N125 EXAM 1 STUDY GUIDE QUESTIONS WITH
ACCURATE ANSWERS
A 4-year-old boy is brought to the emergency department by his mother. She says
he points to his stomach and says, It hurts so bad. Which pain assessment tool
would be the best choice when assessing this childs pain? correct answer FACES
A man is at the clinic for a physical examination. He states that he is very anxious
about the physical examination. What steps can the nurse take to make him more
comfortable?
a.Appear unhurried and confident when examining him.
b.Stay in the room when he undresses in case he needs assistance.
c.Ask him to change into an examining gown and to take off his undergarments.
d.Defer measuring vital signs until the end of the examination, which allows him
time to become comfortable. correct answer A
A nurse completes the following steps during her shift of care. Which are the
steps of nursing assessment? (Select all that apply.)
a. The review of patient data in the medical record
b. Confirming a patient's self-report of abdominal pain by inspecting the abdomen
c. Reporting results of an ongoing assessment to a nurse working the next
scheduled shift
d. Analyzing a set of signs revealing lower leg weakness and unsteady gait with a
pattern of mobility alteration
e. Conducting an interview of a family caregiver correct answer A, B, D
,A nurse enters a patient's room at the beginning of a shift to conduct an
assessment of his condition following a blood transfusion. The nurse cared for the
patient on the previous day as well. The patient has a number of issues he wishes
to share with the nurse, who takes time to explore each issue. The nurse also
assesses the patient and finds no signs or symptoms of a reaction to the blood
product. The nurse observed the patient the prior day and sees a change in his
behavior, a reluctance to get out of bed and ambulate. Which of the following
actions improve the nurse's ability to make clinical decisions about this patient?
(Select all that apply.)
1. Working the same shift each day
2. Spending time during the patient assessment
3. Knowing the early mobility protocol guidelines
4. Caring for the patient on consecutive days.
5. Knowing the pattern of patient behavior about ambulation correct answer 2, 4,
5
A nurse is assigned to a new patient admitted to the nursing unit following
admission through the emergency department. The nurse collects a nursing
history and interviews the patient. Place the following steps for making a nursing
diagnosis in the correct order, beginning with the first step:
1. Considers context of patient's health problem and selects a related factor
2. Reviews assessment data, noting objective and subjective clinical information
3. Clusters clinical cues that form a pattern
4. Identify appropriate assessment findings for diagnosis.
5. Identify a nursing diagnosis. correct answer 2, 3, 5, 1, 4
, Assessment
Diagnosis
Planning
Intervention
Implementation
A nurse is assigned to care for a woman who is expecting her first child. The nurse
organizes herself and plans to gather data about the patient by applying Pender's
health promotion model, including the patient's characteristics and experiences
and situational influences. She plans to observe patient behavior and consider the
patient's psychosocial issues. Such data will offer a clear understanding to help
the nurse identify the patient's needs. This is an example of which of the following
concepts? (Select all that apply.)
1. Diagnostic reasoning
2. Deductive reasoning
3. Inductive reasoning
4. Assessment
5. Problem solving correct answer 2, 4
A nurse is preparing medications for a patient. The nurse checks the name of the
medication on the label with the name of the medication on the doctor's order.
At the bedside the nurse checks the patient's name against the medication order
as well. The nurse is following which critical thinking attitude?
1. Responsibility
ACCURATE ANSWERS
A 4-year-old boy is brought to the emergency department by his mother. She says
he points to his stomach and says, It hurts so bad. Which pain assessment tool
would be the best choice when assessing this childs pain? correct answer FACES
A man is at the clinic for a physical examination. He states that he is very anxious
about the physical examination. What steps can the nurse take to make him more
comfortable?
a.Appear unhurried and confident when examining him.
b.Stay in the room when he undresses in case he needs assistance.
c.Ask him to change into an examining gown and to take off his undergarments.
d.Defer measuring vital signs until the end of the examination, which allows him
time to become comfortable. correct answer A
A nurse completes the following steps during her shift of care. Which are the
steps of nursing assessment? (Select all that apply.)
a. The review of patient data in the medical record
b. Confirming a patient's self-report of abdominal pain by inspecting the abdomen
c. Reporting results of an ongoing assessment to a nurse working the next
scheduled shift
d. Analyzing a set of signs revealing lower leg weakness and unsteady gait with a
pattern of mobility alteration
e. Conducting an interview of a family caregiver correct answer A, B, D
,A nurse enters a patient's room at the beginning of a shift to conduct an
assessment of his condition following a blood transfusion. The nurse cared for the
patient on the previous day as well. The patient has a number of issues he wishes
to share with the nurse, who takes time to explore each issue. The nurse also
assesses the patient and finds no signs or symptoms of a reaction to the blood
product. The nurse observed the patient the prior day and sees a change in his
behavior, a reluctance to get out of bed and ambulate. Which of the following
actions improve the nurse's ability to make clinical decisions about this patient?
(Select all that apply.)
1. Working the same shift each day
2. Spending time during the patient assessment
3. Knowing the early mobility protocol guidelines
4. Caring for the patient on consecutive days.
5. Knowing the pattern of patient behavior about ambulation correct answer 2, 4,
5
A nurse is assigned to a new patient admitted to the nursing unit following
admission through the emergency department. The nurse collects a nursing
history and interviews the patient. Place the following steps for making a nursing
diagnosis in the correct order, beginning with the first step:
1. Considers context of patient's health problem and selects a related factor
2. Reviews assessment data, noting objective and subjective clinical information
3. Clusters clinical cues that form a pattern
4. Identify appropriate assessment findings for diagnosis.
5. Identify a nursing diagnosis. correct answer 2, 3, 5, 1, 4
, Assessment
Diagnosis
Planning
Intervention
Implementation
A nurse is assigned to care for a woman who is expecting her first child. The nurse
organizes herself and plans to gather data about the patient by applying Pender's
health promotion model, including the patient's characteristics and experiences
and situational influences. She plans to observe patient behavior and consider the
patient's psychosocial issues. Such data will offer a clear understanding to help
the nurse identify the patient's needs. This is an example of which of the following
concepts? (Select all that apply.)
1. Diagnostic reasoning
2. Deductive reasoning
3. Inductive reasoning
4. Assessment
5. Problem solving correct answer 2, 4
A nurse is preparing medications for a patient. The nurse checks the name of the
medication on the label with the name of the medication on the doctor's order.
At the bedside the nurse checks the patient's name against the medication order
as well. The nurse is following which critical thinking attitude?
1. Responsibility
