Health Assessment Practice Questions (Test 1)good

The practitioner, entering the examining room to meet a patient for the first time, states "Hello, I'm M.M., and I'm here to gather some information. This will take about 30 minutes. D.D. is a student working with me. If it's all right with you, she will remain during the examination." Which of the following must be added to cover all aspects of the interview contract? A) A statement regarding confedentiality, patient costs and the expectations of each person B) the purpose of the interview and the role of the interviewer C) Time and place of the interviewer and a confedentiality statement D) An explicit purpose of the interview and a description of the physical examination including diagnostic studies

A) A statement regarding confedentiality, patient costs and the expectations of each person 8 items of information that should be comminicated to the client concerning the terms or expectations of the interview: 1. Time and place of the interview and succeeding physical examination 2. Introduction of yourself and a breif explanation of your role 3. The purpose of the interview 4. How long it will take 5. Expectation of participation of each person 6. Presence of any other people 7. Confidentiality 8. Any cost to the client (pg. 27 Jarvis)

Which best describes evidence-based nursing practice? A) Combining clinical expertise with the use of nursing research to provide the best care for patients while considering the patient's values and circumstances B) Appraising and looking at the implication of one or two articles as they relate to the culture and ethnicity of the patient C) Completing a literature search to find relevant articles that use nursing research to encourage nurses to use good practices D) Finding value-based resources to justify nursing actions when working with patients of diverse cultural backgrounds

A) Combining clinical expertise with the use of nursing research to provide the best care for patients while considering the patient's values and circumstances

______ is exhibiting an accurate understanding of the other person's feelings within a communication context A) Empathy B) Liking others C) Facilitation D) A Nonverbal listening technique

A) Empathy: means viewing the world from the other persons inner frame of reference while remaining you. Recognition of another persons feelings without criticism. (pg. 28 Jarvis)

You are reviewing concepts related to steps in the nursing process for determining prioritization and developing patient outcomes. To what are these actions attributed? A) Planning B) Assessment C) Implementation D) Diagnosis

A) Planning

You have reason to question reliability of the information being provided by a patient. One way to verify the reliabilty within the context of the interview is to: A) Rephrase the same questions later in the interview B) Review the patient's previous medical records C) Call the person identified as the emergency contact to verify the data provided D) Provide the patient with a printed history to complete and then compare the data provided

A) Rephrase the same questions later in the interview A reliable person always gives the same answer, even when restated or rephrased later in the interview (pg. 49 Jarvis)

Select the finding that most accurately describes apperance of a patient. A) Tense posture and restless activity. Clothing clean but not appropriate for season B) Oriented X 3. Affect appropriate for circumstances. C) Alert and responds to verbal stimuli. Tearful when diagnosis discussed. D) Laughing inapproprately, oriented X3

A) Tense posture and restless activity. Clothing clean but not appropriate for season

During an interview, a patient denies having anxiety. The patient frequently changes positions in the chair, hold his arms folded tight against his chest, and has little eye contact with the interviewer. The interviewer should: A) Use confrontation to bring the discrepency between verbal and nonverbal behavior to the patients attention B) Proceed with the interview. Patients usually are truthful with a health care practitioner C) Make a mental note to discuss the behavior after the physical examination is complete D) Proceed with the interview and examination as outlined on the agency assessment form. The patients behavior is appropriote for the circumstances

A) Use confrontation to bring the discrepency between verbal and nonverbal behavior to the patients attention Confrontation is used to clarify inconsistent information and focus the clients attention on an observed behavior, action or feeling (pg. 33 Jarvis)

When assessing mental status in children, what statement is true? A) all aspects of mental status in children are interrelated B) children are highly labile and instable until the age of 2 C) children's mental status is largely a function of thier parents' level of functioning until age 7 D) a childs mental status is impossible to assess until the child develops the ability to concentrate

A) all aspects of mental status in children are interrelated

A major characteristic of dementia is: A) impairment of short- and long-term memory B) hallucinations C) sudden onset symptoms D) substance-induced

A) impairment of short- and long-term memory

What does active listening NOT include? A) taking detailed notes during the interview B) watching for clues in body language C) repeating statements back to the person to make sure you have understood D) asking open-ended questions to explore the persons perspective

A) taking detailed notes during the interview Taking too many notes during an interview can be threatening to a patient when they are discussing sensitive issues, (i.e. drug use, sex) it breaks eye contact too often, and shifts your attention away from the patient. (pg. 3o Jarvis)

What is the best description of "review of systems" as a part of the health history? A) the evaluation of the past and present health state of each body system B) a documentation of the problem as described by the patient C) the recording of the objective findings of the practitioner D) a statement that describes the overall health state of the patient

A) the evaluation of the past and present health state of eacb body system

Knowledge of the use of personal space is helpful for the health care provider. Personal distance is generally considerd to be: A) 0 to 1.5 ft B) 1.5 to 4 ft C) 4 to 12 ft D) 12+ ft

B) 1.5 to 4 ft Functional use of space: 1.5 to 4 ft is personal distance, used for much of the physical assesssment (pg. 29 Jarvis)

Children usually come for health care with a parent. At about what age should the interviewer begin to question the child himself or herself regarding presenting symptoms? A) 4 B) 7 C) 9 D) 11

B) 7 Greet the child, but with younger children (1 to 6) focus more on the caregiver. (pg 36 Jarvis)

A patient is in the emergency department with nausea vomiting. Which would you include in the database? A) A complete health history and full physical examination B) A diet and GI history C) Previously identified problems D) Start collection of data in conjunction with livesaving measures

B) A diet and GI history

You conduct an admission interview. Because you are expecting a phone call, you stand near the door. Which would be a more appropriate approach? A) Arrange to have someone page you so you can sit on the side of the bed B) Have someone answer the phone so you can sit facing the patient C) Use this approach given the circumstances D) Arrange for time free of interuptions after the initial physical examination is complete

B) Have someone answer the phone so you can sit facing the patient Refuse Interruptions: Inform support staff of your interview and ask them not to interupt you during this time. Any interuption can destroy any rapport you had previously built. Sit eye level with patient and avoid barriers such as desks, and avoid standing, standing assumes superiority and takes away control from the patient. Keep a distance of 4 to 5 feet for personal space. (pg.29 Jarvis)

The expert nurse differs from the novice nurse by acting without consciously thinking about the actions. This is reffered to as: A) Deductive reasoning B) Intuition C) The nursing process D) Focus assessment

B) Intuition

During an interview with a patient diagnosed with a seizure disorder, the patient states, "I plan to be an airline pilot." If the patient continues to have this as a career goal after teaching regarding seizure disorders has been provided, you might question the patient's: A) Thought processes B) Judgement C) Attention span D) Recent memory

B) Judgement

What statement is an example of patients with dysarthria? A) When asked a question, the patient responds fluently but uses words incorrectly or makes up words so that speech may be incomprehensible B) The word choice and grammar are appropriate, but the sounds are disoriented so the speech is unintelligible C) The pitch and volume of words are difficult and the voice may be hoarse, but language is intact D) Comprehension is intact but there is difficulty in expressing thoughts, with nouns and verbs being the dominant word choices

B) The word choice and grammar are appropriate, but the sounds are disoriented so the speech is unintelligible

When taking a health history for a child, what information, in addition to that for an adult, is usually obtained? A) coping and stress management B) a review of immunizations recieved C) enviornmental hazards D) hospitalizations history

B) a review of immunizations received Children need to be more up-to-date and have more vaccine deadlines than older adults who have already recieved a majority of their vaccinations

During an initial interview, the examiner says, "Mrs. J., tell me what you do when your headaches occur?" This is an example of which type of information? A) the patient's perception of the problem B) aggravating or relieving factors C) the frequency of the problem D) the severity of the problem

B) aggravating or relieving factors What makes the pain worse, what makes it better? These questions are a part of the present health history or history of present illness (pg. 51)

With older adults, how should the examiner proceed with the interview? A) proceed in a more organized and concise manner B) consider the fatigue of the older person and break the interview into shorter segments C) ask a family member to complete some of the record while moving ahead with the interview D) raise your voice if the patient does not appear to hear you

B) consider the fatigue of the older person and break the interview into shorter segments Older patients have a longer more complicated health history and a longer story to tell during an interview, allow time for this by breaking up interviews, but be sure to collect the most important information first. (pg. 40 Jarvis)

One way to assess cognitive function and to screen dementia is with: A) the Proverb Interpretation Test B) the Mini-Cog C) the Denver II D) the Older Adult Behavioral Checklist

B) the Mini-Cog

Which demonstrates a good understanding of the interview process? A) the nurse stops the patient each time something is said that is not understood B) the nurse spends more time listening to the patient than talking C) the nurse is consistently thinking of his or her next response so the patient will know he or she is understood D) the nurse uses "why" questions to seek clarification of unusual symptoms or behaviors

B) the nurse spends more time listening to the patient than talking #8 on Ten Traps of Interviewing: Talking too much (pg. 34 Jarvis)

When interviewing a patient who does not speak English, the examiner should: A) take advantage of family members who are readily available and willing to assist B) use a qualified medical interpreter who is culturally literate C) seek as much information as possible and then continue with the physical examination D) wait until a qualified medical interpreter is availble before starting the interview

B) use a qualified medical interpreter who is culturally literate Before locating an interpreter, identify the language the person speaks at home. Be aware that this may vary from the language spoken in public. (pg. 45 Jarvis)

A patient has recently received health insurance and would like to know how often he should visit the provider. How do you respond? A) "It would be most efficient if you visit on an annual basis." B) "There is no recommendation for the frequency of health care visits." C) "Your visits may vary, depending on your level of wellness" D) "Your visits will be based on your preference."

C) "Your visits may vary, depending on your level of wellness"

Which is an appropriate recording of a patient's reason for seeking health care? A) Angina pectoris, duration 2 hours B) Subternal pain radiating to left axilla, 1 hour duration C) "grabbing" chest pain for 2 hours D) Pleurisy, 2 days duration

C) "grabbing" chest pain for 2 hours Reason for seeking care should be in the patients own words and NOT translated into a diagnosis or any kind. If the patient believes they have strep throat, ask them thier symptoms and record those instead or "strep throat." (pg. 50)

A patient asks the nurse, "May I ask you a question?" This is an example of: A) An open-ended question B) A reflective question C) A closed question D) A double-barreled question

C) A closed question: elicits a "yes" or "no" answer or a forced choice. **Avoid Double-barreled questions are questions that ask more than one question, to where a "yes" or "no" answer would not fully satisfy the question (pg. 32 Jarvis)

You are preparing the discharge plan for a patient with aphasia. What assessment should you include in the plan? A) Ask the patient to calculate serial 7s B) Ask the patient to name his or her grandchildren and thier birthdays C) Ask the patient to demostrate word comprehension by naming articles in the room or on the body as you point to them D) Ask the patient to interpret a proverb

C) Ask the patient to demostrate word comprehension by naming articles in the room or on the body as you point to them

You are reviewing assessment data of a 45 year old male patient and note pain of 8 on a scale of 10, labored breathing, and pale skin color on the electronic health record. This documentation is an example of: A) Hypothetical reasoning B) Diagnostic reasoning C) Data cluster D) Signs and symptoms

C) Data cluster

The concept of health and healing has evolved in recent years. Which is the best description of health? A) Health is the absence of disease B) Health is a dynamic process toward optimal functioning C) Health depends on an interaction of mind, body, and spirit within the enviornment D) Health is the prevention of disease

C) Health depends on an interaction of mind, body, and spirit within the enviornment

Which would be considered a risk diagnosis? A) Identifying existing levels of wellness B) Evaluating previous problems and goals C) Identifying potential problems the individual may develop D) Focusing on strengths and reflecting an individual's transition to higher levels of wellness

C) Identifying potential problems the individual may develop

On a patient's second day in an acute care hospital, the patient complains about the "bugs" on the bed. The bed is clean. This would be an example of altered: A) Thought processes B) Orientation C) Perception D) Higher intellectual funtion

C) Perception

During the evaluation phase of the nursing process, which action would be included? A) Validating the nursing diagnosis B) Establishing priorities related to patient care C) Providing information to the patient and family members D) Establishing a timeline for planned outcomes

C) Providing information to the patient and family members

Mr. B tells you "Everyone here ignores me." You respond, "Ignores you?" This technique is described as: A) Clairification B) Selective listening C) Reflecting D) Validation

C) Reflecting Reflecting echoes clients words by repeating part of what the person has just said. May help the person to elaborate. (pg. 33 Jarvis)

A patient says she is very nervous and nauseated, and she feels like she will vomit. This data would be what type of data? A) Objective B) Reflective C) Subjective D) Introspective

C) Subjective

What can be determined when the nurse clusters data as a part of the critical-thinking process? A) This step identifies problems that may be urgent and require immediate action B) This step involves making assumptions in the data C) The nurse recognizes relevant information among the data D) Risk factors can be determined so the nurse knows how to offer health teachings

C) The nurse recognizes relevant information among the data

Which would be included in a holistic model of assessment? A) nursing goals for the patient B) anticipated growth and development patterns C) a patients perception of his or her health status D) the nurses perception of disease related to the patient

C) a patients perception of his or her health status

Which two sections of the child's health history become separate sections because of their importance to the child's current health status? A) play activities and rest patterns B) prenatal and postnatal status C) developmental and nutritional history D) accidents, injuries, and immunzations

C) developmental and nutritional history Children have more developmental milestones and are going through a time of extreme change. It is important to go over a more detailed analysis of their developmental history as well as nutritional history. Nutrition is important in children because of nutritional milestones, breastmilk vs. formula and making sure the child is getting enough nutrients to reach their developmental milestones. (pg. 61)

A genogram is used for which reasons? A) past history B) past health history, specifically hospitalzations C) family history D) the 8 characteristics of presenting symtoms

C) family history

You are assessing a 75-year-old man. What is an expected finding? A) he will have no decrease in any of his abilities, including response time B) he will have difficulty on tests of remote memory because this typically decreases with age C) it may take him a little longer to respond but his general knowledge and abilities should not have declined D) he will have had a decrease in his response time due to language loss and a decrease in general knowledge

C) it may take him a little longer to respond but his general knowledge and abilities should not have declined

You are preforming a mental health status examination. Which assessments would be most appropriate? A) examining the patient's EEG B) observing the patient as he or she takes an IQ test C) observing the patient and inferring health or dysfunction D) examining the patient's response to a specific set of questions

C) observing the patient and inferring health or dysfunction

The statement "Reason for seeking care" has replaced the "chief complaint," this change is significant because: A) the "cheif complaint" is really a diagnostic statement B) the newer term allows another individual to supply the necessary information C) the newer term incorporates wellness needs D) the "reason for seeking care" can incorporate the history of the present illness

C) the newer term incorporates wellness needs Reason for seeking care could include reasons such as: 3-month follow up, physical exam, annual check-up... reasons that dont have an underlying "cheif complaint" from the patient

The nurse uses health promotion activities with a new patient. What would this focus include? A) the nurse would try to change the patients perceptions of disease B) the nurse would search for identification of biomedical model interventions C) the nurse would help to identify negative health acts of the patient D) The nurse would empower the patient to choose a healthier lifestyle

D) The nurse would empower the patient to choose a healthier lifestyle

While assessing a man for allergies, he states he is allergic to penicillin. Which response is best? A) "Are you allergic to any other drugs?" B) "How often have you recieved penicillan?" C) "I'll write your allergy on your chart so you won't recieve any" D) "Please describe what happens to you when you take penicillin."

D) "Please describe what happens to you when you take penicillin." Not all patients know what an allergy is, or may think having a distaste to something makes it an allergy. As health professionals we need to clarify what happens as a result of the allergen.

Which is an example of objective data? A) Patient's history of allergies B) Patient's use of medications at home C) Last menstrual period 1 month ago D) 2 X 5 cm scar present on the right lower forearm

D) 2 X 5 cm scar present on the right lower forearm

When reading a medical record, you see the following notation: Patient states "I have had a cold for about a week, and now I am having difficulty breathing." This is an example of: A) A past health history B) A review of systems C) A functional assessment D) A reason for seeking care

D) A reason for seeking care This is a brief, spontaneous statement in the person's own words that describes the reason for the visit (pg. 50)

Which would be included in the database for a new patient admission to a surgical unit? A) all subjective and objective data gathered by a health practitioner from a patient B) all objective data obtained from a patient through inspection, percussion, palpation, and auscultation C) a summary of a patient's record, including laboratory studies D) All subjective and objective, and data gathered from a patient and the results of any laboratory or diagnostic study completed

D) All subjective and objective, and data gathered from a patient and the results of any laboratory or diagnostic study completed

Although a full mental status examination may not be required, you must be aware of the 4 main headings of the assessment while performing the interview and physical examination. These headings are: A) Mood, affect, consciousness, and orientation B) Memory, attention, thought content, and perceptions C) Language, orientation, attention, and abstract reasoning D) Appereance, behavior, cognition, and thought process

D) Appereance, behavior, cognition, and thought process

Functional assessment measures how a person manages day-to-day activites. The impact of adoption on the dialy activities of a child is referred to as: A) Developmental history B) Instrumental activies for daily living C) Reason for seeking care D) Interpersonal relationship assessment

D) Interpersonal relationship assessment page 63

Which finding is considered to be subjective? A) temperature of 101.2 F B) pulse rate of 96 beats/min C) measured weight loss of 20 pounds since the previous measurement D) Pain lasting 2 hours

D) Pain lasting 2 hours

Which statement best describes interpretation as a communication technique? A) interpretation is the same as clarification B) interpretation is a summary of a statement made by the patient C) interpretation is used to focus on a particular aspect of what the patient has just said D) interpretation is based on the interviewer's inference from the data that have been presented

D) interpretation is based on the interviewer's inference from the data that have been presented Interpretation links events, makes associations and implies cause, not based on directly observations but instead on inference or conclusion, you interpretation may be incorrect but helps promt further discussion (pg. 33 Jarvis)

For what or with whom should touch be used during the interview? A) only with individuals from a western culture B) as a routine way of establishing contact with the person and communicating empathy C) only with patients of the same gender D) only if the interviewer knows the person well

D) only if the interviewer knows the person well "Do not use physical touch during the interview unless you know the person well and are sure how it will be interpreted" (pg. 36 Jarvis)

What is a priority assessment for aging adults? A) phobias B) general intelligence C) irrational thinking patterns D) sensory perceptive abilities

D) sensory perceptive abilities

Because of adolescents' developmental level, not all interviewing techniques can be used with them. Which techniques should be avoided? A) faciliation and clarification B) confrontation and explanation C) empathy and interpretations D) silence and reflection

D) silence and reflection

Which statement best describes the purpose of a health history? A) to provide an opportunity for interaction between the patient and examiner B) to provide a form for obtaining the patient's biographic information C) to document the normal and abnormal findings of a physical assessment D) to provide a database of subjective information about the patient's past and present health

D) to provide a database of subjective information about the patient's past and present health

You are assessing short-term cognitive function. Which assessment shows the ability to lay down new memories? A) noting whether the patient completes a thought without wandering B) a test of general knowledge C) a description of past medical history D) use of the Four Unrelated Words Test

D) use of the Four Unrelated Words Test