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