NURS 3108 Final Exam Study Guide

Order of Assessment

• Typical: Inspection → Palpation → Percussion → Auscultation

• Abdomen: Inspection → Auscultation → Percussion → Palpation

A&P & Life Span Differences

• Infants: Large head-to-body ratio, softer bones, rapid growth.

• Adolescents: Growth spurts, hormonal changes, scoliosis screening.

• Pregnancy: Lordosis, increased blood volume, breast/nipple changes.

• Older Adults: Decreased skin elasticity, slower reflexes, sensory decline.

Key Health History Questions

• HPI: "Can you describe the pain?"

• PMH: "Have you had this condition before?"

• FMH: "Any family history of heart disease?"

• Social: Smoking, alcohol, occupation, living conditions

Prioritization

• ABCs: Airway, Breathing, Circulation

Musculoskeletal System

• Risk Factors:

  • Osteoarthritis: Age, obesity, joint overuse

  • Osteoporosis: Postmenopausal women, low calcium/vitamin D, inactivity, smoking

• Joint & Muscle Assessment:

  • ROM: Active vs. passive - flexion, extension, etc.

  • Muscle Strength: Graded 0 (no movement) to 5 (full strength)

Neurovascular Assessment

• 6 Ps: Pain, Pallor, Pulses, Paresthesia, Paralysis, Poikilothermia

Musculoskeletal Terms

• Dorsiflexion: Toes toward shin

• Hypertrophy: Muscle enlargement

• Atrophy: Muscle wasting

• Supination: Palm up

• Pronation: Palm down

• Inversion/Eversion: Sole of foot inward/outward

• Flexion/Extension: Bending/Straightening

• Adduction/Abduction: Toward/Away from midline

• Kyphosis/Lordosis/Scoliosis: Spine curvatures

• ADLs: Activities of Daily Living (eating, bathing, dressing)

Neurovascular System - Cranial Nerves

• CN I (Olfactory) – Smell (Sensory)

• CN II (Optic) – Vision (Sensory)

• CN III, IV, VI – Eye movements (Motor)

• CN V – Facial sensation/mastication (Both)

• CN VII – Facial movement/taste (Both)

• CN VIII – Hearing/balance (Sensory)

• CN IX, X – Swallowing, gag (Both)

• CN XI – Shoulder/shrug (Motor)

• CN XII – Tongue movement (Motor)

Stroke Risk Factors

• Hypertension, smoking, atrial fibrillation, diabetes, obesity, inactivity

Proprioception/Balance/Gait

• Romberg test, heel-to-toe walking, tandem walking

Reflexes

• Babinski: Abnormal in adults (toes fan out)

• Abdominal/Cremasteric: Local spinal reflexes

• DTRs: 0 = absent, 1+ = diminished, 2+ = normal, 3+ = brisk, 4+ = hyperactive

• PERRLA: Pupils Equal, Round, Reactive to Light & Accommodation

Key Terms

• Autonomic: Involuntary control (e.g., heart, digestion)

• Sympathetic: “Fight or flight”

• Parasympathetic: “Rest and digest”

• Expressive Aphasia: Can't express speech (Broca's)

• Receptive Aphasia: Can't comprehend speech (Wernicke’s)

Dizziness vs. Vertigo vs. Meniere’s

• Dizziness: Lightheadedness

• Vertigo: Spinning sensation

• Meniere’s: Episodic vertigo, tinnitus, hearing loss

Myasthenia Gravis vs. Guillain-Barré

• MG: Autoimmune, weakness worsens with activity

• GBS: Post-viral, ascending paralysis

HEENT Risk Factors

• Cataracts: Age, smoking, UV light, diabetes

• Glaucoma: Age, race (African American), family history

Vision Tests

• Snellen Chart: Distant vision

• Rosenbaum: Near vision

• Confrontation: Peripheral vision

• Corneal Light Reflex, Cover Test: Eye alignment

Key Terms

• Exophthalmos: Protruding eyes (hyperthyroidism)

• Hordeolum: Stye

• Strabismus: Crossed eyes

• Macular Degeneration: Central vision loss

Hearing Tests

• Whisper: High-frequency loss

• Rinne: Air > bone conduction (normal)

• Weber: Sound lateralization

Lymphatic System Functions

• Drainage of interstitial fluid, immune defense, absorption of fats

Node Chains

• Preauricular, Postauricular, Submandibular, Submental, Sublingual, Occipital, Anterior/Posterior Cervical, Supraclavicular

Lymphatic Terms

• Lymphadenopathy: Enlarged nodes

• Lymphadenitis: Inflamed nodes

• Lymphangitis: Inflamed lymph vessels

• Lymphedema: Swelling due to lymph blockage

Genitalia, Rectum, Anus - Female Cancers

• Cervical: HPV, early sex, smoking

• Ovarian: Age, BRCA mutation, nulliparity

• Endometrial: Obesity, estrogen therapy, late menopause

Male Cancers

• Prostate: Age >50, African American, family history

• Anal: HPV, receptive anal intercourse, smoking

Conditions to Know

• Rectal Fissure: Painful tear

• Hemorrhoids: Swollen veins

• Prostatitis: Painful urination, pelvic pain

• BPH: Enlarged prostate, urinary hesitancy

Breast Cancer Risk Factors

• Age, family history, BRCA, early menarche, late menopause

Breast Exam

• Use pads of fingers, small circular motion, vertical strip method, inspect with arms at sides, over head, hands on hips, leaning forward