Nokea
While the nurse is taking the health history, a patient states, 'My father and grandfather both had heart attacks and were unable to be very active afterwards.' This statement reflects which of the following functional health patterns?
- A. Activity-exercise
- B. Cognitive-perceptual
- C. Coping-stress tolerance
- D. Health perception-health management
Correct Answer: D
Rationale: The information in the patient statement relates to risk factors that may cause cardiovascular problems in the future. Identification of risk factors falls into the health perception-health maintenance pattern.
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An older-adult patient who is having difficulty breathing is admitted to the hospital. Which of the following approaches is the best for the nurse to use to obtain a complete health history?
- A. Obtain subjective data about the patient from family members.
- B. Omit subjective data collection and obtain the physical examination.
- C. Use the health care provider's medical history to obtain subjective data.
- D. Schedule several short sessions with the patient to gather subjective data.
Correct Answer: D
Rationale: In the case of an older-adult patient with a low energy level, several short sessions may have to be scheduled. Allowing time for the patient to volunteer information about particular areas of concern enables the nurse to work with the patient to identify existing and potential health problems. In an emergency situation, the nurse may need to ask only the most pertinent questions for a specific problem and obtain more information later. A complete health history will include subjective information that is not available in the health care provider's medical history. Family members may be able to provide some subjective data, but only the patient will be able to give subjective information about the shortness of breath. Since the subjective data about the patient's respiratory status will be essential, obtaining the physical examination alone will not provide sufficient information.
When admitting a patient who has just arrived on the medical unit with severe abdominal pain, what should the nurse do first?
- A. Complete only basic demographic data before addressing the patient's abdominal pain.
- B. Medicate the patient for the abdominal pain before attending to the health history and examination.
- C. Inform the patient that the abdominal pain will be treated as soon as the health history is completed.
- D. Take the initial vital signs and then deal with the abdominal pain before completing the health history.
Correct Answer: D
Rationale: The patient priority in this situation will be to decrease the pain level because the patient will be unlikely to cooperate in providing demographic data or the health history until the nurse addresses the pain. However, obtaining information about vital signs is essential before using either pharmacological or nonpharmacological therapies for pain control. The vital signs may indicate hemodynamic instability that would need to be addressed immediately.
The nurse records the following general survey of a patient: 'The patient is a 78-year-old Asian female accompanied by her two daughters. Alert and oriented. Does not make eye contact with the nurse and responds appropriately to questions. No apparent disabilities or distinguishing features.' Which of the following information should be added to this general survey documentation?
- A. Nutritional status
- B. Intake and output
- C. Reasons for contact with the health care system
- D. Comments of family members about his condition
Correct Answer: A
Rationale: The general survey also describes the patient's general nutritional status. The other information will be obtained when doing the complete nursing history and examination but is not obtained through the initial scanning of a patient.
The nurse records the following general survey of a patient: 'The patient is a 68-year-old Indigenous male accompanied by his wife and two daughters. Alert and oriented. Does not make eye contact with the nurse and responds slowly, but appropriately, to questions. No apparent disabilities or distinguishing features.' Which of the following areas does the nurse need to assess to complete the general survey?
- A. Body movements
- B. Intake and output
- C. Reasons for contact with the health care system
- D. Comments of family members about his condition
Correct Answer: A
Rationale: To complete a general survey, the nurse needs to assess the patient's body movements. Intake and output, reasons for contact with the health care system, and comments of family members about the patient's condition are not part of the general survey.
When assessing a patient's abdomen during the admission assessment, which of these actions should the nurse take first?
- A. Feel for any masses.
- B. Palpate the abdomen.
- C. Percuss the liver borders.
- D. Listen to the bowel sounds.
Correct Answer: D
Rationale: When assessing the abdomen, auscultation is done before palpation or percussion because palpation and percussion can cause changes in bowel sounds and alter the findings. All of the techniques are appropriate, but auscultation should be done first.