Any advice on an assessment final?

Daytonite, BSN, RN · Jun 11, 2008

Give me an example of what these questions are like.

blur411 · Jun 11, 2008

here are a few examples that i looked up in the book and i was unable to find, along with the answers i selected.

dilated and engorged veins around the umbilicus are known as

a. cullen's sign

b. caput medusae

c. von recklinghausen's disease

d. sister mary josephs nodule

i selected this answer because i googled it, but i searched in both the text and our small assessment hand book and i was unable to find this. i assume it would be in the abdominal assessment chapters.

mr. c is unable to prevent the spread fingers on his left hand from moving together when the nurse applies resistance. this condition may indicate injury to his (i typed this exactly how it is written on the study guide even though it sounds strange to me)

a. radial nerve

b. ulnar nerve

c. median nerve

d. thenar eminence

i guessed on this one, again unable to find in book

the distal funnel-shaped end of the fallopian tube is called:

a. adnexa

b. broad ligament

c. cornu

d. infundibulum

i seleced this because it sounded sort of like funnel

according to the american heart association's eating plan for healthy americans, if you weighed 150 pound, you would maintain that weight if you consumedcalories per day.

a. 3000

b. 2750

c. 2500

d. 2250

again, i googled this after searching in the book.

i can't "google" things on an exam so thats why i'm so concerned. i don't feel like any of these questions i'm being asked are insane, i just think that i need to be taught, or have the information available to me before the exam to be expected to know the answers. is this just a test of our "test taking skills" should i just be eliminating them like i would on the nclex without the knowledge to back it up?

thanks for any help! :heartbeat

Daytonite, BSN, RN · Jun 12, 2008

here are a few examples that i looked up in the book and i was unable to find, along with the answers i selected.
dilated and engorged veins around the umbilicus are known as
a. cullen's sign
b. caput medusae
c. von recklinghausen's disease
d. sister mary josephs nodule
i selected this answer because i googled it, but i searched in both the text and our small assessment hand book and i was unable to find this. i assume it would be in the abdominal assessment chapters.
i found caput madusae in the index of my assessment book and it is in the section of the examination of the abdomen under inspection of the superficial veins of the abdomen. cullen's sign is also in the examination of the abdomen and is a bluish discoloration of the umbilicus. sister mary joseph nodule i found described in
taber's cyclopedic medical dictionary
. it is a hard periumbilical lymph node that occurs when there are metastasized pelvic or gi tumors. von recklinghausen's is genetic disease of the neural system called neurofibromatosis where "buttonhole" tumors occur on the persons skin
mr. c is unable to prevent the spread fingers on his left hand from moving together when the nurse applies resistance. this condition may indicate injury to his (i typed this exactly how it is written on the study guide even though it sounds strange to me)
a. radial nerve
b. ulnar nerve
c. median nerve
d. thenar eminence
i guessed on this one, again unable to find in book
the root of the question is describing what is called the "finger abduction" test. it is a test of the motor function of the ulnar nerve of the c8-t1 nerve roots of the spinal column. having the patient move against any kind of resistance tests muscle strength. there are other tests of the motor function of the upper extremities that test some of the other nerve roots of the spinal column as well. if they are in your textbook, they will be in the section under the assessment of the nervous system.
arm abduction against resistance - tests axillary nerve (c5-c6)

forearm flexion against resistance - tests musculocutaneous nerve (c5-c6)

forearm extension held between flexion and extension against resistance - tests radial nerves (c6-c8)

wrist extension [pushing fist upward] against resistance - tests radial nerve (c6-c8)

wrist flexion [pushing fist downward] against resistance - tests median nerve (c6-c8)

finger adduction [hand grasp strength] - tests median nerve (c7-t1)

thumb adduction [touch base of little finger with tip pf thumb against resistance] - tests median nerve (c8-t1)
the distal funnel-shaped end of the fallopian tube is called:
a. adnexa
b. broad ligament
c. cornu
d. infundibulum
i seleced this because it sounded sort of like funnel
this is a straight forward anatomy question.
according to the american heart association's eating plan for healthy americans, if you weighed 150 pound, you would maintain that weight if you consumedcalories per day.
a. 3000
b. 2750
c. 2500
d. 2250
again, i googled this after searching in the book.
even if i didn't know this, the ada and weight watcher's original plan was based on a 1200 calorie diet. i would have chosen the lowest number of calories.
i can't "google" things on an exam so thats why i'm so concerned. i don't feel like any of these questions i'm being asked are insane, i just think that i need to be taught, or have the information available to me before the exam to be expected to know the answers. is this just a test of our "test taking skills" should i just be eliminating them like i would on the nclex without the knowledge to back it up?
thanks for any help! :heartbeat

got it. it's what i was suspecting when i first saw your post. they are incorporating abnormal assessment features into the course. so, it's not going to be enough for you to have learned what normal assessment of the various body systems are. they also are going to question you over what abnormal assessment you will find.

didn't your textbook go into any of that?

the one question about the fallopian tube was flat out anatomy that could easily be found in any anatomy drawing of the female reproductive system. is anatomy incorporated into this course? even if it isn't, anatomy probably was a pre-requisite to even taking this class and the question was throw away points. and it's ok to guess. on caput medusae--medusa was a monster in greek mythology who had hair of snakes, thus the naming of the tangle of engorged veins around the umbilicus resembling the snakes entangled around medusa's head. another reason supporting why a general education and fine arts studies are important even though we are science majors. [my bsn program was part of the school of arts and sciences at the university i attended and we had to take a good amount of fine arts and other general education credits to get our bachelors degree.]

blur411 · Jun 12, 2008

Thank you for the explainations, but I'm still at a loss on how to study for this exam over all the assessments?

It does cover abnormals, but not all of the ones we have questions on are in our book (actually a majority are not in there). Like I said, the teacher "claims" everything is in the book and just to study that. That isnt working so I'm not sure what all to study to make sure I pass. I had anatomy about 3 years ago (it transfered). Theres a brief anatomy section at the begining of each chapter, but again it didn't cover where some of those questions are coming from. I'm just frustrated because I feel I have no focus to study, the last time I spent hours and hours reading chapters over and over again and still got a 78 on the exam.

I'm trying not to come off as lazy, but as I've said I'm an A student, and I always read my chapters for all my classes. I do the questions in the back of the book, on thepoint.com and in our study guide, thats why I can't understand why I'm failing :-/

pinkiepie_RN · Jun 12, 2008

Thank you for the explainations, but I'm still at a loss on how to study for this exam over all the assessments?
It does cover abnormals, but not all of the ones we have questions on are in our book (actually a majority are not in there). Like I said, the teacher "claims" everything is in the book and just to study that. That isnt working so I'm not sure what all to study to make sure I pass. I had anatomy about 3 years ago (it transfered). Theres a brief anatomy section at the begining of each chapter, but again it didn't cover where some of those questions are coming from. I'm just frustrated because I feel I have no focus to study, the last time I spent hours and hours reading chapters over and over again and still got a 78 on the exam.
I'm trying not to come off as lazy, but as I've said I'm an A student, and I always read my chapters for all my classes. I do the questions in the back of the book, on thepoint.com and in our study guide, thats why I can't understand why I'm failing :-/

It sounds like your instructor wants you to actually apply your knowledge and use critical thinking for these questions. Because you're expected to already have a background with anatomy and you're learning normal assessment, she/he wants to know that you know your stuff by throwing stuff at you. If you don't remember the normal anatomy, it's okay to pull out your A&P book or google it. Definitely use your resources appropriately. It sounds like you weren't prepared for that AEB your rationales. It's not just about reading and knowing how to regurgitate the material. I recommend checking out an NCLEX book or two, maybe Assessment Made Incredibly Easy! Also...I wonder if there's someone in your class who isn't struggling. Maybe see if they have any tips. I know times I've struggled and the rest of the class has too, but there's still that one person who manages an A.

I hope you don't take my response the wrong way. Just my :twocents: .

blur411 · Jun 12, 2008

I understand all of this, and I have looked at A&P books after the tests, but when we are thrown a complete curve on every exam its difficult to score a passing grade. I usually am one of the ones that is getting an A when others are struggling, and I have asked all the others that I know usually do well and they are as frustrated as I am over this. I have looked at NCLEX books, and done all the practice questions in those areas in two editions of the Saunders Comprehensive I got from the library. I feel like I've done everything I can, and at this point its going to come down to my test taking skills. I don't think we should be expected to know all of this information if we were never taught it, or given the opportunity to learn it. I had A&P and it NEVER went into this much detail. I'm taking Fundamentals, and a clinical as well and I'm doing very well in those classes. I just hope this one class doesnt bite me, but I guess if it gets me, I wont be the only one. I'm sure it can't look good if a professor flunks an entire class of 30 students. :banghead:

Daytonite, BSN, RN · Jun 13, 2008

actually, i looked in my copy of assessment made incredibly visual when i was responding to this post the first time. it covers the assessment of the cranial nerves, but not the spinal nerves. i found the answer in a physical examination textbook for medical students. the questions listed above are application type questions. the information in the textbook just gave the information on how to perform the tests. the tests are very specific to elicit the information each of the questions is asking. the symptoms described (the abdominal ones) are also very specific as well and were clearly spoken about in the section of abdominal assessment. some of the answer choices were defined in my taber's, but i recognized the root of the questions as being examination type information except the one anatomy question.

the best i can suggest, if this information was not in your textbook, is to read the assessment and examination information for each of the systematic divisions on this website for medical students from the university of california, san diego: http://medicine.ucsd.edu/clinicalmed/introduction.htm. the website was created to be used by nurses as well. the home page consists of links to body parts or body systems and explains how to do a physical examination of that body part or body system and includes photographs showing abnormal conditions, and more importantly, how to assess for them. each one you link into is only a long page. if you print out or read through a few of them each day before your final, at least you won't be totally in the dark if questions about pathological symptoms or abnormal assessment information is asked on your test.

i've been a practicing nurse a long time. my best guess would be that the instructor would ask questions about diseases and conditions that most of us who have been practicing nurses saw most often in hospitalized patients. that's the kind of questions i would ask on a test. i'm saying psych out the instructor. we all have war stories to tell about interesting patients with awesome diseases we cared for. so, what do you know about this instructor and what kind of nursing she did? what kind of nursing does she have expertise in? as a med/surg nurse i can tell you that the most common diseases i saw patients admitted with were strokes (cranial nerve/spinal nerve assessment), gi problems such as alcoholism, hepatitis and cirrhosis (abdominal assessment), respiratory diseases like pneumonia and lots of copd (respiratory assessment), an occasional renal failure (genitourinary system assessment) and congestive heart failure was a biggie (circulatory system). people, as a general rule, are not hospitalized for skin, hair, mouth, nose, throat or neck conditions but they could be complications that pop up while they are inpatients for other problems. complications secondary to diseases like diabetes are getting to be a regular thing these days. also, certain diseases have a very specific symptom, i.e. heberden's nodes in osteoarthritis, koplik's spots in measles.

hope that gives you some direction and is the shortest direction to last minute help based on what i know about assessing symptoms for differential diagnosis.

blur411 · Jun 13, 2008

Thank you both so much, and Daytonite I will be looking at that all day today I have a long break in between classes and I will pass the info on to other students because we have all been trying to figure out alternative ways. I will let you know how I do! I really appreciate you taking the time to help me!:heartbeat

Daytonite, BSN, RN · Jun 13, 2008

i specifically went to the ucsd assessment page on neurological assessment last night to see what was there because of that question you posted about the spinal nerve assessment and found that it was quite lengthy. however, the spinal nerve assessments were there (after the cranial nerve assessment, of course, which they always list first!) toward the bottom and they were not as clearly worded as my schwartz' textbook of physical diagnosis, but they were there. they also, i noticed, had links to some videos of exams, etc.

by the way, this website is listed on the health assessment resources, techniques, and forms sticky thread (https://allnurses.com/forums/f205/health-assessment-resources-techniques-forms-145091.html) along with several other medical school assessment websites. i just happen to be more familiar with this one. i think that maybe the one from loyola medical school might be similar, but the site just set up differently: http://www.meddean.luc.edu/lumen/meded/medicine/pulmonar/pd/contents.htm

i am so impressed with you and your friends proactive determination to reason this out. you truly exemplify the process of problem solving in action. my hats off to you. i have no doubt that you are going to do well in our profession. you will all be in my thoughts and prayers. wouldn't it be great to ace the exam to the surprise of the instructor?

blur411 · Jun 13, 2008

UPDATE:

I studied a lot today, and I really enjoyed those web sites you posted! What great information! I will be keeping those just for reference in addition to my book!

I went to class (today was the last class before the final) and she told us that the two study guides she gave us are what the test is going to be on. She told us she likes to push us really hard throughout the semester and then take it easy on us for the final.

I'm sort of torn on this because when we were going over the answers I wanted to know more about some of the stuff because I was finding conflicting information, but everyone just wanted to answers.

I am glad that this will be easy only because I need the boost in the grade, but it doesnt mean I'm going to slack off. I'm glad I read the info you posted Daytonite, as well as my book and other research on line I feel smarter for doing so!

Again, I just wanted to thank you for all of your help and to let you know it won't go to waste even though we are going to have an "easier" exam!

:heartbeat

Daytonite, BSN, RN · Jun 14, 2008

I'm sure that's a relief. Now you know where you can get more specific assessment information geared toward disease.