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1. What is the nurse's focus while conducting a health assessment with a client? (Select all that apply.) A) Completing the health history. abirb.com/test B) Interpreting findings. C) Formulating a plan of care D) Implementing a plan of care. E) Conducting a physical examination. abirb.com/test 2. Before beginning a health assessment with a patient, the nurse reviews Healthy People abirb.com/test 2020 because: A) It helps determine the patient's plan of care. B) It serves as a guide for the health assessment. C) It identifies risk factors, health issues, and diseases. abirb.com/test D) It lists specific interventions to address most patient health problems. abirb.com/test 3. The nurse is following a structured head-to-toe approach to identify changes in a patient's body systems. Which component of the health assessment is the nurse completing with the patient? A) Health history abirb.com/test B) Physical examination C) Goal setting D) Planning care abirb.com/test
4. What will be the nurse's initial role when conducting a health assessment with a client reporting abdominal pain? abirb.com/test A) Teaching the client to draw knees to chest to help minimize the pain B) Planning care to help minimize the client's pain C) Collecting data regarding the nature of the pain D) Identifying pain management interventions with input from the client abirb.com/test
5. As the nurse assesses vital signs, he notices the client is shaking. The nurseabirb.com/test notes a change in the client's tone and in a loud voice the hospitalized client insists, "You're not my wife. How did you get into my house?". Based upon the client's behavior, which assessment will the nurse now focus upon? abirb.com/test A) Mental B) Physical C) Spiritual D) Interpersonal abirb.com/test
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6. When doing an overall assessment of a patient, the nurse is able to utilize findings and do what? A) Identify what level of prevention the patient is at abirb.com/test B) Identify in what areas the patient can educate his or her family C) Identify in what areas the patient needs the most care D) Identify the patient's medical diagnosis abirb.com/test
7. During a health assessment, the client identifies having a 1 pack per day smoking habit. What should the nurse initially focus upon when approaching the client about the abirb.com/test benefits of smoking cessation? A) Determining whether the client wants to stop smoking B) Educating the client on the detrimental effects smoking has on the entire body. C) Identifying smoking as a modifiable risk factor for the client. abirb.com/test D) Sharing with the client that there are various smoking cessation methods available. abirb.com/test 8. Which statement by the new nurse demonstrates an understanding of the nurse's responsibility to conduct an effective health assessment of the client? A) "A health assessment requires both a patient history as well as a physical examination." abirb.com/test B) "I always allow sufficient time to conduct the history portion of the assessment effectively." C) "I am always trying to improve my assessment skills." abirb.com/test D) "The health assessment is the foundation of quality patient care."
9. The nurse is performing a health assessment with a client who presented toabirb.com/test the emergency department after falling as a result of feeling dizzy. Which questions demonstrates that the nurse understands the initial purpose of effectively conducting a health assessment? Select all that apply. abirb.com/test A) "Are you experiencing any pain at this time?" B) "Are you feeling dizzy now?" C) "Do you know what may have caused you to fall?" D) "Do you know what your blood pressure is usually?" abirb.com/test E) "What do you think will help you from falling again?" abirb.com/test 10. During a health assessment, a client shares, "I get a little dizzy when I get up from my chair too quickly. "Which question will the nurse ask the client first when attempting to identify client needs and potential health risks? A) "What do you mean by 'a little dizzy'?" abirb.com/test B) "Do you often feel dizzy?" C) "Have you ever been dizzy enough to fall?" D) Can you remember when you first started to feel dizzy?" abirb.com/test
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11. A client is being admitted to the medical unit after being seen in the emergency department. Which statement by the nurse indicates an understanding of the importance abirb.com/test of the appropriate timing of a health assessment? A) "The client has been ordered a nutritional consult; I do the health assessment right after that is finished." B) "I'll do the health assessment when the client's family leaves so that distractions abirb.com/test will be minimal." C) "I'm going to assess the client now so that I can begin formulating the care plan." D) "The health assessment will be more thorough if I wait until the client is pain free." abirb.com/test
12. A client admitted with reports of nausea and vomiting has not reported any vomiting in the last 6 hours. What initial response should the nurse have regarding thisabirb.com/test assessment information and its effect on the client's nursing plan of care? A) Request that the health care team revise the plan of care. B) Notify the primary health care provider of the change in the client's health status. abirb.com/test C) Recognize the need to reevaluate the client's plan of care. D) Monitor the client frequently for other changes in health status. abirb.com/test
13. The nurse recognizes the value of the Healthy People 2020 guidelines when creating a plan of care that addresses which client-centered goals? Select all that apply A) living a healthy lifestyle abirb.com/test B) disease prevention C) improving one's quality of life D) providing affordable health care services E) increasing the longevity of one's life abirb.com/test
14. Consider the nurse's role in the health assessment of a client. What action will the nurse abirb.com/test perform initially when admitting a client to a long-term care facility? A) collecting information regarding the client's health status B) stabilizing the client's physical condition C) developing an effective, respectful nurse–client relationship abirb.com/test D) creating an environment that encourages client autonomy 15. The nurse has completed a health assessment on an older adult client beingabirb.com/test seen at a neighborhood clinic. What client-specific information should the nurse identify as being a priority? A) lives alone abirb.com/test B) significantly impaired hearing C) widowed 2 years ago D) greatly concerned about cost of services abirb.com/test
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16. Data being collected during a health assessment causes the nurse to believe there may be additional issues that are possibly affecting the client's health and wellness. What action abirb.com/test should the nurse take to best address the suggestion of additional health concerns? A) Concentrate first on planning care for the problem identified initially by the client. B) Extend the time originally allotted for the completion of the initial health assessment. abirb.com/test C) Plan to reassess the client with the focus on the possible additional health issues. D) Interview the family about the existence of additional health-related issues when they visit. abirb.com/test
17. When the client begins to cry, the nurse recognizes the need to focus the assessment on the client's emotional health. What factor will have the greatest effect on the nurse's abirb.com/test ability to gather information concerning why the client is crying? A) the client's ability to communicate verbally B) the nurse's ability to ask relevant questions abirb.com/test C) the type and degree of physical issues the client is experiencing D) the rapport that exists between the nurse and the client abirb.com/test
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Answer Key 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17.
A, E C B C A C A C A, B, D A C C A, B, C, E A B B D
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1. In partnership with the client, the nurse identifies a priority health goal for this client is smoking cessation. The nurse and client discuss possible interventions to assist the client in achieving this goal. In which phase of the nursing process are the nurse and abirb.com/test patient participating? A) Assessment B) Diagnosis C) Planning abirb.com/test D) Evaluation
2. A client with a diagnosis of non-insulin dependent diabetes reports she hasabirb.com/test not been able to follow through with recommendations to walk 20-25 minutes after her dinner meal due to leg pain. In this situation, the nurse should revise which phase of the nursing process? abirb.com/test A) Assessment B) Planning C) Implementation abirb.com/test D) Evaluation
3. During an assessment, the nurse asks a patient with low back pain if the pain is abirb.com/test radiating. The nurse is asks this question to obtain assessment information for which category of the mnemonic OLD CART? A) Treatments abirb.com/test B) Duration C) Location D) Onset abirb.com/test
4. The nurse is completing an assessment of a patient who reports two episodes of fainting in the late afternoon. Which data would the nurse categorize as subjective? abirb.com/test A) Blood pressure 168/94 mm Hg B) Respiratory rate 28 and shallow C) Increase in psycho-social stress D) Irregular heart rhythm abirb.com/test
5. After completing an assessment of a female with poorly controlled non-insulin dependent diabetes, the nurse is generating the client's problem list. Whichabirb.com/test problem would have the highest priority for the client? A) Muscle weakness B) Insomnia abirb.com/test C) Anxiety D) Knowledge deficit abirb.com/test
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6. For a client with the chief complaint of urinary incontinence, 10 additional health issues have been identified and need to be included in the problem list. What is the most effective way for the nurse to determine which is the priority problem? abirb.com/test A) Any problem required physician intervention B) The chief complaint should be investigated first. C) Respiratory problems will always take priority D) The client determines which health issue is most serious and acute abirb.com/test 7. The nurse is determining a priority problem that would be appropriate for a client with heart failure. Which problem would have the highest priority for the client?abirb.com/test A) Weight gain of 3 pounds (1.5 kilograms) over 1-2 days B) Ineffective health maintenance related to having last mammogram 2 years ago C) Knowledge deficit related to lack of information regarding low-sodium diet abirb.com/test D) Anxiety related to ineffective coping during hospitalization abirb.com/test 8. The nurse is developing a list of priority problems for a client. Which health concerns would be appropriate for the nurse to identify as health maintenance problems? (Select all that apply.) A) Teaching breast self examination abirb.com/test B) Instruction needed on newly prescribed renal diet C) Importance of having pneumococcal pneumonia vaccination D) Exercises for range of motion and mobility due to arthritis abirb.com/test E) Schedule for hemodialysis to start three times each week
9. The nurse has completed a plan of care for a client having a total knee replacement. abirb.com/testIn order to develop goals which are realistic for the client, what should the nurse do prior to implementing the plan? A) Discuss the plan of care with all of the health care providers involved. abirb.com/test B) Share the assessment and plan with the client's primary health care provider. C) Ask the client for opinions and willingness to proceed with the interventions. D) Identify the needs of the client's family in relation to the priority problem. abirb.com/test
10. A nurse obtains a urine specimen from a client for urinalysis. The test results indicates the urine is positive for leukocytes. Which of the following should the nurse consider abirb.com/test prior to identifying the priority problem for this client. (Select all that apply.) A) Inter-observer reliability B) Validity of the test C) Client symptoms abirb.com/test D) Specificity of the test E) Quality of the specimen abirb.com/test
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11. A 60-year-old female client reports a 5-day history of constipation. She describes a sensation of “burning” in her perianal area. This information is considered which part of the assessment data? abirb.com/test A) subjective data B) objective data C) health history D) physical examination abirb.com/test 12. A client reports difficulty sleeping. Which question would be the most effective way for abirb.com/test the nurse to open the interview? A) "Can you tell me about your sleep problem from when it started until now?" B) "When did the sleep problem begin?" C) 'How would you rate your sleep on a scale from 1 to 10?" abirb.com/test D) "What have you tried to help with your sleep?" abirb.com/test 13. The nurse is reviewing the laboratory report for a client with poorly controlled diabetes. This action falls within which step of clinical reasoning? A) identifying abnormal or positive findings B) making a hypothesis about the nature of the client's problem abirb.com/test C) interpreting the findings D) clustering the findings abirb.com/test
14. Which factor would assist the nurse in determining how to cluster clinical data into a single problem for a 65-year-old male client with a chief report of lower back pain? A) age abirb.com/test B) ethnicity C) timing D) gender abirb.com/test
15. A nurse assesses an older adult client with confusion. When collecting clinical information from the client, which factor is the most important for the nurse to abirb.com/test consider? A) The client will have a long problems list. B) The quality of the data may be low. abirb.com/test C) Clinical information can be interpreted subjectively. D) The client will have multi-system problems. abirb.com/test
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16. A female client tells the nurse it has been 5 years since her last pap smear examination. Where should the nurse document this information? A) physical examination abirb.com/test B) health maintenance C) personal and social history D) review of systems abirb.com/test
17. During an assessment interview, a young male client makes the following statement; "I need something more than friends and family to give me meaning and purpose in life". The nurse should focus on which step in the clinical reasoning process? abirb.com/test A) Identify abnormal or positive findings B) Cluster the findings C) Interpret the findings in terms of probable process abirb.com/test D) Make a hypothesis about the nature of the patient's problem abirb.com/test
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Answer Key 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17.
C D C C A B A A, B, C, D C B, C, D, E A A A C B B C
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1. During an interview, the nurse remains silent and nods the head periodically while the patient is talking. Which therapeutic communication technique is the nurse is using? A) Reflection abirb.com/test B) Validation C) Summarization D) Continuers abirb.com/test
2. The nurse is focusing an interview on a patient's respiratory status. Which question should the nurse ask first to begin this interview? abirb.com/test A) Do you currently have a cough? B) Do you have any difficulty producing sputum? C) Describe how you breathe for me? D) Do you experience any pain when you breathe? abirb.com/test 3. The nurse is preparing to conduct an interview with a hospitalized patient. What nursing abirb.com/test intervention can best ensure a confidential and comfortable environment for the patient? A) Conducting the interview after the client's visitors have left. B) Asking permission to draw the client's privacy curtain. C) Explaining why it is important to take notes during the interview. abirb.com/test D) Implementing therapeutic communication techniques during the interview. 4. During an interview, the patient begins to talk about the frequency of beingabirb.com/test abused by a spouse. What can the nurse do at this time to acknowledge the sensitivity of the information the patient is providing? A) Write down the information as the patient is speaking. abirb.com/test B) Key the information into the electronic medical record as the patient is speaking. C) Avoid maintaining eye contact while the patient is discussing spouse abuse. D) Stop documenting in order to maintain eye contact with the patient. abirb.com/test
5. A patient will require an extended period of intense physical therapy after having a compound fracture of the femur surgically repaired. What question should abirb.com/test the nurse ask when assessing the client's perception of the injury and recovery plan?(Select all that apply.) A) "How does experiencing such a trauma make you feel?" abirb.com/test B) "What did the pain feel like when you broke your femur?" C) "How do you plan to support yourself financially while you recover?" D) "What frustrations are you experiencing since your accident?" E) "What do you expect from the physical therapy you will have?" abirb.com/test
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6. A client angrily tells the nurse that, "It's a shame that you people can't ever be on time. This interview was supposed to start 30 minutes ago." Which technique should the nurse use to diffuse this patient's justified anger? A) Provide a detailed explanation as to why the interview was delayed. abirb.com/test B) Acknowledge their anger by apologizing for the delay. C) Offer to reschedule the interview to a time the client prefers. D) Suggest that the client speak with the administrator about staffing. abirb.com/test 7. What intervention should the nurse implement to regain control of the interview process abirb.com/test when the patient, reporting abdominal pain monopolizes the conversation with unrelated information? A) Share with the client that there is only a limited amount of time left to complete the interview. abirb.com/test B) Suggest that the interview be stopped now and continued later. C) Inform the client that pain medication can not be administered until the interview is completed. D) Politely direct the interview in order to ask about the characteristics ofabirb.com/test the pain.
8. After a patient describes abdominal pain to the nurse, which questions can abirb.com/test the nurse use to help the patient provide more information about the pain? (Select all that apply.) A) "Where do you feel the pain?" B) "Where does the pain travel?" abirb.com/test C) "What other symptoms do you have with the pain?" D) "Is this the worst pain you've ever felt?" E) "What makes the pain less or worse?" abirb.com/test
9. Which statement made by the nurse demonstrates an understanding of the termination phase of the interviewing process? abirb.com/test A) "I'd like to discuss your opinions regarding your plan of care." B) "I am expecting to spend time discussing your past medical record." C) "Let's talk about any health issues you've experienced in the last 12 months." D) "Let me stress the importance of being medication adherent." abirb.com/test
10. During an interview, how can a nurse assure mutual understanding with a client with a abirb.com/test language barrier? A) Request that a trained interpreter be available during the interview. B) The interview should consist of short and simple sentences. C) Ask the client to repeat back in his or her own words what was asked.abirb.com/test D) Allow extra time to develop the nurse–client relationship. abirb.com/test
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11. A client with a terminal diagnosis has asked the nurse about the purpose of a durable power of attorney for health care. What explanation will best answer the client's question? A) It makes health care decision making less burdensome for the client's abirb.com/test family. B) A proxy is identified to make healthcare decisions when the client is no longer able to do so. C) It assures that the client's final health care wishes are known and implemented. abirb.com/test D) Hospice and palliative care will be implemented as a part of the final health care plan. abirb.com/test
12. During an interview, how can the nurse best assist the client as the client tells his or her story? A) interrupting only if absolutely necessary abirb.com/test B) using a focused questioning format C) correcting the client when he or she makes erroneous statements D) suggesting information the client has appeared to have forgotten abirb.com/test
13. Which type of question is asked first by the nurse in order to attain a full description of the client's symptoms and to generate and test diagnostic hypotheses? abirb.com/test A) yes-or-no questions to determine relevant areas of the physical examination B) specific questions to secure a description of every symptom C) pertinent positive and negative questions to determine relevant details D) open-ended questions to encourage the client to tell his or her story abirb.com/test
14. When considering the attributes of a symptom and the OLD CART mnemonic, which abirb.com/test questions will the nurse ask a client who is reporting pain in the left knee? Select all that apply. A) "Is there a particular action that causes the knee pain?" B) "Can you point to where you feel the greatest amount of knee pain?" abirb.com/test C) "What do you think is causing your knee pain?" D) "Do you feel the pain in places other than just your left knee?" E) "What do you do to make the knee pain less severe?" abirb.com/test
15. When focusing on the client's perspective of a symptom or problem, the nurse will ask abirb.com/test which questions? Select all that apply. A) "Do you have any fears about the headaches you experience?" B) "Can you tell me when the headaches first began?" C) "Do you have any idea concerning why you are experiencing these headaches?" abirb.com/test D) "Do the headaches negatively impact your day-to-day life?" E) "What do you do to make the headaches go away?" abirb.com/test
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