Chapter 1 health Assessment test bank
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 til 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 pa- tient now. - ANS Feedback A Personal data and insurance
information will be ob- tained, but in this situation, this data can wait until af- ter the patient is
assessed. B Rather than asking the patient to wait, the nurse needs to begin data collection,
such as vital signs, im- mediately to determine the patient's health status. CA comprehensive
history is not indicated in this situa- tion at this time. Some subjective data will be collected,
such as allergies and medical history related to cardio- vascular disease. 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.
ANS: D
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 ex- amination. 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. d. A patient newly diagnosed with diabetes mellitus comes to test his
fasting blood glucose level. - ANS AA detailed history and physical examination conduct- ed
during a first-time visit to an obstetric clinic is an ex- ample of a comprehensive assessment. BA
health fair at a local mall that provides cholesterol and blood pressure checks is an example of a
screening assessment focused on disease detection. C 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. DA 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. ANS: B
3. For which person is a screening assessment indicat- ed? 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 - ANS Feedback AA shift assessment is most appropriate for the
person who is recovering in the hospital from surgery. BA screening assessment is performed
for the purpose of disease detection. In this case this person may have diabetes mellitus. CA
comprehensive assessment is performed during ad- mission to a facility to obtain a detailed
history and complete physical examination. D An episodic or follow-up assessment is performed
af- ter knee replacement to evaluate the outcome of the procedure. ANS: B
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
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 til 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 pa- tient now. - ANS Feedback A Personal data and insurance
information will be ob- tained, but in this situation, this data can wait until af- ter the patient is
assessed. B Rather than asking the patient to wait, the nurse needs to begin data collection,
such as vital signs, im- mediately to determine the patient's health status. CA comprehensive
history is not indicated in this situa- tion at this time. Some subjective data will be collected,
such as allergies and medical history related to cardio- vascular disease. 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.
ANS: D
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 ex- amination. 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. d. A patient newly diagnosed with diabetes mellitus comes to test his
fasting blood glucose level. - ANS AA detailed history and physical examination conduct- ed
during a first-time visit to an obstetric clinic is an ex- ample of a comprehensive assessment. BA
health fair at a local mall that provides cholesterol and blood pressure checks is an example of a
screening assessment focused on disease detection. C 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. DA 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. ANS: B
3. For which person is a screening assessment indicat- ed? 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 - ANS Feedback AA shift assessment is most appropriate for the
person who is recovering in the hospital from surgery. BA screening assessment is performed
for the purpose of disease detection. In this case this person may have diabetes mellitus. CA
comprehensive assessment is performed during ad- mission to a facility to obtain a detailed
history and complete physical examination. D An episodic or follow-up assessment is performed
af- ter knee replacement to evaluate the outcome of the procedure. ANS: B
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
