Zach Miller, MSN, FNP-BC, is on duty at the center today. Zach has 10 years of experience as an RN in the emergency department and urgent care clinic. He has been a family nurse practitioner (FNP-BC) for 5 years. Zach enters the room and introduces himself to Mr. and Mrs. Nguyen. To begin the exam, Zach reviews the information Mr. Nguyen supplied on the admission form and then asks Nam about his family history.
Zach:
Are your parents still living?
Nam:
Yes, they’re both alive. My father is 80 years old and my mother is 76.
Zach:
I’d like to hear a little more about your family history. Tell me about your father’s cancer. How old was he when he was first diagnosed? Has he had treatment?
Nam:
He was probably about 60 when he first found out about it. I know he had some kind of surgery and takes medicines but I don’t know the details. He seems all right though.
Zach:
Your father also has high blood pressure and heart disease. Please tell me a little more about that.
Nam:
My father and mother both have high blood pressure and heart disease. They both take medicines for their blood pressure. My father had a small heart attack about 10 years ago. My mother has never had a heart attack that I know of, but she sometimes has chest pain.

Zach:
Your mother also has diabetes?
Nam:
She’s had that for a long time. A lot of people in my family have diabetes, especially on my father’s side—but nobody in my mother’s family. Yet my mother is the one with the diabetes!
Yen:
A lot of people in my family have diabetes too. But so far I’m okay, I think.
Zach:
Have you had a health exam lately, Mrs. Nguyen?
Yen:
Not in about a year, but I’m going to schedule an appointment here.

The Nguyens and Zach continue to review the health information. After reviewing the history and discussing current complaints, Zach performs a complete physical exam.
Questions
Caring for the Nguyens

Review the opening scenario of Nam Nguyen in the front of this book. Imagine you are the clinic nurse at the Family Medicine Center. Based on the information presented in the scenario, work through the following questions:

Question
What type of assessment, comprehensive or focused, is being performed at this clinic visit? Explain your thinking.
Identify the types of data (e.g., subjective/objective, primary/secondary) that have been gathered so far. Give an example of each type.
How might you verify data that Mr. Nguyen provided on the intake sheet?
Based on what you know about Mr. Nguyen, what follow-up assessments would provide useful data to help with the care of Mr. Nguyen? Why would you make these assessments?