Test Bank for Health Assessment for
-- -- -- -- -- --
Nursing Practice 7th Edition by Wilson
-- -- -- -- -- --
Chapter 1 - 24 -- -- --
,Chapter--01:--Introduction--to--Health--Assessment
MULTIPLE--CHOICE
1. A--patient--comes--to--the--emergency--department--and--tells--the--triage--nurse--that--he--
is--“having--a--heart--attack.”--What--is--the--nurse’s--top--priority--at--this--time?
a. Determine--the--patient’s--personal--data--and--
insurance--coverage.
b. Ask--the--patient--to--take--a--seat--in--the--waiting-
-room--until--his--name--is--called.
c. Request--that--a--nurse--collect--data--for--a--
comprehensive--history.
d. Ask--a--nurse--to--start--a--focused--assessment-
-of--this--patient--now.
ANSWER:--D
The--nurse--needs--to--begin--an--assessment--as--soon--as--possible--that--is--focused--on--this--
patient’s--cardiovascular--system.--The--type--of--health--assessment--performed--by--the--nurse--is--
also--driven--by--patient--need.--Personal--data--and--insurance--information--will--be--obtained,--but-
-in--this--situation,--these--data--can--wait--until--after--the--patient--is--assessed.--Based--also--on--
Maslow’s--hierarchy--of--needs,--physiologic--needs--take--precedence.--Rather--than--asking--the--
patient--to--wait,--the--nurse--needs--to--begin--data--collection,--such--as--vital--signs,--immediately--
to--determine--the--patient’s--health--status.--Complications--can--be--prevented--if--an--immediate--
assessment--is--made--to--analyze--the--patient’s--symptoms.--A--comprehensive--history--is--not--
indicated--in--this--situation--at--this--time.--Some--subjective--data--will--be--collected,--such--as--
allergies--and--medical--history--related--to--cardiovascular--disease.--Eyes,--ears,--or--a--complete--
musculoskeletal--or--mental--health--assessment--is--not--a--priority--at--this--time.
DIF:- - Cognitive--Level:--Apply REF:--Box--1-3--|--p.--
3--TOP:--Nursing--Process:--Assessment
MSC:--NCLEX--Patient--Needs:--Safe--and--Effective--Care--Environment:--Management--of--Care:--
Establishing--Priorities
2. Which-- situation--illustrates--a- - screening--assessment?
a. A--patient--visits--an--obstetric--clinic--for--the--
first--time--and--the--nurse--conducts--a--detailed--
history--and--physical--examination.
b. A--hospital--sponsors--a--health--fair--at--a--local--
mall--and--provides--cholesterol--and--blood--
pressure--checks--to--mall--patrons.
c. The--nurse--in--an--urgent--care--center--checks--
the--vital--signs--of--a--patient--who--is--
complaining--of--leg--pain.
, d. A--patient--newly--diagnosed--with--diabetes--
mellitus--comes--to--test--his--fasting--blood--
glucose--level.
ANSWER:--B
A- - - - health- - - - fair- - - - at- - - - a- - - - local- - mall- - - - that- - - - provides- - - - cholesterol- - - - and- - - - blood-
- - - pressure--checks- - - - is- - - - an- - - - example- - - - of- - - - a- - - - screening- - - - assessment- - - - focused- -
- - on- - - - disease
detection.- - A- - detailed- - history- - and- - physical- - examination- - conducted- -
during- - a- - first-time visit- - to- - an- - obstetric- - clinic- - is- - an- - example--of- - a-
- comprehensive--assessment.- - - - Assessing- - - - a- - - - patient- - - - complaining- - - - of- - - - leg- - - -
pain- - - - in- - - - the- - - - triage- - - - area
of- - an- - urgent- - care- - center- - is- - an- - example- - of- - a- - problem-
based/focused- - assessment.- - - - A- - - - patient’s- - - - return- - - - appointment- - - - 1- - - - month- - - -
after- - - - today’s- - - - office
visit- - - - to- - - - report- - - - fasting- - blood- - - - glucose- - levels- - is- - an- - example- - of- - an- -
episodic- - or--follow-up- - assessment.
DIF: Cognitive- - - - Level:- - - - Understand-REF:- - - - Box- - - - 1-3
|- - - - p.- - - - 3-- TOP:- - - - Nursing- - - - Process: Assessment
MSC:- - - - NCLEX- - Patient Needs: Health- - Promotion- - - - and- - - - Maintenance:- - - - Health- - - - Screening
3. For- - - - which- - person- - is- - a screening- - assessment- - - - indicated?
a. The- - person- - who had- -
abdominal--surgery--yesterday
b. The- - person- - who- - is- - unaware-
- of--his- - high--serum- - glucose- -
levels
c. The- - person- - who- - is- - being--
admitted- - to- - a--long-term- - care
facility
d. The- - person- - who --is- - beginning--
rehabilitation--after a- - knee- -
replacement
ANSWER: B
A- - - - screening- - - - assessment- - - - is- - - - performed- - - - for- - - - the- - - - purpose- - - - of- - - - disease- - - - detection.
In- - - - this- - - - case- - - - this--person- - - - may- - - - have- - - - diabetes- - - - mellitus.- - - - A- - - - shift- - - - assessment
is- - most- - appropriate- - for- - the- - person- - who- - is- - recovering- - in- - the- -
hospital- - from- - surgery.- - A- - comprehensive- - assessment- - is- - performed--during-
- admission- - to- - a--facility- - to- - obtain- - a- - detailed- - history- - and- - complete- -
physical- - examination.- - An- - episodic- - - - or- - - - follow-up- - - - assessment- - - - is- - - -
performed- - - - after- - - - knee- - - - replacement- - - - to
evaluate- - - - the- - - - outcome- - - - of- - - - the- - - - procedure.
DIF: Cognitive- - - - Level:- - - - Understand-REF:- - - - Box- - - - 1-3
|- - - - p.- - - - 3-- TOP:- - - - Nursing- - - - Process: Assessment
MSC:- - NCLEX- - Patient- - - - Needs:- - Safe- - and- - Effective- - Care- - Environment:- -
Management- - of--Care:--Establishing- - Priorities
4. For- - - - which- - person- - - - is- - a shift- - - - assessment- - - - indicated?
a. The- - person- - who had- -
abdominal--surgery--yesterday
b. The- - person- - who- - is- - unaware-
- of--his- - high--serum- - glucose- -
levels
c. The- - person- - who is- - being- -
admitted--to- - a
long-term- - care- - - - facility
, d. The- - person- - who- - is- - beginning--
rehabilitation--after a- - knee- -
replacement
ANSWER: A
A- - - - shift- - - - assessment- - - - is- - - - most- - - - appropriate- - - - for- - - - the- - - - person- - - - who- - - - is- - - -
recovering--in- - - - the- - - - hospital- - - - from--surgery.- - - - A- - - - screening- - - - assessment- - - - is- - - -
performed- - - - for- - - - the
purpose- - - - of- - - -
disease
-- -- -- -- -- --
Nursing Practice 7th Edition by Wilson
-- -- -- -- -- --
Chapter 1 - 24 -- -- --
,Chapter--01:--Introduction--to--Health--Assessment
MULTIPLE--CHOICE
1. A--patient--comes--to--the--emergency--department--and--tells--the--triage--nurse--that--he--
is--“having--a--heart--attack.”--What--is--the--nurse’s--top--priority--at--this--time?
a. Determine--the--patient’s--personal--data--and--
insurance--coverage.
b. Ask--the--patient--to--take--a--seat--in--the--waiting-
-room--until--his--name--is--called.
c. Request--that--a--nurse--collect--data--for--a--
comprehensive--history.
d. Ask--a--nurse--to--start--a--focused--assessment-
-of--this--patient--now.
ANSWER:--D
The--nurse--needs--to--begin--an--assessment--as--soon--as--possible--that--is--focused--on--this--
patient’s--cardiovascular--system.--The--type--of--health--assessment--performed--by--the--nurse--is--
also--driven--by--patient--need.--Personal--data--and--insurance--information--will--be--obtained,--but-
-in--this--situation,--these--data--can--wait--until--after--the--patient--is--assessed.--Based--also--on--
Maslow’s--hierarchy--of--needs,--physiologic--needs--take--precedence.--Rather--than--asking--the--
patient--to--wait,--the--nurse--needs--to--begin--data--collection,--such--as--vital--signs,--immediately--
to--determine--the--patient’s--health--status.--Complications--can--be--prevented--if--an--immediate--
assessment--is--made--to--analyze--the--patient’s--symptoms.--A--comprehensive--history--is--not--
indicated--in--this--situation--at--this--time.--Some--subjective--data--will--be--collected,--such--as--
allergies--and--medical--history--related--to--cardiovascular--disease.--Eyes,--ears,--or--a--complete--
musculoskeletal--or--mental--health--assessment--is--not--a--priority--at--this--time.
DIF:- - Cognitive--Level:--Apply REF:--Box--1-3--|--p.--
3--TOP:--Nursing--Process:--Assessment
MSC:--NCLEX--Patient--Needs:--Safe--and--Effective--Care--Environment:--Management--of--Care:--
Establishing--Priorities
2. Which-- situation--illustrates--a- - screening--assessment?
a. A--patient--visits--an--obstetric--clinic--for--the--
first--time--and--the--nurse--conducts--a--detailed--
history--and--physical--examination.
b. A--hospital--sponsors--a--health--fair--at--a--local--
mall--and--provides--cholesterol--and--blood--
pressure--checks--to--mall--patrons.
c. The--nurse--in--an--urgent--care--center--checks--
the--vital--signs--of--a--patient--who--is--
complaining--of--leg--pain.
, d. A--patient--newly--diagnosed--with--diabetes--
mellitus--comes--to--test--his--fasting--blood--
glucose--level.
ANSWER:--B
A- - - - health- - - - fair- - - - at- - - - a- - - - local- - mall- - - - that- - - - provides- - - - cholesterol- - - - and- - - - blood-
- - - pressure--checks- - - - is- - - - an- - - - example- - - - of- - - - a- - - - screening- - - - assessment- - - - focused- -
- - on- - - - disease
detection.- - A- - detailed- - history- - and- - physical- - examination- - conducted- -
during- - a- - first-time visit- - to- - an- - obstetric- - clinic- - is- - an- - example--of- - a-
- comprehensive--assessment.- - - - Assessing- - - - a- - - - patient- - - - complaining- - - - of- - - - leg- - - -
pain- - - - in- - - - the- - - - triage- - - - area
of- - an- - urgent- - care- - center- - is- - an- - example- - of- - a- - problem-
based/focused- - assessment.- - - - A- - - - patient’s- - - - return- - - - appointment- - - - 1- - - - month- - - -
after- - - - today’s- - - - office
visit- - - - to- - - - report- - - - fasting- - blood- - - - glucose- - levels- - is- - an- - example- - of- - an- -
episodic- - or--follow-up- - assessment.
DIF: Cognitive- - - - Level:- - - - Understand-REF:- - - - Box- - - - 1-3
|- - - - p.- - - - 3-- TOP:- - - - Nursing- - - - Process: Assessment
MSC:- - - - NCLEX- - Patient Needs: Health- - Promotion- - - - and- - - - Maintenance:- - - - Health- - - - Screening
3. For- - - - which- - person- - is- - a screening- - assessment- - - - indicated?
a. The- - person- - who had- -
abdominal--surgery--yesterday
b. The- - person- - who- - is- - unaware-
- of--his- - high--serum- - glucose- -
levels
c. The- - person- - who- - is- - being--
admitted- - to- - a--long-term- - care
facility
d. The- - person- - who --is- - beginning--
rehabilitation--after a- - knee- -
replacement
ANSWER: B
A- - - - screening- - - - assessment- - - - is- - - - performed- - - - for- - - - the- - - - purpose- - - - of- - - - disease- - - - detection.
In- - - - this- - - - case- - - - this--person- - - - may- - - - have- - - - diabetes- - - - mellitus.- - - - A- - - - shift- - - - assessment
is- - most- - appropriate- - for- - the- - person- - who- - is- - recovering- - in- - the- -
hospital- - from- - surgery.- - A- - comprehensive- - assessment- - is- - performed--during-
- admission- - to- - a--facility- - to- - obtain- - a- - detailed- - history- - and- - complete- -
physical- - examination.- - An- - episodic- - - - or- - - - follow-up- - - - assessment- - - - is- - - -
performed- - - - after- - - - knee- - - - replacement- - - - to
evaluate- - - - the- - - - outcome- - - - of- - - - the- - - - procedure.
DIF: Cognitive- - - - Level:- - - - Understand-REF:- - - - Box- - - - 1-3
|- - - - p.- - - - 3-- TOP:- - - - Nursing- - - - Process: Assessment
MSC:- - NCLEX- - Patient- - - - Needs:- - Safe- - and- - Effective- - Care- - Environment:- -
Management- - of--Care:--Establishing- - Priorities
4. For- - - - which- - person- - - - is- - a shift- - - - assessment- - - - indicated?
a. The- - person- - who had- -
abdominal--surgery--yesterday
b. The- - person- - who- - is- - unaware-
- of--his- - high--serum- - glucose- -
levels
c. The- - person- - who is- - being- -
admitted--to- - a
long-term- - care- - - - facility
, d. The- - person- - who- - is- - beginning--
rehabilitation--after a- - knee- -
replacement
ANSWER: A
A- - - - shift- - - - assessment- - - - is- - - - most- - - - appropriate- - - - for- - - - the- - - - person- - - - who- - - - is- - - -
recovering--in- - - - the- - - - hospital- - - - from--surgery.- - - - A- - - - screening- - - - assessment- - - - is- - - -
performed- - - - for- - - - the
purpose- - - - of- - - -
disease
