Question 1

The nurse is reviewing the following flow chart entries for a client experiencing pain.Which of the following chart entries represents a subjective entry?

Accepted Answer

A) The client's leg is red and swollen. 
B) The client complains of leg tenderness. 
C) The client's white blood cell count is 5.6. 
D) The client demonstrates guarding behaviors during the assessment of the affected extremity. 
A) The client's leg is red and swollen. 
B) The client complains of leg tenderness. 
C) The client's white blood cell count is 5.6. 
D) The client demonstrates guarding behaviors during the assessment of the affected extremity.

Question 2

The nurse is admitting a client to the acute care facility.The health history form has a place for recording subjective data.The nurse understands that primary subjective data should be obtained from which of the following sources?

Accepted Answer

A) The client's physical assessment 
B) The client's self-reports 
C) The client's healthcare provider 
D) The client's significant other 
A) The client's physical assessment 
B) The client's self-reports 
C) The client's healthcare provider 
D) The client's significant other

Question 3

The nurse manager is reviewing the following SOAP chart entries for a recently licensed nurse.Which of the following entries indicate that the nurse needs further instruction concerning documentation?

Accepted Answer

A) S: The client states," I am so nauseated." 
B) O: The client reports feeling fatigued. 
C) A: Bowel sounds are high-pitched in all abdominal quadrants. 
D) P: The client will remain NPO. 
A) S: The client states," I am so nauseated." 
B) O: The client reports feeling fatigued. 
C) A: Bowel sounds are high-pitched in all abdominal quadrants. 
D) P: The client will remain NPO.

Question 4

A client with hepatitis B is admitted to the hospital.When obtaining the physical assessment,what should the nurse keep in mind regarding client confidentiality?

Accepted Answer

A) Confidentiality means that information sharing is limited to those directly involved in the client care. 
B) Complete client confidentiality means that all members of the health care team may have access to the chart. 
C) Health Insurance Portability and Accountability Act (HIPA
A) helps to maintain client confidentiality and dictates who is to be communicating with the client. 
D) The medical records are open to any hospital employee,including administration. 
A) Confidentiality means that information sharing is limited to those directly involved in the client care. 
B) Complete client confidentiality means that all members of the health care team may have access to the chart. 
C) Health Insurance Portability and Accountability Act (HIPA
A) helps to maintain client confidentiality and dictates who is to be communicating with the client. 
D) The medical records are open to any hospital employee,including administration.

Question 5

Which of the following statements best describes the active role of the professional nurse as an educator?

Accepted Answer

A) Nurses must consider learning needs,goals,objectives,content,teaching methods,and evaluation when carrying out client education. 
B) Teaching plans are developed for informal teaching when distinct needs are identified or when common needs are recognized. 
C) In the role of educator,the nurse should refer the client to other health care providers who specialize in the area of need. 
D) Teaching is to be delegated to the advanced practice nurse specialist or the nurse educator. 
A) Nurses must consider learning needs,goals,objectives,content,teaching methods,and evaluation when carrying out client education. 
B) Teaching plans are developed for informal teaching when distinct needs are identified or when common needs are recognized. 
C) In the role of educator,the nurse should refer the client to other health care providers who specialize in the area of need. 
D) Teaching is to be delegated to the advanced practice nurse specialist or the nurse educator.

Question 6

During step 3 of the nursing process,which of the following activities is performed?

Accepted Answer

A) Statement of client goals 
B) Collection of subjective data 
C) Performance of care activities 
D) Review of client goal achievement 
A) Statement of client goals 
B) Collection of subjective data 
C) Performance of care activities 
D) Review of client goal achievement

Question 7

A female client has been admitted to the acute care unit with complaints of abdominal pain,nausea,and vomiting.During the interview the nurse determines the client's history includes pelvic inflammatory disease,mitral valve prolapse,and childbirth.The assessment finds the client's vital signs to be within normal limits.When analyzing the available data,what items should be clustered together?

Accepted Answer

A) Vital signs,complaints of pain history of childbirth 
B) Abdominal pain,nausea,vomiting,and history of pelvic inflammatory disease 
C) Gender,history of mitral valve prolapse,and vital signs 
D) History of pelvic inflammatory disease,mitral valve prolapse,and pain scale reports 
A) Vital signs,complaints of pain history of childbirth 
B) Abdominal pain,nausea,vomiting,and history of pelvic inflammatory disease 
C) Gender,history of mitral valve prolapse,and vital signs 
D) History of pelvic inflammatory disease,mitral valve prolapse,and pain scale reports

Question 8

The nurse is caring for a newly admitted client with Methicillin-resistant Staphylococcus Aureus (MRSA).Which of the following are appropriate goals of the initial health assessment?

Accepted Answer

A) Determine the client's current state of health and ongoing health-promotion activities. 
B) Predict risks to current health status. 
C) Use only objective data to determine client allergies. 
D) Determine how frequently the client is able to change positions. 
E) Identify health-promoting activities. 
A) Determine the client's current state of health and ongoing health-promotion activities. 
B) Predict risks to current health status. 
C) Use only objective data to determine client allergies. 
D) Determine how frequently the client is able to change positions. 
E) Identify health-promoting activities.

Question 9

The nurse manager is considering changing the type of charting/documentation done on the client care unit.The nurses have requested a system that will reduce time spent writing out routine tasks and will still allow for documentation of exceptions.Which type of documentation will best meet the needs of the nursing staff?

Accepted Answer

A) Focus documentation 
B) Flow sheets 
C) SOAP charting 
D) APIE charting 
A) Focus documentation 
B) Flow sheets 
C) SOAP charting 
D) APIE charting

Question 10

The charge nurse has instructed the nurse to complete a focused interview on the client who has just been admitted to the facility with complaints consistent with kidney stones.Which of the following actions by the nurse indicates the best understanding of the assignment?

Accepted Answer

A) The nurse obtains a urine sample to send for a urinalysis. 
B) The nurse takes the client's vital signs. 
C) The nurse questions the client about dietary preferences. 
D) The nurse asks the client about the characteristics of the pain being experienced. 
A) The nurse obtains a urine sample to send for a urinalysis. 
B) The nurse takes the client's vital signs. 
C) The nurse questions the client about dietary preferences. 
D) The nurse asks the client about the characteristics of the pain being experienced.

The nurse is reviewing the following flow chart entries for a client experiencing pain.Which of the following chart entries represents a subjective entry?

The nurse is admitting a client to the acute care facility.The health history form has a place for recording subjective data.The nurse understands that primary subjective data should be obtained from which of the following sources?

The nurse manager is reviewing the following SOAP chart entries for a recently licensed nurse.Which of the following entries indicate that the nurse needs further instruction concerning documentation?

A client with hepatitis B is admitted to the hospital.When obtaining the physical assessment,what should the nurse keep in mind regarding client confidentiality?

Which of the following statements best describes the active role of the professional nurse as an educator?

During step 3 of the nursing process,which of the following activities is performed?

The nurse is caring for a newly admitted client with Methicillin-resistant Staphylococcus Aureus (MRSA).Which of the following are appropriate goals of the initial health assessment?

The charge nurse has instructed the nurse to complete a focused interview on the client who has just been admitted to the facility with complaints consistent with kidney stones.Which of the following actions by the nurse indicates the best understanding of the assignment?

Wellness Health Promotion

Health Assessment Across the Lifespan

Cultural Considerations

Psychosocial Assessment

Techniques Equipment

General Survey

Pain Assessment

Nutritional Assessment

The Health History

Skin, Hair Nails

Head, Neck Related Lymphatics

Eye

Ears, Nose, Mouth Throat

Respiratory System

Breasts and Axillae

Cardiovascular System

Peripheral Vascular System

Abdomen

Urinary System

Male Reproductive System

Female Reproductive System

Musculoskeletal System

Neurologic System

Assessment of Infants, Children Adolescents

The Pregnant Female

Assessing the Older Adult

Putting It All Together

Assessment of the Hospitalized Client

Filters

Exam 1: Health Assessment

The nurse is reviewing the following flow chart entries for a client experiencing pain.Which of the following chart entries represents a subjective entry?

The nurse is admitting a client to the acute care facility.The health history form has a place for recording subjective data.The nurse understands that primary subjective data should be obtained from which of the following sources?

The nurse manager is reviewing the following SOAP chart entries for a recently licensed nurse.Which of the following entries indicate that the nurse needs further instruction concerning documentation?

A client with hepatitis B is admitted to the hospital.When obtaining the physical assessment,what should the nurse keep in mind regarding client confidentiality?

Which of the following statements best describes the active role of the professional nurse as an educator?

During step 3 of the nursing process,which of the following activities is performed?

The nurse is caring for a newly admitted client with Methicillin-resistant Staphylococcus Aureus (MRSA).Which of the following are appropriate goals of the initial health assessment?

The charge nurse has instructed the nurse to complete a focused interview on the client who has just been admitted to the facility with complaints consistent with kidney stones.Which of the following actions by the nurse indicates the best understanding of the assignment?

Wellness Health Promotion

Health Assessment Across the Lifespan

Cultural Considerations

Psychosocial Assessment

Techniques Equipment

General Survey

Pain Assessment

Nutritional Assessment

The Health History

Skin, Hair Nails

Head, Neck Related Lymphatics

Eye

Ears, Nose, Mouth Throat

Respiratory System

Breasts and Axillae

Cardiovascular System

Peripheral Vascular System

Abdomen

Urinary System

Male Reproductive System

Female Reproductive System

Musculoskeletal System

Neurologic System

Assessment of Infants, Children Adolescents

The Pregnant Female

Assessing the Older Adult

Putting It All Together

Assessment of the Hospitalized Client

Filters