TEST BANK
Physical Examination and Health Assessment, Canadian
Edition, 4th Edition
Authors: Carolyn Jarvis, PhD, APN, CNP; Annette J. Browne, RN, PhD, FCAHS; June
MacDonald-Jenkins, RN, BScN, MSc; Marian Luctkar-Flude, RN, PhD, CCSNE, FCNEI
ISBN: 9780323827416
Edition: 4th Canadian Edition
Complete Test Bank with Answers and Rationales
Ch 01: critical thinking and evidence-informed assessment,
4e
Mcq
1) Which type of data is collected by obtaining vital signs?
a) Objective
b) Reflecting
c) Subjective
d) Introspective
(answer): a
Objective data are what the nurse observes by inspecting, percussing, palpating and auscultating during the physical
examination. Subjective data are what the person says about themselves during history taking. The terms reflective and
introspective are not used to describe data.
Difficulty: cognitive level: understanding (comprehension)
Msc: client needs: safe and effective care environment: management of care
2) During an assessment, a patient describes feeling warm, nauseated, and nervous. Which type of data is collected?
a) Objective
b) Reflective
c) Subjective
d) Introspective
(answer): c
, Subjective data are what the person says about themselves during history taking. Objective data are what the nurse observes
by inspecting, percussing, palpating, and auscultating during the physical examination. The terms reflective and introspective
are not used to describe data.
Difficulty: cognitive level: understanding (comprehension)
Msc: client needs: safe and effective care environment: management of care
3) Which part of a patient’s health record is created when combining laboratory studies, objective data, and subjective
data?
a) Database
b) Admitting data
c) Triage form
d) Discharge summary
(answer): a
Together with the patient’s record and laboratory studies, the objective and subjective data form the database. The other items
are not part of the patient’s record, laboratory studies, or data.
Difficulty: cognitive level: remembering (knowledge)
Msc: client needs: safe and effective care environment: management of care
4) Which action will the nurse complete if while listening to a patient’s breath sounds, they are not sure of a sound heard?
a) Immediately notify the patient’s most responsible practitioner.
b) Document the sound exactly as it was heard.
c) Validate the data by asking a coworker to listen to the breath sounds.
d) Assess again in 20 minutes to note whether the sound is still present.
(answer): c
When not sure of a sound heard while listening to a patient’s breath sounds, the nurse validates the data to ensure
accuracy. If the nurse has less experience in an area, then they would ask an expert to listen.
Difficulty: cognitive level: analyzing (analysis)
Msc: client needs: safe and effective care environment: management of care
5) Which approach do novice caregivers utilize when making decisions?
a) Intuition
b) Clear-cut rules
c) Articles in journals
d) Advice from supervisors
(answer): b
Novice caregivers operate from a set of defined, structured rules. Expert practitioners use critical thinking and their
substantial background of experience.
Difficulty: cognitive level: understanding (comprehension) msc: client needs:
general
,6) Which method moves a nurse from novice to expert?
a) Critical thinking
b) The nursing process
c) Clinical knowledge
d) Diagnostic reasoning
(answer): a
Critical thinking is a multidimensional, dynamic, and interactive thinking process by which expert caregivers assess and make
decisions in the clinical area.
Difficulty: cognitive level: understanding (comprehension) msc: client needs: general
7) Which statement reflects the meaning of evidence-informed practice (eip)?
a) Best practice techniques to treat patients. Taking note solely from registered caregivers association of ontario
(rnao)
b) Clinician experience and expertise to guide practice. Sometimes reflecting on the patient perspective
c) Life-long problem-solving approach to clinical decision making using best available evidence
d) The patient’s own preferences are not important in eip
(answer): c
Eip is more than the use of best practice techniques to treat patients; it can be defined as a paradigm and lifelong problem-
solving approach to clinical decision making that involves the conscientious use of the best available evidence (including a
systematic search for and critical appraisal of the most relevant evidence to answer a clinical question) with one’s own clinical
expertise and patient values and preferences to improve outcomes for individuals, groups, communities, and systems. Eip is
more than simply using the best practice techniques to treat patients, and questioning tradition is important when no
compelling and supportive research evidence exists.
Difficulty: cognitive level: applying (application)
Msc: client needs: safe and effective care environment: management of care
8) Which example illustrates a first-level priority problem?
a) Postoperative pain
b) Newly diagnosed diabetes needing diabetic teaching
c) Small laceration on the sole of the foot
d) Shortness of breath and respiratory distress
(answer): d
First-level priority problems are those that are emergent, life-threatening, and immediate (e.g., establishing an airway,
supporting breathing, maintaining circulation, monitoring abnormal vital signs) (see table 1.1 – identifying immediate priorities).
Difficulty: cognitive level: understanding (comprehension)
Msc: client needs: safe and effective care environment: management of care
9) Which critical thinking skill recognizes relationships among the data?
, a) Validation
b) Clustering related cues
c) Identifying gaps in data
d) Distinguishing relevant data from irrelevant data
(answer): b
Clustering related cues helps the nurse see relationships among the data.
Difficulty: cognitive level: understanding (comprehension)
Msc: client needs: safe and effective care environment: management of care
10) Which diagnosis is critical to develop appropriate nursing interventions for a patient?
a) Nursing
b) Medical
c) Admission
d) Collaborative
(answer): a
An accurate nursing diagnosis provides the basis for the selection of nursing interventions to achieve outcomes for which the
nurse is accountable. The other items do not contribute to the development of appropriate nursing interventions.
Difficulty: cognitive level: remembering
Msc: client needs: safe and effective care environment: management of care
11) Which steps are included in the nursing process?
a) Assessment, treatment, planning, evaluation, discharge, and follow-up
b) Admission, assessment, diagnosis, treatment, and discharge planning
c) Admission, diagnosis, treatment, evaluation, and discharge planning
d) Assessment, diagnosis, outcome identification, planning, implementation, and evaluation
(answer): d
The nursing process is a method of problem solving that includes assessment, diagnosis, outcome identification, planning,
implementation, and evaluation.
Difficulty: cognitive level: remembering
Msc: client needs: safe and effective care environment: management of care
12) A newly admitted patient is in acute pain, not sleeping well, and is having difficulty breathing. In which sequence will the
nurse prioritize the assessment?
a) Breathing, pain, and sleep
b) Breathing, sleep, and pain
c) Sleep, breathing, and pain
d) Sleep, pain, and breathing
Physical Examination and Health Assessment, Canadian
Edition, 4th Edition
Authors: Carolyn Jarvis, PhD, APN, CNP; Annette J. Browne, RN, PhD, FCAHS; June
MacDonald-Jenkins, RN, BScN, MSc; Marian Luctkar-Flude, RN, PhD, CCSNE, FCNEI
ISBN: 9780323827416
Edition: 4th Canadian Edition
Complete Test Bank with Answers and Rationales
Ch 01: critical thinking and evidence-informed assessment,
4e
Mcq
1) Which type of data is collected by obtaining vital signs?
a) Objective
b) Reflecting
c) Subjective
d) Introspective
(answer): a
Objective data are what the nurse observes by inspecting, percussing, palpating and auscultating during the physical
examination. Subjective data are what the person says about themselves during history taking. The terms reflective and
introspective are not used to describe data.
Difficulty: cognitive level: understanding (comprehension)
Msc: client needs: safe and effective care environment: management of care
2) During an assessment, a patient describes feeling warm, nauseated, and nervous. Which type of data is collected?
a) Objective
b) Reflective
c) Subjective
d) Introspective
(answer): c
, Subjective data are what the person says about themselves during history taking. Objective data are what the nurse observes
by inspecting, percussing, palpating, and auscultating during the physical examination. The terms reflective and introspective
are not used to describe data.
Difficulty: cognitive level: understanding (comprehension)
Msc: client needs: safe and effective care environment: management of care
3) Which part of a patient’s health record is created when combining laboratory studies, objective data, and subjective
data?
a) Database
b) Admitting data
c) Triage form
d) Discharge summary
(answer): a
Together with the patient’s record and laboratory studies, the objective and subjective data form the database. The other items
are not part of the patient’s record, laboratory studies, or data.
Difficulty: cognitive level: remembering (knowledge)
Msc: client needs: safe and effective care environment: management of care
4) Which action will the nurse complete if while listening to a patient’s breath sounds, they are not sure of a sound heard?
a) Immediately notify the patient’s most responsible practitioner.
b) Document the sound exactly as it was heard.
c) Validate the data by asking a coworker to listen to the breath sounds.
d) Assess again in 20 minutes to note whether the sound is still present.
(answer): c
When not sure of a sound heard while listening to a patient’s breath sounds, the nurse validates the data to ensure
accuracy. If the nurse has less experience in an area, then they would ask an expert to listen.
Difficulty: cognitive level: analyzing (analysis)
Msc: client needs: safe and effective care environment: management of care
5) Which approach do novice caregivers utilize when making decisions?
a) Intuition
b) Clear-cut rules
c) Articles in journals
d) Advice from supervisors
(answer): b
Novice caregivers operate from a set of defined, structured rules. Expert practitioners use critical thinking and their
substantial background of experience.
Difficulty: cognitive level: understanding (comprehension) msc: client needs:
general
,6) Which method moves a nurse from novice to expert?
a) Critical thinking
b) The nursing process
c) Clinical knowledge
d) Diagnostic reasoning
(answer): a
Critical thinking is a multidimensional, dynamic, and interactive thinking process by which expert caregivers assess and make
decisions in the clinical area.
Difficulty: cognitive level: understanding (comprehension) msc: client needs: general
7) Which statement reflects the meaning of evidence-informed practice (eip)?
a) Best practice techniques to treat patients. Taking note solely from registered caregivers association of ontario
(rnao)
b) Clinician experience and expertise to guide practice. Sometimes reflecting on the patient perspective
c) Life-long problem-solving approach to clinical decision making using best available evidence
d) The patient’s own preferences are not important in eip
(answer): c
Eip is more than the use of best practice techniques to treat patients; it can be defined as a paradigm and lifelong problem-
solving approach to clinical decision making that involves the conscientious use of the best available evidence (including a
systematic search for and critical appraisal of the most relevant evidence to answer a clinical question) with one’s own clinical
expertise and patient values and preferences to improve outcomes for individuals, groups, communities, and systems. Eip is
more than simply using the best practice techniques to treat patients, and questioning tradition is important when no
compelling and supportive research evidence exists.
Difficulty: cognitive level: applying (application)
Msc: client needs: safe and effective care environment: management of care
8) Which example illustrates a first-level priority problem?
a) Postoperative pain
b) Newly diagnosed diabetes needing diabetic teaching
c) Small laceration on the sole of the foot
d) Shortness of breath and respiratory distress
(answer): d
First-level priority problems are those that are emergent, life-threatening, and immediate (e.g., establishing an airway,
supporting breathing, maintaining circulation, monitoring abnormal vital signs) (see table 1.1 – identifying immediate priorities).
Difficulty: cognitive level: understanding (comprehension)
Msc: client needs: safe and effective care environment: management of care
9) Which critical thinking skill recognizes relationships among the data?
, a) Validation
b) Clustering related cues
c) Identifying gaps in data
d) Distinguishing relevant data from irrelevant data
(answer): b
Clustering related cues helps the nurse see relationships among the data.
Difficulty: cognitive level: understanding (comprehension)
Msc: client needs: safe and effective care environment: management of care
10) Which diagnosis is critical to develop appropriate nursing interventions for a patient?
a) Nursing
b) Medical
c) Admission
d) Collaborative
(answer): a
An accurate nursing diagnosis provides the basis for the selection of nursing interventions to achieve outcomes for which the
nurse is accountable. The other items do not contribute to the development of appropriate nursing interventions.
Difficulty: cognitive level: remembering
Msc: client needs: safe and effective care environment: management of care
11) Which steps are included in the nursing process?
a) Assessment, treatment, planning, evaluation, discharge, and follow-up
b) Admission, assessment, diagnosis, treatment, and discharge planning
c) Admission, diagnosis, treatment, evaluation, and discharge planning
d) Assessment, diagnosis, outcome identification, planning, implementation, and evaluation
(answer): d
The nursing process is a method of problem solving that includes assessment, diagnosis, outcome identification, planning,
implementation, and evaluation.
Difficulty: cognitive level: remembering
Msc: client needs: safe and effective care environment: management of care
12) A newly admitted patient is in acute pain, not sleeping well, and is having difficulty breathing. In which sequence will the
nurse prioritize the assessment?
a) Breathing, pain, and sleep
b) Breathing, sleep, and pain
c) Sleep, breathing, and pain
d) Sleep, pain, and breathing
