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