Chapter 4 quiz questions

During the interview process, the nurse obtains what type of data from the client? a. Primary b. Secondary c. Objective d. Oral

a. Primary

When assessing the gastrointestinal system, the nurse correctly asks, "Do you have any trouble swallowing?" True False

True

Which observation would cause the nurse to suspect an abusive situation? Select all that apply. a. A child is persistent in trying to please a parent. b. A caregiver of a cognitively intact older adult dominates the interview. c. A pre-schooler rubs her perineum and complains of it hurting. d. The explanation of an injury seems appropriate. e. A parent allows the adolescent to speak privately with the nurse.

a. A child is persistent in trying to please a parent. b. A caregiver of a cognitively intact older adult dominates the interview. c. A pre-schooler rubs her perineum and complains of it hurting.

The nurse documents that a client completed a 4-year college program and speaks English. How will this information be used? a. Determine health literacy b. Validate the client's stated age c. Understand choice of occupation d. Analyze the client's lifestyle patterns

a. Determine health literacy

A client comes to the community clinic seeking help for acute low back pain. Which type of assessment should the nurse complete for this client? a. focused b. follow-up c. emergency d. comprehensive

a. focused

During the review of systems, a client reports dizziness, tingling, and mood changes. In which area should the nurse document this information? a. Neurologic b. . Psychiatric c. Cardiovascular d. Fluid and electrolytes

a. Neurologic

When recording the client's chief concerns during the health history, it is recommended that the interviewer do which of the following? a. Quote the client's words. b. Summarize the client's words. c. Paraphrase the client's words. d. Describe the client's concerns and health goals.

a. Quote the client's words.

comprehensive health history includes which components? Select all that apply. a. Reason for seeking care b. History of present illness c. Past health history d. Employment history e. Income

a. Reason for seeking care b. History of present illness c. Past health history

A patient has come to the physician's office several times in the last month with a black eye, bruises, and lacerations on the lower extremities. The patient always explains having fallen and tripped. The nurse suspects abuse. The next step should be to: a. Report the findings to a supervisor. b. Call social services. c. Call the police. d. Confront the patient.

a. Report the findings to a supervisor.

The nurse is assessing an older adult client a hospice unit. The client cannot speak or communicate, but the client's daughter is there and answers all the questions as best as she can. What type of data source is the daughter? a. Secondary b. Primary c. Tertiary d. Subjective

a. Secondary

During the comprehensive health assessment, the nurse asks several questions relating to the client's family history of illnesses, such as diabetes and cancer. Why does the nurse do this? Select all that apply. a. To help identify those diseases for which the client may be at risk b. To provide counseling and health teaching in high-risk areas c. To identify genetic family trends for which the client is at risk d. To elicit negative family history To help the client feel at ease and not worry about being sick

a. To help identify those diseases for which the client may be at risk b. To provide counseling and health teaching in high-risk areas c. To identify genetic family trends for which the client is at risk

The nurse is asking the patient about the health of her parents, siblings, and grandparents. This is part of the health history and is done for what reason? a. To identify diseases for which the patient may be at risk b. To get to know the patient better c. To establish personal rapport with the patient d.To assess the patient's quality of life

a. To identify diseases for which the patient may be at risk

A pregnant woman comes to the physician's office for her first prenatal visit. The nurse knows the importance of performing a comprehensive health history in this case and understands the following must be included (check all that apply): a. information about current pregnancy b. food preferences c. previous pregnancies d. obstetrical and gynecological history e. family history

a. information about current pregnancy c. previous pregnancies d. obstetrical and gynecological history e. family history

A patient comes to the emergency department with severe abdominal pain. When performing a complete assessment, the nurse would focus on which of the following areas when covering past health history? a. previous medical and surgical problems b. aggravating factors of the pain c. duration of the pain d. intensity of the pain

a. previous medical and surgical problems

While discussing family history with a patient who is healthy except for a current UTI requiring IV antibiotics, the patient tells the nurse that he has three sisters and two brothers. Two of his sisters have died and one brother is in a nursing home after a stroke. The nurse would include the sibling group in a genogram in what manner? a. 3 circles and 3 squares with lines through 2 circles b. 3 circles and 3 squares with lines through 2 squares c. 3 circles and 3 squares with broken lines connecting 2 of the circles d. 3 circles and 3 squares with two diagonal slashed lines through lines connecting the 2 deceased siblings

b. 3 circles and 3 squares with lines through 2 squares

The nurse is assessing a client's lifestyle and habits. At which time should the nurse assess the client for alcohol use? a. During the review of systems b. After assessing for cigarette use c. Before assessing for vaccinations d.While completing the family history

b. After assessing for cigarette use

During a health history, a client reports drinking bloody Mary's several mornings a week before going to work. In which part of the CAGE questionnaire should the nurse document this information? a. Annoyance b. Eye-openers c. Cutting down d. Guilty feelings

b. Eye-openers

A genogram is developed to visually show what? a. Family tree b. Family health patterns c. Family relationships d. Nationalities of family members

b. Family health patterns

In the closing phase of the interview process, the nurse analyzes the data collected for what priority reason? a. Establish a baseline from which to start interviewing the family b. Identifying the primary problems or patterns of concern c. Communicate information to the physician d. Communicate information to other staff members

b. Identifying the primary problems or patterns of concern

A client is describing a very personal part of her history very quickly and in great detail. How should the nurse react to this? a. Write down as much as possible, as quickly as possible. b. Ask her to repeat key phrases or to pause at regular intervals, so the nurse can writed down almost every word. c. Tell her that she can go over the note later to make sure it is accurate. d. Push away from the keyboard or put down the pen.

d. Push away from the keyboard or put down the pen.

A client says that food is not important and meals are not enjoyable. Where should the nurse document this information? a. past medical history b. nutrition health pattern c. history of present illness d. gastrointestinal review of systems

b. nutrition health pattern

A nurse draws a genogram to help organize and illustrate a client's family history. Which shape is a standard format for representing a deceased female relative? a. Simple circle b. Simple square c. Circle with a cross d. Square with a cross

c. Circle with a cross

A patient arrives at the Emergency Department reporting shortness of breath. She is cyanotic with bilateral wheezing. The patient begins to gasp for air and cannot speak. The nurse begins to gather information so that interventions can resolve the immediate breathing problem. Her assessment and interventions are concurrent. The nurse is performing what type of health history? a. Focused b. Comprehensive c. Emergency d. Primary

c. Emergency

The patient is being interviewed upon arrival in the Emergency Department. When collecting subjective data from the patient, the nurse is obtaining what other type of data from the patient? a. Secondary b. Objective c. Primary d. Tertiary

c. Primary

As a nursing student you learn that mastering all the components of the comprehensive history provides what? a. Empathy b. Advocacy c. Proficiency d. Authority

c. Proficiency

During the health history inquiry about alcohol intake, which of the following is a CAGE question? a. "How often do you have a hangover?" b. "How many days per week do you drink?" c. "Describe the types of alcohol that you prefer." d. "Have you ever felt annoyed by criticism about drinking?"

d. "Have you ever felt annoyed by criticism about drinking?"

A client reports pain as being 7 on a scale from 1 to 10. In which area of the symptom should the nurse document this information? a. Onset b. Location c. Duration d. Characteristic

d. Characteristic

The nurse understands that health promotion is a very important part of nursing care. When performing the health history, there are many different opportunities for the nurse to teach healthy behaviors. One way the nurse can do this is by focusing on which of the following topics: a. gender b. spirituality c. culture d. sexual history and pattern

d. sexual history and pattern

The nurse would document driving with car seatbelt fastened, bicycling with properly-fitted helmet, and installing a smoke detector in a vacation home in the client's health history under which of the following? a. Identifying data b. Reliability c. Review of systems d.Personal and social history

d.Personal and social history