{"id":128066,"date":"2023-11-28T08:59:45","date_gmt":"2023-11-28T08:59:45","guid":{"rendered":"https:\/\/learnexams.com\/blog\/?p=128066"},"modified":"2023-11-28T08:59:46","modified_gmt":"2023-11-28T08:59:46","slug":"health-assessment-for-nursing-practice-7th-edition-by-wilson-test-bank-your-complete-guide","status":"publish","type":"post","link":"https:\/\/www.learnexams.com\/blog\/2023\/11\/28\/health-assessment-for-nursing-practice-7th-edition-by-wilson-test-bank-your-complete-guide\/","title":{"rendered":"Health Assessment for Nursing Practice 7th Edition by Wilson Test Bank – Your Complete Guide"},"content":{"rendered":"\n

Health Assessment for Nursing Practice 7th Edition by Wilson Test Bank – Your Complete Guide<\/p>\n\n\n\n

Chapter 01: Introduction to Health Assessment
MULTIPLE CHOICE :<\/p>\n\n\n\n

    \n
  1. A patient comes to the emergency department and tells the
    triage nurse that heis \u201chaving a heart attack.\u201d What is the nurse\u2019s top
    priority at this time?
    a. Determine the patient\u2019s personal data and
    insurance coverage.
    b. Ask the patient to take a seat in the waiting
    room until his name is called.
    c. Request that a nurse collect data for a
    comprehensive history.
    d. Ask a nurse to start a focused assessment
    of this patient now.
    ANS: D
    The nurse needs to begin an assessment as soon as possible that is focused on this patient\u2019s
    cardiovascular system. The type of health assessment performed by the nurse is also driven
    by patient need. Personal data and insurance information will be obtained, but in this
    situation, these data can wait until after the patient is assessed. Based also on Maslow\u2019s
    hierarchy of needs, physiologic needs take precedence. Rather than asking the patient to
    wait, the nurse needs to begin data collection, such as vital signs, immediately to determine
    the patient\u2019s health status. Complications can be prevented if an immediate assessment is
    made to analyze the patient\u2019s symptoms. A comprehensive history is not indicated in this
    situation at this time. Some subjective data will be collected, such as allergies and medical
    history related to cardiovascular disease. Eyes, ears, or a complete musculoskeletal or
    mental health assessment is not a priority at this time.
    DIF: Cognitive Level: Apply REF: Box 1-3 | p. 3
    TOP: Nursing Process: Assessment
    MSC: NCLEX Patient Needs: Safe and Effective Care Environment: Management of Care:
    Establishing Priorities<\/li>\n\n\n\n
  2. Which situation illustrates a screening assessment?
    a. A patient visits an obstetric clinic for the
    first time and the nurse conducts a detailed
    history and physical examination.
    b. A hospital sponsors a health fair at a local
    mall and provides cholesterol and blood
    pressure checks to mall patrons.
    c. The nurse in an urgent care center checks
    the vital signs of a patient who is
    complaining of leg pain.<\/li>\n<\/ol>\n\n\n\n

    d. A patient newly diagnosed with diabetes
    mellitus comes to test his fasting blood
    glucose level.
    ANS: B
    A health fair at a local mall that provides cholesterol and blood pressure checks is an
    example of a screening assessment focused on disease detection. A detailed history and
    physical examination conducted during a first-time visit to an obstetric clinic is an example
    of a comprehensive assessment. Assessing a patient complaining of leg pain in the triage
    area of an urgent care center is an example of a problem-based\/focused assessment. A
    patient\u2019s return appointment 1 month after today\u2019s office visit to report fasting blood
    glucose levels is an example of an episodic or follow-up assessment.
    DIF: Cognitive Level: Understand REF: Box 1-3 | p. 3
    TOP: Nursing Process: Assessment
    MSC: NCLEX Patient Needs: Health Promotion and Maintenance: Health Screening<\/p>\n\n\n\n

      \n
    1. For which person is a screening assessment indicated?
      a. The person who had abdominal surgery
      yesterday
      b. The person who is unaware of his high
      serum glucose levels
      c. The person who is being admitted to a
      long-term care facility
      d. The person who is beginning rehabilitation
      after a knee replacement
      ANS: B
      A screening assessment is performed for the purpose of disease detection. In this case this
      person may have diabetes mellitus. A shift assessment is most appropriate for the person
      who is recovering in the hospital from surgery. A comprehensive assessment is performed
      during admission to a facility to obtain a detailed history and complete physical
      examination. An episodic or follow-up assessment is performed after knee replacement to
      evaluate the outcome of the procedure.
      DIF: Cognitive Level: Understand REF: Box 1-3 | p. 3
      TOP: Nursing Process: Assessment
      MSC: NCLEX Patient Needs: Safe and Effective Care Environment: Management of Care:
      Establishing Priorities<\/li>\n\n\n\n
    2. For which person is a shift assessment indicated?
      a. The person who had abdominal surgery
      yesterday
      b. The person who is unaware of his high
      serum glucose levels
      c. The person who is being admitted to a
      long-term care facility
      d. The person who is beginning rehabilitation
      after a knee replacement
      ANS: A
      A shift assessment is most appropriate for the person who is recovering in the hospital from
      surgery. A screening assessment is performed for the purpose of disease detection, in this
      case diabetes mellitus. A comprehensive assessment is performed during admission to a<\/li>\n<\/ol>\n\n\n\n

      facility to obtain a detailed history and complete physical examination. An episodic or
      follow-up assessment is performed after knee replacement to evaluate the outcome of the
      procedure.
      DIF: Cognitive Level: Understand REF: Box 1-3 | p. 4
      TOP: Nursing Process: Assessment
      MSC: NCLEX Patient Needs: Safe and Effective Care Environment: Management of Care:
      Establishing Priorities<\/p>\n\n\n\n

        \n
      1. For which person is a comprehensive assessment indicated?
        a. The person who had abdominal surgery
        yesterday
        b. The person who is unaware of his high
        serum glucose levels
        c. The person who is being admitted to a
        long-term care facility
        d. The person who is beginning rehabilitation
        after a knee replacement
        ANS: C
        A comprehensive assessment is performed during admission to a facility to obtain a
        detailed history and complete physical examination. A shift assessment is most appropriate
        for the person who is recovering in the hospital from surgery. A screening assessment is
        performed for the purpose of disease detection, in this case diabetes mellitus. An episodic
        or follow-up assessment is performed after knee replacement to evaluate the outcome of
        the procedure.
        DIF: Cognitive Level: Understand REF: Box 1-3 | p. 3
        TOP: Nursing Process: Assessment
        MSC: NCLEX Patient Needs: Safe and Effective Care Environment: Management of Care:
        Establishing Priorities<\/li>\n\n\n\n
      2. For which person is an episodic or follow-up assessment indicated?
        a. The person who had abdominal surgery
        yesterday
        b. The person who is unaware of his high
        serum glucose levels
        c. The person who is being admitted to a
        long-term care facility
        d. The person who is beginning rehabilitation
        after a knee replacement
        ANS: D
        An episodic or follow-up assessment is performed after the knee replacement to evaluate
        the outcome of the procedure. A shift assessment is most appropriate for the person who is
        recovering in the hospital from surgery. A screening assessment is performed for the
        purpose of disease detection, in this case diabetes mellitus. A comprehensive assessment is
        performed during admission to a facility to obtain a detailed history and complete physical
        examination.
        DIF: Cognitive Level: Understand REF: Box 1-3 | p. 3
        TOP: Nursing Process: Assessment<\/li>\n<\/ol>\n\n\n\n

        MSC: NCLEX Patient Needs: Safe and Effective Care Environment: Management of Care:
        Establishing Priorities<\/p>\n\n\n\n

          \n
        1. Which is an example of data a nurse collects during a physical
          examination?
          a. The patient\u2019s lack of hair and shiny skin
          over both shins
          b. The patient\u2019s stated concern about lack of
          money for prescriptions
          c. The patient\u2019s complaints of tingling
          sensations in the feet
          d. The patient\u2019s mother\u2019s statements that the
          patient is very nervous lately
          ANS: A
          The lack of hair and shiny skin over both shins are objective data or signs that are part of
          the physical examination. A patient\u2019s concerns about lack of money are subjective data and
          are part of the health history. A patient\u2019s complaints of tingling sensations in the feet are
          subjective data and are part of the health history. A patient\u2019s family statements are
          considered secondary data, are subjective data, and are part of the health history.
          DIF: Cognitive Level: Apply REF: Box 1-3 | p. 3
          TOP: Nursing Process: Assessment
          MSC: NCLEX Patient Needs: Physiologic Integrity: Reduction of Risk Potential: System
          Specific Assessments<\/li>\n\n\n\n
        2. The nurse documents which information in the patient\u2019s history?
          a. The patient\u2019s skin feels warm to the touch.
          b. The patient is scratching his arm.
          c. The patient\u2019s temperature is 100\u00b0 F.
          d. The patient complains of itching.
          ANS: D
          A patient\u2019s complaint of itching is subjective information, which means it is a symptom
          and is documented in the history. The patient\u2019s warm skin is objective information
          gathered by the nurse through palpation, is also a sign, and is documented in the physical
          examination. The patient\u2019s scratching is objective information gathered by the nurse
          through observation, is also a sign, and is documented in the physical examination. The
          patient\u2019s elevated temperature is objective information gathered by the nurse through
          measurement, is also a sign, and is documented in the physical examination.
          DIF: Cognitive Level: Apply REF: p. 1 | p. 2 and Box 1-2
          TOP: Nursing Process: Assessment
          MSC: NCLEX Patient Needs: Safe and Effective Care Environment: Management of Care:
          Establishing Priorities<\/li>\n\n\n\n
        3. Which patient information does the nurse document in the patient\u2019s physical
          assessment?
          a. Slurred speech
          b. Immunizations
          c. Smoking habit
          d. Allergies
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