During a health history assessment, where is the symptoms description/narrative typically documented?

Review of Systems

Chief Complaint

History of Present Illness

Past Medical History

Answer and Explanation

The Correct Answer is C

Choice A Reason:
The Review of Systems (ROS) is a systematic approach for collecting the patient's self-reported data on all body systems. It is not typically where the narrative of symptoms is documented. Instead, the ROS is used to uncover symptoms the patient may not have mentioned during the initial recounting of their history.

Choice B Reason:
The Chief Complaint (CC) is a concise statement describing the symptom, problem, condition, diagnosis, or other factors that are the reason for the encounter, usually stated in the patient's words¹. While it does include the symptom prompting the visit, it is not the section where a detailed narrative or description of symptoms is provided.

Choice C Reason:
The History of Present Illness (HPI) is indeed where the detailed narrative of the patient's symptoms is documented. It includes the onset of the problem, the setting in which it developed, its manifestations, and any treatments to date. The HPI tells the story of the patient's chief complaint and provides context for the clinical reasoning process.

Choice D Reason:
The Past Medical History (PMH) includes information about the patient's past experiences with illnesses, operations, injuries, and treatments. It does not contain the current symptoms' narrative but rather the patient's health status before the present illness or concern.

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Free Nursing Study Resources

Correct Answer is ["A","B","C","D"]

Explanation

Choice a reason:
Wearing nonslip shoes in the house is a preventive measure against falls, which are a leading cause of traumatic brain injuries (TBIs) in adolescents. Nonslip shoes provide better grip and stability, especially on potentially slippery surfaces like tiles or polished wood, reducing the risk of slips and falls that can lead to head injuries.

Choice b reason:
The supervised use of guns by an adult is critical in preventing accidental shootings, which can result in TBIs. Adolescents may lack the maturity and experience to handle firearms safely, and adult supervision ensures that proper safety protocols are followed, reducing the risk of accidental discharge and potential injury.

Choice c reason:
The use of seat belts is one of the most effective ways to prevent TBIs in the event of a vehicle accident. Seat belts restrain the body and prevent individuals from being thrown around inside or ejected from the vehicle, significantly reducing the likelihood of head trauma.
Choice d reason:
Avoiding risky activities such as snowboarding without proper safety equipment is essential in preventing sports-related TBIs. Snowboarding, like other high-speed sports, carries a risk of falls and collisions, which can cause head injuries. Wearing helmets and other protective gear, and engaging in these activities with caution, can mitigate this risk.

A. Tympany B. Hyperresonance C. Resonance D. Dullness

Correct Answer is B

Explanation

Choice a reason:
Tympany is a drum-like, resonant sound that is typically heard over air-filled structures, such as the gastric bubble, not the chest. It is not a sound associated with the lungs, especially in the context of COPD.

Choice b reason:
Hyperresonance is an abnormally loud, lower-pitched sound than normal resonance heard over hyperinflated areas of the lung, such as in cases of COPD. This is due to the increased air content within the lungs, often because of overdistension or destruction of alveolar tissue, as seen in emphysema, a common type of COPD.

Choice c reason:
Resonance is the normal sound heard over healthy lung tissue when percussed. However, in the case of COPD, particularly emphysema, the destruction of lung tissue leads to hyperinflation and thus a hyperresonant sound rather than the normal resonance.

Choice d reason:
Dullness is heard when fluid or solid tissue replaces air in the lung or occupies the pleural space, as in the case of pneumonia or pleural effusion. This is not characteristic of COPD, where there is an increase in air due to the breakdown of alveolar walls.

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During a health history assessment, where is the symptoms description/narrative typically documented?

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