Chapter 04: The Complete Health History
Jarvis: Physical Examination and Health Assessment, 8th Edition
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 patient’s biographic information
c.
To document the normal and abnormal findings of a physical assessment
d.
To provide a database of subjective information about the patient’s past and
current health
2. When the nurse is evaluating the reliability of a patient’s responses, which of these statements
would be correct?
a.
Patient has a history of drug abuse and therefore is not reliable.
b.
Patient provided consistent information and therefore is reliable.
c.
Patient smiled throughout interview and therefore is assumed reliable.
d.
Patient would not answer questions concerning stress and therefore is not reliable.
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.
4. A patient tells the nurse that she has had abdominal pain for the past week. What would be the
nurse’s best response?
a.
“Can you point to where it hurts?”
b.
“What have you had to eat in the last 24 hours?”
c.
“Have you ever had any surgeries on your abdomen?”
d.
“We’ll talk more about that later in the interview.”
5. A 29-year-old woman tells the nurse that she has “excruciating pain” in her back. Which
response by the nurse would be appropriate?
a.
“How does your family react to your pain?”
b.
“The pain must be terrible. You probably pinched a nerve.”
c.
“I’ve had back pain myself, and it can be excruciating.”
d.
“How would you say the pain affects your ability to do your daily activities?”
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 didn’t.
d.
Patient denies measles, mumps, rubella, chickenpox, pertussis, and strep throat.
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 6 times.
8. A patient tells the nurse that he is allergic to penicillin. What is the best response by the
nurse?
a.
“Are you allergic to any other drugs?”
b.
“How often have you received penicillin?”
c.
“Describe what happens to you when you take penicillin.”
d.
“I’ll write your allergy on your chart so you won’t receive any penicillin.”
9. The nurse is taking a family history. Which specific disease or problem should be included in
the assessment?
a.
Emphysema
b.
Head trauma
c.
Mental illness
d.
Fractured bones
10. What does the review of systems provide the nurse?
a.
Physical findings r/t 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 patient’s medical problem
11. What information obtained by the nurse regarding a patient’s skin should the nurse record in
the patient’s health history?
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.
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 infections?”
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.
“I’m able to transfer myself from the wheelchair to the bed without help.”
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 don’t know how anyone could handle that much stress in 1 year!”
c.
“What did you do to cope with the loss of both your husband and mother?”
d.
“That is a lot of stress; now let’s go on to the next section of your history.”
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 patient’s 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.
16. 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?
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.”
17. During an assessment of a patient’s family history, the nurse constructs a genogram. Which
statement best describes a genogram?
a.
List of diseases present in a person’s 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 patient’s family members up to five generations back
d.
Description of the health of a person’s children and grandchildren
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.
Child’s birth weight
b.
Age at which he crawled
c.
Whether the child has had the measles
d.
Child’s reactions to previous hospitalizations
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 should the nurse recommend?
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.
d.
A recommendation cannot be made until the physician is consulted.
20. In obtaining a review of systems on a “healthy” 7-year-old girl, what should the health care
provider be sure to include?
a.
Last glaucoma examination
b.
Frequency of breast self-examinations
c.
Date of her last electrocardiogram
d.
Limitations r/t her involvement in sports activities
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
22. 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?”
23. 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.
24. 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
25. 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.”
26. 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.
27. The nurse is incorporating a person’s 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?”
28. 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.
“It would help to interview the three of you together.”
b.
“While I interview your daughter, will you step out to the waiting room and
complete these family health history questionnaires?”
c.
“Please stay during the interview; you can answer for her if she does not know the
answer.”
d.
“While I interview your daughter, will you please stay in the room and complete
these family health history questionnaires?”
29. 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?”
MULTIPLE RESPONSE
1. The nurse is assessing a patient’s 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?”
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.
“Can he tell time?”
b.
“Does he have any food allergies?”
c.
“Is he able to tie his shoelaces?”
d.
“Does he take a children’s vitamin?”
e.
“How much junk food does your child eat?”
f.
“How many teeth has he lost, and when did he lose them?”