EXAM 1 - HEALTH ASSESSMENT - NCLEX STYLE QUESTIONS correct answers

EXAM 1 - HEALTH ASSESSMENT - NCLEX STYLE QUESTIONS correct answers A patient is having adverse effects resulting from a medication. The nurse calls the primary care provider to request a change in the medication order. The nurse is functioning as a/an A.educator B.advocate. C.organizer. D.counselor B -- VOICING CONCERNS ABOUT PATIENT, THE NURSE FUNCTIONS TO IMPROVE QUALITY OF CARE Nurses advocate for underserved populations to reduce health disparities. This promotes A.autonomy. B.altruism. C.respect. D.human dignity. C -- WHEN NURSES TREAT INDIVIDUALS TO IMPROVE THE DISPARITIES PRESENT IN THE HEALTH CARE SYSTEM 00:47 00:58 Nurses belong to the ANA as part of their A.ongoing professional responsibility. B.role as manager of care. C.wellness promotion for patients. D.cultural education activities. A -- NURSES CONTINUE TO LEARN AND PROMOTE HEALTH AS PART OF THEIR PROFESSIONAL RESPONSIBILITY The purpose of health assessment is to A.obtain subjective and objective data. B.intervene to correct difficulties. C.outline appropriate care. D.determine whether interventions are effective A -- HEALTH ASSESSMENT IS THE METHOD BY WHICH THE NURSE GATHERS THIS TYPE The nurse provides teaching about smoking cessation to a 20-year-old man. The nurse assesses that the patient is concerned because his father died from lung cancer. Which theory would the nurse most likely use when providing teaching to this patient? A.Health belief model B.Diagnostic reasoning model C.Cultural competence model D.Body systems model A -- TO ASSESS PATIENTS PERSPECTIVE ABOUT RELATIONSHIP BETWEEN DISEASE AND CAUSE. Which of the following processes is the most important when providing nursing care to an ill patient? A.Writing outcomes B.Performing a focused assessment C.Collecting objective data D.Using critical thinking D -- ASSESSMENTS PROVIDES SOLID FOUNDATION FOR CARE, BUT THIS IS NEEDED IN ALL PHASES OF NURSING PROCESS A patient is admitted to a hospital for surgery for colon cancer. What type of assessment is the nurse most likely to perform on admission? A.Emergency B.Focused C.Comprehensive D.Illness C -- INVOLVES ALL BODY SYSTEMS Which of the following are components of a comprehensive health assessment? A.Nursing diagnoses B.Goals and outcomes C.Collaborative problems D.Examination of body systems D - COLLECTS SUBJECTIVE AND OBJECTIVE DATA INCLUDING HISTORY OF CURRENT, HISTORY, COMMON SYMPTOMS, AND HEAD-TO-TOE ASSESSMENT The nurse conducts the health history based on the patient’s responses to the medical diagnosis. This type of framework is based on the A.functional framework. B.objective framework. C.coordinator framework. D.collaborative framework. A -- PROVIDER IS EVALUATING MEDICAL DIAGNOSIS - NURSE ASSESS PATIENT RESPONSE TO DIAGNOSES AND SYMPTOMS AS WELL AS COPING A patient says that she is having throbbing pain that she rates as 6 on a 10-point scale. This is referred to as A.subjective primary data. B.subjective secondary data. C.objective primary data. D.objective secondary data. A -- ONLY THE PATIENT KNOWS WHAT THESE ANSWERS ARE The nurse is gathering the health history data before performing the physical assessment. This phase of the interview process is the A.preinteraction phase. B.beginning phase. C.working phase. D.closing phase. C -- NURSE IS COLLECTING DATA The patient is crying after being given a diagnosis with a poor prognosis. The best response from the nurse is A.“Don’t cry. It will be OK.” B.“My mother has the same thing.” C.“I think that you should have surgery.” D.“I’ll stay with you” (gets a tissue). D -- BE PRESENT, USE SILENCE, ARE EFFECTIVE 00:02 00:58 When gathering the family history, the nurse draws a genogram A.using circles for males and squares for females. B.putting the patient on the left to show birth order. C.inserting lines between parents to show marriage. D.listing health problems above the symbol for the patient. C -- The mother of an infant with severe asthma is extremely anxious. The nurse is treating the patient in the emergency room. When collecting the history, the best response of the nurse is A.“You must be extremely worried.” B.“I’d be in worse shape than you are if it were my baby.” C.“Is there anyone here that you can talk to?” D.“You seem worried, but I need to ask a few questions.” D -- IMPORTANT TO GATHER HISTORY IN EMERGENCY SITUATIONS The nurse asks, “What are the most important things to you in life?” to assess the functional pattern related to A.role. B.self-perception. C.coping. D.values. D -- ADDRESS IMPORTANT BIG CONCEPTS OF LIFE AND DEATH To assess self-perception, the nurse asks A.“How would you describe yourself?” B.“Are you having difficulty handling any family problems?” C.“What gives you hope when times are troubled?” D.“How do you usually deal with stress? Is it effective?” A -- SELF-PERCEPTION FOCUSING ON THE PATIENTS THINKING OF THEMSELVES The nurse who asks about feeding, bathing, toileting, dressing, grooming, mobility, home maintenance, shopping, and cooking is assessing A.whether the patient is a reliable historian. B.functional health patterns. C.ADLs. D.review of systems. C -- NORMAL ACTIVITIES OF EVERYDAY LIVING The nurse assessing an older adult focuses the health history on A.previous pregnancies, obstetrical history, and psychosocial factors. B.birth history, immunizations, and growth and development. C.sensory deficits, illness history, and lifestyle factors. D.religion, spirituality, culture, and values. C -- INCLUDES SIGNIFICANT FINDING WITH AGAING In the SBAR reporting format, which of the following would be an example of data found in the assessment? A.Mrs. Kelly’s diagnosis is Stage II breast cancer. B.Mr. Imami’s lung sounds are decreased. C.Ms. Choi needs to have a social work consult. D.Mr. Jones was admitted at 10:30 this morning. B -- ASSESSMENT FINDINGS ARE SUBJECTIVE OR OBJECTIVE DATA Nursing assessment of trends in an unconscious patient’s neurological status over time is best recorded on A.an admission assessment B.a PO C.a progress note D.a focused assessment flow sheet D The nurse assesses the following vital signs in a 78-year-old man: temperature 36.6°C, temporal; pulse 72 beats/min, regular, 2+; respirations 18 breaths/min, regular, no use of accessory muscles; BP 142/92 mm Hg. Which of the findings is abnormal? A.Pulse B.BP C.Respirations D.Temperature B The best way to assess a client’s respiration rate is by: A.Place a hand over the client’s chest and count for 30 seconds B.Observe and count respirations for 30 seconds and multiply by two without mentioning that you are observing the respirations. C.Ask the client to breath normally for one minute. D.If respirations are irregular have the client rest for 10 minutes and then recount. C The patient’s radial pulse is weak and thready. The next action of the nurse is to A.transfer the patient to a critical care unit. B.notify the primary care provider. C.compare findings with previous findings and opposite extremity. D.assess vital signs every 15 minutes. C (PULSE)