Test Bank for Health Assessment for
Nursing Practice 7th Edition by Wilson
Chapter 1 - 24
,Chaptery01:yIntroductionytoyHealthyAssessment
MULTIPLEyCHOICE
1. Aypatientycomesytoytheyemergencyydepartmentyandytellsytheytriagey nurseythaty hey
isy“havingyayheartyattack.”yWhatyisytheynurse’sytopypriorityyatythisytime?
a. Determineytheypatient’sypersonalydatayandyins
uranceycoverage.
b. Askytheypatientytoytakeyayseatyinytheywaitingyr
oomyuntily hisynameyisycalled.
c. Requestythatyaynurseycollectydatayforya
ycomprehensivey history.
d. Askyaynurseytoystartyayfocusedyassessment
yofythisypatientynow.
ANSWER:y D
Theynurseyneedsytoybeginyanyassessmentyasysoonyasypossibleythatyisyfocusedyonythisypatient’sy
cardiovascularysystem.yTheytypeyofyhealthyassessmentyperformedybyytheynurseyisyalsoydrive
nybyypatientyneed.yPersonalydatayandyinsuranceyinformationywillybeyobtained,ybutyinythisysitu
ation,ytheseydataycanywaityuntilyafterytheypatientyisyassessed.yBasedyalsoyonyMaslow’syhierar
chyyofyneeds,yphysiologicyneedsytakeyprecedence.yRatherythanyaskingytheypatientytoywait,yth
eynurseyneedsytoybeginydataycollection,ysuchyasyvitalysigns,yimmediatelyytoydetermineytheypat
ient’syhealthystatus.yComplicationsycanybeypreventedyifyanyimmediateyassessmentyisymadeyto
yanalyzeytheypatient’sysymptoms.yAycomprehensiveyhistoryyisynotyindicatedyinythisysituationy
atythisytime.ySomeysubjectiveydataywillybeycollected,ysuchyasyallergiesyandymedicalyhistoryyr
elatedytoycardiovascularydisease.yEyes,years,yoryaycompleteymusculoskeletalyorymentaly healt
hyassessmentyisynotyaypriorityyatythisytime.
DIF:yyy CognitiveyLevel:yApply REF:yBoxy1-
3y|yp.y3yTOP:yNursingyProcess:yAssessment
MSC:yNCLEXyPatientyNeeds:ySafeyandyEffectiveyCareyEnvironment:yManagementyofyCare:yEstablis
hingyPriorities
2. Whichysituationyillustratesyay screeningyassessment?
a. Aypatientyvisitsyanyobstetricyclinicyforytheyfir
stytimeyandytheynurseyconductsyaydetailedyhist
oryyandyphysicalyexamination.
b. Ayhospitalysponsorsyayhealthyfairyatyaylocal
ymallyandyprovidesycholesterolyandybloody
pressureychecksytoymallypatrons.
c. Theynurseyinyanyurgentycareycenterychecks
ytheyvitalysignsyofyaypatientywhoyisycompla
iningyofylegypain.
, d. Aypatienty newlyydiagnosedywithydiabetesy
mellitusycomesytoytestyhisyfastingybloody
glucoseylevel.
ANSWER:yB
Ayhealthyfairyatyaylocalymallythatyprovidesycholesterolyandybloodypressureychecksyisyanyexam
pleyofyayscreeningyassessmentyfocusedyonydiseaseydetection.yAydetailedyhistoryyandyphysical
yexaminationyconductedyduringyayfirst-
timeyvisitytoyanyobstetricyclinicyisyanyexampleyofyaycomprehensiveyassessment.yAssessingyayp
atientycomplainingyofylegypainyinytheytriageyareayofyanyurgentycareycenteryisyanyexampleyofya
yproblem-
based/focusedyassessment.yAypatient’syreturnyappointmenty1ymonthyafterytoday’syofficeyvisi
tytoyreportyfastingybloodyglucoseylevelsyisyanyexampleyofyanyepisodicyoryfollow-
upyassessment.
DIF:yyy CognitiveyLevel:yUnderstand REF:yBoxy1-
3y|yp.y3yTOP:yNursingyProcess:yAssessment
MSC:yNCLEXyPatienty Needs:yHealthyPromotionyandyMaintenance:yHealthyScreening
3. Forywhichypersonyisyayscreeningyassessmentyindicated?
a. Theypersonywhoyhadyabdominalysurgeryy
yesterday
b. Theypersonywhoyisyunawareyofyhisyhigh
yserumyglucoseylevels
c. Theypersonywhoyisybeingyadmittedytoy
aylong-termycareyfacility
d. Theypersonywhoyisybeginningyrehabilitationya
fteryaykneeyreplacement
ANSWER:yB
Ayscreeningyassessmentyisyperformedyforytheypurposeyofydiseaseydetection.yInythisycaseythi
sypersonymayyhaveydiabetesymellitus.yAyshiftyassessmentyisymostyappropriateyforytheyperson
ywhoyisyrecoveringyinytheyhospitalyfromysurgery.yAycomprehensiveyassessmentyisyperforme
dyduringyadmissionytoyayfacilityytoyobtainyaydetailedyhistoryyandycompleteyphysicalyexamin
ation.yAnyepisodicyoryfollow-
upyassessmentyisyperformedyafterykneeyreplacementytoyevaluateytheyoutcomeyofytheyprocedu
re.
DIF:yyy CognitiveyLevel:yUnderstand REF:yBoxy1-
3y|yp.y3yTOP:yNursingyProcess:yAssessment
MSC:yNCLEXyPatientyNeeds:ySafeyandyEffectiveyCareyEnvironment:yManagementyofyCare:yEstablis
hingyPriorities
4. Forywhichypersonyisyayshiftyassessmentyindicated?
a. Theypersonywhoyhadyabdominalysurgeryy
yesterday
b. Theypersonywhoyisyunawareyofyhisyhigh
yserumyglucoseylevels
c. Theypersonywhoyisybeingyadmittedytoya
long-termycareyfacility
d. Theypersonywhoyisybeginningyrehabilitationy
afteryaykneeyreplacement
ANSWER:y A
Ayshiftyassessmentyisymostyappropriateyforytheypersonywhoyisyrecoveringyinytheyhospitalyfro
mysurgery.yAyscreeningyassessmentyisyperformedyforytheypurposeyofydiseaseydetection,yinythis
ycaseydiabetesymellitus.y Aycomprehensiveyassessmentyisyperformedyduringyadmissionytoya
, facilityytoyobtainyaydetailedyhistoryyandycompleteyphysicalyexamination.yAnyepisodicyoryf
ollow-
upyassessmentyisyperformedyafterykneeyreplacementytoyevaluateytheyoutcomeyofytheyproced
ure.
DIF:yyy CognitiveyLevel:yUnderstand REF:yBoxy1-
3y|yp.y4yTOP:yNursingyProcess:yAssessment
MSC:yNCLEXyPatientyNeeds:ySafeyandyEffectiveyCareyEnvironment:yManagementyofyCare:yEstablis
hingyPriorities
5. Forywhichypersonyisyaycomprehensiveyassessmentyindicated?
a. Theypersonywhoyhadyabdominalysurgeryy
yesterday
b. Theypersonywhoyisyunawareyofyhisyhigh
yserumyglucoseylevels
c. Theypersonywhoyisybeingyadmittedytoy
aylong-termycareyfacility
d. Theypersonywhoyisybeginningyrehabilitationya
fteryaykneeyreplacement
ANSWER:yC
Aycomprehensiveyassessmentyisyperformedyduringyadmissionytoyayfacilityytoyobtainya
detailedyhistoryyandycompleteyphysicalyexamination.yAyshiftyassessmentyisymostyappropriat
eyforytheypersonywhoyisyrecoveringyinytheyhospitalyfromysurgery.yAyscreeningyassessmentyisy
performedyforytheypurposeyofydiseaseydetection,yinythisycaseydiabetesymellitus.yAnyepisodic
yoryfollow-
upyassessmentyisyperformedyafterykneeyreplacementytoyevaluateytheyoutcomeyofytheyproced
ure.
DIF:yyy CognitiveyLevel:yUnderstand REF:yBoxy1-
3y|yp.y3yTOP:yNursingyProcess:yAssessment
MSC:yNCLEXyPatientyNeeds:ySafeyandyEffectiveyCareyEnvironment:yManagementyofyCare:yEstablis
hingyPriorities
6. Forywhichypersonyisyanyepisodicyoryfollow-upyassessmentyindicated?
a. Theypersonywhoyhadyabdominalysurgeryy
yesterday
b. Theypersonywhoyisyunawareyofyhisyhigh
yserumyglucoseylevels
c. Theypersonywhoyisybeingyadmittedytoya
long-termycareyfacility
d. Theypersonywhoyisybeginningyrehabilitationya
fteryaykneeyreplacement
ANSWER:y D
Anyepisodicyoryfollow-
upyassessmentyisyperformedyafterytheykneeyreplacementytoyevaluateytheyoutcomeyofytheypro
cedure.yAyshiftyassessmentyisymostyappropriateyforytheypersonywhoyisyrecoveringyinytheyhosp
italyfromysurgery.yAyscreeningyassessmentyisyperformedyforytheypurposeyofydiseaseydetectio
n,yinythisycaseydiabetesymellitus.yAycomprehensiveyassessmentyisyperformedyduringyadmissi
onytoyayfacilityytoyobtainyaydetailedyhistoryyandycompleteyphysicalyexamination.
DIF:yyy CognitiveyLevel:yUnderstand REF:yBoxy1-
3y|yp.y3yTOP:yNursingyProcess:yAssessment
Nursing Practice 7th Edition by Wilson
Chapter 1 - 24
,Chaptery01:yIntroductionytoyHealthyAssessment
MULTIPLEyCHOICE
1. Aypatientycomesytoytheyemergencyydepartmentyandytellsytheytriagey nurseythaty hey
isy“havingyayheartyattack.”yWhatyisytheynurse’sytopypriorityyatythisytime?
a. Determineytheypatient’sypersonalydatayandyins
uranceycoverage.
b. Askytheypatientytoytakeyayseatyinytheywaitingyr
oomyuntily hisynameyisycalled.
c. Requestythatyaynurseycollectydatayforya
ycomprehensivey history.
d. Askyaynurseytoystartyayfocusedyassessment
yofythisypatientynow.
ANSWER:y D
Theynurseyneedsytoybeginyanyassessmentyasysoonyasypossibleythatyisyfocusedyonythisypatient’sy
cardiovascularysystem.yTheytypeyofyhealthyassessmentyperformedybyytheynurseyisyalsoydrive
nybyypatientyneed.yPersonalydatayandyinsuranceyinformationywillybeyobtained,ybutyinythisysitu
ation,ytheseydataycanywaityuntilyafterytheypatientyisyassessed.yBasedyalsoyonyMaslow’syhierar
chyyofyneeds,yphysiologicyneedsytakeyprecedence.yRatherythanyaskingytheypatientytoywait,yth
eynurseyneedsytoybeginydataycollection,ysuchyasyvitalysigns,yimmediatelyytoydetermineytheypat
ient’syhealthystatus.yComplicationsycanybeypreventedyifyanyimmediateyassessmentyisymadeyto
yanalyzeytheypatient’sysymptoms.yAycomprehensiveyhistoryyisynotyindicatedyinythisysituationy
atythisytime.ySomeysubjectiveydataywillybeycollected,ysuchyasyallergiesyandymedicalyhistoryyr
elatedytoycardiovascularydisease.yEyes,years,yoryaycompleteymusculoskeletalyorymentaly healt
hyassessmentyisynotyaypriorityyatythisytime.
DIF:yyy CognitiveyLevel:yApply REF:yBoxy1-
3y|yp.y3yTOP:yNursingyProcess:yAssessment
MSC:yNCLEXyPatientyNeeds:ySafeyandyEffectiveyCareyEnvironment:yManagementyofyCare:yEstablis
hingyPriorities
2. Whichysituationyillustratesyay screeningyassessment?
a. Aypatientyvisitsyanyobstetricyclinicyforytheyfir
stytimeyandytheynurseyconductsyaydetailedyhist
oryyandyphysicalyexamination.
b. Ayhospitalysponsorsyayhealthyfairyatyaylocal
ymallyandyprovidesycholesterolyandybloody
pressureychecksytoymallypatrons.
c. Theynurseyinyanyurgentycareycenterychecks
ytheyvitalysignsyofyaypatientywhoyisycompla
iningyofylegypain.
, d. Aypatienty newlyydiagnosedywithydiabetesy
mellitusycomesytoytestyhisyfastingybloody
glucoseylevel.
ANSWER:yB
Ayhealthyfairyatyaylocalymallythatyprovidesycholesterolyandybloodypressureychecksyisyanyexam
pleyofyayscreeningyassessmentyfocusedyonydiseaseydetection.yAydetailedyhistoryyandyphysical
yexaminationyconductedyduringyayfirst-
timeyvisitytoyanyobstetricyclinicyisyanyexampleyofyaycomprehensiveyassessment.yAssessingyayp
atientycomplainingyofylegypainyinytheytriageyareayofyanyurgentycareycenteryisyanyexampleyofya
yproblem-
based/focusedyassessment.yAypatient’syreturnyappointmenty1ymonthyafterytoday’syofficeyvisi
tytoyreportyfastingybloodyglucoseylevelsyisyanyexampleyofyanyepisodicyoryfollow-
upyassessment.
DIF:yyy CognitiveyLevel:yUnderstand REF:yBoxy1-
3y|yp.y3yTOP:yNursingyProcess:yAssessment
MSC:yNCLEXyPatienty Needs:yHealthyPromotionyandyMaintenance:yHealthyScreening
3. Forywhichypersonyisyayscreeningyassessmentyindicated?
a. Theypersonywhoyhadyabdominalysurgeryy
yesterday
b. Theypersonywhoyisyunawareyofyhisyhigh
yserumyglucoseylevels
c. Theypersonywhoyisybeingyadmittedytoy
aylong-termycareyfacility
d. Theypersonywhoyisybeginningyrehabilitationya
fteryaykneeyreplacement
ANSWER:yB
Ayscreeningyassessmentyisyperformedyforytheypurposeyofydiseaseydetection.yInythisycaseythi
sypersonymayyhaveydiabetesymellitus.yAyshiftyassessmentyisymostyappropriateyforytheyperson
ywhoyisyrecoveringyinytheyhospitalyfromysurgery.yAycomprehensiveyassessmentyisyperforme
dyduringyadmissionytoyayfacilityytoyobtainyaydetailedyhistoryyandycompleteyphysicalyexamin
ation.yAnyepisodicyoryfollow-
upyassessmentyisyperformedyafterykneeyreplacementytoyevaluateytheyoutcomeyofytheyprocedu
re.
DIF:yyy CognitiveyLevel:yUnderstand REF:yBoxy1-
3y|yp.y3yTOP:yNursingyProcess:yAssessment
MSC:yNCLEXyPatientyNeeds:ySafeyandyEffectiveyCareyEnvironment:yManagementyofyCare:yEstablis
hingyPriorities
4. Forywhichypersonyisyayshiftyassessmentyindicated?
a. Theypersonywhoyhadyabdominalysurgeryy
yesterday
b. Theypersonywhoyisyunawareyofyhisyhigh
yserumyglucoseylevels
c. Theypersonywhoyisybeingyadmittedytoya
long-termycareyfacility
d. Theypersonywhoyisybeginningyrehabilitationy
afteryaykneeyreplacement
ANSWER:y A
Ayshiftyassessmentyisymostyappropriateyforytheypersonywhoyisyrecoveringyinytheyhospitalyfro
mysurgery.yAyscreeningyassessmentyisyperformedyforytheypurposeyofydiseaseydetection,yinythis
ycaseydiabetesymellitus.y Aycomprehensiveyassessmentyisyperformedyduringyadmissionytoya
, facilityytoyobtainyaydetailedyhistoryyandycompleteyphysicalyexamination.yAnyepisodicyoryf
ollow-
upyassessmentyisyperformedyafterykneeyreplacementytoyevaluateytheyoutcomeyofytheyproced
ure.
DIF:yyy CognitiveyLevel:yUnderstand REF:yBoxy1-
3y|yp.y4yTOP:yNursingyProcess:yAssessment
MSC:yNCLEXyPatientyNeeds:ySafeyandyEffectiveyCareyEnvironment:yManagementyofyCare:yEstablis
hingyPriorities
5. Forywhichypersonyisyaycomprehensiveyassessmentyindicated?
a. Theypersonywhoyhadyabdominalysurgeryy
yesterday
b. Theypersonywhoyisyunawareyofyhisyhigh
yserumyglucoseylevels
c. Theypersonywhoyisybeingyadmittedytoy
aylong-termycareyfacility
d. Theypersonywhoyisybeginningyrehabilitationya
fteryaykneeyreplacement
ANSWER:yC
Aycomprehensiveyassessmentyisyperformedyduringyadmissionytoyayfacilityytoyobtainya
detailedyhistoryyandycompleteyphysicalyexamination.yAyshiftyassessmentyisymostyappropriat
eyforytheypersonywhoyisyrecoveringyinytheyhospitalyfromysurgery.yAyscreeningyassessmentyisy
performedyforytheypurposeyofydiseaseydetection,yinythisycaseydiabetesymellitus.yAnyepisodic
yoryfollow-
upyassessmentyisyperformedyafterykneeyreplacementytoyevaluateytheyoutcomeyofytheyproced
ure.
DIF:yyy CognitiveyLevel:yUnderstand REF:yBoxy1-
3y|yp.y3yTOP:yNursingyProcess:yAssessment
MSC:yNCLEXyPatientyNeeds:ySafeyandyEffectiveyCareyEnvironment:yManagementyofyCare:yEstablis
hingyPriorities
6. Forywhichypersonyisyanyepisodicyoryfollow-upyassessmentyindicated?
a. Theypersonywhoyhadyabdominalysurgeryy
yesterday
b. Theypersonywhoyisyunawareyofyhisyhigh
yserumyglucoseylevels
c. Theypersonywhoyisybeingyadmittedytoya
long-termycareyfacility
d. Theypersonywhoyisybeginningyrehabilitationya
fteryaykneeyreplacement
ANSWER:y D
Anyepisodicyoryfollow-
upyassessmentyisyperformedyafterytheykneeyreplacementytoyevaluateytheyoutcomeyofytheypro
cedure.yAyshiftyassessmentyisymostyappropriateyforytheypersonywhoyisyrecoveringyinytheyhosp
italyfromysurgery.yAyscreeningyassessmentyisyperformedyforytheypurposeyofydiseaseydetectio
n,yinythisycaseydiabetesymellitus.yAycomprehensiveyassessmentyisyperformedyduringyadmissi
onytoyayfacilityytoyobtainyaydetailedyhistoryyandycompleteyphysicalyexamination.
DIF:yyy CognitiveyLevel:yUnderstand REF:yBoxy1-
3y|yp.y3yTOP:yNursingyProcess:yAssessment
