PHYSICAL EXAMINATION AND HEALTH ASSESSMENT 9TH EDITION
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Authors: Carolyn Jarvis And Ann L. Eckhardt
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,TABLE OF CONTENT
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Chapter 01: Evidence-Based Assessment ................................................................................................. 3
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Chapter 02: Cultural Assessment ........................................................................................................... 12
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Chapter 03: The Interview ..................................................................................................................... 23
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Chapter 04: The Complete Health History .............................................................................................. 39
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Chapter 05: Mental Status Assessment ................................................................................................... 51
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Chapter 06: Substance Use Assessment .................................................................................................. 66
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Chapter 07: Family Violence and Human Trafficking............................................................................. 72
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Chapter 08: Assessment Techniques and Safety in the Clinical Setting ................................................... 78
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Chapter 09: General Survey and Measurement ....................................................................................... 93
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Chapter 10: Vital Signs .......................................................................................................................... 98
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Chapter 11: Pain Assessment ............................................................................................................... 112
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Chapter 12: Nutrition Assessment ........................................................................................................ 119
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Chapter 13: Skin, Hair, and Nails ......................................................................................................... 131
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Chapter 14: Head, Face, and Neck, and Regional Lymphatics ............................................................... 149
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Chapter 15: Eyes.................................................................................................................................. 163
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Chapter 16: Ears .................................................................................................................................. 177
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Chapter 17: Nose, Mouth, and Throat .................................................................................................. 192
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Chapter 18: Breasts, Axillae, and Regional Lymphatics ........................................................................ 207
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Chapter 19: Thorax and Lungs ............................................................................................................. 223
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Chapter 20: Heart and Neck Vessels..................................................................................................... 239
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Chapter 21: Peripheral Vascular System and Lymphatic System........................................................... 254
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Chapter 22: Abdomen .......................................................................................................................... 268
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Chapter 23: Musculoskeletal System.................................................................................................... 280
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Chapter 24: Neurologic System ........................................................................................................... 297
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Chapter 25: Male Genitourinary System .............................................................................................. 318
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Chapter 26: Anus, Rectum, and Prostate .............................................................................................. 332
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Chapter 27: Female Genitourinary System ........................................................................................... 343
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Chapter 28: The Complete Health Assessment: Adult........................................................................... 361
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Chapter 29: The Complete Physical Assessment: Infant, Young Child, and Adolescent ........................ 366
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Chapter 30: Bedside Assessment and Electronic Documentation .......................................................... 368
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Chapter 31: Pregnancy......................................................................................................................... 373
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Chapter 32: Functional Assessment of the Older Adult ......................................................................... 384
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,Chapter 01: Evidence-Based Assessment
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Jarvis: Physical Examination and Health Assessment, 9th Edition
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MULTIPLE CHOICE L
1. After completing an initial assessment of a patient, the nurse has charted that his respirations
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are eupneic and his pulse is 58 beats per minute. What type of assessment data is this?
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a. Objective
b. Reflective
c. Subjective
d. Introspective
ANS: A L
Objective data is what the health professional observes by inspecting, percussing, palpating,
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and auscultating during the physical examination. Subjective data is what the person says
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about him or herself during history taking. The terms reflective and introspective are not used
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to describe data.
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DIF: Cognitive Level: Understanding (Comprehension) L L L
MSC: Client Needs: Safe and Effective Care Environment: Management of Care
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2. A patient tells the nurse that he is very nervous, nauseous, and “feels hot.” What type of
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Lassessment data is this? L L L
a. Objective
b. Reflective
c. Subjective
d. Introspective
ANS: C L
Subjective data is what the person says about him or herself during history taking. Objective
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data is what the health professional observes by inspecting, percussing, palpating, and
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auscultating during the physical examination. The terms reflective and introspective are not
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used to describe data.
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DIF: Cognitive Level: Understanding (Comprehension) L L L
MSC: Client Needs: Safe and Effective Care Environment: Management of Care
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3. What do the patient’s record, laboratory studies, objective data, and subjective datacombine
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to form?
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a. Database
b. Admitting data L
c. Financial statement L
d. Discharge summary L
ANS: A L
The objective and subjective data together with the patient’s record and laboratory studies,
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form the database. The other items are not part of the patient’s record, laboratory studies, or
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data.
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DIF: Cognitive Level: Remembering (Knowledge) L L L
MSC: Client Needs: Safe and Effective Care Environment: Management of Care
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, 4. When listening to a patient’s breath sounds, the nurse is unsure of a sound that isheard.
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L Which action would the nurse take next?
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a. Notify the patient’s physician. L L L
b. Document the sound exactly as it was heard. L L L L L L L
c. Validate the data by asking another nurse to listen to the breath sounds.
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d. Assess again in 20 minutes to note whether the sound is still present.
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ANS: C L
When unsure of a sound heard while listening to a patient’s breath sounds, the nurse validates
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the data to ensure accuracy by either repeating the assessment themselves or asking another
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nurse to assess the breath sounds. If the nurse has less experience analyzing breath sounds,
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then he or she should ask an expert to listen. When unsure of a sound heard while listening to a
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patient’s breath sounds, the nurse should validate the data before documenting to ensure
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accuracy and before notifying the patient’s physician. To validate that data, the nurse either
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repeats the assessment himself or herself or asks another nurse to assess the breath sounds.
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DIF: Cognitive Level: Applying (Application) L L L
MSC: Client Needs: Safe and Effective Care Environment: Management of Care
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5. The nurse is conducting a class for new graduate nurses. While teaching the class, what would
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the nurse keep in mind regarding what novice nurses, without a background of skills and
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experience from which to draw upon, are more likely to base their decisions on?
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a. Intuition
b. A set of rules L L L
c. Articles in journals L L
d. Advice fromsupervisors L L
ANS: B L
Novice nurses operate from a set of defined, structured rules to make decisions. It takes time,
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perhaps a few years, in similar clinical situations to achieve competency and it is functioning at
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the level of an expert practitioner when intuition is included in making clinical decisions.
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While information in journal articles and advice from supervisors may assist in making
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decisions, novice nurses do not typically base their decisions on them. It would also be
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important that if information from journal articles and advice from supervisors were used, that
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they were evidence based.
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DIF: Cognitive Level: Understanding (Comprehension) L L L MSC: Client Needs: General L L L
6. The nurse is reviewing information about evidence-based practice (EBP). Which statement
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best reflects EBP?
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a. EBP relies on tradition for support of best practices.
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b. EBP is simply the use of best practice techniques for the treatment of patients.
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c. EBP emphasizes the use of best evidence with the clinician’s experience.
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d. EBP does not consider the patient’s own preferences as important.
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ANS: C L