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NURS 6512 Midterm
Advanced Health Assessment Week 1
| Question | Answer |
|---|---|
| During an interview, you have the impression that a patient may be considering suicide. What action is essential? | He probably is. Mentioning it gives permission to talk about it. |
| A detailed description of the symptoms related to the chief complaint is presented in the: | Signs and symptoms and historical data that lead to the chief complaint are listed in history of present illness. |
| Tom is a 16-year-old diabetic who does not follow his diet. He enjoys his dirt bike and seems unconcerned about any consequences of his activities, Which factor is typical of adolescence and pertinent to Tom's health? | Risky behavior. High incidence of morbidity and mortality. Reluctant to provide info. |
| A pedigree diagram is drafted for the purpose of obtaining: | Pedigree diagram or genogram diagrams for consanguinity of health problems. |
| Which part of the information contained in the patient's record ma y be used in court? | Anything, it's a legal document. |
| The effect of the chief complaint on the patient's lifestyle is recorded in which section of the medical record? | History of present illness. |
| Mary Jane has brought in her 16-year-old son, Kyle. She states he has been sleeping more, doesn't hang around his friends, and recently his girlfriend broke up with him. Your most immediate question is to ask Kyle: | Ask directly about suicidal thoughts. |
| During an interview, tears appear in the patients eyes and his voice becomes shaky. Initially, you should: | Allow the moment to pass at patient's pace. If suppressing, give permission. |
| Constitutional symptoms in the ROS refer to: | Fever, chills, malaise, fatigability, night sweats, sleep patterns, and weight. (average, preferred, present, change) |
| Periods of silence during the interview can serve important purposes, such as: | Reflection, summoning of courage, displaying compassion. Go slower and don't push too hard/ |
| Information that is needed during the initial interview of a pregnant woman includes: | Past history, assessment of health practices, identification of potential risk factors, and assessment of knowledge as it affects pregnancy. |
| In which section of the newborn history would you find details of gestational assessment and extrauterine adjustment data? | Present problem section of the history. |
| When you enter the examination room of a 3-year-old girl, you find her sitting on her father's lap. She turns away from you when you greet her. Initially, you best response is to: | Modify interaction according to age in a manner that promotes trust. |
| Regardless of the orifice, discharge is described by noting: | Color and consistency, and if it's an expected finding. |
| Mr. D complains of a headache. During the history, he mentions his use of alcohol and illicit drugs. This information would most likely belong in the: | Personal and social history. |
| When communicating with older children and teenagers, you should be sensitive to their: | Communicate respect for their confidentiality. |
| When questioning a patient regarding alcohol intake, she tells you that she is only a social drinker. Which initial response is appropriate? | Clarify the patient's own term without asking a leading question or being judgmental. |
| Information recorded about an infant differs from that of an adult, mainly because of the infant's: | The infant's current and future health are referenced in therms of developmental status. |
| When taking a history, you should: | Proceed in a chronological and sequential framework. |
| Drawing of stick figures is most useful to: | Findings in extremities. |
| When you suspect that your 81-year-old patient has short-term memory loss because he cannot remember what he had for breakfast, you should: | Consult family members to clarify discrepancies or to fill in the gaps. |
| Allergies to drugs and foods are generally listed in which section of the medical record? | Past medical history. |
| A survey of mobility and ADL's is part of a: | Functional assessment. |
| A 50-year-old man comes to the primary care clinic. He tells you he is worries because he has had severe chest pains for the past 2 weeks. Which initial history interview question is most appropriate? | An open-ended question. |
| Differential diagnoses belong in the: | Assessment category for each problem. The differentials are prioritized and contributing factors are identified. |
| Which technique is most likely to result in the patient's understanding of questions? | Be clear and explicit while using the patient's idiom and level of understanding. |
| The quality of a symptom, such as pain, is subjective information that should be: | Recorded in the history. |
| To what extent should the patient with a physical disability or emotional disorder be involved in providing health history information to the health professional? | They must be respected and history obtained from them to the extent possible. Family may help. |
| Objective data are usually recorded: | By body systems and anatomic locations. |
| An example of a complementary care modality is: | Acupuncture, aromatherapy, therapeutic touch, and herbal medications. |
| J.M. has been seen in your clinic for 5 years. She presents today with signs and symptoms of acute sinusitis. The type of history that is warranted is a(n) __________ history. | Focused history. |
| When recording assessments during the construction of the problem-oriented medical record, the examiner should: | List of problems constructed, then an assessment for each unique problem. |
| Which action would best promote accurate translations as well as confidentiality when the caregiver does not speak the patient's language? | Stranger as an interpreter. |
| The duties of care providers established by tradition, and within the context of culture, are known as: | Deontologic imperatives. |
| A patient becomes restless during the history and says, I don't have time for all of this conversation. I've got to get back to work. Your most appropriate response would be to: | Acknowledge his anger and proceed with the history and examination. |
| Which of the following is not a characteristic of the plan portion of the problem-oriented medical record? | Differential diagnosis is part of the assessment phase. |
| What is an example of a problem requiring recording on the patient's problem list? | Problems needing further evaluation. |
| A SOAP note is used in which type of recording system? | S-subjective, O-objective, A-assessment, P-plan, is a type of recording system that has a problem oriented style. |
| After you ask a patient about her family history, she says, "Tell me about your family now." Which response is generally most appropriate? | Give a brief undetailed answer. |
| Ms. A states, "My life is just too painful. It isn't worth is." She appears depressed. Which is the best response? | Specific, yet open-ended questions. |
| During a history-taking session, Mr. B appears to be avoiding certain questions. He keeps looking out the window. What should the caregiver do? | Do not push too hard, all information may not happen in one interview. |
| To prevent personal appearance from becoming an obstacle in patient care, the health professional should: | Sensible personal habits, avoidance of extremes in behavior and dress, uniforms identify roles rather than relationships. |
| Mrs. G reports an increase in her alcohol intake over the past 5 years. To screen her for problem drinking, you would use the: | CAGE questionnaire. |
| Direct questioning about domestic violence in the home should be: | Direct and routinely queried. |
| If information is purposefully omitted from the record, you should: | Document omitted and rationale. |
| When are open-ended questions generally most useful? | At the beginning of an interview. |
| During the course of the interview you should: | Maintain eye contact, spend as little time as possible looking at your notes. |
| When interviewing older adults, the examiner should: | Position self so older patient can see face. |
| Your patient returns for a blood pressure check 2 weeks after a visit during which you performed a complete history and physical. This visit would be documented by creating a(n): | Progress note. |
| The patient's perceived disabilities and functional limitations are recorded in the: | Past medical history. |
| A guideline for history taking is for caregivers to: | Maintain eye contact, observe body language, proceed from open-ended to direct questions. |
| Pain is difficult to assess in older adults because: | They lose pain perception and experience pain in a different manner form other age groups. |
| Subjective and symptomatic data are: | Not part of the physical examination findings. Documented in history portion. |
| Which questions would be considered a leading question? | "You don't get headaches often, do you?" |
| In issues surrounding ethical decision making, beneficence refers to the: | Refers to ones duty to benefit or promote the good of others. |
| Behaviors that diffuse anxiety during the interview include: | Answer patient questions forthrightly, avoid overload of information, don't hurry conversation. |
| When questioning the patient regarding his or her sexual history, which questions should be asked initially? | Do you have any worries or concerns regarding your sex life? |
| A 36-year-old woman complains that she has had crushing chest pain for the past 2 days. She seems nervous as she speaks to you. An appropriate response is to: | Don't hurry and remain calm. |
| Ms. T is crying and states that her mother couldn't possibly have a tumor. No one else in the family, exclaims the daughter, has ever had cancer! The most appropriate response to Ms. T would be: | Why do you think your mother's tumor is cancer? |
| A problem may be defined as anything that will require: | Further evaluation or attention. |
Created by:
tisab1971