HEALTH ASSESSMENT EXAMINATION:
COMPREHENSIVE QUESTIONS AND ANSWERS
GRADED A+
⩥ The nurse uses the mnemonic DIAPERS to assess for urinary
incontinence in an older adult patient. The "P" indicates
pharmaceuticals. Answer: T
⩥ Mr. Chin, 82 years old, comes to the office for a routine examination.
The nurse notices a somewhat high-pitched murmur in the second right
intercostal space during systole. It does not radiate, and the rest of his
examination findings are within expected parameters for age. Which is
true of the most likely cause of this murmur? Answer: It carries with it
increased risk for cardiovascular disease.
⩥ A nurse assesses a client's blood pressure and the findings suggest
orthostatic hypotension. Which area should the nurse emphasize during
client education? Answer: Prevention of falls
⩥ A nurse assesses the skin of an older adult's forearms and observes
purpura. The nurse interprets this finding as indicative of which issue?
Answer: Vascular fragility
,⩥ A client has come to the clinic for a routine checkup. The client is 77
years old, weighs 198 pounds (89.8 kg), stands 5'4" (162.5 cm), and lives
alone. The client's B/P is 147/89, pulse is 80, and respirations 18. The
nurse is planning client teaching. What is an appropriate topic to include
in the teaching plan? Answer: Encouraging a diet that supports a normal
BMI
⩥ Mrs. Geller is somewhat quiet today. She has several bruises of
different colours on the ulnar aspects of her forearms and on her
abdomen. She otherwise has no complaints, and her diabetes and
hypertension are well managed. Her son from out of state accompanies
her today and has recently moved in to help her. What should the nurse
suspect? Answer: Elder abuse
⩥ With a client suspected of suffering from presbycusis, the nurse would
expect difficulty hearing: Answer: High-pitched sounds
⩥ The nurse is assessing an older adult. Which assessment finding
would the nurse recognize as a finding associated with aging? Answer:
Kyphosis
⩥ An elderly client visits her community health clinic with an outbreak
of vesicles on her skin. She tests positive for the herpes zoster virus. The
nurse should recognize this condition as which of the following? Answer:
Shingles
, ⩥ Which intervention should the nurse suggest to a client to improve the
condition of dry skin? Answer: Use lanolin-based products
⩥ A nurse is working with an 88-year-old client who has developed
stress incontinence. In this case, as in all cases, the nurse should
understand that which of the following is the key to recognizing
pathology and illness in the very old? Answer: Knowing the person's
baseline functional status and recognizing deviations from it
⩥ A nurse assesses a client's blood pressure and the findings suggest
orthostatic hypotension. Which area should the nurse emphasize during
client education? Answer: Prevention of falls
⩥ An older adult client has come to the clinic with new complaints of
fatigue, constipation, and cold intolerance. The nurse would refer the
client for what type of testing? Answer: Assessment of thyroid function
⩥ The nurse has assessed and informed the healthcare provider of a
brown-colored lesion on an older client's left cheek. The lesion is
diagnosed as solar lentigines. What is the nurse's best action? Answer:
Encourage the client to wear sunscreen daily.
⩥ A hospitalized client develop thrombocytopenia. Which lab result
does the nurse expect in this client? Answer: Platelet count less than
100,000