Bates' Guide: Nursing Applications & Testbank - Critical Thinking for Safe Care, Exams of Nursing

Download Bates' Guide: Nursing Applications & Testbank - Critical Thinking for Safe Care and more Exams Nursing in PDF only on Docsity! FNP 509 Bates’ Guide To Physical Examination and History Taking TESTBANK, Download to score Bates’ Guide To Physical Examination and History Taking 13th Edition Test Bank CHAPTER 1 Foundations for Clinical Proficiency MULTIPLE CHOICE  After completing an initial assessment of a patient, the nurse has charted that his respirations are eupneic and his pulse is 58 beats per minute. These types of data would be: a . Objective. b . Reflective. c . Subjective. d . Introspective. ANS: A FNP 509 Bates’ Guide To Physical Examination and History Taking 13th Edition Bickley TESTBANK FNP 509 Bates’ Guide To Physical Examination and History Taking TESTBANK, Download to score Objective data are what the health professional observes by inspecting, percussing, palpating, and auscultating during the physical examination. Subjective data is what the person says about him or herself during history taking. The terms reflective and introspective are not used to describe data. DIF: Cognitive Level: Understanding (Comprehension) REF: p. 2 MSC: Client Needs: Safe and Effective Care Environment: Management of Care  A patient tells the nurse that he is very nervous, is nauseated, and feels hot. These types of data would be: a . Objective. b . Reflective. c . Subjective. d . Introspective. FNP 509 Bates’ Guide To Physical Examination and History Taking 13th Edition Bickley TESTBANK FNP 509 Bates’ Guide To Physical Examination and History Taking TESTBANK, Download to score DIF: Cognitive Level: Remembering (Knowledge) REF: p. 2 MSC: Client Needs: Safe and Effective Care Environment: Management of Care  When listening to a patients breath sounds, the nurse is unsure of a sound that is heard. The nurses next action should be to: a . Immediately notify the patients physician. b . Document the sound exactly as it was heard. c . Validate the data by asking a coworker to listen to the breath sounds. d . Assess again in 20 minutes to note whether the sound is still present. ANS: C When unsure of a sound heard while listening to a patients breath sounds, the nurse validates the data to ensure accuracy. If the nurse has less experience in an area, then he or she asks an expert to listen. FNP 509 Bates’ Guide To Physical Examination and History Taking 13th Edition Bickley TESTBANK FNP 509 Bates’ Guide To Physical Examination and History Taking TESTBANK, Download to score DIF: Cognitive Level: Analyzing (Analysis) REF: p. 2 MSC: Client Needs: Safe and Effective Care Environment: Management of Care FNP 509 Bates’ Guide To Physical Examination and History Taking 13th Edition Bickley TESTBANK FNP 509 Bates’ Guide To Physical Examination and History Taking TESTBANK, Download to score  Which critical thinking skill helps the nurse see relationships among the data? a . Validation b . Clustering related cues c . Identifying gaps in data d . Distinguishing relevant from irrelevant ANS: B Clustering related cues helps the nurse see relationships among the data. DIF: Cognitive Level: Understanding (Comprehension) REF: p. 2 MSC: Client Needs: Safe and Effective Care Environment: Management of Care  The nurse knows that developing appropriate nursing interventions for a patient relies on the appropriateness of the diagnosis. FNP 509 Bates’ Guide To Physical Examination and History Taking 13th Edition Bickley TESTBANK FNP 509 Bates’ Guide To Physical Examination and History Taking TESTBANK, Download to score planning . c Admission, diagnosis, treatment, evaluation, and discharge planning . d Assessment, diagnosis, outcome identification, planning, implementation, and . evaluation ANS: D The nursing process is a method of problem solving that includes assessment, diagnosis, outcome identification, planning, implementation, and evaluation. DIF: Cognitive Level: Understanding (Comprehension) REF: p. 3 MSC: Client Needs: Safe and Effective Care Environment: Management of Care  A newly admitted patient is in acute pain, has not been sleeping well lately, and is having difficulty breathing. How should the nurse prioritize these problems? FNP 509 Bates’ Guide To Physical Examination and History Taking 13th Edition Bickley TESTBANK FNP 509 Bates’ Guide To Physical Examination and History Taking TESTBANK, Download to score a . Breathing, pain, and sleep b . Breathing, sleep, and pain c . Sleep, breathing, and pain FNP 509 Bates’ Guide To Physical Examination and History Taking 13th Edition Bickley TESTBANK FNP 509 Bates’ Guide To Physical Examination and History Taking TESTBANK, Download to score d Sleep, pain, and breathing . ANS: A First-level priority problems are immediate priorities, remembering the ABCs (airway, breathing, and circulation), followed by second-level problems, and then third-level problems. DIF: Cognitive Level: Analyzing (Analysis) REF: p. 4 MSC: Client Needs: Safe and Effective Care Environment: Management of Care  Which of these would be formulated by a nurse using diagnostic reasoning? a . Nursing diagnosis b . Medical diagnosis c . Diagnostic hypothesis d Diagnostic assessment FNP 509 Bates’ Guide To Physical Examination and History Taking 13th Edition Bickley TESTBANK FNP 509 Bates’ Guide To Physical Examination and History Taking TESTBANK, Download to score DIF: Cognitive Level: Understanding (Comprehension) REF: p. 6 MSC: Client Needs: General  What step of the nursing process includes data collection by health history, physical examination, and interview? a Planning . b Diagnosis . c Evaluation . d Assessment . ANS: D Data collection, including performing the health history, physical examination, and interview, is the assessment step of the nursing process (see Figure 1-2). FNP 509 Bates’ Guide To Physical Examination and History Taking 13th Edition Bickley TESTBANK FNP 509 Bates’ Guide To Physical Examination and History Taking TESTBANK, Download to score DIF: Cognitive Level: Remembering (Knowledge) REF: p. 2 MSC: Client Needs: General  During a staff meeting, nurses discuss the problems with accessing research studies to incorporate evidence-based clinical decision making into their practice. Which suggestion by the nurse manager would best help these problems? a . Form a committee to conduct research studies. b . Post published research studies on the units bulletin boards. c . Encourage the nurses to visit the library to review studies. d . Teach the nurses how to conduct electronic searches for research studies. ANS: D Facilitating support for EBP would include teaching the nurses how to conduct electronic searches; time to visit the library may not be available for many nurses. Actually conducting research studies may be helpful in the long-run but not an immediate solution to reviewing FNP 509 Bates’ Guide To Physical Examination and History Taking 13th Edition Bickley TESTBANK FNP 509 Bates’ Guide To Physical Examination and History Taking TESTBANK, Download to score existing research. DIF: Cognitive Level: Applying (Application) REF: p. 6 FNP 509 Bates’ Guide To Physical Examination and History Taking 13th Edition Bickley TESTBANK FNP 509 Bates’ Guide To Physical Examination and History Taking TESTBANK, Download to score expert practitioner uses intuitive links. DIF: Cognitive Level: Understanding (Comprehension) REF: p. 3 MSC: Client Needs: General  Expert nurses learn to attend to a pattern of assessment data and act without consciously labeling it. These responses are referred to as: a . Intuition. b . The nursing process. c . Clinical knowledge. d . Diagnostic reasoning. ANS: A Intuition is characterized by pattern recognitionexpert nurses learn to attend to a pattern of assessment data and act without consciously labeling it. The other options are not correct. FNP 509 Bates’ Guide To Physical Examination and History Taking 13th Edition Bickley TESTBANK FNP 509 Bates’ Guide To Physical Examination and History Taking TESTBANK, Download to score DIF: Cognitive Level: Understanding (Comprehension) REF: p. 4 MSC: Client Needs: General  The nurse is reviewing information about evidence-based practice (EBP). Which statement best reflects EBP? FNP 509 Bates’ Guide To Physical Examination and History Taking 13th Edition Bickley TESTBANK FNP 509 Bates’ Guide To Physical Examination and History Taking TESTBANK, Download to score a . EBP relies on tradition for support of best practices. b . EBP is simply the use of best practice techniques for the treatment of patients. c . EBP emphasizes the use of best evidence with the clinicians experience. d . The patients own preferences are not important with EBP. ANS: C EBP is a systematic approach to practice that emphasizes the use of best evidence in combination with the clinicians experience, as well as patient preferences and values, when making decisions about care and treatment. EBP is more than simply using the best practice techniques to treat patients, and questioning tradition is important when no compelling and supportive research evidence exists. DIF: Cognitive Level: Applying (Application) REF: p. 5 MSC: Client Needs: Safe and Effective Care Environment: Management of Care  The nurse is conducting a class on priority setting for a group of new FNP 509 Bates’ Guide To Physical Examination and History Taking 13th Edition Bickley TESTBANK FNP 509 Bates’ Guide To Physical Examination and History Taking TESTBANK, Download to score a . Low self-esteem b . Lack of knowledge c . Abnormal laboratory values d . Severely abnormal vital signs ANS: C Second-level priority problems are those that require prompt intervention to forestall further deterioration (e.g., mental status change, acute pain, abnormal laboratory values, risks to safety or security) (see Table 1-1). DIF: Cognitive Level: Understanding (Comprehension) REF: p. 4 MSC: Client Needs: Safe and Effective Care Environment: Management of Care  The nurse recognizes that the concept of prevention in describing health is essential because: FNP 509 Bates’ Guide To Physical Examination and History Taking 13th Edition Bickley TESTBANK FNP 509 Bates’ Guide To Physical Examination and History Taking TESTBANK, Download to score a . Disease can be prevented by treating the external environment. b . The majority of deaths among Americans under age 65 years are not preventable. c . Prevention places the emphasis on the link between health and personal behavior. d . The means to prevention is through treatment provided by primary health care practitioners. ANS: C A natural progression to prevention rounds out the present concept of health. Guidelines to prevention place the emphasis on the link between health and personal behavior. DIF: Cognitive Level: Understanding (Comprehension) REF: p. 7 MSC: Client Needs: General  The nurse is performing a physical assessment on a newly admitted patient. An example of objective information obtained during the physical assessment includes the: FNP 509 Bates’ Guide To Physical Examination and History Taking 13th Edition Bickley TESTBANK FNP 509 Bates’ Guide To Physical Examination and History Taking TESTBANK, Download to score a . Patients history of allergies. b . Patients use of medications at home. c . Last menstrual period 1 month ago. d . 2 5 cm scar on the right lower forearm. ANS: D Objective data are the patients record, laboratory studies, and condition that the health professional observes by inspecting, percussing, palpating, and auscultating during the physical examination. The other responses reflect subjective data. DIF: Cognitive Level: Applying (Application) REF: p. 2 MSC: Client Needs: Safe and Effective Care Environment: Management of Care  A visiting nurse is making an initial home visit for a patient who has many chronic medical problems. Which type of data base is most FNP 509 Bates’ Guide To Physical Examination and History Taking 13th Edition Bickley TESTBANK FNP 509 Bates’ Guide To Physical Examination and History Taking TESTBANK, Download to score a . Patient is admitted to a long-term care facility. b . Patient has a sudden and severe shortness of breath. c . Patient is admitted to the hospital for surgery the following day. d . Patient in an outpatient clinic has cold and influenza-like symptoms. ANS: D In a focused or problem-centered data base, the nurse collects a mini data base, which is smaller in scope than the completed data base. This mini data base primarily concerns one problem, one cue complex, or one body system. DIF: Cognitive Level: Applying (Application) REF: p. 7 MSC: Client Needs: Safe and Effective Care Environment: Management of Care  A patient is at the clinic to have her blood pressure checked. She has been coming to the clinic weekly since she changed medications 2 months ago. The nurse should: FNP 509 Bates’ Guide To Physical Examination and History Taking 13th Edition Bickley TESTBANK FNP 509 Bates’ Guide To Physical Examination and History Taking TESTBANK, Download to score a . Collect a follow-up data base and then check her blood pressure. b . Ask her to read her health record and indicate any changes since her last visit. c . Check only her blood pressure because her complete health history was documented 2 months ago. d . Obtain a complete health history before checking her blood pressure because much of her history information may have changed. ANS: A A follow-up data base is used in all settings to follow up short-term or chronic health problems. The other responses are not appropriate for the situation. DIF: Cognitive Level: Applying (Application) REF: p. 7 MSC: Client Needs: Safe and Effective Care Environment: Management of Care  A patient is brought by ambulance to the emergency department with multiple traumas received in an automobile accident. He is alert and cooperative, but his injuries are quite severe. How would the nurse FNP 509 Bates’ Guide To Physical Examination and History Taking 13th Edition Bickley TESTBANK FNP 509 Bates’ Guide To Physical Examination and History Taking TESTBANK, Download to score proceed with data collection? a Collect history information first, then perform the physical examination and . institute life-saving measures. FNP 509 Bates’ Guide To Physical Examination and History Taking 13th Edition Bickley TESTBANK FNP 509 Bates’ Guide To Physical Examination and History Taking TESTBANK, Download to score b . Inspection. c . Percussion. FNP 509 Bates’ Guide To Physical Examination and History Taking 13th Edition Bickley TESTBANK FNP 509 Bates’ Guide To Physical Examination and History Taking TESTBANK, Download to score d Auscultation. . ANS: B The skills requisite for the physical examination are inspection, palpation, percussion, and auscultation. The skills are performed one at a time and in this order (with the exception of the abdominal assessment, during which auscultation takes place before palpation and percussion). The assessment of each body system begins with inspection. A focused inspection takes time and yields a surprising amount of information. DIF: Cognitive Level: Remembering (Knowledge) REF: p. 115 MSC: Client Needs: Safe and Effective Care Environment: Management of Care  The nurse is preparing to perform a physical assessment. Which statement is true about the physical assessment? The inspection phase: a . Usually yields little information. b . Takes time and reveals a surprising amount of information. FNP 509 Bates’ Guide To Physical Examination and History Taking 13th Edition Bickley TESTBANK FNP 509 Bates’ Guide To Physical Examination and History Taking TESTBANK, Download to score c . May be somewhat uncomfortable for the expert practitioner. d . Requires a quick glance at the patients body systems before proceeding with palpation. ANS: B A focused inspection takes time and yields a surprising amount of information. Initially, the examiner may feel uncomfortable, staring at the person without also doing something. A focused assessment is significantly more than a quick glance. DIF: Cognitive Level: Understanding (Comprehension) REF: p. 115 MSC: Client Needs: Safe and Effective Care Environment: Management of Care  The nurse is assessing a patients skin during an office visit. What part of the hand and technique should be used to best assess the patients skin temperature? a . Fingertips; they are more sensitive to small changes in temperature. b Dorsal surface of the hand; the skin is thinner on this surface FNP 509 Bates’ Guide To Physical Examination and History Taking 13th Edition Bickley TESTBANK FNP 509 Bates’ Guide To Physical Examination and History Taking TESTBANK, Download to score . d . Auscultation ANS: A Palpation uses the sense of touch to assess the patient for these factors. Inspection involves vision; percussion assesses through the use of palpable vibrations and audible sounds; and auscultation uses the sense of hearing. DIF: Cognitive Level: Remembering (Knowledge) REF: p. 115 MSC: Client Needs: Safe and Effective Care Environment: Management of Care  The nurse is preparing to assess a patients abdomen by palpation. How should the nurse proceed? a . Palpation of reportedly tender areas are avoided because palpation in these areas may cause pain. b . Palpating a tender area is quickly performed to avoid any discomfort that the patient may experience. c The assessment begins with deep palpation, while FNP 509 Bates’ Guide To Physical Examination and History Taking 13th Edition Bickley TESTBANK FNP 509 Bates’ Guide To Physical Examination and History Taking TESTBANK, Download to score . encouraging the patient to relax and to take deep breaths. d . The assessment begins with light palpation to detect surface characteristics and to accustom the patient to being touched. FNP 509 Bates’ Guide To Physical Examination and History Taking 13th Edition Bickley TESTBANK FNP 509 Bates’ Guide To Physical Examination and History Taking TESTBANK, Download to score ANS: D Light palpation is initially performed to detect any surface characteristics and to accustom the person to being touched. Tender areas should be palpated last, not first. DIF: Cognitive Level: Applying (Application) REF: p. 115 MSC: Client Needs: Safe and Effective Care Environment: Management of Care  The nurse would use bimanual palpation technique in which situation? a . Palpating the thorax of an infant b . Palpating the kidneys and uterus c . Assessing pulsations and vibrations d . Assessing the presence of tenderness and pain ANS: B Bimanual palpation requires the use of both hands to envelop or FNP 509 Bates’ Guide To Physical Examination and History Taking 13th Edition Bickley TESTBANK FNP 509 Bates’ Guide To Physical Examination and History Taking TESTBANK, Download to score MSC: Client Needs: Safe and Effective Care Environment: Management of Care  The nurse is reviewing percussion techniques with a newly graduated nurse. Which technique, if used by the new nurse, indicates that more review is needed? a Percussing once over each area . b Quickly lifting the striking finger after each stroke . c Striking with the fingertip, not the finger pad . d Using the wrist to make the strikes, not the arm . ANS: A For percussion, the nurse should percuss two times over each location. The striking finger should be quickly lifted because a resting finger damps off vibrations. The tip of the striking finger should make contact, not the pad of the finger. The wrist must be relaxed and is used to make the strikes, not the arm. FNP 509 Bates’ Guide To Physical Examination and History Taking 13th Edition Bickley TESTBANK FNP 509 Bates’ Guide To Physical Examination and History Taking TESTBANK, Download to score DIF: Cognitive Level: Applying (Application) REF: p. 116 MSC: Client Needs: Safe and Effective Care Environment: Management of Care  When percussing over the liver of a patient, the nurse notices a dull sound. The nurse should: a Consider this a normal finding. . b Palpate this area for an underlying mass. . c Reposition the hands, and attempt to percuss in this area again. . d Consider this finding as abnormal, and refer the patient for additional treatment. . ANS: A Percussion over relatively dense organs, such as the liver or spleen, will produce a dull sound. The other responses are not correct. FNP 509 Bates’ Guide To Physical Examination and History Taking 13th Edition Bickley TESTBANK FNP 509 Bates’ Guide To Physical Examination and History Taking TESTBANK, Download to score DIF: Cognitive Level: Analyzing (Analysis) REF: p. 117 MSC: Client Needs: Safe and Effective Care Environment: Management of Care  The nurse is unable to identify any changes in sound when percussing over the abdomen of an obese patient. What should the nurse do next? FNP 509 Bates’ Guide To Physical Examination and History Taking 13th Edition Bickley TESTBANK FNP 509 Bates’ Guide To Physical Examination and History Taking TESTBANK, Download to score MSC: Client Needs: Safe and Effective Care Environment: Management of Care  A patient has suddenly developed shortness of breath and appears to be in significant respiratory distress. After calling the physician and placing the patient on oxygen, which of these actions is the best for the nurse to take when further assessing the patient? a Count the patients respirations. . FNP 509 Bates’ Guide To Physical Examination and History Taking 13th Edition Bickley TESTBANK FNP 509 Bates’ Guide To Physical Examination and History Taking TESTBANK, Download to score b . Bilaterally percuss the thorax, noting any differences in percussion tones. c . Call for a chest x-ray study, and wait for the results before beginning an assessment. d . Inspect the thorax for any new masses and bleeding associated with respirations. ANS: B Percussion is always available, portable, and offers instant feedback regarding changes in underlying tissue density, which may yield clues of the patients physical status. DIF: Cognitive Level: Analyzing (Analysis) REF: p. 115 MSC: Client Needs: Safe and Effective Care Environment: Management of Care  The nurse is teaching a class on basic assessment skills. Which of these statements is true regarding the stethoscope and its use? a Slope of the earpieces should point posteriorly (toward the occiput). FNP 509 Bates’ Guide To Physical Examination and History Taking 13th Edition Bickley TESTBANK FNP 509 Bates’ Guide To Physical Examination and History Taking TESTBANK, Download to score . b Although the stethoscope does not magnify sound, it does block out extraneous . room noise. c Fit and quality of the stethoscope are not as important as its ability to magnify . sound. d Ideal tubing length should be 22 inches to dampen the distortion of sound. . ANS: B The stethoscope does not magnify sound, but it does block out extraneous room sounds. The slope of the earpieces should point forward toward the examiners nose. Long tubing will distort sound. The fit and quality of the stethoscope are both important. DIF: Cognitive Level: Understanding (Comprehension) REF: p. 116 MSC: Client Needs: Safe and Effective Care Environment: Management of Care  The nurse is preparing to use a stethoscope for auscultation. Which statement is true FNP 509 Bates’ Guide To Physical Examination and History Taking 13th Edition Bickley TESTBANK FNP 509 Bates’ Guide To Physical Examination and History Taking TESTBANK, Download to score water. . b Leave the gown on the patient to ensure that he or she does not get chilled . during the examination. c Ensure that the bell side of the stethoscope is turned to the on position. . d Check the temperature of the room, and offer blankets to the patient if he or she . feels cold. ANS: D The examination room should be warm. If the patient shivers, then the involuntary muscle contractions can make it difficult to hear the underlying sounds. The end of the stethoscope should be warmed between the examiners hands, not with water. The nurse should never listen through a gown. The diaphragm of the stethoscope should be used to auscultate for bowel sounds. DIF: Cognitive Level: Applying (Application) REF: p. 117 MSC: Client Needs: Safe and Effective Care Environment: Management of FNP 509 Bates’ Guide To Physical Examination and History Taking 13th Edition Bickley TESTBANK FNP 509 Bates’ Guide To Physical Examination and History Taking TESTBANK, Download to score Care  The nurse will use which technique of assessment to determine the presence of crepitus, swelling, and pulsations? a Palpation . b Inspection . FNP 509 Bates’ Guide To Physical Examination and History Taking 13th Edition Bickley TESTBANK FNP 509 Bates’ Guide To Physical Examination and History Taking TESTBANK, Download to score c Percussion . d Auscultation . ANS: A Palpation applies the sense of touch to assess texture, temperature, moisture, organ location and size, as well as any swelling, vibration or pulsation, rigidity or spasticity, crepitation, presence of lumps or masses, and the presence of tenderness or pain. DIF: Cognitive Level: Understanding (Comprehension) REF: p. 115 MSC: Client Needs: Safe and Effective Care Environment: Management of Care  The nurse is preparing to use an otoscope for an examination. Which statement is true regarding the otoscope? The otoscope: a Is often used to direct light onto the sinuses. . b Uses a short, broad speculum to help visualize the ear. FNP 509 Bates’ Guide To Physical Examination and History Taking 13th Edition Bickley TESTBANK FNP 509 Bates’ Guide To Physical Examination and History Taking TESTBANK, Download to score d Rotating the lens selector dial to bring the object into focus . ANS: D The ophthalmoscope is used to examine the internal eye structures. It can compensate for nearsightedness or farsightedness, but it will not correct for astigmatism. The grid is used to assess size and location of lesions on the fundus. The large full spot of light is used to assess dilated pupils. Rotating the lens selector dial brings the object into focus. DIF: Cognitive Level: Analyzing (Analysis) REF: p. 119 MSC: Client Needs: Safe and Effective Care Environment: Management of Care  The nurse is unable to palpate the right radial pulse on a patient. The best action would be to: a . Auscultate over the area with a fetoscope. b . Use a goniometer to measure the pulsations. FNP 509 Bates’ Guide To Physical Examination and History Taking 13th Edition Bickley TESTBANK FNP 509 Bates’ Guide To Physical Examination and History Taking TESTBANK, Download to score c . Use a Doppler device to check for pulsations over the area. d . Check for the presence of pulsations with a stethoscope. ANS: C Doppler devices are used to augment pulse or blood pressure measurements. Goniometers measure joint range of motion. A fetoscope is used to auscultate fetal heart tones. Stethoscopes are used to auscultate breath, bowel, and heart sounds. DIF: Cognitive Level: Analyzing (Analysis) REF: p. 120 MSC: Client Needs: Safe and Effective Care Environment: Management of Care  The nurse is examining an infant and prepares to elicit the Moro reflex at which time during the examination? a . When the infant is sleeping b . At the end of the examination FNP 509 Bates’ Guide To Physical Examination and History Taking 13th Edition Bickley TESTBANK FNP 509 Bates’ Guide To Physical Examination and History Taking TESTBANK, Download to score c . Before auscultation of the thorax d . Halfway through the examination ANS: B The Moro or startle reflex is elicited at the end of the examination because it may cause the infant to cry. DIF: Cognitive Level: Understanding (Comprehension) REF: p. 123 MSC: Client Needs: Safe and Effective Care Environment: Management of Care FNP 509 Bates’ Guide To Physical Examination and History Taking 13th Edition Bickley TESTBANK FNP 509 Bates’ Guide To Physical Examination and History Taking TESTBANK, Download to score MSC: Client Needs: Safe and Effective Care Environment: Management of Care  A 2-year-old child has been brought to the clinic for a well-child checkup. The best way for the nurse to begin the assessment is to: FNP 509 Bates’ Guide To Physical Examination and History Taking 13th Edition Bickley TESTBANK FNP 509 Bates’ Guide To Physical Examination and History Taking TESTBANK, Download to score a . Ask the parent to place the child on the examining table. b . Have the parent remove all of the childs clothing before the examination. c . Allow the child to keep a security object such as a toy or blanket during the examination. d . Initially focus the interactions on the child, essentially ignoring the parent until the childs trust has been obtained. ANS: C The best place to examine the toddler is on the parents lap. Toddlers understand symbols; therefore, a security object is helpful. Initially, the focus is more on the parent, which allows the child to adjust gradually and to become familiar with you. A 2-year-old child does not like to take off his or her clothes. Therefore, ask the parent to undress one body part at a time. DIF: Cognitive Level: Applying (Application) REF: p. 123 MSC: Client Needs: Safe and Effective Care Environment: Management of Care  The nurse is examining a 2-year-old child and asks, May I listen to FNP 509 Bates’ Guide To Physical Examination and History Taking 13th Edition Bickley TESTBANK FNP 509 Bates’ Guide To Physical Examination and History Taking TESTBANK, Download to score your heart now? Which critique of the nurses technique is most accurate? a . Asking questions enhances the childs autonomy b . Asking the child for permission helps develop a sense of trust c . This question is an appropriate statement because children at this age like to have choices d . Children at this age like to say, No. The examiner should not offer a choice when no choice is available ANS: D Children at this age like to say, No. Choices should not be offered when no choice is really available. If the child says, No and the nurse does it anyway, then the nurse loses trust. Autonomy is enhanced by offering a limited option, Shall I listen to your heart next or your tummy? CHAPTER 3 Interviewing and the Health History MULTIPLE CHOICE  The nurse is conducting an interview with a woman who has recently FNP 509 Bates’ Guide To Physical Examination and History Taking 13th Edition Bickley TESTBANK FNP 509 Bates’ Guide To Physical Examination and History Taking TESTBANK, Download to score receiver is most likely to misinterpret a message sent by a health care professional? a . Well-adjusted adolescent who came in for a sports physical b . Recovering alcoholic who came in for a basic physical examination c . Man whose wife has just been diagnosed with lung cancer d . Man with a hearing impairment who uses sign language to communicate and who has an interpreter with him ANS: C The receiver attaches meaning determined by his or her experiences, culture, self-concept, and current physical and emotional states. The man whose wife has just been diagnosed with lung cancer may be experiencing emotions that affect his receiving. DIF: Cognitive Level: Analyzing (Analysis) REF: p. 28 MSC: Client Needs: Psychosocial Integrity  The nurse makes which adjustment in the physical environment to FNP 509 Bates’ Guide To Physical Examination and History Taking 13th Edition Bickley TESTBANK FNP 509 Bates’ Guide To Physical Examination and History Taking TESTBANK, Download to score promote the success of an interview? FNP 509 Bates’ Guide To Physical Examination and History Taking 13th Edition Bickley TESTBANK FNP 509 Bates’ Guide To Physical Examination and History Taking TESTBANK, Download to score a . Reduces noise by turning off televisions and radios b . Reduces the distance between the interviewer and the patient to 2 feet or less c . Provides a dim light that makes the room cozy and helps the patient relax d . Arranges seating across a desk or table to allow the patient some personal space ANS: A The nurse should reduce noise by turning off the television, radio, and other unnecessary equipment, because multiple stimuli are confusing. The interviewer and patient should be approximately 4 to 5 feet apart; the room should be well-lit, enabling the interviewer and patient to see each other clearly. Having a table or desk in between the two people creates the idea of a barrier; equal-status seating, at eye level, is better. DIF: Cognitive Level: Applying (Application) REF: p. 29 MSC: Client Needs: Psychosocial Integrity  In an interview, the nurse may find it necessary to take notes to aid his FNP 509 Bates’ Guide To Physical Examination and History Taking 13th Edition Bickley TESTBANK FNP 509 Bates’ Guide To Physical Examination and History Taking TESTBANK, Download to score phase of the interview process. a . Summary b . Closing c . Body d . Opening or introduction ANS: D When gathering a complete history, the nurse should give the reason for the interview during the opening or introduction phase of the interview, not during or at the end of the interview. DIF: Cognitive Level: Understanding (Comprehension) REF: p. 31 MSC: Client Needs: Psychosocial Integrity  A woman has just entered the emergency department after being battered by her husband. The nurse needs to get some information from FNP 509 Bates’ Guide To Physical Examination and History Taking 13th Edition Bickley TESTBANK FNP 509 Bates’ Guide To Physical Examination and History Taking TESTBANK, Download to score her to begin treatment. What is the best choice for an opening phase of the interview with this patient? a . Hello, Nancy, my name is Mrs. C. b . Hello, Mrs. H., my name is Mrs. C. It sure is cold today! c . Mrs. H., my name is Mrs. C. How are you? d . Mrs. H., my name is Mrs. C. Ill need to ask you a few questions about what happened. ANS: D Address the person by using his or her surname. The nurse should introduce him or herself and give the reason for the interview. Friendly small talk is not needed to build rapport. DIF: Cognitive Level: Applying (Application) REF: p. 31 MSC: Client Needs: Psychosocial Integrity  During an interview, the nurse states, You mentioned having shortness of breath. Tell me more about that. Which verbal skill is FNP 509 Bates’ Guide To Physical Examination and History Taking 13th Edition Bickley TESTBANK FNP 509 Bates’ Guide To Physical Examination and History Taking TESTBANK, Download to score used with this statement? FNP 509 Bates’ Guide To Physical Examination and History Taking 13th Edition Bickley TESTBANK FNP 509 Bates’ Guide To Physical Examination and History Taking TESTBANK, Download to score responses focus on the patients frame of reference and some focus on the health care providers perspective. An example of a verbal response that focuses on the health care providers perspective would be: FNP 509 Bates’ Guide To Physical Examination and History Taking 13th Edition Bickley TESTBANK FNP 509 Bates’ Guide To Physical Examination and History Taking TESTBANK, Download to score a . Empathy. b . Reflection. c . Facilitation. d . Confrontation. ANS: D When the health care provider uses the response of confrontation, the frame of reference shifts from the patients perspective to the perspective of the health care provider, and the health care provider starts to express his or her own thoughts and feelings. Empathy, reflection, and facilitation responses focus on the patients frame of reference. DIF: Cognitive Level: Remembering (Knowledge) REF: p. 32 MSC: Client Needs: Psychosocial Integrity  When taking a history from a newly admitted patient, the nurse notices that he often pauses and expectantly looks at the nurse. What FNP 509 Bates’ Guide To Physical Examination and History Taking 13th Edition Bickley TESTBANK FNP 509 Bates’ Guide To Physical Examination and History Taking TESTBANK, Download to score would be the nurses best response to this behavior? a . Be silent, and allow him to continue when he is ready. b . Smile at him and say, Dont worry about all of this. Im sure we can find out why youre having these pains. c . Lean back in the chair and ask, You are looking at me kind of funny; there isnt anything wrong, is there? d . Stand up and say, I can see that this interview is uncomfortable for you. We can continue it another time. ANS: A Silent attentiveness communicates that the person has time to think and to organize what he or she wishes to say without an interruption from the nurse. Health professionals most often interrupt this thinking silence. The other responses are not conducive to ideal communication.  Which of these statements represents subjective data the nurse obtained from the patient regarding the patients skin? a Skin appears dry. . FNP 509 Bates’ Guide To Physical Examination and History Taking 13th Edition Bickley TESTBANK FNP 509 Bates’ Guide To Physical Examination and History Taking TESTBANK, Download to score c Have you had any problems with passing urine? . d Do you have any history of sexually transmitted diseases? . ANS: A Health promotion for a man would include the performance of testicular self-examinations. The other questions are asking about possible disease or illness issues. DIF: Cognitive Level: Understanding (Comprehension) REF: p. 56 MSC: Client Needs: Safe and Effective Care Environment: Management of Care  Which of these responses might the nurse expect during a functional assessment of a patient whose leg is in a cast? a . I broke my right leg in a car accident 2 weeks ago. b . The pain is decreasing, but I still need to take acetaminophen. c I check the color of my toes every evening just like I was taught. FNP 509 Bates’ Guide To Physical Examination and History Taking 13th Edition Bickley TESTBANK FNP 509 Bates’ Guide To Physical Examination and History Taking TESTBANK, Download to score . FNP 509 Bates’ Guide To Physical Examination and History Taking 13th Edition Bickley TESTBANK FNP 509 Bates’ Guide To Physical Examination and History Taking TESTBANK, Download to score d Im able to transfer myself from the wheelchair to the bed without help. . ANS: D Functional assessment measures a persons self-care ability in the areas of general physical health or absence of illness. The other statements concern health or illness issues. DIF: Cognitive Level: Applying (Application) REF: p. 56 MSC: Client Needs: Safe and Effective Care Environment: Management of Care  In response to a question about stress, a 39-year-old woman tells the nurse that her husband and mother both died in the past year. Which response by the nurse is most appropriate? a . This has been a difficult year for you. b . I dont know how anyone could handle that much stress in 1 year! c What did you do to cope with the loss of both your husband and FNP 509 Bates’ Guide To Physical Examination and History Taking 13th Edition Bickley TESTBANK FNP 509 Bates’ Guide To Physical Examination and History Taking TESTBANK, Download to score Alcohol adversely interacts with all medications and is a factor in many social problems such as child or sexual abuse, automobile accidents, and assaults; alcohol also contributes to many illnesses and disease processes. Therefore, assessing for signs of hazardous alcohol use is important. The other options are not correct. DIF: Cognitive Level: Understanding (Comprehension) REF: p. 58 MSC: Client Needs: Safe and Effective Care Environment: Management of Care  The mother of a 16-month-old toddler tells the nurse that her daughter has an earache. What would be an appropriate response? a . Maybe she is just teething. b . I will check her ear for an ear infection. c . Are you sure she is really having pain? d . Describe what she is doing to indicate she is having pain. FNP 509 Bates’ Guide To Physical Examination and History Taking 13th Edition Bickley TESTBANK FNP 509 Bates’ Guide To Physical Examination and History Taking TESTBANK, Download to score ANS: D With a very young child, the parent is asked, How do you know the child is in pain? A young child pulling at his or her ears should alert parents to the childs ear pain. Statements about teething and questioning whether the child is really having pain do not explore the symptoms, which should be done before a physical examination. DIF: Cognitive Level: Applying (Application) REF: p. 59 MSC: Client Needs: Safe and Effective Care Environment: Management of Care  During an assessment of a patients family history, the nurse constructs a genogram. Which statement best describes a genogram? a . List of diseases present in a persons near relatives b . Graphic family tree that uses symbols to depict the gender, relationship, and age of immediate family members c . Drawing that depicts the patients family members up to five generations back d . Description of the health of a persons children and grandchildren FNP 509 Bates’ Guide To Physical Examination and History Taking 13th Edition Bickley TESTBANK FNP 509 Bates’ Guide To Physical Examination and History Taking TESTBANK, Download to score ANS: B A genogram (or pedigree) is a graphic family tree that uses symbols to depict the gender, FNP 509 Bates’ Guide To Physical Examination and History Taking 13th Edition Bickley TESTBANK FNP 509 Bates’ Guide To Physical Examination and History Taking TESTBANK, Download to score ANS: B Because of recent outbreaks of measles across the United States, the American Academy of Pediatrics (2006) recommends two doses of the MMR vaccine, one at 12 to 15 months of age and one at age 4 to 6 years. FNP 509 Bates’ Guide To Physical Examination and History Taking 13th Edition Bickley TESTBANK FNP 509 Bates’ Guide To Physical Examination and History Taking TESTBANK, Download to score DIF: Cognitive Level: Analyzing (Analysis) REF: p. 60 MSC: Client Needs: Safe and Effective Care Environment: Management of Care  The nurse is preparing to perform a physical assessment. The correct action by the nurse is reflected by which statement? The nurse: a . Performs the examination from the left side of the bed. b . Examines tender or painful areas first to help relieve the patients anxiety. c . Follows the same examination sequence, regardless of the patients age or condition. d . Organizes the assessment to ensure that the patient does not change positions too often. FNP 509 Bates’ Guide To Physical Examination and History Taking 13th Edition Bickley TESTBANK FNP 509 Bates’ Guide To Physical Examination and History Taking TESTBANK, Download to score ANS: D The steps of the assessment should be organized to ensure that the patient does not change positions too often. The sequence of the steps of the assessment may differ, depending on the age of the person and the examiners preference. Tender or painful areas should be assessed last. DIF: Cognitive Level: Applying (Application) REF: p. 121 MSC: Client Needs: Safe and Effective Care Environment: Management of Care  A man is at the clinic for a physical examination. He states that he is very anxious about the physical examination. What steps can the nurse take to make him more comfortable? a . Appear unhurried and confident when examining him. b . Stay in the room when he undresses in case he needs assistance. c . Ask him to change into an examining gown and to take off his undergarments. d . Defer measuring vital signs until the end of the examination, which allows him time to become comfortable. FNP 509 Bates’ Guide To Physical Examination and History Taking 13th Edition Bickley TESTBANK