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NR 509 Study Guide Chapter 03 Jarvis: Physical Examination and Health Assessment, 5th edition Chapter 03: Cultural Competence: Cultural Care Text Bank

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Chamberlain College of Nursing - NR 509 Study Guide Chapter_03 Jarvis: Physical Examination and Health Assessment, 5th edition Chapter 03: Cultural Competence: Cultural Care Text Bank MULTIPLE C... HOICE 1. Which statement is correct regarding the development of one’s culture? 1. Culture is genetically determined on the basis of racial background. 2. Culture is learned through language acquisition and socialization. 3. Culture is a nonspecific phenomenon and is adaptive but unnecessary. 4. Culture is biologically determined on the basis of physical characteristics. ANS: 2 Culture is learned from birth through language acquisition and socialization. DIF: Comprehension REF: Page: 40 MSC: NCLEX: Psychosocial Integrity 2. Culture has four basic characteristics. Which statement correctly reflects one of these characteristics? 1. Cultures are static and unchanging despite changes around them. 2. Cultures are never specific, which makes them hard to identify. 3. Culture is most clearly reflected in a person’s language and behavior. 4. Culture adapts to specific environmental factors and available natural resources. ANS: 4 Culture has four basic characteristics. Culture adapts to specific conditions related to environmental and technical factors and to the availability of natural resources and is dynamic and ever changing. DIF: Analysis REF: Page: 40 MSC: NCLEX: Psychosocial Integrity3-2 3. The specific and distinct knowledge, beliefs, skills, and customs acquired by members of a society are known as: 1. mores. 2. norms. 3. culture. 4. social learning. ANS: 3 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. DIF: Knowledge REF: Page: 40 MSC: NCLEX: Psychosocial Integrity 4. The term subculture is used: 1. to fit as many people into the majority culture as possible. 2. to define small groups of people who do not want to be identified with the larger culture. 3. to single out groups of people who suffer differential and unequal treatment as a result of cultural variations. 4. to identify fairly large groups of people with shared characteristics that are not common to all members of a culture. ANS: 4 The term subculture is used for fairly large aggregates of people who have shared characteristics that are not common to all members of the culture and that enable them to be thought of as a distinguishable subgroup. DIF: Comprehension REF: Page: 40 MSC: NCLEX: Psychosocial Integrity 5. The largest and fasting growing population in the United States is: 1. Hispanics 2. Blacks 3. Asians 4. American Indians ANS: 1 Hispanics are the largest and fastest growing population in the United States, followed by blacks, Asians, American Indians, and other groups. DIF: Knowledge REF: Page: 37 MSC: NCLEX: General3-3 6. One aspect of society’s value orientation concerns the dimension of time. An example of a person with “present” time value orientation would be: 1. a patient with a total hip replacement who has not been able to plan for discharge. 2. a patient with leukemia who continually seeks the latest medication and treatments. 3. a patient who feels loss after an amputation but is looking forward to finding out about prosthetic limbs. 4. a newly diagnosed diabetic who seeks a consultation with a medicine man who can contact ancestral spirits for guidance. ANS: 1 The focus may be on the present, with little attention being paid to the past or the future. These individuals are concerned with “now” and the future is perceived as vague or unpredictable. The nurse may have difficulty encouraging these individuals to prepare for the future. DIF: Application REF: Page: 43 MSC: NCLEX: Psychosocial Integrity 7. Which accurately describes the concept of culturally competent care? 1. The caregiver is able to speak the patient’s native language. 2. The caregiver possesses some basic knowledge of the patient’s cultural background. 3. The caregiver applies the proper background knowledge of a patient’s cultural background to provide the best possible health care. 4. The caregiver understands and attends to the total context of the patient’s situation. ANS: 4 Culturally competent implies that the caregiver understands and attends to the total context of the individual’s situation. This includes awareness of immigration status, stress factors, other social factors, and cultural similarities and differences. DIF: Analysis REF: Page: 40 MSC: NCLEX: Psychosocial Integrity 8. An example of a person who is heritage consistent would be: 1. a woman who has adapted the clothing style of her new country. 2. a woman who follows the traditions regarding meals that her mother followed. 3. a man who is not sure of the country of origin of his ancestors. 4. a child who is not able to speak his parents’ native language. ANS: 2 Someone who is heritage consistent is traditional, living within the norms of the traditional culture. DIF: Comprehension REF: Page: 40 MSC: NCLEX: Psychosocial Integrity3-4 9. Which statement is accurate regarding one’s ethnicity? 1. Ethnicity is dynamic and ever-changing. 2. Ethnicity is the belief in a higher power. 3. Ethnicity pertains to a social group within the social system that claims shared values and traditions. 4. It is learned from birth through the processes of language acquisition and socialization. ANS: 3 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, shared values, traditions, symbols, or food preferences. Answers 1 and 4 refer to culture, and answer 2 refers to religion. DIF: Comprehension REF: Page: 40 MSC: NCLEX: Psychosocial Integrity 10. Which statement is an appropriate component of one’s spirituality? 1. Belief in the worship of God or gods 2. Attendance at a specific church 3. A personal effort to find purpose and meaning in life 4. Closely tied to one’s ethnic background ANS: 3 Spirituality refers to each person’s unique life experience and his or her personal effort to find purpose and meaning in life. The other responses apply to religion. DIF: Application REF: Page: 42 MSC: NCLEX: 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 degree. She now dresses like her peers and says that her family “back home” would hardly recognize her. This illustrates: 1. assimilation. 2. heritage consistency. 3. biculturalism. 4. acculturation. ANS: 1 Assimilation is the process by which a person develops a new cultural identity and becomes like members of the dominant culture. DIF: Comprehension REF: Page: 42 MSC: NCLEX: Psychosocial Integrity3-5 12. A patient is in the hospital with a new diagnosis of lung cancer. He is anxious and talks to his oncologist about getting the “latest and best treatment out there.” This reflect which time orientation? 1. Past 2. Current 3. Present 4. Future ANS: 4 People who are focused on the future value progress and change and will inquire about the “latest” treatments and most modern equipment available for a problem. DIF: Application REF: Page: 43 MSC: NCLEX: Psychosocial Integrity 13. A woman brings her 15-month-old son in for a well-child visit. When asked questions about his pattern of behaviors and appetite, she seems at a loss for answers. What is the nurse’s best response? 1. Contact social services because she may be neglecting her son. 2. Determine whether she is the primary provider of care for her son. 3. Assume that she knows her son’s habits and may be hiding something unusual. 4. Discuss with her how important it is to observe growth and development patterns to see a delay early. ANS: 2 When assessing infants and children, it is important to identify the primary provider of care because this individual may or may not be the biologic parent. DIF: Application REF: Page: 44 MSC: NCLEX: Psychosocial Integrity 14. A physician in the clinic is frequently bothered when patients arrive late for appointments. He is so irritated by this behavior that he often finds it hard to provide appropriate care to these individuals. What should he do first in trying to overcome his difficulty? 1. Identify the meaning of health to the patient. 2. Understand that these cultural practices are helpful to the patient. 3. Allow the patients to arrive late and build this into his schedule. 4. Examine his own culturally based values, beliefs, attitudes, and practices. ANS: 4 The first step in understanding the health care needs of others is to understand one’s own culturally based values, beliefs, attitudes, and practices. DIF: Comprehension REF: Page: 42 MSC: NCLEX: Psychosocial Integrity3-6 15. 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. This is probably because Mexican-Americans: 1. have less efficient immune systems and are often ill. 2. consider these symptoms a part of normal living, not symptoms of ill health. 3. come from Mexico and coughing is normal and healthy there. 4. are usually in a lower socioeconomic group and are more likely to be sick. ANS: 2 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: Comprehension REF: Page: 54 MSC: NCLEX: Psychosocial Integrity 16. The germ theory, which posits that microscopic organisms such as bacteria and viruses are responsible for specific disease conditions, is a basic belief of which theory of illness? 1. Holistic 2. Biomedical 3. Naturalistic 4. Magicoreligious ANS: 2 Among the biomedical explanations for disease is the germ theory, which posits that microscopic organisms such as bacteria and viruses are responsible for specific disease conditions. DIF: Comprehension REF: Page: 47 MSC: NCLEX: Psychosocial Integrity 17. If an Asian-American woman is experiencing a symptom, such as diarrhea (which is felt to be “yin”), she is likely to try to treat it with: 1. foods that are “hot” or “yang.” 2. readings and Eastern medicine meditations. 3. high doses of medicines thought to be “cold.” 4. no treatment at all because diarrhea is an expected part of life. ANS: 1 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. DIF: Application REF: Page: 47 MSC: NCLEX: Psychosocial Integrity3-7 18. Among many Asians there is a belief in the yin/yang theory, rooted in the ancient Chinese philosophy of Tao. Which statement would most accurately reflect “health” in an Asian with these naturalistic beliefs? 1. A person is able to work and produce. 2. A person is happy, stable, and feels good. 3. All aspects of the person are in perfect balance. 4. A person is able to care for others and function socially. ANS: 3 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. DIF: Analysis REF: Page: 47 MSC: NCLEX: Psychosocial Integrity 19. Illness is seen as a part of life’s rhythmic course and as an outward sign of disharmony within. This statement most accurately reflects the views about illness from the: 1. naturalistic theory. 2. biomedical theory. 3. reductionist theory. 4. magicoreligious theory. ANS: 1 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 seen as an introducing agent but as a part of life’s rhythmic course and as an outward sign of disharmony within. DIF: Application REF: Page: 47 MSC: NCLEX: Psychosocial Integrity 20. An individual who takes the magicoreligious perspective of illness and disease is likely to believe that their illness was caused by: 1. germs and viruses. 2. supernatural forces. 3. eating imbalanced foods. 4. an imbalance within his or her spiritual nature. ANS: 2 The third major way in which people view the world and explain the causation of illness is from a magicoreligious perspective. The basic premise of this explanatory model is that the world is seen as an arena in which supernatural forces dominate. The fate of the world and those in it depends on the actions of supernatural forces for good or evil. DIF: Comprehension REF: Page: 47 MSC: NCLEX: Psychosocial Integrity3-8 21. If an American Indian has come to the clinic to seek help with regulating her diabetes, the nurse can expect that she: 1. will comply with the treatment prescribed. 2. has obviously given up her beliefs in naturalistic causes of disease. 3. may also be seeking the assistance of a shaman or medicine man. 4. will need extra help in dealing with her illness and may be experiencing a crisis of faith. ANS: 3 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/scientific health care provider, patients may also seek help from folk or religious healers. DIF: Analysis REF: Page: 49 MSC: NCLEX: Psychosocial Integrity 22. An elderly Mexican-American woman with traditional beliefs has been admitted to an inpatient care unit. A culturally sensitive nurse would: 1. contact the hospital administrator about the best course of action. 2. automatically get a curandero for her because it is not culturally appropriate for her to request one. 3. further assess her cultural beliefs and offer her assistance in contacting a curandero or priest if she desires. 4. ask the family what they would like to do because Mexican-Americans traditionally give control of decisions to their families. ANS: 3 In addition to seeking help from the biomedical/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 healing of body, mind, and spirit are all carried out (although the division of the person into parts is itself a Western concept). DIF: Analysis REF: Page: 49 MSC: NCLEX: Psychosocial Integrity3-9 23. 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 nurse’s best course of action? 1. The focus should be a full cardiac assessment. 2. He may be having difficulty after learning of his wife’s cancer and is expressing psychosomatic complaints. 3. This patient is not in any danger at present and should be sent home with instructions to contact his physician. 4. It is unclear what is happening with this patient and his assessment should include physical and psychosocial realms. ANS: 4 Wide cultural variation exists in the manner in which certain symptoms and disease conditions are perceived, diagnosed, labeled, and treated. ChineseAmericans 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: Application REF: Page: 45 MSC: NCLEX: Psychosocial Integrity 24. Symptoms, such as pain, are often influenced by a person’s cultural heritage. Which of the following is a true statement in regard to pain? 1. Nurses’ attitudes toward their patients’ pain are unrelated to their own experiences with pain. 2. The ethnic background of a patient is important in a nurse’s assessment of that patient’s pain. 3. A nurse’s area of clinical practice is most likely to determine his or her assessment of a patient’s pain. 4. A nurse’s years of clinical experience and current position are a strong indicator of his or her response to patient pain. ANS: 2 In research studies of nurses’ attitudes toward pain, it was discovered that the ethnic background of patients is important in the nurses’ assessment of both physical and psychologic pain. DIF: Comprehension REF: Page: 52 MSC: NCLEX: Psychosocial Integrity3-10 25. Which of the following statements is true regarding pain? 1. All patients will behave the same way when in pain. 2. Just as patients vary in their perception of pain, so will they vary in their expression of it. 3. Cultural norms have very little to do with pain tolerance—it is always biologically determined. 4. A patient’s expression of pain is largely dependent on the amount of tissue injury associated with the pain. ANS: 2 In addition to expecting variations in pain perception and tolerance, the nurse should also expect variations in the expression of pain. It is well known that individuals turn to their social environment for validation and comparison. DIF: Comprehension REF: Page: 53 MSC: NCLEX: Psychosocial Integrity 26. Which of the following is the best definition of spirituality? 1. A personal search to discover a supreme being 2. An organized system of beliefs concerning the cause, nature, and purpose of the universe 3. A belief that each person exists forever in some form, such as a belief in reincarnation or the afterlife 4. That which arises out of each person’s unique life experience and his or her personal effort to find purpose in life ANS: 4 Spirituality arises out of each person’s unique life experience and his or her personal effort to find purpose and meaning in life. DIF: Comprehension REF: Page: 42 MSC: NCLEX: Psychosocial Integrity3-11 27. Why can working with children with a different cultural perspective be especially difficult? 1. Children have spiritual needs that are influenced by their stage of development. 2. Children have spiritual needs that are a direct reflection of what is occurring in the home. 3. Religious beliefs rarely affect the parents’ perception of the illness. 4. Parents are often the decision makers and have no knowledge of their children’s spiritual needs. ANS: 1 Illness during childhood may be an especially difficult clinical situation. Children as well as adults have spiritual needs that vary according to the child’s developmental level and the religious climate that exists in the family. DIF: Application REF: Page: 46 MSC: NCLEX: Psychosocial Integrity 28. A 30-year-old woman has recently moved to the United States with her husband. They are living with relatives until they can get a house of their own. When company arrives to visit with her sister, she feels suddenly shy and retreats to the back bedroom to hide until the company leaves again. She states that this is just because she doesn’t know how to speak perfect English. This woman could be experiencing: 1. culture shock. 2. cultural taboos. 3. cultural unfamiliarity. 4. culture disorientation. ANS: 1 These individuals may be in various stages of culture shock, 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 individual’s perceptions and expectations. DIF: Analysis REF: Page: 44 MSC: NCLEX: Psychosocial Integrity3-12 29. After a symptom is recognized, the first effort at treatment is often self-care. Which statement is true with regard to self-care? 1. Self-care is not recognized as valuable by most health care providers. 2. Self-care is usually ineffective and may delay more effective treatment. 3. Self-care is always less expensive than biomedical alternatives. 4. Self-care is influenced by the accessibility of over-the-counter medicines. ANS: 4 After a symptom is identified, the first effort at treatment is often self-care. The availability of over-the-counter medications, relatively high literacy level of Americans, and influence of the mass media in communicating health-related information to the general population have contributed to the high percentage of cases of self-treatment. DIF: Comprehension REF: Page: 53 MSC: NCLEX: Psychosocial Integrity 30. Many individuals embrace the hot/cold theory of health illness. Which of the following best describes the basic tenets of this theory? 1. The causation of illness is based on supernatural forces that influence the humors of the body. 2. Herbs and medicines are classified on their physical characteristics of hot and cold and the humors of the body. 3. The four humors of the body consist of blood, yellow bile, spiritual connectedness, and social aspects of the individual. 4. The treatment of disease consists of adding or subtracting cold, heat, dryness, or wetness to restore the balance of the humors of the body. ANS: 4 The hot/cold theory of health and illness is based on the four humors of the body: blood, phlegm, black bile, and yellow bile. These humors regulate the basic bodily functions, described in terms of temperature, dryness, and moisture. DIF: Comprehension REF: Page: 47 MSC: NCLEX: Psychosocial Integrity3-13 31. In the hot/cold theory, illnesses are believed to be caused by hot or cold entering the body. Which of the following patients’ conditions is most consistent with a “cold” condition? 1. A diabetic patient with renal failure 2. A teenager with an abscessed tooth 3. A child with symptoms of itching and a rash 4. An elderly male with gastrointestinal discomfort ANS: 4 Illnesses believed to be caused by cold entering the body include earache, chest cramps, gastrointestinal discomfort, rheumatism, and tuberculosis. Those illnesses believed to be caused by heat, or overheating, include sore throats, abscessed teeth, rashes, and kidney disorders. DIF: Analysis REF: Page: 47 MSC: NCLEX: Psychosocial Integrity 32. When providing culturally competent care, nurses must incorporate cultural assessment into their health assessment. Which statement is most appropriate to use when initiating an assessment of cultural beliefs with an elderly American Indian patient? 1. “Are you of the Christian faith?” 2. “Do you want to see a medicine man?” 3. “How often do you seek help from medical providers?” 4. “What cultural or spiritual beliefs are important to you?” ANS: 4 American Indians may seek assistance from a medicine man or “shaman,” but the nurse should not assume this. An open-ended question regarding cultural and spiritual beliefs is best utilized initially when performing a cultural assessment. DIF: Analysis REF: Page: 44 MSC: NCLEX: Psychosocial Integrity3-14 33. There are a variety of healing beliefs and practices used by numerous subcultural groups in the United States. Which statement best explains why it is important for the nurse to be aware of alternative healing practices? 1. Many of these practices will interfere with the medical model of treatment. 2. Western medicines will interact with folk remedies and cause an adverse reaction for the patient. 3. The patient and family can be educated regarding the ineffectiveness of folk healing methods. 4. Many folk remedies are harmless and can be used in conjunction with Western medical practices and treatments. ANS: 4 It is dangerous to assume that all folk healing remedies are harmless; however, the majority are quite harmless and may or may not be effective cures. DIF: Comprehension REF: Pages: 49-50 MSC: NCLEX: Psychosocial Integrity 34. Which of the following examples illustrates the concept of a cultural taboo? 1. Belief that illness is a punishment of sin 2. Trying prayer before seeking medical help 3. Refusing to accept blood products as part of treatment 4. Stating that a child’s birth defect is the result of the parents’ sins ANS: 3 Cultural taboos are practices that are to be avoided, such as receiving blood products, eating pork, and consuming caffeine. DIF: Application REF: Page: 46 MSC: NCLEX: Psychosocial Integrity 35. Categories such as ethnicity, gender, and religion illustrate the concept of: 1. family. 2. cultures. 3. spirituality. 4. subcultures. ANS: 4 The term subculture is used for fairly large aggregates of people who have shared characteristics that are not common to all members of the culture and that enable them to be thought of as a distinguishable subgroup. DIF: Comprehension REF: Page: 40 MSC: NCLEX: Psychosocial Integrity3-15 36. The belief in a divine or superhuman power or powers to be obeyed and worshipped as the creator(s) and ruler(s) of the universe is known as: 1. culture. 2. religion. 3. ethnicity. 4. spirituality. ANS: 2 Religion is defined as an organized system of beliefs concerning the cause, nature, and purpose of the universe, especially belief in or the worship of God or gods. Spirituality is born out of each person’s unique life experience and his or her personal effort to find purpose and meaning in life. DIF: Knowledge REF: Page: 41 MSC: NCLEX: Psychosocial Integrity 37. Which of the following illustrates an appropriate category in a cultural assessment? 1. Family history 2. Chief complaint 3. Medical history 4. Health-related beliefs ANS: 4 Health-related beliefs and practices are one component of a cultural assessment. See Table 3-1. DIF: Comprehension REF: Page: 45 MSC: NCLEX: Psychosocial Integrity 38. Which of the following culture-bound syndromes is more common among North Americans? 1. Bulimia 2. Evil eye 3. Empacho 4. Low blood ANS: 1 Bulimia is a culture-bound syndrome associated with North Americans. Empacho and evil eye are associated with Mexican-Americans; low blood is associated with people of African origin. DIF: Comprehension REF: Page: 53 MSC: NCLEX: Psychosocial Integrity3-16 39. The first step in understanding the health care needs of another person is: 1. identifying the meaning of health to the other person. 2. understanding one’s own heritage-based cultural values, beliefs, attitudes, and practices relevant to health and illness. 3. understanding how the health care delivery system works. 4. being knowledgable about the person’s social background. ANS: 2 Understanding one’s own cultural values, beliefs, attitudes, and practices related to health and illness is the first step to understanding the health care needs of others. The others listed are subsequent steps in the process. DIF: Application REF: Page: 37 MSC: NCLEX: Psychosocial Integrity 40. Which of the following practices reflects traditional health and illness beliefs/practices of those of African heritage? 1. Health is the reward for good behavior. 2. Balance of the body and spirit 3. The wearing of jade amulets 4. Health is harmony with nature. ANS: 4 The belief that health is harmony with nature reflects the health beliefs of those of African heritages. The other examples represent Iberian/Central/South American heritages, American Indian heritages, and Asian heritages, respectively. DIF: Analysis REF: Page: 49 MSC: NCLEX: Psychosocial Integrity MULTIPLE RESPONSE 1. Which of the following statements illustrate proper cultural care? Select all that apply. 1. Examine the patient within the context of your own cultural health and illness practices. 2. Select questions that are not complex. 3. Ask questions rapidly. 4. Touch patients within the cultural boundaries of their heritage. 5. Pace questions throughout the physical examination. ANS: 2, 4, 5 Patients should be examined within the context of THEIR own cultural health and illness practices. Questions should not be asked rapidly. Options 2, 4, and 5 reflect proper cultural care. DIF: Analysis REF: Page: 52 MSC: NCLEX: Psychosocial Integrity [Show More]

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