ATI RN
jarvis physical examination and health assessment 9th edition test bank Questions
Question 1 of 5
To assess affect, the nurse should ask the patient:
Correct Answer: A
Rationale: Step-by-step rationale for why answer A is correct: 1. Asking "How do you feel today?" directly addresses the patient's emotional state. 2. Assessing affect involves understanding the patient's emotional response or mood. 3. This open-ended question encourages the patient to express their feelings. 4. It allows the nurse to gain insight into the patient's emotional well-being. 5. Options B, C, and D focus on different aspects like memory, medication effectiveness, and functional ability, not directly related to assessing affect.
Question 2 of 5
The nurse is planning health education for a 65-year-old woman who has had a cerebrovascular accident (stroke) and is aphasic. Which of the following is most important to use when assessing mental health in this situation?
Correct Answer: C
Rationale: The correct answer is C: Please point to articles in the room and parts of the body as I name them. This is the most important assessment for mental health in an aphasic patient post-stroke because it evaluates their comprehension, communication abilities, and cognitive function. Pointing to articles and body parts demonstrates understanding and ability to follow instructions, which are crucial aspects of mental health assessment in this context. A: Please count back from 100 by sevens - This choice involves memory and mathematical abilities, which may not accurately assess mental health in an aphasic patient. B: I will name three items and ask you to repeat them in a few minutes - This choice tests memory recall, which is not as relevant for assessing mental health in an aphasic patient post-stroke. D: What would you do if you found a stamped, addressed envelope on the sidewalk? - This choice assesses problem-solving skills, which may not be the most appropriate indicator of mental health in an aphasic patient.
Question 3 of 5
A 35-year-old pregnant woman comes to the clinic for her monthly appointment. During assessment, the nurse notices that she has a brown patch of hyperpigmentation on her face. The nurse continues the skin assessment aware that another finding may be:
Correct Answer: C
Rationale: The correct answer is C: Linea nigra. This is a common finding during pregnancy due to hormonal changes causing hyperpigmentation on the abdomen. The other choices are incorrect because keratosis refers to a skin condition characterized by rough, scaly patches; melasma is a condition causing dark patches on the skin, often due to hormonal changes; and linea gravida is not a recognized term in dermatology. Therefore, based on the context of the patient being pregnant and presenting with hyperpigmentation on her face, the most likely finding would be Linea nigra, a dark line that runs from the navel to the pubic bone during pregnancy.
Question 4 of 5
A patient is experiencing dizziness, blurred vision, and nausea. The nurse should first assess the patient's:
Correct Answer: B
Rationale: The correct answer is B, Blood pressure. Dizziness, blurred vision, and nausea can be symptoms of hypotension or hypertension. Assessing the patient's blood pressure first is crucial to determine if the symptoms are related to blood pressure fluctuations. Electrolyte levels (A) and blood glucose levels (C) may be assessed later but do not address the immediate concern. Temperature and respiratory rate (D) are important assessments but are not the priority in this scenario where cardiovascular status needs to be evaluated first.
Question 5 of 5
A 40-year-old woman presents to the clinic with complaints of fatigue and weight gain. On assessment, the nurse finds that the patient has cold intolerance, dry skin, and a slow heart rate. The nurse suspects:
Correct Answer: B
Rationale: The correct answer is B: Hypothyroidism. In this case, the patient's symptoms of fatigue, weight gain, cold intolerance, dry skin, and slow heart rate are indicative of hypothyroidism. The thyroid gland is underactive, leading to decreased production of thyroid hormones, which regulate metabolism. These symptoms align with the typical clinical presentation of hypothyroidism. Other choices are incorrect because hyperthyroidism (choice A) would present with symptoms like weight loss, heat intolerance, and a fast heart rate. Cushing's syndrome (choice C) and Addison's disease (choice D) are both conditions related to the adrenal glands and would have different symptom presentations compared to what is described in the case scenario.