Chapter 24: Head-to-Toe Examination [formerly Chapter 25: "Putting It All Together"]
MULTIPLE CHOICE
1. Which is true regarding the relationship between the examiner and patient?
a. I i he e a i e s responsibility to help the patient understand that he or she is qualified to make
decisions regarding health care.
b. The patient must trust the examiner completely.
c. The examiner-patient relationship is enhanced by ignoring cultural issues.
d. The patient is a full partner with the examiner.
ANS: D
The patient is a full partner with the examiner. The examiner should keep the patient informed and
should develop a relationship to ensure trust. Cultural issues should be acknowledged, not ig ed. The e
a i e h d ee he a ie i f ed, b i i he e a i e
responsibility to help the patient understand that he or she is qualified to make healthcare decisions.
The examiner should develop a relationship to ensure trust, but it is not necessary for the patient to
trust the examiner completely.
DIF: Cognitive Level: Understanding (Comprehension)
OBJ: Nursing process assessment MSC: Physiologic Integrity: Basic Care and Comfort
2. Which e ai e beha i d he ii ie a ie di a i fac i?
a. Assume a busy and rushed attitude.
b. Convey your own feelings of discomfort.
c. Keep the patient waiting for more than 30 minutes.
d. See i f ai ab he a ie be .
ANS: D
When performing an examination, you are seeking information about the patient and the problem that
brings the patient to you. This process teaches you about the patient and teaches the patient about your
personal discipline, professional composure, and respect for others.
DIF: Cognitive Level: Applying (Application)
OBJ: Nursing process assessment MSC: Physiologic Integrity: Basic Care and Comfort
3. An examiner might be able to help a patient who seems uncomfortable with close contact during an
examination by:
a. acknowledging the discomfort.
b. backing away from the patient.
c. i g ab he a ie di c f .
d. moving briskly to completion.
ANS: A
Ac edgi g he a ie s discomfort during the examination will help the patient feel more
relaxed. Your professional concern can be reassuring to the patient. You should explain what you are
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,doing to the patient before the assessment and what the patient will experience; if not, you will run the
risk of losing trust. The other choices would make the patient more uneasy.
DIF: Cognitive Level: Applying (Application)
OBJ: Nursing process assessment MSC: Physiologic Integrity: Basic Care and Comfort
4. When performing a history and physical assessment, the examiner should:
a. change the sequence of observation with each interview.
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, b. develop a sequence of standard observations.
c. develop a preliminary diagnosis at the onset.
d. direct patient responses to fit the history sequence.
ANS: B
When performing a history and physical assessment, you should develop an approach that is
comfortable to you and ensures comfort for the patient. Part of the history can be obtained while you
are doing the physical examination.
DIF: Cognitive Level: Understanding (Comprehension)
OBJ: Nursing process assessment MSC: Physiologic Integrity: Basic Care and Comfort
5. The examiner should develop a demeanor that is exemplified by which one of the following
behaviors?
a. Exhibits visible distaste about the condition. b. Gives immediate reassurances to the patient. c.
Gives patient unsolicited advice.
d. Va ida e he a ie ified c ce .
ANS: D
The examiner needs to learn a gentle and balanced demeanor. By showing concern for the to lose
trust in the relationship.; gi i g ici ed ad ice can cause the patient a ie fee i g , gai he a ieN
DIF: Cognitive Level: Understanding (Comprehension)
OBJ: Nursing process assessment MSC: Physiologic Integrity: Basic Care and Comfort
6. At your first meeting with a patient, it is usually best to say:
a. Le ge he i .
b. Ih e i ea e.
c. Le e e ca d f e f. .
d. Te e ab
ANS: D
Take the time to ask open-ended questions to ensure that the patient has the opportunity to report
accurately. Too great an adherence to routine may prevent the true story from emerging. The other
statements are not open-ended, which would not allow the patient to elaborate. In addition, they are
not comforting statements and would make the patient feel uncomfortable at the initial meeting.
DIF: Cognitive Level: Applying (Application)
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