Advanced Health Assessment Exam

ADVANCED HEALTH ASSESSMENT
EXAM

Aoo59ooyearoooldoopatientsootellsootheoonurseoopractitioneroothatooheoothinksooheoomustooh
aveooulcerativeoocolitis.ooHeoohasoobeenoohavingoo"blackoostools"ooforootheoolastoo24oohou
rs.ooHowoowouldootheoonurseoopractitioneroobestoodocumentooTHEooFACTSooforoohisoorea
sonooforooseekingoocare?
A)ooJMooisooaoo59ooyearoooldoomaleoohereooforoohavingoo"blackoostools"ooforootheoopastoo2
4oohours.
B)ooJMoocameoointoootheooclinicoocomplainingooofooblackoostoolsooforootheoopastoo24oohou
rs.
C)ooJMooisooaoo59ooyearoooldoomaleoohereooforoo"ulcerativeoocolitis."
D)ooJM,ooaoo59ooyearoooldoomale,oostatesooheoohasooulcerativeoocolitisooandoowantsooitooc
hecked.oo-ooans--
A)ooJMooisooaoo59ooyearoooldoomaleoohereooforoohavingoo"blackoostools"ooforootheoopastoo2
4oohours.

ChiefooComplaint(s)ooTheoooneoooroomoreoosymptomsooorooconcernsoocausingootheoopati
entootoooseekoocare.ooMakeooeveryooeffortootoooquoteootheoopatient'sooownoowords.

Aoopatientootellsootheoonurseoopractitioneroothatoosheoohasoohadooabdominaloopainooforoot
heoopastooweek.ooWhatoowouldoobeootheoobestooresponseoobyootheoonurseoopractitioner?
A)ooWe'llootalkoomoreooaboutoothatoolaterooinootheoointerview."
B)oo"Haveooyouooeveroohadooanyoochildren?"
C)oo"Whatoohaveooyouoohadootoooeatooinootheoolastoo4oohours?"
D)oo"Canooyouoopointootooowhereooitoohurts?"oo-ooans--
D)oo"Canooyouoopointootooowhereooitoohurts?"

Eachooprincipleoosymptomooshouldoobeoowell-
characterized,oowithoodescriptionsooofoolocation;ooalongoowithootheoootheroosevenooattribut
es.ooLocation:ooAskootheoopatientootooopointootoootheoopainoobecauseoolayootermsoomayoon
otoobeoospecificooenoughootooolocalizeootheoositeooofooorigin.

Aoo29-year-
oldoowomanootellsootheoonurseoothatoosheoohasoo"excruciatingoopain"ooinooherooback.ooWh
ichooofootheoofollowingoowouldoobeooanooappropriateooresponseoobyootheoonurseootooohero
ostatement?
A)oo"Howoodoesooyouroofamilyooreactootoooyouroopain?"
B)oo"Thatoomustoobeooterrible.ooYouooprobablyoopinchedooaoonerve."
C)oo"I'veoohadoobackoopainoomyselfooandooitoocanoobeooexcruciating."

,D)oo"Howoowouldooyouoosayootheoopainooaffectsooyourooabilityootooodoooyouroodailyooactivit
ies?"oo-ooans--
D)oo"Howoowouldooyouoosayootheoopainooaffectsooyourooabilityootooodoooyouroodailyooactivit
ies?"

Inquireooaboutootheooeffectsooofoopainooonootheoopatient'soodailyooactivities,oomood,ooslee
p,oowork,ooandoosexualooactivity.

Inoorecordingootheoochildhoodooillnessesooofooaoopatientoowhooodeniesoohavingoohadooany
,oowhichooofootheoofollowingoonotesoobyootheoonurseoowouldoobeoomostooaccurate?
A)ooPatientoodeniesoousualoochildhoodooillnesses.
B)ooPatientoostatesooheoowasooaoo"veryoohealthy"oochild.
C)ooPatientoostatesoosisteroohadoomeasles,oobutooheoodidn't.
D)ooPatientoodeniesoomeasles,oomumps,oorubella,oochickenpox,oopertussis,oorheumaticoof
ever,ooandoopolio.oo-ooans--
D)ooPatientoodeniesoomeasles,oomumps,oorubella,oochickenpox,oopertussis,oorheumaticoof
ever,ooandoopolio.

Childhoodooillnessesooincludeoomeasles,oorubella,oomumps,oowhoopingoocough,oorheuma
ticoofever,ooscarletoofever,ooandoopolio.ooTheyooareooincludedooinootheoopastoohistory.

Aoopatientootellsootheoonurseoothatooheooisooallergicootooopenicillin.ooWhatoowouldoobeoothe
oonurse'soobestooresponseootooothisooinformation?
A)oo"Areooyouooallergicootoooanyoootheroodrugs?"
B)oo"Howoooftenoohaveooyouooreceivedoopenicillin?"
C)oo"I'lloowriteooyourooallergyooonooyouroochartoosoooyouoowon'tooreceiveooany."
D)oo"Pleaseoodescribeoowhatoohappensootoooyouoowhenooyouootakeoopenicillin."oo-ooans--
D)oo"Pleaseoodescribeoowhatoohappensootoooyouoowhenooyouootakeoopenicillin."

Allergies,ooincludingoospecificooreactionsootoooeachoomedication,oosuchooasoorashoooroona
usea,oomustoobeoorecorded.

Theoonurseooisootakingooaoofamilyoohistory.ooImportantoodiseasesooorooproblemsootoooasko
otheoopatientooaboutooinclude:
A)ooemphysema.
B)ooheadootrauma.
C)oomentalooillness.
D)oofracturedoobones.oo-ooans--C)oomentalooillness.

Specificallyooaskooforooanyoofamilyoohistoryooofooheartoodisease,oohighoobloodoopressure,o
ostroke,oodiabetes,ooobesity,oobloodoodisorders,ooovarianoocancer,oocolonoocancer,oosickl
eoocellooanemia,ooarthritis,ooallergies,ooalcoholoooroodrugooaddiction,oomentalooillness,oosu
icide,ooseizureoodisorder,ookidneyoodisease,ooandootuberculosis.ooTheoootherooanswersoo
areooacquired.

, Theoofollowingooinformationooisoorecordedooinootheoohealthoohistory:oo"Patientoodeniesooch
estoopain,oopalpitations,ooorthopnea,ooandooparoxysmaloonocturnaloodyspnea."ooWhichooc
ategoryoodoesooitoobelongooto?
A)ooChiefoocomplaint
B)ooPresentooillness
C)ooPersonalooandoosocialoohistory
D)ooReviewooofoosystemsoo-ooans--D)ooReviewooofoosystems

Mostooreviewooofoosystemsooquestionsoopertainootooosystems.ooYouoomayooalsooodrawooo
nooReviewooofooSystemsooquestionsoorelatedootoootheooChiefooComplaintootoooestablishoo
positivesooandoonegativesoothatoohelpooclarifyootheoodiagnosis.

Whichooofootheoofollowingoostatementsoorepresentsoosubjectiveoodataooobtainedoofromooth
eoopatientooregardingoohisooskin?
A)ooSkinooappearsoodry.
B)ooNoooobviousoolesions
C)ooDeniesoocoloroochange
D)ooLesionoonotedoolateralooaspectoorightooarmoo-ooans--C)ooDeniesoocoloroochange

Rememberoothatootheoohistoryoo(fromootheoochiefoocomplaintoothroughooreviewooofoosyste
ms)ooshouldoobeoolimitedootooopatientoostatementsoooroosubjectiveoodata—
factorsoothatootheoopersonoosaysoowereoooroowereoonotoopresent.
Subjectiveoodataooisoowhatootheoopatientootellsooyou.

Theoofollowingooinformationooisoobestooplacedooinoowhichoocategory?
oo"Theoopatientoohadooaoostentooplacedooinootheooleftooanterioroodescendingooarteryoo(LAD
)ooinoo1999."
A)ooMedical
B)ooSurgical
C)ooObstetrics/gynecology
D)ooPsychiatricoo-ooans--B)ooSurgical

ProvideooinformationoorelativeootoooAdultooIllnessesooinooeachooofoofourooareas:ooMedical,
ooSurgical,ooObstetric/Gynecologic,ooandooPsychiatric.


Duringootheooagingooprocess,ootheoohairoocanoolookoograyoooroowhiteooandoobeginootooofee
loothinooandoofine.ooTheoonurseoopractitionerooknowsoothatoothisoooccursoobecauseooofooao
odecreaseooin:
A)oopigmentation
B)oothyroidoostimulatingoohormone
C)oophagocytes
D)oofungacytesoo-ooans--A)oopigmentation

Hairooundergoesooaooseriesooofoochanges.ooScalpoohairoolosesooitsoopigmentoo(functionin
gooofoomelanocytes)oosoootheoohairoolooksoograyoooroowhiteooandoofeelsoothinooandoofine.o
oTheoootheroooptionsooareoonotoocorrect.