TEST BANK
Advanced Health Assessment and Differential Diagnosis:
Essentials for Clinical Practice
Karen Myrick, and Laima Karosas
1st Edition
,Table of Contents
Chapter 1. Health History, The Patient Interview, And Motivational Interviewing 1
Chapter 2. Advanced Health Assessment of the Head, Neck, and Lymphatic System 13
Chapter 3. Advanced Health Assessment of the Nose, Mouth, and Throat 24
Chapter 4. Advanced Health Assessment of the Eyes and Ears 36
Chapter 5. Advanced Health Assessment of Skin, Hair, and Nails 42
Chapter 6. Advanced Health Assessment of the Cardiovascular System 48
Chapter 7. Advanced Health Assessment of the Respiratory System 60
Chapter 8. Advanced Health Assessment of the Abdomen, Rectum, and Anus 72
Chapter 9. Advanced Health Assessment of the Male Genitourinary System 83
Chapter 10. Advanced Assessment of the Female Reproductive System 93
Chapter 11. Advanced Health Assessment of the Neurological System 105
Chapter 12. Advanced Health Assessment of the Musculoskeletal System 117
, Test Bank - Advanced Health Assessment and Differential Diagnosis, 1st Edition (Myrick, 2020)
Chapter 1. Health History, The Patient Interview, And Motivational Interviewing
MULTIPLE CHOICE
1. The nurse is preparing to conduct a health history. Which of these statements best describes the
purpose of a health history?
a. To provide an opportunity for interaction between the patient and the nurse
b. To provide a form for obtaining the patients biographic information
c. To document the normal and abnormal findings of a physical assessment
d. To provide a database of subjective information about the patients past and current health
ANS: D
The purpose of the health history is to collect subjective data what the person says about him or
herself. The other options are not correct.
DIF: Cognitive Level: Understanding (Comprehension) REF: dm. 49
MSC: Client Needs: Safe and Effective Care Environment: Management of Care
2. When the nurse is evaluating the reliability of a patients responses, which of these statements would be
correct? The patient:
a. Has a history of drug abuse and therefore is not reliable.
b. Provided consistent information and therefore is reliable.
c. Smiled throughout interview and therefore is assumed reliable.
d. Would not answer questions concerning stress and therefore is not reliable.
ANS: B
A reliable person always gives the same answers, even when questions are rephrased or are repeated
later in the interview. The other s t a t W
e mWe nWt s.a T
re B
noS
t cMor.reW
ctS
.
DIF: Cognitive Level: Applying (Application) REF: dm. 49
MSC: Client Needs: Safe and Effective Care Environment: Management of Care
3. A 59-year-old patient tells the nurse that he has ulcerative colitis. He has been having black stools for
the last 24 hours. How would the nurse best document his reason for seeking care?
a. J.M. is a 59-year-old man seeking treatment for ulcerative colitis.
b. J.M. came into the clinic complaining of having black stools for the past 24 hours.
c. J.M. is a 59-year-old man who states that he has ulcerative colitis and wants it checked.
d. J.M. is a 59-year-old man who states that he has been having black stools for the past 24
hours.
ANS: D
The reason for seeking care is a brief spontaneous statement in the persons own words that describes
the reason for the visit. It states one (possibly two) signs or symptoms and their duration. It is enclosed
in quotation marks to indicate the persons exact words.
DIF: Cognitive Level: Applying (Application) REF: dm. 50
MSC: Client Needs: Safe and Effective Care Environment: Management of Care
4. A patient tells the nurse that she has had abdominal pain for the past week. What would be the nurses
best response?
a. Can you point to where it hurts?
b. Well talk more about that later in the interview.
c. What have you had to eat in the last 24 hours?
1|Page
, Test Bank - Advanced Health Assessment and Differential Diagnosis, 1st Edition (Myrick, 2020)
d. Have you ever had any surgeries on your abdomen?
ANS: A
A final summary of any symptom the person has should include, along with seven other critical
characteristics, Location: specific. The person is asked to point to the location.
DIF: Cognitive Level: Applying (Application) REF: dm. 50
MSC: Client Needs: Safe and Effective Care Environment: Management of Care
5. A 29-year-old woman tells the nurse that she has excruciating pain in her back. Which would be the
nurses appropriate response to the womans statement?
a. How does your family react to your pain?
b. The pain must be terrible. You probably pinched a nerve.
c. Ive had back pain myself, and it can be excruciating.
d. How would you say the pain affects your ability to do your daily activities?
ANS: D
The symptom of pain is difficult to quantify because of individual interpretation. With pain, adjectives
should be avoided and the patient should be asked how the pain affects his or her daily activities. The
other responses are not appropriate.
DIF: Cognitive Level: Applying (Application) REF: dm. 50
MSC: Client Needs: Safe and Effective Care Environment: Management of Care
6. In recording the childhood illnesses of a patient who denies having had any, which note by the nurse
would be most accurate?
a. Patient denies usual childhood illnesses.
b. Patient states he was a very healthy child.
c. Patient states his sister had measles, but he didnt.
d. Patient denies measles, mumps,Wr uWbeWll .
a, T
chB
ickSenMp.
oxW
, pSertussis, and strep throat.
ANS: D
Childhood illnesses include measles, mumps, rubella, chickenpox, pertussis, and strep throat. Avoid
recording usual childhood illnesses because an illness common in the persons childhood may be
unusual today (e.g., measles).
DIF: Cognitive Level: Remembering (Knowledge) REF: dm. 51
MSC: Client Needs: Safe and Effective Care Environment: Management of Care
7. A female patient tells the nurse that she has had six pregnancies, with four live births at term and two
spontaneous abortions. Her four children are still living. How would the nurse record this information?
a. P-6, B-4, (S)Ab-2
b. Grav 6, Term 4, (S)Ab-2, Living 4
c. Patient has had four living babies.
d. Patient has been pregnant six times.
ANS: B
Obstetric history includes the number of pregnancies (gravidity), number of deliveries in which the
fetus reached term (term), number of preterm pregnancies (preterm), number of incomplete
pregnancies (abortions), and number of children living (living). This is recorded: Grav
Term Preterm Ab Living . For any incomplete
pregnancies, the duration is recorded and whether the pregnancy resulted in a spontaneous (S) or an
induced (I) abortion.
DIF: Cognitive Level: Applying (Application) REF: dm. 51
2|Page
, Test Bank - Advanced Health Assessment and Differential Diagnosis, 1st Edition (Myrick, 2020)
MSC: Client Needs: Safe and Effective Care Environment: Management of Care
8. A patient tells the nurse that he is allergic to penicillin. What would be the nurses best response to this
information?
a. Are you allergic to any other drugs?
b. How often have you received penicillin?
c. Ill write your allergy on your chart so you wont receive any penicillin.
d. Describe what happens to you when you take penicillin.
ANS: D
Note both the allergen (medication, food, or contact agent, such as fabric or environmental agent) and
the reaction (rash, itching, runny nose, watery eyes, or difficulty breathing). With a drug, this symptom
should not be a side effect but a true allergic reaction.
DIF: Cognitive Level: Understanding (Comprehension) REF: dm. 52
MSC: Client Needs: Safe and Effective Care Environment: Management of Care
9. The nurse is taking a family history. Important diseases or problems about which the patient should be
specifically asked include:
a. Emphysema.
b. Head trauma.
c. Mental illness.
d. Fractured bones.
ANS: C
Questions concerning any family history of heart disease, high blood pressure, stroke, diabetes,
obesity, blood disorders, breast and ovarian cancers, colon cancer, sickle cell anemia, arthritis,
allergies, alcohol or drug addiction, mental illness, suicide, seizure disorder, kidney disease, and
tuberculosis should be asked.
WWW.TBSM.WS
DIF: Cognitive Level: Remembering (Knowledge) REF: dm. 53-54
MSC: Client Needs: Safe and Effective Care Environment: Management of Care
10. The review of systems provides the nurse with:
a. Physical findings related to each system.
b. Information regarding health promotion practices.
c. An opportunity to teach the patient medical terms.
d. Information necessary for the nurse to diagnose the patients medical problem.
ANS: B
The purposes of the review of systems are to: (1) evaluate the past and current health state of each
body system, (2) double check facts in case any significant data were omitted in the present illness
section, and (3) evaluate health promotion practices.
DIF: Cognitive Level: Remembering (Knowledge) REF: dm. 54
MSC: Client Needs: Safe and Effective Care Environment: Management of Care
11. Which of these statements represents subjective data the nurse obtained from the patient regarding the
patients skin?
a. Skin appears dry.
b. No lesions are obvious.
c. Patient denies any color change.
d. Lesion is noted on the lateral aspect of the right arm.
ANS: C
3|Page
Advanced Health Assessment and Differential Diagnosis:
Essentials for Clinical Practice
Karen Myrick, and Laima Karosas
1st Edition
,Table of Contents
Chapter 1. Health History, The Patient Interview, And Motivational Interviewing 1
Chapter 2. Advanced Health Assessment of the Head, Neck, and Lymphatic System 13
Chapter 3. Advanced Health Assessment of the Nose, Mouth, and Throat 24
Chapter 4. Advanced Health Assessment of the Eyes and Ears 36
Chapter 5. Advanced Health Assessment of Skin, Hair, and Nails 42
Chapter 6. Advanced Health Assessment of the Cardiovascular System 48
Chapter 7. Advanced Health Assessment of the Respiratory System 60
Chapter 8. Advanced Health Assessment of the Abdomen, Rectum, and Anus 72
Chapter 9. Advanced Health Assessment of the Male Genitourinary System 83
Chapter 10. Advanced Assessment of the Female Reproductive System 93
Chapter 11. Advanced Health Assessment of the Neurological System 105
Chapter 12. Advanced Health Assessment of the Musculoskeletal System 117
, Test Bank - Advanced Health Assessment and Differential Diagnosis, 1st Edition (Myrick, 2020)
Chapter 1. Health History, The Patient Interview, And Motivational Interviewing
MULTIPLE CHOICE
1. The nurse is preparing to conduct a health history. Which of these statements best describes the
purpose of a health history?
a. To provide an opportunity for interaction between the patient and the nurse
b. To provide a form for obtaining the patients biographic information
c. To document the normal and abnormal findings of a physical assessment
d. To provide a database of subjective information about the patients past and current health
ANS: D
The purpose of the health history is to collect subjective data what the person says about him or
herself. The other options are not correct.
DIF: Cognitive Level: Understanding (Comprehension) REF: dm. 49
MSC: Client Needs: Safe and Effective Care Environment: Management of Care
2. When the nurse is evaluating the reliability of a patients responses, which of these statements would be
correct? The patient:
a. Has a history of drug abuse and therefore is not reliable.
b. Provided consistent information and therefore is reliable.
c. Smiled throughout interview and therefore is assumed reliable.
d. Would not answer questions concerning stress and therefore is not reliable.
ANS: B
A reliable person always gives the same answers, even when questions are rephrased or are repeated
later in the interview. The other s t a t W
e mWe nWt s.a T
re B
noS
t cMor.reW
ctS
.
DIF: Cognitive Level: Applying (Application) REF: dm. 49
MSC: Client Needs: Safe and Effective Care Environment: Management of Care
3. A 59-year-old patient tells the nurse that he has ulcerative colitis. He has been having black stools for
the last 24 hours. How would the nurse best document his reason for seeking care?
a. J.M. is a 59-year-old man seeking treatment for ulcerative colitis.
b. J.M. came into the clinic complaining of having black stools for the past 24 hours.
c. J.M. is a 59-year-old man who states that he has ulcerative colitis and wants it checked.
d. J.M. is a 59-year-old man who states that he has been having black stools for the past 24
hours.
ANS: D
The reason for seeking care is a brief spontaneous statement in the persons own words that describes
the reason for the visit. It states one (possibly two) signs or symptoms and their duration. It is enclosed
in quotation marks to indicate the persons exact words.
DIF: Cognitive Level: Applying (Application) REF: dm. 50
MSC: Client Needs: Safe and Effective Care Environment: Management of Care
4. A patient tells the nurse that she has had abdominal pain for the past week. What would be the nurses
best response?
a. Can you point to where it hurts?
b. Well talk more about that later in the interview.
c. What have you had to eat in the last 24 hours?
1|Page
, Test Bank - Advanced Health Assessment and Differential Diagnosis, 1st Edition (Myrick, 2020)
d. Have you ever had any surgeries on your abdomen?
ANS: A
A final summary of any symptom the person has should include, along with seven other critical
characteristics, Location: specific. The person is asked to point to the location.
DIF: Cognitive Level: Applying (Application) REF: dm. 50
MSC: Client Needs: Safe and Effective Care Environment: Management of Care
5. A 29-year-old woman tells the nurse that she has excruciating pain in her back. Which would be the
nurses appropriate response to the womans statement?
a. How does your family react to your pain?
b. The pain must be terrible. You probably pinched a nerve.
c. Ive had back pain myself, and it can be excruciating.
d. How would you say the pain affects your ability to do your daily activities?
ANS: D
The symptom of pain is difficult to quantify because of individual interpretation. With pain, adjectives
should be avoided and the patient should be asked how the pain affects his or her daily activities. The
other responses are not appropriate.
DIF: Cognitive Level: Applying (Application) REF: dm. 50
MSC: Client Needs: Safe and Effective Care Environment: Management of Care
6. In recording the childhood illnesses of a patient who denies having had any, which note by the nurse
would be most accurate?
a. Patient denies usual childhood illnesses.
b. Patient states he was a very healthy child.
c. Patient states his sister had measles, but he didnt.
d. Patient denies measles, mumps,Wr uWbeWll .
a, T
chB
ickSenMp.
oxW
, pSertussis, and strep throat.
ANS: D
Childhood illnesses include measles, mumps, rubella, chickenpox, pertussis, and strep throat. Avoid
recording usual childhood illnesses because an illness common in the persons childhood may be
unusual today (e.g., measles).
DIF: Cognitive Level: Remembering (Knowledge) REF: dm. 51
MSC: Client Needs: Safe and Effective Care Environment: Management of Care
7. A female patient tells the nurse that she has had six pregnancies, with four live births at term and two
spontaneous abortions. Her four children are still living. How would the nurse record this information?
a. P-6, B-4, (S)Ab-2
b. Grav 6, Term 4, (S)Ab-2, Living 4
c. Patient has had four living babies.
d. Patient has been pregnant six times.
ANS: B
Obstetric history includes the number of pregnancies (gravidity), number of deliveries in which the
fetus reached term (term), number of preterm pregnancies (preterm), number of incomplete
pregnancies (abortions), and number of children living (living). This is recorded: Grav
Term Preterm Ab Living . For any incomplete
pregnancies, the duration is recorded and whether the pregnancy resulted in a spontaneous (S) or an
induced (I) abortion.
DIF: Cognitive Level: Applying (Application) REF: dm. 51
2|Page
, Test Bank - Advanced Health Assessment and Differential Diagnosis, 1st Edition (Myrick, 2020)
MSC: Client Needs: Safe and Effective Care Environment: Management of Care
8. A patient tells the nurse that he is allergic to penicillin. What would be the nurses best response to this
information?
a. Are you allergic to any other drugs?
b. How often have you received penicillin?
c. Ill write your allergy on your chart so you wont receive any penicillin.
d. Describe what happens to you when you take penicillin.
ANS: D
Note both the allergen (medication, food, or contact agent, such as fabric or environmental agent) and
the reaction (rash, itching, runny nose, watery eyes, or difficulty breathing). With a drug, this symptom
should not be a side effect but a true allergic reaction.
DIF: Cognitive Level: Understanding (Comprehension) REF: dm. 52
MSC: Client Needs: Safe and Effective Care Environment: Management of Care
9. The nurse is taking a family history. Important diseases or problems about which the patient should be
specifically asked include:
a. Emphysema.
b. Head trauma.
c. Mental illness.
d. Fractured bones.
ANS: C
Questions concerning any family history of heart disease, high blood pressure, stroke, diabetes,
obesity, blood disorders, breast and ovarian cancers, colon cancer, sickle cell anemia, arthritis,
allergies, alcohol or drug addiction, mental illness, suicide, seizure disorder, kidney disease, and
tuberculosis should be asked.
WWW.TBSM.WS
DIF: Cognitive Level: Remembering (Knowledge) REF: dm. 53-54
MSC: Client Needs: Safe and Effective Care Environment: Management of Care
10. The review of systems provides the nurse with:
a. Physical findings related to each system.
b. Information regarding health promotion practices.
c. An opportunity to teach the patient medical terms.
d. Information necessary for the nurse to diagnose the patients medical problem.
ANS: B
The purposes of the review of systems are to: (1) evaluate the past and current health state of each
body system, (2) double check facts in case any significant data were omitted in the present illness
section, and (3) evaluate health promotion practices.
DIF: Cognitive Level: Remembering (Knowledge) REF: dm. 54
MSC: Client Needs: Safe and Effective Care Environment: Management of Care
11. Which of these statements represents subjective data the nurse obtained from the patient regarding the
patients skin?
a. Skin appears dry.
b. No lesions are obvious.
c. Patient denies any color change.
d. Lesion is noted on the lateral aspect of the right arm.
ANS: C
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