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Name: __________________________________________ Date: _____________ Score: _____________
Procedure 37–4 Steps
Start Time: End Time: Total Time:
Steps
Possible
Points
First
Attempt
Second
Attempt
Third
Attempt
1. Check the examination room for cleanliness.
Incorporate critical thinking skills in performing
patient assessment and care.
15
2. Identify the patient and introduce yourself. 15
3.
Explain to the patient the rationale for performance of
the procedure.
15
4. Give clear instructions to the patient regarding the
amount of clothing to be removed and where it is to be
placed, and instruct the patient in the use of the gown.
15
5. Assist the patient with gown if help is needed. 15
6. Assist the patient onto the examination table if help is
needed.
15
7. Explain to the patient the necessary exam and the
position required.
15
8. Assist the patient into the required position:
• Anatomical
15
• Sitting
15
• Horizontal recumbent (supine)
15
• Dorsal recumbent
15
• Prone
15
• Sims’
15
• Knee-chest
15
• Trendelenburg
15
• Fowler’s
15
• Semi-Fowler’s
15
• Lithotomy
15
9. Drape the sheet evenly over the patient, but leave loose
on all sides.
15
10. Assist the patient from the table when the examination is
complete.
15
Points Awarded / Points Possible _____/
300
