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Vaccines

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Proficiency Examination General Instructions

1. Be Prompt! Written excuse is required for appointment cancellations due to emergencies.

2. Dress Professionally! Lab coats are to be worn during the health provider-client interaction if you are the examiner. No Gum chewing!!!

3. Use appropriate communication techniques.

4. Use effective management! Organize the collection of history data to guide your physical exam.

5. Lab Partners – keep communication and responses clear and truthful. Please wear a bathing suit underneath your uniform. A hospital gown will be provided to you.

6. Proficiency Exam Performance Scores – students will have one opportunity to retest during the session in which the Health Assessment course is taken if total laboratory performance scores fall below 70%. a. Upon faculty recommendation, if a student is still unsuccessful after the initial retest, the student may receive an incomplete “I” for NUR 3069L and retest in the first week of the following semester. b. If a student is still unsuccessful after the second attempt, the student will receive a failing grade for NUR 3069L and must repeat the course.

7. Final Grade – students will receive their final grades in the mail and their final scores posted on Blackboard.

Recommended approach

1. Arrive 5 minutes early to familiarize yourself with supplies and equipment and to pose last minute questions. a. You will have 30 minutes to complete your exam (twenty-five minutes for hands on and 5- minutes to review or recap areas that may have been missed). 2. Select your system from the container provided. b. You are allowed 5 minutes to review your notes 3. Select supplies and equipment needed to conduct the exam and prepare exam station. 4. Introduce yourself to your client. 5. Wash your hands 6. Escort client to the examination area. 7. Collect biographical data and client history. 8. Conduct the client assessment. 9. Verbalize your assessment as you progress. 10. Summarize findings before indicating to the faculty that you have concluded the exam. 11. Document findings on the form provided and submit to examiner before leaving the testing area.

Proficiency Exam Results

Exam performed:

1. Head, neck (nodes), eyes, ears, nose, and throat

X_

2. External chest, heart, lungs, and blood vessels

3. Musculoskeletal-Neurological (Upper Body)

4. Musculoskeletal-Neurological (Lower Body)

Test Scores Part I: /30

Test Scores Part II: /70

Total possible demonstrated points: 100 points

Student demonstrated points:

Demonstrated all + and ++ steps: Yes No

Examiner recommendation (check one)

Exam successfully completed Unsuccessfully

* at least 70 out of 100 points completed exam * critical steps

Student signature:

Examiner signature:

EVALUATION FORM

NAME DATE EXAMINER

PART I: MAXIMUM SCORE 30 POINTS (HEENT, Neck, and Nodes)

SKILL STEPS DEMONSTRATED

YES NO POINTS

1. Introduces self to client/wash hands / 6

2. Takes accurate health history (must include all 6 areas) * chief complaint * history of present illness * past medical history * family history * personal social history * review of pertinent systems

3. Uses therapeutic communication techniques during the interview process (at least 2 of the following must be observed) * open and closed ended questions used appropriately * questions are simple and in easily understood language * avoids racial or culturally biased terminology.

4. Assess for immunization status

* Influenza * Tdap or Td
*Pneumococcal
*Meningococcal, etc.

5. Obtains vital signs * pulse * respirations * temperature * blood pressure (must be within +/- 2 for BP, P, R) * Pain score (must use correct pain scale) Subtotal points for part I: / 6

/ 6

/ 6

/ 6

/ 30

NAME DATE EXAMINER

PART II: MAXIMUM SCORE 70 POINTS HEENT, Neck, and Nodes)

SKILL STEPS DEMONSTRATED

YES NO POINTS

1. Applies Gloves Correctly

2. Gathers equipment * Stethoscope * Tongue blade * Otoscope
*Ophthalmoscope
*Penlight
*Tuning fork
*Drinking cup 3. Explains procedures / 5

/ 5

/ 5

4. Inspection / 10_

* Inspect hair and scalp * Inspect face for symmetry
*Inspect TMJ for swelling or redness
*Inspect sclera, cornea, iris, pupils, lens and conjunctiva
*Inspect lacrimal apparatus, nasal septum and turbinates
*Inspect gums, teeth,tongue, uvula and posterior pharynx
*Inspect external ear lobe, tragus, and mastoid process
*Inspect middle ear

5. Palpation / 10_

* Palpate skull and hair texture * Palpate TMJ for crepitus * Palpate sinuses [maxillary and frontal]
*Palpate the nasolacrimal duct

6. Assess the neck / 5

* Lymph nodes *Trachea and Thyroid 7. Assess Hearing / 5

* Rinne and Weber test *Whisper Test SKILL STEPS DEMONSTRATED

YES NO POINTS

8. Assess Vision /10

*Visual acuity [Snellen chart] + Jaeger
*Visual fields [by confrontation]
*Extraoccular movements [EOMs]
*Convergence]
*Ophthamoscopic exam (optic disc, fovea, macula)
*Light reflex

9. Performs correct sequence /5_

10. Summarizes exam findings in written documentation

Subtotal Points for Part II: /10_

/ 70

Examiner Comments:

Proficiency Exam Results

Exam performed:

1. Head, neck (nodes), eyes, ears, nose, and throat

2. External chest, heart, lungs, and blood vessels _X_

3. Musculoskeletal-Neurological (Upper Body)

4. Musculoskeletal-Neurological (Lower Body)

Test Scores Part I: /30

Test Scores Part II: /70

Total possible demonstrated points: 100 points

Student demonstrated points:

Demonstrated all + and ++ steps: Yes No

Examiner recommendation (check one)

Exam successfully completed * at least 70 out of 100 points Unsuccessfully completed

* critical steps

Student signature:

Examiner signature:

NAME DATE EXAMINER

PART I: MAXIMUM SCORE 30 POINTS (External chest, heart, lungs, and blood vessels) SKILL STEPS DEMONSTRATED YES NO POINTS

1. Introduces self to client/wash hands / 6

2. Takes accurate health history (must include all 6 areas) * chief complaint * history of present illness * past medical history * family history * personal social history * review of pertinent systems

3. Uses therapeutic communication techniques during the interview process (at least 2 of the following must be observed) * open and closed ended questions used appropriately * questions are simple and in easily understood language * avoids racial or culturally biased terminology.

4. Obtains accurate measurements

* weight * height
*BMI
(Must be within +/- 1/4)

5. Obtains vital signs * pulse * respirations * temperature * blood pressure (must be within +/- 2 for BP, P, R) * Pain score (must use correct pain scale) Subtotal points for part I:

/ 30 / 6

/ 6

/ 6

/ 6

NAME DATE EXAMINER

PART II: MAXIMUM SCORE 70 POINTS (External chest, heart, lungs, and blood vessels) SKILL STEPS DEMONSTRATED POINTS

YES NO

1. Applies Gloves Correctly

2. Gathers equipment * Stethoscope * Ruler * Skin marker

3. Explains procedures / 5

/ 5

/ 5

4. Inspection / 10

* Inspect chest landmarks * Inspect chest wall for pulsations, heaves, symmetry * Note respiratory pattern and movement * Inspect carotid arteries * Inspect extremities for color, hair distribution venous distention

5. Palpation / 10

* Palpate anterior and posterior chest bones and muscles for pulsations, pain, bulges, movement, depression, and position. * Palpate precordium, apex, left sternal border, and base. * Palpate for precordial thrills or vibrations. * Palpate tactile fremitus at bifurcation of bronchi by using palmar surfaces of fingers. * Palpate each carotid artery * Palpate temporal, brachial, radial, femoral, popliteal, dorsalis pedis, and posterior tibial pulse.

SKILL STEPS DEMONSTRATED

YES NO POINTS

6. Percussion

* Percuss anterior, posterior and lateral chest at 4-5 cm intervals, superior to inferior and medial to lateral chest wall. * Measure diaphragmatic excursion

7. Auscultation * Listen to breath sounds and vocal resonance * Listen to heart sounds with patient sitting, supine, and on left side. * Listen over aortic, pulmonic, mitral, tricuspid, apical, and epigastric area. * Describe rate, rhythm, duration of cycle, timing, intensity, murmurs, and quality. * Auscultate carotid arteries for bruits or murmurs.

8. Performs correct sequence / 10

/ 10

/ 5

9. Summarizes exam findings in written documentation

Subtotal Points for Part II: / 10

/ 70

Examiner Comments:

Proficiency Exam Results

Exam performed:

1. Head, neck (nodes), eyes, ears, nose, and throat

2. External chest, heart, lungs, and blood vessels

3. Musculoskeletal-Neurological (Upper Body) _X_

4. Musculoskeletal-Neurological (Lower Body)

Test Scores Part I: /30

Test Scores Part II: /70

Total possible demonstrated points: 100 points

Student demonstrated points:

Demonstrated all + and ++ steps: Yes No

Examiner recommendation (check one)

Exam successfully completed * at least 70 out of 100 points Unsuccessfully completed

* critical steps

Student signature:

Examiner signature:

NAME DATE EXAMINER

PART I: MAXIMUM SCORE 30 POINTS (Musculoskeletal/Neuro Upper Body)

SKILL STEPS DEMONSTRATED

YES NO POINTS

1. Introduces self to client/wash hands /6

2. Takes accurate health history (must include all 6 areas) * chief complaint * history of present illness * past medical history * family history * personal social history * review of pertinent systems

3. Uses therapeutic communication techniques during the interview process (at least 2 of the following must be observed) * Open and closed ended questions used appropriately * Questions are simple and in easily understood language * Avoids racial or culturally biased terminology.

4. Performs mental status Assessment /6

/6

/6

5. Obtains vital signs

* pulse * respirations * temperature * blood pressure
(Must be within +/- 2 for BP, P, R) * Pain score (must correct pain scale) Subtotal points for part I: Examiner Comments: /6

/30_

NAME DATE EXAMINER

PART II: MAXIMUM SCORE 70 POINTS (Musculoskeletal/Neuro Upper Body)

SKILL STEPS DEMONSTRATED POINTS YES NO POINTS

1. Applies Gloves Correctly

2. Gathers equipment * Goniometer * Ruler / tape measure * Skin marker * Percussion hammer * Cotton tip applicator

3. Explains procedures / 5

/ 5

/ 5

4. Inspection / 10_

* Inspect face for symmetry * Inspect TMJ for swelling or redness
*Inspect should and shoulder girdle
*Inspect elbow, wrist, and hand joints
*Inspect for erect position of head and
*coordinated neck movement

5. Palpation / 10_

* Palpate muscles of mastication * Palpate bony landmarks of the shoulder * Palpate the bicipital groove and tendon Palpate the olecranon process * Palpate the wrist and the radial/ulna bones * Palpate the fingers and thumb * Palpate the spinous process

6. Assess Range of Motion / 5

* Neck movement [flexion, hyperextension, lateral flexion, and rotation]
*Shoulder movement [extension, abduction, adduction, internal rotation, rotator cuff]
*Elbow movement [flexion, extension, supination, pronation]
*Wrist movement [flexion and extension]

.

SKILL STEPS DEMONSTRATED

YES NO POINTS

7. Test the Following / 5_

* Hand grip * Carpal tunnel [thumb abduction, Tinel’s sign, or Phalen’s sign]

8. Neurological Tests /10

*Finger-to-nose
*Stereognosis, graphesthesia, two-point discrimination
*Deep tendon reflexes [biceps, triceps, brachioradialis]

9. Performs correct sequence /5_

10. Summarizes exam findings in written documentation

Subtotal Points for Part II: /10_

/ 70

Examiner Comments:

Proficiency Exam Results

Exam performed:

1. Head, neck (nodes), eyes, ears, nose, and throat

2. External chest, heart, lungs, and blood vessels

3. Musculoskeletal-Neurological (Upper Body)

4. Musculoskeletal-Neurological (Lower Body) _X_

Test Scores Part I: /30

Test Scores Part II: /70

Total possible demonstrated points: 100 points

Student demonstrated points:

Demonstrated all + and ++ steps: Yes No

Examiner recommendation (check one)

Exam successfully completed * at least 70 out of 100 points Unsuccessfully completed

* critical steps Student signature:

Examiner signature:

NAME DATE EXAMINER

PART I: MAXIMUM SCORE 30 POINTS (Musculoskeletal/Neuro Lower Body)

SKILL STEPS DEMONSTRATED

YES NO POINTS

1. Introduces self to client/wash hands /6

2. Takes accurate health history (must include all 6 areas) * chief complaint * history of present illness * past medical history * family history * personal social history * review of pertinent systems

3. Uses therapeutic communication techniques during the interview process (at least 2 of the following must be observed) * Open and closed ended questions used appropriately * Questions are simple and in easily understood language * Avoids racial or culturally biased terminology.

4. Obtains accurate measurements

* weight * height
*BMI
(Must be within +/- 1/4)

5. Obtains vital signs * pulse * respirations * temperature * blood pressure
(Must be within +/- 2 for BP, P, R) * Pain score (must use correct pain scale)
Subtotal points for part I: Examiner Comments: /6

/6

/ 6

/6

/30_

NAME DATE EXAMINER

PART II: MAXIMUM SCORE 70 POINTS (Musculoskeletal/Neuro Lower Body)

SKILL STEPS DEMONSTRATED POINTS YES NO POINTS

1. Applies Gloves Correctly

2. Gathers equipment * Goniometer * Ruler / tape measure * Skin marker * Tuning fork * Cotton tip applicator

3. Explains procedures / 5

/ 5

/ 5

4. Inspection / 10_

* Inspect joint symmetry, alignment, bony deformities
*Inspect alignment and contour of the knee
*Inspect surface of ankles and feet
*Inspect surrounding tissues for skin changes, nodules, crepitus
*Inspect for inflammation or arthritis [swelling, warmth, redness]
*Inspect for posture and erect position.
*Inspect for scoliosis, lordosis, and kyphosis

5. Palpation / 10_

* Palpate bony landmarks [iliac crest, greater trochanter, hips] * Palpate bony landmarks of the knee * Palpate the spinous process of the vertebrae
*Palpate the heel for tenderness

6. Assess Range of Motion / 5

*Back movement [flexion, extension, lateral bending, and rotation]
*Ankle [flexion, extension, inversion, eversion]
*Knee movement [flexion, extension, internal and external rotation]

.

SKILL STEPS DEMONSTRATED

YES NO POINTS

7. Test the Following / 5_

* Bulge sign [for minor effusions] * Balloon sign [for major effusions]

8. Neurological Tests /10

*Romberg [balance and coordination]
* Two phases of gait [stance and swing]
*Deep tendon reflexes [Achilles, patella, plantar]
*Sensory stimuli [tactile touch, vibratory, position]
*Superficial and deep pain

9. Performs correct sequence /5_

10. Summarizes exam findings in written documentation

Subtotal Points for Part II: /10_

/ 70

Examiner Comments:

Date:

Name:

RE: Midterm Evaluation

This letter is to inform you that your performance in NUR 3069/L is unsatisfactory as of midterm. The following test results detail your performance: A. Theory Grade Average:

Online Unit Exam 1

Online Unit Exam 2

Online Unit Exam 3

Online Unit Exam 4

Online Unit Exam 5

Online Unit Exam 6

B. Laboratory course

Comments:

I acknowledge receipt of this letter.

Faculty

Student

Date:

Name:

RE: Final Evaluation

This letter is to inform you that you have not completed laboratory requirements in NUR 3069L and will receive an "I" letter grade if skills/ write-ups are not accomplished by . If "I" grade is not changed after one academic semester, it will convert to an "F" letter grade.

Your immediate attention to this matter is warranted.

I acknowledge receipt of this letter.

Faculty

Student

NAME DATE EXAMINER

PART II: MAXIMUM SCORE 70 POINTS

SKILL STEPS DEMONSTRATED

YES NO POINTS

1. Washes hands 5
(One minute) 2. Gathers equipment 5 3. Explains procedures 5 4. Inspection 10 5. Palpation 10 6. Percussion 10 7. Auscultation 10 8. Performs correct sequence 5 9. Summarizes exam findings 10 in written documentation

Subtotal Points for Part II: / 70

Examiner Comments:

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