Edition by Janet R Weber and Jane H Kelley Fully
Covered
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,1 A nurse on a postsurgical unit is admitting a client following the client's cholecystecto
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my (gall bladder removal). What is the overall purpose of assessment forthis client?
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A) Collecting accurate data WQ WQ
B) Assisting the primary care provider WQ WQ WQ WQ
C) Validating previous data WQ WQ
D) Making clinical judgments WQ WQ
2. A client has presented to the emergency department (ED) with complaints of abdominal
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pain. Which member of the care team would most likely be responsible for collecting
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the subjective data on the client during the initial comprehensive assessment?
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A) Gastroenterologist
B) ED nurse WQ
C) Admissions clerk WQ
D) Diagnostic technician WQ
3. The nurse has completed an initial assessment of a newly admitted client and is applying
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the nursing process to plan the client's care. What principle should the nurse apply whe
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n using the nursing process?
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A) Each step is independent of the others. WQ WQ WQ WQ WQ WQ
B) It is ongoing and continuous.
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C) It is used primarily in acute care settings.
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D) It involves independent nursing actions.
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4. The nurse who provides care at an ambulatory clinic is preparing to meet a client and
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perform a comprehensive health assessment. Which of the following actions should the
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nurse perform first?
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A) Review the client's medical record. WQ WQ WQ WQ
B) Obtain basic biographic data. WQ WQ WQ
C) Consult clinical resources explaining the client's diagnosis. WQ WQ WQ WQ WQ WQ
D) Validate information with the client. WQ WQ WQ WQ
5. Which of the following client situations would the nurse interpret as requiring an
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emergency assessment?
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A) A pediatric client with severe sunburn
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B) A client needing an employment physical
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C) A client who overdosed on acetaminophen
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D) A distraught client who wants a pregnancy test
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,6. In response to a client's query, the nurse is explaining the differences between the ph
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ysician's medical exam and the comprehensive health assessment performed by the n
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urse. The nurse should describe the fact that the nursing assessment focuses on which
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aspect of the client's situation?
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A) Current physiologic status WQ WQ
B) Effect of health on functional status WQ WQ WQ WQ WQ
C) Past medical history WQ WQ
D) Motivation for adherence to treatment WQ WQ WQ WQ
7. After teaching a group of students about the phases of the nursing process, the instructor
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determines that the teaching was successful when the students identify which phase as
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being foundational to all other phases?
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A) Assessment
B) Planning
C) Implementation
D) Evaluation
8. The nurse has completed the comprehensive health assessment of a client who has been
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admitted for the treatment of community-
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acquired pneumonia. Following the completion of this assessment, the nurse periodica
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lly performs a partial assessment primarily for which reason?
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A) Reassess previously detected problems WQ WQ WQ
B) Provide information for the client's record WQ WQ WQ WQ WQ
C) Address areas previously omitted WQ WQ WQ
D) Determine the need for crisis intervention WQ WQ WQ WQ WQ
9. The nurse is working in an ambulatory care clinic that is located in a busy, inner-
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city neighborhood. Which client would the nurse determine to be in most need of a
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n emergency assessment?
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A) A 14-year-old girl who is crying because she thinks she is pregnant
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B) A 45-year-old man with chest pain and diaphoresis for 1 hour
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C) A 3-year-old child with fever, rash, and sore throat
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D) A 20-year-old man with a 3-inch shallow laceration on his leg
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, 10. A nurse has completed gathering some basic data about a client who has multiple healt
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h problems that stem from heavy alcohol use. The nurse has then reflected on her perso
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nal feelings about the client and his circumstances. The nurse does this primarily to acc
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omplish which of the following? WQ WQ WQ WQ
A) Determine if pertinent data has been omitted WQ WQ WQ WQ WQ WQ
B) Identify the need for referral WQ WQ WQ WQ
C) Avoid biases and judgments WQ WQ WQ
D) Construct a plan of care WQ WQ WQ WQ
11. The nurse is collecting data from a client who has recently been diagnosed with type 1
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diabetes and who will begin an educational program. The nurse is collecting subjective
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and objective data. Which of the following would the nurse categorize as objective data?
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A) Family history WQ
B) Occupation
C) Appearance
D) History of present health concern WQ WQ WQ WQ
12. An older adult client has been admitted to the hospital with failure to thrive resulting
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from complications of diabetes. Which of the following would the nurse implement i
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n response to a collaborative problem?
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A) Encourage the client to increase oral fluid intake. WQ WQ WQ WQ WQ WQ WQ
B) Provide the client with a bedtime protein snack. WQ WQ WQ WQ WQ WQ WQ
C) Assist the client with personal hygiene. WQ WQ WQ WQ WQ
D) Measure the client's blood glucose four times daily. WQ WQ WQ WQ WQ WQ WQ
13. The nurse at a busy primary care clinic is analyzing the data obtained from the foll
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owing clients. For which clients would the nurse most likely expect to facilitate a ref
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erral?
A) An 80-year-old client who lives with her daughter
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B) A 50-year-old client newly diagnosed with diabetes
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C) An adult presenting for an influenza vaccination
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D) A teenager seeking information about contraception
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14. An instructor is reviewing the evolution of the nurse's role in health assessment. The i
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nstructor determines that the teaching was successful when the students identify which
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of the following as the major method used by nurses early in the history of the profess
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ion?
A) Natural senses WQ
B) Biomedical knowledge WQ
C) Simple technology WQ
D) Critical pathways WQ
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