NURSING PROCESS APPROACH, 11TH EDITION BY
LINDA E. MCCUISTION CHAPTER 1-58 NEW UPDATE
Chapter 01: The Nursing Process and Patient-Centered Care
McCuistion: Pharmacology: A Patient-Centered Nursing Process Approach, 11th
Edition
MULTIPLE CHOICE
1.All of the following would be considered subjective data, EXCEPT:
a. Patient-reported health history
b. Patient-reported signs and symptoms of their illness
c. Financial barriers reported by the patient’s caregiver.
d. Vital signs obtained from the medical record.
ANS: D.
Subjective data is based on what patients or family members communicate to
the nurse. Patient-reported health history, signs and symptoms, and caregiver
reported financial barriers would be considered subjective data. Vital signs
obtained from the medical record would be considered objective data.
DIF: Cognitive Level: Understanding (Comprehension) TOP: Nursing Process:
PlanningMSC: NCLEX: Management of Client Care
2. The nurse is using data collected to define a set of interventions to
achieve the most desirableoutcomes. Which of the following steps is
the nurse applying? a. Recognizing cues (assessment)
b. Analyze cues & prioritize hypothesis (analysis)
c. Generate solutions (planning)
d. Take action (nursing interventions)
ANS: C
When generating solutions (planning), the nurse identifies expected outcomes
and uses the patient’s problem(s) to define a set of interventions to achieve the
most desirable outcomes. Recognizing cues (assessment) involves the gathering
of cues (information) from the patient about their health and lifestyle practices,
, which are important facts that aid the nurse in making clinical care decisions.
Prioritizing hypothesis is used to organize and rank the patient
problem(s)identified. Finally, taking action involves implementation of nursing
interventions to accomplish the expected outcomes.
DIF: Cognitive Level: Understanding
(Comprehension)TOP: Nursing Process: Nursing
Intervention
MSC: NCLEX: Management of Client Care
3. A 5-year-old child with type 1 diabetes mellitus has had repeated
hospitalizations for episodes ofhyperglycemia. The parents tell the nurse that
they can’t keep track of everything
that has to be done to care for their child. The nurse reviews medications, diet,
and symptom management withthe parents and draws up a daily checklist for the
family to use. These activities are completed inwhich step of the nursing process?
a. Recognizing cues (assessment)
b. Analyze cues & prioritize hypothesis (analysis)
, c. Generate solutions (planning)
d. Take action (nursing interventions)
ANS: D
Taking action through nursing interventions is where the nurse provides patient
health teaching,drug administration, patient care, and other interventions
necessary to assist the patient in accomplishing expected outcomes.
DIF: Cognitive Level: Understanding
(Comprehension)TOP: Nursing Process: Nursing
Intervention
MSC: NCLEX: Management of Client Care
4. The nurse is preparing to administer a medication and reviews the patient’s
chart for drug allergies, serum creatinine, and blood urea nitrogen (BUN)
levels. The nurse’s actions arereflective of which of the following? a.
Recognizing cues (assessment)
b. Analyze cues & prioritize hypothesis (analysis)
c. Take action (nursing interventions)
d. Generate solutions (planning)
ANS: A
Recognizing cues (assessment) involves gathering subjective and objective
information about thepatient and the medication. Laboratory values from the
patient’s chart would be considered collection of objective data.
DIF: Cognitive Level: Understanding (Comprehension)
TOP: Nursing Process: Assessment MSC: NCLEX: Management of Client Care
5. Which of the following would be correctly categorized as objective data?
a. A list of herbal supplements regularly used provided by the patient.
b. Lab values associated with the drugs the patient is taking.
c. The ages and relationship of all household members to the patient.
d. Usual dietary patterns and food intake.
ANS: B
Objective data are measured and detected by another person and would
include lab values. Theother examples are subjective data.
DIF: Cognitive Level: Understanding (Comprehension)
TOP: Nursing Process: Assessment MSC: NCLEX: Management of Client Care
6. The nurse reviews a patient’s database and learns that the patient lives alone,
is forgetful, and does not have an established routine. The patient will be sent
home with three new medications to be taken at different times of the day.