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PHYSICAL EXAMINATION AND HEALTH ASSESSMENT 9TH EDITION
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Authors: a d Carolyn Jarvis And Ann L. Eckhardt
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,TABLE OF CONTENTad ad
Chapter 01: Evidence-Based Assessment .................................................................................................. 3
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Chapter 02: Cultural Assessment ............................................................................................................. 12
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Chapter 03: The Interview........................................................................................................................ 23
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Chapter 04: The Complete Health History.............................................................................................. 39
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Chapter 05: Mental Status Assessment.................................................................................................... 51
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Chapter 06: Substance Use Assessment .................................................................................................. 66
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Chapter 07: Family Violence and Human Trafficking ........................................................................... 72
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Chapter 08: Assessment Techniques and Safety in the Clinical Setting .............................................. 78
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Chapter 09: General Survey and Measurement ...................................................................................... 93
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Chapter 10: Vital Signs ............................................................................................................................ 98
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Chapter 11: Pain Assessment ................................................................................................................. 112
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Chapter 12: Nutrition Assessment.......................................................................................................... 119
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Chapter 13: Skin, Hair, and Nails ......................................................................................................... 131
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Chapter 14: Head, Face, and Neck, and Regional Lymphatics........................................................... 149
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Chapter 15: Eyes ..................................................................................................................................... 163
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Chapter 16: Ears...................................................................................................................................... 177
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Chapter 17: Nose, Mouth, and Throat ................................................................................................... 192
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Chapter 18: Breasts, Axillae, and Regional Lymphatics ...................................................................... 207
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Chapter 19: Thorax and Lungs .............................................................................................................. 223
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Chapter 20: Heart and Neck Vessels ..................................................................................................... 239
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Chapter 21: Peripheral Vascular System and Lymphatic System........................................................ 254
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Chapter 22: Abdomen ............................................................................................................................. 268
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Chapter 23: Musculoskeletal System ..................................................................................................... 280
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Chapter 24: Neurologic System ............................................................................................................. 297
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Chapter 25: Male Genitourinary System ............................................................................................... 318
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Chapter 26: Anus, Rectum, and Prostate .............................................................................................. 332
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Chapter 27: Female Genitourinary System............................................................................................ 343
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Chapter 28: The Complete Health Assessment: Adult ......................................................................... 361
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Chapter 29: The Complete Physical Assessment: Infant, Young Child, and Adolescent.................. 366
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Chapter 30: Bedside Assessment and Electronic Documentation ........................................................ 368
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Chapter 31: Pregnancy ............................................................................................................................ 373
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Chapter 32: Functional Assessment of the Older Adult ...................................................................... 384
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,Chapter 01: Evidence-Based Assessment
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Jarvis: Physical Examination and Health Assessment, 9th Edition
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MULTIPLE CHOICE ad
1. After completing an initial assessment of a patient, the nurse has charted that his
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respirationsare eupneic and his pulse is 58 beats per minute. What type of assessment
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data is this?
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a. Objective
b. Reflective
c. Subjective
d. Introspective
ANS: a d A
Objective data is what the health professional observes by inspecting, percussing,
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palpating, and auscultating during the physical examination. Subjective data is what the
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person says about him or herself during history taking. The terms reflective and
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introspective are not usedto describe data.
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DIF: Cognitive Level: Understanding (Comprehension) ad ad ad
MSC: Client Needs: Safe and Effective Care Environment: Management of Care
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2. A patient tells the nurse that he is very nervous, nauseous, and “feels hot.” What
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ad type ofassessment data is this?
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a. Objective
b. Reflective
c. Subjective
d. Introspective
ANS: C ad
Subjective data is what the person says about him or herself during history taking.
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Objectivedata is what the health professional observes by inspecting, percussing,
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palpating, and auscultating during the physical examination. The terms reflective and
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introspective are not used to describe data.
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DIF: Cognitive Level: Understanding (Comprehension) ad ad ad
MSC: Client Needs: Safe and Effective Care Environment: Management of Care
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3. What do the patient’s record, laboratory studies, objective data, and subjective data
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combineto form?
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a. Database
b. Admitting data ad
c. Financial statement ad
d. Discharge summary ad
ANS: A ad
The objective and subjective data together with the patient’s record and laboratory
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studies, form the database. The other items are not part of the patient’s record,
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laboratory studies, ordata.
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DIF: Cognitive Level: Remembering (Knowledge) ad ad ad
MSC: Client Needs: Safe and Effective Care Environment: Management of Care
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, 4. When listening to a patient’s breath sounds, the nurse is unsure of a sound that
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ad isheard.Which action would the nurse take next?
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a. Notify the patient’s physician. ad ad ad
b. Document the sound exactly as it was heard. ad ad ad ad ad ad ad
c. Validate the data by asking another nurse to listen to the breath sounds.
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d. Assess again in 20 minutes to note whether the sound is still present.
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ANS: C ad
When unsure of a sound heard while listening to a patient’s breath sounds, the nurse
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validatesthe data to ensure accuracy by either repeating the assessment themselves or
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asking another nurse to assess the breath sounds. If the nurse has less experience
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analyzing breath sounds, then he or she should ask an expert to listen. When unsure of
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a sound heard while listening toa patient’s breath sounds, the nurse should validate the
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data before documenting to ensure accuracy and before notifying the patient’s
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physician. To validate that data, the nurse either repeats the assessment himself or
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herself or asks another nurse to assess the breath sounds.
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DIF: Cognitive Level: Applying (Application) ad ad ad
MSC: Client Needs: Safe and Effective Care Environment: Management of Care
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5. The nurse is conducting a class for new graduate nurses. While teaching the class, what
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wouldthe nurse keep in mind regarding what novice nurses, without a background of
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skills and experience from which to draw upon, are more likely to base their decisions
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on?
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a. Intuition
b. A set of rules ad ad ad
c. Articles in journals ad ad
d. Advice from supervisors ad ad
ANS: B ad
Novice nurses operate from a set of defined, structured rules to make decisions. It takes
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time, perhaps a few years, in similar clinical situations to achieve competency and it is
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functioning at the level of an expert practitioner when intuition is included in making
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clinical decisions. While information in journal articles and advice from supervisors may
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assist in making decisions, novice nurses do not typically base their decisions on them.
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It would also be important that if information from journal articles and advice from
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supervisors were used, thatthey were evidence based.
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DIF: Cognitive Level: Understanding (Comprehension) ad ad ad MSC: Client Needs: Generalad ad ad
6. The nurse is reviewing information about evidence-based practice (EBP). Which
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statementbest reflects EBP?
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a. EBP relies on tradition for support of best practices.
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b. EBP is simply the use of best practice techniques for the treatment of patients.
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c. EBP emphasizes the use of best evidence with the clinician’s experience.
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d. EBP does not consider the patient’s own preferences as important.
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ANS: C ad