Deck 8: The Health History

Question 1

The nurse is gathering client data from secondary sources. Which sources would the nurse utilize to collect this data?

A) The client's past medical records.
B) The client.
C) The history and physical.
D) The client's physical therapist.
E) The client's spouse.

Answer 1

The client's past medical records.
The history and physical.
The client's physical therapist.
The client's spouse.

Question 2

The nurse is completing a focused interview. Which piece of information would the nurse include during this interaction?

A) Identify new nursing diagnoses after clarifying previously obtained data.
B) Review information collected during client's previous health screening activities.
C) Obtain biographic data about the client.
D) Review data from previous medical records.

Answer 2

Identify new nursing diagnoses after clarifying previously obtained data.

Question 3

The nurse is preparing to interview the hospitalized client. Which statements by the client's nurse indicate that the interview should be postponed?

A) "I can't seem to get her pain under control this morning."
B) "I just gave her morphine sulfate through her IV for pain about 20 minutes ago."
C) "She was anxious earlier and received some lorazepam."
D) "She's been oriented to 'self' only since admission."
E) "I gave her some ibuprofen about 1 hour ago."

Answer 3

"I can't seem to get her pain under control this morning."
"I just gave her morphine sulfate through her IV for pain about 20 minutes ago."
"She was anxious earlier and received some lorazepam."
"She's been oriented to 'self' only since admission."

Question 4

The nurse is obtaining information about a client's past medical history. Which source would provide the nurse with this data?

A) Medication list.
B) Immunization records.
C) Average amount of hours of sleep each night.
D) Marital status.

Question 5

The nurse is obtaining a family health history when the client reports that a grandparent had type 1 diabetes. Where should the nurse document this information?

A) Family pedigree.
B) Health practices.
C) Past medical history.
D) Present health/illness.

Question 6

Which are appropriate focuses for the health history collected by the nurse?

A) Physical status.
B) Patterns of daily living.
C) Wellness practices.
D) Self-care activities.
E) Medical diagnoses.

Question 7

The nurse is developing a pedigree. Which pieces of information can be used to help identify the widowed female?

A) A square is used to denote the female.
B) A circle is used to denote the male.
C) A horizontal line connects the circle and the square in the middle.
D) A line above the circle and square that is linked on the top of each shape.
E) The square has a diagonal line through the square from bottom left to upper right corner.

Question 8

When creating a pedigree, which items would the nurse consider as red flags?

A) Known genetic conditions.
B) Multiple family members with the same disease.
C) Late age of disease onset.
D) Death from chronic illness.
E) Multiple pregnancy losses.

Question 9

The nurse is gathering information regarding the client's psychosocial history. Which question would be included in this assessment?

A) "How did your father die?"
B) "Have you had any major surgeries?"
C) "Have you noticed any change in your vision?"
D) "How long have you worked for your current employer?"

Question 10

The client has been diagnosed with an early stage of wide-angle glaucoma. The nurse is performing a wellness assessment during the client's initial interview. Which statements by the client may be elicited during this portion of the health history?

A) "My mom was diagnosed with glaucoma when she was 60 years old."
B) "I pay attention to the foods that I eat, because I want my body to stay well."
C) "I think I do a good job of managing stress with yoga every day and running three times a week."
D) "My husband and I have three couples that we would classify as our very good friends."
E) "Sometimes, my eyes feel very tired and sort of ache."

Question 11

The nurse is interviewing an older African American client and determines that a teaching plan should be implemented. Based on the client's race, which statement by the client may prompt the nurse to plan develop a teaching plan?

A) "My hands and feet are always cold."
B) "I do not take calcium replacements."
C) "My blood pressure is high most of the time."
D) "I'm worried that my bones may be weak."

Question 12

The nurse says to the client, "Before the healthcare provider comes in to see you, we will need to spend about 30 minutes talking about your current problem and any other health issues that might impact how you are feeling right now." The nurse is participating in which phase of the health assessment interview?

A) Pre-interaction.
B) The initial interview.
C) The focused interview.
D) Closure of the interview.

Question 13

During the course of a health history the nurse would like to review a client's medications. Which question is most important to ask when gathering the medication history?

A) "Can you tell me how much the co-pay is for your medications?"
B) "Do you carry health insurance?"
C) "Can you tell me about any over-the-counter or prescription medications that you take?"
D) "Where do you store your medications in your home?"

Question 14

A client has been brought to the emergency department (ED) by a family member. The client is speaking incoherently. To obtain information about the client's current health status, what should the nurse do?

A) Call the client's healthcare provider.
B) Call the Medical Records department to obtain other records for the client.
C) Discuss the situation with the family member who brought the client to the hospital.
D) Conduct a thorough physical assessment and document the health history as "unable to obtain."

Question 15

The student nurse is preparing to perform a health history interview. Which statements indicate that the student nurse requires further education regarding the purpose of the health history?

A) "As the nurse, I will mainly focus on the course of the client's illness."
B) "The client's health history can be gathered during the initial interview."
C) "I realize that the client is sick, but I also need to perform a wellness assessment."
D) "The healthcare provider's and nurse's assessments should be almost identical with the same focus."
E) "The nurse typically has a more holistic point of view regarding the client's health."

Question 16

Which is the purpose of a health history when admitting a client into the hospital with an exacerbation of a chronic disease process?

A) Documenting the client response to health concerns.
B) Documenting the client's dietary history.
C) Documenting the client's stress management skills.
D) Documenting the client's social interactions.

Question 17

Which piece of information will the nurse collect when assessing the client's past medical history?

A) Name.
B) Marital status.
C) Childhood illnesses.
D) Reason for seeking care.

Question 18

The nurse is performing a focused interview with the client. Which behaviors indicate that the client may be feeling anxious?

A) While seated, the client begins to wiggle his foot back and forth quickly.
B) The client leans back in his chair and seems to move away from the nurse.
C) The client crosses his arms and becomes very quiet.
D) The client leans forward in the chair and uncrosses his legs.
E) The client seems to be distracted and is no longer making direct eye contact with the nurse.

Question 19

During the pre-interaction stage, the nurse is preparing for the initial interview. Which setting is the least appropriate setting for the initial interview?

A) The client has been admitted to the hospital with pneumonia. The nurse is preparing to interview the client in the client's private hospital room.
B) The client lives at home. The nurse is preparing to interview the client in the client's living room.
C) The client lives at home. The nurse is preparing to interview the client at a small coffee shop not far from the client's home.
D) The client lives at home. The nurse is preparing to interview the client in the client's backyard.

Question 20

The nurse is interviewing a client who has been admitted to the hospital with severe abdominal pain. The nurse is assessing the client's pain using the acronym OLDCART & ICE. Rank the following the statements by the nurse in order of the way they are normally assessed. Standard Text: Click on the down arrow for each response in the right column and select the correct choice from the list.
Response

A) "How long have you had this pain?" Response
B) "Would you please point to the location of your pain?" Response
C) "How would you describe your pain? Is it sharp, dull, stabbing?" Response
D) "Can you tell me when your pain first began?"

Question 21

The nurse in the clinic is assessing an adult client who has 2+ ankle edema, crackles throughout the lung fields, and dyspnea on exertion. The nurse concludes that the client will need lifestyle-change teaching. Which is an important area for the nurse to assess next during the health history?

A) The client's family history.
B) If the client eats foods high in salt.
C) How many children the client has.
D) If the client is married or divorced.

Question 22

The nurse is examining a client with congestive heart failure who takes propranolol and furosemide. The client complains of fatigue and an inability to finish tasks. Which conclusion by the nurse is the most appropriate?

A) The medication needs adjustment.
B) The client has not been exercising.
C) The client is experiencing expected manifestations of the disease process.
D) The client should be hospitalized.

Question 23

While conducting a review of systems assessment during a health history, which question is appropriate?

A) "Have you ever had a surgical procedure?"
B) "What is your level of education?"
C) "Are you currently taking any medication?"
D) "Do you have a history of respiratory issues?"

Question 24

Which is the priority when assessing the client's sexual history?

A) Determining sexual health.
B) Asking about sexual orientation.
C) Establishing rapport.
D) Assessing age of secondary sex characteristics.

Question 25

Which documentation is appropriate after assessing head, neck, and lymphatics?

A) Occasional headaches relieved by acetaminophen. No history of injury, seizure, tremor, dizziness. No neck swelling.
B) Denies hearing problems, never had specific exam. Nose patent, no injury, sense of smell intact, clear drainage with cold. No trouble eating or swallowing. Dental exam annually, last exam one month ago. Brushes and flosses twice daily.
C) Denies problems. "My bowels move every day with no problem. I get diarrhea when I'm nervous sometimes." Active bowel sounds present in all quadrants. Abdomen soft and non-tender to palpation.
D) Denies problems. No history of UTI. I pass urine five or six times a day and more if I drink more.

Question 26

The nurse is constructing a pedigree for a client. Which symbol designates the client's biological parents?

A)
B)
C)
D)

Question 27

The nurse wants to assess the client's self-esteem and emotional state. Which question is most appropriate for the nurse to ask this client?

A) "Can you describe the image that you see when looking in the mirror?"
B) "Tell me about your financial status?"
C) "How often do you have a bowel movement?"
D) "Have you ever contracted a sexually transmitted infection?"

Question 28

In obtaining a past history as part of a history of present illness (HPI), the nurse asks the client about allergies to drugs, animals, insects, and other environmental agents. In addition to this information and asking about how the reaction is treated, which is the most important allergy-related information that the nurse should inquire about?

A) The location where the reaction occurred.
B) The type of reaction that occurred with exposure.
C) Exactly how long the symptoms lasted.
D) Immediate and extended family members with the same allergy.