Medical Surgical Nursing Assessment and Management of Clinical Problems, 10th Edition by Sharon L. Lewis
Medical Surgical Nursing Assessment and Management of Clinical Problems, 10th Edition by Sharon L. Lewis
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Chapter 03: Health History and Physical Examination
Complete Chapter Questions With Answers
Sample Questions Are Posted Below
MULTIPLE CHOICE
| a. | Briefly interview the patient while obtaining vital signs. |
| b. | Obtain subjective data about the patient from family members. |
| c. | Omit subjective data collection and obtain the physical examination. |
| d. | Use the health care provider’s medical history to obtain subjective data. |
ANS: A
In an emergency situation, the nurse may need to ask only the most pertinent questions for a specific problem and obtain more information later. A complete health history will include subjective information that is not available in the health care provider’s medical history. Family members may be able to provide some subjective data, but only the patient will be able to give subjective information about the bleeding. Because the subjective data about the cause of the patient’s bleeding will be essential, obtaining the physical examination alone will not provide sufficient information.
DIF: Cognitive Level: Apply (application) REF: 40
TOP: Nursing Process: Assessment MSC: NCLEX: Health Promotion and Maintenance
| a. | “Can you rate your pain on a 0 to 10 scale?” |
| b. | “What do you think caused this abdominal pain?” |
| c. | “How do you feel about yourself and your hospitalization?” |
| d. | “Are there other major problems that are a concern right now?” |
ANS: D
The coping–stress tolerance pattern includes information about other major stressors confronting the patient. The health perception–health management pattern includes information about the patient’s ideas about risk factors. Feelings about self and the hospitalization are assessed in the self-perception–self-concept pattern. Intensity of pain is part of the cognitive–perceptual pattern.
DIF: Cognitive Level: Apply (application) REF: 37
TOP: Nursing Process: Assessment MSC: NCLEX: Psychosocial Integrity
| a. | “How frequently do you have the fainting spells?” |
| b. | “Where are you when you have the fainting spells?” |
| c. | “Do the spells tend to occur at any special time of day?” |
| d. | “Do you have any other symptoms along with the spells?” |
ANS: D
Asking about other associated symptoms will provide the nurse more information about all the clinical manifestations related to the fainting spells. Information about the setting is obtained by asking where the patient was and what the patient was doing when the symptom occurred. The other questions from the nurse are appropriate for obtaining information about chronology and frequency.
DIF: Cognitive Level: Apply (application) REF: 35
TOP: Nursing Process: Assessment MSC: NCLEX: Health Promotion and Maintenance
| a. | Nutritional status |
| b. | Intake and output |
| c. | Reasons for contact with the health care system |
| d. | Comments of family members about his condition |
ANS: A
The general survey also describes the patient’s general nutritional status. The other information will be obtained when doing the complete nursing history and examination but is not obtained through the initial scanning of a patient.
DIF: Cognitive Level: Understand (comprehension) REF: 39
TOP: Nursing Process: Assessment MSC: NCLEX: Health Promotion and Maintenance
| a. | Patient has several bruised and swollen areas on the right leg. |
| b. | Patient states that there have been no other recent health problems. |
| c. | Patient refuses to bend the right knee because of the associated pain. |
| d. | Patient denies having pain when the area over the fracture is palpated. |
ANS: D
The nurse expects that a patient with a leg fracture will have pain over the fractured area. The bruising and swelling and pain with bending are positive findings. Having no other recent health problems is neither a positive nor a negative finding with regard to a leg fracture.
DIF: Cognitive Level: Apply (application) REF: 39
TOP: Nursing Process: Assessment MSC: NCLEX: Health Promotion and Maintenance
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