Summary NR 509 take 2 Week 4 discussion
- Chamberlain College Of Nursing (NR 509
Advanced Physical Assessment)
SECTION I: Foundational Concepts & Health History
1. A patient tells the nurse that he is “very nervous, nauseated, and feels hot.”
These types of data would be:
A) Objective
B) Reflective
C) Subjective
D) Introspective
Correct Answer: C
Rationale: Subjective data are the patient's verbal descriptions of their
own symptoms, feelings, and perceptions that cannot be independently verified
by the examiner. Objective data are measurable and observable findings from the
physical examination, laboratory studies, or diagnostic tests.
2. Which of the following is an example of objective data?
A) Patient reports headache
B) Patient states feeling anxious
C) 2.5 cm scar on the right lower forearm
D) Patient describes nausea
Correct Answer: C
Rationale: Objective data are observable and measurable findings
obtained through inspection, palpation, percussion, and auscultation. A scar
measurement is a physical finding that can be verified by the examiner, unlike
subjective symptoms reported by the patient.
,3. Which statement best reflects Evidence-Based Practice (EBP)?
A) EBP relies on tradition for support of best practices
B) EBP is simply the use of best practice techniques
C) EBP emphasizes the use of best evidence with the clinician's experience
D) The patient's own preferences are not important with EBP
Correct Answer: C
Rationale: Evidence-Based Practice integrates the best available research
evidence with the clinician's clinical expertise and the patient's unique values and
circumstances. It is not simply tradition, and patient preferences are an essential
component.
4. Which critical thinking skill helps see relationships among the data?
A) Validation
B) Clustering related cues
C) Identifying gaps in data
D) Distinguishing relevant from irrelevant
Correct Answer: B
Rationale: Clustering related cues involves grouping together pieces of
data that are related, which helps the clinician see patterns and relationships. This
skill is essential for developing accurate differential diagnoses.
5. Which step of the nursing process includes data collection by health history,
physical examination, and interview?
A) Planning
B) Diagnosis
C) Evaluation
D) Assessment
Correct Answer: D
, Rationale: The assessment phase of the nursing process involves collecting
comprehensive data through health history, physical examination, and interview.
This is the foundational step that guides all subsequent nursing actions.
6. A 52-year-old male presents with substernal chest pressure that occurs with
exertion and resolves with rest. What is the most appropriate initial question to
further characterize this symptom?
A) "Can you point to the exact spot with one finger?"
B) "What were you doing when it started, and how long did it last?"
C) "Does the pain radiate to your jaw or left arm?"
D) "Have you taken nitroglycerin for this?"
Correct Answer: B
Rationale: Asking about the activity at onset and duration helps
differentiate stable angina from unstable angina or other cardiac conditions. This
focuses on the "context" and "timing" of the symptom as part of the OLDCARTS
mnemonic.
7. When documenting a patient's history of present illness (HPI), which
represents the "OLDCARTS" element of "Quality"?
A) "The pain started 3 days ago."
B) "The pain is a sharp, stabbing sensation."
C) "The pain worsens when I lie down."
D) "The pain is an 8 out of 10."
Correct Answer: B
Rationale: "Quality" refers to the descriptive nature of the symptom
(sharp, dull, crushing, burning). The other options represent Onset (A),
Aggravating factors (C), and Severity (D).
, 8. A 34-year-old female reports chronic fatigue. During ROS, she notes cold
intolerance and dry skin. This is most pertinent to which body system?
A) Hematologic
B) Musculoskeletal
C) Endocrine
D) Neurologic
Correct Answer: C
Rationale: Cold intolerance and dry skin are classic signs of
hypothyroidism, which falls under the endocrine system.
9. Which is an example of a "pertinent negative" in a patient presenting with
acute abdominal pain?
A) The patient has a history of cholecystectomy
B) The patient reports nausea and vomiting
C) The patient denies rebound tenderness or guarding
D) The patient's pain is localized to the right lower quadrant
Correct Answer: C
Rationale: A pertinent negative is a clinically significant finding that is
absent, helping to rule out specific pathologies (e.g., peritonitis). The absence of
rebound tenderness helps rule out peritoneal inflammation.
10. Which type of question is MOST effective when beginning an open-ended
patient interview?
A) "Do you have chest pain?"
B) "Is your pain sharp or dull?"
C) "Does the pain radiate to your left arm?"
D) "Tell me what brought you in today."
Correct Answer: D
- Chamberlain College Of Nursing (NR 509
Advanced Physical Assessment)
SECTION I: Foundational Concepts & Health History
1. A patient tells the nurse that he is “very nervous, nauseated, and feels hot.”
These types of data would be:
A) Objective
B) Reflective
C) Subjective
D) Introspective
Correct Answer: C
Rationale: Subjective data are the patient's verbal descriptions of their
own symptoms, feelings, and perceptions that cannot be independently verified
by the examiner. Objective data are measurable and observable findings from the
physical examination, laboratory studies, or diagnostic tests.
2. Which of the following is an example of objective data?
A) Patient reports headache
B) Patient states feeling anxious
C) 2.5 cm scar on the right lower forearm
D) Patient describes nausea
Correct Answer: C
Rationale: Objective data are observable and measurable findings
obtained through inspection, palpation, percussion, and auscultation. A scar
measurement is a physical finding that can be verified by the examiner, unlike
subjective symptoms reported by the patient.
,3. Which statement best reflects Evidence-Based Practice (EBP)?
A) EBP relies on tradition for support of best practices
B) EBP is simply the use of best practice techniques
C) EBP emphasizes the use of best evidence with the clinician's experience
D) The patient's own preferences are not important with EBP
Correct Answer: C
Rationale: Evidence-Based Practice integrates the best available research
evidence with the clinician's clinical expertise and the patient's unique values and
circumstances. It is not simply tradition, and patient preferences are an essential
component.
4. Which critical thinking skill helps see relationships among the data?
A) Validation
B) Clustering related cues
C) Identifying gaps in data
D) Distinguishing relevant from irrelevant
Correct Answer: B
Rationale: Clustering related cues involves grouping together pieces of
data that are related, which helps the clinician see patterns and relationships. This
skill is essential for developing accurate differential diagnoses.
5. Which step of the nursing process includes data collection by health history,
physical examination, and interview?
A) Planning
B) Diagnosis
C) Evaluation
D) Assessment
Correct Answer: D
, Rationale: The assessment phase of the nursing process involves collecting
comprehensive data through health history, physical examination, and interview.
This is the foundational step that guides all subsequent nursing actions.
6. A 52-year-old male presents with substernal chest pressure that occurs with
exertion and resolves with rest. What is the most appropriate initial question to
further characterize this symptom?
A) "Can you point to the exact spot with one finger?"
B) "What were you doing when it started, and how long did it last?"
C) "Does the pain radiate to your jaw or left arm?"
D) "Have you taken nitroglycerin for this?"
Correct Answer: B
Rationale: Asking about the activity at onset and duration helps
differentiate stable angina from unstable angina or other cardiac conditions. This
focuses on the "context" and "timing" of the symptom as part of the OLDCARTS
mnemonic.
7. When documenting a patient's history of present illness (HPI), which
represents the "OLDCARTS" element of "Quality"?
A) "The pain started 3 days ago."
B) "The pain is a sharp, stabbing sensation."
C) "The pain worsens when I lie down."
D) "The pain is an 8 out of 10."
Correct Answer: B
Rationale: "Quality" refers to the descriptive nature of the symptom
(sharp, dull, crushing, burning). The other options represent Onset (A),
Aggravating factors (C), and Severity (D).
, 8. A 34-year-old female reports chronic fatigue. During ROS, she notes cold
intolerance and dry skin. This is most pertinent to which body system?
A) Hematologic
B) Musculoskeletal
C) Endocrine
D) Neurologic
Correct Answer: C
Rationale: Cold intolerance and dry skin are classic signs of
hypothyroidism, which falls under the endocrine system.
9. Which is an example of a "pertinent negative" in a patient presenting with
acute abdominal pain?
A) The patient has a history of cholecystectomy
B) The patient reports nausea and vomiting
C) The patient denies rebound tenderness or guarding
D) The patient's pain is localized to the right lower quadrant
Correct Answer: C
Rationale: A pertinent negative is a clinically significant finding that is
absent, helping to rule out specific pathologies (e.g., peritonitis). The absence of
rebound tenderness helps rule out peritoneal inflammation.
10. Which type of question is MOST effective when beginning an open-ended
patient interview?
A) "Do you have chest pain?"
B) "Is your pain sharp or dull?"
C) "Does the pain radiate to your left arm?"
D) "Tell me what brought you in today."
Correct Answer: D
