Fundamentals of Nursing 201: Exam 1 -
NCLEX questions
Read the following scenario and identify the adjective used to describe the
characteristics of patient data that are numbered below.
The nurse is conducting an initial assessment of a 79-year-old female patient admitted
to the hospital with a diagnosis of dehydration. The nurse (1) uses clinical reasoning to
identify the need to perform a comprehensive assessment and gather the appropriate
patient data. (2) First the nurse asks the patient about the most important details leading
up to her diagnosis. Then the nurse (3) collects as much information as possible to
understand the patient's health problems; (4) collects the patient data in an organized
manner; (5) verifies that the data obtained is pertinent to the patient care plan; and (6)
records the data according to facility's policy. correct answers (1) Purposeful: The
nurse identifies the purpose of the nursing assessment (comprehensive) and gathers
the appropriate data
(2) Prioritized: The nurse gets the most important information first
(3) Complete: The nurse gathers as much data as possible to understand the patient
health problem and develop a care plan.
(4) Systemic: The nurse gathers the information in an organized manner.
(5) Accurate and relevant: the nurse verifies that the information is reliable.
(6) Recorded in a standard format: The nurse records the data according to the facility's
policy so that all caregivers can easily access what is learned.
The nurse practitioner is performing a short assessment of a newborn who is displaying
signs of jaundice. The nurse observes the infant's skin color and orders a test for
bilirubin levels to report to the primary care provider. What type of assessment has this
nurse performed?
a. Comprehensive
b. initial
c. time-lapsed
d. quick priority correct answers d. quick priority
The nurse is admitting a 35 year old pregnant woman to the hospital for treatment for
preeclampsia. The patient asks the nurse: "Why are you doing a history and physical
exam when the doctor just did one?" Which statements best explain the primary
reasons a nursing assessment is performed? Select all that apply.
a. "The nursing assessment will allow us to plan and deliver individualized, holistic
nursing care that draws on your strengths."
b. "It's hospital policy. I know it must be tiresome, but I will try to make this quick!"
success
, c. "I'm a student nurse and need to develop the skill of assessing your health status and
need for nursing care."
d. "We want to make sure that your responses to the medical exam are consistent and
that all our data are accurate."
e. "We need to check your health status and see what kind of nursing care you may
need."
f. "We need to see if you require a referral to a physician or other health correct
answers a,e,f
A nurse notes that a shift report states that a patient has no special skin care needs.
The nurse is surprised to observed reddened areas over bony prominences during the
patient bath. What nursing action is appropriate?
a. correct the initial assessment form.
b. Redo the initial assessment and document current findings.
c. Conduct and document an emergency assessment.
d. perform and document a focused assessment of skin integrity. correct answers d
A student nurse attempts o perform a nursing history for the first time. The student
nurse asks the instructor how anyone ever learns all the questions the nurse must ask
to get good baseline data. What would be the instructor's best reply?
a. "There's a lot to learn at first, but once it becomes part of you, you just keep asking
the same questions over and over in each situation until you can do it in your sleep!"
b. "You make the basic questions a part of you and then learn to modify them for each
unique situation, asking yourself how much you need to know to plan good care."
c. "No one ever really learns how to do this well because each history is different! I often
feel like I'm starting afresh with each new patient."
d. "Don't worry about learning all the questions to ask. Every facility has its own
assessment form you must use. correct answers b
The nurse collects objective and subjective data when conducting patient assessments.
Which patient situations are examples of subjective data? Select all that apply.
a. A patient tells the nurse that she is feeling nauseous.
b. A patient's ankles are swollen.
c. A patient tells the nurse that she is nervous about her test results.
d. A patient complains that the skin on her arms is tingling.
e. A patient rates his pain as a 7 on a scale of 1 to 10.
f. A patient vomits after eating supper. correct answers a,c,d,e
When a nurse enters the patient's room to begin a nursing history, the patient's wife is
there. After introducing herself to the patient and his wife, what should the nurse do?
a. Thank the wife for being present.
b. Ask the wife if she wants to remain.
c. Ask the wife to leave.
d. Ask the patient if he would like the wife to stay. correct answers d
success
NCLEX questions
Read the following scenario and identify the adjective used to describe the
characteristics of patient data that are numbered below.
The nurse is conducting an initial assessment of a 79-year-old female patient admitted
to the hospital with a diagnosis of dehydration. The nurse (1) uses clinical reasoning to
identify the need to perform a comprehensive assessment and gather the appropriate
patient data. (2) First the nurse asks the patient about the most important details leading
up to her diagnosis. Then the nurse (3) collects as much information as possible to
understand the patient's health problems; (4) collects the patient data in an organized
manner; (5) verifies that the data obtained is pertinent to the patient care plan; and (6)
records the data according to facility's policy. correct answers (1) Purposeful: The
nurse identifies the purpose of the nursing assessment (comprehensive) and gathers
the appropriate data
(2) Prioritized: The nurse gets the most important information first
(3) Complete: The nurse gathers as much data as possible to understand the patient
health problem and develop a care plan.
(4) Systemic: The nurse gathers the information in an organized manner.
(5) Accurate and relevant: the nurse verifies that the information is reliable.
(6) Recorded in a standard format: The nurse records the data according to the facility's
policy so that all caregivers can easily access what is learned.
The nurse practitioner is performing a short assessment of a newborn who is displaying
signs of jaundice. The nurse observes the infant's skin color and orders a test for
bilirubin levels to report to the primary care provider. What type of assessment has this
nurse performed?
a. Comprehensive
b. initial
c. time-lapsed
d. quick priority correct answers d. quick priority
The nurse is admitting a 35 year old pregnant woman to the hospital for treatment for
preeclampsia. The patient asks the nurse: "Why are you doing a history and physical
exam when the doctor just did one?" Which statements best explain the primary
reasons a nursing assessment is performed? Select all that apply.
a. "The nursing assessment will allow us to plan and deliver individualized, holistic
nursing care that draws on your strengths."
b. "It's hospital policy. I know it must be tiresome, but I will try to make this quick!"
success
, c. "I'm a student nurse and need to develop the skill of assessing your health status and
need for nursing care."
d. "We want to make sure that your responses to the medical exam are consistent and
that all our data are accurate."
e. "We need to check your health status and see what kind of nursing care you may
need."
f. "We need to see if you require a referral to a physician or other health correct
answers a,e,f
A nurse notes that a shift report states that a patient has no special skin care needs.
The nurse is surprised to observed reddened areas over bony prominences during the
patient bath. What nursing action is appropriate?
a. correct the initial assessment form.
b. Redo the initial assessment and document current findings.
c. Conduct and document an emergency assessment.
d. perform and document a focused assessment of skin integrity. correct answers d
A student nurse attempts o perform a nursing history for the first time. The student
nurse asks the instructor how anyone ever learns all the questions the nurse must ask
to get good baseline data. What would be the instructor's best reply?
a. "There's a lot to learn at first, but once it becomes part of you, you just keep asking
the same questions over and over in each situation until you can do it in your sleep!"
b. "You make the basic questions a part of you and then learn to modify them for each
unique situation, asking yourself how much you need to know to plan good care."
c. "No one ever really learns how to do this well because each history is different! I often
feel like I'm starting afresh with each new patient."
d. "Don't worry about learning all the questions to ask. Every facility has its own
assessment form you must use. correct answers b
The nurse collects objective and subjective data when conducting patient assessments.
Which patient situations are examples of subjective data? Select all that apply.
a. A patient tells the nurse that she is feeling nauseous.
b. A patient's ankles are swollen.
c. A patient tells the nurse that she is nervous about her test results.
d. A patient complains that the skin on her arms is tingling.
e. A patient rates his pain as a 7 on a scale of 1 to 10.
f. A patient vomits after eating supper. correct answers a,c,d,e
When a nurse enters the patient's room to begin a nursing history, the patient's wife is
there. After introducing herself to the patient and his wife, what should the nurse do?
a. Thank the wife for being present.
b. Ask the wife if she wants to remain.
c. Ask the wife to leave.
d. Ask the patient if he would like the wife to stay. correct answers d
success
