavior and how often the
behavior is repeated; physical behavior, as well as emotional and intellectual responses, should be
noted; also consider the child's age and developmental level, the abnormal environment of the
healthcare facility, and if the child has been hospitalized previously or otherwise separated from family
caregivers.
Measuring Height and Weight
The child's height and weight are helpful indicators of growth and development.
• When to measure. Height and weight should be measured and recorded each time the child has a
routine physical examination, as well as at other health care visits.
How to measure weight. In a hospital setting, the infant or child should be weighed at the same time
each day on the same scales while wearing the same amount of clothing; the infant is weighed nude,
lying on an infant scale, or when the infant is big enough to sit, the child can be weighed while sitting.
• How to measure height. The child who can stand usually is measured for height at the same time; to
measure the height of a child who is not able to stand alone steadily, usually under the age of about 2,
place the child flat, with knees held flat, on an examining table; measure the child's height by
straightening the child's body and measuring from the top of the head to the bottom of the foot.
Measuring Head Circumference
The head circumference is measured routinely in children to age 2 or 3 years or in any child with a
neurologic concern.
• How to measure. A paper or plastic tape measure is placed around the largest part of the head just
above the eyebrows and around the most prominent part of the back of the head.
• Record and plot. This measurement is recorded and plotted on a growth chart to monitor the growth
of the child's head.

• Vital Signs
Vital signs, including temperature, pulse, respirations, and blood pressure, are taken at each visit and
compared with the normal values for children at the same age

Temperature
• The temperature can be measured by the oral, rectal, axillary, or tympanic method; temperatures are
recorded in Celsius or Fahrenheit, according to the policy of the health care facility.
• A normal oral temperature range is 36.4* Celsius to 37.4° Celsius (97.6° Fahrenheit to 99.3°
Fahrenheit).
A rectal temperature is usually 0.5 to 1.0 degrees higher than the oral measurement.
An axillary temperature usually measures 0.5 degrees to 1.0 degrees lower than the oral measurement.

Pulse
• The apical pulse should be counted before the child is disturbed for other procedures. The
stethoscope is placed between the child's left nipple and sternum.
You sent
-A radial pulse may be taken on an older child
-A pulse that is unusual in quality, rate, or rhythm should be counted for a full minute and should be
compared on the opposite site.
Pulse rates vary with age: from 100 to 180 beats per minute for a neonate to 50 to 95 beats per minute
for the
14-to 18-year-old adolescent.

Respirations
• The child can be observed while lying or sitting quietly; infants are abdominal breathers; therefore the
movement of the infant's abdomen is observed to count respirations;
• The older child's chest can be observed how an adult's would be.
• The infant's respirations must be counted for a full minute because of normal irregularity.
Retractions are noted as substernal, subcostal, intercostal, suprasternal, or supraclavicular.

Blood pressure
 For children 3 years of age and older, blood pressure monitoring is part of routine and ongoing
data collection;
 Taking the blood pressure on a stuffed animal or doll will show the child the procedure is not to
be feared.
 The most common sites used to obtain a blood pressure reading in children are the upper arm,
lower arm or forearm, thigh, and calf or ankle;
 The blood pressure is taken by auscultation, palpation, or Doppler or electronic method.

SESSION 5 : CULTURAL AND SPIRITUAL ASSESSMENT

CULTURAL ASSESSMENT
• Refers to a systematic, comprehensive examination of individuals, families, groups and communities
regarding their health-related cultural beliefs, values and practices.
 Global Migration - increased the challenges of providing health care to patients with health care
beliefs, practices and needs different from health care provider
Cultural Competence
Recognizes the need for a set of skills necessary to care for people of different cultures
• Culture as a process, not a state

Cultural Humility
• The process that requires humility as individuals continually engages in self-reflection and self-critique
as lifelong learners and reflective practitioners.
The process that includes the difficult work of examining cultural beliefs and cultural systems of both
patients and nurses to locate the points of cultural dissonance or synergy that contribute to patients'
health outcomes.

(REFLECTION)
Begin Self-Reflection by answering the following:
1. Am I aware of my biases? Prejudices? Stereotypes?
2. Am I comfortable interacting with people with different cultures?
3. Do I seek out experiences with other cultures?
4. Do I seek out opportunities to learn about other cultures?
5. Do I respect the beliefs of individuals from other cultures?
6. Do I know how to access language interpreter services for patients?
SESSION 6: MENTAL STATUS EXAMINATION
Mental Status Examination (MSE)
Tool for assessing psychological dysfunction and identifying.
Examines patient's LOC, general appearance, behavior, speech, mood and affect, intellectual
performance, judgment, insight, perception, and thought content.

Thought process
 Record the patient's thought process information. The process of thoughts can be described
with the following terms: looseness of association (irrelevance), flight of ideas (change topics),
racing (rapid thoughts), tangential (departure from topic with no return), circumstantial (being
vague, i.e., "beating around the bush," giving inordinately long responses that only eventually
answer the stated question), word salad (nonsensical responses, i.e., jabberwocky), derailment
(extreme irrelevance), neologism (creating new words), clanging (rhyming words, punning
talking in riddles), thought blocking (speech is halted), and poverty (limited content.
Thought content
 To determine whether or not a patient is experiencing hallucinations, ask some of the following
questions. "Do you hear voices when no one else is around?" "Do these voices seem to come
from outside of your head, so that you turn to look and see who is talking?" "Can you see things
that no one else can see?

Suicidal ideation or intent:

 Inquiring about suicidal ideation at each visit is always important. In addition, the interviewer
should inquire about past acts of self-harm or violence. Ask the following types of questions
when determining suicidal ideation or intent. "Do you have any thoughts of wanting to harm or
kill yourself?" "Do you have any thoughts that you would be better off dead?" If the reply is
positive for these thoughts, inquire about specific plans, suicide notes, family history
(anniversary reaction), and impulse control. Also, ask how the patient views suicide to
determine if a suicidal gesture or act is ego-syntonic or ego-dystonic.
Next, determine if the patient will contract for safety. For homicidal ideation, make similar inquiries.
Consciousness:
 Levels of consciousness are determined by the interviewer and are rated as (1) coma,
characterized by unresponsiveness; (2) stuporous, characterized by response to pain; (3)
lethargic, characterized by drowsiness; and (4) alert, characterized by tull awareness. If patients
exhibit decreased levels of consciousness note the stimulus required to arouse the patient.
Orientation: To elicit responses concerning orientation, ask the patient questions, as follows:
)
-"What is your full name?" (i.e., person)
-"Do you know where you are?" (i.e., place)
-"What is the month, date, year, day of the week, and time?" (i.e., time)
-"Do you know why you are here?" (i.e., situation)
Memory:
 To evaluate a patient's memory, have them respond to the following prompts. "What was the
name of your first grade teacher?" (i.e., for remote memory). "What did you eat for dinner last
night?" (i.e., for recent memory). "Repeat these 3 words: pen, chair, and flag." (I.e., for
immediate recall). Tell the patient to remember these words. Then, after 5 minutes, have the
patient repeat the words. Orientation represents recent memory.

The purpose of the integumentary history is to identity the following:

 Diseases of the skin

 Systematic diseases that have skin manifestations
 Physical abuse
 Risk for pressure ulcer formation
 Risk for skin cancer
 Need for health promotion education regarding the skin

SESSION 7: THE INTEGUMENTARY SYSTEM

Common or concerning symptoms (use the OLDCART method in obtaining the health history of each
symptom).
 Lesions
 Rash
 Non-healing lesions
 Bruising (ecchymosIs)
 Hair loss
 Moles
Physical Examination of the Skin
Skin color will vary according to genetic background and may have fair, olive, tan, brown, or golden
hues. Patients may notice a change in their skin color before the nurse does. Ask about it.
 Look for increased pigmentation (brownness), lossof pigmentation, or redness of the skin.
 Assess for cyanosis or pallor. Note the red color of oxyhemoglobin and the pallor (e.g.
fingernails, lips, and the mucous membranes. Inspecting the palms and soles may be useful in
dark people.

SESSION 8: THE HEAD AND NECK

COMMON OR CONCERNING SYMPTOMS OF THE HEAD
 Headache
 Head injury
 Head or neck surgery
 Traumatic brain injury

History Interview (OLDCART)

Onset: When did you first notice the lump?
Location: Where is the lump? Is there more than one lump?
Duration: How long have you had the lump?
Characteristic Symptoms: Has the lump changed (size, tenderness, drainage, shape, consistency)?
Associated Manifestations: Do you have difficulty swallowing? Have you had any recent infections?
Trauma?
Radiation? Surgery? History of smoking? Drinking alcohol? Chewing tobacco?
Relieving Factors: Does anything make the lump smaller? Less tender? Have you tried compresses on
the site?
Treatment: Have you been to a health care provider?

History Interview (OLDCART)

Onset: When did you first notice the headache?
Location: Where do you feel the headache? Can you point to the areas?
Duration: How long has this been going on? Did the headache begin suddenly (in a few minutes or less
than an hour) or gradually (over a few hours or days)? Is it temporary or constant? When does the pain
begin (morning. evening)? Does it wake you at night? How long do the headaches last? Are they
recurring? Is there a pattern?
Characteristic Symptoms: Describe what it feels like (throbbing, hammering, squeezing). Describe the
pain on a scale of 1 to 10 with 1 being minimal pain and 10 being the worst pain you ever felt.
Relieving Factors: What have you tried to make the headache go away? (e.g. Sleep? Dark room? Cool
compresses? Relaxation techniques?) What has worked the best? What has not worked at all? Does
anything make it worse? How have the headaches affected your daily life and activities?
Treatment: Has anyone treated you for headaches in the past? (e.g. physician, nurse practitioner, or
massage therapist). Have you used any medication? If yes, then the name of the medication, dosage,
and affect?

Head Trauma or Brain Injury:

Onset: When did this occur? Can you describe what happened? Do you remember when you hurt your
head?
Precipitating Factors: what nappened to cause the traumatic brain injury? e.g. Lack of protective
equipment or helmet? Environmental)?
location: Can vou show me where you hurt your head?
Duration: Did you lose consciousness? If yes, for how long? Did you fall first or lose consciousness first?
Characteristic Symptoms: Did you experience any symptoms prior to the head injury (headache,
shortness of breath, chest pain, numbness, or tingling)? Do you have any medical issues (cardiac history,
diabetes, seizures)?
Associated Manifestations: Do you experience vision changes; nausea or vomiting: attention span
deficits; drainage from the ears, nose, eyes, or mouth; tremors; seizures; or gait changes?
Relieving Factors/Strategies: Prevention of further injury
HEALTH EDUCATION REVIEWER
HES 008- 1" Quiz Prelim 6. Informed consent, which is a basic tenet of
1. At this time, nursing was first acknowledged ethical thought, was established in the courts as
as a unique discipline, and the responsibility for early as 1914 by:
teaching has been A. Immanuel Kant
recognized as an important role of nurses as B. John Stuart Mill
care givers C. Justice Benjamin Cardozo
a. Early 1900s D. American Nurses Association
b. Mid 18005
c. 1918 7. Who purported a teleological approach
d. 1970 A. Immanuel Kant
B. John Stuart Mill
2. She was recognized as the ultimate educator. C. Justice Benjamin Cardozo
a. Dreeben D. American Nurses Association
b. Grueninger
c. Nightingale 8. A Perception and the patterning of stimuli are
d. Levine the keys to learning, with each learner
perceiving, interpreting, and reorganizing
3. In today's role of the nurse as educator, he experiences in her/his own way.
following are considered requirements, except: A. Respondent Conditioning
a. Continuing education B. Social Constructivist Perspective
b. In service programs C. Gestalt Perspective
C. Consistent Caregiver D. Operant Conditioning
d. Staff Development
9. Also called association learning or
4. Which documents define a profession and classical/Pavlovian conditioning where learning
were developed to protect the public from occurs as the organism responds to stimulus
unqualified practitioners and to protect the conditions and forms associations.
professional's title. A. Respondent Conditioning
A. Ethics B. Social Constructivist Perspective
B. Moral C. Gestalt Perspective
C. Legal rights and duties D. Operant Conditioning
D. Practiced Acts
10. A phase in the Social Learning Theory that is
5. Which is an ethical belief system that stresses influenced by vicarious reinforcement and
the importance of doing one's duty and punishment
following the rules. A. Motivational
A. Morality B. Attentional
B. Deontology C. Retention
C. Beneficence D. Reproduction
D. Non maleficence
11. 4. One of the following is not included in the
determinants of learning:
A. The needs of the learner 16. Jean Piaget's Sensorimotor Stage is as to
B. The state of readiness to earn what counterpart development in Erikson's
C. The preferred learning styles for processing, Theory?
information. a. Identity VS Role Confusion
D. The preferred needs assessment b. Trust VS Mistrust
c. Initiative VS Guilt
d. Industry VS Inferiority
17. What salient psychosocial characteristic is
12. This assessment will yield information that visible during the above mentioned
reflects the climate of the organization. What is developmental stage
the organization's philosophy, mission, strategic a. responds to step-by-step commands
plan, and goals? b. interacts with playmates
a. Assess demands of the organization. c. routines provide sense of security
D. RisK- Taking behavior d. can build on past experiences
c. Determine availability or educational
resources 18. Adolescence is marked by what operational
[Link] interviews stage according to Piaget
a. Identity VS. Role Confusion
13. This criteria for prioritizing needs for b. Formal Operations Stage
information are nice to know but not essential c. Concrete Operations Stage
or required because they are not directly d. Preoperational period
related to daily activities
a. Mandator 19. During this period, salient cognitive
b. Desirable characteristics will include:
C. Possible a. able to draw conclusions
d. Threatened b. intellectually can understand cause and effect
c. fears illness and disability
14. It refers to the learner's past experiences d. All of the above
with learning. Before starting to teach, the e. A&B only
educator should assess
whether previous learning experiences have 20. 3. LOCUS OF CONROL is known as an
been positive or negative in individual's sense of personal responsibility for
overcoming problems or accomplishing new behavior and extent to which
tasks. motivation to act originates from self. All of the
a. Knowledge readiness following are considered as health locus of
b. Experiential readiness control (HLOC) dimensions, except one:
c. Emotional readiness a. internal
d. Physical readiness b. Chance external
c. Outer external
15. In this developmental stage, there is gaining d. Doctors external
a sense of responsibility and reliability;
increased susceptibility to social forces outside
the family unit;
a. Infancy
b. Toddlerhood 21. A commitment or attachment to a
c. Middle Childhood prescribed, predetermined regimen
d. Adulthood a. Compliance
b. Adherence
c. Nonadherence A. Adult illiteracy is on the rise despite public
d. Noncompliance and private efforts to address the issue.
B. Literacy levels are an issue in teaching
22. There are four perspectives on compliance. healthcare practices to patients as well as to
Theories related to patient compliance with nursing staff populations.
healthcare regimens include the following, C. The initiation of appropriate interventions for
except: patients with low literacy skills has become a
a. Biomedical subject of
b. Behavioral/social learning considerable concern by healthcare providers.
c. Communication (e g.. feedback loop) D. Government initiatives in the last two
d. Irrational belief decades have raised media attention about the
literacy issue.
[Link] introduces opposing positions, case
studies, and variable instructional 28. Here in this tool, a three minute passage at
presentations. approximately the fifth-grade level is read
A. Attention aloud.
B. Relevance a. Cloze Procedure
C. Confidence b. OPS Procedure
D. Satisfaction c. Listening Test
d. Memory Test
24. This pertains to timely use of a new skill, use
of rewards, praise, and self-evaluation. 29. It is also necessary to simplify the readability
A. Attention of printed education materials. Audience
B. Relevance suitability usually depends
C. Confidence a. Grade level demand
D. Satisfaction b. Technical format
c. Concept density
25. 2. Illiteracy is generally interpreted as having d. All of the above
reading skills at or below which grade level?
A. Fourth 30 . In using techniques for writing effective
B. Fifth health materials, we consider the following
C. Seventh criterion, except:
D. Eighth a. Write in a conversational style with an active
voice, using the personal pronouns "you" and
26. Which is a false assumption about "your."
individuals who are illiterate or low literate? b. You can exceed more than 30 to 40
A. Many have been found to have a normal or characters per line.
above normal 10. c. Define any technical or unfamiliar words in
B. They come from very diverse backgrounds. parentheses
C. They react to complex learning situations by d. Highlight important ideas or words with bold
withdrawal or avoidance. type or underlining.
D. Many have reading abilities that correlate
with the number of years of schooling
completed.
31. This phase is dedicated to teaching
27. Which statement about literacy in the adult strategies and resources.
population is accurate? a. PHASE II
[Link] III
C. PHASE IV
d. PHASE I

32. defined as a change in behavior (knowledge, skills, and attitudes) that can occur at any time or in any
place as a result of exposure to environmental stimuli
a. Behavior
b. learning
[Link]
d. beliefs

33. is a self reporting instrument that is widely used in the identification of how individuals prefer to
function, learn, concentrate, and perform in their educational activitiesa.
[Link] and Dunn Learning Style
[Link]
[Link] Erickson
d. Maslows

34. Trust VS. Mistrust

a. Erikson
b. Piaget
[Link]
[Link]

35. Four Types of Client Resistance, except:

a. Arguing
b. Denying
c. Interrupting
[Link]