Question 1

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.

Question 2

In obtaining a review of systems on a "healthy" 7-year-old girl, the nurse knows that it would be important to include the:

Accepted Answer

When reviewing the cardiovascular system, the nurse should ask whether 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.

Question 3

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.

Question 4

A patient tells the nurse that he is allergic to penicillin.What would be the nurse's best response to this information?

Accepted Answer

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).With a drug, this symptom should not be a side effect but a true allergic reaction.

Question 5

Which of these statements represents subjective data the nurse obtained from the patient regarding the patient's skin?

Accepted Answer

The history should be limited to patient statements or subjective data-factors that the person says were or were not present.

Question 6

The review of systems section provides the nurse with:

Accepted Answer

The purposes of the review of systems are to: (1) evaluate the past and current health states 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.

Question 7

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

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 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

A final summary of any symptom the person has should include, along with seven other critical characteristics, "Location: Be specific." The person is asked to point to the location.

Question 9

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 (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 10

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 himself or herself.The other options are not correct.

Question 11

The nurse is obtaining the 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 activities for a man would include the performance of testicular self-examinations.The other questions are asking about possible disease or illness issues.

Question 12

The nurse is taking a family history.Important diseases or problems about which the patient should be specifically asked include:

Accepted Answer

Questions asked should specifically enquire about 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.

Question 13

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

Accepted Answer

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).

Question 14

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 age 15 months.What recommendation should the nurse make?

Accepted Answer

The Centers of Disease control and Prevention (CDC) recommends that children received two doses of MMR vaccine, starting with the first dose at age 12 to 15 months, and the second dose at ages 4 through 6 years.

Question 15

A 59-year-old patient tells the nurse that he has ulcerative colitis.He has been having "black stools" for the past 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.The symptom description is enclosed in quotation marks to indicate the person's exact words.

Question 16

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

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 17

In response to a question about stress, a 39-year-old woman tells the nurse that her husband and her 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 past year, any changes in lifestyle or any current stress, methods tried to relieve stress, and whether these methods have been helpful.

Question 18

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

Accepted Answer

The symptom of pain is difficult to quantify because of individual interpretation.With pain, adjectives should be avoided, and the patient should be asked how the pain affects his or her daily activities.The other responses are not appropriate.

Question 19

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 abuse 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.

Question 20

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.

Quiz 5: The Complete Health History