Test Bank for Health Assessment for
Nursing Practice 7th Edition by Wilson
Chapter 1 - 24
,Chapterl01:lIntroductionltolHealthlAssessment
MULTIPLElCHOICE
1. Alpatientlcomesltolthelemergencyldepartmentlandltellsltheltriagelnurselthatlhelisl“
havinglalheartlattack.”lWhatlislthelnurse’sltoplprioritylatlthisltime?
a. Determinelthelpatient’slpersonalldatalandlinsu
rancelcoverage.
b. Asklthelpatientltoltakelalseatlinlthelwaitinglroo
mluntillhislnamelislcalled.
c. Requestlthatlalnurselcollectldatalforlalc
omprehensivelhistory.
d. Asklalnurseltolstartlalfocusedlassessmentlo
flthislpatientlnow.
ANSWER:lD
Thelnurselneedsltolbeginlanlassessmentlaslsoonlaslpossiblelthatlislfocusedlonlthislpatient’slcard
iovascularlsystem.lTheltypeloflhealthlassessmentlperformedlbylthelnurselislalsoldrivenlbylpatie
ntlneed.lPersonalldatalandlinsurancelinformationlwilllbelobtained,lbutlinlthislsituation,ltheselda
talcanlwaitluntillafterlthelpatientlislassessed.lBasedlalsolonlMaslow’slhierarchyloflneeds,lphysi
ologiclneedsltakelprecedence.lRatherlthanlaskinglthelpatientltolwait,lthelnurselneedsltolbeginld
atalcollection,lsuchlaslvitallsigns,limmediatelyltoldeterminelthelpatient’slhealthlstatus.lCompli
cationslcanlbelpreventedliflanlimmediatelassessmentlislmadeltolanalyzelthelpatient’slsymptom
s.lAlcomprehensivelhistorylislnotlindicatedlinlthislsituationlatlthisltime.lSomelsubjectiveldatal
willlbelcollected,lsuchlaslallergieslandlmedicallhistorylrelatedltolcardiovascularldisease.lEyes,l
ears,lorlalcompletelmusculoskeletallorlmentallhealthlassessmentlislnotlalprioritylatlthisltime.
DIF:lll CognitivelLevel:lApply REF:lBoxl1-
3l|lp.l3lTOP:lNursinglProcess:lAssessment
MSC:lNCLEXlPatientlNeeds:lSafelandlEffectivelCarelEnvironment:lManagementloflCare:lEstablishin
glPriorities
2. Whichlsituationlillustrateslalscreeninglassessment?
a. Alpatientlvisitslanlobstetriclcliniclforlthelfirstlt
imelandlthelnurselconductslaldetailedlhistoryla
ndlphysicallexamination.
b. Alhospitallsponsorslalhealthlfairlatlallocallm
alllandlprovideslcholesterollandlbloodlpres
surelchecksltolmalllpatrons.
c. Thelnurselinlanlurgentlcarelcenterlcheckslth
elvitallsignsloflalpatientlwholislcomplainin
gloflleglpain.
, d. Alpatientlnewlyldiagnosedlwithldiabetesl
mellituslcomesltoltestlhislfastinglbloodlgl
ucosellevel.
ANSWER:lB
Alhealthlfairlatlallocallmalllthatlprovideslcholesterollandlbloodlpressurelcheckslislanlexamplelo
flalscreeninglassessmentlfocusedlonldiseaseldetection.lAldetailedlhistorylandlphysicallexamin
ationlconductedlduringlalfirst-
timelvisitltolanlobstetriclcliniclislanlexampleloflalcomprehensivelassessment.lAssessinglalpatie
ntlcomplainingloflleglpainlinltheltriagelarealoflanlurgentlcarelcenterlislanlexampleloflalproblem
-
based/focusedlassessment.lAlpatient’slreturnlappointmentl1lmonthlafterltoday’slofficelvisitltol
reportlfastinglbloodlglucosellevelslislanlexampleloflanlepisodiclorlfollow-uplassessment.
DIF:lllCognitivelLevel:lUnderstand REF:lBoxl1-
3l|lp.l3lTOP:lNursinglProcess:lAssessment
MSC:lNCLEXlPatientlNeeds:lHealthlPromotionlandlMaintenance:lHealthlScreening
3. Forlwhichlpersonlislalscreeninglassessmentlindicated?
a. Thelpersonlwholhadlabdominallsurgeryly
esterday
b. Thelpersonlwholislunawareloflhislhighls
erumlglucosellevels
c. Thelpersonlwholislbeingladmittedltolallo
ng-termlcarelfacility
d. Thelpersonlwholislbeginninglrehabilitationlaft
erlalkneelreplacement
ANSWER:lB
Alscreeninglassessmentlislperformedlforlthelpurposelofldiseaseldetection.lInlthislcaselthislper
sonlmaylhaveldiabeteslmellitus.lAlshiftlassessmentlislmostlappropriatelforlthelpersonlwholislr
ecoveringlinlthelhospitallfromlsurgery.lAlcomprehensivelassessmentlislperformedlduringlad
missionltolalfacilityltolobtainlaldetailedlhistorylandlcompletelphysicallexamination.lAnlepiso
diclorlfollow-
uplassessmentlislperformedlafterlkneelreplacementltolevaluateltheloutcomeloflthelprocedure.
DIF:lllCognitivelLevel:lUnderstand REF:lBoxl1-
3l|lp.l3lTOP:lNursinglProcess:lAssessment
MSC:lNCLEXlPatientlNeeds:lSafelandlEffectivelCarelEnvironment:lManagementloflCare:lEstablishin
glPriorities
4. Forlwhichlpersonlislalshiftlassessmentlindicated?
a. Thelpersonlwholhadlabdominallsurgeryly
esterday
b. Thelpersonlwholislunawareloflhislhighls
erumlglucosellevels
c. Thelpersonlwholislbeingladmittedltola
long-termlcarelfacility
d. Thelpersonlwholislbeginninglrehabilitationla
fterlalkneelreplacement
ANSWER:lA
Alshiftlassessmentlislmostlappropriatelforlthelpersonlwholislrecoveringlinlthelhospitallfromlsur
gery.lAlscreeninglassessmentlislperformedlforlthelpurposelofldiseaseldetection,linlthislcaseldia
beteslmellitus.lAlcomprehensivelassessmentlislperformedlduringladmissionltola
, facilityltolobtainlaldetailedlhistorylandlcompletelphysicallexamination.lAnlepisodiclorlfollo
w-
uplassessmentlislperformedlafterlkneelreplacementltolevaluateltheloutcomeloflthelprocedure.
DIF:lllCognitivelLevel:lUnderstand REF:lBoxl1-
3l|lp.l4lTOP:lNursinglProcess:lAssessment
MSC:lNCLEXlPatientlNeeds:lSafelandlEffectivelCarelEnvironment:lManagementloflCare:lEstablishin
glPriorities
5. Forlwhichlpersonlislalcomprehensivelassessmentlindicated?
a. Thelpersonlwholhadlabdominallsurgeryly
esterday
b. Thelpersonlwholislunawareloflhislhighls
erumlglucosellevels
c. Thelpersonlwholislbeingladmittedltolallo
ng-termlcarelfacility
d. Thelpersonlwholislbeginninglrehabilitationlaft
erlalkneelreplacement
ANSWER:lC
Alcomprehensivelassessmentlislperformedlduringladmissionltolalfacilityltolobtainla
detailedlhistorylandlcompletelphysicallexamination.lAlshiftlassessmentlislmostlappropriatelfor
lthelpersonlwholislrecoveringlinlthelhospital lfromlsurgery.lAlscreeninglassessmentlis lperform
edlforlthelpurposelofldiseaseldetection,linlthislcaseldiabeteslmellitus.lAnlepisodiclorlfollow-
uplassessmentlislperformedlafterlkneelreplacementltolevaluateltheloutcomeloflthelprocedure.
DIF:lllCognitivelLevel:lUnderstand REF:lBoxl1-
3l|lp.l3lTOP:lNursinglProcess:lAssessment
MSC:lNCLEXlPatientlNeeds:lSafelandlEffectivelCarelEnvironment:lManagementloflCare:lEstablishin
glPriorities
6. Forlwhichlpersonlislanlepisodiclorlfollow-uplassessmentlindicated?
a. Thelpersonlwholhadlabdominallsurgeryly
esterday
b. Thelpersonlwholislunawareloflhislhighls
erumlglucosellevels
c. Thelpersonlwholislbeingladmittedltola
long-termlcarelfacility
d. Thelpersonlwholislbeginninglrehabilitationlaft
erlalkneelreplacement
ANSWER:lD
Anlepisodiclorlfollow-
uplassessmentlislperformedlafterlthelkneelreplacementltolevaluateltheloutcomeloflthelprocedu
re.lAlshiftlassessmentlislmostlappropriatelforlthelpersonlwholislrecoveringlinlthelhospitallfroml
surgery.lAlscreeninglassessmentlislperformedlforlthelpurposelofldiseaseldetection,linlthislcasel
diabeteslmellitus.lAlcomprehensivelassessmentlislperformedlduringladmissionltolalfacilityltol
obtainlaldetailedlhistorylandlcompletelphysicallexamination.
DIF:lllCognitivelLevel:lUnderstand REF:lBoxl1-
3l|lp.l3lTOP:lNursinglProcess:lAssessment
Nursing Practice 7th Edition by Wilson
Chapter 1 - 24
,Chapterl01:lIntroductionltolHealthlAssessment
MULTIPLElCHOICE
1. Alpatientlcomesltolthelemergencyldepartmentlandltellsltheltriagelnurselthatlhelisl“
havinglalheartlattack.”lWhatlislthelnurse’sltoplprioritylatlthisltime?
a. Determinelthelpatient’slpersonalldatalandlinsu
rancelcoverage.
b. Asklthelpatientltoltakelalseatlinlthelwaitinglroo
mluntillhislnamelislcalled.
c. Requestlthatlalnurselcollectldatalforlalc
omprehensivelhistory.
d. Asklalnurseltolstartlalfocusedlassessmentlo
flthislpatientlnow.
ANSWER:lD
Thelnurselneedsltolbeginlanlassessmentlaslsoonlaslpossiblelthatlislfocusedlonlthislpatient’slcard
iovascularlsystem.lTheltypeloflhealthlassessmentlperformedlbylthelnurselislalsoldrivenlbylpatie
ntlneed.lPersonalldatalandlinsurancelinformationlwilllbelobtained,lbutlinlthislsituation,ltheselda
talcanlwaitluntillafterlthelpatientlislassessed.lBasedlalsolonlMaslow’slhierarchyloflneeds,lphysi
ologiclneedsltakelprecedence.lRatherlthanlaskinglthelpatientltolwait,lthelnurselneedsltolbeginld
atalcollection,lsuchlaslvitallsigns,limmediatelyltoldeterminelthelpatient’slhealthlstatus.lCompli
cationslcanlbelpreventedliflanlimmediatelassessmentlislmadeltolanalyzelthelpatient’slsymptom
s.lAlcomprehensivelhistorylislnotlindicatedlinlthislsituationlatlthisltime.lSomelsubjectiveldatal
willlbelcollected,lsuchlaslallergieslandlmedicallhistorylrelatedltolcardiovascularldisease.lEyes,l
ears,lorlalcompletelmusculoskeletallorlmentallhealthlassessmentlislnotlalprioritylatlthisltime.
DIF:lll CognitivelLevel:lApply REF:lBoxl1-
3l|lp.l3lTOP:lNursinglProcess:lAssessment
MSC:lNCLEXlPatientlNeeds:lSafelandlEffectivelCarelEnvironment:lManagementloflCare:lEstablishin
glPriorities
2. Whichlsituationlillustrateslalscreeninglassessment?
a. Alpatientlvisitslanlobstetriclcliniclforlthelfirstlt
imelandlthelnurselconductslaldetailedlhistoryla
ndlphysicallexamination.
b. Alhospitallsponsorslalhealthlfairlatlallocallm
alllandlprovideslcholesterollandlbloodlpres
surelchecksltolmalllpatrons.
c. Thelnurselinlanlurgentlcarelcenterlcheckslth
elvitallsignsloflalpatientlwholislcomplainin
gloflleglpain.
, d. Alpatientlnewlyldiagnosedlwithldiabetesl
mellituslcomesltoltestlhislfastinglbloodlgl
ucosellevel.
ANSWER:lB
Alhealthlfairlatlallocallmalllthatlprovideslcholesterollandlbloodlpressurelcheckslislanlexamplelo
flalscreeninglassessmentlfocusedlonldiseaseldetection.lAldetailedlhistorylandlphysicallexamin
ationlconductedlduringlalfirst-
timelvisitltolanlobstetriclcliniclislanlexampleloflalcomprehensivelassessment.lAssessinglalpatie
ntlcomplainingloflleglpainlinltheltriagelarealoflanlurgentlcarelcenterlislanlexampleloflalproblem
-
based/focusedlassessment.lAlpatient’slreturnlappointmentl1lmonthlafterltoday’slofficelvisitltol
reportlfastinglbloodlglucosellevelslislanlexampleloflanlepisodiclorlfollow-uplassessment.
DIF:lllCognitivelLevel:lUnderstand REF:lBoxl1-
3l|lp.l3lTOP:lNursinglProcess:lAssessment
MSC:lNCLEXlPatientlNeeds:lHealthlPromotionlandlMaintenance:lHealthlScreening
3. Forlwhichlpersonlislalscreeninglassessmentlindicated?
a. Thelpersonlwholhadlabdominallsurgeryly
esterday
b. Thelpersonlwholislunawareloflhislhighls
erumlglucosellevels
c. Thelpersonlwholislbeingladmittedltolallo
ng-termlcarelfacility
d. Thelpersonlwholislbeginninglrehabilitationlaft
erlalkneelreplacement
ANSWER:lB
Alscreeninglassessmentlislperformedlforlthelpurposelofldiseaseldetection.lInlthislcaselthislper
sonlmaylhaveldiabeteslmellitus.lAlshiftlassessmentlislmostlappropriatelforlthelpersonlwholislr
ecoveringlinlthelhospitallfromlsurgery.lAlcomprehensivelassessmentlislperformedlduringlad
missionltolalfacilityltolobtainlaldetailedlhistorylandlcompletelphysicallexamination.lAnlepiso
diclorlfollow-
uplassessmentlislperformedlafterlkneelreplacementltolevaluateltheloutcomeloflthelprocedure.
DIF:lllCognitivelLevel:lUnderstand REF:lBoxl1-
3l|lp.l3lTOP:lNursinglProcess:lAssessment
MSC:lNCLEXlPatientlNeeds:lSafelandlEffectivelCarelEnvironment:lManagementloflCare:lEstablishin
glPriorities
4. Forlwhichlpersonlislalshiftlassessmentlindicated?
a. Thelpersonlwholhadlabdominallsurgeryly
esterday
b. Thelpersonlwholislunawareloflhislhighls
erumlglucosellevels
c. Thelpersonlwholislbeingladmittedltola
long-termlcarelfacility
d. Thelpersonlwholislbeginninglrehabilitationla
fterlalkneelreplacement
ANSWER:lA
Alshiftlassessmentlislmostlappropriatelforlthelpersonlwholislrecoveringlinlthelhospitallfromlsur
gery.lAlscreeninglassessmentlislperformedlforlthelpurposelofldiseaseldetection,linlthislcaseldia
beteslmellitus.lAlcomprehensivelassessmentlislperformedlduringladmissionltola
, facilityltolobtainlaldetailedlhistorylandlcompletelphysicallexamination.lAnlepisodiclorlfollo
w-
uplassessmentlislperformedlafterlkneelreplacementltolevaluateltheloutcomeloflthelprocedure.
DIF:lllCognitivelLevel:lUnderstand REF:lBoxl1-
3l|lp.l4lTOP:lNursinglProcess:lAssessment
MSC:lNCLEXlPatientlNeeds:lSafelandlEffectivelCarelEnvironment:lManagementloflCare:lEstablishin
glPriorities
5. Forlwhichlpersonlislalcomprehensivelassessmentlindicated?
a. Thelpersonlwholhadlabdominallsurgeryly
esterday
b. Thelpersonlwholislunawareloflhislhighls
erumlglucosellevels
c. Thelpersonlwholislbeingladmittedltolallo
ng-termlcarelfacility
d. Thelpersonlwholislbeginninglrehabilitationlaft
erlalkneelreplacement
ANSWER:lC
Alcomprehensivelassessmentlislperformedlduringladmissionltolalfacilityltolobtainla
detailedlhistorylandlcompletelphysicallexamination.lAlshiftlassessmentlislmostlappropriatelfor
lthelpersonlwholislrecoveringlinlthelhospital lfromlsurgery.lAlscreeninglassessmentlis lperform
edlforlthelpurposelofldiseaseldetection,linlthislcaseldiabeteslmellitus.lAnlepisodiclorlfollow-
uplassessmentlislperformedlafterlkneelreplacementltolevaluateltheloutcomeloflthelprocedure.
DIF:lllCognitivelLevel:lUnderstand REF:lBoxl1-
3l|lp.l3lTOP:lNursinglProcess:lAssessment
MSC:lNCLEXlPatientlNeeds:lSafelandlEffectivelCarelEnvironment:lManagementloflCare:lEstablishin
glPriorities
6. Forlwhichlpersonlislanlepisodiclorlfollow-uplassessmentlindicated?
a. Thelpersonlwholhadlabdominallsurgeryly
esterday
b. Thelpersonlwholislunawareloflhislhighls
erumlglucosellevels
c. Thelpersonlwholislbeingladmittedltola
long-termlcarelfacility
d. Thelpersonlwholislbeginninglrehabilitationlaft
erlalkneelreplacement
ANSWER:lD
Anlepisodiclorlfollow-
uplassessmentlislperformedlafterlthelkneelreplacementltolevaluateltheloutcomeloflthelprocedu
re.lAlshiftlassessmentlislmostlappropriatelforlthelpersonlwholislrecoveringlinlthelhospitallfroml
surgery.lAlscreeninglassessmentlislperformedlforlthelpurposelofldiseaseldetection,linlthislcasel
diabeteslmellitus.lAlcomprehensivelassessmentlislperformedlduringladmissionltolalfacilityltol
obtainlaldetailedlhistorylandlcompletelphysicallexamination.
DIF:lllCognitivelLevel:lUnderstand REF:lBoxl1-
3l|lp.l3lTOP:lNursinglProcess:lAssessment
