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Physical Examination: Best Practices
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2nd Edition by Kate Gawlik
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ALL CHAPTERS 1-29 WITH RATIONALES|A+ GRADE
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,Chapter1.APPROACHTOEVIDENCE-BASEDASSESSMENTOFHEALTHANDWELL-BEING j
MULTIPLECHOICE
1. Aftercompletinganinitialassessmentofapatient,thenursehaschartedthathisrespirationsare
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n eupneicandhispulseis58beatsperminute.Thesetypesofdatawouldbe:
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a. Objective.
b. Reflective.
c. Subjective.
d. Introspective.
ANS:A
Objectivedataarewhatthehealthprofessionalobservesbyinspecting,percussing,palpating,and
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auscultatingduringthephysicalexamination.Subjectivedataiswhatthepersonsaysabouthimorherselfduring
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historytaking.Thetermsreflectiveandintrospectivearenotusedtodescribedata.
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DIF:CognitiveLevel:Understanding(Comprehension)REF:z.2
nnn MSC:ClientNeeds:SafeandEffectiveCareEnvironment:ManagementofCare
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2. Apatienttellsthenursethatheisverynervous,isnauseated,andfeelshot.Thesetypesofdatawouldbe:
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a. Objective.
b. Reflective.
c. Subjective.
d. Introspective.
ANS:C
Subjective dataare whatthe personsaysabout himorherself during historytaking. Objective dataare what
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thehealthprofessional observes byinspecting, percussing, palpating, andauscultatingduringthe
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physical examination.Thetermsreflectiveandintrospectivearenotusedtodescribedata.
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DIF:CognitiveLevel:Understanding(Comprehension)REF:z.2
nnn MSC:ClientNeeds:SafeandEffectiveCareEnvironment:ManagementofCare
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,3. Thepatientsrecord,laboratorystudies,objectivedata,andsubjectivedatacombinetoformthe: j
a. Database. j
b. Admitting data. j
c. Financialstatement.
d. Dischargesummary.
ANS:A
Togetherwiththepatientsrecordandlaboratorystudies,theobjectiveandsubjectivedataformthedatabase.The j j n
otheritemsarenotpartofthepatientsrecord,laboratorystudies,ordata.
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DIF:CognitiveLevel:Remembering(Knowledge)REF:z.2 j j
nnn MSC:ClientNeeds:SafeandEffectiveCareEnvironment:ManagementofCare
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4. Whenlisteningtoapatientsbreathsounds,thenurseisunsureofasoundthatisheard.Thenursesnext j j
actionshouldbeto:
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a. Immediatelynotifythepatientsphysician.
b. Documentthesoundexactlyasitwasheard. j
c. Validatethedatabyaskingacoworkertolistentothebreath n n n n n n sounds.
d. Assessagainin 20 minutestonotewhetherthesoundisstill
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ANS:C
Whenunsureofasoundheardwhilelisteningtoapatientsbreathsounds,thenursevalidatesthedatatoensure
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accuracy.Ifthenursehaslessexperienceinanarea,thenheorsheasksanexperttolisten.
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DIF:CognitiveLevel:Analyzing(Analysis)REF:z.2 j
nnn MSC:ClientNeeds:SafeandEffectiveCareEnvironment:ManagementofCare
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5. Thenurseisconductingaclassfornewgraduatenurses.Duringtheteachingsession,thenurseshould keep j j
n in mindthatnovicenurses,withoutabackgroundofskillsandexperiencefromwhichtodraw,aremore likelyto
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maketheirdecisionsusing:
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a. Intuition.
b. Asetofrules.
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, c. Articlesinjournals.
d. Advicefromsupervisors.
ANS:B
Novicenursesoperatefromasetofdefined,structuredrules.Theexpertpractitionerusesintuitivelinks.DIF: n
nnn CognitiveLevel:Understanding(Comprehension)REF:z.3MSC:ClientNeeds:General
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6. Expertnurseslearntoattendtoapatternofassessmentdataandactwithoutconsciouslylabelingit.
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n Theseresponsesarereferredtoas:
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a. Intuition.
b. Thenursingprocess.
c. Clinicalknowledge.
d. Diagnosticreasoning.
ANS:A
Intuitionischaracterizedbypatternrecognitionexpertnurseslearntoattendtoapatternofassessmentdata
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n andactwithoutconsciouslylabelingit.Theotheroptionsarenotcorrect.
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DIF:CognitiveLevel:Understanding(Comprehension)REF:z.4MSC:ClientNeeds:General j
7. Thenurseisreviewinginformationaboutevidence-basedpractice(EBP).Whichstatementbestreflects
EBP?
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a. EBPreliesontraditionforsupportofbestpractices. j
b. EBPissimplytheuseofbestpracticetechniquesforthetreatmentofpatients.
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c. EBPemphasizes n n n theuseofbestevidencewiththeclinicians n n n experience.
d. ThepatientsownpreferencesarenotimportantwithEBP.
ANS:C
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EBPis asystematicapproachtopracticethat emphasizestheuseofbest evidenceincombination withthe
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cliniciansexperience,aswellaspatientpreferencesandvalues,whenmakingdecisionsaboutcareandtreatment.
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EBPismorethansimplyusingthebestpracticetechniquestotreatpatients,andquestioningtraditionisimportant when
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nocompellingandsupportiveresearchevidenceexists.
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DIF:CognitiveLevel:Applying(Application)REF:z.5
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