health assessment exam 1 test bank

health assessment exam 1 test bank Related

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A 19-year-old woman comes to the clinic at the insistence of her brother. She is wearing black combat boots and a black lace nightgown over her other clothes. Her hair is dyed pink with black streaks. She has several piercings in her nares and ears and is wearing an earring on her eyebrow and heavy black makeup. The nurse concludes that:

  • A. She probably does not have any problems at all.
  • B. She is just trying to shock people, and her appearance should be ignored.
  • C. She has manic syndrome because of her abnormal way of dressing and grooming.
  • D. More information should be gathered to decide whether her way of dressing is appropriate.
Correct Answer: D

Rationale: The correct answer is D because more information should be gathered to assess the situation appropriately. The woman's appearance may suggest alternative lifestyles or personal expression rather than mental health issues. It is essential to avoid assumptions based solely on appearance and gather a comprehensive history to understand her choices. Options A and B are dismissive and judgmental, failing to consider the complexity of human behavior. Option C is incorrect as the presented information does not provide enough evidence to diagnose manic syndrome. In summary, option D is the most logical and ethical approach to understanding the woman's situation without making unfounded assumptions.

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The interview portion of data collection obtains:

  • A. Physical data.
  • B. Historical data.
  • C. Objective data.
  • D. Subjective data.
Correct Answer: D

Rationale: The correct answer is D: Subjective data. During the interview portion of data collection, subjective data is obtained as it involves personal opinions, feelings, and experiences shared by the interviewee. This data is based on individual perspectives and cannot be measured objectively. Physical data (A) refers to tangible measurements, historical data (B) relates to past events or records, and objective data (C) is based on observable and measurable facts. In contrast, subjective data (D) captures the interviewee's viewpoints and interpretations, making it the most appropriate choice for the given scenario.

Which of the following is the appropriate health promotion question to ask during a review of symptoms?

  • A. "Do you use sunscreen while outside?"
  • B. "I need to see if your skin is warm and dry."
  • C. "Have you experienced any dizziness or headaches?"
  • D. "When you cough, what colour is the sputum you bring up?"
Correct Answer: A

Rationale: The correct answer is A: "Do you use sunscreen while outside?" because it directly relates to health promotion by addressing preventive measures. Sunscreen helps prevent skin cancer and other skin conditions. Choice B is incorrect as it focuses on assessing skin condition rather than promoting health. Choice C is incorrect as it relates to symptoms rather than prevention. Choice D is incorrect as it is related to assessing a specific symptom rather than promoting overall health.

A 32-year-old female patient complains that she has noticed several small, slightly raised, bright-red dots on her chest. On examination, the nurse thinks that the spots are probably:

  • A. Anasarca.
  • B. Scleroderma.
  • C. Senile angiomas.
  • D. Latent myeloma.
Correct Answer: C

Rationale: The correct answer is C: Senile angiomas. Senile angiomas are common benign growths of small blood vessels that appear as bright-red dots on the skin, commonly seen in older individuals. In this case, the patient is 32 years old, which is relatively young for an appearance of senile angiomas, but still within the possible age range. Anasarca (A) is generalized edema, not related to the described skin condition. Scleroderma (B) is a connective tissue disorder characterized by skin thickening and not associated with bright-red dots. Latent myeloma (D) is a type of bone marrow cancer and not related to the skin findings described.

Which of the following positions is most appropriate for performing an abdominal examination on an obese patient?

  • A. Head elevated to 45 degrees
  • B. Have the patient lie flat
  • C. Place the patient in the supine position
  • D. Position the patient on their side
Correct Answer: C

Rationale: The correct answer is C: Place the patient in the supine position. This position allows optimal access to the abdomen for examination due to gravitational forces aiding in organ palpation. Having the patient lie flat (choice B) may not provide adequate access. Positioning the patient on their side (choice D) may limit visibility and palpation. Elevating the head to 45 degrees (choice A) is unnecessary for an abdominal examination on an obese patient.

A nurse is providing education to a patient with hypertension. Which of the following statements by the patient indicates the need for further education?

  • A. I will limit my sodium intake.
  • B. I will monitor my blood pressure regularly.
  • C. I can stop taking my medication once my blood pressure is normal.
  • D. I will exercise regularly to improve my health.
Correct Answer: C

Rationale: The correct answer is C. This statement indicates a misunderstanding because stopping medication once blood pressure is normal can lead to a relapse of hypertension. Step 1: Medication management is crucial for long-term control of hypertension. Step 2: Stopping medication abruptly can cause blood pressure to rise again. Step 3: Regular monitoring, limiting sodium intake, and exercising are all important aspects of hypertension management. Summary: Choices A, B, and D demonstrate good understanding of hypertension management, while choice C shows a need for further education on the importance of continued medication use.

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