nursing health assessment a best practice approach
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Nursing Health Assessment A Best Practice Approach 3rd Edition Jensen
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Test Bank For Nursing Health Assessment A Best Practice
Approach 3rd Edition Jensen | 9781496349170 | All Chapters
with Answers and Rationals
The nurse is performing a physical assessment on a newly admitted patient. Which is an example of
objective information obtained during the physical assessment?
a. 2 x 5 cm scar on the right lower forearm
b. Patient's history of allergies
c. Last menstrual period 1 month ago
d. Patient's use of medications at home - ANSWER: a. 2 x 5 cm scar on the right lower forearm
A patient is brought by ambulance to the emergency department with multiple injuries received in an
automobile accident. He is alert and cooperative, but his injuries are quite severe. How would the
nurse proceed with data collected?
a. Perform lifesaving measures and delay asking any history questions until the patient is transferred
to the intensive care unit.
b. Simultaneously ask history questions while performing the examination and initiating lifesaving
measures.
c. Collect all information on the history form, including social support patterns, strengths, and coping
patterns
d. Collect history information first, then perform the physical examination and institute lifesaving
measures - ANSWER: b. Simultaneously ask history questions while performing the examination and
initiating lifesaving measures.
After completing an initial assessment of a patient, the nurse has charted that his respirations are
eupneic and his pulse is 58 beats per minute. What type of assessment data is this?
a. Introspective
b. Reflective
c. Subjective
d. Objective - ANSWER: d. Objective
Which statement best desribes a proficient nurse?
a. Has little experience with a specified population and uses rules to guide performance
b. Has an intuitive grasp of a clinical situation and quickly identifies the accurate solution
c. Sees actions in the context of daily plans for patients
d. Understands a patient situation as a whole rather than a list of tasks and recognizes the long-term
goals for the patient - ANSWER: d. Understands a patient situation as a whole rather than a list of
tasks and recognizes the long-term goals for the patient
The nurse is conducting a class for new graduate nurses. While teaching the class, what should the
nurse keep in mind regarding what novice nurses, without a background of skills and experience from
which to draw upon, are more likely to base their decisions on?
a. Intuition
b. A set of rules
c. Articles in journals
d. Advice from supervisors - ANSWER: b. A set of rules
, What information obtained by the nurse regarding a patient's skin should the nurse record in the
patient's health history?
a. Patient denies any color change
b. Lesion is noted on the lateral aspect of the right arm
c. No lesions are obvious
d. Skin appears dry - ANSWER: a. Patient denies any color change
When the nurse is evaluating the reliability of a patient's responses, which of these statements would
be correct?
a. Patient has a history of drug abuse and therefore is not reliable
b. Patient provided consistent information and therefore is reliable
c. Patient would not answer questions concerning stress and therefore is not reliable
d. Patient smiled throughout interview and therefore is assumed reliable - ANSWER: b. Patient
provided consistent information and therefore is reliable
The nurse is preparing to do a functional assessment. Which statement best describes the purpose of
a functional assessment?
a. It determines how children are meeting developmental milestones
b. It helps determine how a person is managing day-to-day activities
c. The functional assessment assesses how the individual is coping with life at home
d. The functional assessment can identify any problems with memory the individual may be
experiencing - ANSWER: b. It helps determine how a person is managing day-to-day activities
A patient is describing his symptoms to the nurse. Which of these statements reflects a description of
the setting of his symptoms?
a. "I think this pain is telling me that something bad is wrong with me."
b. "I also have the sweats and nausea when I feel this pain."
c. "This pain happens every time I sit down to use the computer."
d. "It is a sharp, burning pain in my stomach - ANSWER: c. ""This pain happens every time I sit down to
use the computer."
In response to a question about stress, a 39-year-old women tells the nurse that her husband and
mother both died in the past year. Which response by the nurse is most appropriate?
a. "That is a lot of stress; now let's go on to the next section of your history."
b. "What did you do to cope with the loss of both your husband and mother?"
c. "I don't know how anyone could handle that much stress in 1 year!"
d. "This has been a difficult year for you." - ANSWER: b. "What did you do to cope with the loss of
both your husband and mother?"
After a symptoms is recognized, the first effort at treatment is often self-treatment. Which of the
following statements is true about self-treatment?
a. "Not recognized as valuable by most health care providers."
b. "Influenced by the accessibility of over-the-counter medicines."
c. "Always less expensive than biomedical alternatives."
d. "Usually ineffective and may delay more effective treatment." - ANSWER: b. "Influenced by the
accessibility of over-the-counter medicines."
The nurse is discussing the term subculture with a student nurse. Which statement by the nurse
would best describe subculture?
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