Chapter 25: Putting it All Together
Ball: Seidel’s Guide to Physical Examination, 9th Edition
MULTIPLE CHOICE
1. Which is true regarding the relationship between the examiner and patient?
a. It is the examiner’s responsibility to help the patient understand that he or she is qualified to
make decisions regarding health care.
b. The patient must trust the examiner completely.
c. The examiner-patient relationship is enhanced by ignoring cultural issues.
d. The patient is a full partner with the examiner.
ANS: D
The patient is a full partner with the examiner. The examiner should keep the patient informed
and should develop a relationship to ensure trust. Cultural issues should be acknowledged, not
ignored. The examiner should keep the patient informed, but it is not the examiner’s
responsibility to help the patient understand that he or she is qualified to make healthcare
decisions. The examiner should develop a relationship to ensure trust, but it is not necessary for
the patient to trust the examiner completely.
DIF: Cognitive Level: Understanding (Comprehension)
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Basic Care and Comfort
2. Which examiner behavior would help minimize your patient’s dissatisfaction?
a. Assume a busy and rushed attitude.
b. Convey your own feelings of discomfort.
c. Keep the patient waiting for more than 30 minutes.
d. Seek information about the patient’s problem.
ANS: D
When performing an examination, you are seeking information about the patient and the problem
that brings the patient to you.
This process teaches you about the patient and teaches the patient about your personal discipline,
professional composure, and
respect for others.
DIF: Cognitive Level: Applying (Application)
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Basic Care and Comfort
3. An examiner might be able to help a patient who seems uncomfortable with close contact
during an examination by:
a. acknowledging the discomfort.
b. backing away from the patient.
c. joking about the patient’s discomfort.
d. moving briskly to completion.
ANS: A
Acknowledging the patient’s discomfort during the examination will help the patient feel more
relaxed. Your professional concern can be reassuring to the patient. You should explain what you
, are doing to the patient before the assessment and what the patient will experience; if not, you
will run the risk of losing trust. The other choices would make the patient more uneasy.
DIF: Cognitive Level: Applying (Application)
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Basic Care and Comfort
4. When performing a history and physical assessment, the examiner should:
a. change the sequence of observation with each interview.
b. develop a sequence of standard observations.
c. develop a preliminary diagnosis at the onset.
d. direct patient responses to fit the history sequence.
ANS: B
When performing a history and physical assessment, you should develop an approach that is
comfortable to you and ensures comfort for the patient. Part of the history can be obtained while
you are doing the physical examination.
DIF: Cognitive Level: Understanding (Comprehension)
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Basic Care and Comfort
5. The examiner should develop a demeanor that is exemplified by which one of the following
behaviors?
a. Exhibits visible distaste about the condition.
b. Gives immediate reassurances to the patient.
c. Gives patient unsolicited advice.
d. Validates the patient’s justified concerns.
ANS: D
The examiner needs to learn a gentle and balanced demeanor. By showing concern for the
patient’s feelings, you gain the patient’s trust; giving unsolicited advice can cause the patient to
lose trust in the relationship.
DIF: Cognitive Level: Understanding (Comprehension)
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Basic Care and Comfort
6. At your first meeting with a patient, it is usually best to say:
a. “Let’s get to the point.”
b. “I hope you will learn to trust me.”
c. “Let me tell you what I can do for you.”
d. “Tell me about yourself.”
ANS: D
Take the time to ask open-ended questions to ensure that the patient has the opportunity to report
accurately. Too great an adherence to routine may prevent the true story from emerging. The
other statements are not open-ended, which would not allow the patient to elaborate. In addition,
they are not comforting statements and would make the patient feel uncomfortable at the initial
meeting.
DIF: Cognitive Level: Applying (Application)
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Basic Care and Comfort
7. Which patient characteristic is most likely to limit patient reliability during history taking?
a. The patient’s measured IQ is above average.
b. The patient is alert and oriented to time and place.
c. The patient is depressed.
Ball: Seidel’s Guide to Physical Examination, 9th Edition
MULTIPLE CHOICE
1. Which is true regarding the relationship between the examiner and patient?
a. It is the examiner’s responsibility to help the patient understand that he or she is qualified to
make decisions regarding health care.
b. The patient must trust the examiner completely.
c. The examiner-patient relationship is enhanced by ignoring cultural issues.
d. The patient is a full partner with the examiner.
ANS: D
The patient is a full partner with the examiner. The examiner should keep the patient informed
and should develop a relationship to ensure trust. Cultural issues should be acknowledged, not
ignored. The examiner should keep the patient informed, but it is not the examiner’s
responsibility to help the patient understand that he or she is qualified to make healthcare
decisions. The examiner should develop a relationship to ensure trust, but it is not necessary for
the patient to trust the examiner completely.
DIF: Cognitive Level: Understanding (Comprehension)
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Basic Care and Comfort
2. Which examiner behavior would help minimize your patient’s dissatisfaction?
a. Assume a busy and rushed attitude.
b. Convey your own feelings of discomfort.
c. Keep the patient waiting for more than 30 minutes.
d. Seek information about the patient’s problem.
ANS: D
When performing an examination, you are seeking information about the patient and the problem
that brings the patient to you.
This process teaches you about the patient and teaches the patient about your personal discipline,
professional composure, and
respect for others.
DIF: Cognitive Level: Applying (Application)
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Basic Care and Comfort
3. An examiner might be able to help a patient who seems uncomfortable with close contact
during an examination by:
a. acknowledging the discomfort.
b. backing away from the patient.
c. joking about the patient’s discomfort.
d. moving briskly to completion.
ANS: A
Acknowledging the patient’s discomfort during the examination will help the patient feel more
relaxed. Your professional concern can be reassuring to the patient. You should explain what you
, are doing to the patient before the assessment and what the patient will experience; if not, you
will run the risk of losing trust. The other choices would make the patient more uneasy.
DIF: Cognitive Level: Applying (Application)
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Basic Care and Comfort
4. When performing a history and physical assessment, the examiner should:
a. change the sequence of observation with each interview.
b. develop a sequence of standard observations.
c. develop a preliminary diagnosis at the onset.
d. direct patient responses to fit the history sequence.
ANS: B
When performing a history and physical assessment, you should develop an approach that is
comfortable to you and ensures comfort for the patient. Part of the history can be obtained while
you are doing the physical examination.
DIF: Cognitive Level: Understanding (Comprehension)
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Basic Care and Comfort
5. The examiner should develop a demeanor that is exemplified by which one of the following
behaviors?
a. Exhibits visible distaste about the condition.
b. Gives immediate reassurances to the patient.
c. Gives patient unsolicited advice.
d. Validates the patient’s justified concerns.
ANS: D
The examiner needs to learn a gentle and balanced demeanor. By showing concern for the
patient’s feelings, you gain the patient’s trust; giving unsolicited advice can cause the patient to
lose trust in the relationship.
DIF: Cognitive Level: Understanding (Comprehension)
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Basic Care and Comfort
6. At your first meeting with a patient, it is usually best to say:
a. “Let’s get to the point.”
b. “I hope you will learn to trust me.”
c. “Let me tell you what I can do for you.”
d. “Tell me about yourself.”
ANS: D
Take the time to ask open-ended questions to ensure that the patient has the opportunity to report
accurately. Too great an adherence to routine may prevent the true story from emerging. The
other statements are not open-ended, which would not allow the patient to elaborate. In addition,
they are not comforting statements and would make the patient feel uncomfortable at the initial
meeting.
DIF: Cognitive Level: Applying (Application)
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Basic Care and Comfort
7. Which patient characteristic is most likely to limit patient reliability during history taking?
a. The patient’s measured IQ is above average.
b. The patient is alert and oriented to time and place.
c. The patient is depressed.
