You have recently returned from a medical missions trip to sub-Saharan Africa, where you learned a great deal about malaria. You decide to use some of the same questions and maneuvers in your “routine” when examining patients in the midwestern United States. You are disappointed to find that despite getting some positive answers and findings, on further workup, none of your patients has
malaria except one, who recently emigrated from Ghana. How should you next approach these questions and maneuvers?
A) Continue asking these questions in a more selective way.
B) Stop asking these questions, because they are low yield.
C) Question the validity of the questions.
D) Ask these questions of all your patients.
A) Continue asking these questions in a more selective way.
The predictive value of a positive finding depends upon the prevalence of a given disease in a population. The prevalence of malaria in the Midwest is almost zero, except in people immigrating from areas of high prevalence. You will waste time and resources applying these questions and maneuvers to all patients. It would be wise to continue applying what you learned to those who are from areas of high prevalence of a given disease. Likewise, physicians from Ghana should not ask about signs or symptoms of multiple sclerosis, as it is found almost exclusively in northern latitudes. You will learn to tailor your examination to the population you are serving.
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To determine a patient's costal angle, you should visually estimate the angle formed by the
a. articulation of the manubrium and body of the sternum; it is continuous with the second rib. b. costal ribs and the vertebrae. c. right and left costal margins where they meet at the xiphoid process. d. vertebrosternal ribs during inhalation.
A gerontologic nurse is assessing a patient who has numerous comorbid health problems. What assessment findings should prompt the nurse to suspect a UTI? Select all that apply
A) Food cravings B) Upper abdominal pain C) Insatiable thirst D) Uncharacteristic fatigue E) New onset of confusion
A nurse is writing learning outcomes for a client recovering from severe burns. Which of the following verbs would be good choices to use when preparing outcomes related to learning how to change dressings? Select all that apply
A) Assembles B) Demonstrates C) Gives examples D) Identifies E) Chooses