NUR 3066C: Health Assessment Questions With Complete
Solutions
**Adaptations of health history for the CHILD Correct
Answers The most important point about a child's assessment
is GROWTH, MILESTONES, and CURRENT
DEVELOPMENT. Are they meeting their milestones. What is
their current development?
Assess parent's coping ability and family support
Health history includes information specific for age and
developmental level of child; signs and symptoms include effect
on activity, eating, etc.
**Core Temperature Correct Answers •An adult's internal
temperature is called this...
•Rectal and tympanic sites measures this...
1 degree higher than oral temperature
A normal assessment findings for HAIR Correct Answers
A normal assessment findings for NAILS Correct Answers
A normal assessment findings for SKIN Correct Answers •
skin tone is consistent with genetic background, varies from
pinkish tan to ruddy dark tan, or from light to dark brown, and
may have yellow or olive overtones
,ABCDE Skin Assessment Correct Answers •Danger signs:
Abnormal characteristics of pigmented lesions are ABCDE rule:
•A: Asymmetry
•B: Borders Irregularity
•C: Changes in color
•D: Diameter over 1/4in or 6mm
•E: Evolving/elevation and enlargement
Abnormal assessment findings for SKIN Correct Answers
•widespread color change, note if transient or due to pathology
•Note color change over entire body skin, such as pallor (pale),
erythema (red), cyanosis (blue), or jaundice (yellow)
•In dark-skin person, amount of normal pigment may mask color
change.
• Where is the best place to assess in dark-skin person?
Abnormal nails Correct Answers Clubbing---angle is greater
than 160 degrees (this is abnormal & occurs in heart or
pulmonary disease, lung cancer)
Sluggish color return takes longer than 3 seconds
Abnormal pupils Correct Answers When the size of both
pupils do not match; one is bigger than the other.
Accommodation Correct Answers the process by which the
eye's lens changes shape to focus near or far objects on the
retina
,Able to touch my finger with your finger
Achilles reflex Correct Answers Foot plantar flexing againist
your hand is the normal response
Acrocyanosis Correct Answers Temporary cyanotic condition,
usually in newborns resulting in a bluish color around the lips,
hands and fingernails, feet and toenails. May last for a few hours
and disappear with warming.
Action cues Correct Answers posture, facial expression, and
gestures
acute pain Correct Answers short-term, self-limiting, often
predictable trajectory; stops after injury heals
Adaptations of health history for the ADOESCENT Correct
Answers HEEADESS is psychosocial interview
Method of interviewing focuses on assessment of Home
environment
Education and employment
Eating
peer-related Activities
Drugs
Sexuality
Suicide
Depression
Safety from injury and violence
, Adaptations of the health history for the older ADULT Correct
Answers Includes same format descried for younger adults,
plus additional questions related to functioning, chronic
problems.
Alopecia Correct Answers hair loss
An abnormal assessment findings for HAIR Correct Answers
An abnormal assessment findings for SKIN (Temperature)
Correct Answers •Hypothermia
•Hyperthermia
Anaphylaxis (shock) Correct Answers Severe, potentially fatal
allergic response that occurs shortly after drug is given
Apnea Correct Answers absence of breathing
Assess Lesions Correct Answers •Inspect & palpate lesions
•Note color, elevation, pattern or shape, size, location and
distribution on body, any exudate, odor
•Assessment of dark skin---lesions that appear red or brown on
light skin often are black or purple on dark skin
Assessment Correct Answers •What do I think the problem is?
•Nurse's interpretation of data relative to patient issue
Solutions
**Adaptations of health history for the CHILD Correct
Answers The most important point about a child's assessment
is GROWTH, MILESTONES, and CURRENT
DEVELOPMENT. Are they meeting their milestones. What is
their current development?
Assess parent's coping ability and family support
Health history includes information specific for age and
developmental level of child; signs and symptoms include effect
on activity, eating, etc.
**Core Temperature Correct Answers •An adult's internal
temperature is called this...
•Rectal and tympanic sites measures this...
1 degree higher than oral temperature
A normal assessment findings for HAIR Correct Answers
A normal assessment findings for NAILS Correct Answers
A normal assessment findings for SKIN Correct Answers •
skin tone is consistent with genetic background, varies from
pinkish tan to ruddy dark tan, or from light to dark brown, and
may have yellow or olive overtones
,ABCDE Skin Assessment Correct Answers •Danger signs:
Abnormal characteristics of pigmented lesions are ABCDE rule:
•A: Asymmetry
•B: Borders Irregularity
•C: Changes in color
•D: Diameter over 1/4in or 6mm
•E: Evolving/elevation and enlargement
Abnormal assessment findings for SKIN Correct Answers
•widespread color change, note if transient or due to pathology
•Note color change over entire body skin, such as pallor (pale),
erythema (red), cyanosis (blue), or jaundice (yellow)
•In dark-skin person, amount of normal pigment may mask color
change.
• Where is the best place to assess in dark-skin person?
Abnormal nails Correct Answers Clubbing---angle is greater
than 160 degrees (this is abnormal & occurs in heart or
pulmonary disease, lung cancer)
Sluggish color return takes longer than 3 seconds
Abnormal pupils Correct Answers When the size of both
pupils do not match; one is bigger than the other.
Accommodation Correct Answers the process by which the
eye's lens changes shape to focus near or far objects on the
retina
,Able to touch my finger with your finger
Achilles reflex Correct Answers Foot plantar flexing againist
your hand is the normal response
Acrocyanosis Correct Answers Temporary cyanotic condition,
usually in newborns resulting in a bluish color around the lips,
hands and fingernails, feet and toenails. May last for a few hours
and disappear with warming.
Action cues Correct Answers posture, facial expression, and
gestures
acute pain Correct Answers short-term, self-limiting, often
predictable trajectory; stops after injury heals
Adaptations of health history for the ADOESCENT Correct
Answers HEEADESS is psychosocial interview
Method of interviewing focuses on assessment of Home
environment
Education and employment
Eating
peer-related Activities
Drugs
Sexuality
Suicide
Depression
Safety from injury and violence
, Adaptations of the health history for the older ADULT Correct
Answers Includes same format descried for younger adults,
plus additional questions related to functioning, chronic
problems.
Alopecia Correct Answers hair loss
An abnormal assessment findings for HAIR Correct Answers
An abnormal assessment findings for SKIN (Temperature)
Correct Answers •Hypothermia
•Hyperthermia
Anaphylaxis (shock) Correct Answers Severe, potentially fatal
allergic response that occurs shortly after drug is given
Apnea Correct Answers absence of breathing
Assess Lesions Correct Answers •Inspect & palpate lesions
•Note color, elevation, pattern or shape, size, location and
distribution on body, any exudate, odor
•Assessment of dark skin---lesions that appear red or brown on
light skin often are black or purple on dark skin
Assessment Correct Answers •What do I think the problem is?
•Nurse's interpretation of data relative to patient issue
