Patient Assessment and Evaluation Flashcards
7 cards from real TRIVIUM practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Patient Assessment and Evaluation flashcards as text
A patient with dementia is pacing and repeatedly saying 'I need to go home.' Using a behavioral pain assessment approach, this behavior most likely indicates:
Answer: The patient may be experiencing pain, discomfort, or anxiety
In patients who cannot verbalize pain clearly, behavioral cues like agitation and repetitive statements may signal pain or distress.
Which vital sign pattern would indicate a patient may be going into septic shock?
Answer: BP 88/52, HR 118, Temp 103.2°F
Low blood pressure, rapid heart rate, and high fever together suggest septic shock and require emergency intervention.
A nurse aide is assessing a patient's level of consciousness. The patient opens eyes to voice, speaks in confused sentences, and localizes pain. Using the AVPU scale, how is this patient classified?
Answer: Voice responsive
The patient responds to voice stimulation, placing them in the 'Voice' category of the AVPU scale.
During a nutritional assessment, which observation most warrants reporting to the nurse?
Answer: Patient has consumed less than 25% of meals for three days
Consistently poor intake over multiple days indicates a nutritional risk that requires nursing and dietary follow-up.
Which assessment technique is used to evaluate the equality and strength of pedal pulses?
Answer: Palpation of the dorsal foot arteries bilaterally
Pedal pulses are assessed by palpating the dorsalis pedis and posterior tibial arteries and comparing both sides.
A patient who was alert and conversational this morning is now drowsy and only mumbles brief responses. This change most likely indicates:
Answer: A significant neurological or systemic change requiring immediate reporting
Acute changes in mental status are a red flag for serious conditions such as stroke, infection, or metabolic crisis.
When assessing a wound during dressing change, which finding requires immediate reporting?
Answer: Sudden increase in purulent, foul-smelling drainage
Sudden increase in purulent, malodorous drainage suggests infection and requires prompt nursing assessment.