Chapter 001

Jarvis: Physical Examination and Health Assessment, 8th Edition
Chapter 01: Evidence-Based Assessment
Answer Keys: Study Guide and Lab Manual
1. Individual answers may vary. Use the answers provided as a guideline.
Cue recognition
A.J., a 62-year-old male, appears pale,
diaphoretic, and anxious.
Hypothesis formulation
A.J. states that he feels a terrible “tightness”
and pain in his chest. The pain started while he
was shoveling snow. At this point, you
formulate a hypothesis of angina pectoris.
Data gathering for hypothesis testing
During the history and physical examination,
you gather hypothesis testing data to support or
reject the tentative hypothesis: you take vital
signs, measure the PO2 by pulse oximetry,
listen to breath sounds and heart sounds, assess
the characteristics of the chest pain, and order a
Hypothesis evaluation
You synthesize the new data collected, which
support the hypothesis of angina pectoris,
which has now subsided with two doses of
sublingual nitroglycerin. The final diagnosis is
activity-induced angina pectoris.
2. To identify assumptions, recognize that you could take information for granted, or see it as
fact when, in reality, there is no evidence for it. In this situation, the speaker is assuming that
Ellen must break up with her boyfriend due to rough treatment. To get facts in this situation,
one needs to find out more information about how Ellen’s boyfriend has acted toward her
and what they have done to resolve this situation, if anything. A joint counseling session
could accomplish this. In the meantime, it would be prudent for Ellen to seek safe shelter if
indeed her boyfriend is abusing her. A more appropriate response is: “Please tell me more
about your relationship with your boyfriend.”
3. Findings from case study include the following:
 For Mr. Quinn, ask him to step on the scale again so that you can validate that the
weight was measured accurately.
 For Ellen, validate the counselor’s statements with Ellen. Using an open-ended
approach, say, “Ellen, it can be upsetting to be admitted to residential treatment. How
are you feeling about this?”
 When auscultating a heart sound that you may not be sure about, ask an experienced
colleague to listen to it as well and compare assessments.
4. Barriers to evidence-based practice on an individual and organizational level include the
 It often takes up to 17 years for research findings to be implemented into practice.
Copyright © 2020 by Elsevier Inc. All rights reserved.
Answer Keys: Study Guide and Lab Manual
Nurses lack time to go to the library or perform Internet research.
Health care institutions have inadequate library research holdings.
Organizational support for EBP is lacking when nurses wish to implement changes in
patient care.
The differences are:
 Subjective data: complaint of sore shoulder; family has just moved to a new area;
dizziness; sore throat; earache.
 Objective data: unconscious; blood in the urine; weight gain.
The correct data collection types are as follows:
 Barbiturate overdose: emergency.
 Ambulatory patient presenting with rash: focused (problem-centered).
 Checkup visit: complete (total health).
 Patient on new anti-hypertensive regimen: follow-up.
Close to 50% of the U.S. population soon will consist of people from diverse racial, ethnic,
and cultural groups. Some groups expect culturally relevant health care that incorporates
their specific beliefs and practices. However, the cultural health rites often conflict with the
unicultural, Western, biomedical view taught in U.S. educational programs. Thus, knowledge
of and concern for diverse cultural beliefs and practices are increasingly important.
Individual answers may vary.
Individual answers may vary.
Copyright © 2020 by Elsevier Inc. All rights reserved.