The Complete Health History Chapter 4

Chapter04:TheCompleteHealthHistory MULTIPLECHOICE 1.Thenurseispreparingtoconductahealthhistory.Whichofthesestatementsbestdescribesthepurposeofa healthhistory? a. Toprovideanopportunityforinteractionbetweenthepatientandthenurse b. Toprovideaformforobtainingthepatientsbiographicinformation c. Todocumentthenormalandabnormalfindingsofaphysicalassessment d. Toprovideadatabaseofsubjectiveinformationaboutthepatientspastandcurrenthealth ANS:D Thepurposeofthehealthhistoryistocollectsubjectivedatawhatthepersonsaysabouthimorherself.The otheroptionsarenotcorrect. DIF:CognitiveLevel:Understanding(Comprehension) MSC:ClientNeeds:SafeandEffectiveCareEnvironment:ManagementofCare 2.Whenthenurseisevaluatingthereliabilityofapatientsresponses,whichofthesestatementswouldbe correct?Thepatient: a. Hasahistoryofdrugabuseandthereforeisnotreliable. b. Providedconsistentinformationandthereforeisreliable. c. Smiledthroughoutinterviewandthereforeisassumedreliable. d. Wouldnotanswerquestionsconcerningstressandthereforeisnotreliable. ANS:B 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. DIF:CognitiveLevel:Applying(Application) MSC:ClientNeeds:SafeandEffectiveCareEnvironment:ManagementofCare 3.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? a. J.M.isa59-year-oldmanseekingtreatmentforulcerativecolitis. b. J.M.cameintothecliniccomplainingofhavingblackstoolsforthepast24hours. c. J.M.isa59-year-oldmanwhostatesthathehasulcerativecolitisandwantsitchecked. d. J.M.isa59-year-oldmanwhostatesthathehasbeenhavingblackstoolsforthepast24hours. ANS:D Thereasonforseekingcareisabriefspontaneousstatementinthepersons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personsexactwords. DIF:CognitiveLevel:Applying(Application) MSC:ClientNeeds:SafeandEffectiveCareEnvironment:ManagementofCare 4.Apatienttellsthenursethatshehashadabdominalpainforthepastweek.Whatwouldbethenursesbest response? a. Canyoupointtowhereithurts? b. Welltalkmoreaboutthatlaterintheinterview. c. Whathaveyouhadtoeatinthelast24hours? d. Haveyoueverhadanysurgeriesonyourabdomen? ANS:A Afinalsummaryofanysymptomthepersonhasshouldinclude,alongwithsevenothercriticalcharacteristics, Location:specific.Thepersonisaskedtopointtothelocation. DIF:CognitiveLevel:Applying(Application) MSC:ClientNeeds:SafeandEffectiveCareEnvironment:ManagementofCare 5.A29-year-oldwomantellsthenursethatshehasexcruciatingpaininherback.Whichwouldbethenurses appropriateresponsetothewomansstatement? a. Howdoesyourfamilyreacttoyourpain? b. Thepainmustbeterrible.Youprobablypinchedanerve. c. Ivehadbackpainmyself,anditcanbeexcruciating. d. Howwouldyousaythepainaffectsyourabilitytodoyourdailyactivities? ANS:D 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. DIF:CognitiveLevel:Applying(Application) MSC:ClientNeeds:SafeandEffectiveCareEnvironment:ManagementofCare 6.Inrecordingthechildhoodillnessesofapatientwhodenieshavinghadany,whichnotebythenursewould bemostaccurate? a. Patientdeniesusualchildhoodillnesses. b. Patientstateshewasaveryhealthychild. c. Patientstateshissisterhadmeasles,buthedidnt. d. Patientdeniesmeasles,mumps,rubella,chickenpox,pertussis,andstrepthroat. ANS:D Childhoodillnessesincludemeasles,mumps,rubella,chickenpox,pertussis,andstrepthroat.Avoidrecording usualchildhoodillnessesbecauseanillnesscommoninthepersonschildhoodmaybeunusualtoday(e.g., measles). DIF:CognitiveLevel:Remembering(Knowledge) MSC:ClientNeeds:SafeandEffectiveCareEnvironment:ManagementofCare 7.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? a. P-6,B-4,(S)Ab-2 b. Grav6,Term4,(S)Ab-2,Living4 c. Patienthashadfourlivingbabies. d. Patienthasbeenpregnantsixtimes. ANS:B 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. DIF:CognitiveLevel:Applying(Application) MSC:ClientNeeds:SafeandEffectiveCareEnvironment:ManagementofCare 8.Apatienttellsthenursethatheisallergictopenicillin.Whatwouldbethenursesbestresponsetothis information? a. Areyouallergictoanyotherdrugs? b. Howoftenhaveyoureceivedpenicillin? c. Illwriteyourallergyonyourchartsoyouwontreceiveanypenicillin. d. Describewhathappenstoyouwhenyoutakepenicillin. ANS:D 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. DIF:CognitiveLevel:Understanding(Comprehension) MSC:ClientNeeds:SafeandEffectiveCareEnvironment:ManagementofCare 9.Thenurseistakingafamilyhistory.Importantdiseasesorproblemsaboutwhichthepatientshouldbe specificallyaskedinclude: a. Emphysema. b. Headtrauma. c. Mentalillness. d. Fracturedbones. ANS:C 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. DIF:CognitiveLevel:Remembering(Knowledge) MSC:ClientNeeds:SafeandEffectiveCareEnvironment:ManagementofCare 10.Thereviewofsystemsprovidesthenursewith: a. Physicalfindingsrelatedtoeachsystem. b. Informationregardinghealthpromotionpractices. c. Anopportunitytoteachthepatientmedicalterms. d. Informationnecessaryforthenursetodiagnosethepatientsmedicalproblem. ANS:B 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. DIF:CognitiveLevel:Remembering(Knowledge) MSC:ClientNeeds:SafeandEffectiveCareEnvironment:ManagementofCare 11.Whichofthesestatementsrepresentssubjectivedatathenurseobtainedfromthepatientregardingthe patientsskin? a. Skinappearsdry. b. Nolesionsareobvious. c. Patientdeniesanycolorchange. d. Lesionisnotedonthelateralaspectoftherightarm. ANS:C Thehistoryshouldbelimitedtopatientstatementsorsubjectivedatafactorsthatthepersonsayswereorwere notpresent. DIF:CognitiveLevel:Understanding(Comprehension) MSC:ClientNeeds:SafeandEffectiveCareEnvironment:ManagementofCare 12.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? a. Doyouperformtesticularself-examinations? b. Haveyouevernoticedanypaininyourtesticles? c. Haveyouhadanyproblemswithpassingurine? d. Doyouhaveanyhistoryofsexuallytransmitteddiseases? ANS:A Healthpromotionforamanwouldincludetheperformanceoftesticularself-examinations.Theother questionsareaskingaboutpossiblediseaseorillnessissues. DIF:CognitiveLevel:Understanding(Comprehension) MSC:ClientNeeds:SafeandEffectiveCareEnvironment:ManagementofCare 13.Whichoftheseresponsesmightthenurseexpectduringafunctionalassessmentofapatientwhoselegisin acast? a. Ibrokemyrightleginacaraccident2weeksago. b. Thepainisdecreasing,butIstillneedtotakeacetaminophen. c. IcheckthecolorofmytoeseveryeveningjustlikeIwastaught. d. Imabletotransfermyselffromthewheelchairtothebedwithouthelp. ANS:D Functionalassessmentmeasuresapersonsself-careabilityintheareasofgeneralphysicalhealthorabsenceof illness.Theotherstatementsconcernhealthorillnessissues. DIF:CognitiveLevel:Applying(Application) MSC:ClientNeeds:SafeandEffectiveCareEnvironment:ManagementofCare 14.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? a. Thishasbeenadifficultyearforyou. b. Idontknowhowanyonecouldhandlethatmuchstressin1year! c. Whatdidyoudotocopewiththelhusbandandmother? d. Thatisalotofstress;nowletsgoontothenextsectionofyourhistory. ANS:C Questionsaboutcopingandstressmanagementincludequestionsregardingthekindsofstressesinones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. DIF:CognitiveLevel:Applying(Application) MSC:ClientNeeds:SafeandEffectiveCareEnvironment:ManagementofCare 15.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? a. Thisinformationisnecessarytodeterminethepatientsreliability. b. Alcoholcaninteractwithallmedicationsandcanmakesomediseasesworse. c. Thenurseneedstobeabletoteachthepatientaboutthedangersofalcoholuse. d. Thisinformationisnotnecessaryunlessadrinkingproblemisobvious. ANS:B 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. DIF:CognitiveLevel:Understanding(Comprehension) MSC:ClientNeeds:SafeandEffectiveCareEnvironment:ManagementofCare 16.Themotherofa16-month-oldtoddlertellsthenursethatherdaughterhasanearache.Whatwouldbean appropriateresponse? a. Maybesheisjustteething. b. Iwillcheckherearforanearinfection. c. Areyousuresheisreallyhavingpain? d. Describewhatsheisdoingtoindicatesheishavingpain. ANS:D 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childs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. DIF:CognitiveLevel:Applying(Application) MSC:ClientNeeds:SafeandEffectiveCareEnvironment:ManagementofCare 17.Duringanassessmentofapatientsfamilyhistory,thenurseconstructsagenogram.Whichstatementbest describesagenogram? a. Listofdiseasespresentinapersonsnearrelatives b. Graphicfamilytreethatusessymbolstodepictthegender,relationship,andageofimmediate familymembers c. Drawingthatdepictsthepatientsfamilymembersuptofivegenerationsback d. Descriptionofthehealthofapersonschildrenandgrandchildren ANS:B 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. DIF:CognitiveLevel:Applying(Application) MSC:ClientNeeds:SafeandEffectiveCareEnvironment:ManagementofCare 18.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? a. Childsbirthweight b. Ageatwhichhecrawled c. Whetherthechildhashadthemeasles d. Childsreactionstoprevioushospitalizations ANS:D 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. DIF:CognitiveLevel:Analyzing(Analysis) MSC:ClientNeeds:SafeandEffectiveCareEnvironment:ManagementofCare 19.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recommendationshouldthenursemake? a. NofurtherMMRimmunizationsareneeded. b. MMRvaccinationneedstoberepeatedat4to6yearsofage. c. MMRimmunizationneedstoberepeatedevery4yearsuntilage21years. d. Arecommendationcannotbemadeuntilthephysicianisconsulted. ANS:B BecauseofrecentoutbreaksofmeaslesacrosstheUnitedStates,theAmericanAcademyofPediatrics(2006) recommendstwodosesoftheMMRvaccine,oneat12to15monthsofageandoneatage4to6years. DIF:CognitiveLevel:Analyzing(Analysis) MSC:ClientNeeds:SafeandEffectiveCareEnvironment:ManagementofCare 20.Inobtainingareviewofsystemsonahealthy7-year-oldgirl,thehealthcareproviderknowsthatitwould beimportanttoincludethe: a. Lastglaucomaexamination. b. Frequencyofbreastself-examinations. c. Dateofherlastelectrocardiogram. d. Limitationsrelatedtoherinvolvementinsportsactivities. ANS:D Whenreviewingthecardiovascularsystem,thehealthcareprovider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. DIF:CognitiveLevel:Applying(Application) MSC:ClientNeeds:SafeandEffectiveCareEnvironment:ManagementofCare 21.Whenthenurseasksforadescriptionofwholiveswithachild,themethodofdiscipline,andthesupport systemofthechild,whatpartoftheassessmentisbeingperformed? a. Familyhistory b. Reviewofsystems c. Functionalassessment d. Reasonforseekingcare ANS:C Functionalassessmentincludesinterpersonalrelationshipsandhomeenvironment.Familyhistoryincludes illnessesinfamilymembers;areviewofsystemsincludesquestionsaboutthevariousbodysystems;andthe reasonforseekingcareistherationaleforrequestinghealthcare. DIF:CognitiveLevel:Understanding(Comprehension) MSC:ClientNeeds:SafeandEffectiveCareEnvironment:ManagementofCare 22.Thenurseisobtainingahealthhistoryonan87-year-oldwoman.Whichofthefollowingareasof questioningwouldbemostusefulatthistime? a. Obstetrichistory b. Childhoodillnesses c. Generalhealthforthepast20years d. Currenthealthpromotionactivities ANS:D Itisimportantforthenursetorecognizepositivehealthmeasures,suchaswhatthepersonhasbeendoingto helphimorherselfstaywellandtolivetoanolderage.Theotherresponsesarenotpertinenttoapatientof thisage. DIF:CognitiveLevel:Applying(Application) MSC:ClientNeeds:SafeandEffectiveCareEnvironment:ManagementofCare 23.Thenurseisperformingareviewofsystemsona76-year-oldpatient.Whichofthesestatementsiscorrect forthissituation? a. Thequestionsaskedareidenticalforallages. b. Theinterviewerwillstartincorporatingdifferentquestionsforpatients70yearsofageandolder. c. Questionsthatarereflectiveofthenormaleffectsofagingareadded. d. Atthisage,areviewofsystemsisnotnecessarythefocusshouldbeoncurrentproblems. ANS:C Thehealthhistoryincludesthesameformatasthatdescribedfortheyoungeradult,aswellassomeadditional questions.Theseadditionalquestionsaddresswaysinwhichtheactivitiesofdailylivingmayhavebeen affectedbythenormalagingprocessesorbytheeffectsofchronicillnessordisability. DIF:CognitiveLevel:Understanding(Comprehension) MSC:ClientNeeds:SafeandEffectiveCareEnvironment:ManagementofCare 24.A90-year-oldpatienttellsthenursethathecannotrememberthenamesofthemedicationsheistakingor forwhatreasonheistakingthem.Anappropriateresponsefromthenursewouldbe: a. Canyoutellmewhattheylooklike? b. Dontworryaboutit.Youareonlytakingtwomedications. c. Howlonghaveyoubeentakingeachofthepills? d. Wouldyouhaveafamilymemberbringinyourmedications? ANS:D Thepersonmaynotknowthedrugnameorpurpose.Whenthisoccurs,askthepersonorafamilymemberto bringinthedrugtobeidentified.Theotherresponseswouldnothelptoidentifythemedications. DIF:CognitiveLevel:Applying(Application) MSC:ClientNeeds:SafeandEffectiveCareEnvironment:ManagementofCare 25.Thenurseisperformingafunctionalassessmentonan82-year-oldpatientwhorecentlyhadastroke. Whichofthesequestionswouldbemostimportanttoask? a. Doyouwearglasses? b. Areyouabletodressyourself? c. Doyouhaveanythyroidproblems? d. Howmanytimesadaydoyouhaveabowelmovement? ANS:B Functionalassessmentmeasureshowapersonmanagesday-to-dayactivities.Fortheolderperson,the meaningofhealthbecomesthoseactivitiesthattheycanorcannotdo.Theotherresponsesdonotrelateto functionalassessment. DIF:CognitiveLevel:Applying(Application) MSC:ClientNeeds:SafeandEffectiveCareEnvironment:ManagementofCare 26.Thenurseispreparingtodoafunctionalassessment.Whichstatementbestdescribesthepurposeofa functionalassessment? a. Thefunctionalassessmentassesseshowtheindividualiscopingwithlifeathome. b. Itdetermineshowchildrenaremeetingdevelopmentalmilestones. c. Thefunctionalassessmentcanidentifyanyproblemswithmemorytheindividualmaybe experiencing. d. Ithelpsdeterminehowapersonismanagingday-to-dayactivities. ANS:D Thefunctionalassessmentmeasureshowapersonmanagesday-to-dayactivities.Theotheranswersdonot reflectthepurposeofafunctionalassessment. DIF:CognitiveLevel:Remembering(Knowledge) MSC:ClientNeeds:SafeandEffectiveCareEnvironment:ManagementofCare 27.Thenurseisaskingapatientforhisreasonforseekingcareandasksaboutthesignsandsymptomsheis experiencing.Whichoftheseisanexampleofasymptom? a. Chestpain b. Clammyskin c. Serumpotassiumlevelat4.2mEq/L d. Bodytemperatureof100F ANS:A Asymptomisasubjectivesensation(e.g.,chestpain)thatapersonfeelsfromadisorder.Asignisanobjective abnormalitythattheexaminercandetectonphysicalexaminationorinlaboratoryreports,asillustratedbythe otherresponses. DIF:CognitiveLevel:Understanding(Comprehension) MSC:ClientNeeds:SafeandEffectiveCareEnvironment:ManagementofCare 28.Apatientisdescribinghissymptomstothenurse.Whichofthesestatementsreflectsadescriptionofthe settingofhissymptoms? a. Itisasharp,burningpaininmystomach. b. IalsohavethesweatsandnauseawhenIfeelthispain. c. Ithinkthispainistellingmethatsomethingbadiswrongwithme. d. ThispainhappenseverytimeIsitdowntousethecomputer. ANS:D Thesettingdescribeswherethepersonisorwhatthepersonisdoingwhenthesymptomstarts.Describingthe painassharpandburningreflectsthecharacterorqualityofthepain;statingthatthepainistellingthepatient thatsomethingbadiswrongwithhimreflectsthepatientsperceptionofthepain;anddescribingthesweatsand nauseareflectsassociatedfactorsthatoccurwiththepain. DIF:CognitiveLevel:Analyzing(Analysis) MSC:ClientNeeds:SafeandEffectiveCareEnvironment:ManagementofCare 29.Duringanassessment,thenurseusestheCAGEtest.Thepatientanswersyestotwoofthequestions.What couldthisbeindicating? a. Thepatientisanalcoholic. b. Thepatientisannoyedatthequestions. c. Thepatientshouldbethoroughlyexaminedforpossiblealcoholwithdrawalsymptoms. d. Thenurseshouldsuspectalcoholabuseandcontinuewithamorethoroughsubstanceabuse assessment. ANS:D TheCAGEtestisknownasthecutdown,annoyed,guilty,andeye-openertest.Ifapersonanswersyestotwo ormoreofthefourCAGEquestions,thenthenurseshouldsuspectalcoholabuseandcontinuewithamore completesubstanceabuseassessment. DIF:CognitiveLevel:Analyzing(Analysis) MSC:ClientNeeds:SafeandEffectiveCareEnvironment:ManagementofCare 30.Thenurseisincorporatingapersonsspiritualvaluesintothehealthhistory.Whichofthesequestions illustratesthecommunityportionoftheFICA(faithandbelief,importanceandinfluence,community,and addressingorapplyingincare)questions? a. DoyoubelieveinGod? b. Areyouapartofanyreligiousorspiritualcongregation? c. Doyouconsideryourselftobeareligiousorspiritualperson? d. Howdoesyourreligiousfaithinfluencethewayyouthinkaboutyourhealth? ANS:B Thecommunityisassessedwhenthenurseaskswhetherapersonispartofareligiousorspiritualcommunity orcongregation.Theotherareasassessedarefaith,influence,andaddressinganyreligiousorspiritualissues orconcerns. DIF:CognitiveLevel:Understanding(Comprehension) MSC:ClientNeeds:SafeandEffectiveCareEnvironment:ManagementofCare 31.Thenurseispreparingtocompleteahealthassessmentona16-year-oldgirlwhoseparentshavebrought hertotheclinic.Whichinstructionwouldbeappropriatefortheparentsbeforetheinterviewbegins? a. Pleasestayduringtheinterview;youcananswerforherifshedoesnotknowtheanswer. b. Itwouldhelptointerviewthethreeofyoutogether. c. WhileIinterviewyourdaughter,willyoupleasestayintheroomandcompletethesefamilyhealth historyquestionnaires? d. WhileIinterviewyourdaughter,willyoustepouttothewaitingroomandcompletethesefamily healthhistoryquestionnaires? ANS:D Thegirlshouldbeinterviewedalone.Theparentscanwaitoutsideandfilloutthefamilyhealthhistory questionnaires. DIF:CognitiveLevel:Analyzing(Analysis) MSC:ClientNeeds:SafeandEffectiveCareEnvironment:ManagementofCare 32.ThenurseisassessinganewpatientwhohasrecentlyimmigratedtotheUnitedStates.Whichquestionis appropriatetoaddtothehealthhistory? a. WhydidyoucometotheUnitedStates? b. WhendidyoucometotheUnitedStatesandfromwhatcountry? c. Whatmadeyouleaveyournativecountry? d. Areyouplanningtoreturntoyourhome? ANS:B Biographicdata,suchaswhenthepersonenteredtheUnitedStatesandfromwhatcountry,areappropriate additionstothehealthhistory.Theotheranswersdonotreflectappropriatequestions. DIF:CognitiveLevel:Analyzing(Analysis) MSC:ClientNeeds:PsychosocialIntegrity MULTIPLERESPONSE 1.Thenurseisassessingapatientsheadachepain.Whichquestionsreflectoneormoreofthecritical characteristicsofsymptomsthatshouldbeassessed?Selectallthatapply. a. Whereistheheadachepain? b. Didyouhavetheseheadachesasachild? c. Onascaleof1to10,howbadisthepain? d. Howoftendotheheadachesoccur? e. Whatmakestheheadachesfeelbetter? f. Doyouhaveanyfamilyhistoryofheadaches? ANS:A,C,D,E ThemnemonicPQRSTUmayhelpthenurseremembertoaddressthecriticalcharacteristicsthatneedtobe assessed:(1)P:provocativeorpalliative;(2)Q:qualityorquantity;(3)R:regionorradiation;(4)S:severity scale;(5)T:timing;and(6)U:understandthepatientsperception.Asking,Whereisthepain?reflectsregion. Askingthepatienttoratethepainona1to10scalereflectsseverity.AskingHowoftenreflectstiming. Askingwhatmakesthepainbetterreflectsprovocative.Theotheroptionsreflecthealthhistoryandfamily history. DIF:CognitiveLevel:Analyzing(Analysis) MSC:ClientNeeds:SafeandEffectiveCareEnvironment:ManagementofCare 2.Thenurseisconductingadevelopmentalhistoryona5-year-oldchild.Whichquestionsareappropriateto asktheparentsforthispartoftheassessment?Selectallthatapply. a. Howmuchjunkfooddoesyourchildeat? b. Howmanyteethhashelost,andwhendidhelosethem? c. Isheabletotiehisshoelaces? d. Doeshetakeachildrensvitamin? e. Canhetelltime? f. Doeshehaveanyfoodallergies? ANS:B,C,E Questionsabouttoothloss,abilitytotelltime,andabilitytotieshoelacesareappropriatequestionsfora developmentalassessment.Questionsaboutjunkfoodintakeandvitaminsarepartofanutritionalhistory. Questionsaboutfoodallergiesarenotpartofadevelopmentalhistory. DIF:CognitiveLevel:Analyzing(Analysis) MSC:ClientNeeds:SafeandEffectiveCareEnvironment:ManagementofCare