Jarvis ch. 5 - the complete health history Flashcards
When the nurse is evaluating the reliability of a patient’s 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
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?
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 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
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. “We’ll talk more about that later in the interview.”
c. “What have you had to eat in the past 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: Be specific.” The person is asked to point to the location
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 did not.
d. Patient denies having had 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 person’s childhood may be unusual today (e.g., measles).
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 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
The review of systems section 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 patient’s medical problem
ANS: B
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
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
ANS: B
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 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 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
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 measles
d. Child’s 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.
