For which of the following patients would a comprehensive health history be appropriate?
An established patient with the chief complaint of "I sprained my ankle"
An established patient with the chief complaint of "I have a bad cold".
A new patient with the chief complaint of "I am here to establish care".
An established patient with the chief complaint of "I cut my left hand".
The Correct Answer is C
A. An established patient presenting with a sprained ankle is having a problem-focused visit. The assessment is limited to the specific acute issue, including the mechanism of injury, pain level, swelling, and range of motion. A comprehensive health history is unnecessary because the patient’s general health and chronic conditions are already documented.
B. An established patient with a cold also requires a focused or episodic history, targeting symptom onset, severity, associated symptoms, and risk factors for complications. A full comprehensive history would be redundant since the provider already has the patient’s baseline medical information.
C. A new patient presenting to establish care is correct because a comprehensive health history is indicated for new patients. This involves collecting detailed information about medical history, surgical history, medications, allergies, family history, social habits, and a complete review of systems. It establishes a baseline for future care, preventive screening, and chronic disease management. The comprehensive assessment also allows the provider to identify risk factors or previously unrecognized health conditions.
D. An established patient with a cut hand is also seen for a problem-focused visit. The assessment targets the injury itself, such as depth, bleeding, infection risk, and functional status. A full comprehensive history is not required in this context.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Heart failure is incorrect because heart failure primarily affects ventricular filling and ejection, leading to extra heart sounds like S3 or S4 gallops, not a systolic click. S3 occurs due to rapid ventricular filling, often in systolic dysfunction, while S4 is related to stiff ventricles in diastolic dysfunction. Neither produces the characteristic high-pitched mid-systolic click of MVP.
B. Ventricular volume overload is incorrect because while it can cause systolic murmurs from regurgitant lesions or S3 gallop, a click is not a feature of volume overload alone. The click is specific to valvular leaflet motion rather than increased volume.
C. Decreased myocardial contractility is incorrect because reduced contractility typically produces weak or low-output heart sounds, S3, or systolic murmurs related to ventricular dilation, but not a systolic click.
Correct Answer is B
Explanation
A. Lower mandible is incorrect because the mandible (jawbone) is superior to the thyroid gland. While it serves as a general landmark for the neck, the thyroid is located lower and is not directly palpated beneath the mandible.
B. Cricoid cartilage is correct because the thyroid gland lies immediately below the cricoid cartilage, spanning the 2nd to 4th tracheal rings. When palpating the thyroid, the APRN places their fingers just below the cricoid cartilage on either side of the trachea to assess for size, nodules, and symmetry. This landmark ensures accurate palpation of the thyroid without interference from other neck structures.
C. Vocal cords are incorrect because the vocal cords are internal structures within the larynx and cannot be palpated externally. Their location is superior to the thyroid gland, and they are assessed indirectly via laryngoscopy, not manual examination.
D. Suprasternal notch is incorrect because this is inferior and medial to the thyroid gland. While it is a useful landmark for identifying the trachea and jugular notch, thyroid palpation is performed above this notch, not directly on it.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.