Matelyn Oarga

BSN- 3rd yr

QUIZ 1

Health History and Physical Examination

1. During the day, while being admitted to the nursing unit from the emergency department, a patient tells the nurse
that she is short of breath and has pain in her chest when she breathes. Her respiratory rate is 28, and she is coughing
up yellow sputum. Her skin is hot and moist, and her temperature is 102.2° F (39° C). The laboratory results show
white blood cell count elevation and the sputum result is pending. The patient says that coughing makes her head
hurt, and she aches all over. Identify the subjective and objective assessment findings for this patient.

Answers:

Subjective: Short of breath, pain in chest upon breathing, coughing makes head hurt, aches all over

Objective: Respiratory rate of 28 bpm, coughing yellow sputum, skin hot and moist, temperature 102.2°F (39°C)

2. Priority Decision: For the patient described in Question 1, the data will lead the night shift nurse to complete a
focused nursing assessment of which body part(s)?
a. Abdomen
b. Arms and legs
c. Head and neck
d. Anterior and posterior chest

3. Give an example of a sensitive way to ask a patient each of the following questions.
a. Is the patient on antihypertensive medication having a side effect of impotence?
b. Has the patient with a history of alcoholism had recent alcohol intake?
c. Who are the sexual contacts of a patient with gonorrhea?
d. Does the patient skip taking medications because they cost too much?

Answers:
a. “Many patients taking drugs for hypertension have problems with sexual function. Have you experienced any
problems?”
b. “Alcohol may interact dangerously with drugs you receive or it may cause withdrawal problems in the hospital. Can you
describe your recent alcohol intake?”
c. “It is important to contact and treat others who might have the same infection you do. Would you tell me with whom
you have been sexually intimate in the last 6 weeks?”
d. “Today medications are so expensive that some people must choose between eating and taking their medications. Are
you able to get and take all of the medications prescribed for you?”

4. Priority Decision: The nurse prepares to interview a patient for a nursing history but finds the patient in obvious
pain. Which action by the nurse is the best at this time?
a. Delay the interview until the patient is free of pain.
b. Administer pain medication before initiating the interview.
c. Gather as much information as quickly as possible by using closed-ended questions that require brief answers.
d. Ask only those questions pertinent to the specific problem and complete the interview when the patient is
more comfortable.

5. Priority Decision: While the nurse is obtaining a health history, the patient tells the nurse, “I am so tired, I
Brgy. Paciano Rizal, Calamba City, Laguna, 4027 Philippines  Tel. No.: (049) 834-1159
www.perpetualdalta.edu.ph
Calamba Campus
 can hardly function.” What is the nurse's best action at this time?
a. Stop the interview and leave the patient alone to be able to rest.
b. Arrange another time with the patient to complete the interview.
c. Question the patient further about the characteristics of the symptoms.
d. Reassure the patient that the symptoms will improve when treatment has had time to be effective.

6. Rewrite each of the following questions asked by the nurse so that it is an open-ended question designed to
gather information about the patient's functional health patterns.
a. Are you having any pain?
b. Do you have a good relationship with your spouse?
c. How long have you been ill?
d. Do you exercise regularly?

Answer:
a. “Can you tell me how are you feeling?”
b. “Describe your relationship with your spouse.”
c. “Can you describe your experience with this illness?”
d. “What is your usual activity during the day?”

7. A patient has come to the health clinic and reports having diarrhea for 3 days. He says the stools occur five or six
times per day and are very watery. Every time he eats or drinks something, he has an urgent diarrhea stool. He denies
being out of the country but did attend a large family reunion held at a campground in the mountains about a week
ago. Identify the areas of symptom investigation using PQRST that still must be addressed to provide additional
important information (select all that apply).
a. Timing
b. Quality
c. Severity
d. Palliative
e. Radiation
f. Precipitating factors

Brgy. Paciano Rizal, Calamba City, Laguna, 4027 Philippines  Tel. No.: (049) 834-1159
www.perpetualdalta.edu.ph
Calamba Campus
8. The following data are obtained from a patient during a nursing history. Organize these data according to Gordon's
functional health patterns. Patterns may be used more than once, and some data may apply to more than one pattern.

1 a. 78-yr-old woman
10 b. Married, three grown children who all live out of town
10 c. Cares for invalid husband in home with help of daily homemaker
8 d. Vision corrected with glasses; hearing normal
4 e. Height 5 ft, 8 in; weight 170 lb
4,6 f. Considers herself a stress eater; eats when stressed
2,3 g. 5-year history of adult-onset asthma; smokes two or three cigarettes a day
6 h. Coughing, wheezing, with stated shortness of breath
6 i. Moderate light-yellow sputum
6 j. Says she now has no energy to care for husband
7 k. Awakens three or four times per night and has to use a bronchodilator inhaler
5 l. Uses a laxative twice a week for bowel function; no urinary problems
3,9 m. Feels her health is good for her age
2 n. Allergic to codeine and aspirin
4 o. Has esophageal reflux and eats bland foods
12 p. Can usually handle the stress of caring for her husband but if she becomes
overwhelmed, asthma worsens
11 q. Has been menopausal for 26 years; no sexual activity
2 r. Takes medications for asthma, hypertension, and hypothyroidism and uses diazepam (Valium)
PRN for anxiety
10 s. Goes out to lunch with friend’s weekly
13 t. Says she misses going to church with her husband but watches religious services with him on TV

1. Demographic data
2. Important health information
3. Health-perception/health-management pattern
4. Nutrition-metabolic pattern
5. Elimination pattern
6. Activity-exercise pattern
7. Sleep-rest pattern
8. Cognitive-perceptual pattern
9. Self-perception/self-concept pattern
10. Role-relationship pattern
11. Sexuality-reproductive pattern
12. Coping–stress tolerance pattern
13. Value-belief pattern

9. What is an example of a pertinent negative finding during a physical examination?

10. Match the following data with the assessment technique used to obtain the information.
a. Normal blood flow through arteries = 2
b. Abnormal blood flow in carotid artery =4
c. Tympany of the abdomen =3
d. Pitting edema =2
e. Cyanosis of the lips =1
f. Hyperactive peristalsis =4
g. Bruising of the lateral left thigh =1
h. Cool, clammy skin =2
1. Inspection =E, G
2. Palpation = A, D, H
3. Percussion = C
4. Auscultation = B, F

11. What is the correct sequence of examination techniques that should be used when assessing the
patient's abdomen?
a. Inspection, palpation, auscultation, percussion
b. Palpation, percussion, auscultation, inspection
c. Auscultation, inspection, percussion, palpation
d. Inspection, auscultation, percussion, palpation

12. When performing a physical examination, what approach is most important for the nurse to use?
a. A head-to-toe approach to avoid missing an important area
b. The same systematic, efficient sequence for all examinations
c. A sequence that is least revealing and embarrassing for the patient
d. An approach that allows time to collect the nursing history data while performing the examination

13. The nurse is performing a physical examination on a 90-yr-old male patient who has been bedridden for the past
year. Which adaptations for performing the examination would be appropriate for the patient (select all that
apply)?
a. Make sure that a family member is with him.
b. Handle the skin with care because of potential fragility.
c. Keep the patient warm and comfortable during the assessment.
d. Allow the patient to watch TV to distract him from any painful assessments.
e. Place the patient in a position of comfort and avoid unnecessary changes in position.

14. In what patient situations would a comprehensive assessment be performed (select all that apply)? a. Complaints
of chest pain
b. On initial admission to the telemetry unit
c. On initial evaluation by the home health nurse
d. Found lying on the floor, unresponsive, with moist skin
e. On arrival in the surgery holding area of the operating room

15. Which assessment tools can be used to assess the cardiac system (select all that apply)?
a. Watch
b. Stethoscope
c. Reflex hammer
d. Ophthalmoscope
e. Blood pressure cuff

16. What is the term used for assessment data that the patient tells you about?

a. Focused b. Objective c. Subjective d. Comprehensive

17. On the first encounter with the patient, the nurse will complete a general survey. Which features are included
(select all that apply)?
a. Mental state and behavior
b. Lung sounds and bowel tones
c. Body temperature and pulses
d. Speech and body movements
e. Body features and obvious physical signs
f. Abnormal heart murmur and limited mobility
Due on or before September 29, 2020

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