j j j
Physical Examination: Best Practices
j j j
j j j j j
2nd Edition by Kate Gawlik
j j j j
ALL CHAPTERS 1-29 WITH RATIONALES|A+ GRADE
j j j j j j
Page1of759
,Chapter1.APPROACHTOEVIDENCE-BASEDASSESSMENTOFHEALTHANDWELL-BEING j
MULTIPLECHOICE
1. Aftercompletinganinitialassessmentofapatient,thenursehaschartedthathisrespirationsare
j
eupneicandhispulseis58beatsperminute.Thesetypesofdatawouldbe:
n j j j j j j j
a. Objective.
b. Reflective.
c. Subjective.
d. Introspective.
ANS:A
Objectivedataarewhatthehealthprofessionalobservesbyinspecting,percussing,palpating,and
j j j j
auscultatingduringthephysicalexamination.Subjectivedataiswhatthepersonsaysabouthimorherselfduring
n
nhistorytaking.Thetermsreflectiveandintrospectivearenotusedtodescribedata.
j j j j
DIF:CognitiveLevel:Understanding(Comprehension)REF:z.2
MSC:ClientNeeds:SafeandEffectiveCareEnvironment:ManagementofCare
n j j j
2. Apatienttellsthenursethatheisverynervous,isnauseated,andfeelshot.Thesetypesofdatawouldbe:
j j j j
a. Objective.
b. Reflective.
c. Subjective.
d. Introspective.
ANS:C
Subjective dataare whatthe personsaysabout himorherself during historytaking. Objective dataare what
n n n n n n n n n
thehealthprofessional observes byinspecting, percussing, palpating, andauscultatingduringthe physical
n n n n n n n
examination.Thetermsreflectiveandintrospectivearenotusedtodescribedata.
n j j j j j
DIF:CognitiveLevel:Understanding(Comprehension)REF:z.2
MSC:ClientNeeds:SafeandEffectiveCareEnvironment:ManagementofCare
n j j j
Page2of759
,3. Thepatientsrecord,laboratorystudies,objectivedata,andsubjectivedatacombinetoformthe:
j
a. Database.
j
b. Admitting data. j
c. Financialstatement.
d. Dischargesummary.
ANS:A
Togetherwiththepatientsrecordandlaboratorystudies,theobjectiveandsubjectivedataformthedatabase.The j j n
otheritemsarenotpartofthepatientsrecord,laboratorystudies,ordata.
n j j j j j
DIF:CognitiveLevel:Remembering(Knowledge)REF:z.2 j j
MSC:ClientNeeds:SafeandEffectiveCareEnvironment:ManagementofCare
n j j j
4. Whenlisteningtoapatientsbreathsounds,thenurseisunsureofasoundthatisheard.Thenursesnext j j
actionshouldbeto:
n j j
a. Immediatelynotifythepatientsphysician.
b. Documentthesoundexactlyasitwasheard.
j
c. Validatethedatabyaskingacoworkertolistentothebreath n n sounds.
d. Assessagainin 20 minutestonotewhetherthesoundisstill present.
n n n
ANS:C
Whenunsureofasoundheardwhilelisteningtoapatientsbreathsounds,thenursevalidatesthedatatoensure
j
accuracy.Ifthenursehaslessexperienceinanarea,thenheorsheasksanexperttolisten.
n j j j j j j j j j
DIF:CognitiveLevel:Analyzing(Analysis)REF:z.2
j
MSC:ClientNeeds:SafeandEffectiveCareEnvironment:ManagementofCare
n j j j
5. Thenurseisconductingaclassfornewgraduatenurses.Duringtheteachingsession,thenurseshould keep in j j n
mindthatnovicenurses,withoutabackgroundofskillsandexperiencefromwhichtodraw,aremore likelyto
n j j j j j j j j
maketheirdecisionsusing:
n
a. Intuition.
b. Asetofrules.
Page3of759
, c. Articlesinjournals.
d. Advicefromsupervisors.
ANS:B
Novicenursesoperatefromasetofdefined,structuredrules.Theexpertpractitionerusesintuitivelinks.DIF: n
n CognitiveLevel:Understanding(Comprehension)REF:z.3MSC:ClientNeeds:General
j j j j
6. Expertnurseslearntoattendtoapatternofassessmentdataandactwithoutconsciouslylabelingit.
j n
nTheseresponsesarereferredtoas:
a. Intuition.
b. Thenursingprocess.
c. Clinicalknowledge.
d. Diagnosticreasoning.
ANS:A
Intuitionischaracterizedbypatternrecognitionexpertnurseslearntoattendtoapatternofassessmentdata
j j
n andactwithoutconsciouslylabelingit.Theotheroptionsarenotcorrect.
j j j j
DIF:CognitiveLevel:Understanding(Comprehension)REF:z.4MSC:ClientNeeds:General j
7. Thenurseisreviewinginformationaboutevidence-basedpractice(EBP).Whichstatementbestreflects
EBP?
n
a. EBPreliesontraditionforsupportofbestpractices. j
b. EBPissimplytheuseofbestpracticetechniquesforthetreatmentofpatients.
j j
c. EBPemphasizes theuseofbestevidencewiththeclinicians experience.
n n
d. ThepatientsownpreferencesarenotimportantwithEBP.
ANS:C
n
EBPis asystematicapproachtopracticethat emphasizestheuseofbest evidenceincombination withthe
n n n n
cliniciansexperience,aswellaspatientpreferencesandvalues,whenmakingdecisionsaboutcareandtreatment.
n j j j j j j j j
nEBPismorethansimplyusingthebestpracticetechniquestotreatpatients,andquestioningtraditionisimportant when
j j j j j j j j j j j
nocompellingandsupportiveresearchevidenceexists.
n j
DIF:CognitiveLevel:Applying(Application)REF:z.5
Page4of759