l
OMo
ARc
PSD|
1
1
629
741
PhysicalExaminat
ionand
HealthAs ses
sment
CANADI AN3rdEdi ti
on
Jarvi
sTes tBank
, l
OMo
ARc
PSD|
1
1
629
741
Ph
ysi
cal
Exa
min
ati
ona
ndHe
alt
hAs
ses
sme
ntCANADI
AN3
rdEd
iti
onJ
arv
isTe
st
Ba
nk
Chap
ter05:TheComp
leteHeal
thHi
sto
ry
Ja
rvi
s:Physic
alEx
amina
tion&Heal
thAss
ess
men
t,3r
dCa
nad
iane
dit
ion
MUL
TIPL
ECHOI
CE
Th
en u
rseispre
parin
gtoc onductah eal
thhist
ory.Whichofthesest
ateme
ntsbe
st
des
cri
besthepurposeofah ealt
hh i
stor
y?
Toprov
ideanop por
tuni
tyfori
n t
eract
ionbetweenthep at
ien
ta n
dthenur
se
Toprovi
deaformf orobtai
ningthepa t
ien
t’sbi
o gr
aphicinf
ormati
on
Todocumentthenormal a
nda bnormalfi
nding
sofap hys
icalas
sessment
Toprovi
dead a
tabaseo fsubj
ectiv
ein f
ormati
ona boutthepati
ent
’s
pastandcurr
enth e
alth
ANS:
D
Thepur
poseoftheh
e a
lthhist
oryi
stocol
le
ctsub
ject
iv
edata
—whatthe
pe
rsonsay
sab ou
thimselforher
sel
f.Th
eothe
ropti
onsar
enotc
orre
ct.
DI
F:Cogni
ti
veLe
vel
:Unde
rst
andi
ng(Compre
hensi
on)
MSC:Cl
i
entNee
ds:Saf
eandEff
ect
iv
eCa r
eEnvi
ron
ment:
Man
age
men
tofCa
re
.Wh
2 ent
hen
urs
eise
val
uat
ingt
her
eli
abi
li
tyofap
ati
ent
’sr
esp
ons
es,
whi
chof
t
hes
estat
eme nt
swou l
dbec or
rec
t?Thepati
ent
:
.Ha
a sahist
o r
yofdrugabuseandth
eref
oreisnotr
eli
abl
e.
.P
b rov
ide
dc onsi
ste
ntinf
ormati
onandther
efor
eisrel
iab
le.
.S
c mil
edthr
ou gh
outint
erv
iewandther
efor
eisassumedrel
ia
ble
.
.Wo
d u
ldn
ota
nswe
rqu
est
ion
scon
cer
nin
gst
res
san
dth
ere
for
eisn
otr
eli
abl
e.
ANS:
B
Areli
abl
epe
rsona
lwaysgi
vesth
esameanswer
s,e
venwhenques
ti
onsar
e
r
e p
hrase
dorar
erepe
atedl
ateri
nth
ein
ter
vi
e w.
Theot
hers
tate
me nt
sar
enot
cor
rect
.
DI
F:Cogni
ti
veLe
vel
:Appl
yi
ng(
Appli
cat
ion)
MSC:Cl
i
entNee
ds:Saf
eandEf
fec
ti
veCa r
eEnv
ir
onme
nt:
Man
age
men
tofCa
re
A5
9-y
ear
-ol
dpa
tie
ntt
ell
sth
enu
rset
hath
eha
sul
cer
ati
vec
oli
ti
s.Heh
asb
eenh
avi
ng“
bla
ck
s
too
ls”f
ort
hep
ast24h
our
s.Ho
wwou
ldt
hen
urs
ebe
std
ocu
men
thi
sre
asonf
ors
eek
ingc
are
?
J
.M.i
sa5 9-
year
-ol
dma nse
eki
ngtr
eatmentf
orul
cer
ati
vecoli
ti
s.
J
.M.camein
tothecli
ni
ccompl
aini
ngofhavi
ngbl
ackst
oolsfort
hepast2
4hou
rs.
J
.M.i
sa5 9-
year
-ol
dma nwhost
ate
sthath
eh asu
lcer
ati
vecoli
ti
sand
want
sitche
cked.
J
.M.i
sa5 9-
year
-ol
dma nwhost
ate
sthathehasbee
nh av
ing“bla
ck
st
ools
”fort
hep as
t24hour
s.
,ANS:
D
Ther
eas
onf
ors
eek
ingc
arei
sab
rie
fsp
ont
ane
ouss
tat
eme
nti
nth
epe
rso
n’sownwo
rdst
hat
d
escr
ibesth
ereas
onfort
hevis
it
. I
tsta
tesone(p
oss
ibl
ytwo)s
ign
sorsymptomsandt
hei
r
d
ura
tion.Thes
ymptomdesc
ript
ionisencl
osedi
nquot
ati
onmarkst
oin
d i
catet
he
p
ers
on ’
s
e
xac
twor
ds.
DI
F:Cogni
ti
veLe
vel
:Appl
yi
ng(
Appli
cat
ion)
MSC:Cl
i
entNee
ds:Saf
eandEf
fec
ti
veCa r
eEnv
ir
onme
nt:
Man
age
men
tofCa
re
Down
loa
dedb
yma
rlonma
rlonJ
uni
or(
ben
kig
och
i@g
mai
l
.com)
, l
OMoARc
PSD|
1162
9741
Ph
ysi
cal
Exa
min
ati
ona
ndHe
alt
hAs
ses
sme
ntCANADI
AN3
rdEd
iti
onJ
arv
isTe
st
Ba
nk
Ap
ati
entte
ll
sthen ur
sethatsheh ashada bdomina
lpai
nfort
hep
astwe
ek.
Wha
t
wouldbethenu r
se’sbestresponse
?
“Canyoupointtowh e
reithurts?”
“We’l
ltal
kmo reaboutthatla
terintheint
e r
vie
w.”
“Whathaveyouh adtoeatinth epast24h o
urs?”
“Haveyoueverhada nysurgeriesonyourabdomen?”
ANS:
A
Afi
nalsu
mma r
yofanysympt
omtheper
sonhassh
oul
dincl
ude
,al
ongwi
ths
evenoth
er
cr
it
ica
lchar
act
eri
sti
cs,
“Loc
ati
on:Bes
peci
fi
c.”Thep
ers
onisask
edtop
oin
ttothel
oca
tio
n.
DI
F:Cogni
ti
veLe
vel
:Appl
yi
ng(
Appli
cat
ion)
MSC:Cl
i
entNee
ds:Saf
eandEf
fec
ti
veCa r
eEnv
ir
onme
nt:
Man
age
men
tofCa
re
A2
9-yea
r-o
ldwo mantel
lsthen ur
sethatshehas“excr
uci
ati
ngpai
n ”i
nher
back.Whichwo u
ldbethen urse
’sappr
op r
iat
erespons
etothewoma n
’s
stat
eme nt
?
“Howd oesyourfami
lyreacttoyourpai
n?”
“Thepainmu stbete
rri
ble.Youp r
obabl
yp i
nchedanerve
.”
“I’
vehadb ac
kp ai
nmy se
lf,anditcanbeexcruci
ati
ng.
”
“Howwo uldyousaythepa i
naffect
syourabil
it
ytodoyourdai
lyact
ivi
ti
es?
”
ANS:
D
Thesymptomofpaini
sdif
fi
cul
ttoquant
if
ybecaus
eofindi
vi
duali
nte
rpr
etat
ion.
Wit
hp ai
n,adj
ecti
vessh
ouldbeavoid
ed,andth
ep at
ie
ntshoul
dbea sk
edh ow
th
ep aina f
fec
tsh i
so rherdail
ya ct
iv
it
ie
s.Theot he
rresponse
sa ren ot
appr
opri
ate.
DI
F:Cog
nit
iv
eLe
vel
:Ap
ply
inNU(Application)RSI
g NGTB.
COM
MSC:
Cli
entNe
eds
:Sa
fea
ndE
ffe
cti
veCa
reE
nvi
ron
men
t:Ma
nag
eme
ntofCa
re
I
nreco
rdi
n gthechi
ldhoodil
lnesse
sofap atie
ntwh odeni
eshavi
nghada
ny,
whi
ch
not
ebyt henurs
ewou ldbemos taccur
ate?
Pat
ien
td eni
esus u
alchil
dhoodill
nesse
s.
Pat
ientstat
eshewa sa“ve r
yhe a
lth
y”ch i
ld.
Pat
ien
ts t
ateshissi
sterhadme asl
es,buthedidnot.
Pat
ien
td eni
esha v
inghadme asl
es,mump s,r
ub el
l
a,chi
cke
npox,
pertus
sis,a
nds tr
epthroat
.
ANS:
D
Chi
ldh
oodil
lnes
sesincl
udemeasl
es,
mu mps,r
ubel
la
,chi
cken
pox,p
ertus
sis
,an
d
st
repthr
oat
.Avoidre
cordi
ng“usu
alchi
ldh
oodill
ness
es”beca
useanil
lnes
s
co
mmo ninthepers
on’schi
l
dhoodmaybeu n
usualt
oday(
e.g
.,measl
es)
.
OMo
ARc
PSD|
1
1
629
741
PhysicalExaminat
ionand
HealthAs ses
sment
CANADI AN3rdEdi ti
on
Jarvi
sTes tBank
, l
OMo
ARc
PSD|
1
1
629
741
Ph
ysi
cal
Exa
min
ati
ona
ndHe
alt
hAs
ses
sme
ntCANADI
AN3
rdEd
iti
onJ
arv
isTe
st
Ba
nk
Chap
ter05:TheComp
leteHeal
thHi
sto
ry
Ja
rvi
s:Physic
alEx
amina
tion&Heal
thAss
ess
men
t,3r
dCa
nad
iane
dit
ion
MUL
TIPL
ECHOI
CE
Th
en u
rseispre
parin
gtoc onductah eal
thhist
ory.Whichofthesest
ateme
ntsbe
st
des
cri
besthepurposeofah ealt
hh i
stor
y?
Toprov
ideanop por
tuni
tyfori
n t
eract
ionbetweenthep at
ien
ta n
dthenur
se
Toprovi
deaformf orobtai
ningthepa t
ien
t’sbi
o gr
aphicinf
ormati
on
Todocumentthenormal a
nda bnormalfi
nding
sofap hys
icalas
sessment
Toprovi
dead a
tabaseo fsubj
ectiv
ein f
ormati
ona boutthepati
ent
’s
pastandcurr
enth e
alth
ANS:
D
Thepur
poseoftheh
e a
lthhist
oryi
stocol
le
ctsub
ject
iv
edata
—whatthe
pe
rsonsay
sab ou
thimselforher
sel
f.Th
eothe
ropti
onsar
enotc
orre
ct.
DI
F:Cogni
ti
veLe
vel
:Unde
rst
andi
ng(Compre
hensi
on)
MSC:Cl
i
entNee
ds:Saf
eandEff
ect
iv
eCa r
eEnvi
ron
ment:
Man
age
men
tofCa
re
.Wh
2 ent
hen
urs
eise
val
uat
ingt
her
eli
abi
li
tyofap
ati
ent
’sr
esp
ons
es,
whi
chof
t
hes
estat
eme nt
swou l
dbec or
rec
t?Thepati
ent
:
.Ha
a sahist
o r
yofdrugabuseandth
eref
oreisnotr
eli
abl
e.
.P
b rov
ide
dc onsi
ste
ntinf
ormati
onandther
efor
eisrel
iab
le.
.S
c mil
edthr
ou gh
outint
erv
iewandther
efor
eisassumedrel
ia
ble
.
.Wo
d u
ldn
ota
nswe
rqu
est
ion
scon
cer
nin
gst
res
san
dth
ere
for
eisn
otr
eli
abl
e.
ANS:
B
Areli
abl
epe
rsona
lwaysgi
vesth
esameanswer
s,e
venwhenques
ti
onsar
e
r
e p
hrase
dorar
erepe
atedl
ateri
nth
ein
ter
vi
e w.
Theot
hers
tate
me nt
sar
enot
cor
rect
.
DI
F:Cogni
ti
veLe
vel
:Appl
yi
ng(
Appli
cat
ion)
MSC:Cl
i
entNee
ds:Saf
eandEf
fec
ti
veCa r
eEnv
ir
onme
nt:
Man
age
men
tofCa
re
A5
9-y
ear
-ol
dpa
tie
ntt
ell
sth
enu
rset
hath
eha
sul
cer
ati
vec
oli
ti
s.Heh
asb
eenh
avi
ng“
bla
ck
s
too
ls”f
ort
hep
ast24h
our
s.Ho
wwou
ldt
hen
urs
ebe
std
ocu
men
thi
sre
asonf
ors
eek
ingc
are
?
J
.M.i
sa5 9-
year
-ol
dma nse
eki
ngtr
eatmentf
orul
cer
ati
vecoli
ti
s.
J
.M.camein
tothecli
ni
ccompl
aini
ngofhavi
ngbl
ackst
oolsfort
hepast2
4hou
rs.
J
.M.i
sa5 9-
year
-ol
dma nwhost
ate
sthath
eh asu
lcer
ati
vecoli
ti
sand
want
sitche
cked.
J
.M.i
sa5 9-
year
-ol
dma nwhost
ate
sthathehasbee
nh av
ing“bla
ck
st
ools
”fort
hep as
t24hour
s.
,ANS:
D
Ther
eas
onf
ors
eek
ingc
arei
sab
rie
fsp
ont
ane
ouss
tat
eme
nti
nth
epe
rso
n’sownwo
rdst
hat
d
escr
ibesth
ereas
onfort
hevis
it
. I
tsta
tesone(p
oss
ibl
ytwo)s
ign
sorsymptomsandt
hei
r
d
ura
tion.Thes
ymptomdesc
ript
ionisencl
osedi
nquot
ati
onmarkst
oin
d i
catet
he
p
ers
on ’
s
e
xac
twor
ds.
DI
F:Cogni
ti
veLe
vel
:Appl
yi
ng(
Appli
cat
ion)
MSC:Cl
i
entNee
ds:Saf
eandEf
fec
ti
veCa r
eEnv
ir
onme
nt:
Man
age
men
tofCa
re
Down
loa
dedb
yma
rlonma
rlonJ
uni
or(
ben
kig
och
i@g
mai
l
.com)
, l
OMoARc
PSD|
1162
9741
Ph
ysi
cal
Exa
min
ati
ona
ndHe
alt
hAs
ses
sme
ntCANADI
AN3
rdEd
iti
onJ
arv
isTe
st
Ba
nk
Ap
ati
entte
ll
sthen ur
sethatsheh ashada bdomina
lpai
nfort
hep
astwe
ek.
Wha
t
wouldbethenu r
se’sbestresponse
?
“Canyoupointtowh e
reithurts?”
“We’l
ltal
kmo reaboutthatla
terintheint
e r
vie
w.”
“Whathaveyouh adtoeatinth epast24h o
urs?”
“Haveyoueverhada nysurgeriesonyourabdomen?”
ANS:
A
Afi
nalsu
mma r
yofanysympt
omtheper
sonhassh
oul
dincl
ude
,al
ongwi
ths
evenoth
er
cr
it
ica
lchar
act
eri
sti
cs,
“Loc
ati
on:Bes
peci
fi
c.”Thep
ers
onisask
edtop
oin
ttothel
oca
tio
n.
DI
F:Cogni
ti
veLe
vel
:Appl
yi
ng(
Appli
cat
ion)
MSC:Cl
i
entNee
ds:Saf
eandEf
fec
ti
veCa r
eEnv
ir
onme
nt:
Man
age
men
tofCa
re
A2
9-yea
r-o
ldwo mantel
lsthen ur
sethatshehas“excr
uci
ati
ngpai
n ”i
nher
back.Whichwo u
ldbethen urse
’sappr
op r
iat
erespons
etothewoma n
’s
stat
eme nt
?
“Howd oesyourfami
lyreacttoyourpai
n?”
“Thepainmu stbete
rri
ble.Youp r
obabl
yp i
nchedanerve
.”
“I’
vehadb ac
kp ai
nmy se
lf,anditcanbeexcruci
ati
ng.
”
“Howwo uldyousaythepa i
naffect
syourabil
it
ytodoyourdai
lyact
ivi
ti
es?
”
ANS:
D
Thesymptomofpaini
sdif
fi
cul
ttoquant
if
ybecaus
eofindi
vi
duali
nte
rpr
etat
ion.
Wit
hp ai
n,adj
ecti
vessh
ouldbeavoid
ed,andth
ep at
ie
ntshoul
dbea sk
edh ow
th
ep aina f
fec
tsh i
so rherdail
ya ct
iv
it
ie
s.Theot he
rresponse
sa ren ot
appr
opri
ate.
DI
F:Cog
nit
iv
eLe
vel
:Ap
ply
inNU(Application)RSI
g NGTB.
COM
MSC:
Cli
entNe
eds
:Sa
fea
ndE
ffe
cti
veCa
reE
nvi
ron
men
t:Ma
nag
eme
ntofCa
re
I
nreco
rdi
n gthechi
ldhoodil
lnesse
sofap atie
ntwh odeni
eshavi
nghada
ny,
whi
ch
not
ebyt henurs
ewou ldbemos taccur
ate?
Pat
ien
td eni
esus u
alchil
dhoodill
nesse
s.
Pat
ientstat
eshewa sa“ve r
yhe a
lth
y”ch i
ld.
Pat
ien
ts t
ateshissi
sterhadme asl
es,buthedidnot.
Pat
ien
td eni
esha v
inghadme asl
es,mump s,r
ub el
l
a,chi
cke
npox,
pertus
sis,a
nds tr
epthroat
.
ANS:
D
Chi
ldh
oodil
lnes
sesincl
udemeasl
es,
mu mps,r
ubel
la
,chi
cken
pox,p
ertus
sis
,an
d
st
repthr
oat
.Avoidre
cordi
ng“usu
alchi
ldh
oodill
ness
es”beca
useanil
lnes
s
co
mmo ninthepers
on’schi
l
dhoodmaybeu n
usualt
oday(
e.g
.,measl
es)
.
