health assessment ex 1 Flashcards

Which statement, if said by the nursing student, indicates a correct understanding of the health

history?

A. “The health history is a minor part of evaluating a patient’s health status.”

B. “The health history provides a snapshot of the patient and their daily life.”

C. “The health history does not reveal the patient’s understanding about health.”

D. “The health history is a holistic picture of the patient, their support systems, and habits.”

The clinician is getting ready to perform a health history but wants to ensure the patient can communicate before beginning. Which of the following areas should the clinician assess? Select all

that apply.

a. Mental status

b. Memory

c. Stressors

d. Reasoning

e. Hygiene

The clinician is performing a health history on a patient who does not speak English. In light of the language barrier, which of the following considerations are important for this patient? Select all that

apply.

a. Address the patient, even if the interpreter is in the room.

b. Focus on the interpreter.

c. Focus on the patient.

d. Ask the patient to bring a family member to the visit to interpret.

e. Use an in-person interpreter when available.

Clinicians try to ask open-ended questions to get patients to answer more fully. Which of the following questions is an example of an open-ended question?

a. “Do you smoke?”

b. “How much alcohol do you drink?”

c. “Are you in pain?”

d. “Do you want to eat lunch?”

What information gathered by the clinician would be classified as the history of the present illness

(HPI)?

a. Age, gender, and occupation

b. Support system, profession, and dietary habits

c. Onset, location, duration, frequency, intensity, and alleviating and exacerbating factors surrounding the patient’s symptom(s)

d. The reason for the visit. It may be a direct quote or brief summary of patent’s comments.

What information should the clinician include in the allergy section of the health history? Select all that apply.

a. When the allergy occurred

b. The use of over-the-counter medications

c. The type of reaction experienced

d. The name of the offending substance

e. Any reaction related to eating shellfish

Why is the social history important for the clinician to document?

a. The social history addresses patient’s habits, such as smoking.

b. The social history addresses only patient information.

c. The social history should take place with family members in the room.

d. The social history should include the habits of parents and children.

Identify the components of the Review of Systems (ROS) as done by the clinician. Select all that apply.

a. Skin

b. Neurological

c. Allergies

d. Musculoskeletal

e. Smoking

A clinician engages with a patient who presents with a chief complaint of a sore throat. Which areas should be included in the assessment of this patient?

a. Dietary concerns

b. Ears, nose, and throat

c. Respiratory and cardiac

d. Family history

The clinician is attempting to identify a patient’s differential diagnosis. Which of the following is a

component of differential diagnosis?

a. It is not necessary to use the health history in determining the differential diagnosis.

b. The differential diagnosis can be made during the physical examination.

c. The provider must maintain a wide focus during the physical examination.

d. A differential diagnosis cannot be made until after both the health history and physical examination.

Which information gathered by the clinician would be classified as the chief complaint (CC)?

a. Age, gender, and occupation

b. Support system, profession, and dietary habits

c. The onset, location, duration, frequency, intensity, and alleviating and exacerbating factors surrounding the patient’s symptom(s)

d. The reason for the visit. It may be a direct quote or brief summary of the patient’s comments.

A patient with a diagnosis of congestive heart failure (CHF) is seen in the medical office by the clinician. Which question should be included in the review of systems (ROS) for this patient?

a. “Do you have any difficulty swallowing?”

b. “Are you experiencing any trouble speaking words?”

c. “Are you short of breath when walking short distances?”

d. “Do you have any double vision?”

Which of the following correctly expands the mnemonic OLD CART to describe the seven attributes of a symptom?

A) Onset, Location, Duration, Characteristics, Alleviating factors, Related symptoms, Timing B) Onset, Location, Duration, Characteristics, Aggravating factors, Relieving factors, Treatment

C) Origin, Level, Duration, Course, Associated symptoms, Response, Therapy

D) Onset, Length, Description, Cause, Aggravating factors, Relief, Type

Which of the following best describes the methods for documenting a patient’s family history?

A) Solely through verbal interviews without any written or visual aids.

B) In a narrative format or by constructing a genogram.

C) Exclusively using electronic spreadsheets and databases.

D) By focusing only on genetic testing results without personal details.

Which of the following best describes the purpose of motivational interviewing?

A) To enforce strict adherence to medical protocols and provider directives during patient consultations.

B) To help a provider shift toward a more patient-centered approach in the health history interview.

C) To focus solely on diagnosing symptoms without considering patient emotions or motivations.

D) To prioritize administrative documentation over direct patient interaction and empathy.

Which of the following best describes the role of a focused health history?

A) A comprehensive review of all body systems regardless of the patient's current symptoms or issues.

B) A detailed assessment of specific body system(s) relating to the presenting problem or current concern(s) of the patient.

C) An initial screening tool used to gather general demographic information about the patient.

D) A method for documenting long-term family medical histories without focusing on immediate concerns.

Which of the following best identifies some considerations a clinician should take into account when caring for special populations of patients?

A) Age, gender, and socioeconomic status only.

B) Physical disabilities, mental disabilities, and communication difficulties due to culture and language.

C) Dietary preferences, exercise habits, and sleep patterns exclusively.

D) Medical history, current medications, and allergies without regard to other factors.

Which of the following best explains why it is important to differentiate between subjective and objective information obtained during the taking of a patient's health history?

A) To ensure that all data collected is based solely on the patient's personal opinions and experiences without any clinical validation.

B) Because what the patient tells the provider may be confirmed or opposed to the findings of the provider.

C) To focus exclusively on objective measurements while disregarding the patient's reported symptoms entirely.

D) To simplify the documentation process by combining both types of information into a single category.

Which of the following best describes the information that should be included under the allergies section of the health history?

A) Only the names of allergens without any details on timing or symptoms.

B) When the allergy occurred and what the reaction was.

C) A general list of potential future allergies based on family history alone.

D) Exclusive focus on medication dosages and frequencies related to allergies.

Which of the following best states why the social history is such an important part of the health history?

A) It primarily focuses on documenting the patient's genetic predispositions and hereditary conditions.

B) The social history fills in the gaps regarding the living situation and support system for the patient.

C) It is used exclusively to assess the patient's financial status and insurance coverage details.

D) It emphasizes the chronological record of past medical procedures and hospitalizations only.

The clinician is assessing the skull of an adolescent. The clinician notes the skull bones are separated by the following sutures: (Select all that apply.)

a. Squamosal

b. Sagittal

c. Sphenoid

d. Coronal

e. Lambdoid

A 63-year-old male presents to the office complaining of increasing dry mouth that began approximately 1 month ago. Which of the following should the clinician assess to identify a possible cause for the dry mouth?

a. Submandibular gland

b. Sternocleidomastoid muscle

c. Cervico-trigeminal reflexes

d. Mylohyoid

Which areas should the clinician expect to assess for lymph nodes in a patient’s leg? Select all that apply.

a. Axillary

b. Inguinal

c. Submental

d. Occipital

e. Popliteal

A patient complains of a migraine headache that is precipitated by her menstrual cycle. The symptoms include generalized location lasting hours to days with noted throbbing. Which test would be prudent for the clinician to order?

a. x-Ray

b. MRI

c. Ultrasound

d. Thyroid function tests

The clinician is assessing a patient who presents with complaints of a headache. If the clinician is

assessing for headaches, which question should be asked to the patient? Select all that apply.

a. “Do you experience rebound pain if you don't consume caffeine?”

b. “Do you take oral contraceptives?”

c. “Do you experience any photophobia?”

d. “Do you experience any decreased lacrimation?”

e. “Do you notice the headaches occurring with your menstrual cycle?”

A clinician is examining a 42-year-old male patient with a headache. The patient reports the following symptoms: a constriction-type pain occurring unilaterally, lasting hours to days, but that always begins with stress and in the evening. Which differential diagnosis would be consistent with these characteristics reported?

a. Migraine headache

b. Muscular tension headache

c. Cluster headache

d. Temporal arteritis headache

A clinician is examining a 36-year-old female patient with a headache. The patient reports the following symptoms: a throbbing pain in the occipital region, lasting hours, that remits as the day progresses, that does not have any precipitating factors. Which differential diagnosis would be consistent with these characteristics reported?

a. Temporal arteritis headache

b. Cluster headache

c. Hypertensive headache

d. Migraine headache

A clinician is examining a female patient with a headache. The patient reports the following symptoms: throbbing pain that is diffuse, lasting hours to days, with an increase in frequency to daily. The patient reports stopping her daily coffee. Which differential diagnosis would be consistent with these characteristics reported?

a. Hypertensive headache

b. Temporal arteritis headache

c. Cluster headache

d. Medication-rebound headache

What changes should a clinician expect to see in the head and neck region of the geriatric population?

a. An increase in the size of the lymph nodes

b. An increase in the number of lymph modes

c. A decrease in scalp dryness

d. A decrease in the number of teeth

A clinician is assessing a patient who presented with a stiff neck. Which of the following assessments should the clinician make? Select all that apply.

a. Assess for pain with movement

b. Assess for continuous pain

c. Assess for any recent trauma

d. Assess for hypothermia

e. Assess work position

Which assessment finding by the clinician suggests malignancy in a patient with lymphadenopathy?

a. Soft nodes

b. Mobile nodes

c. Small nodes

d. Fixed nodes

Which lymph node can be found along the anterior edge of the trapezius?

a. Superficial cervical

b. Posterior cervical

c. Submental

d. Occipital

A patient presents with a heavy epistasis. The clinician suspects that the patient may have which anatomical structure associated with nose bleeds?

a. Nasal veins joining the sagittal suture

b. Woodruff’s plexus

c. Spheno-ethmoid recess

d. Sphenopalatine artery

The clinician is assessing a patient complaining of difficulty breathing through the nose. The clinician should: (Select all that apply.)

a. Question the patient about alcohol intake

b. Assess for a deviated septum

c. Occlude each nare independently to assess air flow

d. Use a nasal speculum to inspect the turbinates

e. Gently press the tip of the nose

The clinician is assessing a patient who was a passenger in a car involved in a collision. The clinician notes clear fluid discharging from both of the patient’s nares. Which of the following would be the priority action for the clinician to take?

a. Evaluate the patient for a skull fracture.

b. Question the patient about use of intranasal medications.

c. Occlude each nare independently to evaluate for septal deviation.

d. Ask the patient about the ability to smell.

The clinician is assessing the oropharynx of a small child. To facilitate this, the clinician: (Select all that apply.)

a. Examines the child while he sits on his mother’s lap

b. Allows the child to play with the penlight

c. Has the child suck on the clinician’s gloved finger

d. Asks the caregiver to leave the room during the assessment

e. Assesses the oropharynx before proceeding to other body systems

Upon assessment of a patient’s oral cavity, the clinician discovers a bony protuberance along the midline of the inner lower jaw. The clinician determines that it is a torus palatinus. The clinician:

a. Explains to the patient that this is a type of cancer

b. Consults with the healthcare team concerning this abnormality

c. Asks the patient about use of medications

d. Documents the finding in the patient’s record

The clinician is examining a patient who experienced facial trauma. The clinician notes a hematoma forming on the nasal septum. The clinician’s next action is to:

a. Document the finding in the patient’s medical record

b. Explain to the patient that this is a normal finding

c. Compress each nare independently to evaluate air flow

d. Initiate the healthcare team into action to treat the hematoma

A patient is presenting with difficulty breathing. The clinician determines that the pharyngeal tonsils are enlarged. Which of the following is correct concerning the adenoid tissue and this condition?

(Select all that apply.)

a. Adenoid tissue begins to decrease in size after age 5.

b. Tonsils are a significant source of oropharyngeal cancer.

c. Hypertrophic adenoid tissue can block the Eustachian tubes.

d. Grade 4 tonsils occlude more than 75% of the oropharynx.

e. Adenoid tissue is also located in the posterior nasal cavity.

The clinician is assessing a patient with edema of the lips, tongue, palate, and floor of the mouth. The clinician diagnoses the patient with:

a. Gingival hyperplasia

b. Pharyngitis

c. Peutz–Jeghers syndrome

d. Angioedema

The clinician is assessing the oral cavity of a patient. During the oral exam, the clinician should:

(Select all that apply.)

a. Use a penlight to visually inspect

b. Gently percuss the teeth

c. Pull the tongue forward and laterally with gauze

d. Palpate the oral cavity for masses

e. Percuss under the zygomatic processes

A patient is having difficulty with anosmia, the inability to smell odors. Critical safety education for this condition should include: (Select all that apply.)

a. Train the patient to eat only cooked food

b. Advise the patient to only use unscented body lotion

c. Educate the patient to store food properly

d. Urge the patient to maintain working smoke detectors

e. Teach the patient to use food by the expiration date

The clinician is evaluating a patient’s cranial nerves during the physical assessment. To evaluate functioning of the cranial nerve XII, the hypoglossal nerve, the clinician should:

a. Instruct the patient to sense taste

b. Test the patient’s ability to chew

c. Test the patient’s ability to distinguish odors

d. Ask the patient to hold out his tongue

A patient reports pain with drinking of fluids and chewing for the last few weeks. The patient is now experiencing severe constant pain and throbbing. The patient’s entire right lower face and jaw is enlarged. The clinician’s priority action is to:

a. Ask the patient about daily dental hygiene

b. Complete paperwork for a dental referral

c. Evaluate the patient for an abscessed tooth

d. Fully assess the patient’s cranial nerves

The clinician is examining a patient’s extraocular muscles and cranial nerve (CN) innervation. The clinician examines the function of CN III and is looking for adduction. The clinician should perform testing on the:

a. Superior rectus muscle

b. Inferior rectus muscle

c. Medial rectus muscle

d. Lateral rectus muscle

The nursing student is discussing the role of lacrimation in eye care with the nursing instructor.

Identify the role of lacrimation. Select all that apply.

a. Removes debris from the eye

b. Prevents bacterial infection

c. Promotes friction within the eye

d. Provides nutrients to portions of the conjunctival epithelium

e. Provides oxygen to portions of the conjunctival epithelium

The clinician is performing an assessment of visual acuity. The clinician is using the Rosenbaum card. Which instruction would be consistent with performing this test? (Select all that apply.)

a. Instruct the patient to hold the card 6 inches from the face.

b. Instruct the patient to read the largest line possible.

c. Instruct the patient to hold the card 14 inches from the face.

d. Instruct the patient to read the smallest line possible.

e. Instruct the patient to stand up for the test.

A patient complains of eye twitching. Which factors should the clinician expect may be the cause of eye twitching? (Select all that apply.)

a. Fatigue

b. Stress

c. Cranial nerve VII lesion

d. Dry eyes

e. Foreign body

The clinician is teaching a nursing student about visual reflexes and accommodation. Which

statement made by the nursing student indicates the need for further teaching?

a. “Upon exposure to light, the pupillary light reflex can be elicited.”

b. “Accommodation is a reflex that allows the eyes to focus on far objects.”

c. “Exposure to light in one eye causes the pupil in the contralateral eye to constrict concurrently.”

d. “The accommodation reflex cannot be directly observed but can be indirectly assessed when pupillary constriction and convergence of the eyes occur simultaneously.”

The clinician is assessing a patient who came in after suffering a head injury. The clinician wants to rule out a basilar skull fracture. Which symptoms would be consistent with this diagnosis? (Select all that apply.)

a. Tenderness at the lacrimal gland

b. Periorbital ecchymosis

c. Conjunctival hemorrhage

d. Edematous eyelid

e. Purulent discharge from the eyes

The clinician is assessing for hearing loss in a patient. Which questions would be appropriate for the clinician to ask this patient? (Select all that apply.)

a. “Does anyone smoke at home?”

b. “Do sounds appear muffled, as if underwater?”

c. “Are you exposed to loud noises at work?”

d. “Do you use cotton swabs to clean inside your ears?”

e. “Is the hearing issue most notable while talking on the phone?”

The clinician is performing an otoscopic exam on a 22-year-old patient. Which considerations must the clinician take when performing this assessment? (Select all that apply.)

a. Instruct the patient to tilt their head away from the clinician.

b. Pull the pinna down and back.

c. Grasp the otoscope “upside down” along the clinician's fingers.

d. Cautiously introduce the speculum slowly along the axis of the canal.

e. Pull the pinna up and back.

The clinician is teaching an advanced practice nursing student how to complete a voice test. Which action performed by the student indicates the need for further teaching? Select all that apply.

a. The student positions himself directly in front of the patient.

b. The student performs the test one ear at a time.

c. The student asks the patient to place their hand over the ear not being tested.

d. The student whispers four-syllable words for the patient to repeat.

A mother brings in her 10-month-old son who is experiencing another episode of otitis media. Which statement made by the patient’s mother warrants further teaching?

a. “I hold my child upright for bottle feeding.”

b. “I breastfeed my son exclusively.”

c. “I sit my son upright in his bouncy seat for me to bottle feed him.”

d. “I lay my son supine in his crib for his bedtime bottle.”

Which patient is most at risk for developing presbycusis?

a. A 20-year-old

b. A 30-year-old

c. A 40-year-old

d. A 50-year-old

The clinician is performing a physical examination on a patient complaining of ear pain. The patient presents with pain with movement over the mastoid process. The clinician wants to rule out a diagnosis of mastoiditis. Which symptoms would be consistent with this diagnosis?

a. Pain at the posterior auricular node

b. Erythema and warmth of the ear

c. Dry scaling skin over the ears

d. The presence of exudate

The clinician is educating a group of new students about the skin, hair, and nails. Which statement outlines the primary function of the skin?

a. Providing warmth to internal organs

b. Providing areas for tactile sensation

c. Acting as a barrier for protection of the body

d. Maintaining the alignment of internal organs

Cells that provide the opportunity for the brain to recognize touch are known as which cell type?

a. Melanocytes

b. Merkel cells

c. Keratinocytes

d. Langerhans cells

Which finding should the clinician anticipate in patients receiving medications with anticholinergic effects?

a. Hypohidrosis

b. Hypothermia

c. Hyperpigmentation

d. Alopecia

Which of the following hormonal factors influence hair growth? (Select all that apply).

a. Estrogens

b. Prolactin

c. Retinoids

d. Glucocorticoids

e. Albumin

A patient presents with male pattern baldness. Which hormonal factors are responsible for this finding?

a. Androgens

b. Estrogens

c. Retinoids

d. Glucocorticoids

Which finding would the clinician anticipate in a patient with a history of respiratory disorders?

a. Spooning

b. Clubbing

c. Thickening

d. Beau’s lines

The clinician would expect to find nail pitting in patients with which disorders?

a. Diabetes and hypertension

b. Psoriasis and eczema

c. Asthma and emphysema

d. Crohn’s and ulcerative colitis

An infant born at 33 weeks’ gestation is covered with fine hairs. The clinician reassures the parents this occurrence is a normal finding. The clinician is referring to what type of hair growth?

a. Lanugo

b. Vellus

c. Terminal hair

d. Hyper follicular hair

The clinician assessing a new patient complaining of increased tiredness throughout the later part of the day notes pallor of the face and fingers. The clinician would be correct in identifying that this finding is associated with which disorder?

a. Arterial insufficiency

b. Vitiligo

c. Liver disease

d. Cardiopulmonary disease

Which cells are responsible for the differences in skin pigmentation?

a. Melanocytes

b. Merkel cells

c. Keratinocytes

d. Langerhans cells

Which of the following disorders have been associated with free radical damage? (Select all that apply)

a. Aging

b. Cancer

c. Wrinkles

d. Weight gain

e. Brittle nails

In assessing a 6-year-old with atopic dermatitis, the clinician asks the parents to describe the eating behavior and most commonly ingested foods. The mother asks the clinician about the rationale for assessing dietary intake. What is the reasoning behind this assessment?

a. Absence of specific vitamins in the diet is the root cause.

b. Triggers for this type of dermatitis are often food related.

c. Malnutrition can lead to skin disorders.

d. Dermatitis is often a sign of child abuse.