Medical, Pharmaceutical & Health Sciences
NursingFundamentals NursingNursing Active LearningPractice Set 6
NursingFundamentals NursingNursing Active LearningPractice Set 6Health History And Physical Assessment
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- Nursing, Theory, and Professional PracticeValues, Beliefs, and CaringCommunicationCritical Thinking in NursingIntroduction to the Nursing ProcessAssessmentNursing DiagnosisPlanningImplementation and EvaluationDocumentation, Electronic Health Records, and ReportingEthical and Legal ConsiderationsLeadership and ManagementEvidence-Based Practice and Nursing ResearchHealth Literacy and Patient EducationNursing InformaticsHealth and WellnessHuman Development: Conception through AdolescenceHuman Development Young Adult to Older AdultVital SignsHealth History and Physical AssessmentEthnicity and Cultural AssessmentSpiritual HealthPublic Health, Community Base, and Home Health CareHuman SexualitySafetyAsepsis and Infection ControlHygiene and Personal CareActivity, Immobility, and Safe MovementSkin Integrity and Wound CareNutritionCognitive and Sensory AlterationsStress and CopingSleepDiagnostic TestingMedication AdministrationPain ManagementPerioperative Nursing CareOxygenation and Tissue PerfusionFluid, Electrolytes, and Acid-Base BalanceBowel EliminationUrinary EliminationDeath and Loss
Question 1
Free
Multiple Choice
A nurse is conducting a physical assessment in a clinic with a partly undressed patient. What action by the nurse is most appropriate?
Choose correct answer/s
Offer the patient a small pillow for under his/her head.
Provide a method for ensuring the patient stays warm.
Raise the head of the bed to about 30 degrees.
Ensure there is enough lighting for an adequate examination.
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Question 2
Free
Multiple Choice
A patient wishes to review his medical record. What response by the nurse is best?
Choose correct answer/s
"I'm sorry, we don't allow you to look at your chart."
"Let me check to see if we can allow you to do that."
"Yes, I can sit with you while you look at it so you can ask questions."
"Yes, all patients can review their charts at any time they wish."
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Question 3
Free
Multiple Choice
A clinic nurse is examining an older, confused patient on an examination table and realizes a piece of needed equipment was left outside in the hall. What action by the nurse is best?
Choose correct answer/s
Tell the patient to lie still and go get the equipment.
Call for another staff member to bring the equipment.
Have the patient get into a chair and get the equipment.
Finish the rest of the exam, get the equipment, and use it.
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Question 4
Free
Multiple Choice
A student nurse is preparing to auscultate a patient's lungs. What action by the student leads the instructor to intervene?
Choose correct answer/s
Student asks to turn the television volume down.
Student warms the bell of the stethoscope before use.
Student uses the stethoscope bell to listen to bowel sounds.
Student places the stethoscope diaphragm on the patient's skin.
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Question 5
Free
Multiple Choice
The nurse is assessing a patient's alcohol intake. What question is most appropriate?
Choose correct answer/s
"Do you drink alcohol at all?"
"You don't drink much do you?"
"When was your last drink?"
"How much alcohol do you drink daily?"
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Question 6
Multiple Choice
The nurse is planning to educate four patients on preventing skin cancer and early warning signs. Which patient is the priority for this education?
Choose correct answer/s
Adolescent who uses a tanning bed
Middle-aged adult who walks for fitness
Older woman who sits in the sun for 10 minutes daily
Person who works indoors under fluorescent lights
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Question 7
Multiple Choice
A nurse has assessed a patient's capillary refill, which was 5 seconds. What action by the nurse is most appropriate?
Choose correct answer/s
Document the findings and continue the examination.
Ask the patient about the use of artificial nails.
Ask the patient about his/her occupation.
Assess the patient for signs of hypoxia.
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Question 8
Multiple Choice
The student nurse asks if it matters whether a healthy eye or a diseased eye should be examined first. What response by the faculty is best?
Choose correct answer/s
Diseased eye first because it is the priority
Healthy eye first to prevent spread of disease
It does not matter as long as both eyes are examined
Start with the eye the patient wants you to start with
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Question 9
Multiple Choice
A nurse observes a patient sitting up in bed, leaning forward with the arms braced against the over-the-bed table. What action by the nurse is best?
Choose correct answer/s
Assess the patient for a barrel-chest appearance.
Palpate the patient's abdomen for tenderness.
Inspect the patient's spine for deformities.
Ask the patient if he/she is experiencing dizziness.
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Question 10
Multiple Choice
The nurse is assessing a patient whose chart indicates a Grade 3 heart murmur. What action is best in order to hear the murmur?
Choose correct answer/s
Ensure that the room is extremely quiet.
Use a specialized stethoscope with amplification.
Auscultate the patient's chest with a stethoscope.
Place the stethoscope diaphragm on the patient's back.
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Question 11
Multiple Choice
A nurse has conducted an Allen's test on a patient and the result was 8 seconds. What action by the nurse is best?
Choose correct answer/s
Document the findings and continue the assessment.
Notify the health care provider immediately.
Elevate the patient's arm above the level of the heart.
Assess the patient for other signs of circulatory problems.
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Question 12
Multiple Choice
A hospitalized patient complains of bilateral leg pain and asks the nurse to massage her legs. One calf is noticeably larger than the other and is warm and slightly reddened. What action by the nurse is best?
Choose correct answer/s
Only massage the leg with normal assessment findings.
Massage the front of both legs gently, and avoid the posterior surfaces.
Perform a Homan's test to both legs prior to massaging either of them.
Educate the patient on why a massage would be contraindicated.
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Question 13
Multiple Choice
A nurse is told in handoff report that a patient opens eye spontaneously, is confused but able to answer questions, and demonstrates purposeful movement to painful stimuli. What does the nurse calculate the patient's Glasgow Coma Scale to be?
Choose correct answer/s
7
9
11
13
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Question 14
Multiple Choice
A nurse is assessing a patient's abdomen and hears bowel sounds every 20 to 25 seconds. What action by the nurse is best?
Choose correct answer/s
Avoid palpating this patient's abdomen.
Document the findings in the patient's chart.
Have another nurse verify the findings.
Ask the patient when the last food intake was.
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Question 15
Multiple Choice
A nurse is assisting a patient who is having an examination of the female genitalia. What action by the nurse is best?
Choose correct answer/s
Get the provider; assist patient into lithotomy position.
Assist the patient into lithotomy position; get the provider.
Get the provider; assist patient into Sims position.
Assist the patient into Sims position; get the provider.
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Question 16
Multiple Choice
A nurse assesses a patient's lungs and notes the presence of low-pitched snoring sounds that clear with coughing. What action by the nurse is best?
Choose correct answer/s
Prepare to treat the patient for asthma.
Prepare to treat the patient for pneumonia.
Teach the parent how to prevent croup.
Assess the patient for heart failure.
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Question 17
Multiple Choice
The nurse is assessing a patient's cranial nerve III. What technique is best?
Choose correct answer/s
Have patient identify a common scent with closed eyes.
Shine a light into the patient's eyes to assess pupil response.
Have the patient read a newspaper or use the Snellen chart.
Assess if patient can hear both spoken and whispered words.
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Question 18
Multiple Choice
A nurse is assessing a patient's cranial nerves and notes an abnormal response to testing cranial nerve VI. What action by the nurse is best?
Choose correct answer/s
Ask the patient about recent facial trauma.
Inform the provider immediately.
Document findings in the patient's chart.
Have the patient frown and lift the eyebrows.
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Question 19
Multiple Choice
The nurse reads in a chart that a patient has a paronychia. What assessment technique is most appropriate?
Choose correct answer/s
Auscultate the patient's bowel sounds.
Test the cranial nerves for sensory function.
Inspect the patient's nails and surrounding skin.
Inspect the skin using the ABCDE mnemonic.
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Question 20
Multiple Choice
A new nurse is conducting a patient interview. What behaviors observed by the experienced nurse require education on this process? (Select all that apply.)
Choose correct answer/s
Typing intently on a keyboard when asking questions.
Allowing family to accompany the patient as requested.
Using gestures and eye contact to demonstrate interest.
Closing the door to the room to ensure privacy.
Providing non-verbal cues to negative thoughts.
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