Perry and Potter Clinical Nursing Skills and Techniques Chapter 6: Healt
Assessment
Study online at https://quizlet.com/_fi4mbl
1. The nurse is visiting c. Inspection
the patient for the
first time this shift. Rationale: Inspection is the visual examination of body parts or areas. An
She introduces her- experienced nurse learns to make
self and asks the pa- multiple observations, almost simultaneously, while becoming very percep-
tient tive of abnormalities.
several questions re- Palpation uses the sense of touch. Percussion involves tapping the body with
lated to his condition. the fingertips to evaluate
While doing so, and the size, borders, and consistency of body organs and to discover fluid in
without being obvi- body cavities. Auscultation is
ous, she is looking at listening with a stethoscope to sounds produced by the body.
the color of his eyes
and is assessing his
ears and nose for dis-
charge and the sym-
metry of his mouth.
Which assessment
technique is the nurse
using?
a. Palpation
b. Percussion
c. Inspection
d. Auscultation
2. The patient is admit- a. touch the patient's skin with the dorsum of her hand.
ted with fever and
acute lower abdomi- Rationale: The dorsum (back) of the hand is more sensitive to temperature
nal pain. He has taken variations. The pads of the fingertips
Tylenol but says he detect subtle changes in texture, shape, size, consistency, and pulsation of
still feels feverish. Be- body parts. Bimanual
, Perry and Potter Clinical Nursing Skills and Techniques Chapter 6: Healt
Assessment
Study online at https://quizlet.com/_fi4mbl
fore taking the pa- palpation involves one hand placed over the other while pressure is applied.
tient's temperature, The upper hand exerts
the nurse may: downward pressure as the other hand feels the subtle characteristics of
underlying organs and masses.
a. touch the patient's Seek the assistance of a qualified instructor before attempting deep palpa-
skin with the dorsum tion. Percussion involves
of her hand. tapping the body with the fingertips to evaluate the size, borders, and
b. touch the patient's consistency of body organs and
skin with the pads of to discover fluid in body cavities.
her fingers.
c. palpate the skin
using the bimanual
method.
d. tap the patient's
skin using the finger-
tips.
3. What should the c. Treat the patient as an individual.
nurse do when
preparing to com- Rationale: Older children and adolescents tend to respond best when treat-
plete an assessment ed as adults and individuals and often
for a 16-year-old pa- can provide details about their health history and severity of symptoms.
tient? Routine examinations of
children have a focus on health promotion and illness prevention, particu-
a. Focus on illness be- larly in the care of well
haviors. children with competent parenting and no serious health problems. The
b. Plan for a dimin- focus is on growth and
ished energy level. development, sensory screening, dental examination, and behavioral as-
c. Treat the patient as sessment. Children who are
an individual. chronically ill, disabled, in foster care, or foreign-born adopted may require
additional assessment. The
, Perry and Potter Clinical Nursing Skills and Techniques Chapter 6: Healt
Assessment
Study online at https://quizlet.com/_fi4mbl
d. Have the parents adolescent has a right to confidentiality. After talking with the parents about
present throughout. historical information, the
nurse arranges to be alone with the adolescent to speak further privately
and to perform the
examination.
4. The general survey d. Obtaining initial vital signs
begins with a review
of the patient's pri- Rationale: Because the initial set of vital signs are part of the general health
mary health problems assessment they must be taken by the
and an evaluation of nurse. After that the NAP may take vital signs for a stable patient. The nurse
the patient's vital directs NAP to report a
signs, height and patient's subjective signs and symptoms to the nurse, to measure the
weight, general be- patient's height and weight, and
havior, and appear- to monitor oral intake and urinary output.
ance. It also provides
information about the
patient's illness, hy-
giene, skin condi-
tion, body image, and
emotional state.
Which of the follow-
ing cannot be dele-
gated to nursing as-
sistive personnel?
a. Reporting subjec-
tive signs and symp-
toms
b. Measuring the pa-
tient's height and
Assessment
Study online at https://quizlet.com/_fi4mbl
1. The nurse is visiting c. Inspection
the patient for the
first time this shift. Rationale: Inspection is the visual examination of body parts or areas. An
She introduces her- experienced nurse learns to make
self and asks the pa- multiple observations, almost simultaneously, while becoming very percep-
tient tive of abnormalities.
several questions re- Palpation uses the sense of touch. Percussion involves tapping the body with
lated to his condition. the fingertips to evaluate
While doing so, and the size, borders, and consistency of body organs and to discover fluid in
without being obvi- body cavities. Auscultation is
ous, she is looking at listening with a stethoscope to sounds produced by the body.
the color of his eyes
and is assessing his
ears and nose for dis-
charge and the sym-
metry of his mouth.
Which assessment
technique is the nurse
using?
a. Palpation
b. Percussion
c. Inspection
d. Auscultation
2. The patient is admit- a. touch the patient's skin with the dorsum of her hand.
ted with fever and
acute lower abdomi- Rationale: The dorsum (back) of the hand is more sensitive to temperature
nal pain. He has taken variations. The pads of the fingertips
Tylenol but says he detect subtle changes in texture, shape, size, consistency, and pulsation of
still feels feverish. Be- body parts. Bimanual
, Perry and Potter Clinical Nursing Skills and Techniques Chapter 6: Healt
Assessment
Study online at https://quizlet.com/_fi4mbl
fore taking the pa- palpation involves one hand placed over the other while pressure is applied.
tient's temperature, The upper hand exerts
the nurse may: downward pressure as the other hand feels the subtle characteristics of
underlying organs and masses.
a. touch the patient's Seek the assistance of a qualified instructor before attempting deep palpa-
skin with the dorsum tion. Percussion involves
of her hand. tapping the body with the fingertips to evaluate the size, borders, and
b. touch the patient's consistency of body organs and
skin with the pads of to discover fluid in body cavities.
her fingers.
c. palpate the skin
using the bimanual
method.
d. tap the patient's
skin using the finger-
tips.
3. What should the c. Treat the patient as an individual.
nurse do when
preparing to com- Rationale: Older children and adolescents tend to respond best when treat-
plete an assessment ed as adults and individuals and often
for a 16-year-old pa- can provide details about their health history and severity of symptoms.
tient? Routine examinations of
children have a focus on health promotion and illness prevention, particu-
a. Focus on illness be- larly in the care of well
haviors. children with competent parenting and no serious health problems. The
b. Plan for a dimin- focus is on growth and
ished energy level. development, sensory screening, dental examination, and behavioral as-
c. Treat the patient as sessment. Children who are
an individual. chronically ill, disabled, in foster care, or foreign-born adopted may require
additional assessment. The
, Perry and Potter Clinical Nursing Skills and Techniques Chapter 6: Healt
Assessment
Study online at https://quizlet.com/_fi4mbl
d. Have the parents adolescent has a right to confidentiality. After talking with the parents about
present throughout. historical information, the
nurse arranges to be alone with the adolescent to speak further privately
and to perform the
examination.
4. The general survey d. Obtaining initial vital signs
begins with a review
of the patient's pri- Rationale: Because the initial set of vital signs are part of the general health
mary health problems assessment they must be taken by the
and an evaluation of nurse. After that the NAP may take vital signs for a stable patient. The nurse
the patient's vital directs NAP to report a
signs, height and patient's subjective signs and symptoms to the nurse, to measure the
weight, general be- patient's height and weight, and
havior, and appear- to monitor oral intake and urinary output.
ance. It also provides
information about the
patient's illness, hy-
giene, skin condi-
tion, body image, and
emotional state.
Which of the follow-
ing cannot be dele-
gated to nursing as-
sistive personnel?
a. Reporting subjec-
tive signs and symp-
toms
b. Measuring the pa-
tient's height and
