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Jarvis Physical Examination And Health

Assessment 8th Edition Test Bank
Chapter01:Evidence-BasedAssessment
MULTIPLECHOICE

1. Aftercompletinganinitialassessmentofapatient,thenursehaschartedthathisrespirationsareeupneicandhispulse
is58beatsperminute.Thesetypesofdatawouldbe:

a. Objective.

b. Reflective.

c. Subjective.

d. Introspective.

ANS:A

Objectivedataarewhatthehealthprofessionalobservesbyinspecting,percussing,palpating,andauscultatingduring
the physical examination. Subjective data is what the person says about him or herself during
historytaking.Thetermsreflectiveandintrospectivearenotusedtodescribedata.

DIF:CognitiveLevel:Understanding(Comprehension)

MSC:ClientNeeds:SafeandEffectiveCareEnvironment:ManagementofCare

2. ApatienttellsthenursethatheisverynervN
ouUsR,SisIN
naGuTsB
ea.C
teOdM
,andfeelshot.Thesetypesofdatawouldbe:

a. Objective.

b. Reflective.

c. Subjective.

d. Introspective.

ANS:C

Subjectivedataarewhatthepersonsaysabouthimorherselfduringhistorytaking.Objectivedataarewhatthehealth
professional observes by inspecting, percussing, palpating, and auscultating during the
physicalexamination.Thetermsreflectiveandintrospectivearenotusedtodescribedata.

DIF:CognitiveLevel:Understanding(Comprehension)

MSC:ClientNeeds:SafeandEffectiveCareEnvironment:ManagementofCare

3. Thepatientsrecord,laboratorystudies,objectivedata,andsubjectivedatacombinetoformthe:

a. Database.

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b. Admittingdata.

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c. Financialstatement.

d. Dischargesummary.

ANS:A

Togetherwiththepatientsrecordandlaboratorystudies,theobjectiveandsubjectivedataformthedatabase.Theother
itemsarenotpartofthepatientsrecord,laboratorystudies,ordata.

DIF:CognitiveLevel:Remembering(Knowledge)

MSC:ClientNeeds:SafeandEffectiveCareEnvironment:ManagementofCare

4. Whenlisteningtoapatientsbreathsounds,thenurseisunsureofasoundthatisheard.Thenursesnextactionsho
uldbeto:

a. Immediatelynotifythepatientsphysician.

b. Documentthesoundexactlyasitwasheard.

c. Validatethedatabyaskingacoworkertolistentothebreathsounds.

d. Assessagainin20minutestonotewhetherthesoundisstillpresent.

NURSINGTB.COM
ANS:C

Whenunsureofasoundheardwhilelisteningtoapatientsbreathsounds,thenursevalidatesthedatatoensureaccuracy.If
thenursehaslessexperienceinanarea,thenheorsheasksanexperttolisten.

DIF:CognitiveLevel:Analyzing(Analysis)

MSC:ClientNeeds:SafeandEffectiveCareEnvironment:ManagementofCare

5. Thenurseisconductingaclassfornewgraduatenurses.Duringtheteachingsession,thenurseshouldkeepinmindt
hatnovicenurses,withoutabackgroundofskillsandexperiencefromwhichtodraw,aremorelikelytomaketheirdeci
sionsusing:

a. Intuition.

b. Asetofrules.

c. Articlesinjournals.

d. Advicefromsupervisors.

ANS:B

Novicenursesoperatefromasetofdefined,structuredrules.Theexpertpractitionerusesintuitivelinks.DIF:Cognit

iveLevel:Understanding(Comprehension)

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MSC:ClientNeeds:General

6. Expertnurseslearntoattendtoapatternofassessmentdataandactwithoutconsciouslylabelingit.Theserespons
esarereferredtoas:

a. Intuition.

b. Thenursingprocess.

c. Clinicalknowledge.

d. Diagnosticreasoning.

ANS:A

Intuitionischaracterizedbypatternrecognitionexpertnurseslearntoattendtoapatternofassessmentdataandactwithou
tconsciouslylabelingit.Theotheroptionsarenotcorrect.

DIF:CognitiveLevel:Understanding(Comprehension)MS

C:ClientNeeds:General

7. Thenurseisreviewinginformationaboutevidence-basedpractice(EBP).WhichstatementbestreflectsEBP?

a. EBPreliesontraditionforsupportNoUfR
bSesIN
tpGrT
acBt.iC
ceOsM
.

b. EBPissimplytheuseofbestpracticetechniquesforthetreatmentofpatients.

c. EBPemphasizestheuseofbestevidencewiththecliniciansexperience.

d. ThepatientsownpreferencesarenotimportantwithEBP.AN

S:C

EBPisasystematicapproachtopracticethatemphasizestheuseofbestevidenceincombinationwiththeclinicians
experience, as well as patient preferences and values, when making decisions about care andtreatment. EBP is
more than simply using the best practice techniques to treat patients, and
questioningtraditionisimportantwhennocompellingandsupportiveresearchevidenceexists.

DIF:CognitiveLevel:Applying(Application)

MSC:ClientNeeds:SafeandEffectiveCareEnvironment:ManagementofCare

8. Thenurseisconductingaclassonprioritysettingforagroupofnewgraduatenurses.Whichisanexampleofafirst-
levelpriorityproblem?

a. Patientwithpostoperativepain

b. Newlydiagnosedpatientwithdiabeteswhoneedsdiabeticteaching

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c. Individualwithasmalllacerationonthesoleofthefoot

d. IndividualwithshortnessofbreathandrespiratorydistressA

NS:D

First-
levelpriorityproblemsarethosethatareemergent,lifethreatening,andimmediate(e.g.,establishinganairway,supporti
ngbreathing,maintainingcirculation,monitoringabnormalvitalsigns).

DIF:CognitiveLevel:Understanding(Comprehension)

MSC:ClientNeeds:SafeandEffectiveCareEnvironment:ManagementofCare

9. Whenconsideringprioritysettingofproblems,thenursekeepsinmindthatsecond-
levelpriorityproblemsincludewhichoftheseaspects?

a. Lowself-esteem

b. Lackofknowledge

c. Abnormallaboratoryvalues

d. Severelyabnormalvitalsigns

ANS:C NURSINGTB.COM

Second-
levelpriorityproblemsarethosethatrequirepromptinterventiontoforestallfurtherdeterioration(e.g.,mentalstatuscha
nge,acutepain,abnormallaboratoryvalues,riskstosafetyorsecurity).

DIF:CognitiveLevel:Understanding(Comprehension)

MSC:ClientNeeds:SafeandEffectiveCareEnvironment:ManagementofCare

10. Whichcriticalthinkingskillhelpsthenurseseerelationshipsamongthedata?

a. Validation

b. Clusteringrelatedcues

c. Identifyinggapsindata

d. DistinguishingrelevantfromirrelevantA

NS:B

Clusteringrelatedcueshelpsthenurseseerelationshipsamongthedata.DIF:Cog

nitiveLevel:Understanding(Comprehension)

MSC:ClientNeeds:SafeandEffectiveCareEnvironment:ManagementofCare

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11. Thenurseknowsthatdevelopingappropriatenursinginterventionsforapatientreliesontheappro
priatenessofthe diagnosis.

a. Nursing

b. Medical

c. Admission

d. Collaborative

ANS:A

Anaccuratenursingdiagnosisprovidesthebasisfortheselectionofnursinginterventionstoachieveoutcomesforwhic
hthenurseisaccountable.Theotheritemsdonotcontributetothedevelopmentofappropriatenursinginterventions.

DIF:CognitiveLevel:Understanding(Comprehension)

MSC:ClientNeeds:SafeandEffectiveCareEnvironment:ManagementofCare

12. Thenursingprocessisasequentialmethodofproblemsolvingthatnursesuseandincludeswhichsteps?

a. Assessment,treatment,planning,evaluation,discharge,andfollow-up

NURSINGTB.COM
b. Admission,assessment,diagnosis,treatment,anddischargeplanning

c. Admission,diagnosis,treatment,evaluation,anddischargeplanning

d. Assessment,diagnosis,outcomeidentification,planning,implementation,andevaluationANS:

Thenursingprocessisamethodofproblemsolvingthatincludesassessment,diagnosis,outcomeidentification,plan
ning,implementation,andevaluation.

DIF:CognitiveLevel:Understanding(Comprehension)

MSC:ClientNeeds:SafeandEffectiveCareEnvironment:ManagementofCare

13. Anewlyadmittedpatientisinacutepain,hasnotbeensleepingwelllately,andishavingdifficultybreathin
g.Howshouldthenurseprioritizetheseproblems?

a. Breathing,pain,andsleep

b. Breathing,sleep,andpain

c. Sleep,breathing,andpain

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d. Sleep,pain,andbreathing

ANS:A

First-
levelpriorityproblemsareimmediatepriorities,rememberingtheABCs(airway,breathing,andcirculation),followed
bysecond-levelproblems,andthenthird-levelproblems.

DIF:CognitiveLevel:Analyzing(Analysis)

MSC:ClientNeeds:SafeandEffectiveCareEnvironment:ManagementofCare

14. Whichofthesewouldbeformulatedbyanurseusingdiagnosticreasoning?

a. Nursingdiagnosis

b. Medicaldiagnosis

c. Diagnostichypothesis

d. Diagnosticassessment

ANS:C

Diagnosticreasoningcallsforthenursetoformulateadiagnostichypothesis;thenursingprocesscallsforanursingdiagn
osis.
NURSINGTB.COM
DIF:CognitiveLevel:Understanding(Comprehension)MS

C:ClientNeeds:General

15. BarrierstoincorporatingEBPinclude:

a. Nurseslackofresearchskillsinevaluatingthequalityofresearchstudies.

b. Lackofsignificantresearchstudies.

c. Insufficientclinicalskillsofnurses.

d. Inadequatephysicalassessmentskills.

ANS:A

Asindividuals,nurseslackresearchskillsinevaluatingthequalityofresearchstudies,areisolatedfromothercolleagues
whoareknowledgeableinresearch,andoftenlackthetimetovisitthelibrarytoreadresearch.Theotherresponsesarenot
consideredbarriers.

DIF:CognitiveLevel:Understanding(Comprehension)MS

C:ClientNeeds:General

16. Whatstepofthenursingprocessincludesdatacollectionbyhealthhistory,physicalexamination,andintervi
ew?

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a. Planning

b. Diagnosis

c. Evaluation

d. Assessment

ANS:D

Datacollection,includingperformingthehealthhistory,physicalexamination,andinterview,istheassessmenstepofth
enursingprocess.

DIF:CognitiveLevel:Remembering(Knowledge)MSC:Cli

entNeeds:General

17. During a staff meeting, nurses discuss the problems with accessing research studies to
incorporateevidence-
basedclinicaldecisionmakingintotheirpractice.Whichsuggestionbythenursemanagerwouldbesthelpthesepr
oblems?

a. Formacommitteetoconductresearchstudies.

b. PostpublishedresearchstudiesonNthUeRuSnIN
itsGbTuBll.eCtO
inMboards.

c. Encouragethenursestovisitthelibrarytoreviewstudies.

d. Teachthenurseshowtoconductelectronicsearchesforresearchstudies.

ANS:D

Facilitating support for EBP would include teaching the nurses how to conduct electronic searches; time
tovisitthelibrarymaynotbeavailableformanynurses.Actuallyconductingresearchstudiesmaybehelpfulinthelon
g-runbutnotanimmediatesolutiontoreviewingexistingresearch.

DIF:CognitiveLevel:Applying(Application)

MSC:ClientNeeds:SafeandEffectiveCareEnvironment:ManagementofCare

18. Whenreviewingtheconceptsofhealth,thenurserecallsthatthecomponentsofholistichealthincludewhicho
fthese?

a. Diseaseoriginatesfromtheexternalenvironment.

b. Theindividualhumanisaclosedsystem.

c. Nursesareresponsibleforapatientshealthstate.

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d. Holistichealthviewsthemind,body,andspiritasinterdependent.

ANS:D

Considerationofthewholepersonistheessenceofholistichealth,whichviewsthemind,body,andspiritas interdepende
nt.Thebasisofdiseaseoriginatesfromboththeexternalenvironmentandfromwithintheperson.Boththeindividualhu
manandtheexternalenvironmentareopensystems,continuallychangingandadapting,andeachpersonisresponsiblef
orhisorherownpersonalhealthstate.

DIF:CognitiveLevel:Understanding(Comprehension)

MSC:ClientNeeds:SafeandEffectiveCareEnvironment:ManagementofCare

19. Thenurserecognizesthattheconceptofpreventionindescribinghealthisessentialbecause:

a. Diseasecanbepreventedbytreatingtheexternalenvironment.

b. ThemajorityofdeathsamongAmericansunderage65yearsarenotpreventable.

c. Preventionplacestheemphasisonthelinkbetweenhealthandpersonalbehavior.

d. Themeanstopreventionisthroughtreatmentprovidedbyprimaryhealthcarepractitioners.

ANS:C

AnaturalprogressiontopreventionroundsouN
tU
thR
e SpIrNesGeTnB
tc.CoO
ncMeptofhealth.Guidelinestopreventionplace
theemphasisonthelinkbetweenhealthandpersonalbehavior.

DIF:CognitiveLevel:Understanding(Comprehension)MS

C:ClientNeeds:General

20. Thenurseisperformingaphysicalassessmentonanewlyadmittedpatient.Anexampleofobjectiveinform
ationobtainedduringthephysicalassessmentincludesthe:

a. Patientshistoryofallergies.

b. Patientsuseofmedicationsathome.

c. Lastmenstrualperiod1monthago.

d. 25cmscarontherightlowerforearm.

ANS:D

Objectivedataarethepatientsrecord,laboratorystudies,andconditionthatthehealthprofessionalobservesbyinspecti
ng,percussing,palpating,andauscultatingduringthephysicalexamination.Theotherresponsesreflectsubjectivedat
a.

DIF:CognitiveLevel:Applying(Application)

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MSC:ClientNeeds:SafeandEffectiveCareEnvironment:ManagementofCare

21. Avisitingnurseismakinganinitialhomevisitforapatientwhohasmanychronicmedicalproblems.Whicht
ypeofdatabaseismostappropriatetocollectinthissetting?

a. Afollow-updatabasetoevaluatechangesatappropriateintervals

b. Anepisodicdatabasebecauseofthecontinuing,complexmedicalproblemsofthispatient

c. Acompletehealthdatabasebecauseofthenursesprimaryresponsibilityformonitoringthepatien
tshealth

d. Anemergencydatabasebecauseoftheneedtocollectinformationandmakeaccuratediagnosesrapidly

ANS:C

Thecompletedatabaseiscollectedinaprimarycaresetting,suchasapediatricorfamilypracticeclinic, independentor
groupprivatepractice,collegehealthservice,womenshealthcareagency,visitingnurseagency,orcommunityhealt
hagency.Inthesesettings,thenurseisthefirsthealthprofessionaltoseethepatientandhastheprimaryresponsibilityf
ormonitoringthepersonshealthcare.

DIF:CognitiveLevel:Applying(Application)

MSC:ClientNeeds:SafeandEffectiveCareEnvironment:ManagementofCare

22. WhichsituationismostappropriateduringNw
UhRiScIhNtG
heTB
nu.CrsOeMperformsafocusedorproblem-centered
history?

a. Patientisadmittedtoalong-termcarefacility.

b. Patienthasasuddenandsevereshortnessofbreath.

c. Patientisadmittedtothehospitalforsurgerythefollowingday.

d. Patientinanoutpatientclinichascoldandinfluenza-likesymptoms.

ANS:D

Inafocusedorproblem-
centereddatabase,thenursecollectsaminidatabase,whichissmallerinscopethanthecompleteddatabase.Thismini
databaseprimarilyconcernsoneproblem,onecuecomplex,oronebodysystem.

DIF:CognitiveLevel:Applying(Application)

MSC:ClientNeeds:SafeandEffectiveCareEnvironment:ManagementofCare

23. Apatientisattheclinictohaveherbloodpressurechecked.Shehasbeencomingtotheclinicweeklysinceshec
hangedmedications2monthsago.Thenurseshould:

a. Collectafollow-updatabaseandthencheckherbloodpressure.

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b. Askhertoreadherhealthrecordandindicateanychangessinceherlastvisit.

c. Checkonlyherbloodpressurebecausehercompletehealthhistorywasdocumented2monthsago.

d. Obtainacompletehealthhistorybeforecheckingherbloodpressurebecausemuchofherhistoryinform
ationmayhavechanged.

ANS:A

Afollow-updatabaseisusedinallsettingstofollowupshort-
termorchronichealthproblems.Theotherresponsesarenotappropriateforthesituation.

DIF:CognitiveLevel:Applying(Application)

MSC:ClientNeeds:SafeandEffectiveCareEnvironment:ManagementofCare

24. Apatientisbroughtbyambulancetotheemergencydepartmentwithmultipletraumasreceivedinanautomo
bileaccident.Heisalertandcooperative,buthisinjuriesarequitesevere.Howwouldthenurseproceedwithdata
collection?

a. Collecthistoryinformationfirst,thenperformthephysicalexaminationandinstitutelife-
savingmeasures.

b. Simultaneouslyaskhistoryquestionswhileperformingtheexaminationandinitiatinglife-
savingmeasures.
NURSINGTB.COM

c. Collectallinformationonthehistoryform,includingsocialsupportpatterns,strengths,andcopingpatter
ns.

d. Performlife-
savingmeasuresanddelayaskinganyhistoryquestionsuntilthepatientistransferredtotheintensivecare
unit.

ANS:B

Theemergencydatabasecallsforarapidcollectionofthedatabase,oftenconcurrentlycompiledwithlife-
savingmeasures.Theotherresponsesarenotappropriateforthesituation.

DIF:CognitiveLevel:Analyzing(Analysis)

MSC:ClientNeeds:SafeandEffectiveCareEnvironment:ManagementofCare

25. A42-year-
oldpatientofAsiandescentisbeingseenattheclinicforaninitialexamination.Thenurseknowsthatincludingcu
lturalinformationinhishealthassessmentisimportantto:

a. Identifythecauseofhisillness.

b. Makeaccuratediseasediagnoses.

c. Provideculturalhealthrightsfortheindividual.

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d. Provideculturallysensitiveandappropriatecare.

ANS:D

Theinclusionofculturalconsiderationsinthehealthassessmentisofparamountimportancetogatheringdatathatareacc
urateandmeaningfulandtointerveningwithculturallysensitiveandappropriatecare.

DIF:CognitiveLevel:Understanding(Comprehension)MS

C:ClientNeeds:PsychosocialIntegrity

26. Inthehealthpromotionmodel,thefocusofthehealthprofessionalincludes:

a. Changingthepatientsperceptionsofdisease.

b. Identifyingbiomedicalmodelinterventions.

c. Identifyingnegativehealthactsoftheconsumer.

d. Helpingtheconsumerchooseahealthierlifestyle.

ANS:D

Inthehealthpromotionmodel,thefocusofthehealthprofessionalisonhelpingtheconsumerchooseahealthierlifesty
le.
NURSINGTB.COM
DIF: Cognitive Level: Remembering

(Knowledge)MSC:ClientNeeds:HealthPromotionandMain

tenance

27. Thenursehasimplementedseveralplannedinterventionstoaddressthenursingdiagnosisofacutepain.Which
wouldbethenextappropriateaction?

a. Establishpriorities.

b. Identifyexpectedoutcomes.

c. Evaluatetheindividualscondition,andcompareactualoutcomeswithexpectedoutcomes.

d. Interpretdata,andthenidentifyclustersofcuesandmakeinferences.

ANS:C

Evaluationisthenextstepaftertheimplementationphaseofthenursingprocess.Duringthisstep,thenurseevaluatesthei
ndividualsconditionandcomparestheactualoutcomeswithexpectedoutcomes.

DIF:CognitiveLevel:Applying(Application)

MSC:ClientNeeds:SafeandEffectiveCareEnvironment:ManagementofCare

28. Whichstatementbestdescribesaproficientnurse?Aproficientnurseisonewho:

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a. Haslittleexperiencewithaspecifiedpopulationandusesrulestoguideperformance.

b. Hasanintuitivegraspofaclinicalsituationandquicklyidentifiestheaccuratesolution.

c. Seesactionsinthecontextofdailyplansforpatients.

d. Understandsapatientsituationasawholeratherthanalistoftasksandrecognizesthelong-
termgoalsforthepatient.

ANS:D

The proficient nurse, with more time and experience than the novice nurse, is able to understand a
patientsituationasawholeratherthanasalistoftasks.Theproficientnurseisabletoseehowtodaysnursingactionscanap
plytothepointthenursewantsthepatienttoreachatafuturetime.

DIF:CognitiveLevel:Applying(Application)MSC:Cli

entNeeds:General

MULTIPLERESPONSE

1.Thenurseisreviewingdatacollectedafteranassessment.Ofthedatalistedbelow,whichwouldbeconsideredrelate
dcuesthatwouldbeclusteredtogetherduringdataanalysis?Selectallthatapply.

a. Inspiratorywheezesnotedinleftlowerlobes
NURSINGTB.COM

b. Hypoactivebowelsounds

c. Nonproductivecough

d. Edema,+2,notedonlefthand

e. Patientreportsdyspneauponexertion

f. Rateofrespirations16breathsperminuteA

NS:A,C,E,F

Clusteringrelatedcueshelpthenurserecognizerelationshipsamongthedata.Thecuesrelatedtothepatientsrespiratory
status(e.g.,wheezes,cough,reportofdyspnea,respirationrateandrhythm)areallrelated.Cuesrelatedtobowelsandper
ipheraledemaarenotrelatedtotherespiratorycues.

DIF:CognitiveLevel:Analyzing(Analysis)

MSC:ClientNeeds:SafeandEffectiveCareEnvironment:ManagementofCare

MATCHING

Putthefollowingpatientsituationsinorderaccordingtothelevelofpriority.

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a. Apatientnewlydiagnosedwithtype2diabetesmellitusdoesnotknowhowtocheckhisownbloodgl
ucoselevelswithaglucometer.

b. Ateenagerwhowasstungbyabeeduringasoccermatchishavingtroublebreathing.

c. Anolderadultwithaurinarytractinfectionisalsoshowingsignsofconfusionandagitation.

1. a=First-levelpriorityproblem

2. b=Second-levelpriorityproblem

3. c=Third-levelpriorityproblem

1. ANS:BDIF:CognitiveLevel:Analyzing(Analysis)

MSC:ClientNeeds:SafeandEffectiveCareEnvironment:ManagementofCare

NOT: First-level priority problems are immediate priorities, such as trouble breathing (remember the
airway,breathing, circulation priorities). Second-level priority problems are next in urgency, but not life-
threatening.Third-
levelpriorities(e.g.,patienteducation)areimportanttoapatientshealthbutcanbeaddressedaftermoreurgenthealthpr
oblemsareaddressed.

2. ANS:CDIF:CognitiveLevel:Analyzing(Analysis)

MSC:ClientNeeds:SafeandEffectiveCareEnvironment:ManagementofCare

NOT:First-
levelpriorityproblemsareimmediatepriorities,suchastroublebreathing(remembertheairway,breathing,circulationp
riorities).Second-levelpriorityproblemsarenextinurgency,butnotlife-threatening.
Third-levelpriorities(e.g.,patienteducation)N
arU
eRim
SIpNoG
rtT
anBt.C
toOaMpatientshealthbutcanbeaddressedaftermore
urgenthealthproblemsareaddressed.

3. ANS:ADIF:CognitiveLevel:Analyzing(Analysis)

MSC:ClientNeeds:SafeandEffectiveCareEnvironment:ManagementofCare

NOT: First-level priority problems are immediate priorities, such as trouble breathing (remember the
airway,breathing, circulation priorities). Second-level priority problems are next in urgency, but not life-
threatening.Third-
levelpriorities(e.g.,patienteducation)areimportanttoapatientshealthbutcanbeaddressedaftermoreurgenthealthpr
oblemsareaddressed.

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