Deck 5: The Complete Health History

Question 1

When the nurse is evaluating the reliability of a patient's responses,which of the following would be a correct statement?
1)The patient has a history of drug abuse and therefore is not reliable.
2)The patient provided consistent information and therefore is reliable.
3)The patient smiled throughout interview and therefore is assumed reliable.
4)The patient would not answer questions concerning stress and therefore is not reliable.

Answer 1

2
A reliable person always gives the same answers,even when questions are rephrased or are repeated later in the interview.

Question 2

A 29-year-old woman tells the nurse that she has "excruciating pain" in her back.Which of the following would be an appropriate response by the nurse to her statement?
1)"How does your family react to your pain?"
2)"That must be terrible.You probably pinched a nerve."
3)"I've had back pain myself and it can be excruciating."
4)"How would you say the pain affects your ability to do your daily activities?"

Answer 2

4
The symptom of pain is difficult to quantify because of individual interpretation.With pain,avoid adjectives and ask how it affects daily activities.

Question 3

Which of the following statements best describes the purpose of a health history?
1)To provide an opportunity for interaction between patient and nurse
2)To provide a form for obtaining the patient's biographic information
3)To document the normal and abnormal findings of a physical assessment
4)To provide a database of subjective information about the patient's past and current health

Answer 3

4
The purpose of the health history is to collect subjective data-what the person says about himself or herself.

Question 4

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?
1)P-6,B-4, (S)Ab-2
2)Grav 6,Term 4, (S)Ab 2,Living 4
3)Patient has had four living babies.
4)Patient has been pregnant six times.

Question 5

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?
1)"This has been a difficult year for you."
2)"I don't know how anyone could handle that much stress in 1 year!"
3)"What did you do to cope with the loss of both your husband and mother?"
4)"That is a lot of stress;now let's go on to the next section of your history."

Question 6

Which of the following statements represents subjective data obtained from the patient regarding his skin?
1)Skin appears dry.
2)No obvious lesions
3)Denies color change
4)Lesion noted lateral aspect right arm

Question 7

The nurse is obtaining a history from a 30-year-old male patient and is concerned about health promotion activities.Which of the following questions would be appropriate to use to assess health promotion activities for this patient?
1)"Do you perform testicular self-exams?"
2)"Have you ever noticed any pain in your testicles?"
3)"Have you had any problems with passing your urine?"
4)"Do you have any history of sexually transmitted disease?"

Question 8

A patient tells the nurse that she has had abdominal pain for the past week.What would be the best response by the nurse?
1)"Can you point to where it hurts?"
2)"We'll talk more about that later in the interview."
3)"What have you had to eat in the last 24 hours?"
4)"Have you ever had any surgeries on your abdomen?"

Question 9

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?
1)Obstetric history
2)Childhood illnesses
3)General health for the past 20 years
4)Current health promotion activities

Question 10

Which of the following responses might the nurse expect during a functional assessment of a patient whose leg is in a cast?
1)"I broke my right leg in a car accident 2 weeks ago."
2)"The pain is getting less,but I still need to take Tylenol."
3)"I check the color of my toes every evening just like I was taught."
4)"I'm able to transfer myself from the wheelchair to the bed without help."

Question 11

The mother of a 16-month-old toddler tells the nurse that her daughter has an earache.What would be an appropriate response?
1)"Maybe she is just teething."
2)"I will check her ear for an ear infection."
3)"Are you sure she is really having pain?"
4)"Please describe what she is doing to indicate she is having pain."

Question 12

A 90-year-old patient tells the nurse that he can't remember the names of the drugs he is taking or what they are for.An appropriate response would be:
1)"Can you tell me what they look like?"
2)"Don't worry about it.You are only taking two."
3)"How long have you been taking each of the pills?"
4)"Would you have your family bring in your medications?"

Question 13

The review of systems provides the nurse with:
1)physical findings related to each system.
2)information regarding health promotion practices.
3)an opportunity to teach the patient medical terms.
4)information necessary for the nurse to diagnose the patient's medical problem.

Question 14

In response to a question regarding use of alcohol,a patient asks the nurse why the nurse needs to know.What is the reason for needing this information?
1)This is necessary to determine the patient's reliability.
2)Alcohol can interact with all medications and make some diseases worse.
3)The nurse needs to be able to teach the patient about the dangers of alcohol use.
4)It's not really necessary to have this information unless there is an obvious drinking problem.

Question 15

A description of who lives with a child,the method of discipline,and support system are all related to which part of the assessment?
1)Family history
2)Review of systems
3)Functional assessment
4)Reason for seeking care

Question 16

The nurse is taking a family history.Important diseases or problems to ask the patient about include:
1)emphysema.
2)head trauma.
3)mental illness.
4)fractured bones.

Question 17

In obtaining the history from the mother of a 2-year-old with pneumonia,the nurse asks the mother if she smoked or used drugs during her pregnancy.Her response is,"What does that have to do with pneumonia?" How would the nurse answer her question?
1)"You don't need to answer if it makes you uncomfortable."
2)"It's not really that important;we just ask everyone the same questions."
3)"The use of tobacco during pregnancy could be the cause of your daughter's pneumonia."
4)"Knowing about your pregnancy gives us a more complete picture of your daughter's health."

Question 18

The nurse is performing a review of systems on a 76-year-old patient.Which of the following statements is correct for this situation?
1)The questions asked are identical for all ages.
2)The interviewer will start incorporating different questions for patients 70 years of age and older.
3)Additional questions to include are reflective of the normal effects of aging.
4)At this age,a review of systems is not necessary-just focus on current problems.

Question 19

A patient tells the nurse that he is allergic to penicillin.What would be the nurse's best response to this information?
1)"Are you allergic to any other drugs?"
2)"How often have you received penicillin?"
3)"I'll write your allergy on your chart so you won't receive any."
4)"Please describe what happens to you when you take penicillin."

Question 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:
1)last glaucoma exam.
2)frequency of breast self-exam.
3)date of her last electrocardiogram.
4)limitations related to her involvement in sports activities.

Question 21

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 better?"
F)"Do you have any family history of headaches?"
G)"What do you think is causing these headaches?"

Question 22

The nurse is performing a functional assessment on an 82-year-old patient with a recent stroke.Which of the following questions would be most important to ask?
1)"Do you wear glasses?"
2)"Are you able to dress yourself?"
3)"Do you have any thyroid problems?"
4)"How many times a day do you have a bowel movement?"

Question 23

Which of the following best describes the purpose of a functional assessment?
1)It assesses how the individual is coping with life at home.
2)It determines how children are meeting developmental milestones.
3)It can identify any problems with memory the individual may be experiencing.
4)With the elderly,it helps to determine how they are managing day-to-day activities.

Question 24

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?
1)"Why did you come to the United States?"
2)"When did you come to the United States,and from what country?"
3)"What made you leave your native country?"
4)"Are you planning to return to your home?"

Question 25

Which are appropriate health promotion questions to ask during a review of symptoms?
1)"Do you use sunscreen while outside?"
2)"I need to see if your skin is warm and dry."
3)"Have you had any dizziness or headaches?"
4)"When you cough,what color is the sputum you bring up?"

Question 26

Which of the following is an example of a symptom?

A)Chest pain
B)Clammy skin
C)Serum potassium level 4.2 mEq/L
D)A temperature of 100 ^$\circ$ F

Question 27

When incorporating the person's spiritual values into the health history,which of the following questions illustrates the "community" portion of the FICA questions?
1)"Do you believe in God?"
2)"Are you a part of any religious or spiritual congregation?"
3)"Do you consider yourself to be a religious or spiritual person?"
4)"How does your religious faith influence the way you think about your health?"

Question 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?
1)"Please stay during the interview;you can answer for her if she does not know the answer."
2)"It would help to interview the three of you together."
3)"While I interview your daughter,will you please stay in the room and complete these family health history questionnaires?"
4)"While I interview your daughter,will you step out to the waiting room and complete these family health history questionnaires?"

Question 29

During an assessment,the nurse uses the CAGE test.The patient answers "yes" to two of the questions.What could this be indicating?
1)The patient is an alcoholic.
2)The patient is annoyed at the questions.
3)The patient should be examined thoroughly for possible alcohol withdrawal symptoms.
4)The nurse should suspect alcohol abuse and continue with a more thorough substance abuse assessment.

Question 30

When a patient is describing his symptoms,which of the following statements reflects a description of the setting of his symptoms?
1)"It is a sharp,burning pain in my stomach."
2)"I also have the sweats and nausea when I feel this pain."
3)"I think this pain is telling me that something bad is wrong with me."
4)"This pain happens every time I sit down to use the computer."