Lewis Test Bank - Medical-Surgical Nursing 10th Edition Chapter 3
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Course
Lewis medical surgical nursing 11th
Institution
Lewis Medical Surgical Nursing 11th
Chapter 03: Health History and Physical Examination
Lewis: Medical-Surgical Nursing, 10th Edition
MULTIPLE CHOICE
1. A patient who is actively bleeding is admitted to the emergency department. Which approach
is best for the nurse to use to obtain a health history?
a. Briefly interview the pati...
Lewis Test Bank - Medical-Surgical Nursing 10th Edition Chapter 3
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Chapter 03: Health History and Physical Examination
Lewis: Medical-Surgical Nursing, 10th Edition
MULTIPLE CHOICE
1. A patient who is actively bleeding is admitted to the emergency department. Which approach
is best for the nurse to use to obtain a health history?
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
2. Immediate surgery is planned for a patient with acute abdominal pain. Which question by the
nurse will elicit the most complete information about the patient‘s coping-stress tolerance
pattern?
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.
3. During the health history interview, a patient tells the nurse about periodic fainting spells.
Which question by the nurse will best elicit any associated clinical manifestations?
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
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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
4. The nurse records the following general survey of a patient: ―The patient is a 50-yr-old Asian
female attended by her husband and two daughters. Alert and oriented. Does not make eye
contact with the nurse and responds slowly, but appropriately, to questions. No apparent
disabilities or distinguishing features.‖ What additional information should the nurse add to
this general survey?
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
5. A nurse performs a health history and physical examination with a patient who has a right leg
fracture. Which assessment would be a pertinent negative finding?
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
6. The nurse who is assessing an older adult with rectal bleeding asks, ―Have you ever had a
colonoscopy?‖ The nurse is performing what type of assessment?
a. Focused assessment c. Detailed health assessment
b. Emergency assessment d. Comprehensive assessment
ANS: A
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