THIS DOCUMENT BELONGS TO
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Test Bank for Health Assessment for Nursing Practice 7th
Edition
by Susan Fickertt Wilson, Jean Foret Giddens
All Chapters (1-24)|Q&As Verified | Grade A+ Assured
ISBN 9780323763196
~1~
,THIS DOCUMENT BELONGS TO
TESTBANKSPROF
Chapter 01: Introduction to Health Assessment
MULTIPLE CHOICE
1.A patient comes to the emergency department and tells the triage nurse
that he is “having a heart attack.” What is the nurse’s top priority at this time?
a. Determine the patient’s personal data and
insurance coverage.
b. Ask the patient to take a seat in the
waiting room until his name is called.
c. Request that a nurse collect data for a
comprehensive history.
d. Ask a nurse to start a focused
assessment of this patient now.
ANSWER: D
The nurse needs to begin an assessment as soon as possible that is focused on this
patient’s cardiovascular system. The type of health assessment performed by the
nurse is also driven by patient need. Personal data and insurance information will be
obtained, but in this situation, these data can wait until after the patient is assessed.
Based also on Maslow’s hierarchy of needs, physiologic needs take precedence.
Rather than asking the patient to wait, the nurse needs to begin data collection, such
as vital signs, immediately to determine the patient’s health status. Complications can
be prevented if an immediate assessment is made to analyze the patient’s symptoms.
A comprehensive history is not indicated in this situation at this time. Some
subjective data will be collected, such as allergies and medical history related to
cardiovascular disease. Eyes, ears, or a complete musculoskeletal or mental health
assessment is not a priority at this time.
DIF: Cognitive Level: Apply REF: Box 1-3 | p. 3
TOP: Nursing Process: Assessment
MSC: NCLEX Patient Needs: Safe and Effective Care Environment: Management of Care:
Establishing Priorities
2. Which situation illustrates a screening assessment?
a. A patient visits an obstetric clinic for the
first time and the nurse conducts a
detailed history and physical
examination.
b. A hospital sponsors a health fair at a local
mall and provides cholesterol and blood
pressure checks to mall patrons.
c. The nurse in an urgent care center
checks the vital signs of a patient who
is complaining of leg pain.
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d. A patient newly diagnosed with diabetes
mellitus comes to test his fasting blood
glucose level.
ANSWER: B
A health fair at a local mall that provides cholesterol and blood pressure checks is an
example of a screening assessment focused on disease detection. A detailed history
and physical examination conducted during a first-time visit to an obstetric clinic is an
example of a comprehensive assessment. Assessing a patient complaining of leg pain
in the triage area of an urgent care center is an example of a problem-based/focused
assessment. A patient’s return appointment 1 month after today’s office visit to report
fasting blood glucose levels is an example of an episodic or follow-up assessment.
DIF: Cognitive Level: Understand REF: Box 1-3 | p. 3
TOP: Nursing Process: Assessment
MSC: NCLEX Patient Needs: Health Promotion and Maintenance: Health Screening
3. For which person is a screening assessment indicated?
a. The person who had abdominal surgery
yesterday
b. The person who is unaware of his high
serum glucose levels
c. The person who is being admitted
to a long-term care facility
d. The person who is beginning
rehabilitation after a knee replacement
ANSWER: B
A screening assessment is performed for the purpose of disease detection. In this case
this person may have diabetes mellitus. A shift assessment is most appropriate for the
person who is recovering in the hospital from surgery. A comprehensive assessment is
performed during admission to a facility to obtain a detailed history and complete
physical examination. An episodic or follow-up assessment is performed after knee
replacement to evaluate the outcome of the procedure.
DIF: Cognitive Level: Understand REF: Box 1-3 | p. 3
TOP: Nursing Process: Assessment
MSC: NCLEX Patient Needs: Safe and Effective Care Environment: Management of Care:
Establishing Priorities
4. For which person is a shift assessment indicated?
a. The person who had abdominal surgery
yesterday
b. The person who is unaware of his high
serum glucose levels
c. The person who is being admitted
to a long-term care facility
d. The person who is beginning
rehabilitation
after a knee replacement
ANSWER: A
A shift assessment is most appropriate for the person who is recovering in the
~3~
, THIS DOCUMENT BELONGS TO
TESTBANKSPROF
hospital from surgery. A screening assessment is performed for the purpose of
disease detection, in this case diabetes mellitus. A comprehensive assessment is
performed during admission to a
~4~
TESTBANKSPROF
Test Bank for Health Assessment for Nursing Practice 7th
Edition
by Susan Fickertt Wilson, Jean Foret Giddens
All Chapters (1-24)|Q&As Verified | Grade A+ Assured
ISBN 9780323763196
~1~
,THIS DOCUMENT BELONGS TO
TESTBANKSPROF
Chapter 01: Introduction to Health Assessment
MULTIPLE CHOICE
1.A patient comes to the emergency department and tells the triage nurse
that he is “having a heart attack.” What is the nurse’s top priority at this time?
a. Determine the patient’s personal data and
insurance coverage.
b. Ask the patient to take a seat in the
waiting room until his name is called.
c. Request that a nurse collect data for a
comprehensive history.
d. Ask a nurse to start a focused
assessment of this patient now.
ANSWER: D
The nurse needs to begin an assessment as soon as possible that is focused on this
patient’s cardiovascular system. The type of health assessment performed by the
nurse is also driven by patient need. Personal data and insurance information will be
obtained, but in this situation, these data can wait until after the patient is assessed.
Based also on Maslow’s hierarchy of needs, physiologic needs take precedence.
Rather than asking the patient to wait, the nurse needs to begin data collection, such
as vital signs, immediately to determine the patient’s health status. Complications can
be prevented if an immediate assessment is made to analyze the patient’s symptoms.
A comprehensive history is not indicated in this situation at this time. Some
subjective data will be collected, such as allergies and medical history related to
cardiovascular disease. Eyes, ears, or a complete musculoskeletal or mental health
assessment is not a priority at this time.
DIF: Cognitive Level: Apply REF: Box 1-3 | p. 3
TOP: Nursing Process: Assessment
MSC: NCLEX Patient Needs: Safe and Effective Care Environment: Management of Care:
Establishing Priorities
2. Which situation illustrates a screening assessment?
a. A patient visits an obstetric clinic for the
first time and the nurse conducts a
detailed history and physical
examination.
b. A hospital sponsors a health fair at a local
mall and provides cholesterol and blood
pressure checks to mall patrons.
c. The nurse in an urgent care center
checks the vital signs of a patient who
is complaining of leg pain.
~2~
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TESTBANKSPROF
d. A patient newly diagnosed with diabetes
mellitus comes to test his fasting blood
glucose level.
ANSWER: B
A health fair at a local mall that provides cholesterol and blood pressure checks is an
example of a screening assessment focused on disease detection. A detailed history
and physical examination conducted during a first-time visit to an obstetric clinic is an
example of a comprehensive assessment. Assessing a patient complaining of leg pain
in the triage area of an urgent care center is an example of a problem-based/focused
assessment. A patient’s return appointment 1 month after today’s office visit to report
fasting blood glucose levels is an example of an episodic or follow-up assessment.
DIF: Cognitive Level: Understand REF: Box 1-3 | p. 3
TOP: Nursing Process: Assessment
MSC: NCLEX Patient Needs: Health Promotion and Maintenance: Health Screening
3. For which person is a screening assessment indicated?
a. The person who had abdominal surgery
yesterday
b. The person who is unaware of his high
serum glucose levels
c. The person who is being admitted
to a long-term care facility
d. The person who is beginning
rehabilitation after a knee replacement
ANSWER: B
A screening assessment is performed for the purpose of disease detection. In this case
this person may have diabetes mellitus. A shift assessment is most appropriate for the
person who is recovering in the hospital from surgery. A comprehensive assessment is
performed during admission to a facility to obtain a detailed history and complete
physical examination. An episodic or follow-up assessment is performed after knee
replacement to evaluate the outcome of the procedure.
DIF: Cognitive Level: Understand REF: Box 1-3 | p. 3
TOP: Nursing Process: Assessment
MSC: NCLEX Patient Needs: Safe and Effective Care Environment: Management of Care:
Establishing Priorities
4. For which person is a shift assessment indicated?
a. The person who had abdominal surgery
yesterday
b. The person who is unaware of his high
serum glucose levels
c. The person who is being admitted
to a long-term care facility
d. The person who is beginning
rehabilitation
after a knee replacement
ANSWER: A
A shift assessment is most appropriate for the person who is recovering in the
~3~
, THIS DOCUMENT BELONGS TO
TESTBANKSPROF
hospital from surgery. A screening assessment is performed for the purpose of
disease detection, in this case diabetes mellitus. A comprehensive assessment is
performed during admission to a
~4~
