nur 2090 - final exam Questions with
100% Correct Answers
delegation: nurses cannot delegate to whom and which actions? Correct
Answer: -LPNs, CNAs, other ancillaries (misc.)
-anything that requires an assessment/significant procedure
delegation: pt needs ambulating, but if suffering from orthostatic hypotension.
what can the CNA and nurse do? Correct Answer: -CNA can ambulate the pt
-nurse can assess for orthostatic hypotension
prioritizing care: case study: what to prioritize?
-BP 145/92
-RR 24
-Temp. 104.2º
,-HR 102 Correct Answer: address situation that is most dire at the time
-in this case: temp. (104.2º)
normal/average vital signs Correct Answer: -BP: 120/80
-RR: 12-20
-Temp.: 97-99º F (36.1-37.2º C)
-HR: 60-100 bpm
components of subjective data assessment Correct Answer: -pt feelings and
statements about health
-data that cannot be directly observed
*performed during interview portion of assessment
components of objective data assessment Correct Answer: -observable and
measurable data
-can be directly observed through sight/hearing/touch/smell
*performed during physical assessment portion of assessment
components of therapeutic communication (PHETS) Correct Answer: -positive
regard: assumption that pt is worth dignity; avoids any unnecessary labeling
,-honesty: open, direct, sincere
-empathy: ability to look at things from a different perspective
-trust: demonstrate ability to rely on nurses without doubt/question/judgement
-self-awareness/self-reflection: being aware of one's bias; taking responsibility for
one's actions
examples of non-therapeutic responses Correct Answer: -rescue feelings
-false reassurance: "everything will be okay-"
-giving advice: "i think you should-"
-changing the subject: "well look at this-"
-being moralistic: "you should-"
, -nonprofessional involvement: "check out my business-"
communication: opening remarks Correct Answer: general statements based
on observations/assessments
-e.g., "where would you like to begin?", "you seem to be feeling better today"
communication: reflection Correct Answer: identifying main emotional themes
and deflecting back to pt
-e.g., "what do you think you should do?", "you do not like the way the medicine
tastes?"
communication: focusing Correct Answer: goal-directed questions to help pt
focus on key concerns
-e.g., "tell me a little about your children", "give me an example of what you
mean"
communication: giving information Correct Answer: sharing with pt relevant
information for their well-being
-e.g., "i'm in here today for-", "we could talk about relevant strategies to-"
100% Correct Answers
delegation: nurses cannot delegate to whom and which actions? Correct
Answer: -LPNs, CNAs, other ancillaries (misc.)
-anything that requires an assessment/significant procedure
delegation: pt needs ambulating, but if suffering from orthostatic hypotension.
what can the CNA and nurse do? Correct Answer: -CNA can ambulate the pt
-nurse can assess for orthostatic hypotension
prioritizing care: case study: what to prioritize?
-BP 145/92
-RR 24
-Temp. 104.2º
,-HR 102 Correct Answer: address situation that is most dire at the time
-in this case: temp. (104.2º)
normal/average vital signs Correct Answer: -BP: 120/80
-RR: 12-20
-Temp.: 97-99º F (36.1-37.2º C)
-HR: 60-100 bpm
components of subjective data assessment Correct Answer: -pt feelings and
statements about health
-data that cannot be directly observed
*performed during interview portion of assessment
components of objective data assessment Correct Answer: -observable and
measurable data
-can be directly observed through sight/hearing/touch/smell
*performed during physical assessment portion of assessment
components of therapeutic communication (PHETS) Correct Answer: -positive
regard: assumption that pt is worth dignity; avoids any unnecessary labeling
,-honesty: open, direct, sincere
-empathy: ability to look at things from a different perspective
-trust: demonstrate ability to rely on nurses without doubt/question/judgement
-self-awareness/self-reflection: being aware of one's bias; taking responsibility for
one's actions
examples of non-therapeutic responses Correct Answer: -rescue feelings
-false reassurance: "everything will be okay-"
-giving advice: "i think you should-"
-changing the subject: "well look at this-"
-being moralistic: "you should-"
, -nonprofessional involvement: "check out my business-"
communication: opening remarks Correct Answer: general statements based
on observations/assessments
-e.g., "where would you like to begin?", "you seem to be feeling better today"
communication: reflection Correct Answer: identifying main emotional themes
and deflecting back to pt
-e.g., "what do you think you should do?", "you do not like the way the medicine
tastes?"
communication: focusing Correct Answer: goal-directed questions to help pt
focus on key concerns
-e.g., "tell me a little about your children", "give me an example of what you
mean"
communication: giving information Correct Answer: sharing with pt relevant
information for their well-being
-e.g., "i'm in here today for-", "we could talk about relevant strategies to-"
