# Test Bank – Health Assessment in Nursing, 7th Edition
(Weber & Kelley)
## Section 1: The Nurse's Role in Health Assessment (Questions 1–25)
**1. A nurse on a postsurgical unit is admitting a client following the client's cholecystectomy. What is
the overall purpose of assessment for this client?**
A) Collecting accurate data
B) Assisting the primary care provider
C) Validating previous data
D) Making clinical judgments
**Answer: D**
*Rationale:* The overall purpose of the nursing assessment is to make clinical judgments, which form
the basis for nursing diagnoses and the plan of care. While collecting accurate data is part of the
process, it serves the larger goal of clinical decision-making .
**2. A client has presented to the emergency department with complaints of abdominal pain. Which
member of the care team would most likely be responsible for collecting the subjective data during
the initial comprehensive assessment?**
A) Gastroenterologist
B) ED nurse
C) Admissions clerk
D) Diagnostic technician
**Answer: B**
*Rationale:* The nurse is responsible for collecting subjective data during the initial comprehensive
assessment. This is part of the nursing assessment role, distinct from the physician's medical
examination .
**3. The nurse has completed an initial assessment of a newly admitted client and is applying the
nursing process to plan the client's care. What principle should the nurse apply when using the
nursing process?**
A) Each step is independent of the others.
,B) It is ongoing and continuous.
C) It is used primarily in acute care settings.
D) It involves independent nursing actions.
**Answer: B**
*Rationale:* The nursing process is ongoing and continuous. Assessment is not a one-time event but a
dynamic process that continues throughout the client's care .
**4. When preparing to meet a client and perform a comprehensive health assessment, which action
should the nurse perform first?**
A) Review the client's medical record.
B) Obtain basic biographic data.
C) Consult clinical resources.
D) Validate information with the client.
**Answer: A**
*Rationale:* The nurse should first review the client's medical record to gather existing information
before beginning the interview and physical examination. This helps the nurse prepare appropriate
questions and identify areas requiring further exploration .
**5. Which client situation would the nurse interpret as requiring an emergency assessment?**
A) A pediatric client with severe sunburn
B) A client needing an employment physical
C) A client who overdosed on acetaminophen
D) A distraught client who wants a pregnancy test
**Answer: C**
*Rationale:* An emergency assessment is required in life-threatening or potentially life-threatening
situations. An acetaminophen overdose can cause acute liver failure and requires immediate
assessment and intervention .
**6. The nurse is explaining the differences between the physician's medical exam and the
comprehensive health assessment performed by the nurse. The nursing assessment focuses on which
aspect of the client's situation?**
A) Current physiologic status
,B) Effect of health on functional status
C) Past medical history
D) Motivation for adherence to treatment
**Answer: B**
*Rationale:* The nursing assessment focuses on the effect of health on functional status. While the
medical examination focuses primarily on physiologic status, the nursing assessment takes a holistic
view of the client's health and its impact on daily functioning .
**7. After teaching a group of students about the phases of the nursing process, the instructor
determines that the teaching was successful when the students identify which phase as foundational
to all other phases?**
A) Assessment
B) Planning
C) Implementation
D) Evaluation
**Answer: A**
*Rationale:* Assessment is foundational to all other phases of the nursing process. Without accurate
assessment data, planning, implementation, and evaluation cannot be effectively carried out .
**8. The nurse periodically performs a partial assessment after completing a comprehensive health
assessment primarily for which reason?**
A) Reassess previously detected problems
B) Provide information for the client's record
C) Address areas previously omitted
D) Determine the need for crisis intervention
**Answer: A**
*Rationale:* A partial assessment is performed to reassess previously detected problems and monitor
the client's response to treatment. It is not meant to replace the comprehensive assessment .
**9. When preparing to interview a client, which position is most appropriate for the nurse?**
A) Standing to maintain control
B) Sitting at eye level with the client
, C) Sitting at the client's feet
D) Standing at the head of the bed
**Answer: B**
*Rationale:* Sitting at eye level with the client helps establish rapport and reduces perceived power
differences. This promotes open communication and demonstrates respect for the client .
**10. The technique the nurse will always use first when performing a physical assessment is:**
A) Palpation
B) Inspection
C) Percussion
D) Auscultation
**Answer: B**
*Rationale:* The skills requisite for the physical examination are inspection, palpation, percussion,
and auscultation. The assessment of each body system begins with inspection, which takes time and
yields a surprising amount of information .
**11. A nurse observes that a client's respirations are eupneic and pulse is 58 beats per minute. What
type of assessment data is this?**
A) Subjective data
B) Objective data
C) Historical data
D) Interpretive data
**Answer: B**
*Rationale:* Objective data are observable and measurable findings obtained through physical
examination and diagnostic tests. Respirations and pulse rate are examples of objective data .
**12. Which of the following would the nurse identify as subjective data? (Select all that apply)**
A) "I feel so tired sometimes."
B) Weight: 145 lbs
C) Lungs clear to auscultation
D) "I have a headache."
E) "My father died of a heart attack."
(Weber & Kelley)
## Section 1: The Nurse's Role in Health Assessment (Questions 1–25)
**1. A nurse on a postsurgical unit is admitting a client following the client's cholecystectomy. What is
the overall purpose of assessment for this client?**
A) Collecting accurate data
B) Assisting the primary care provider
C) Validating previous data
D) Making clinical judgments
**Answer: D**
*Rationale:* The overall purpose of the nursing assessment is to make clinical judgments, which form
the basis for nursing diagnoses and the plan of care. While collecting accurate data is part of the
process, it serves the larger goal of clinical decision-making .
**2. A client has presented to the emergency department with complaints of abdominal pain. Which
member of the care team would most likely be responsible for collecting the subjective data during
the initial comprehensive assessment?**
A) Gastroenterologist
B) ED nurse
C) Admissions clerk
D) Diagnostic technician
**Answer: B**
*Rationale:* The nurse is responsible for collecting subjective data during the initial comprehensive
assessment. This is part of the nursing assessment role, distinct from the physician's medical
examination .
**3. The nurse has completed an initial assessment of a newly admitted client and is applying the
nursing process to plan the client's care. What principle should the nurse apply when using the
nursing process?**
A) Each step is independent of the others.
,B) It is ongoing and continuous.
C) It is used primarily in acute care settings.
D) It involves independent nursing actions.
**Answer: B**
*Rationale:* The nursing process is ongoing and continuous. Assessment is not a one-time event but a
dynamic process that continues throughout the client's care .
**4. When preparing to meet a client and perform a comprehensive health assessment, which action
should the nurse perform first?**
A) Review the client's medical record.
B) Obtain basic biographic data.
C) Consult clinical resources.
D) Validate information with the client.
**Answer: A**
*Rationale:* The nurse should first review the client's medical record to gather existing information
before beginning the interview and physical examination. This helps the nurse prepare appropriate
questions and identify areas requiring further exploration .
**5. Which client situation would the nurse interpret as requiring an emergency assessment?**
A) A pediatric client with severe sunburn
B) A client needing an employment physical
C) A client who overdosed on acetaminophen
D) A distraught client who wants a pregnancy test
**Answer: C**
*Rationale:* An emergency assessment is required in life-threatening or potentially life-threatening
situations. An acetaminophen overdose can cause acute liver failure and requires immediate
assessment and intervention .
**6. The nurse is explaining the differences between the physician's medical exam and the
comprehensive health assessment performed by the nurse. The nursing assessment focuses on which
aspect of the client's situation?**
A) Current physiologic status
,B) Effect of health on functional status
C) Past medical history
D) Motivation for adherence to treatment
**Answer: B**
*Rationale:* The nursing assessment focuses on the effect of health on functional status. While the
medical examination focuses primarily on physiologic status, the nursing assessment takes a holistic
view of the client's health and its impact on daily functioning .
**7. After teaching a group of students about the phases of the nursing process, the instructor
determines that the teaching was successful when the students identify which phase as foundational
to all other phases?**
A) Assessment
B) Planning
C) Implementation
D) Evaluation
**Answer: A**
*Rationale:* Assessment is foundational to all other phases of the nursing process. Without accurate
assessment data, planning, implementation, and evaluation cannot be effectively carried out .
**8. The nurse periodically performs a partial assessment after completing a comprehensive health
assessment primarily for which reason?**
A) Reassess previously detected problems
B) Provide information for the client's record
C) Address areas previously omitted
D) Determine the need for crisis intervention
**Answer: A**
*Rationale:* A partial assessment is performed to reassess previously detected problems and monitor
the client's response to treatment. It is not meant to replace the comprehensive assessment .
**9. When preparing to interview a client, which position is most appropriate for the nurse?**
A) Standing to maintain control
B) Sitting at eye level with the client
, C) Sitting at the client's feet
D) Standing at the head of the bed
**Answer: B**
*Rationale:* Sitting at eye level with the client helps establish rapport and reduces perceived power
differences. This promotes open communication and demonstrates respect for the client .
**10. The technique the nurse will always use first when performing a physical assessment is:**
A) Palpation
B) Inspection
C) Percussion
D) Auscultation
**Answer: B**
*Rationale:* The skills requisite for the physical examination are inspection, palpation, percussion,
and auscultation. The assessment of each body system begins with inspection, which takes time and
yields a surprising amount of information .
**11. A nurse observes that a client's respirations are eupneic and pulse is 58 beats per minute. What
type of assessment data is this?**
A) Subjective data
B) Objective data
C) Historical data
D) Interpretive data
**Answer: B**
*Rationale:* Objective data are observable and measurable findings obtained through physical
examination and diagnostic tests. Respirations and pulse rate are examples of objective data .
**12. Which of the following would the nurse identify as subjective data? (Select all that apply)**
A) "I feel so tired sometimes."
B) Weight: 145 lbs
C) Lungs clear to auscultation
D) "I have a headache."
E) "My father died of a heart attack."
