Test Bank For Health Assessment For Nursing Practice 7th Edition By
a a a a a a a a a a
Wilson Chapter 1 - 24
a a a a a
,Chapter 01: Introduction to Health Assessment a a a a a
MULTIPLE CHOICE a
1. Apatient comesto the emergencydepartment and tellsthe triage nurse that heis
a a a a a a a a a a a a a a
“havinga heart attack.” What isthe nurse’stop priorityat thistime?
a a a a a a a a a a a a a
a. Determinethepatient’s personal data and a a a a a
insurance coverage. a a
b. Ask the patient to take a seat in the waiting
a a a a a a a a a
room until his name iscalled.
a a a a a a
c. Request that a nurse collect data for a a a a a a a a
comprehensive history.
a a
d. Ask a nurse to start a focused assessmentof
a a a a a a a a
thispatient now.
a a a
ANSWER: D a
The nurse needs to begin an assessment as soon as possible that is focused on this patient’s
a a a a a a a a a a a a a a a a
cardiovascular system. The type of health assessment performed by the nurse is also drivenby
a a a a a a a a a a a a a a a
patient need. Personal data and insurance information will be obtained, but in this situation,
a a a a a a a a a a a a a a
these data can wait until after the patient is assessed. Based also on Maslow’s hierarchy of
a a a a a a a a a a a a a a a a
needs, physiologic needs take precedence. Rather than asking the patient to wait, the nurse
a a a a a a a a a a a a a a
needs to begin data collection, such as vital signs, immediately to determinethe patient’s health
a a a a a a a a a a a a a a a
status. Complications can be prevented if an immediate assessment is made to analyze the
a a a a a a a a a a a a a a
patient’s symptoms. A comprehensive history is not indicated in this situation at this time.
a a a a a a a a a a a a a a
Some subjective data will be collected, such as allergies and medical history related to
a a a a a a a a a a a a a a
cardiovascular disease. Eyes, ears, or a complete musculoskeletal or mental healthassessment
a a a a a a a a a a a a
is not a priorityat this time.
a a a a a a a
DIF: Cognitive Level: Apply
aa a REF: Box 1-3 | p. 3 a a a a a a a
TOP: Nursing Process: Assessment
a a a a
MSC: NCLEX Patient Needs: Safe and Effective Care Environment: Managementof Care:Establishing
a a a a a a a a a a a a
Priorities
a
2. Which situationillustratesa screeningassessment?
a a a a a
a. A patient visits an obstetric clinic for the first a a a a a a a a
timeand the nurseconductsa detailedhistory a a a a a a a a
and physical examination. a a a
b. Ahospital sponsorsa health fair at a local a a a a a a a a
mall and provides cholesterol and blood a a a a a a
pressure checksto mall patrons. a a a a a
c. The nurse in an urgent care center checks a a a a a a a
the vital signs of a patient who is a a a a a a a a
complainingof legpain. a a a a
, d. A patient newly diagnosed with diabetes
a a a a a
mellitus comes to test his fasting blood
a a a a a a a
glucose level.
a a
ANSWER: B a
A health fair at a local mall that provides cholesterol and blood pressure checks is an example of
a a a a a a a a a a a a a a a a a
a screening assessment focused on disease detection. A detailed history and physical
a a a a a a a a a a a a
examination conducted during a first-time visit to an obstetric clinic is an exampleof a
a a a a a a a a a a a a a a a
comprehensive assessment. Assessing a patient complaining of leg pain in the triage area of an
a a a a a a a a a a a a a a a
urgent care center is an example of a problem-based/focused assessment. A patient’s return
a a a a a a a a a a a a a
appointment 1 month after today’s office visit to report fasting blood glucose levels isan
a a a a a a a a a a a a a a a
example ofan episodic or follow-up assessment.
a a a a a a a
DIF: Cognitive Level: Understand
aa a REF: Box 1-3 | p. 3 a a a a a a a
TOP: Nursing Process: Assessment
a a a a
MSC: NCLEXPatient Needs: HealthPromotion and Maintenance: Health Screening
a a a a a a a a a
3. For whichpersonisa screeningassessment indicated?
a a a a a a a
a. The personwho had abdominal surgery a a a a a
yesterday a
b. The person who is unaware of hishigh
a a a a a a a
serum glucose levels
a a a
c. The person who isbeing admitted to a
a a a a a a a
long-termcare facility
a a a
d. The person who isbeginning rehabilitation
a a a a a
after a knee replacement
a a a a
ANSWER: B a
A screening assessment is performed for the purpose of disease detection. In this case this
a a a a a a a a a a a a a a
person may have diabetes mellitus. A shift assessment is most appropriate for the person who
a a a a a a a a a a a a a a a
is recovering in the hospital from surgery. A comprehensive assessment is performedduring
a a a a a a a a a a a a a
admission to a facility to obtain a detailed history and complete physical examination. An
a a a a a a a a a a a a a a
episodic or follow-up assessment is performed after knee replacement toevaluate the
a a a a a a a a a a a a
outcome of the procedure.
a a a a
DIF: Cognitive Level: Understand
aa a REF: Box 1-3 | p. 3 a a a a a a a
TOP: Nursing Process: Assessment
a a a a
MSC: NCLEX Patient Needs: Safe and Effective Care Environment: Managementof Care:Establishing
a a a a a a a a a a a a
Priorities
a
4. For whichperson isa shift assessment indicated?
a a a a a a a
a. The personwho had abdominal surgery a a a a a
yesterday a
b. The person who is unaware of hishigh a a a a a a a
serum glucose levels a a a
c. The person who isbeing admitted to a a a a a a a a
long-termcare facility a a
d. The person who isbeginning rehabilitation a a a a a
after a knee replacement a a a a
ANSWER: A a
A shift assessment is most appropriate for the person who is recovering in the hospital from
a a a a a a a a a a a a a a a
surgery. A screening assessment is performed for the purpose of disease detection, in this case
a a a a a a a a a a a a a a a
diabetes mellitus. A comprehensive assessment isperformed duringadmission to a
a a a a a a a a a a a
, facility to obtain a detailed history and complete physical examination. An episodic or
a a a a a a a a a a a a
follow-up assessment isperformed after knee replacement to evaluate the outcome of the
a a a a a a a a a a a a a
procedure.
a
DIF: Cognitive Level: Understand
aa a REF: Box 1-3 | p. 4 a a a a a a a
TOP: Nursing Process: Assessment
a a a a
MSC: NCLEX Patient Needs: Safe and Effective Care Environment: Managementof Care:Establishing
a a a a a a a a a a a a
Priorities
a
5. For whichpersonis a comprehensive assessment indicated?
a a a a a a a
a. The personwho had abdominal surgery a a a a a
yesterday a
b. The person who is unaware of hishigh a a a a a a a
serum glucose levels a a a
c. The person who isbeing admitted to a a a a a a a a
long-termcare facility a a a
d. The person who isbeginning rehabilitation a a a a a
after a knee replacement a a a a
ANSWER: C a
Acomprehensive assessment isperformed duringadmission to a facilityto obtain a
a a a a a a a a a a a a
detailed history and complete physical examination. A shift assessment is most appropriatefor
a a a a a a a a a a a a
the person who is recovering in the hospital from surgery. A screening assessment is
a a a a a a a a a a a a a a
performed for the purpose of disease detection, in this case diabetes mellitus. An episodic or
a a a a a a a a a a a a a a a
follow-up assessment is performed after knee replacement to evaluate the outcome of the
a a a a a a a a a a a a a
procedure.
a
DIF: Cognitive Level: Understand
aa a REF: Box 1-3 | p. 3 a a a a a a a
TOP: Nursing Process: Assessment
a a a a
MSC: NCLEX Patient Needs: Safe and Effective Care Environment: Managementof Care:Establishing
a a a a a a a a a a a a
Priorities
a
6. For whichperson isanepisodic or follow-up assessment indicated?
a a a a a a a a a
a. The personwho had abdominal surgery a a a a a
yesterday a
b. The person who isunaware of his high a a a a a a a
serum glucose levels a a a
c. The person who isbeingadmitted to a a a a a a a a
long-termcare facility a a
d. The person who isbeginning rehabilitation a a a a a
after a knee replacement a a a a
ANSWER: D a
An episodic or follow-up assessment is performed after the knee replacement to evaluate the
a a a a a a a a a a a a a
outcome of the procedure. A shift assessment is most appropriate for the person who is
a a a a a a a a a a a a a a a
recovering in the hospital from surgery. A screening assessment is performed for the purpose
a a a a a a a a a a a a a a
ofdisease detection, inthiscase diabetes mellitus. A comprehensive assessment is performed
a a a a a a a a a a a a a
during admission to a facility to obtain a detailed history and complete physicalexamination.
a a a a a a a a a a a a a a
DIF: Cognitive Level: Understand
aa a a a REF: Box 1-3 | p. 3 a a a a a
TOP: Nursing Process: Assessment
a a a a
a a a a a a a a a a
Wilson Chapter 1 - 24
a a a a a
,Chapter 01: Introduction to Health Assessment a a a a a
MULTIPLE CHOICE a
1. Apatient comesto the emergencydepartment and tellsthe triage nurse that heis
a a a a a a a a a a a a a a
“havinga heart attack.” What isthe nurse’stop priorityat thistime?
a a a a a a a a a a a a a
a. Determinethepatient’s personal data and a a a a a
insurance coverage. a a
b. Ask the patient to take a seat in the waiting
a a a a a a a a a
room until his name iscalled.
a a a a a a
c. Request that a nurse collect data for a a a a a a a a
comprehensive history.
a a
d. Ask a nurse to start a focused assessmentof
a a a a a a a a
thispatient now.
a a a
ANSWER: D a
The nurse needs to begin an assessment as soon as possible that is focused on this patient’s
a a a a a a a a a a a a a a a a
cardiovascular system. The type of health assessment performed by the nurse is also drivenby
a a a a a a a a a a a a a a a
patient need. Personal data and insurance information will be obtained, but in this situation,
a a a a a a a a a a a a a a
these data can wait until after the patient is assessed. Based also on Maslow’s hierarchy of
a a a a a a a a a a a a a a a a
needs, physiologic needs take precedence. Rather than asking the patient to wait, the nurse
a a a a a a a a a a a a a a
needs to begin data collection, such as vital signs, immediately to determinethe patient’s health
a a a a a a a a a a a a a a a
status. Complications can be prevented if an immediate assessment is made to analyze the
a a a a a a a a a a a a a a
patient’s symptoms. A comprehensive history is not indicated in this situation at this time.
a a a a a a a a a a a a a a
Some subjective data will be collected, such as allergies and medical history related to
a a a a a a a a a a a a a a
cardiovascular disease. Eyes, ears, or a complete musculoskeletal or mental healthassessment
a a a a a a a a a a a a
is not a priorityat this time.
a a a a a a a
DIF: Cognitive Level: Apply
aa a REF: Box 1-3 | p. 3 a a a a a a a
TOP: Nursing Process: Assessment
a a a a
MSC: NCLEX Patient Needs: Safe and Effective Care Environment: Managementof Care:Establishing
a a a a a a a a a a a a
Priorities
a
2. Which situationillustratesa screeningassessment?
a a a a a
a. A patient visits an obstetric clinic for the first a a a a a a a a
timeand the nurseconductsa detailedhistory a a a a a a a a
and physical examination. a a a
b. Ahospital sponsorsa health fair at a local a a a a a a a a
mall and provides cholesterol and blood a a a a a a
pressure checksto mall patrons. a a a a a
c. The nurse in an urgent care center checks a a a a a a a
the vital signs of a patient who is a a a a a a a a
complainingof legpain. a a a a
, d. A patient newly diagnosed with diabetes
a a a a a
mellitus comes to test his fasting blood
a a a a a a a
glucose level.
a a
ANSWER: B a
A health fair at a local mall that provides cholesterol and blood pressure checks is an example of
a a a a a a a a a a a a a a a a a
a screening assessment focused on disease detection. A detailed history and physical
a a a a a a a a a a a a
examination conducted during a first-time visit to an obstetric clinic is an exampleof a
a a a a a a a a a a a a a a a
comprehensive assessment. Assessing a patient complaining of leg pain in the triage area of an
a a a a a a a a a a a a a a a
urgent care center is an example of a problem-based/focused assessment. A patient’s return
a a a a a a a a a a a a a
appointment 1 month after today’s office visit to report fasting blood glucose levels isan
a a a a a a a a a a a a a a a
example ofan episodic or follow-up assessment.
a a a a a a a
DIF: Cognitive Level: Understand
aa a REF: Box 1-3 | p. 3 a a a a a a a
TOP: Nursing Process: Assessment
a a a a
MSC: NCLEXPatient Needs: HealthPromotion and Maintenance: Health Screening
a a a a a a a a a
3. For whichpersonisa screeningassessment indicated?
a a a a a a a
a. The personwho had abdominal surgery a a a a a
yesterday a
b. The person who is unaware of hishigh
a a a a a a a
serum glucose levels
a a a
c. The person who isbeing admitted to a
a a a a a a a
long-termcare facility
a a a
d. The person who isbeginning rehabilitation
a a a a a
after a knee replacement
a a a a
ANSWER: B a
A screening assessment is performed for the purpose of disease detection. In this case this
a a a a a a a a a a a a a a
person may have diabetes mellitus. A shift assessment is most appropriate for the person who
a a a a a a a a a a a a a a a
is recovering in the hospital from surgery. A comprehensive assessment is performedduring
a a a a a a a a a a a a a
admission to a facility to obtain a detailed history and complete physical examination. An
a a a a a a a a a a a a a a
episodic or follow-up assessment is performed after knee replacement toevaluate the
a a a a a a a a a a a a
outcome of the procedure.
a a a a
DIF: Cognitive Level: Understand
aa a REF: Box 1-3 | p. 3 a a a a a a a
TOP: Nursing Process: Assessment
a a a a
MSC: NCLEX Patient Needs: Safe and Effective Care Environment: Managementof Care:Establishing
a a a a a a a a a a a a
Priorities
a
4. For whichperson isa shift assessment indicated?
a a a a a a a
a. The personwho had abdominal surgery a a a a a
yesterday a
b. The person who is unaware of hishigh a a a a a a a
serum glucose levels a a a
c. The person who isbeing admitted to a a a a a a a a
long-termcare facility a a
d. The person who isbeginning rehabilitation a a a a a
after a knee replacement a a a a
ANSWER: A a
A shift assessment is most appropriate for the person who is recovering in the hospital from
a a a a a a a a a a a a a a a
surgery. A screening assessment is performed for the purpose of disease detection, in this case
a a a a a a a a a a a a a a a
diabetes mellitus. A comprehensive assessment isperformed duringadmission to a
a a a a a a a a a a a
, facility to obtain a detailed history and complete physical examination. An episodic or
a a a a a a a a a a a a
follow-up assessment isperformed after knee replacement to evaluate the outcome of the
a a a a a a a a a a a a a
procedure.
a
DIF: Cognitive Level: Understand
aa a REF: Box 1-3 | p. 4 a a a a a a a
TOP: Nursing Process: Assessment
a a a a
MSC: NCLEX Patient Needs: Safe and Effective Care Environment: Managementof Care:Establishing
a a a a a a a a a a a a
Priorities
a
5. For whichpersonis a comprehensive assessment indicated?
a a a a a a a
a. The personwho had abdominal surgery a a a a a
yesterday a
b. The person who is unaware of hishigh a a a a a a a
serum glucose levels a a a
c. The person who isbeing admitted to a a a a a a a a
long-termcare facility a a a
d. The person who isbeginning rehabilitation a a a a a
after a knee replacement a a a a
ANSWER: C a
Acomprehensive assessment isperformed duringadmission to a facilityto obtain a
a a a a a a a a a a a a
detailed history and complete physical examination. A shift assessment is most appropriatefor
a a a a a a a a a a a a
the person who is recovering in the hospital from surgery. A screening assessment is
a a a a a a a a a a a a a a
performed for the purpose of disease detection, in this case diabetes mellitus. An episodic or
a a a a a a a a a a a a a a a
follow-up assessment is performed after knee replacement to evaluate the outcome of the
a a a a a a a a a a a a a
procedure.
a
DIF: Cognitive Level: Understand
aa a REF: Box 1-3 | p. 3 a a a a a a a
TOP: Nursing Process: Assessment
a a a a
MSC: NCLEX Patient Needs: Safe and Effective Care Environment: Managementof Care:Establishing
a a a a a a a a a a a a
Priorities
a
6. For whichperson isanepisodic or follow-up assessment indicated?
a a a a a a a a a
a. The personwho had abdominal surgery a a a a a
yesterday a
b. The person who isunaware of his high a a a a a a a
serum glucose levels a a a
c. The person who isbeingadmitted to a a a a a a a a
long-termcare facility a a
d. The person who isbeginning rehabilitation a a a a a
after a knee replacement a a a a
ANSWER: D a
An episodic or follow-up assessment is performed after the knee replacement to evaluate the
a a a a a a a a a a a a a
outcome of the procedure. A shift assessment is most appropriate for the person who is
a a a a a a a a a a a a a a a
recovering in the hospital from surgery. A screening assessment is performed for the purpose
a a a a a a a a a a a a a a
ofdisease detection, inthiscase diabetes mellitus. A comprehensive assessment is performed
a a a a a a a a a a a a a
during admission to a facility to obtain a detailed history and complete physicalexamination.
a a a a a a a a a a a a a a
DIF: Cognitive Level: Understand
aa a a a REF: Box 1-3 | p. 3 a a a a a
TOP: Nursing Process: Assessment
a a a a
