Facilitating Evidence-Based Practice in Nursing, Exams of Nursing

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Test Bank For Physical Examination and Health

Assessment 9th Edition by Carolyn Jarvis

Complete Guide.

Test Bank - Physical Examination and Health Assessment 9e (by Jarvis) 2

Chapter 01: Evidence-Based Assessment

MULTIPLE CHOICE

1. After completing an initial assessment of a patient, the nurse has charted that his respirations are eupneic and

his pulse is 58 beats per minute. These types of data would be:

a. Objective.

b. Reflective.

c. Subjective.

d. Introspective.

ANS: A

Objective data are what the health professional observes by inspecting, percussing, palpating, and auscultating

during the physical examination. Subjective data is what the person says about him or herself during history

taking. The terms reflective and introspective are not used to describe data.

DIF: Cognitive Level: Understanding (Comprehension)

MSC: Client Needs: Safe and Effective Care Environment: Management of Care

2. A patient tells the nurse that he is very nerv

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, and feels hot. These types of data would be:

a. Objective.

b. Reflective.

c. Subjective.

d. Introspective.

ANS: C

Subjective data are what the person says about him or herself during history taking. Objective data are what the

health professional observes by inspecting, percussing, palpating, and auscultating during the physical

examination. The terms reflective and introspective are not used to describe data.

DIF: Cognitive Level: Understanding (Comprehension)

MSC: Client Needs: Safe and Effective Care Environment: Management of Care

3. The patients record, laboratory studies, objective data, and subjective data combine to form the:

a. Data base.

b. Admitting data.

Test Bank - Physical Examination and Health Assessment 9e (by Jarvis) 3

c. Financial statement.

d. Discharge summary.

ANS: A

Together with the patients record and laboratory studies, the objective and subjective data form the data base.

The other items are not part of the patients record, laboratory studies, or data.

DIF: Cognitive Level: Remembering (Knowledge)

MSC: Client Needs: Safe and Effective Care Environment: Management of Care

4. When listening to a patients breath sounds, the nurse is unsure of a sound that is heard. The nurses next

action should be to:

a. Immediately notify the patients physician.

b. Document the sound exactly as it was heard.

c. Validate the data by asking a coworker to listen to the breath sounds.

d. Assess again in 20 minutes to note whether the sound is still present.

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ANS: C

When unsure of a sound heard while listening to a patients breath sounds, the nurse validates the data to ensure

accuracy. If the nurse has less experience in an area, then he or she asks an expert to listen.

DIF: Cognitive Level: Analyzing (Analysis)

MSC: Client Needs: Safe and Effective Care Environment: Management of Care

5. The nurse is conducting a class for new graduate nurses. During the teaching session, the nurse should keep

in mind that novice nurses, without a background of skills and experience from which to draw, are more likely

to make their decisions using:

a. Intuition.

b. A set of rules.

c. Articles in journals.

d. Advice from supervisors.

ANS: B

Novice nurses operate from a set of defined, structured rules. The expert practitioner uses intuitive links.

DIF: Cognitive Level: Understanding (Comprehension)

Test Bank - Physical Examination and Health Assessment 9e (by Jarvis) 4

MSC: Client Needs: General

6. The nurse is reviewing information about evidence-based practice (EBP). Which statement best reflects

EBP?

a. EBP relies on tradition for support N

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b. EBP is simply the use of best practice techniques for the treatment of patients.

c. EBP emphasizes the use of best evidence with the clinicians experience.

d. The patients own preferences are not important with EBP.

ANS: C

EBP is a systematic approach to practice that emphasizes the use of best evidence in combination with the

clinicians experience, as well as patient preferences and values, when making decisions about care and

treatment. EBP is more than simply using the best practice techniques to treat patients, and questioning

tradition is important when no compelling and supportive research evidence exists.

DIF: Cognitive Level: Applying (Application)

MSC: Client Needs: Safe and Effective Care Environment: Management of Care

7. Expert nurses learn to attend to a pattern of assessment data and act without consciously labeling it. These

responses are referred to as:

a. Intuition.

b. The nursing process.

c. Clinical knowledge.

d. Diagnostic reasoning.

ANS: A

Intuition is characterized by pattern recognitionexpert nurses learn to attend to a pattern of assessment data and

act without consciously labeling it. The other options are not correct.

DIF: Cognitive Level: Understanding (Comprehension)

MSC: Client Needs: General

8. The nurse is conducting a class on priority setting for a group of new graduate nurses. Which is an example

of a first-level priority problem?

a. Patient with postoperative pain

Test Bank - Physical Examination and Health Assessment 9e (by Jarvis) 5

c. Individual with a small laceration on the sole of the foot

d. Individual with shortness of breath and respiratory distress

ANS: D

First-level priority problems are those that are emergent, life threatening, and immediate (e.g., establishing an

airway, supporting breathing, maintaining circulation, monitoring abnormal vital signs).

DIF: Cognitive Level: Understanding (Comprehension)

MSC: Client Needs: Safe and Effective Care Environment: Management of Care

9. When considering priority setting of problems, the nurse keeps in mind that second-level priority problems

include which of these aspects?

a. Low self-esteem

b. Lack of knowledge

c. Abnormal laboratory values

d. Severely abnormal vital signs

ANS: C

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Second-level priority problems are those that require prompt intervention to forestall further deterioration (e.g.,

mental status change, acute pain, abnormal laboratory values, risks to safety or security).

DIF: Cognitive Level: Understanding (Comprehension)

MSC: Client Needs: Safe and Effective Care Environment: Management of Care

10. Which critical thinking skill helps the nurse see relationships among the data?

a. Validation

b. Clustering related cues

c. Identifying gaps in data

d. Distinguishing relevant from irrelevant

ANS: B

Clustering related cues helps the nurse see relationships among the data.

DIF: Cognitive Level: Understanding (Comprehension)

MSC: Client Needs: Safe and Effective Care Environment: Management of Care

Test Bank - Physical Examination and Health Assessment 9e (by Jarvis) 6

11. The nurse knows that developing appropriate nursing interventions for a patient relies on the

appropriateness of the diagnosis.

a. Nursing

b. Medical

c. Admission

d. Collaborative

ANS: A

An accurate nursing diagnosis provides the basis for the selection of nursing interventions to achieve outcomes

for which the nurse is accountable. The other items do not contribute to the development of appropriate nursing

interventions.

DIF: Cognitive Level: Understanding (Comprehension)

MSC: Client Needs: Safe and Effective Care Environment: Management of Care

12. The nursing process is a sequential method of problem solving that nurses use and includes which steps?

a. Assessment, treatment, planning, evaluation, discharge, and follow-up

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b. Admission, assessment, diagnosis, treatment, and discharge planning

c. Admission, diagnosis, treatment, evaluation, and discharge planning

d. Assessment, diagnosis, outcome identification, planning, implementation, and evaluation

ANS: D

The nursing process is a method of problem solving that includes assessment, diagnosis, outcomeidentification,

planning, implementation, and evaluation.

DIF: Cognitive Level: Understanding (Comprehension)

MSC: Client Needs: Safe and Effective Care Environment: Management of Care

13. A newly admitted patient is in acute pain, has not been sleeping well lately, and is having difficulty

breathing. How should the nurse prioritize these problems?

a. Breathing, pain, and sleep

b. Breathing, sleep, and pain

c. Sleep, breathing, and pain

Test Bank - Physical Examination and Health Assessment 9e (by Jarvis) 7

d. Sleep, pain, and breathing

ANS: A

First-level priority problems are immediate priorities, remembering the ABCs (airway, breathing, and

circulation), followed by second-level problems, and then third-level problems.

DIF: Cognitive Level: Analyzing (Analysis)

MSC: Client Needs: Safe and Effective Care Environment: Management of Care

14. Which of these would be formulated by a nurse using diagnostic reasoning?

a. Nursing diagnosis

b. Medical diagnosis

c. Diagnostic hypothesis

d. Diagnostic assessment

ANS: C

Diagnostic reasoning calls for the nurse to formulate a diagnostic hypothesis; the nursing process calls for a

nursing diagnosis.

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DIF: Cognitive Level: Understanding (Comprehension)

MSC: Client Needs: General

15. Barriers to incorporating EBP include:

a. Nurses lack of research skills in evaluating the quality of research studies.

b. Lack of significant research studies.

c. Insufficient clinical skills of nurses.

d. Inadequate physical assessment skills.

ANS: A

As individuals, nurses lack research skills in evaluating the quality of research studies, are isolated from other

colleagues who are knowledgeable in research, and often lack the time to visit the library to read research. The

other responses are not considered barriers.

DIF: Cognitive Level: Understanding (Comprehension)

MSC: Client Needs: General

16. What step of the nursing process includes data collection by health history, physical examination, and

interview?

Test Bank - Physical Examination and Health Assessment 9e (by Jarvis) 8

a. Planning

b. Diagnosis

c. Evaluation

d. Assessment

ANS: D

Data collection, including performing the health history, physical examination, and interview, is the assessmen

step of the nursing process.

DIF: Cognitive Level: Remembering (Knowledge)

MSC: Client Needs: General

17. During a staff meeting, nurses discuss the problems with accessing research studies to incorporate

evidence-based clinical decision making into their practice. Which suggestion by the nurse manager would

best help these problems?

a. Form a committee to conduct research studies.

b. Post published research studies on

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boards.

c. Encourage the nurses to visit the library to review studies.

d. Teach the nurses how to conduct electronic searches for research studies.

ANS: D

Facilitating support for EBP would include teaching the nurses how to conduct electronic searches; time to

visit the library may not be available for many nurses. Actually conducting research studies may be helpful in

the long-run but not an immediate solution to reviewing existing research.

DIF: Cognitive Level: Applying (Application)

MSC: Client Needs: Safe and Effective Care Environment: Management of Care

18. When reviewing the concepts of health, the nurse recalls that the components of holistic health include

which of these?

a. Disease originates from the external environment.

b. The individual human is a closed system.

c. Nurses are responsible for a patients health state.

Test Bank - Physical Examination and Health Assessment 9e (by Jarvis) 9

d. Holistic health views the mind, body, and spirit as interdependent.

ANS: D

Consideration of the whole person is the essence of holistic health, which views the mind, body, and spirit as

interdependent. The basis of disease originates from both the external environment and from within the person.

Both the individual human and the external environment are open systems, continually changing and adapting,

and each person is responsible for his or her own personal health state.

DIF: Cognitive Level: Understanding (Comprehension)

MSC: Client Needs: Safe and Effective Care Environment: Management of Care

19. The nurse recognizes that the concept of prevention in describing health is essential because:

a. Disease can be prevented by treating the external environment.

b. The majority of deaths among Americans under age 65 years are not preventable.

c. Prevention places the emphasis on the link between health and personal behavior.

d. The means to prevention is through treatment provided by primary health care practitioners.

ANS: C

A natural progression to prevention rounds ou

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ept of health. Guidelines to prevention place

the emphasis on the link between health and personal behavior.

DIF: Cognitive Level: Understanding (Comprehension)

MSC: Client Needs: General

20. The nurse is performing a physical assessment on a newly admitted patient. An example of objective

information obtained during the physical assessment includes the:

a. Patients history of allergies.

b. Patients use of medications at home.

c. Last menstrual period 1 month ago.

d. 2 5 cm scar on the right lower forearm.

ANS: D

Objective data are the patients record, laboratory studies, and condition that the health professional observes by

inspecting, percussing, palpating, and auscultating during the physical examination. The other responses reflect

subjective data.

DIF: Cognitive Level: Applying (Application)

Test Bank - Physical Examination and Health Assessment 9e (by Jarvis) 10

MSC: Client Needs: Safe and Effective Care Environment: Management of Care

21. A visiting nurse is making an initial home visit for a patient who has many chronic medical problems.

Which type of data base is most appropriate to collect in this setting?

a. A follow-up data base to evaluate changes at appropriate intervals

b. An episodic data base because of the continuing, complex medical problems of this patient

c. A complete health data base because of the nurses primary responsibility for monitoring the

patients health

d. An emergency data base because of the need to collect information and make accurate diagnoses

rapidly

ANS: C

The complete data base is collected in a primary care setting, such as a pediatric or family practice clinic,

independent or group private practice, college health service, womens health care agency, visiting nurse

agency, or community health agency. In these settings, the nurse is the first health professional to see the

patient and has the primary responsibility for monitoring the persons health care.

DIF: Cognitive Level: Applying (Application)

MSC: Client Needs: Safe and Effective Care Environment: Management of Care

22. Which situation is most appropriate during

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performs a focused or problem-centered

history?

a. Patient is admitted to a long-term care facility.

b. Patient has a sudden and severe shortness of breath.

c. Patient is admitted to the hospital for surgery the following day.

d. Patient in an outpatient clinic has cold and influenza-like symptoms.

ANS: D

In a focused or problem-centered data base, the nurse collects a mini data base, which is smaller in scope than

the completed data base. This mini data base primarily concerns one problem, one cue complex, or one body

system.

DIF: Cognitive Level: Applying (Application)

MSC: Client Needs: Safe and Effective Care Environment: Management of Care

23. A patient is at the clinic to have her blood pressure checked. She has been coming to the clinic weekly

since she changed medications 2 months ago. The nurse should:

a. Collect a follow-up data base and then check her blood pressure.

Test Bank - Physical Examination and Health Assessment 9e (by Jarvis) 11

b. Ask her to read her health record and indicate any changes since her last visit.

c. Check only her blood pressure because her complete health history was documented 2 months ago.

d. Obtain a complete health history before checking her blood pressure because much of her history

information may have changed.

ANS: A

A follow-up data base is used in all settings to follow up short-term or chronic health problems. The other

responses are not appropriate for the situation.

DIF: Cognitive Level: Applying (Application)

MSC: Client Needs: Safe and Effective Care Environment: Management of Care

24. A patient is brought by ambulance to the emergency department with multiple traumas received in an

automobile accident. He is alert and cooperative, but his injuries are quite severe. How would the nurse

proceed with data collection?

a. Collect history information first, then perform the physical examination and institute life-saving

measures.

b. Simultaneously ask history questions while performing the examination and initiating life-saving

measures.

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c. Collect all information on the history form, including social support patterns, strengths, and coping

patterns.

d. Perform life-saving measures and delay asking any history questions until the patient is transferred

to the intensive care unit.

ANS: B

The emergency data base calls for a rapid collection of the data base, often concurrently compiled with life-

saving measures. The other responses are not appropriate for the situation.

DIF: Cognitive Level: Analyzing (Analysis)

MSC: Client Needs: Safe and Effective Care Environment: Management of Care

25. A 42-year-old patient of Asian descent is being seen at the clinic for an initial examination. The nurse

knows that including cultural information in his health assessment is important to:

a. Identify the cause of his illness.

b. Make accurate disease diagnoses.

c. Provide cultural health rights for the individual.

Test Bank - Physical Examination and Health Assessment 9e (by Jarvis) 12

d. Provide culturally sensitive and appropriate care.

ANS: D

The inclusion of cultural considerations in the health assessment is of paramount importance to gathering data

that are accurate and meaningful and to intervening with culturally sensitive and appropriate care.

DIF: Cognitive Level: Understanding (Comprehension)

MSC: Client Needs: Psychosocial Integrity

26. In the health promotion model, the focus of the health professional includes:

a. Changing the patients perceptions of disease.

b. Identifying biomedical model interventions.

c. Identifying negative health acts of the consumer.

d. Helping the consumer choose a healthier lifestyle.

ANS: D

In the health promotion model, the focus of the health professional is on helping the consumer choose a

healthier lifestyle.

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DIF: Cognitive Level: Remembering (Knowledge)

MSC: Client Needs: Health Promotion and Maintenance

27. The nurse has implemented several planned interventions to address the nursing diagnosis of acute pain.

Which would be the next appropriate action?

a. Establish priorities.

b. Identify expected outcomes.

c. Evaluate the individuals condition, and compare actual outcomes with expected outcomes.

d. Interpret data, and then identify clusters of cues and make inferences.

ANS: C

Evaluation is the next step after the implementation phase of the nursing process. During this step, the nurse

evaluates the individuals condition and compares the actual outcomes with expected outcomes.

DIF: Cognitive Level: Applying (Application)

MSC: Client Needs: Safe and Effective Care Environment: Management of Care

28. Which statement best describes a proficient nurse? A proficient nurse is one who:

Test Bank - Physical Examination and Health Assessment 9e (by Jarvis) 13

a. Has little experience with a specified population and uses rules to guide performance.

b. Has an intuitive grasp of a clinical situation and quickly identifies the accurate solution.

c. Sees actions in the context of daily plans for patients.

d. Understands a patient situation as a whole rather than a list of tasks and recognizes the long-term

goals for the patient.

ANS: D

The proficient nurse, with more time and experience than the novice nurse, is able to understand a patient

situation as a whole rather than as a list of tasks. The proficient nurse is able to see how todays nursing actions

can apply to the point the nurse wants the patient to reach at a future time.

DIF: Cognitive Level: Applying (Application)

MSC: Client Needs: General

MULTIPLE RESPONSE

1. The nurse is reviewing data collected after an assessment. Of the data listed below, which would be

considered related cues that would be clustered together during data analysis? Select all that apply.

a. Inspiratory wheezes noted in left lower lobes

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b. Hypoactive bowel sounds

c. Nonproductive cough

d. Edema, +2, noted on left hand

e. Patient reports dyspnea upon exertion

f. Rate of respirations 16 breaths per minute

ANS: A, C, E, F

Clustering related cues help the nurse recognize relationships among the data. The cues related to the patients

respiratory status (e.g., wheezes, cough, report of dyspnea, respiration rate and rhythm) are all related. Cues

related to bowels and peripheral edema are not related to the respiratory cues.

DIF: Cognitive Level: Analyzing (Analysis)

MSC: Client Needs: Safe and Effective Care Environment: Management of Care

MATCHING

Put the following patient situations in order according to the level of priority.

Test Bank - Physical Examination and Health Assessment 9e (by Jarvis) 14

a. A patient newly diagnosed with type 2 diabetes mellitus does not know how to check his own

blood glucose levels with a glucometer.

b. A teenager who was stung by a bee during a soccer match is having trouble breathing.

c. An older adult with a urinary tract infection is also showing signs of confusion and agitation.

1. a = First-level priority problem
2. b = Second-level priority problem
3. c = Third-level priority problem
4. ANS: B DIF: Cognitive Level: Analyzing (Analysis)

MSC: Client Needs: Safe and Effective Care Environment: Management of Care

NOT: First-level priority problems are immediate priorities, such as trouble breathing (remember the airway,

breathing, circulation priorities). Second-level priority problems are next in urgency, but not life-threatening.

Third-level priorities (e.g., patient education) are important to a patients health but can be addressed after more

urgent health problems are addressed.

2. ANS: C DIF: Cognitive Level: Analyzing (Analysis)

MSC: Client Needs: Safe and Effective Care Environment: Management of Care

NOT: First-level priority problems are immediate priorities, such as trouble breathing (remember the airway,

breathing, circulation priorities). Second-level priority problems are next in urgency, but not life-threatening.

Third-level priorities (e.g., patient education)

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patients health but can be addressed after more

urgent health problems are addressed.

3. ANS: A DIF: Cognitive Level: Analyzing (Analysis)

MSC: Client Needs: Safe and Effective Care Environment: Management of Care

NOT: First-level priority problems are immediate priorities, such as trouble breathing (remember the airway,

breathing, circulation priorities). Second-level priority problems are next in urgency, but not life-threatening.

Third-level priorities (e.g., patient education) are important to a patients health but can be addressed after more

urgent health problems are addressed.

Test Bank - Physical Examination and Health Assessment 9e (by Jarvis) 15

Chapter 02: Cultural Assessment

MULTIPLE CHOICE

1. The nurse is reviewing the development of culture. Which statement is correct regarding the development of

ones culture? Culture is:

a. Genetically determined on the basis of racial background.

b. Learned through language acquisition and socialization.

c. A nonspecific phenomenon and is adaptive but unnecessary.

d. Biologically determined on the basis of physical characteristics.

ANS: B

Culture is learned from birth through language acquisition and socialization. It is not biologically or

genetically determined and is learned by the individual.

DIF: Cognitive Level: Understanding (Comprehension)

MSC: Client Needs: Psychosocial Integrity

2. During a class on the aspects of culture, the nurse shares that culture has four basic characteristics. Which

statement correctly reflects one of these characteristics?

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a. Cultures are static and unchanging, despite changes around them.

b. Cultures are never specific, which makes them hard to identify.

c. Culture is most clearly reflected in a persons language and behavior.

d. Culture adapts to specific environmental factors and available natural resources.

ANS: D

Culture has four basic characteristics. Culture adapts to specific conditions related to environmental and

technical factors and to the availability of natural resources, and it is dynamic and ever changing. Culture is

learned from birth through the process of language acquisition and socialization, but it is not most clearly

reflected in ones language and behavior.

DIF: Cognitive Level: Analyzing (Analysis)

MSC: Client Needs: Psychosocial Integrity

3. During a seminar on cultural aspects of nursing, the nurse recognizes that the definition stating the specific

and distinct knowledge, beliefs, skills, and customs acquired by members of a society reflects which term?

a. Mores

Test Bank - Physical Examination and Health Assessment 9e (by Jarvis) 16

b. Norms

c. Culture

d. Social learning

ANS: C

The culture that develops in any given society is always specific and distinctive, encompassing all of the

knowledge, beliefs, customs, and skills acquired by members of the society. The other terms do not fit the

given definition.

DIF: Cognitive Level: Remembering (Knowledge)

MSC: Client Needs: Psychosocial Integrity

4. When discussing the use of the term subculture , the nurse recognizes that it is best described as:

a. Fitting as many people into the majority culture as possible.

b. Defining small groups of people who do not want to be identified with the larger culture.

c. Singling out groups of people who suffer differential and unequal treatment as a result of cultural

variations.

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d. Identifying fairly large groups of people with shared characteristics that are not common to all

members of a culture.

ANS: D

Within cultures, groups of people share different beliefs, values, and attitudes. Differences occur because of

ethnicity, religion, education, occupation, age, and gender. When such groups function within a large culture,

they are referred to as subcultural groups.

DIF: Cognitive Level: Understanding (Comprehension)

MSC: Client Needs: Psychosocial Integrity

5. When reviewing the demographics of ethnic groups in the United States, the nurse recalls that the largest

and fastest growing population is:

a. Hispanic.

b. Black.

c. Asian.

d. American Indian.

ANS: A

Test Bank - Physical Examination and Health Assessment 9e (by Jarvis) 17

Hispanics are the largest and fastest growing population in the United States, followed by Asians, Blacks,

American Indians and Alaska natives, and other groups.

DIF: Cognitive Level: Remembering (Knowledge)

MSC: Client Needs: General

6. During an assessment, the nurse notices that a patient is handling a small charm that is tied to a leather strip

around his neck. Which action by the nurse is appropriate?

a. Ask the patient about the item and its significance.

b. Ask the patient to lock the item with other valuables in the hospitals safe.

c. Tell the patient that a family member should take valuables home.

d. No action is necessary.

ANS: A

The nurse should inquire about the amulets meaning. Amulets, such as charms, are often considered an

important means of protection from evil spirits by some cultures.

DIF: Cognitive Level: Applying (Application)

MSC: Client Needs: Psychosocial Integrity

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7. The nurse manager is explaining culturally competent care during a staff meeting. Which statement

accurately describes the concept of culturally competent care? The caregiver:

a. Is able to speak the patients native language.

b. Possesses some basic knowledge of the patients cultural background.

c. Applies the proper background knowledge of a patients cultural background to provide the best

possible health care.

d. Understands and attends to the total context of the patients situation.

ANS: D

Culturally competent implies that the caregiver understands and attends to the total context of the individuals

situation. This competency includes awareness of immigration status, stress factors, other social factors, and

cultural similarities and differences. It does not require the caregiver to speak the patients native language.

DIF: Cognitive Level: Analyzing (Analysis)

MSC: Client Needs: Psychosocial Integrity

8. The nurse recognizes that an example of a person who is heritage consistent would be a:

a. Woman who has adapted her clothing to the clothing style of her new country.

Test Bank - Physical Examination and Health Assessment 9e (by Jarvis) 18

b. Woman who follows the traditions that her mother followed regarding meals.

c. Man who is not sure of his ancestors country of origin.

d. Child who is not able to speak his parents native language.

ANS: B

Someone who is heritage consistent lives a lifestyle that reflects his or her traditional heritage, not the norms

and customs of the new country.

DIF: Cognitive Level: Understanding (Comprehension)

MSC: Client Needs: Psychosocial Integrity

9. After a class on culture and ethnicity, the new graduate nurse reflects a correct understanding of the concept

of ethnicity with which statement?

a. Ethnicity is dynamic and ever changing.

b. Ethnicity is the belief in a higher power.

c. Ethnicity pertains to a social group within the social system that claims shared values and

traditions.

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d. Ethnicity is learned from birth through the processes of language acquisition and socialization.

ANS: C

Ethnicity pertains to a social group within the social system that claims to have variable traits, such as a

common geographic origin, migratory status, religion, race, language, values, traditions, symbols, or food

preferences. Culture is dynamic, ever changing, and learned from birth through the processes of language

acquisition and socialization. Religion is the belief in a higher power.

DIF: Cognitive Level: Applying (Application)

MSC: Client Needs: Psychosocial Integrity

10. The nurse is comparing the concepts of religion and spirituality. Which of the following is an appropriate

component of ones spirituality?

a. Belief in and the worship of God or gods

b. Attendance at a specific church or place of worship

c. Personal effort made to find purpose and meaning in life

d. Being closely tied to ones ethnic background

Test Bank - Physical Examination and Health Assessment 9e (by Jarvis) 19

ANS: C

Spirituality refers to each persons unique life experiences and his or her personal effort to find purpose and

meaning in life. The other responses apply to religion.

DIF: Cognitive Level: Applying (Application)

MSC: Client Needs: Psychosocial Integrity

11. A woman who has lived in the United States for a year after moving from Europe has learned to speak

English and is almost finished with her college studies. She now dresses like her peers and says that her family

in Europe would hardly recognize her. This nurse recognizes that this situation illustrates which concept?

a. Assimilation

b. Heritage consistency

c. Biculturalism

d. Acculturation

ANS: A

Assimilation is the process by which a person develops a new cultural identity and becomes like members of

the dominant culture. This concept does not reflect heritage consistency. Biculturalism is a dual pattern of

identification; acculturation is the process of adapting to and acquiring another culture.

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DIF: Cognitive Level: Understanding (Comprehension)

MSC: Client Needs: Psychosocial Integrity

12. The nurse is conducting a heritage assessment. Which question is most appropriate for this assessment?

a. What is your religion?

b. Do you mostly participate in the religious traditions of your family?

c. Do you smoke?

d. Do you have a history of heart disease?

ANS: B

Asking questions about participation in the religious traditions of family enables the nurse to assess a persons

heritage. Simply asking about ones religion, smoking history, or health history does not reflect heritage.

DIF: Cognitive Level: Applying (Application)

MSC: Client Needs: Psychosocial Integrity

13. In the majority culture of America, coughing, sweating, and diarrhea are symptoms of an illness. For some

individuals of Mexican-American origin, however, these symptoms are a normal part of living. The nurse

recognizes that this difference is true, probably because Mexican-Americans:

Test Bank - Physical Examination and Health Assessment 9e (by Jarvis) 20

a. Have less efficient immune systems and are often ill.

b. Consider these symptoms part of normal living, not symptoms of ill health.

c. Come from Mexico, and coughing is normal and healthy there.

d. Are usually in a lower socioeconomic group and are more likely to be sick.

ANS: B

The nurse needs to identify the meaning of health to the patient, remembering that concepts are derived, in

part, from the way in which members of the cultural group define health.

DIF: Cognitive Level: Understanding (Comprehension)

MSC: Client Needs: Psychosocial Integrity

14. The nurse is reviewing theories of illness. The germ theory, which states that microscopic organisms such

as bacteria and viruses are responsible for specific disease conditions, is a basic belief of which theory of

illness?

a. Holistic

b. Biomedical

c. Naturalistic

d. Magicoreligious

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ANS: B

Among the biomedical explanations for disease is the germ theory, which states that microscopic organisms

such as bacteria and viruses are responsible for specific disease conditions. The naturalistic, or holistic,

perspective holds that the forces of nature must be kept in natural balance. The magicoreligious perspective

holds that supernatural forces dominate and cause illness or health.

DIF: Cognitive Level: Understanding (Comprehension)

MSC: Client Needs: Psychosocial Integrity

15. An Asian-American woman is experiencing diarrhea, which is believed to be cold or yin. The nurse

expects that the woman is likely to try to treat it with:

a. Foods that are hot or yang.

b. Readings and Eastern medicine meditations.

c. High doses of medicines believed to be cold.

d. No treatment is tried because diarrhea is an expected part of life.

Test Bank - Physical Examination and Health Assessment 9e (by Jarvis) 21

ANS: A

Yin foods are cold and yang foods are hot. Cold foods are eaten with a hot illness, and hot foods are eaten with

a cold illness. The other explanations do not reflect the yin/yang theory.

DIF: Cognitive Level: Applying (Application)

MSC: Client Needs: Psychosocial Integrity

16. Many Asians believe in the yin/yang theory, which is rooted in the ancient Chinese philosophy of Tao.

Which statement most accurately reflects health in an Asian with this belief?

a. A person is able to work and produce.

b. A person is happy, stable, and feels good.

c. All aspects of the person are in perfect balance.

d. A person is able to care for others and function socially.

ANS: C

Many Asians believe in the yin/yang theory, in which health is believed to exist when all aspects of the person

are in perfect balance. The other statements do not describe this theory.

DIF: Cognitive Level: Analyzing (Analysis)

MSC: Client Needs: Psychosocial Integrity

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17. Illness is considered part of lifes rhythmic course and is an outward sign of disharmony within. This

statement most accurately reflects the views about illness from which theory?

a. Naturalistic

b. Biomedical

c. Reductionist

d. Magicoreligious

ANS: A

The naturalistic perspective states that the laws of nature create imbalances, chaos, and disease. From the

perspective of the Chinese, for example, illness is not considered an introducing agent; rather, illness is

considered a part of lifes rhythmic course and an outward sign of disharmony within. The other options are not

correct.

DIF: Cognitive Level: Understanding (Comprehension)

MSC: Client Needs: Psychosocial Integrity

Test Bank - Physical Examination and Health Assessment 9e (by Jarvis) 22

18. An individual who takes the magicoreligious perspective of illness and disease is likely to believe that his

or her illness was caused by:

a. Germs and viruses.

b. Supernatural forces.

c. Eating imbalanced foods.

d. An imbalance within his or her spiritual nature.

ANS: B

The basic premise of the magicoreligious perspective is that the world is seen as an arena in which supernatura

forces dominate. The fate of the world and those in it depends on the actions of supernatural forces for good or

evil. The other answers do not reflect the magicoreligious perspective.

DIF: Cognitive Level: Understanding (Comprehension)

MSC: Client Needs: Psychosocial Integrity

19. If an American Indian woman has come to the clinic to seek help with regulating her diabetes, then the

nurse can expect that she:

a. Will comply with the treatment prescribed.

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b. Has obviously given up her belief in naturalistic causes of disease.

c. May also be seeking the assistance of a shaman or medicine man.

d. Will need extra help in dealing with her illness and may be experiencing a crisis of faith.

ANS: C

When self-treatment is unsuccessful, the individual may turn to the lay or folk healing systems, to spiritual or

religious healing, or to scientific biomedicine. In addition to seeking help from a biomedical or scientific health

care provider, patients may also seek help from folk or religious healers.

DIF: Cognitive Level: Analyzing (Analysis)

MSC: Client Needs: Psychosocial Integrity

20. An older Mexican-American woman with traditional beliefs has been admitted to an inpatient care unit. A

culturally sensitive nurse would:

a. Contact the hospital administrator about the best course of action.

b. Automatically get a curandero for her, because requesting one herself is not culturally appropriate.

c. Further assess the patients cultural beliefs and offer the patient assistance in contacting a curandero

Test Bank - Physical Examination and Health Assessment 9e (by Jarvis) 23

or priest if she desires.

d. Ask the family what they would like to do because Mexican-Americans traditionally give control

of decision making to their families.

ANS: C

In addition to seeking help from the biomedical or scientific health care provider, patients may also seek help

from folk or religious healers. Some people, such as those of Mexican-American or American-Indian origins,

may believe that the cure is incomplete unless the body, mind, and spirit are also healed (although the division

of the person into parts is a Western concept).

DIF: Cognitive Level: Analyzing (Analysis)

MSC: Client Needs: Psychosocial Integrity

21. A 63-year-old Chinese-American man enters the hospital with complaints of chest pain, shortness of

breath, and palpitations. Which statement most accurately reflects the nurses best course of action?

a. The nurse should focus on performing a full cardiac assessment.

b. The nurse should focus on psychosomatic complaints because the patient has just learned that his

wife has cancer.

c. This patient is not in any danger at present; therefore, the nurse should send him home with

instructions to contact his physician.

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d. It is unclear what is happening with this patient; consequently, the nurse should perform an

assessment in both the physical and the psychosocial realms.

ANS: D

Wide cultural variations exist in the manner in which certain symptoms and disease conditions are perceived,

diagnosed, labeled, and treated. Chinese-Americans sometimes convert mental experiences or states into

bodily symptoms (e.g., complaining of cardiac symptoms because the center of emotion in the Chinese culture

is the heart).

DIF: Cognitive Level: Analyzing (Analysis)

MSC: Client Needs: Psychosocial Integrity

22. Symptoms, such as pain, are often influenced by a persons cultural heritage. Which of the following is a

true statement regarding pain?

a. Nurses attitudes toward their patients pain are unrelated to their own experiences with pain.

b. Nurses need to recognize that many cultures practice silent suffering as a response to pain.

c. A nurses area of clinical practice will most likely determine his or her assessment of a patients

pain.

d. A nurses years of clinical experience and current position are strong indicators of his or her

Test Bank - Physical Examination and Health Assessment 9e (by Jarvis) 24

response to patient pain.

ANS: B

Silent suffering is a potential response to pain in many cultures. The nurses assessment of pain needs to be

embedded in a cultural context. The other responses are not correct.

DIF: Cognitive Level: Understanding (Comprehension)

MSC: Client Needs: Psychosocial Integrity

23. The nurse is reviewing concepts of cultural aspects of pain. Which statement is true regarding pain?

a. All patients will behave the same way when in pain.

b. Just as patients vary in their perceptions of pain, so will they vary in their expressions of pain.

c. Cultural norms have very little to do with pain tolerance, because pain tolerance is always

biologically determined.

d. A patients expression of pain is largely dependent on the amount of tissue injury associated with

the pain.

ANS: B

In addition to expecting variations in pain perc

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expression of pain. It is well known that individuals turn to their social environment for validation and

comparison. The other statements are incorrect.

DIF: Cognitive Level: Understanding (Comprehension)

MSC: Client Needs: Psychosocial Integrity

24. During a class on religion and spirituality, the nurse is asked to define spirituality. Which answer is

correct? Spirituality:

a. Is a personal search to discover a supreme being.

b. Is an organized system of beliefs concerning the cause, nature, and purpose of the universe.

c. Is a belief that each person exists forever in some form, such as a belief in reincarnation or the

afterlife.

d. Arises out of each persons unique life experience and his or her personal effort to find purpose in

life.

ANS: D

Spirituality arises out of each persons unique life experience and his or her personal effort to find purpose and

meaning in life. The other definitions reflect the concept of religion.

DIF: Cognitive Level: Understanding (Comprehension)

Test Bank - Physical Examination and Health Assessment 9e (by Jarvis) 25

MSC: Client Needs: Psychosocial Integrity

25. The nurse recognizes that working with children with a different cultural perspective may be especially

difficult because:

a. Children have spiritual needs that are influenced by their stages of development.

b. Children have spiritual needs that are direct reflections of what is occurring in their homes.

c. Religious beliefs rarely affect the parents perceptions of the illness.

d. Parents are often the decision makers, and they have no knowledge of their childrens spiritual

needs.

ANS: A

Illness during childhood may be an especially difficult clinical situation. Children, as well as adults, have

spiritual needs that vary according to the childs developmental level and the religious climate that exists in the

family. The other statements are not correct.

DIF: Cognitive Level: Applying (Application)

MSC: Client Needs: Psychosocial Integrity

26. A 30-year-old woman has recently moved to the United States with her husband. They are living with the

womans sister until they can get a home of their own. When company arrives to visit with the womans sister,

the woman feels suddenly shy and retreats to t

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to hide until the company leaves. She explains

that her reaction to guests is simply because she does not know how to speak perfect English. This woman

could be experiencing:

a. Culture shock.

b. Cultural taboos.

c. Cultural unfamiliarity.

d. Culture disorientation.

ANS: A

Culture shock is a term used to describe the state of disorientation or inability to respond to the behavior of a

different cultural group because of its sudden strangeness, unfamiliarity, and incompatibility with the

individuals perceptions and expectations. The other terms are not correct.

DIF: Cognitive Level: Analyzing (Analysis)

MSC: Client Needs: Psychosocial Integrity

27. After a symptom is recognized, the first effort at treatment is often self-care. Which of the following

statements about self-care is true? Self-care is:

a. Not recognized as valuable by most health care providers.