Patient Assessment and Care
Exam Solutions
Course Introduction
Patient Assessment and Care is a comprehensive course designed to equip students with the foundational skills and knowledge required to evaluate, monitor, and manage patient health across a range of clinical settings. Through a combination of theoretical lessons and practical exercises, students learn systematic approaches to collecting patient histories, conducting physical examinations, interpreting vital signs, and assessing diverse health conditions. The course emphasizes the development of effective communication, critical thinking, and diagnostic reasoning skills essential for delivering safe, ethical, and compassionate care. Students also explore the integration of evidence-based practices into patient assessment and learn to tailor care plans that respond to individual patient needs, supporting optimal outcomes throughout the continuum of care.
Recommended Textbook
Physical Examination and Health Assessment 6th Edition by Carolyn Jarvis
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30 Chapters
1147 Verified Questions
1147 Flashcards
Source URL: https://quizplus.com/study-set/1044
Page 2
Chapter 1: Evidence Based Assessment
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34 Verified Questions
34 Flashcards
Source URL: https://quizplus.com/quiz/20681
Sample Questions
Q1) When reviewing concepts of health,the nurse recalls that components of holistic health include which of these?
A) Disease originates from the external environment.
B) The individual human is a closed system.
C) Nurses are responsible for a patient's health state.
D) Holistic health views the mind, body, and spirit as interdependent.
Answer: D
Q2) Barriers to incorporating evidence-based practice (EBP)include:
A) nurses' lack of research skills in evaluating quality of research studies.
B) lack of significant research studies.
C) insufficient clinical skills of nurses.
D) inadequate physical assessment skills.
Answer: A
Q3) The nurse is reviewing information about evidence-based practice (EBP).Which statement best reflects evidence-based practice?
A) EBP relies on tradition for support of best practices.
B) EBP is simply the use of best practice techniques for treatment of patients.
C) EBP emphasizes the use of best evidence with the clinician's experience.
D) The patient's own preferences are not important with EBP.
Answer: C
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Chapter 2: Cultural Competence: Cultural Care
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41 Verified Questions
41 Flashcards
Source URL: https://quizplus.com/quiz/20682
Sample Questions
Q1) A physician in the clinic is frequently bothered when patients arrive late for appointments.The physician is so irritated by this behavior that he often finds it hard to provide appropriate care to these individuals.What should he do first in trying to overcome this difficulty?
A) Identify the meaning of health to the patient.
B) Understand that these cultural practices are helpful to the patient.
C) Allow the patients to arrive late and build this into his schedule.
D) Examine his own culturally based values, beliefs, attitudes, and practices.
Answer: D
Q2) The nurse recognizes that the first step in understanding the health care needs of another person is:
A) identifying the meaning of health to the other person.
B) understanding one's own heritage-based cultural values, beliefs, attitudes, and practices relevant to health and illness.
C) understanding how the health care delivery system works.
D) being knowledgeable about the person's social background.
Answer: B
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Chapter 3: The Interview
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41 Verified Questions
41 Flashcards
Source URL: https://quizplus.com/quiz/20683
Sample Questions
Q1) As the nurse enters a patient's room,the nurse finds her crying.The patient states that she has just found out that the lump in her breast is cancer and says,"I'm so afraid of,um,you know." The nurse's most therapeutic response would be to say,in a gentle manner:
A) "You're afraid you might lose your breast?"
B) "No, I'm not sure what you are talking about."
C) "I'll wait here until you get yourself under control and then we can talk."
D) "I can see that you are very upset. Perhaps we should discuss this later."
Answer: A
Q2) During an interview,a parent of a hospitalized child is sitting in an open position.As the interviewer begins to discuss his son's treatment,however,he suddenly crosses his arms against his chest and crosses his legs.This would suggest that the parent is:
A) just changing positions.
B) more comfortable in this position.
C) tired and needs a break from the interview.
D) uncomfortable talking about his son's treatment.
Answer: D
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Page 5
Chapter 4: The Complete Health History
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35 Verified Questions
35 Flashcards
Source URL: https://quizplus.com/quiz/20684
Sample Questions
Q1) In response to a question about stress,a 39-year-old woman tells the nurse that her husband and mother both died in the past year.Which response by the nurse is most appropriate?
A) "This has been a difficult year for you."
B) "I don't know how anyone could handle that much stress in one year!"
C) "What did you do to cope with the loss of both your husband and mother?"
D) "That is a lot of stress; now let's go on to the next section of your history."
Q2) The nurse is asking a patient for his reason for seeking care,and asks about the signs and symptoms he is experiencing.Which of these is an example of a symptom?
A) Chest pain
B) Clammy skin
C) Serum potassium level 4.2 mEq/L
D) A temperature of 100F
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Chapter 5: Mental Status Assessment
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41 Verified Questions
41 Flashcards
Source URL: https://quizplus.com/quiz/20685
Sample Questions
Q1) During an interview,the nurse notes that the patient gets up several times to wash her hands even though they are not dirty.This is an example of:
A) social phobia.
B) compulsive disorder.
C) generalized anxiety disorder.
D) posttraumatic stress disorder.
Q2) The nurse is planning to assess new memory with a patient.The best way for the nurse to do this would be to:
A) administer the FACT test.
B) ask him to describe his first job.
C) give him the Four Unrelated Words Test.
D) ask him to describe what television show he was watching before coming to the clinic.
Q3) During an examination,the nurse can assess mental status by which activity?
A) Examining the patient's electroencephalogram
B) Observing the patient as he or she performs an IQ test
C) Observing the patient and inferring health or dysfunction
D) Examining the patient's response to a specific set of questions
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Chapter 6: Substance Use Assessment
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14 Verified Questions
14 Flashcards
Source URL: https://quizplus.com/quiz/20686
Sample Questions
Q1) The nurse is asking an adolescent about illicit substance abuse.The adolescent answers,"Yes,I've used marijuana at parties with my friends." What is the next question the nurse should ask?
A) "Who are these friends?"
B) "Do your parents know about this?"
C) "When was the last time you used marijuana?"
D) "Is this a regular habit?"
Q2) A woman has come to the clinic to seek help with a substance abuse problem.She admits to using cocaine just before arrival.Which of these assessment findings would the nurse expect to find when examining this woman?
A) Dilated pupils, pacing, psychomotor agitation
B) Dilated pupils, unsteady gait, aggressiveness
C) Pupil constriction, lethargy, apathy, dysphoria
D) Constricted pupils, euphoria, decreased temperature
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Chapter 7: Domestic Violence Assessment
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15 Verified Questions
15 Flashcards
Source URL: https://quizplus.com/quiz/20687
Sample Questions
Q1) During an examination,the nurse notices a patterned injury on a patient's back.Which of these would cause such an injury?
A) Blunt force
B) Friction abrasion
C) Stabbing from a kitchen knife
D) Whipping from an extension cord
Q2) The nurse is using the danger assessment (DA)tool to evaluate the risk of homicide.Which of these statements best describes its use?
A) The DA tool is to be administered by law enforcement personnel.
B) The DA tool should be used in every assessment of suspected abuse.
C) The number of yes answers indicates the woman's understanding of her situation.
D) The higher the number of yes answers, the more serious the danger of the woman's situation.
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9
Chapter 8: Assessment Techniques and the Clinical Setting
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43 Verified Questions
43 Flashcards
Source URL: https://quizplus.com/quiz/20688
Sample Questions
Q1) The nurse keeps in mind that the most important reason to share information and offer brief teaching while performing the physical examination is to help:
A) the examiner feel more comfortable and gain control of the situation.
B) build rapport and increase the patient's confidence in the examiner.
C) the patient understand his or her disease process and treatment modalities.
D) the patient identify questions about his or her disease and potential areas of patient education.
Q2) The nurse is preparing to examine a 6-year-old child.Which action is most appropriate?
A) Start with the thorax, abdomen, and genitalia before examining the head.
B) Avoid talking about the equipment being used because it may increase the child's anxiety.
C) Keep in mind that a child this age will have a sense of modesty.
D) Have the child undress from the waist up.
Q3) The nurse would use bimanual palpation technique in which situation?
A) Palpating the thorax of an infant
B) Palpating the kidneys and uterus
C) Assessing pulsations and vibrations
D) Assessing the presence of tenderness and pain
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Page 10
Chapter 9: General Survey, Measurement, Vital Signs
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52 Verified Questions
52 Flashcards
Source URL: https://quizplus.com/quiz/20689
Sample Questions
Q1) While measuring a patient's blood pressure,the nurse uses proper technique to obtain an accurate reading.Which of these situations will result in a falsely high blood pressure reading? Select all that apply.
A) The person supports his or her own arm during the blood pressure reading.
B) The blood pressure cuff is too narrow for the extremity.
C) The arm is held above level of the heart.
D) The cuff is wrapped loosely around the arm.
E) The person is sitting with his or her legs crossed.
F) The nurse does not inflate the cuff high enough.
Q2) When checking for proper blood pressure cuff size,the nurse knows that which guideline is correct?
A) The standard cuff size is appropriate for all sizes.
B) The length of the rubber bladder should equal 80% of the arm circumference.
C) The width of the rubber bladder should equal 80% of the arm circumference.
D) The width of the rubber bladder should equal 40% of the arm circumference.
Q3) What is the pulse pressure for a patient whose blood pressure is 158/96 mm Hg and whose pulse rate is 72 beats per minute?
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Chapter 10: Pain Assessment: The Fifth Vital Sign
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17 Verified Questions
17 Flashcards
Source URL: https://quizplus.com/quiz/20690
Sample Questions
Q1) The nurse knows that which statement is true regarding the pain experienced by infants?
A) Pain in infants can only be assessed by physiologic changes, such as increased heart rate.
B) The Faces Pain Scale-revised (FPS-R) can be used to assess pain in infants.
C) A procedure that induces pain in adults will also induce pain in the infant.
D) Infants feel pain less than adults do.
Q2) A patient has been admitted to the hospital with vertebral fractures related to osteoporosis.She is in extreme pain.This type of pain would be classified as:
A) referred.
B) cutaneous.
C) visceral.
D) deep somatic.
Q3) When assessing the intensity of a patient's pain,which question by the nurse is appropriate?
A) "What makes your pain better or worse?"
B) "How much pain do you have now?"
C) "How does pain limit your activities?"
D) "What does your pain feel like?"
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Page 12
Chapter 11: Nutritional Assessment
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46 Verified Questions
46 Flashcards
Source URL: https://quizplus.com/quiz/20691
Sample Questions
Q1) The nurse is assessing a 30-year-old unemployed immigrant from an underdeveloped country who has been in the United States for 1 month.Which of these problems related to his nutritional status might the nurse expect to find?
A) Obesity
B) Hypotension
C) Osteomalacia
D) Coronary artery disease
Q2) The nurse is preparing to measure fat and lean body mass and bone mineral density.Which tool is appropriate?
A) Measuring tape
B) Skin fold calipers
C) Bioelectrical impedance analysis
D) Dual-energy x-ray absorptiometry
Q3) In teaching a patient how to determine total body fat at home,the nurse includes instructions to obtain measurements of:
A) height and weight.
B) frame size and weight.
C) waist and hip circumferences.
D) mid-upper arm circumference and arm span.
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Page 13
Chapter 12: Skin, Hair, and Nails
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52 Verified Questions
52 Flashcards
Source URL: https://quizplus.com/quiz/20692
Sample Questions
Q1) The nurse educator is preparing an education module for the nursing staff on the dermis layer of skin.Which of these statements would be included in the module? The dermis:
A) contains mostly fat cells.
B) consists mostly of keratin.
C) is replaced every 4 weeks.
D) contains sensory receptors.
Q2) A 70-year-old woman who loves to garden has small,flat,brown macules over her arms and hands.She asks,"What causes these liver spots?" The nurse tells her,"They are:
A) signs of decreased hematocrit related to anemia."
B) due to destruction of melanin in your skin from exposure to the sun."
C) clusters of melanocytes that appear after extensive sun exposure."
D) areas of hyperpigmentation related to decreased perfusion and vasoconstriction."
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Chapter 13: Head, Face, and Neck, Including Regional Lymphatics
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42 Verified Questions
42 Flashcards
Source URL: https://quizplus.com/quiz/20693
Sample Questions
Q1) During an examination,the nurse finds that a patient's left temporal artery is tortuous and feels hardened and tender compared with the right temporal artery.The nurse suspects which condition?
A) Crepitation
B) Mastoiditis
C) Temporal arteritis
D) Bell palsy
Q2) A mother brings in her newborn infant for an assessment and tells the nurse that she has noticed that whenever her newborn's head is turned to the right side,she straightens out the arm and leg on the same side and flexes the opposite arm and leg.After finding this on examination,the nurse would tell her that this is:
A) abnormal and is called the atonic neck reflex.
B) normal and should disappear by the first year of life.
C) normal and should disappear between 3 and 4 months of age.
D) abnormal. The baby should be flexing the arm and leg on the right side of his body when the head is turned to the right.
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Chapter 14: Eyes
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41 Verified Questions
41 Flashcards
Source URL: https://quizplus.com/quiz/20694
Sample Questions
Q1) An ophthalmic examination reveals papilledema.The nurse is aware that this finding indicates:
A) retinal detachment.
B) diabetic retinopathy.
C) acute-angle glaucoma.
D) increased intracranial pressure.
Q2) During a physical education class,a student is hit in the eye with the end of a baseball bat.When examined in the emergency department,the nurse notices the presence of blood in the anterior chamber of the eye.This finding indicates the presence of:
A) hypopyon.
B) hyphema.
C) corneal abrasion.
D) pterygium
Q3) When a light is directed across the iris of a patient's eye from the temporal side,the nurse is assessing for:
A) drainage from dacryocystitis.
B) the presence of conjunctivitis over the iris.
C) the presence of shadows, which may indicate glaucoma.
D) a scattered light reflex, which may be indicative of cataracts.
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Chapter 15: Ears
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41 Verified Questions
41 Flashcards
Source URL: https://quizplus.com/quiz/20695
Sample Questions
Q1) The nurse assesses the hearing of a 7-month-old by clapping hands.What is the expected response?
A) The infant turns the head to localize sound.
B) There is no obvious response to noise.
C) There is a startle and acoustic blink reflex.
D) The infant stops movement and appears to listen.
Q2) The nurse is performing an ear examination of an 80-year-old patient.Which of these would be considered a normal finding?
A) A high-tone frequency loss
B) Increased elasticity of the pinna
C) A thin, translucent membrane
D) A shiny, pink tympanic membrane
Q3) The nurse is performing an otoscopic examination on an adult.Which of these actions is correct?
A) Tilt the person's head forward during the exam.
B) Once the speculum is in the ear, release the traction.
C) Pull the pinna up and back before inserting the speculum.
D) Use the smallest speculum to decrease the amount of discomfort.
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17
Chapter 16: Nose, Mouth, and Throat
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43 Verified Questions
43 Flashcards
Source URL: https://quizplus.com/quiz/20696
Sample Questions
Q1) A mother is concerned because her 18-month-old child has 12 teeth.She is wondering if this is normal for a child of this age.The nurse's best response would be:
A) "How many teeth did you have at this age?"
B) "All 20 deciduous teeth are expected to erupt by age 4 years."
C) "This is a normal number of teeth for an 18 month old."
D) "Normally, by age 2 1/2, 16 deciduous teeth are expected."
Q2) The primary purpose of the ciliated mucous membrane in the nose is to:
A) warm the inhaled air.
B) filter out dust and bacteria.
C) filter coarse particles from inhaled air.
D) facilitate movement of air through the nares.
Q3) The nurse is reviewing the development of the newborn infant.Regarding the sinuses,which statement is true in relation to a newborn infant?
A) The sphenoid sinuses are full size at birth.
B) The maxillary sinuses reach full size after puberty.
C) The frontal sinuses are fairly well developed at birth.
D) The maxillary and ethmoid sinuses are the only sinuses present at birth.
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Chapter 17: Breasts and Regional Lymphatics
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45 Verified Questions
45 Flashcards
Source URL: https://quizplus.com/quiz/20697
Sample Questions
Q1) In performing an assessment of a woman's axillary lymph system,the nurse should assess which of these nodes?
A) Central, axillary, lateral, and sternal nodes
B) Pectoral, lateral, anterior, and sternal nodes
C) Central, lateral, pectoral, and subscapular nodes
D) Lateral, pectoral, axillary, and suprascapular nodes
Q2) During an examination of a woman,the nurse notices that her left breast is slightly larger than her right breast.Which of these statements is true about this finding?
A) Breasts should always be symmetric.
B) This finding is probably due to breastfeeding and is nothing to worry about.
C) This finding is not unusual, but the nurse should verify that this change is not new.
D) This finding is very unusual and means she may have an inflammation or growth.
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Chapter 18: Thorax and Lungs
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43 Verified Questions
43 Flashcards
Source URL: https://quizplus.com/quiz/20698
Sample Questions
Q1) A patient with pleuritis has been admitted to the hospital and complains of pain with breathing.What other key assessment finding would the nurse expect to find upon auscultation?
A) Stridor
B) Friction rub
C) Crackles
D) Wheezing
Q2) During auscultation of the lungs,the nurse expects decreased breath sounds to be heard in which situation?
A) When the bronchial tree is obstructed
B) When adventitious sounds are present
C) In conjunction with whispered pectoriloquy
D) In conditions of consolidation, such as pneumonia
Q3) When assessing a patient's lungs,the nurse recalls that the left lung:
A) consists of two lobes.
B) is divided by the horizontal fissure.
C) consists primarily of an upper lobe on the posterior chest.
D) is shorter than the right lung because of the underlying stomach.
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Chapter 19: Heart and Neck Vessels
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43 Verified Questions
43 Flashcards
Source URL: https://quizplus.com/quiz/20699
Sample Questions
Q1) The mother of a 3-month-old infant states that her baby has not been gaining weight.With further questioning,the nurse finds that the infant falls asleep after nursing and wakes up after a short amount of time,hungry again.What other information would the nurse want to have?
A) The infant's sleeping position
B) Sibling history of eating disorders
C) Amount of background noise when eating
D) Presence of dyspnea or diaphoresis when sucking
Q2) The direction of blood flow through the heart is best described by which of these?
A) Vena cava right atrium right ventricle lungs pulmonary artery left atrium left ventricle
B) Right atrium right ventricle pulmonary artery lungs pulmonary vein left atrium left ventricle
C) Aorta right atrium right ventricle lungs pulmonary vein left atrium left ventricle vena cava
D) Right atrium right ventricle pulmonary vein lungs pulmonary artery left atrium left ventricle
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Chapter 20: Peripheral Vascular System and Lymphatic System
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42 Verified Questions
42 Flashcards
Source URL: https://quizplus.com/quiz/20700
Sample Questions
Q1) When performing a peripheral vascular assessment on a patient,the nurse is unable to palpate the ulnar pulses.The patient's skin is warm and capillary refill time is normal.The nurse should next:
A) check for the presence of claudication.
B) refer the individual for further evaluation.
C) consider this a normal finding and proceed with the peripheral vascular evaluation.
D) ask the patient if he or she has experienced any unusual cramping or tingling in the arm.
Q2) The nurse is preparing to perform a modified Allen test.Which is an appropriate reason for this test?
A) To measure the rate of lymphatic drainage
B) To evaluate the adequacy of capillary patency before venous blood draws
C) To evaluate the adequacy of collateral circulation before cannulating the radial artery
D) To evaluate the venous refill rate that occurs after the ulnar and radial arteries are temporarily occluded
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22
Chapter 21: Abdomen
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41 Verified Questions
41 Flashcards
Source URL: https://quizplus.com/quiz/20701
Sample Questions
Q1) A 45-year-old man is in the clinic for a physical examination.During the abdominal assessment,the nurse percusses the abdomen and notices an area of dullness above the right costal margin of about 10 cm.The nurse should:
A) document the presence of hepatomegaly.
B) ask additional history questions regarding his alcohol intake.
C) describe this as an enlarged liver and refer him to a physician.
D) consider this a normal finding and proceed with the examination.
Q2) The nurse is assessing the abdomen of a pregnant woman who is complaining of having "acid indigestion" all the time.The nurse knows that esophageal reflux during pregnancy can cause:
A) diarrhea.
B) pyrosis.
C) dysphagia.
D) constipation.
Q3) Which structure is located in the left lower quadrant of the abdomen?
A) Liver
B) Duodenum
C) Gallbladder
D) Sigmoid colon
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Page 23
Chapter 22: Musculoskeletal System
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53 Verified Questions
53 Flashcards
Source URL: https://quizplus.com/quiz/20702
Sample Questions
Q1) The nurse is assessing a patient's ischial tuberosity.To palpate the ischial tuberosity,the nurse knows that it is best to have the patient:
A) stand.
B) flex the hip.
C) flex the knee.
D) in the supine position.
Q2) The nurse is explaining the mechanism of the growth of long bones to a mother of a toddler.Where does lengthening of the bones occur?
A) Bursa
B) Calcaneus
C) Epiphyses
D) Tuberosities
Q3) The nurse is teaching a class on osteoporosis prevention to a group of postmenopausal women.Which of these actions is the best way to prevent or delay bone loss in this group?
A) Taking calcium and vitamin D supplements
B) Taking medications to prevent osteoporosis
C) Performing physical activity, such as fast walking
D) Assessing bone density annually
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Page 24
Chapter 23: Neurologic System
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56 Flashcards
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Sample Questions
Q1) During the history of a 78-year-old man,his wife states that he occasionally has problems with short-term memory loss and confusion: "He can't even remember how to button his shirt." In doing the assessment of his sensory system,which action by the nurse is most appropriate?
A) The nurse would not do this part of the examination because results would not be valid.
B) The nurse would perform the tests, knowing that mental status does not affect sensory ability.
C) The nurse would proceed with the explanations of each test, making sure the wife understands.
D) Before testing, the nurse would assess the patient's mental status and ability to follow directions at this time.
Q2) During the history,a patient tells the nurse that "it feels like the room is spinning around me." The nurse would document this as:
A) vertigo.
B) syncope.
C) dizziness.
D) seizure activity.
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Chapter 24: Male Genitourinary System
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42 Verified Questions
42 Flashcards
Source URL: https://quizplus.com/quiz/20704
Sample Questions
Q1) The mother of a 10-year-old boy asks the nurse to discuss the recognition of puberty.The nurse should reply by saying:
A) "Puberty usually begins about age fifteen."
B) "The first sign of puberty is enlargement of the testes."
C) "Penis size does not increase until about the age of sixteen."
D) "The development of pubic hair precedes testicular or penis enlargement."
Q2) When performing a genitourinary assessment on a 16-year-old boy,the nurse notices a swelling in the scrotum that increases with increased intra-abdominal pressure and decreases when he is lying down.The patient complains of pain when straining.The nurse knows that this description is most consistent with a(n)_____ hernia.
A) femoral
B) incisional
C) direct inguinal
D) indirect inguinal
Q3) An accessory glandular structure for the male genital organs is the:
A) testis.
B) penis.
C) prostate.
D) vas deferens.
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Chapter 25: Anus, Rectum, and Prostate
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32 Verified Questions
32 Flashcards
Source URL: https://quizplus.com/quiz/20705
Sample Questions
Q1) While doing an assessment of the perianal area of a patient,the nurse notices that the pigmentation of anus is darker than surrounding skin,the anal opening is closed,and there is a skin sac that is shiny and blue.The patient mentioned that he has had pain with bowel movements and has noted some spots of blood occasionally.What would this assessment and history be most likely to indicate?
A) Anal fistula
B) Pilonidal cyst
C) Rectal prolapse
D) Thrombosed hemorrhoid
Q2) During an assessment of a 20-year-old man,the nurse finds a small palpable lesion with a tuft of hair located directly over the coccyx.The nurse knows that this lesion would most likely be a:
A) polyp.
B) pruritus ani.
C) carcinoma.
D) pilonidal cyst.
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Chapter 26: Female Genitourinary System
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49 Verified Questions
49 Flashcards
Source URL: https://quizplus.com/quiz/20706
Sample Questions
Q1) A woman is in the clinic for an annual gynecologic examination.The nurse should plan to begin the interview with the:
A) menstrual history because it is generally nonthreatening.
B) obstetric history because it is the most important information.
C) urinary system history because there may be problems in this area as well.
D) sexual history because it will build rapport to discuss this first.
Q2) A 50-year-old woman calls the clinic because she has noticed some changes in her body and breasts and wonders if they could be due to the hormone replacement therapy (HRT)she started 3 months ago.The nurse should tell her:
A) "Hormone replacement therapy is at such a low dose that side effects are very unusual."
B) "Hormone replacement therapy has several side effects, including fluid retention, breast tenderness, and vaginal bleeding."
C) "It would be very unusual to have vaginal bleeding with hormone replacement therapy, and I suggest you come in to the clinic immediately to have this evaluated."
D) "It sounds as if your dose of estrogen is too high; I think you may need to decrease the amount you are taking and then call back in a week."
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40 Verified Questions
40 Flashcards
Source URL: https://quizplus.com/quiz/20707
Sample Questions
Q1) During the examination of a patient's mouth,the nurse observes a nodular bony ridge down the middle of the hard palate.The nurse would chart this finding as:
A) cheilosis.
B) leukoplakia.
C) ankyloglossia.
D) torus palatinus.
Q2) A patient tells the nurse that "sometimes I wake up at night and I have real trouble breathing.I have to sit up in bed to get a good breath." When documenting this information,the nurse would note:
A) orthopnea.
B) acute emphysema.
C) paroxysmal nocturnal dyspnea.
D) acute shortness of breath episode.
Q3) After the examination of an infant,the nurse documents opisthotonos.The nurse recognizes that this finding often occurs with:
A) cerebral palsy.
B) meningeal irritation.
C) a lower motor neuron lesion.
D) a upper motor neuron lesion.
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Chapter 28: Bedside Assessment of the Hospitalized Adult
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12 Verified Questions
12 Flashcards
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Sample Questions
Q1) The nurse is completing an assessment on a patient who was just admitted from the emergency department.Which assessment findings would require immediate attention? Select all that apply.
A) Temperature is 101.4° F.
B) Systolic blood pressure is 150 mm Hg.
C) Respiratory rate is 22 breaths per minute.
D) Heart rate is 130 beats per minute.
E) Oxygen saturation is 95%.
F) Patient exhibits sudden restlessness.
Q2) What should the nurse assess before entering the patient's room on morning rounds?
A) Posted conditions, such as isolation precautions
B) The patient's input and output chart from the previous shift
C) The patient's general appearance
D) The presence of any visitors in the room
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Chapter 29: The Pregnant Woman
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35 Verified Questions
35 Flashcards
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Sample Questions
Q1) When assessing a woman who is in her third trimester of pregnancy,the nurse looks for the classic symptoms associated with preeclampsia,which include:
A) edema, headaches, and seizures.
B) elevated blood pressure and proteinuria.
C) elevated liver enzymes and high platelet counts.
D) decreased blood pressure and edema.
Q2) The nurse is palpating the fundus of a pregnant woman.Which of these statements about palpation of the fundus is true?
A) It should be hard and slightly tender to palpation during the first trimester.
B) Fetal movement may not be felt by the examiner until the end of the second trimester.
C) After 20 weeks of gestation, the number of centimeters should approximate the number of weeks of gestation.
D) Fundal height is usually less than the number of weeks of gestation, unless there is an abnormal condition such as too much amniotic fluid present.
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Chapter 30: Functional Assessment of the Older Adult
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16 Verified Questions
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Sample Questions
Q1) The nurse is assessing an older adult's functional ability.Which definition correctly describes one's functional ability? Functional ability:
A) is the measure of the expected changes of aging that one is experiencing.
B) refers to the individual's motivation to live independently.
C) refers to the level of cognition present in an older person.
D) refers to one's ability to perform activities necessary to live in modern society.
Q2) The nurse is assessing the forms of support an older patient has before she is discharged.Which of these examples is an informal source of support?
A) The local senior center
B) Her Medicare check
C) Meals on Wheels meal delivery service
D) Her neighbor, who visits with her daily
Q3) When beginning to assess a person's spirituality,which question by the nurse would be most appropriate?
A) "Do you believe in God?"
B) "How does your spirituality relate to your health care decisions?"
C) "What religious faith do you follow?"
D) "Do you believe in the power of prayer?"
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