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
ct.S
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, m um ps ,Wr uWb eWll .a, T
chB
ickSen
Mp.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
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
ct.S
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, m um ps ,Wr uWb eWll .a, T
chB
ickSen
Mp.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
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