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Get faster at matching terms Terms in this set (20)1. The nurse is using critical thinking skills during the first phase of the nursing process. Which action indicates the nurse is in the first phase? a. Completes a comprehensive database ANS: A 2. A nurse is using the problem-oriented approach to data collection. Which action will the nurse take first? a. Complete the questions in chronological order. ANS: B 3. After reviewing the database, the nurse discovers that the patient's vital signs have not been recorded by the nursing assistive personnel (NAP). Which clinical decision should the nurse make? a. Administer scheduled medications assuming that the NAP would have reported abnormal vital signs. ANS: C 4. The nurse is gathering data on a patient. Which data will the nurse report as objective data? a. States "doesn't feel good" ANS: C 5. A patient expresses fear of going home and being alone. Vital signs are stable and the incision is nearly completely healed. What can the nurse infer from the subjective data? a. The patient can now perform the dressing changes without help. ANS: C 6. Which method of data collection will the nurse use to establish a patient's database? a. Reviewing the current literature to determine evidence-based nursing actions ANS: C 7. A nurse is gathering information about a patient's habits and lifestyle patterns. Which method of data collection will the nurse use that will best obtain this information? a. Carefully review lab results. ANS: C 8. While interviewing an older female patient of Asian descent, the nurse notices that the patient looks at the ground when answering questions. What should the nurse do? a. Consider cultural differences during this assessment. ANS: A 9. A nurse has already set the agenda during a patient-centered interview. What will the nurse do next? a. Begin with introductions. ANS: B 10. The nurse is attempting to prompt the patient to elaborate on the reports of daytime fatigue. Which question should the nurse ask? a. "Is there anything that you are stressed about right now that I should know?" ANS: B 11. A nurse is conducting a nursing health history. Which component will the nurse address? a. Nurse's concerns ANS: B 12. While the patient's lower extremity, which is in a cast, is assessed, the patient tells the nurse about an inability to rest at night. The nurse disregards this information, thinking that no correlation has been noted between having a leg cast and developing restless sleep. Which action would have been best for the nurse to take? a. Tell the
patient to just focus on the leg and cast right now. ANS: D 13. The nurse begins a shift assessment by examining a surgical dressing that is saturated with serosanguineous drainage on a patient who had open abdominal surgery yesterday (or 1 day ago). Which type of assessment approach is the nurse using? a. Gordon's Functional Health Patterns ANS: D 14. Which statement by a nurse indicates a good understanding about the differences between data validation and data interpretation? a. "Data interpretation occurs before data validation." ANS: C 15. Which scenario best illustrates the nurse using data validation when making a nursing clinical decision for a patient? a. The nurse determines to remove a wound dressing when the patient reveals the time of the last dressing change and notices old and new drainage. ANS: A 16. While completing an admission database, the nurse is interviewing a patient who states "I am allergic to latex." Which action will the nurse take first? a. Immediately place the patient in isolation. ANS: B 17. A patient verbalizes a low pain level of 2 out of 10 but exhibits extreme facial grimacing while moving around in bed. What is the nurse's initial action in response to these observations? a. Proceed to the next patient's room to make rounds. ANS: C 18. The nurse is interviewing a patient with a hearing deficit. Which area should the nurse use to conduct this interview? a. The patient's room with the door closed ANS: A 19. A new nurse is completing an assessment on an 80-year-old patient who is alert and oriented. The patient's daughter is present in the room. Which action by the nurse will require follow-up by the charge nurse? a. The nurse makes eye contact with the patient. ANS: B 20. A nurse is completing an assessment. Which findings will the nurse report as subjective data? (Select all that apply.) a. Patient's temperature ANS: C, E Sets found in the same folderFundamentals: Chapter 19: Implementing Nursing Care24 terms nurs78 Chapter 17 Nursing Diagnosis21 terms KingTut7838 Chapter 15: Critical Thinking in Nursing Practice21 terms ellayoyo chapter 1821 terms taygors
Other sets by this creatorChapter 19 - Pediatrics Exam Prep57 terms JanviPatel2 NR446: Collaborative Healthcare: Quiz #138 terms JanviPatel2 Nursing Fundamentals Exam 1 Practice Test129 terms JanviPatel2 Chapter 17: Health Promotion Of Adolescent and Fam…24 terms JanviPatel2 Other Quizlet setschapter 1621 terms taygors Fundamentals: Chapter 16: Nursing Assessment20 terms cedric_campo Chapter 16: Nursing Assessment20 terms Rachel_McLinden Chapter 16: Nursing Assessment44 terms hildaniac Related questionsQUESTION Which information should be included in the teaching plan for a client receiving glargine, a "peakless" basal insulin? 15 answers
QUESTION Appoints an agent an individual trusts to make decisions in the event of a subsequent incapacity. 2 answers QUESTION A nurse is starting the shift by making rounds. Which client does the nurse decide to assess first? 12 answers QUESTION Quality and safety education project (QSEN) 2 answers Which techniques can the nurse use for collecting patient assessment data?A structured physical examination allows the nurse to obtain a complete assessment of the patient. Observation/inspection, palpation, percussion and auscultation are techniques used to gather information.
How do nurses collect data from patients?The primary methods used to collect data are observing, interviewing, and examining. Observation occurs whenever the nurse is in contact with the client or support persons. Interviewing is used mainly while taking the nursing health history. Examining is the major method used in the physical health assessments.
Which data collected during the nurse patient interview is a subjective finding?Subjective data include patient's feelings, perceptions, and reported symptoms. Expressing feelings such as excitement or fear is an example of subjective data. Objective data are observations or measurements of a patient's health status.
What data should be collected in nursing assessment?The five methods of data collection are observation, interview, the health history, the physical examination, and laboratory and diagnostic testing.
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Which method of data collection will the nurse use to establish a patients database group of answer choices?
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