,TestzBankz-zPhysicalzExaminationzandzHealthzAssessmentz8ez(byzJarvis) 1
Tablez ofz Contents
TablezofzContent 1
s
Chapterz01:zEvidence- 2
BasedzAssessmentzChapterz02:zCulturalzAss 15
essment 31
Chapterz 03:z Thez Interview 49
Chapterz04:zThezCompletezHealthzHistoryzC 64
hapterz05:zMentalzStatuszAssessmentzChapt 80
erz06:zSubstancezUsezAssessment 86
Chapterz 07:z Domesticz andz Familyz Violencez Assessment 92
Chapterz08:zAssessmentzTechniqueszandzSafetyzinzthezClinicalzSetti 111
ngzChapterz09:zGeneralzSurveyzandzMeasurement 118
Chapterz10:zVitalzSignszChap 133
terz11:zPainzAssessment 141
Chapterz12:zNutritionzAssessmentzCha 155
pterz13:zSkin,zHair,zandzNails 176
Chapterz14:zHead,zFace,zNeck,zandzRegionalzLymphaticszC 194
hapterz15:zEyes 211
Chapterz 16:z Ears 228
Chapterz 17:z Nose,z Mouth,z andz Throat 246
Chapterz18:zBreasts,zAxillae,zandzRegionalzLymphaticszCha 266
pterz19:zThoraxzandzLungs 284
Chapterz 20:z Heartz andz Neckz Vessels 303
Chapterz21:zPeripheralzVascularzSystemzandzLymphaticzSystemzCha 320
pterz22:zAbdomen 337
Chapterz23:zMusculoskeletalzSystemzC 358
hapterz24:z Neurologicz Systemz Chapte 382
rz25:zMalezGenitourinaryzSystemzChapt 400
erz26:zAnus,zRectum,zandzProstate 414
Chapterz 27:z Femalez Genitourinaryz System 436
Chapterz 28:z Thez Completez Healthz Assessment:z Adult 449
Chapterz29:zThezCompletezPhysicalzAssessment:zInfant,zChild,zandzAdolesce 452
ntzChapterz30:zBedsidezAssessmentzandzElectroniczDocumentation 458
Chapterz 31:z Thez Pregnantz Woman 471
Chapterz 32:z Functionalz Assessmentz ofz thez Olderz Adult
,Chapterz 01:z Evidence-Basedz Assessment
MULTIPLEzCHOICE
1. Afterzcompletingzanzinitialzassessmentzofzazpatient,ztheznursezhaszchartedzthatzhiszrespirationszareze
upneiczandzhiszpulsezisz58zbeatszperzminute.zTheseztypeszofzdatazwouldzbe:
a. Objective.
b. Reflective.
c. Subjective.
d. Introspective.
ANS:zA
Objectivezdatazarezwhatzthezhealthzprofessionalzobserveszbyzinspecting,zpercussing,zpalpating,zandzaus
cultatingzduringzthezphysicalzexamination.zSubjectivezdataziszwhatzthezpersonzsayszaboutzhimzorzhersel
fzduringzhistoryztaking.zTheztermszreflectivezandzintrospectivezareznotzusedztozdescribezdata.
DIF:z Cognitivez Level:z Understandingz (Comprehension)
MSC:zClientzNeeds:zSafezandzEffectivezCarezEnvironment:zManagementzofzCare
2. Azpatientztellsztheznursezthatzheziszveryznervous,zisznauseated,zandzfeelszhot.zTheseztypeszofzdatazwould
zbe:
a. Objective.
b. Reflective.
c. Subjective.
d. Introspective.
ANS:zC
Subjectivezdatazarezwhatzthezpersonzsayszaboutzhimzorzherselfzduringzhistoryztaking.zObjectivezdatazar
ezwhatzthezhealthzprofessionalzobserveszbyzinspecting,zpercussing,zpalpating,zandzauscultatingzduringzt
hezphysicalzexamination.zTheztermszreflectivezandzintrospectivezareznotzusedztozdescribezdata.
DIF:z Cognitivez Level:z Understandingz (Comprehension)
MSC:zClientzNeeds:zSafezandzEffectivezCarezEnvironment:zManagementzofzCare
3. Thezpatientszrecord,zlaboratoryzstudies,zobjectivezdata,zandzsubjectivezdatazcombineztozformzthe:
a. Datazbase.
b. Admittingzdata.
, c. Financialz statement.
d. Dischargezsummary.
ANS:zA
Togetherzwithzthezpatientszrecordzandzlaboratoryzstudies,zthezobjectivezandzsubjectivezdatazformzthez
datazbase.zThezotherzitemszareznotzpartzofzthezpatientszrecord,zlaboratoryzstudies,zorzdata.
DIF:z Cognitivez Level:z Rememberingz (Knowledge)
MSC:zClientzNeeds:zSafezandzEffectivezCarezEnvironment:zManagementzofzCare
4. Whenzlisteningztozazpatientszbreathzsounds,ztheznurseziszunsurezofzazsoundzthatziszheard.zThe
znursesznextzactionzshouldzbezto:
a. Immediatelyznotifyzthezpatientszphysician.
b. Documentzthezsoundzexactlyzaszitzwaszheard.
c. Validatezthezdatazbyzaskingzazcoworkerztozlistenztozthezbreathzsounds.
d. Assesszagainzinz20zminutesztoznotezwhetherzthezsoundziszstillzpresent.
ANS:zC
Whenzunsurezofzazsoundzheardzwhilezlisteningztozazpatientszbreathzsounds,ztheznursezvalidateszthezdata
ztozensurezaccuracy.zIfztheznursezhaszlesszexperiencezinzanzarea,zthenzhezorzshezaskszanzexpertztozlist
en.
DIF:zCognitivezLevel:zAnalyzingz(Analysis)
MSC:zClientzNeeds:zSafezandzEffectivezCarezEnvironment:zManagementzofzCare
5. Theznurseziszconductingzazclasszforznewzgraduateznurses.zDuringzthezteachingzsession,ztheznursezsh
ouldzkeepzinzmindzthatznoviceznurses,zwithoutzazbackgroundzofzskillszandzexperiencezfromzwhichztozd
raw,zarezmorezlikelyztozmakeztheirzdecisionszusing:
a. Intuition.
b. Azsetzofzrules.
c. Articleszinzjournals.
d. Advicezfromzsupervisors.
ANS:zB
Noviceznurseszoperatezfromzazsetzofzdefined,zstructuredzrules.zThezexpertzpractitionerzuseszintuitivezlin
ks.zDIF:zCognitivezLevel:zUnderstandingz(Comprehension)
Tablez ofz Contents
TablezofzContent 1
s
Chapterz01:zEvidence- 2
BasedzAssessmentzChapterz02:zCulturalzAss 15
essment 31
Chapterz 03:z Thez Interview 49
Chapterz04:zThezCompletezHealthzHistoryzC 64
hapterz05:zMentalzStatuszAssessmentzChapt 80
erz06:zSubstancezUsezAssessment 86
Chapterz 07:z Domesticz andz Familyz Violencez Assessment 92
Chapterz08:zAssessmentzTechniqueszandzSafetyzinzthezClinicalzSetti 111
ngzChapterz09:zGeneralzSurveyzandzMeasurement 118
Chapterz10:zVitalzSignszChap 133
terz11:zPainzAssessment 141
Chapterz12:zNutritionzAssessmentzCha 155
pterz13:zSkin,zHair,zandzNails 176
Chapterz14:zHead,zFace,zNeck,zandzRegionalzLymphaticszC 194
hapterz15:zEyes 211
Chapterz 16:z Ears 228
Chapterz 17:z Nose,z Mouth,z andz Throat 246
Chapterz18:zBreasts,zAxillae,zandzRegionalzLymphaticszCha 266
pterz19:zThoraxzandzLungs 284
Chapterz 20:z Heartz andz Neckz Vessels 303
Chapterz21:zPeripheralzVascularzSystemzandzLymphaticzSystemzCha 320
pterz22:zAbdomen 337
Chapterz23:zMusculoskeletalzSystemzC 358
hapterz24:z Neurologicz Systemz Chapte 382
rz25:zMalezGenitourinaryzSystemzChapt 400
erz26:zAnus,zRectum,zandzProstate 414
Chapterz 27:z Femalez Genitourinaryz System 436
Chapterz 28:z Thez Completez Healthz Assessment:z Adult 449
Chapterz29:zThezCompletezPhysicalzAssessment:zInfant,zChild,zandzAdolesce 452
ntzChapterz30:zBedsidezAssessmentzandzElectroniczDocumentation 458
Chapterz 31:z Thez Pregnantz Woman 471
Chapterz 32:z Functionalz Assessmentz ofz thez Olderz Adult
,Chapterz 01:z Evidence-Basedz Assessment
MULTIPLEzCHOICE
1. Afterzcompletingzanzinitialzassessmentzofzazpatient,ztheznursezhaszchartedzthatzhiszrespirationszareze
upneiczandzhiszpulsezisz58zbeatszperzminute.zTheseztypeszofzdatazwouldzbe:
a. Objective.
b. Reflective.
c. Subjective.
d. Introspective.
ANS:zA
Objectivezdatazarezwhatzthezhealthzprofessionalzobserveszbyzinspecting,zpercussing,zpalpating,zandzaus
cultatingzduringzthezphysicalzexamination.zSubjectivezdataziszwhatzthezpersonzsayszaboutzhimzorzhersel
fzduringzhistoryztaking.zTheztermszreflectivezandzintrospectivezareznotzusedztozdescribezdata.
DIF:z Cognitivez Level:z Understandingz (Comprehension)
MSC:zClientzNeeds:zSafezandzEffectivezCarezEnvironment:zManagementzofzCare
2. Azpatientztellsztheznursezthatzheziszveryznervous,zisznauseated,zandzfeelszhot.zTheseztypeszofzdatazwould
zbe:
a. Objective.
b. Reflective.
c. Subjective.
d. Introspective.
ANS:zC
Subjectivezdatazarezwhatzthezpersonzsayszaboutzhimzorzherselfzduringzhistoryztaking.zObjectivezdatazar
ezwhatzthezhealthzprofessionalzobserveszbyzinspecting,zpercussing,zpalpating,zandzauscultatingzduringzt
hezphysicalzexamination.zTheztermszreflectivezandzintrospectivezareznotzusedztozdescribezdata.
DIF:z Cognitivez Level:z Understandingz (Comprehension)
MSC:zClientzNeeds:zSafezandzEffectivezCarezEnvironment:zManagementzofzCare
3. Thezpatientszrecord,zlaboratoryzstudies,zobjectivezdata,zandzsubjectivezdatazcombineztozformzthe:
a. Datazbase.
b. Admittingzdata.
, c. Financialz statement.
d. Dischargezsummary.
ANS:zA
Togetherzwithzthezpatientszrecordzandzlaboratoryzstudies,zthezobjectivezandzsubjectivezdatazformzthez
datazbase.zThezotherzitemszareznotzpartzofzthezpatientszrecord,zlaboratoryzstudies,zorzdata.
DIF:z Cognitivez Level:z Rememberingz (Knowledge)
MSC:zClientzNeeds:zSafezandzEffectivezCarezEnvironment:zManagementzofzCare
4. Whenzlisteningztozazpatientszbreathzsounds,ztheznurseziszunsurezofzazsoundzthatziszheard.zThe
znursesznextzactionzshouldzbezto:
a. Immediatelyznotifyzthezpatientszphysician.
b. Documentzthezsoundzexactlyzaszitzwaszheard.
c. Validatezthezdatazbyzaskingzazcoworkerztozlistenztozthezbreathzsounds.
d. Assesszagainzinz20zminutesztoznotezwhetherzthezsoundziszstillzpresent.
ANS:zC
Whenzunsurezofzazsoundzheardzwhilezlisteningztozazpatientszbreathzsounds,ztheznursezvalidateszthezdata
ztozensurezaccuracy.zIfztheznursezhaszlesszexperiencezinzanzarea,zthenzhezorzshezaskszanzexpertztozlist
en.
DIF:zCognitivezLevel:zAnalyzingz(Analysis)
MSC:zClientzNeeds:zSafezandzEffectivezCarezEnvironment:zManagementzofzCare
5. Theznurseziszconductingzazclasszforznewzgraduateznurses.zDuringzthezteachingzsession,ztheznursezsh
ouldzkeepzinzmindzthatznoviceznurses,zwithoutzazbackgroundzofzskillszandzexperiencezfromzwhichztozd
raw,zarezmorezlikelyztozmakeztheirzdecisionszusing:
a. Intuition.
b. Azsetzofzrules.
c. Articleszinzjournals.
d. Advicezfromzsupervisors.
ANS:zB
Noviceznurseszoperatezfromzazsetzofzdefined,zstructuredzrules.zThezexpertzpractitionerzuseszintuitivezlin
ks.zDIF:zCognitivezLevel:zUnderstandingz(Comprehension)
