Question 1

A 29-year-old woman tells the nurse that she has "excruciating pain" in her back. Which response by the nurse would be appropriate?

Accepted Answer

The symptom of pain is difficult to quantify because of individual interpretation. It is important to find out the meaning of the pain to the person by asking how it affects daily activities. The nurse needs to find out the patient's perception or meaning of the pain, rather than how the family reacts to it. The nurse should avoid the use of adjectives when discussing the person's pain, should not give his or her opinion of the cause, or focus on their own experience with pain. Instead, the nurse should ask the patient how the pain affects his or her daily activities.

Question 2

During an assessment of a patient's family history, the nurse constructs a genogram. Which statement best describes a genogram?

Accepted Answer

A genogram (or pedigree) is a graphic family tree that uses symbols to depict the gender, relationship, and age of immediate blood relatives in at least three generations (parents, grandparents, siblings). The other options do not describe a genogram. Although identifying the illnesses of relatives on a genogram is important, the listing of the diseases of near relatives is not part of the genogram. A genogram (or pedigree) is a graphic family tree that uses symbols to depict the gender, relationship, and age of immediate blood relatives in at least three generations (parents, grandparents, siblings); it does not have to be five generations and they are the person's preceding generations, not generations after them.

Question 3

The nurse is taking a family history. Which specific disease or problem should be included in the assessment?

Accepted Answer

When reviewing the family history, the nurse should ask specifically about any history of heart disease, high blood pressure, stroke, diabetes, obesity, blood disorders, breast and ovarian cancers, colon cancer, sickle cell anemia, arthritis, allergies, alcohol or drug addiction, mental illness, suicide, seizure disorder, kidney disease, and tuberculosis (TB). Although a family history of emphysema and fractured bones may be good to know, they are not one of the specific diseases that should be specifically asked. A family history of head trauma is not a familial or hereditary characteristic and is not necessary to include in the assessment. Questions concerning any family history of heart disease, high blood pressure, stroke, diabetes, obesity, blood disorders, breast and ovarian cancers, colon cancer, sickle cell anemia, arthritis, allergies, alcohol or drug addiction, mental illness, suicide, seizure disorder, kidney disease, and tuberculosis should be asked.

Question 4

As part of the health history of a 6-year-old boy at a clinic for a sports physical examination, the nurse reviews his immunization record and notes that his last measles-mumps-rubella (MMR) vaccination was at 15 months of age. What should the nurse recommend?

Accepted Answer

Because of recent outbreaks of measles across the United States, the American Academy of Pediatrics (2018) recommends two doses of the MMR vaccine, one at 12 to 15 months of age and one at age 4 to 6 years.

Question 5

The nurse is obtaining a history from a 30-year-old male patient and is concerned about health promotion activities. Which of these questions would be appropriate to use to assess health promotion activities for this patient?

Accepted Answer

Health promotion refers to activities that promote a person's health. For a man that includes the performance of testicular self-examinations. The other questions are asking about possible disease or illness issues. Asking a male patient if they have ever noticed any pain in their testicles, problems with passing urine, or a history of sexually transmitted infections are questions asking about possible disease or illness issues rather than health promotion. Health promotion refers to activities that promote a person's health.

Question 6

In response to a question regarding the use of alcohol, a patient asks the nurse why the nurse needs to know. What is the reason for needing this information?

Accepted Answer

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. Determining a person's alcohol use is important information whether a drinking problem is obvious or not. The reason for needing information about a person's alcohol use is not to determine their reliability or for the nurse to teach the patient about the dangers of alcohol use. Instead the reason is that 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.

Question 7

What information obtained by the nurse regarding a patient's skin should the nurse record in the patient's health history?

Accepted Answer

The purpose of the health history is to collect subjective data, or what the person says about him or herself, so should be limited to patient statements that the person says were or were not present. Skin appears dry, no lesions are obvious, and lesions noted on the lateral aspect of the right arm are all objective data, or things that nurse observed. The purpose of the health history is to collect subjective data, or what the person says about him or herself, so should be limited to patient statements that the person says were or were not present.

Question 8

A patient tells the nurse that she has had abdominal pain for the past week. What would be the nurse's best response?

Accepted Answer

As a person talks, the nurse should not come to any conclusions but should collect all data first of a symptom. A final summary of any symptom the person has should include the specific location, so having the patient point to where the pain is located is appropriate. There are eight critical characteristics to be included in the summary of any symptom: "Location, Character or Quality, Quantity or Severity, Timing, Setting, Aggravating or Relieving Factors, Associated Factors, and Patient's Perception. Options B, C, and D do not collect the necessary data to make a summary of the symptom. A final summary of any symptom the person has should include eight critical characteristics: "Location, Character or Quality, Quantity or Severity, Timing, Setting, Aggravating or Relieving Factors, Associated Factors, and Patient's Perception."

Question 9

What does the review of systems provide the nurse?

Accepted Answer

The purposes of the review of systems are to: (1) evaluate the past and current health state of each body system, (2) double-check facts in case any significant data were omitted in the present illness section, and (3) evaluate health promotion practices. The review of systems does not provide the physical findings of each body system, an opportunity to teach the patient medical terms, or the information necessary for the nurse to diagnose the patient's medical problem.

Question 10

In obtaining a review of systems on a "healthy" 7-year-old girl, what should the health care provider be sure to include?

Accepted Answer

When completing a review of the cardiovascular system for a child the health care provider should ask whether there are any congenital heart defects, history of murmurs, or cyanosis as well as if any activity is limited or whether the child can keep up with her peers. The other items are not appropriate for a child this age. The date of the last glaucoma examination, frequency of breast self-examinations, and date of last electrocardiogram are not appropriate questions for a review of systems for a "healthy" 7-year-old.

Question 11

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?

Accepted Answer

Questions about coping and stress management include questions regarding the kinds of stresses in one's life, especially in the last year, any changes in lifestyle or any current stress, methods tried to relieve stress, and whether these methods have been helpful. Options A, B, and D do not assess the person's methods to cope or alleviate their stress. When asking questions about coping and stress, the nurse should ask regarding the kinds of stresses in one's life, especially in the last year, any changes in lifestyle or any current stress, methods tried to relieve stress, and whether these methods have been helpful.

Question 12

When the nurse is evaluating the reliability of a patient's responses, which of these statements would be correct?

Accepted Answer

A reliable person always gives the same answers, even when questions are rephrased or are repeated later in the interview. The other statements are not correct.

Question 13

Which of these responses might the nurse expect during a functional assessment of a patient whose leg is in a cast?

Accepted Answer

Functional assessment measures a person's self-care ability in the areas of general physical health or absence of illness. The other statements concern health or illness issues. Statements such as "I broke my right leg in a car accident 2 weeks ago," "the pain is decreasing, but I still need to take acetaminophen," or "I check the color of my toes every evening just like I was taught" are statements concerning health or illness issues and not a person's self-care or functional ability.

Question 14

A 5-year-old boy is being admitted to the hospital to have his tonsils removed. Which information should the nurse collect before this procedure?

Accepted Answer

How the child reacted to previous hospitalizations and any complications should be assessed. If the child reacted poorly, then he or she may be afraid now and will need special preparation for the examination that is to follow. The other items are not significant for the procedure. The child's weight at birth, age at which he crawled, or whether or not had the measles is not information needed for the upcoming surgery.

Question 15

A female patient tells the nurse that she has had six pregnancies, with four live births at term and two spontaneous abortions. Her four children are still living. How would the nurse record this information?

Accepted Answer

Obstetric history includes the number of pregnancies (gravidity), number of deliveries in which the fetus reached term (term), number of preterm pregnancies (preterm), number of incomplete pregnancies (miscarriages or abortions), and number of children living (living). This is recorded: Grav _____ Term _____ Preterm _____ Ab _____ Living _____. For any incomplete pregnancies, the duration is recorded and whether the pregnancy resulted in a spontaneous (S) or an induced (I) abortion. Option A does not use approved medical abbreviations and does not include the number of living children. Options C and D do not include all the pertinent data of the person's obstetric history. Obstetric history includes the number of pregnancies (gravidity), number of deliveries in which the fetus reached term (term), number of preterm pregnancies (preterm), number of incomplete pregnancies (miscarriages or abortions), and number of children living (living). This is recorded: Grav _____ Term _____ Preterm _____ Ab _____ Living _____. For any incomplete pregnancies, the duration is recorded and whether the pregnancy resulted in a spontaneous (S) or an induced (I) abortion.

Question 16

A 59-year-old patient tells the nurse that he has ulcerative colitis. He has been having "black stools" for the last 24 hours. How would the nurse best document his reason for seeking care?

Accepted Answer

The reason for seeking care is a brief spontaneous statement in the person's own words that describes the reason for the visit. It states one (possibly two) signs or symptoms and their duration. It is enclosed in quotation marks to indicate the person's exact words. Options A, B, and C do not contain the patient's exact words in quotations regarding the reason they are seeking care. The reason for seeking care is a brief spontaneous statement in the person's own words that describes the reason for the visit. It states one (possibly two) signs or symptoms and their duration. It is enclosed in quotation marks to indicate the person's exact words.

Question 17

The nurse is preparing to conduct a health history. Which of these statements best describes the purpose of a health history?

Accepted Answer

The purpose of the health history is to collect subjective data-what the person says about him or herself. The other options are not correct. Although conducting a health history allows the nurse an opportunity for interaction with the patient and a method for obtaining a patient's biographic data, the purpose of the health history is to collect subjective data-what the person says about him or herself. The other options are not correct. The documentation of normal and abnormal findings of a physical assessment is part of the physical examination.

Question 18

The mother of a 16-month-old toddler tells the nurse that her daughter has an earache. What would be an appropriate response by the nurse?

Accepted Answer

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 child's 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.

Question 19

A patient tells the nurse that he is allergic to penicillin. What is the best response by the nurse?

Accepted Answer

When a person states he or she has an allergy, the nurse should note both the allergen (medication, food, or contact agent, such as fabric or environmental agent) and the reaction (rash, itching, runny nose, watery eyes, or difficulty breathing). Before asking the patient about other allergies, the nurse should find out the patient's reaction to penicillin. Asking how often the patient has received penicillin is not necessary. Before documenting that a patient is allergic to a medication, the nurse should find out the reaction to it to determine if it is a true allergy or an unpleasant side effect. Both the allergen (medication, food, or contact agent, such as fabric or environmental agent) and the reaction (rash, itching, runny nose, watery eyes, or difficulty breathing) should be recorded.

Question 20

In recording the childhood illnesses of a patient who denies having had any, which note by the nurse would be most accurate?

Accepted Answer

This is the most specific statement about childhood illnesses. Childhood illnesses include measles, mumps, rubella, chickenpox, pertussis, and strep throat. Avoid recording "usual childhood illnesses" because an illness common in the person's childhood may be unusual today (e.g., measles). When recording information about childhood illnesses, the nurse should avoid recording "usual childhood illnesses" because an illness common in the person's childhood may be unusual today (e.g., measles). Recording the patient was a very healthy child does not confirm or deny specific childhood illnesses and recording the patient stated his sister had measles but he didn't does not address the other childhood illnesses. Childhood illnesses include measles, mumps, rubella, chickenpox, pertussis, and strep throat.

Quiz 4: The Complete Health History