Chapter 15 Health Assessment and Physical Examination

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Chapter 15  Health Assessment and Physical Examination

 

 

Complete Chapter Questions And Answers
 

Sample Questions

 

MULTIPLE CHOICE

1. Harriett is a nursing student who is performing a physical examination on Jarred, a 6-year-old patient who is being admitted to the pediatric unit with abdominal pain. When would be the most appropriate time in the examination to palpate Jarred’s abdomen?
A.
Palpate tender areas last.
B.
Palpate tender areas first to get it over.
C.
Palpate tender areas between other portions of the exam.
D.
Do not palpate tender areas.

ANS: A
Be sure to ask the patient to point out the more sensitive areas, and note any nonverbal signs of discomfort.

PTS: 1 DIF: Cognitive Level: Application REF: 311
OBJ: List techniques to promote the patient’s physical and psychological comfort during an examination TOP: Nursing Process: Assessment
MSC: Client Needs: Safe and Effective Care Environment

2. Debra is a registered nurse who works on a pulmonary unit in an urban hospital. She is precepting Thomas, a first-year nursing student. Debra is demonstrating to Thomas how to appropriately auscultate. Auscultation is defined as:
A.
listening with a stethoscope to sounds produced by the body.
B.
tapping the body with the fingertips to produce a vibration.
C.
becoming familiar with the nature and source of body odors.
D.
using the hands to touch body parts to make a sensitive assessment.

ANS: A
Auscultation is listening with a stethoscope to sounds produced by the body.

PTS: 1 DIF: Cognitive Level: Knowledge REF: 312
OBJ: Describe the techniques used with each assessment skill
TOP: Nursing Process: Assessment
MSC: Client Needs: Safe and Effective Care Environment

3. A nurse is preparing to do a physical examination on a patient. What is the most important thing that the nurse should do to prepare for the examination?
A.
Gathering all the necessary equipment
B.
Making sure the equipment is in working order
C.
Performing thorough hand hygiene
D.
Having the appropriate forms available for documentation

ANS: C
Performing hand hygiene thoroughly before equipment preparation and the examination is of primary importance.

PTS: 1 DIF: Cognitive Level: Application REF: 314
OBJ: Describe the techniques used with each assessment skill
TOP: Nursing Process: Assessment
MSC: Client Needs: Safe and Effective Care Environment

4. A registered nurse is preparing to perform a physical examination on a 5-year-old child. What can the nurse do to make the child feel safer during the examination?
A.
Examining his fingernails before listening to his breath sounds
B.
Asking the child to put on a gown before the examination
C.
Using medical language to demonstrate her competence
D.
Inviting the child’s siblings to be present for the examination

ANS: A
Children will feel safer during an examination if it is initiated from the periphery and then moves to the central. For example, examine the extremities before moving to the chest.

PTS: 1 DIF: Cognitive Level: Analysis REF: 315
OBJ: List techniques to promote the patient’s physical and psychological comfort during an examination TOP: Nursing Process: Assessment
MSC: Client Needs: Safe and Effective Care Environment

5. A nurse is admitting a 79-year-old woman with a fractured hip to the orthopedic unit. The patient states that she broke her hip when she tripped in her garden. Upon examination, the nurse notes purple, green, and yellow bruises on the back and arms. The patient states that those were received when she fell. The nurse is concerned because she knows that this can be a sign of:
A.
hemophilia.
B.
stroke.
C.
abuse.
D.
blood dyscrasia.

ANS: C
With abuse of older individuals, injuries and trauma are inconsistent with reported cause (e.g., cigarette burn, scratch, bruise, bite).

PTS: 1 DIF: Cognitive Level: Analysis REF: 317
OBJ: Discuss normal physical findings for patients across the life span
TOP: Nursing Process: Assessment
MSC: Client Needs: Safe and Effective Care Environment

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