eJ eJ eJ eJ
Health Assessment, 9th Edition by Carolyn
eJ eJ eJ eJ eJ eJ
Jarvis
eJ
, Table of Contents
eJ eJ
Table eJof eJContents 1
Chapter eJ01: eJEvidence-Based 2
eJAssessment Ej 15
Chapter eJ02: eJCultural eJAssessment 31
eJChapter eJ03: eJThe eJInterview 49
Chapter eJ04: eJThe eJComplete eJHealth 64
eJHistory e 80
JChapter eJ05: eJMental eJStatus eJAssessment
eChapter eJ06: eJSubstance eJUse
eJAssessment
Chapter eJ07: eJDomestic eJand eJFamily eJViolence eJAssessment 86
Chapter eJ08: eJAssessment eJTechniques eJand eJSafety eJin eJthe eJCli eJnical eJSetting 92
Chapter eJ09: eJGeneral eJSurvey eJand eJMeasurement 111
eJChapter eJ10: eJVital eJSigns eJChapter 118
11: eJPain eJAssessment 133
Chapter eJ12: eJNutrition eJAssessment 141
eJChapter eJ13: eJSkin, eJHair, eJand eJNails 155
Chapter eJ14: eJHead, eJFace, eJNeck, eJand eJRegional eJLymphatics 176
eJChapter eJ15: eJEyes 194
Chapter eJ16: eJEars 211
Chapter eJ17: eJNose, eJMouth, eJand eJThroat 228
Chapter eJ18: eJBreasts, eJAxillae, eJand eJRegional eJLymphatics 246
eJChapter eJ19: eJThorax eJand eJLungs 266
Chapter eJ20: eJHeart eJand eJNeck eJVessels 284
Chapter eJ21: eJPeripheral eJVascular eJSystem eJand eJLymphatic eJSystem 303
eJChapter eJ22: eJAbdomen 320
Chapter eJ23: eJMusculoskeletal eJSystem 337
eJChapter e J 24: e J Neurologic e J System 358
eJChapter eJ25: eJMale eJGenitourinary eJSystem 382
eJChapter eJ26: 400
Anus, eJRectum, eJand eJProstate 414
Chapter eJ27: eJFemale eJGenitourinary eJSystem 436
Chapter eJ28: eJThe eJComplete eJHealth eJAssessment: eJAdult 449
Chapter eJ29: eJThe eJComplete eJPhysical eJAssessment: eJInfant, eJChild, eJand eJAdolescent 452
Chapter eJ30: eJBedside eJAssessment eJand eJElectronic eJDocumentation 458
Chapter eJ31: eJThe eJPregnant eJWoman 471
Chapter eJ32: eJFunctional eJAssessment eJof eJthe eJOlder eJAdult
,Chapter 01: Evidence-Based Assessment
eJ eJ eJ
MULTIPLE e J CHOICE
1. After eJcompleting eJan eJinitial eJassessment eJof eJa eJpatient, eJthe eJnurse eJhas eJcharted eJthat eJhis eJrespirations eJare
eJeupneic eJand eJhis e J pulse e J is e J 58 e J beats e J per e J minute. e J These e J types e J of e J data e J wouldbe:
a. Objective.
b. Reflective.
c. Subjective.
d. Introspective.
ANS: e J A
Objective eJdata eJare eJwhat eJthe eJhealth eJprofessional eJobserves eJby eJinspecting, eJpercussing, eJpalpating, eJand
eJauscultating eJduring eJthe eJphysical eJexamination. eJSubjective eJdata eJis eJwhat eJthe eJperson eJsays eJabout eJhim eJor
eJherself eJduring eJhistory eJtaking. e J The e J terms e J reflective e J and e J introspective e J are e J not e J used e J to
e J describe e J data.
DIF: e J Cognitive e J Level: e J Understanding e J (Comprehension)
MSC: eJ Client e J Needs: e J Safe e J and eJ Effective e J Care e J Environment: e J Management e J of e J Care
2. A eJpatient eJtells eJthe eJ nurse eJthat eJhe eJis eJ very eJnervous, eJis eJnauseated, eJ and eJfeels eJ hot. eJThese eJtypes eJ of eJ data eJwould
eJbe:
a. Objective.
b. Reflective.
c. Subjective.
d. Introspective.
ANS: e J C
Subjective eJdata eJare eJwhat eJthe eJperson eJsays eJabout eJhim eJor eJherself eJduring eJhistory eJtaking. eJObjective eJdata eJare
eJwhat eJthe eJhealth e J professional e J observes e J by e J inspecting, e J percussing, e J palpating, e J and e J auscultating
e J during e J the e J physical eJexamination. e J The e J terms e J reflective e J and e J introspective e J are e J not e J used eJto
e J describe e J data.
DIF: e J Cognitive e J Level: e J Understanding e J (Comprehension)
MSC: eJ Client e J Needs: e J Safe e J and eJ Effective e J Care e J Environment: e J Management e J of e J Care
3. The e J patients eJ record, eJ laboratory e J studies, e J objective e J data, e J and eJsubjective e J data e J combine e J to eJform eJthe:
a. Data eJ base.
b. Admitting e J data.
, c. Financial e J statement.
d. Discharge e J summary.
ANS: e J A
Together eJwith eJthe eJpatients eJrecord eJand eJlaboratory eJstudies, eJthe eJobjective eJand eJsubjective eJdata eJform eJthe
eJdata eJbase. eJThe e J other e J items e J are e J not e J part e J of e J the e J patients e J record, e J laboratory e J studies, e J or
e J data.
DIF: eJ Cognitive e J Level: e J Remembering e J (Knowledge)
MSC: eJ Client e J Needs: e J Safe e J and eJ Effective e J Care e J Environment: e J Management e J of e J Care
4. When eJlistening eJto eJa eJpatients eJbreath eJsounds, eJthe eJnurse eJis eJunsure eJof eJa eJsound eJthat eJis eJheard. eJThe
eJnurses eJnext eJaction eJshould eJbe eJto:
a. Immediately e J notify e J the e J patients e J physician.
b. Document eJ the e J sound eJ exactly eJ as e J it e J was eJ heard.
c. Validate eJthe eJ data eJ by eJasking eJa eJcoworker eJto eJlisten eJto eJthe eJbreath eJsounds.
d. Assess eJagain eJin eJ20 eJ minutes eJto eJnote eJwhether eJ the eJsound eJis eJ still eJpresent.
ANS: e J C
When eJunsure eJof eJa eJsound eJheard eJwhile eJlistening eJto eJa eJpatients eJbreath eJsounds, eJthe eJnurse eJvalidates eJthe eJdata
eJto eJensure eJaccuracy. e J If e J the e J nurse e J has e J less eJexperience e J in e J an e J area, e J then e J he e J or e J she e J asks
e J an e J expert e J to e J listen.
DIF: e J Cognitive e J Level: e J Analyzing e J (Analysis)
MSC: eJ Client e J Needs: e J Safe e J and eJ Effective e J Care e J Environment: e J Management e J of e J Care
5. The eJnurse eJis eJconducting e J a eJclass eJfor eJnew e J graduate eJnurses. e J During eJthe eJteaching eJsession, eJthe eJnurse
eJshould e J keep e J in e J mind e J that e J novice eJnurses, e J without e J a e J background e J of eJskills e J and eJexperience e J from
eJwhich e J to eJdraw, e J are e J more e J likely eJto eJmake eJtheir eJdecisions eJusing:
a. Intuition.
b. A eJset eJ of eJrules.
c. Articles e J in eJjournals.
d. Advice e J from eJsupervisors.
ANS: eJ B
Novice eJnurses eJoperate eJfrom eJa eJset eJof eJdefined, eJstructured eJrules. eJThe eJexpert eJpractitioner eJuses eJintuitive
links. eJDIF: eJCognitive
eJ eJ Level: eJ Understanding eJ(Comprehension)