Test Bank for Health Assessment for
Nursing Practice 7th Edition by Wilson
Chapter 1 - 24
,Chapterw01:wIntroductionwtowHealthwAssessment
MULTIPLEwCHOICE
1. Awpatientwcomeswtowthewemergencywdepartmentwandwtellswthewtriagew nursewthatw
hewisw“havingwawheartwattack.”wWhatwiswthewnurse’swtopwprioritywatwthiswtime?
a. Determinewthewpatient’swpersonalwdatawandwin
surancewcoverage.
b. Askwthewpatientwtowtakewawseatwinwthewwaitingw
roomwuntilw hiswnamewiswcalled.
c. Requestwthatwawnursewcollectwdatawforw
awcomprehensivewhistory.
d. Askwawnursewtowstartwawfocusedwassessmen
twofwthiswpatientwnow.
ANSWER:w D
Thewnursewneedswtowbeginwanwassessmentwaswsoonwaswpossiblewthatwiswfocusedwonwthiswpatient
’swcardiovascularwsystem.wThewtypewofwhealthwassessmentwperformedwbywthewnursewiswalsowdri
venwbywpatientwneed.wPersonalwdatawandwinsurancewinformationwwillwbewobtained,wbutwinwthisw
situation,wthesewdatawcanwwaitwuntilwafterwthewpatientwiswassessed.wBasedwalsowonwMaslow’swh
ierarchywofwneeds,wphysiologicwneedswtakewprecedence.wRatherwthanwaskingwthewpatientwtoww
ait,wthewnursewneedswtowbeginwdatawcollection,wsuchwaswvitalwsigns,wimmediatelywtowdeterminew
thewpatient’swhealthwstatus.wComplicationswcanwbewpreventedwifwanwimmediatewassessmentwisw
madewtowanalyzewthewpatient’swsymptoms.wAwcomprehensivewhistorywiswnotwindicatedwinwthisw
situationwatwthiswtime.wSomewsubjectivewdatawwillwbewcollected,wsuchwaswallergieswandwmedica
lwhistorywrelatedwtowcardiovascularwdisease.wEyes,wears,worwawcompletewmusculoskeletalworwm
entalw healthwassessmentwiswnotwawprioritywatwthiswtime.
DIF:www CognitivewLevel:wApply REF:wBoxw1-
3w|wp.w3wTOP:wNursingwProcess:wAssessment
MSC:wNCLEXwPatientwNeeds:wSafewandwEffectivewCarewEnvironment:wManagementwofwCare:wEstabli
shingwPriorities
2. Whichwsituationwillustrateswaw screeningwassessment?
a. Awpatientwvisitswanwobstetricwclinicwforwthewfi
rstwtimewandwthewnursewconductswawdetailedwhi
storywandwphysicalwexamination.
b. Awhospitalwsponsorswawhealthwfairwatwawloc
alwmallwandwprovideswcholesterolwandwbloo
dwpressurewcheckswtowmallwpatrons.
c. Thewnursewinwanwurgentwcarewcenterwcheck
swthewvitalwsignswofwawpatientwwhowiswcomp
lainingwofwlegwpain.
, d. Awpatientw newlywdiagnosedwwithwdiabete
swmellituswcomeswtowtestwhiswfastingwbloo
dwglucosewlevel.
ANSWER:wB
Awhealthwfairwatwawlocalwmallwthatwprovideswcholesterolwandwbloodwpressurewcheckswiswanwexa
mplewofwawscreeningwassessmentwfocusedwonwdiseasewdetection.wAwdetailedwhistorywandwphys
icalwexaminationwconductedwduringwawfirst-
timewvisitwtowanwobstetricwclinicwiswanwexamplewofwawcomprehensivewassessment.wAssessingwaw
patientwcomplainingwofwlegwpainwinwthewtriagewareawofwanwurgentwcarewcenterwiswanwexamplewo
fwawproblem-
based/focusedwassessment.wAwpatient’swreturnwappointmentw1wmonthwafterwtoday’swofficewvis
itwtowreportwfastingwbloodwglucosewlevelswiswanwexamplewofwanwepisodicworwfollow-
upwassessment.
DIF:www CognitivewLevel:wUnderstand REF:wBoxw1-
3w|wp.w3wTOP:wNursingwProcess:wAssessment
MSC:wNCLEXwPatientw Needs:w HealthwPromotionwandwMaintenance:wHealthwScreening
3. Forwwhichwpersonwiswawscreeningwassessmentwindicated?
a. Thewpersonwwhowhadwabdominalwsurger
ywyesterday
b. Thewpersonwwhowiswunawarewofwhiswhig
hwserumwglucosewlevels
c. Thewpersonwwhowiswbeingwadmittedwtow
awlong-termwcarewfacility
d. Thewpersonwwhowiswbeginningwrehabilitationw
afterwawkneewreplacement
ANSWER:wB
Awscreeningwassessmentwiswperformedwforwthewpurposewofwdiseasewdetection.wInwthiswcasewth
iswpersonwmaywhavewdiabeteswmellitus.wAwshiftwassessmentwiswmostwappropriatewforwthewpers
onwwhowiswrecoveringwinwthewhospitalwfromwsurgery.wAwcomprehensivewassessmentwiswperfor
medwduringwadmissionwtowawfacilitywtowobtainwawdetailedwhistorywandwcompletewphysicalwexa
mination.wAnwepisodicworwfollow-
upwassessmentwiswperformedwafterwkneewreplacementwtowevaluatewthewoutcomewofwthewproced
ure.
DIF:www CognitivewLevel:wUnderstand REF:wBoxw1-
3w|wp.w3wTOP:wNursingwProcess:wAssessment
MSC:wNCLEXwPatientwNeeds:wSafewandwEffectivewCarewEnvironment:wManagementwofwCare:wEstabli
shingwPriorities
4. Forwwhichwpersonwiswawshiftwassessmentwindicated?
a. Thewpersonwwhowhadwabdominalwsurger
ywyesterday
b. Thewpersonwwhowiswunawarewofwhiswhig
hwserumwglucosewlevels
c. Thewpersonwwhowiswbeingwadmittedwtowa
long-termwcarewfacility
d. Thewpersonwwhowiswbeginningwrehabilitatio
nwafterwawkneewreplacement
ANSWER:w A
Awshiftwassessmentwiswmostwappropriatewforwthewpersonwwhowiswrecoveringwinwthewhospitalwfro
mwsurgery.wAwscreeningwassessmentwiswperformedwforwthewpurposewofwdiseasewdetection,winwth
iswcasewdiabeteswmellitus.wAwcomprehensivewassessmentwiswperformedwduringwadmissionwtowa
, facilitywtowobtainwawdetailedwhistorywandwcompletewphysicalwexamination.wAnwepisodicworw
follow-
upwassessmentwiswperformedwafterwkneewreplacementwtowevaluatewthewoutcomewofwthewproce
dure.
DIF:www CognitivewLevel:wUnderstand REF:wBoxw1-
3w|wp.w4wTOP:wNursingwProcess:wAssessment
MSC:wNCLEXwPatientwNeeds:wSafewandwEffectivewCarewEnvironment:wManagementwofwCare:wEstabli
shingwPriorities
5. Forwwhichwpersonwiswawcomprehensivewassessmentwindicated?
a. Thewpersonwwhowhadwabdominalwsurger
ywyesterday
b. Thewpersonwwhowiswunawarewofwhiswhig
hwserumwglucosewlevels
c. Thewpersonwwhowiswbeingwadmittedwtow
awlong-termwcarewfacility
d. Thewpersonwwhowiswbeginningwrehabilitationw
afterwawkneewreplacement
ANSWER:wC
Awcomprehensivewassessmentwiswperformedwduringwadmissionwtowawfacilitywtowobtainwa
detailedwhistorywandwcompletewphysicalwexamination.wAwshiftwassessmentwiswmostwappropria
tewforwthewpersonwwhowiswrecoveringwinwthewhospitalwfromwsurgery.wAwscreeningwassessmentw
iswperformedwforwthewpurposewofwdiseasewdetection,winwthiswcasewdiabeteswmellitus.wAnwepiso
dicworwfollow-
upwassessmentwiswperformedwafterwkneewreplacementwtowevaluatewthewoutcomewofwthewproce
dure.
DIF:www CognitivewLevel:wUnderstand REF:wBoxw1-
3w|wp.w3wTOP:wNursingwProcess:wAssessment
MSC:wNCLEXwPatientwNeeds:wSafewandwEffectivewCarewEnvironment:wManagementwofwCare:wEstabli
shingwPriorities
6. Forwwhichwpersonwiswanwepisodicworwfollow-upwassessmentwindicated?
a. Thewpersonwwhowhadwabdominalwsurger
ywyesterday
b. Thewpersonwwhowiswunawarewofwhiswhig
hwserumwglucosewlevels
c. Thewpersonwwhowiswbeingwadmittedwtowa
long-termwcarewfacility
d. Thewpersonwwhowiswbeginningwrehabilitationw
afterwawkneewreplacement
ANSWER:w D
Anwepisodicworwfollow-
upwassessmentwiswperformedwafterwthewkneewreplacementwtowevaluatewthewoutcomewofwthewpr
ocedure.wAwshiftwassessmentwiswmostwappropriatewforwthewpersonwwhowiswrecoveringwinwthewh
ospitalwfromwsurgery.wAwscreeningwassessmentwiswperformedwforwthewpurposewofwdiseasewdet
ection,winwthiswcasewdiabeteswmellitus.wAwcomprehensivewassessmentwiswperformedwduringwad
missionwtowawfacilitywtowobtainwawdetailedwhistorywandwcompletewphysicalwexamination.
DIF:www CognitivewLevel:wUnderstand REF:wBoxw1-
3w|wp.w3wTOP:wNursingwProcess:wAssessment
Nursing Practice 7th Edition by Wilson
Chapter 1 - 24
,Chapterw01:wIntroductionwtowHealthwAssessment
MULTIPLEwCHOICE
1. Awpatientwcomeswtowthewemergencywdepartmentwandwtellswthewtriagew nursewthatw
hewisw“havingwawheartwattack.”wWhatwiswthewnurse’swtopwprioritywatwthiswtime?
a. Determinewthewpatient’swpersonalwdatawandwin
surancewcoverage.
b. Askwthewpatientwtowtakewawseatwinwthewwaitingw
roomwuntilw hiswnamewiswcalled.
c. Requestwthatwawnursewcollectwdatawforw
awcomprehensivewhistory.
d. Askwawnursewtowstartwawfocusedwassessmen
twofwthiswpatientwnow.
ANSWER:w D
Thewnursewneedswtowbeginwanwassessmentwaswsoonwaswpossiblewthatwiswfocusedwonwthiswpatient
’swcardiovascularwsystem.wThewtypewofwhealthwassessmentwperformedwbywthewnursewiswalsowdri
venwbywpatientwneed.wPersonalwdatawandwinsurancewinformationwwillwbewobtained,wbutwinwthisw
situation,wthesewdatawcanwwaitwuntilwafterwthewpatientwiswassessed.wBasedwalsowonwMaslow’swh
ierarchywofwneeds,wphysiologicwneedswtakewprecedence.wRatherwthanwaskingwthewpatientwtoww
ait,wthewnursewneedswtowbeginwdatawcollection,wsuchwaswvitalwsigns,wimmediatelywtowdeterminew
thewpatient’swhealthwstatus.wComplicationswcanwbewpreventedwifwanwimmediatewassessmentwisw
madewtowanalyzewthewpatient’swsymptoms.wAwcomprehensivewhistorywiswnotwindicatedwinwthisw
situationwatwthiswtime.wSomewsubjectivewdatawwillwbewcollected,wsuchwaswallergieswandwmedica
lwhistorywrelatedwtowcardiovascularwdisease.wEyes,wears,worwawcompletewmusculoskeletalworwm
entalw healthwassessmentwiswnotwawprioritywatwthiswtime.
DIF:www CognitivewLevel:wApply REF:wBoxw1-
3w|wp.w3wTOP:wNursingwProcess:wAssessment
MSC:wNCLEXwPatientwNeeds:wSafewandwEffectivewCarewEnvironment:wManagementwofwCare:wEstabli
shingwPriorities
2. Whichwsituationwillustrateswaw screeningwassessment?
a. Awpatientwvisitswanwobstetricwclinicwforwthewfi
rstwtimewandwthewnursewconductswawdetailedwhi
storywandwphysicalwexamination.
b. Awhospitalwsponsorswawhealthwfairwatwawloc
alwmallwandwprovideswcholesterolwandwbloo
dwpressurewcheckswtowmallwpatrons.
c. Thewnursewinwanwurgentwcarewcenterwcheck
swthewvitalwsignswofwawpatientwwhowiswcomp
lainingwofwlegwpain.
, d. Awpatientw newlywdiagnosedwwithwdiabete
swmellituswcomeswtowtestwhiswfastingwbloo
dwglucosewlevel.
ANSWER:wB
Awhealthwfairwatwawlocalwmallwthatwprovideswcholesterolwandwbloodwpressurewcheckswiswanwexa
mplewofwawscreeningwassessmentwfocusedwonwdiseasewdetection.wAwdetailedwhistorywandwphys
icalwexaminationwconductedwduringwawfirst-
timewvisitwtowanwobstetricwclinicwiswanwexamplewofwawcomprehensivewassessment.wAssessingwaw
patientwcomplainingwofwlegwpainwinwthewtriagewareawofwanwurgentwcarewcenterwiswanwexamplewo
fwawproblem-
based/focusedwassessment.wAwpatient’swreturnwappointmentw1wmonthwafterwtoday’swofficewvis
itwtowreportwfastingwbloodwglucosewlevelswiswanwexamplewofwanwepisodicworwfollow-
upwassessment.
DIF:www CognitivewLevel:wUnderstand REF:wBoxw1-
3w|wp.w3wTOP:wNursingwProcess:wAssessment
MSC:wNCLEXwPatientw Needs:w HealthwPromotionwandwMaintenance:wHealthwScreening
3. Forwwhichwpersonwiswawscreeningwassessmentwindicated?
a. Thewpersonwwhowhadwabdominalwsurger
ywyesterday
b. Thewpersonwwhowiswunawarewofwhiswhig
hwserumwglucosewlevels
c. Thewpersonwwhowiswbeingwadmittedwtow
awlong-termwcarewfacility
d. Thewpersonwwhowiswbeginningwrehabilitationw
afterwawkneewreplacement
ANSWER:wB
Awscreeningwassessmentwiswperformedwforwthewpurposewofwdiseasewdetection.wInwthiswcasewth
iswpersonwmaywhavewdiabeteswmellitus.wAwshiftwassessmentwiswmostwappropriatewforwthewpers
onwwhowiswrecoveringwinwthewhospitalwfromwsurgery.wAwcomprehensivewassessmentwiswperfor
medwduringwadmissionwtowawfacilitywtowobtainwawdetailedwhistorywandwcompletewphysicalwexa
mination.wAnwepisodicworwfollow-
upwassessmentwiswperformedwafterwkneewreplacementwtowevaluatewthewoutcomewofwthewproced
ure.
DIF:www CognitivewLevel:wUnderstand REF:wBoxw1-
3w|wp.w3wTOP:wNursingwProcess:wAssessment
MSC:wNCLEXwPatientwNeeds:wSafewandwEffectivewCarewEnvironment:wManagementwofwCare:wEstabli
shingwPriorities
4. Forwwhichwpersonwiswawshiftwassessmentwindicated?
a. Thewpersonwwhowhadwabdominalwsurger
ywyesterday
b. Thewpersonwwhowiswunawarewofwhiswhig
hwserumwglucosewlevels
c. Thewpersonwwhowiswbeingwadmittedwtowa
long-termwcarewfacility
d. Thewpersonwwhowiswbeginningwrehabilitatio
nwafterwawkneewreplacement
ANSWER:w A
Awshiftwassessmentwiswmostwappropriatewforwthewpersonwwhowiswrecoveringwinwthewhospitalwfro
mwsurgery.wAwscreeningwassessmentwiswperformedwforwthewpurposewofwdiseasewdetection,winwth
iswcasewdiabeteswmellitus.wAwcomprehensivewassessmentwiswperformedwduringwadmissionwtowa
, facilitywtowobtainwawdetailedwhistorywandwcompletewphysicalwexamination.wAnwepisodicworw
follow-
upwassessmentwiswperformedwafterwkneewreplacementwtowevaluatewthewoutcomewofwthewproce
dure.
DIF:www CognitivewLevel:wUnderstand REF:wBoxw1-
3w|wp.w4wTOP:wNursingwProcess:wAssessment
MSC:wNCLEXwPatientwNeeds:wSafewandwEffectivewCarewEnvironment:wManagementwofwCare:wEstabli
shingwPriorities
5. Forwwhichwpersonwiswawcomprehensivewassessmentwindicated?
a. Thewpersonwwhowhadwabdominalwsurger
ywyesterday
b. Thewpersonwwhowiswunawarewofwhiswhig
hwserumwglucosewlevels
c. Thewpersonwwhowiswbeingwadmittedwtow
awlong-termwcarewfacility
d. Thewpersonwwhowiswbeginningwrehabilitationw
afterwawkneewreplacement
ANSWER:wC
Awcomprehensivewassessmentwiswperformedwduringwadmissionwtowawfacilitywtowobtainwa
detailedwhistorywandwcompletewphysicalwexamination.wAwshiftwassessmentwiswmostwappropria
tewforwthewpersonwwhowiswrecoveringwinwthewhospitalwfromwsurgery.wAwscreeningwassessmentw
iswperformedwforwthewpurposewofwdiseasewdetection,winwthiswcasewdiabeteswmellitus.wAnwepiso
dicworwfollow-
upwassessmentwiswperformedwafterwkneewreplacementwtowevaluatewthewoutcomewofwthewproce
dure.
DIF:www CognitivewLevel:wUnderstand REF:wBoxw1-
3w|wp.w3wTOP:wNursingwProcess:wAssessment
MSC:wNCLEXwPatientwNeeds:wSafewandwEffectivewCarewEnvironment:wManagementwofwCare:wEstabli
shingwPriorities
6. Forwwhichwpersonwiswanwepisodicworwfollow-upwassessmentwindicated?
a. Thewpersonwwhowhadwabdominalwsurger
ywyesterday
b. Thewpersonwwhowiswunawarewofwhiswhig
hwserumwglucosewlevels
c. Thewpersonwwhowiswbeingwadmittedwtowa
long-termwcarewfacility
d. Thewpersonwwhowiswbeginningwrehabilitationw
afterwawkneewreplacement
ANSWER:w D
Anwepisodicworwfollow-
upwassessmentwiswperformedwafterwthewkneewreplacementwtowevaluatewthewoutcomewofwthewpr
ocedure.wAwshiftwassessmentwiswmostwappropriatewforwthewpersonwwhowiswrecoveringwinwthewh
ospitalwfromwsurgery.wAwscreeningwassessmentwiswperformedwforwthewpurposewofwdiseasewdet
ection,winwthiswcasewdiabeteswmellitus.wAwcomprehensivewassessmentwiswperformedwduringwad
missionwtowawfacilitywtowobtainwawdetailedwhistorywandwcompletewphysicalwexamination.
DIF:www CognitivewLevel:wUnderstand REF:wBoxw1-
3w|wp.w3wTOP:wNursingwProcess:wAssessment
