nclex chapter 11-15 practice questions
1. Read the following scenario and identify the term for the characteristics of patient
data that are numbered below. Place your answers on the lines provided.
The nurse is conducting an initial assessment of a 79-year old female patient admitted
to the hospital with a diagnosis of dehydration.
The nurse:
(1) uses clinical reasoning to identify the need to perform a comprehensive assessment
and gather the appropriate patient data,
(2) first asks the patient about the most important details leading up to her diagnosis,
(3) collects as much information as possible to understand the patient's health
problems,
(4) collects the patient data in an organized manner,
(5) verifies that the data obtained is pertinent to the patient care plan, and
(6) records the data according to agency policy. correct answers (1) Purposeful
(2) Prioritized
(3) Complete
(4) Systematic
(5) Factual and accurate
(6) Recorded in a standard manner
2. The nurse practitioner is performing a short assessment of a newborn who is
displaying signs of jaundice. The nurse observes the infant's skin color and orders a test
for bilirubin levels to report to the primary care provider. What type of assessment has
this nurse performed?
a. Comprehensive
b. Initial
c. Time-lapsed
d. Quick priority correct answers d. Quick priority
3. The nurse is admitting a 35-year-old pregnant woman to the hospital for treatment of
preeclampsia. The patient asks the nurse: "Why are you doing a history and physical
exam when the doctor just did one?" Which statements best explain the primary
reasons a nursing assessment is performed? Select all that apply.
a. "The nursing assessment will allow us to plan and deliver individualized, holistic
nursing care that draws on your strengths."
b. "It's hospital policy. I know it must be tiresome, but I will try to make this quick!"
,c. "I'm a student nurse and need to develop the skill of assessing your health status and
need for nursing care."
d. "We want to make sure that your responses to the medical exam are consistent and
that all our data are accurate."
e. "We need to check your health status and see what kind of nursing care you may
need."
f. "We need to see if you require a referral to a physician or other correct answers a.
"The nursing assessment will allow us to plan and deliver individualized, holistic nursing
care that draws on your strengths."
e. "We need to check your health status and see what kind of nursing care you may
need."
f. "We need to see if you require a referral to a physician or other health care
professional.
4. When you receive the shift report, you learn that your patient has no special skin care
needs. You are surprised during the bath to observe reddened areas over bony
prominences. What action is appropriate?
a. Correct the initial assessment form.
b. Redo the initial assessment and document current findings.
c. Conduct and document an emergency assessment.
d. Perform and document a focused assessment of skin integrity. correct answers d.
Perform and document a focused assessment of skin integrity.
5. A student nurse attempts to perform a nursing history for the first time. The student
nurse asks the instructor how anyone ever learns all the questions the nurse must ask
to get good baseline data. What would be the instructor's best reply?
a. "There's a lot to learn at first, but once it becomes part of you, you just keep asking
the same questions over and over in each situation until you can do it in your sleep!"
b. "You make the basic questions a part of you and then learn to modify them for each
unique situation, asking yourself how much you need to know to plan good care."
c. "No one ever really learns how to do this well because each history is different! I often
feel like I'm starting afresh with each new patient."
, d. "Don't worry about learning all of the questions to ask. Every agency has its own
assessment form you must use." correct answers b. "You make the basic questions a
part of you and then learn to modify them for each unique situation, asking yourself how
much you need to know to plan good care."
6. The nurse collects objective and subjective data when conducting patient
assessments. Which patient conditions are examples of subjective data? Select all that
apply.
a. A patient tells the nurse that she is feeling nauseous.
b. A patient's ankles are swollen.
c. A patient tells the nurse that she is nervous about her test results.
d. A patient complains of having a rash on her arm that is itchy.
e. A patient rates his pain as a 7 on a scale of 1 to 10.
f. A patient vomits after eating supper. correct answers a. A patient tells the nurse that
she is feeling nauseous.
c. A patient tells the nurse that she is nervous about her test results.
d. A patient complains of having a rash on her arm that is itchy.
e. A patient rates his pain as a 7 on a scale of 1 to 10.
7. When a nurse enters the patient's room to begin a nursing history, the patient's wife
is there. What should the nurse do?
a. Introduce oneself and thank the wife for being present.
b. Introduce oneself and ask the wife if she wants to remain.
c. Introduce oneself and ask the wife to leave.
d. Introduce oneself and ask the patient if he would like the wife to stay. correct
answers d. Introduce oneself and ask the patient if he would like the wife to stay.
8. A nurse is performing an initial comprehensive assessment of an 84-year-old male
patient admitted to a long-term care facility from home. The nurse begins the
assessment by asking the patient, "How would you describe your health status and well-
being?" The nurse also asks the patient, "What do you do to keep yourself healthy?"
Which model for organizing data is this nurse following?
1. Read the following scenario and identify the term for the characteristics of patient
data that are numbered below. Place your answers on the lines provided.
The nurse is conducting an initial assessment of a 79-year old female patient admitted
to the hospital with a diagnosis of dehydration.
The nurse:
(1) uses clinical reasoning to identify the need to perform a comprehensive assessment
and gather the appropriate patient data,
(2) first asks the patient about the most important details leading up to her diagnosis,
(3) collects as much information as possible to understand the patient's health
problems,
(4) collects the patient data in an organized manner,
(5) verifies that the data obtained is pertinent to the patient care plan, and
(6) records the data according to agency policy. correct answers (1) Purposeful
(2) Prioritized
(3) Complete
(4) Systematic
(5) Factual and accurate
(6) Recorded in a standard manner
2. The nurse practitioner is performing a short assessment of a newborn who is
displaying signs of jaundice. The nurse observes the infant's skin color and orders a test
for bilirubin levels to report to the primary care provider. What type of assessment has
this nurse performed?
a. Comprehensive
b. Initial
c. Time-lapsed
d. Quick priority correct answers d. Quick priority
3. The nurse is admitting a 35-year-old pregnant woman to the hospital for treatment of
preeclampsia. The patient asks the nurse: "Why are you doing a history and physical
exam when the doctor just did one?" Which statements best explain the primary
reasons a nursing assessment is performed? Select all that apply.
a. "The nursing assessment will allow us to plan and deliver individualized, holistic
nursing care that draws on your strengths."
b. "It's hospital policy. I know it must be tiresome, but I will try to make this quick!"
,c. "I'm a student nurse and need to develop the skill of assessing your health status and
need for nursing care."
d. "We want to make sure that your responses to the medical exam are consistent and
that all our data are accurate."
e. "We need to check your health status and see what kind of nursing care you may
need."
f. "We need to see if you require a referral to a physician or other correct answers a.
"The nursing assessment will allow us to plan and deliver individualized, holistic nursing
care that draws on your strengths."
e. "We need to check your health status and see what kind of nursing care you may
need."
f. "We need to see if you require a referral to a physician or other health care
professional.
4. When you receive the shift report, you learn that your patient has no special skin care
needs. You are surprised during the bath to observe reddened areas over bony
prominences. What action is appropriate?
a. Correct the initial assessment form.
b. Redo the initial assessment and document current findings.
c. Conduct and document an emergency assessment.
d. Perform and document a focused assessment of skin integrity. correct answers d.
Perform and document a focused assessment of skin integrity.
5. A student nurse attempts to perform a nursing history for the first time. The student
nurse asks the instructor how anyone ever learns all the questions the nurse must ask
to get good baseline data. What would be the instructor's best reply?
a. "There's a lot to learn at first, but once it becomes part of you, you just keep asking
the same questions over and over in each situation until you can do it in your sleep!"
b. "You make the basic questions a part of you and then learn to modify them for each
unique situation, asking yourself how much you need to know to plan good care."
c. "No one ever really learns how to do this well because each history is different! I often
feel like I'm starting afresh with each new patient."
, d. "Don't worry about learning all of the questions to ask. Every agency has its own
assessment form you must use." correct answers b. "You make the basic questions a
part of you and then learn to modify them for each unique situation, asking yourself how
much you need to know to plan good care."
6. The nurse collects objective and subjective data when conducting patient
assessments. Which patient conditions are examples of subjective data? Select all that
apply.
a. A patient tells the nurse that she is feeling nauseous.
b. A patient's ankles are swollen.
c. A patient tells the nurse that she is nervous about her test results.
d. A patient complains of having a rash on her arm that is itchy.
e. A patient rates his pain as a 7 on a scale of 1 to 10.
f. A patient vomits after eating supper. correct answers a. A patient tells the nurse that
she is feeling nauseous.
c. A patient tells the nurse that she is nervous about her test results.
d. A patient complains of having a rash on her arm that is itchy.
e. A patient rates his pain as a 7 on a scale of 1 to 10.
7. When a nurse enters the patient's room to begin a nursing history, the patient's wife
is there. What should the nurse do?
a. Introduce oneself and thank the wife for being present.
b. Introduce oneself and ask the wife if she wants to remain.
c. Introduce oneself and ask the wife to leave.
d. Introduce oneself and ask the patient if he would like the wife to stay. correct
answers d. Introduce oneself and ask the patient if he would like the wife to stay.
8. A nurse is performing an initial comprehensive assessment of an 84-year-old male
patient admitted to a long-term care facility from home. The nurse begins the
assessment by asking the patient, "How would you describe your health status and well-
being?" The nurse also asks the patient, "What do you do to keep yourself healthy?"
Which model for organizing data is this nurse following?
