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