Test Bank for Health Assessment for
Nursing Practice 7th Edition by Wilson
Chapter 1 - 24
,Chapter5601:56Introduction56to56Health56Assessment
MULTIPLE56CHOICE
1. A56patient56comes56to56the56emergency56department56and56tells56the56triage56 n
urse56that56 he56is56“having56a56heart56attack.”56What56is56the56nurse’s56top56priority56at56th
is56time?
a. Determine56the56patient’s56personal56data56a
nd56insurance56coverage.
b. Ask56the56patient56to56take56a56seat56in56the5
6waiting56room56until56 his56name56is56called.
c. Request56that56a56nurse56collect56data
56for56a56comprehensive56 history.
d. Ask56a56nurse56to56start56a56focused56ass
essment56of56this56patient56now.
ANSWER:56 D
The56nurse56needs56to56begin56an56assessment56as56soon56as56possible56that56is56focused56
on56this56patient’s56cardiovascular56system.56The56type56of56health56assessment56performed
56by56the56nurse56is56also56driven56by56patient56need.56Personal56data56and56insurance56info
rmation56will56be56obtained,56but56in56this56situation,56these56data56can56wait56until56after5
6the56patient56is56assessed.56Based56also56on56Maslow’s56hierarchy56of56needs,56physiolog
ic56needs56take56precedence.56Rather56than56asking56the56patient56to56wait,56the56nurse56ne
eds56to56begin56data56collection,56such56as56vital56signs,56immediately56to56determine56the56
patient’s56health56status.56Complications56can56be56prevented56if56an56immediate56assessm
ent56is56made56to56analyze56the56patient’s56symptoms.56A56comprehensive56history56is56no
t56indicated56in56this56situation56at56this56time.56Some56subjective56data56will56be56collecte
d,56such56as56allergies56and56medical56history56related56to56cardiovascular56disease.56Eyes,
56ears,56or56a56complete56musculoskeletal56or56mental56 health56assessment56is56not56a56pri
ority56at56this56time.
DIF:565656 Cognitive56Level:56Apply REF:56Box561-
356|56p.56356TOP:56Nursing56Process:56Assessment
MSC:56NCLEX56Patient56Needs:56Safe56and56Effective56Care56Environment:56Management56of56C
are:56Establishing56Priorities
2. Which56situation56illustrates56a56 screening56assessment?
a. A56patient56visits56an56obstetric56clinic56for
56the56first56time56and56the56nurse56conducts
56a56detailed56history56and56physical56examin
ation.
b. A56hospital56sponsors56a56health56fair56at5
6a56local56mall56and56provides56cholestero
l56and56blood56pressure56checks56to56mall
56patrons.
c. The56nurse56in56an56urgent56care56center5
6checks56the56vital56signs56of56a56patient56
who56is56complaining56of56leg56pain.
, d. A56patient56 newly56diagnosed56with56dia
betes56mellitus56comes56to56test56his56fast
ing56blood56glucose56level.
ANSWER:56B
A56health56fair56at56a56local56mall56that56provides56cholesterol56and56blood56pressure56che
cks56is56an56example56of56a56screening56assessment56focused56on56disease56detection.56A56
detailed56history56and56physical56examination56conducted56during56a56first-
time56visit56to56an56obstetric56clinic56is56an56example56of56a56comprehensive56assessment.56
Assessing56a56patient56complaining56of56leg56pain56in56the56triage56area56of56an56urgent56c
are56center56is56an56example56of56a56problem-
based/focused56assessment.56A56patient’s56return56appointment56156month56after56today’s5
6office56visit56to56report56fasting56blood56glucose56levels56is56an56example56of56an56episodi
c56or56follow-up56assessment.
DIF:565656 Cognitive56Level:56Understand REF:56Box561-
356|56p.56356TOP:56Nursing56Process:56Assessment
MSC:56NCLEX56Patient56Needs:56Health56Promotion56and56Maintenance:56Health56Screening
3. For56which56person56is56a56screening56assessment56indicated?
a. The56person56who56had56abdominal56su
rgery56yesterday
b. The56person56who56is56unaware56of56h
is56high56serum56glucose56levels
c. The56person56who56is56being56admitte
d56to56a56long-term56care56facility
d. The56person56who56is56beginning56rehabilita
tion56after56a56knee56replacement
ANSWER:56B
A56screening56assessment56is56performed56for56the56purpose56of56disease56detection.56In5
6this56case56this56person56may56have56diabetes56mellitus.56A56shift56assessment56is56most5
6appropriate56for56the56person56who56is56recovering56in56the56hospital56from56surgery.56A
56comprehensive56assessment56is56performed56during56admission56to56a56facility56to56obtai
n56a56detailed56history56and56complete56physical56examination.56An56episodic56or56follo
w-
up56assessment56is56performed56after56knee56replacement56to56evaluate56the56outcome56of5
6the56procedure.
DIF:565656 Cognitive56Level:56Understand REF:56Box561-
356|56p.56356TOP:56Nursing56Process:56Assessment
MSC:56NCLEX56Patient56Needs:56Safe56and56Effective56Care56Environment:56Management56of56C
are:56Establishing56Priorities
4. For56which56person56is56a56shift56assessment56indicated?
a. The56person56who56had56abdominal56su
rgery56yesterday
b. The56person56who56is56unaware56of56h
is56high56serum56glucose56levels
c. The56person56who56is56being56admitted56to5
6a
long-term56care56facility
d. The56person56who56is56beginning56rehabilit
ation56after56a56knee56replacement
ANSWER:56 A
A56shift56assessment56is56most56appropriate56for56the56person56who56is56recovering56in56th
e56hospital56from56surgery.56A56screening56assessment56is56performed56for56the56purpose56o
f56disease56detection,56in56this56case56diabetes56mellitus.56 A56comprehensive56assessment56
is56performed56during56admission56to56a
, facility56to56obtain56a56detailed56history56and56complete56physical56examination.56An56e
pisodic56or56follow-
up56assessment56is56performed56after56knee56replacement56to56evaluate56the56outcome56o
f56the56procedure.
DIF:565656 Cognitive56Level:56Understand REF:56Box561-
356|56p.56456TOP:56Nursing56Process:56Assessment
MSC:56NCLEX56Patient56Needs:56Safe56and56Effective56Care56Environment:56Management56of56C
are:56Establishing56Priorities
5. For56which56person56is56a56comprehensive56assessment56indicated?
a. The56person56who56had56abdominal56su
rgery56yesterday
b. The56person56who56is56unaware56of56h
is56high56serum56glucose56levels
c. The56person56who56is56being56admitte
d56to56a56long-term56care56facility
d. The56person56who56is56beginning56rehabilita
tion56after56a56knee56replacement
ANSWER:56C
A56comprehensive56assessment56is56performed56during56admission56to56a56facility56to56obtain56a
detailed56history56and56complete56physical56examination.56A56shift56assessment56is56most5
6appropriate56for56the56person56who56is56recovering56in56the56hospital56from56surgery.56A5
6screening56assessment56is56performed56for56the56purpose56of56disease56detection,56in56thi
s56case56diabetes56mellitus.56An56episodic56or56follow-
up56assessment56is56performed56after56knee56replacement56to56evaluate56the56outcome56of
56the56procedure.
DIF:565656 Cognitive56Level:56Understand REF:56Box561-
356|56p.56356TOP:56Nursing56Process:56Assessment
MSC:56NCLEX56Patient56Needs:56Safe56and56Effective56Care56Environment:56Management56of56C
are:56Establishing56Priorities
6. For56which56person56is56an56episodic56or56follow-up56assessment56indicated?
a. The56person56who56had56abdominal56su
rgery56yesterday
b. The56person56who56is56unaware56of56h
is56high56serum56glucose56levels
c. The56person56who56is56being56admitted56to56
a
long-term56care56facility
d. The56person56who56is56beginning56rehabilita
tion56after56a56knee56replacement
ANSWER:56 D
An56episodic56or56follow-
up56assessment56is56performed56after56the56knee56replacement56to56evaluate56the56outcom
e56of56the56procedure.56A56shift56assessment56is56most56appropriate56for56the56person56wh
o56is56recovering56in56the56hospital56from56surgery.56A56screening56assessment56is56perfor
med56for56the56purpose56of56disease56detection,56in56this56case56diabetes56mellitus.56A56com
prehensive56assessment56is56performed56during56admission56to56a56facility56to56obtain56a5
6detailed56history56and56complete56physical56examination.
DIF:565656 Cognitive56Level:56Understand REF:56Box561-
356|56p.56356TOP:56Nursing56Process:56Assessment
Nursing Practice 7th Edition by Wilson
Chapter 1 - 24
,Chapter5601:56Introduction56to56Health56Assessment
MULTIPLE56CHOICE
1. A56patient56comes56to56the56emergency56department56and56tells56the56triage56 n
urse56that56 he56is56“having56a56heart56attack.”56What56is56the56nurse’s56top56priority56at56th
is56time?
a. Determine56the56patient’s56personal56data56a
nd56insurance56coverage.
b. Ask56the56patient56to56take56a56seat56in56the5
6waiting56room56until56 his56name56is56called.
c. Request56that56a56nurse56collect56data
56for56a56comprehensive56 history.
d. Ask56a56nurse56to56start56a56focused56ass
essment56of56this56patient56now.
ANSWER:56 D
The56nurse56needs56to56begin56an56assessment56as56soon56as56possible56that56is56focused56
on56this56patient’s56cardiovascular56system.56The56type56of56health56assessment56performed
56by56the56nurse56is56also56driven56by56patient56need.56Personal56data56and56insurance56info
rmation56will56be56obtained,56but56in56this56situation,56these56data56can56wait56until56after5
6the56patient56is56assessed.56Based56also56on56Maslow’s56hierarchy56of56needs,56physiolog
ic56needs56take56precedence.56Rather56than56asking56the56patient56to56wait,56the56nurse56ne
eds56to56begin56data56collection,56such56as56vital56signs,56immediately56to56determine56the56
patient’s56health56status.56Complications56can56be56prevented56if56an56immediate56assessm
ent56is56made56to56analyze56the56patient’s56symptoms.56A56comprehensive56history56is56no
t56indicated56in56this56situation56at56this56time.56Some56subjective56data56will56be56collecte
d,56such56as56allergies56and56medical56history56related56to56cardiovascular56disease.56Eyes,
56ears,56or56a56complete56musculoskeletal56or56mental56 health56assessment56is56not56a56pri
ority56at56this56time.
DIF:565656 Cognitive56Level:56Apply REF:56Box561-
356|56p.56356TOP:56Nursing56Process:56Assessment
MSC:56NCLEX56Patient56Needs:56Safe56and56Effective56Care56Environment:56Management56of56C
are:56Establishing56Priorities
2. Which56situation56illustrates56a56 screening56assessment?
a. A56patient56visits56an56obstetric56clinic56for
56the56first56time56and56the56nurse56conducts
56a56detailed56history56and56physical56examin
ation.
b. A56hospital56sponsors56a56health56fair56at5
6a56local56mall56and56provides56cholestero
l56and56blood56pressure56checks56to56mall
56patrons.
c. The56nurse56in56an56urgent56care56center5
6checks56the56vital56signs56of56a56patient56
who56is56complaining56of56leg56pain.
, d. A56patient56 newly56diagnosed56with56dia
betes56mellitus56comes56to56test56his56fast
ing56blood56glucose56level.
ANSWER:56B
A56health56fair56at56a56local56mall56that56provides56cholesterol56and56blood56pressure56che
cks56is56an56example56of56a56screening56assessment56focused56on56disease56detection.56A56
detailed56history56and56physical56examination56conducted56during56a56first-
time56visit56to56an56obstetric56clinic56is56an56example56of56a56comprehensive56assessment.56
Assessing56a56patient56complaining56of56leg56pain56in56the56triage56area56of56an56urgent56c
are56center56is56an56example56of56a56problem-
based/focused56assessment.56A56patient’s56return56appointment56156month56after56today’s5
6office56visit56to56report56fasting56blood56glucose56levels56is56an56example56of56an56episodi
c56or56follow-up56assessment.
DIF:565656 Cognitive56Level:56Understand REF:56Box561-
356|56p.56356TOP:56Nursing56Process:56Assessment
MSC:56NCLEX56Patient56Needs:56Health56Promotion56and56Maintenance:56Health56Screening
3. For56which56person56is56a56screening56assessment56indicated?
a. The56person56who56had56abdominal56su
rgery56yesterday
b. The56person56who56is56unaware56of56h
is56high56serum56glucose56levels
c. The56person56who56is56being56admitte
d56to56a56long-term56care56facility
d. The56person56who56is56beginning56rehabilita
tion56after56a56knee56replacement
ANSWER:56B
A56screening56assessment56is56performed56for56the56purpose56of56disease56detection.56In5
6this56case56this56person56may56have56diabetes56mellitus.56A56shift56assessment56is56most5
6appropriate56for56the56person56who56is56recovering56in56the56hospital56from56surgery.56A
56comprehensive56assessment56is56performed56during56admission56to56a56facility56to56obtai
n56a56detailed56history56and56complete56physical56examination.56An56episodic56or56follo
w-
up56assessment56is56performed56after56knee56replacement56to56evaluate56the56outcome56of5
6the56procedure.
DIF:565656 Cognitive56Level:56Understand REF:56Box561-
356|56p.56356TOP:56Nursing56Process:56Assessment
MSC:56NCLEX56Patient56Needs:56Safe56and56Effective56Care56Environment:56Management56of56C
are:56Establishing56Priorities
4. For56which56person56is56a56shift56assessment56indicated?
a. The56person56who56had56abdominal56su
rgery56yesterday
b. The56person56who56is56unaware56of56h
is56high56serum56glucose56levels
c. The56person56who56is56being56admitted56to5
6a
long-term56care56facility
d. The56person56who56is56beginning56rehabilit
ation56after56a56knee56replacement
ANSWER:56 A
A56shift56assessment56is56most56appropriate56for56the56person56who56is56recovering56in56th
e56hospital56from56surgery.56A56screening56assessment56is56performed56for56the56purpose56o
f56disease56detection,56in56this56case56diabetes56mellitus.56 A56comprehensive56assessment56
is56performed56during56admission56to56a
, facility56to56obtain56a56detailed56history56and56complete56physical56examination.56An56e
pisodic56or56follow-
up56assessment56is56performed56after56knee56replacement56to56evaluate56the56outcome56o
f56the56procedure.
DIF:565656 Cognitive56Level:56Understand REF:56Box561-
356|56p.56456TOP:56Nursing56Process:56Assessment
MSC:56NCLEX56Patient56Needs:56Safe56and56Effective56Care56Environment:56Management56of56C
are:56Establishing56Priorities
5. For56which56person56is56a56comprehensive56assessment56indicated?
a. The56person56who56had56abdominal56su
rgery56yesterday
b. The56person56who56is56unaware56of56h
is56high56serum56glucose56levels
c. The56person56who56is56being56admitte
d56to56a56long-term56care56facility
d. The56person56who56is56beginning56rehabilita
tion56after56a56knee56replacement
ANSWER:56C
A56comprehensive56assessment56is56performed56during56admission56to56a56facility56to56obtain56a
detailed56history56and56complete56physical56examination.56A56shift56assessment56is56most5
6appropriate56for56the56person56who56is56recovering56in56the56hospital56from56surgery.56A5
6screening56assessment56is56performed56for56the56purpose56of56disease56detection,56in56thi
s56case56diabetes56mellitus.56An56episodic56or56follow-
up56assessment56is56performed56after56knee56replacement56to56evaluate56the56outcome56of
56the56procedure.
DIF:565656 Cognitive56Level:56Understand REF:56Box561-
356|56p.56356TOP:56Nursing56Process:56Assessment
MSC:56NCLEX56Patient56Needs:56Safe56and56Effective56Care56Environment:56Management56of56C
are:56Establishing56Priorities
6. For56which56person56is56an56episodic56or56follow-up56assessment56indicated?
a. The56person56who56had56abdominal56su
rgery56yesterday
b. The56person56who56is56unaware56of56h
is56high56serum56glucose56levels
c. The56person56who56is56being56admitted56to56
a
long-term56care56facility
d. The56person56who56is56beginning56rehabilita
tion56after56a56knee56replacement
ANSWER:56 D
An56episodic56or56follow-
up56assessment56is56performed56after56the56knee56replacement56to56evaluate56the56outcom
e56of56the56procedure.56A56shift56assessment56is56most56appropriate56for56the56person56wh
o56is56recovering56in56the56hospital56from56surgery.56A56screening56assessment56is56perfor
med56for56the56purpose56of56disease56detection,56in56this56case56diabetes56mellitus.56A56com
prehensive56assessment56is56performed56during56admission56to56a56facility56to56obtain56a5
6detailed56history56and56complete56physical56examination.
DIF:565656 Cognitive56Level:56Understand REF:56Box561-
356|56p.56356TOP:56Nursing56Process:56Assessment
