Health Assessment Skills Check-Off Exam

Health Assessment Skills Check-Off Exam
Directions: This form will be used to evaluate your performance during the final physical exam assessment. Present this form to the adjunct faculty/instructor prior to the start of your exam.
Tips for successful preparation:
• Watch the GCU Head-to-Toe video two or three times per week. This video is used for the advanced practice nursing students; however, it demonstrates appropriate technique for all of the skills on this check-off.
• Practice the assessment skills 30-60 minutes daily.
• Incorporate YouTube videos on all assessment skills and techniques.
• Ask questions.
• Familiarize yourself with all areas on the form; remaining systematic and organized.
• Develop a flow and time yourself.
• Practice until you are comfortable.
• Refer to the rubric in the classroom on the required details to each area of this check-off.
• You will be given 60 minutes to complete this check-off.
There are 250 possible points. You are required to achieve a 76% (190 points) as the minimum score on this exam. You will have two attempts to successfully pass this check-off. If you do not achieve 76% on the initial Skills Check-Off Exam, you will be required to remediate and repeat the needed areas of improvement.
Points will be earned based on successful completion of each item/task, as well as display of technical skill (where applicable).
Name:
E-mail: Date:
Evaluator (Adjunct faculty/instructor)
Instructor: Performance:
Pass ______ Grade: ______
No Pass _____
Remediation Required
Completed Remediation:
Yes_________ No__________ NA ________
Performance:
Initial: _____ Retest: ______ NA ________
Final Physical Exam Assessment
Directions: This form will be used by the faculty to evaluate your performance during the final physical exam assessment. Present this form to the faculty prior to the start of your exam. Points will be earned based on successful completion of each item/task, as well as display of technical skill (where applicable).
Initial Approach and History Taking Points Possible Points Earned
Introduce self, identify role, explain intent for exam, gather supplies, wash hands. 2
Obtain patient identification information – Age, gender, race, date of birth. 2
Complete an HPI workup using OPQRST. 6
Total for Initial Approach and History Taking (Out of 10)
Past Medical History Points Possible Points Earned
General Health – Include last dates/findings of exams 2
Chronic Illness – What, when, how treated 2
Infectious Diseases 2
Allergies 2
Surgery – Type, complications, anesthesia 2
Injuries 2
Previous Hospitalizations 2
Immunizations 2
Female – GYN 2
Male and Female 2
Total for Past Medical History (Out of 20)
Family History Points Possible Points Earned
Grandparents, parents, siblings, children – Health status, age, cause of death 2
CVD 2
Neurological 2
Pulmonary 2
Endocrine 2
Osteoporosis 2
Obesity 2
Cancer 2
Bleeding Disorders 2
Mental/Emotional 2
Seizures 2
Substance Abuse 2
Total for Family History (Out of 24)
Social History Points Possible Points Earned
Place of Birth 2
Nationality/Ethnicity 2
Marital Status 2
Occupation 2
Military History 2
Social and Economic Status 2
Habits 2
Tobacco/Alcohol/Drug Use 2
Emotional, Sleep 2
Violence and Safety 2
Children 2
Total for Social History (Out of 22)
Review of Systems Points Possible Points Earned
Constitutional 2
Eyes 3
ENT/Mouth 3
Cardiovascular 3
Respiratory 3
GI 3
GU 3
M/S 3
Skin/Breasts 3
Neurologic 3
Psychiatric 3
Endocrine 3
Hem/Lymph 3
Allergic/Immunologic 3
Total for Review of Systems (Out of 41)
Initial Physical Exam Points Possible Points Earned
General Appearance 2
Assess Vital Signs 2
Total for Initial Physical Exam (Out of 4)
Exam of Head and Neck Points Possible Points Earned
Inspect and Palpate head
Describe normal findings
Cranium palpate shape, appearance, hair/scalp appearance 3
Name all cranial nerves and demonstrate appropriate assessment testing for all Cranial nerves I-XII 12
Neck – Demonstrate thyroid exam
Palpate and name all lymph nodes of the neck. 7
Opthalmascopic Exam 5
Ears 5
Nose 5
Mouth/Throat 6
Total for Exam of Head and Neck (Out of 43)
Exam of Posterior Thorax Points Possible Points Earned
Inspect Skin 2
Inspect Thorax and AP Diameter 5
Palpate Spine 2
CVA Assessment 2
Auscultate Lung Fields 2
Total for Exam of Posterior Thorax (Out of 13)
Exam of Anterior Thorax Points Possible Points Earned
Inspect Skin 2
Skin Turgor 2
Palpate Ribs and Sternum 2
Auscultate Lung Sounds 2
Auscultate heart first sitting then lying down 7
Teach BSE 2
Total for Exam of Anterior Thorax (Out of 17)
Exam of Abdomen Points Possible Points Earned
Inspect Abdomen 2
Auscultate BS 4 quadrants + assess for bruits in pertinent locations 8
Percuss abdomen including liver and spleen 2
Palpate light and deep 4 quadrants, liver, spleen, kidneys 7
Assess pulses and lymph nodes 2
Teach Male TSE 2
Total for Exam of Abdomen (Out of 23)
Exam of Upper Extremities Points Possible Points Earned
Inspect Skin 2
ROM and Muscle Strength 3
Palpate and name lymph nodes 2
Name and demonstrate assessment of DTRs 3
Sensory Assessment 2
Assess and name location of pulses, capillary refill 3
Total for Exam of Upper Extremities (Out of 15)
Exam of Lower Extremities Points Possible Points Earned
Inspect skin 2
ROM and Muscle Strength 5
Scoliosis Check 2
Name and Demonstrate assessment of DTRs 2
Sensory Assessment 2
Assess gait, coordination and balance – which tests 2
Assess and name location of pulses 3
Total for Exam of Lower Extremities (Out of 18)
The overall summary of your performance on the Final Physical Exam Assessment is presented below. Section totals are transferred to the table below from the information recorded above.
SECTION PERFORMANCE SECTION TOTAL
Initial Approach and History Taking
Past Medical History
Family History
Social History
Review of Systems
Initial Physical Exam
Exam of Head and Neck
Exam of Posterior Thorax
Exam of Anterior Thorax
Exam of Abdomen
Exam of Upper Extremities
Exam of Lower Extremities
SUMMARY OF OVERALL PERFORMANCE:
Student Signature: ______________________________________ Date ______________
Evaluator Signature: ____________________________________ Date ______________
Remediation Plan:
_______ Evaluator reviewed and demonstrated areas of needed improvement.
_______ I will review my notes from the readings and class.
_______ I will spend ____ hours preparing and practicing for the repeat exam
in 7-10 days.
_______ I will schedule my repeat assessment check off in 7-10 days.
__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
Student Signature: _______________________________________ Date ______________
Evaluator Signature: _____________________________________ Date ______________
Review Details
Take a moment to review the details of this assignment below and gather any necessary files. Once you're ready to submit your assignment, move on to Step 2.
Assessment Description
Read the "NUR-643E Procedures for Advanced Health Assessment Check-Offs" and submit your response below in this forum within the allotted timeframe for completion:
Procedures for Advanced Health Assessment Check-Offs Acknowledgement:
I, (INSERT NAME), verify that I have read, understand, and will comply with the requirements set forth in the "NUR-643E Procedures for Advanced Health Assessment Check-Offs" document.