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Advanced Health Assessment and Differential Diagnosis: Essentials
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for Clinical Practice
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Karen Myrick, and Laima Karosas
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1st Edition
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,Table of Contents
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Chapter 1. Health History, The Patient Interview, And Motivational Interviewing
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Chapter 2. Advanced Health Assessment of the Head, Neck, and Lymphatic System
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Chapter 3. Advanced Health Assessment of the Nose, Mouth, and Throat
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Chapter 4. Advanced Health Assessment of the Eyes and Ears
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Chapter 5. Advanced Health Assessment of Skin, Hair, and Nails
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Chapter 6. Advanced Health Assessment of the Cardiovascular System
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Chapter 7. Advanced Health Assessment of the Respiratory System
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Chapter 8. Advanced Health Assessment of the Abdomen, Rectum, and Anus
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Chapter 9. Advanced Health Assessment of the Male Genitourinary System
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Chapter 10. Advanced Assessment of the Female Reproductive System
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Chapter 11. Advanced Health Assessment of the Neurological System
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Chapter 12. Advanced Health Assessment of the Musculoskeletal System
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, Test Bank - cn cn
Advanced Health Assessment and Differential Diagnosis, 1st Edition (Myrick, 2020)
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Chapter 1. Health History, The Patient Interview, And Motivational Interviewing
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MULTIPLE CHOICE cn
1. The nurse is preparing to conduct a health history. Which of these statements best describes the
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purpose of a health history? cn cn cn cn
a. To provide an opportunity for interaction between the patient and the nurse
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b. To provide a form for obtaining the patients biographic information
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c. To document the normal and abnormal findings of a physical assessment
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d. To provide a database of subjective information about the patients past and current health
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ANS: D c n
The purpose of the health history is to collect subjective data what the person says about him or hersel
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f. The other options are not correct.
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DIF: Cognitive Level: Understanding (Comprehension) cn cn cn
REF: dm. 49 MSC: Client Needs: Safe and Effective Care Environmen c n cn cn c n cn cn cn cn cn cn
t: Management of Care
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2. When the nurse is evaluating the reliability of a patients responses, which of these statements would be
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correct? The patient: cn cn
a. Has a history of drug abuse and therefore is not reliable.
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b. Provided consistent information and therefore is reliable. cn cn cn cn cn cn
c. Smiled throughout interview and therefore is assumed reliable. cn cn cn cn cn cn cn
d. Would not answer questions concerning stress and therefore is not reliable.
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ANS: B c n
A reliable person always gives the same answers, even when questions are rephrased or are repeated l
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ater in the interview. The other s t a t W
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noS
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ct.S cn cn cn cn cn
DIF: Cognitive Level: Applying (Application) cn cn cn
REF: dm. 49 MSC: Client Needs: Safe and Effective Care Environmen c n cn cn c n cn cn cn cn cn cn
t: Management of Care
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3. A 59-year-cn
old patient tells the nurse that he has ulcerative colitis. He has been having black stools for the last 24
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hours. How would the nurse best document his reason for seeking care?
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a. J.M. is a 59-year-old man seeking treatment for ulcerative colitis.
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b. J.M. came into the clinic complaining of having black stools for the past 24 hours.
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c. J.M. is a 59-year-old man who states that he has ulcerative colitis and wants it checked.
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d. J.M. is a 59-year- cn cn cn
old man who states that he has been having black stools for the past 24 hours.
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ANS: D c n
The reason for seeking care is a brief spontaneous statement in the persons own words that describes t
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he reason for the visit. It states one (possibly two) signs or symptoms and their duration. It is enclosed i
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n quotation marks to indicate the persons exact words.
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DIF: Cognitive Level: Applying (Application) cn cn cn
REF: dm. 50 MSC: Client Needs: Safe and Effective Care Environmen c n cn cn c n cn cn cn cn cn cn
t: Management of Care
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4. A patient tells the nurse that she has had abdominal pain for the past week. What would be the nurses
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best response?
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a. Can you point to where it hurts? cn cn cn cn cn cn
b. Well talk more about that later in the interview. cn cn cn cn cn cn cn cn
c. What have you had to eat in the last 24 hours? cn cn cn cn cn cn cn cn cn cn
1|Page
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, Test Bank - cn cn
Advanced Health Assessment and Differential Diagnosis, 1st Edition (Myrick, 2020)
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d. Have you ever had any surgeries on your abdomen?
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ANS: A c n
A final summary of any symptom the person has should include, along with seven other critical character
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istics, Location: specific. The person is asked to point to the location.
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DIF: Cognitive Level: Applying (Application) cn cn cn
REF: dm. 50 MSC: Client Needs: Safe and Effective Care Environmen
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t: Management of Care
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5. A 29-year-cn
old woman tells the nurse that she has excruciating pain in her back. Which would be the nurses app
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ropriate response to the womans statement? cn cn cn cn cn
a. How does your family react to your pain? cn cn cn cn cn cn cn
b. The pain must be terrible. You probably pinched a nerve.
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c. Ive had back pain myself, and it can be excruciating.
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d. How would you say the pain affects your ability to do your daily activities?
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ANS: D c n
The symptom of pain is difficult to quantify because of individual interpretation. With pain, adjectives sh
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ould be avoided and the patient should be asked how the pain affects his or her daily activities. The other
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responses are not appropriate.
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DIF: Cognitive Level: Applying (Application) cn cn cn
REF: dm. 50 MSC: Client Needs: Safe and Effective Care Environmen
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t: Management of Care
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6. In recording the childhood illnesses of a patient who denies having had any, which note by the nurse
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would be most accurate? cn cn cn
a. Patient denies usual childhood illnesses. cn cn cn cn
b. Patient states he was a very healthy child. cn cn cn cn cn cn cn
c. Patient states his sister had measles, but he didnt. cn cn cn cn cn cn cn cn
d. Patient denies measles, mumps,Wr uWbeWll .
a, T
chB
ickSenMp.
oxW
, pSertussis, and strep throat.
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ANS: D c n
Childhood illnesses include measles, mumps, rubella, chickenpox, pertussis, and strep throat. Avoid r
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ecording usual childhood illnesses because an illness common in the persons childhood may be unus
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ual today (e.g., measles).
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DIF: Cognitive Level: Remembering (Knowledge) cn cn cn
REF: dm. 51 MSC: Client Needs: Safe and Effective Care Environmen
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t: Management of Care
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7. A female patient tells the nurse that she has had six pregnancies, with four live births at term and two
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spontaneous abortions. Her four children are still living. How would the nurse record this information?
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a. P-6, B-4, (S)Ab-2 cn cn
b. Grav 6, Term 4, (S)Ab-2, Living 4 cn cn cn cn cn cn
c. Patient has had four living babies. cn cn cn cn cn
d. Patient has been pregnant six times. cn cn cn cn cn
ANS: B c n
Obstetric history includes the number of pregnancies (gravidity), number of deliveries in which the
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fetus reached term (term), number of preterm pregnancies (preterm), number of incomplete pregna
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ncies (abortions), and number of children living (living). This is recorded: Grav
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Term Preterm Ab Living cn cn cn cn cn
. For any incomplete pregnancies, the duration is recorded and whether the pr cn cn cn cn cn cn cn cn cn cn cn cn
egnancy resulted in a spontaneous (S) or an induced (I) abortion.
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DIF: Cognitive Level: Applying (Application) cn cn cn REF: c n c n dm. 51 cn
2|Pagecn cn cn cn cn
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