Health Assessment Hesi Exam with Correct Solutions

Health Assessment Hesi Exam with Correct Solutions Which of the following statements from a patient's history is it most important to investigate further? a. "I have an allergy to peanuts." b. "I have lost 30 pounds over the last 4 months." c. "I don't like many vegetables so I take multivitamins." d. "I drink 2 cups of coffee each morning." - Answer -ANS: B The statement in option "b is most important to investigate further because any significant weight loss may indicate a serious problem. The statement about an allergy to peanuts is not the most important piece of information, although the nurse would want to investigate and document any food allergies. Option "c" is not the most significant statement; however, the nurse should investigate the types and amounts of vegetables the patient eats. Two cups of coffee is considered fairly typical and the patient is not consuming an excessive amount of caffeine. Your patient complains of pruritus. You should examine the patient for which of the following associated signs and symptoms? a. rash and edema b. coolness and pallor c. cyanosis and coolnessd. ecchymosis and purpura - Answer -ANS: A Pruritus or itching of the skin is associated with the following manifestations: rashes, lesions, edema, angioedema, anaphylaxis, excoriation or ulcers as a result of scratching, lichenification or thickening of the skin, and systemic disease. As a result of scratching the skin due to pruritus, the skin would most likely be warm and red, not pale, cool, or cyanotic. Ecchymosis is a violaceous discoloration, also called a black-and-blue mark. Purpura is a condition characterized by the presence of confluent petechiae or confluent ecchymosis. Neither of these is associated with pruritus. ____ 3. Your patient asks you about the small, reddish purple discolorations of the skin, less than 0.5 cm in diameter. You inform the patient that this is known as which of the following? a. ecchymoses c. purpura b. petechiae d. spider telangiectasia - Answer -ANS: B