ATI LPN
Lewis's Medical Surgical Nursing in Canada, 5th Edition
Chapter 3 Questions
Question 1 of 5
When assessing the circulation to the lower leg of a patient who has had knee surgery, which action should the nurse take first?
Correct Answer: B
Rationale: Inspection is the first of the major techniques used in the physical examination. Palpation and auscultation are used later in the examination.
Question 2 of 5
During the health history interview, a patient tells the nurse about periodic fainting spells. Which question by the nurse will be most helpful in determining the setting in which the fainting spells occur?
Correct Answer: B
Rationale: Information about the setting is obtained by asking where the patient was and what the patient was doing when the symptom occurred. The other questions from the nurse are appropriate for obtaining information about chronology, frequency, and associated clinical manifestations.
Question 3 of 5
A nurse is performing a health history and physical examination for a patient with right-sided rib fractures. Which of the following data is a pertinent negative finding?
Correct Answer: B
Rationale: The nurse expects that a patient with rib fractures will have pain over the fractured area. The first statement is neither a positive nor a negative finding with regard to the rib fractures. The bruising and swelling and pain with breathing are positive findings.
Question 4 of 5
While the nurse is taking the health history, a patient states, 'My father and grandfather both had heart attacks and were unable to be very active afterwards.' This statement reflects which of the following functional health patterns?
Correct Answer: D
Rationale: The information in the patient statement relates to risk factors that may cause cardiovascular problems in the future. Identification of risk factors falls into the health perception-health maintenance pattern.
Question 5 of 5
The nurse is completing a neurological assessment on an adult patient. Which of the following assessments should the nurse include when assessing the patient's coordination?
Correct Answer: B,D,E
Rationale: A neurological assessment is completed to observe motor status by assessing gait, toe and heel walk, and drift, whereas when assessing coordination, the nurse observes finger to nose, Romberg sign, and heel to opposite shin.