Red Flags
An older adult presents with new confusion but normal vital signs. Why is this concerning?
Early sign of delirium, hypoxia, or infection—not normal aging
Lower baseline temperature in older adults—expected or unexpected?
Expected
You cannot palpate a radial pulse. What is your next step?
Assess apical pulse
What is the correct order of abdominal assessment and why?
Inspect → auscultate → palpate (to avoid altering bowel sounds)
Crackles in lungs are commonly associated with what condition?
Fluid overload/heart failure
A patient has SpO₂ of 89% but is texting and not in distress. What is your concern?
Hypoxemia—objective data overrides appearance
Irregular bordered mole—expected or unexpected?
Unexpected: possible malignancy
You hear crackles during lung auscultation. What should you have the patient do?
Cough and reassess
Give an example of an open-ended question.
“Can you tell me more about your symptoms?”
Poor skin turgor indicates what?
Dehydration
Rigid abdomen with rebound tenderness suggests what condition?
Peritonitis (medical emergency)
S3 heart sound in an older adult—expected or unexpected?
Often expected due to decreased ventricular compliance
A patient does not speak English well. What is your responsibility?
Use a certified medical interpreter
What is proper technique for auscultation?
Use diaphragm, direct skin contact, systematic pattern
Why are older adults prone to orthostatic hypotension?
Decreased cardiovascular compensation
Pediatric patient with nasal flaring and retractions—what does this indicate?
Respiratory distress
HR 140 in a toddler—expected or unexpected?
Expected - age related norm
Patient is embarrassed during GU exam. What is the best response?
Maintain professionalism, reassure, explain, preserve dignity
How long should you auscultate if bowel sounds are absent?
Up to 5 minutes
Post-void residual >100 mL suggests what?
Urinary retention
Why is tachycardia often seen before hypotension in shock?
Compensatory mechanism to maintain cardiac output
Fundal height significantly larger than gestational age—expected or unexpected?
Unexpected (macrosomia, polyhydramnios)
You note altered level of consciousness. What is your priority?
Immediate assessment and escalation (ABCs)
What is an example of poor documentation?
Vague terms like “normal” without specifics
Pediatric patient with poor feeding and lethargy—what is the concern?
Serious illness/dehydration → requires evaluation