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Health Assessment

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Health Assessment- RLE

1. Bianca, a patient in prolonged labor said she cannot go on anymore. The health care team decided
that both the child and the mother cannot anymore endure the process. The baby is premature and
has a little chance of surviving. Caesarian section is not possible because Bianca already lost enough
blood during labor and additional losses tend to be fatal. The husband decided that Bianca should
survive and gave his consent to terminate the fetus. The principle that we will be used by the health
care team is:

A. Beneficence

B. Non Maleficence

C. Justice

D. Double Effect

2. What should the nurse do when planning nursing care for a client with a different cultural
background? The nurse should:

A. Allow the family to provide care during the hospital stay so no rituals or customs are broken.

B. Identify how these cultural variables effect the health problem

C. Speak slowly and show pictures to make sure the client always understands

D. Explain how the client must adopt to hospital routines to be effectively cared for while in the
hospital

3. A 15 year old girl just gave birth to a baby boy who needs emergency surgery. The nurse prepared
the consent form and it should be signed by:

A. The Physician

B. The Registered Nurse caring for the client

C. The 15 year old mother of the baby boy

D. The mother of the girl

4. A patient with chronic cough is scheduled fro Bronchoscopy. The nurse is tasked to bring the
informed consent document into the patient’s room for a signature. The patient asks the nurse for
deatils of the procedures and demands an explanation why the process of informed consent is
necessary. The nurse responds that informed consent means:

A. The patient releases the physician from all the responsibility for the procedure.
B. The immediate family may make decision against the patient’s will.

C. The physician must give the client or surrogates enough information to make health care
judgments consistent with their values and goals.

D. The patient agrees to a procedure ordered by the physician even if the patient does not
understand what the outcome will be.

5. Maria, 45 years old was diagnosed with breast cancer. The physician suggested to have herself
undergo chemotherapy. Maria did not want to submit her self in such therapy. In this situation, she
exercises her right to:

A. Medical Care

B. Self-determination

C. Refuse

D. Information

6. After completing Ms. Santiago’s assessment, which of the following statements made by the client
would require the nurse to ask more questions?

A. “ I think it might be the food that I ate in the cafeteria that has made me sick, because it all started
after I ate supper in the student cafeteria last night.”

B. “ I usually eat three meals a day.”

C. “I have not taken anything for my symptoms, because I wanted to be checked out first.”

D. “ My roommate did not get sick last night.”

7. The nurse is documenting the findings from a health assessment. Which of the following
demonstrates the documentation of subjective information?

A. “ It hurts when I put weight on my leg.”

B. Abdomen soft and nontender to palpation

C. Blood pressure 110/68

D. “PUlses present in lower extremeties.”

8. The nurse is looking at the information collected during the health interview in an effort to cluster
or group the data together. The nurse is demonstrating which phase of the nursing process?

A. Assessment
B. Diagnosis

C. Planning

D. Evaluation

9. Patient C expresses her financial problems to her assigned nurse. Patient C secured a guarantor and
decided to transfer to a public hospital but the hospital did not allow her. Which patient’s bill of rights
did the hospital violates?

10. When doing an initial assessment, the best way for you to identify the patient’s priority problem is
to:

A. Interview the client for chief complaints and other symptoms

B. Talk to the relatives to gather data about history of illness

C. Do auscultation to check for chest congestion

D. Do a physical examination while asking the patient relevant questions.

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