Chapter 46 Clinical Toxicology
MULTIPLE CHOICE
1. What is the primary purpose of the nursing assessment?
a. Identifying underlying pathologic conditions
b. Assisting the physician in identifying medical conditions
c. Determining the patients mental status
d. Exploring patient responses to health problems
ANS D
A nursing assessment is done to identify the patients response to health problems. During the
nursing assessment phase, a comprehensive information base is developed through a physical
examination, nursing history, medication history, and professional observation. Identifying
underlying pathologic conditions and assisting the physician in identifying medical conditions
is not part of the nursing process. Determining the patients mental status is one part of the
nursing assessment, but it is not the primary purpose.
DIF Cognitive Level Comprehension REF dm. 36 OBJ 1 | 3
TOP Nursing Process Step Assessment
MSC NCLEX Client Needs Category Health Promotion and Maintenance
2. What is the basis of the NANDA I taxonomy?
a. Functional health patterns
b. Human response patterns
c. Basic human needs
d. Pathophysiologic needs
ANS B
Page 1 of 17
,The NANDA I taxonomy identifies human response patterns. Functional components of health
patterns are limited to activity, fluid volume, nutrition, self care, and sensory perception. Basic
human needs comprise less than merely health patterns. Pathophysiologic needs are not part of
the scope of NANDA I.
DIF Cognitive Level Knowledge REF pp. 37-38 OBJ 5 TOP
Nursing Process Step Diagnosis
MSC NCLEX Client Needs Category Physiological Integrity
3. Which task is included in the assessment step of the nursing process?
a. Establishing patient goals/outcomes
b. Implementing the nursing care plan (NCP)
c. Measuring goal/outcome achievement
d. Collecting and communicating data
ANS D
Data are collected and communicated in the assessment phase of the nursing process.
Establishing goals is the function of planning. Implementing the NCP is the function
of implementation. Measuring outcome achievement is the function of evaluation.
DIF Cognitive Level Comprehension REF dm. 36 OBJ 2 | 3
TOP Nursing Process Step Assessment
MSC NCLEX Client Needs Category Health Promotion and Maintenance
4. Which statement regarding nursing diagnoses is accurate?
a. Nursing diagnoses remain the same for as long as the disease is present.
b. Nursing diagnoses are written to identify disease states.
c. Nursing diagnoses describe patient problems that nurses treat.
Page 2 of 17
, d. Nursing diagnoses identify causes related to illness.
ANS C
Diagnostic statements identify problems a nurse is independently able to treat within the scope
of professional practice. Nursing diagnoses vary with the changing condition of the patient. The
response patterns are unique to the patient and are not disease specific. Nursing diagnoses
describe the patients human response pattern.
DIF Cognitive Level Comprehension REF pp. 37-38 OBJ 5
TOP Nursing Process Step Diagnosis
MSC NCLEX Client Needs Category Physiological Integrity
5. What do the classification systems NIC and NOC provide?
a. Individualized data banks of treatments related to disease processes
b. Standardized language for reporting and analyzing nursing care delivery
c. A measure for cost containment within medical institutions
d. Specialized interventions for rare diseases
ANS B
Nursing classification systems such as NIC and NOC are designed to provide a standardized
language for reporting and analyzing nursing care delivery that is individualized for each
patient. Standardized terminology assists practitioners in the implementation of the five phases
of the nursing process. Classification systems are not related to disease process and are not
used for financial purposes. Classification systems include interventions for all health
conditions.
DIF Cognitive Level Knowledge REF dm. 34 OBJ 11
TOP Nursing Process Step Implementation
MSC NCLEX Client Needs Category Safe, Effective Care Environment
Page 3 of 17
MULTIPLE CHOICE
1. What is the primary purpose of the nursing assessment?
a. Identifying underlying pathologic conditions
b. Assisting the physician in identifying medical conditions
c. Determining the patients mental status
d. Exploring patient responses to health problems
ANS D
A nursing assessment is done to identify the patients response to health problems. During the
nursing assessment phase, a comprehensive information base is developed through a physical
examination, nursing history, medication history, and professional observation. Identifying
underlying pathologic conditions and assisting the physician in identifying medical conditions
is not part of the nursing process. Determining the patients mental status is one part of the
nursing assessment, but it is not the primary purpose.
DIF Cognitive Level Comprehension REF dm. 36 OBJ 1 | 3
TOP Nursing Process Step Assessment
MSC NCLEX Client Needs Category Health Promotion and Maintenance
2. What is the basis of the NANDA I taxonomy?
a. Functional health patterns
b. Human response patterns
c. Basic human needs
d. Pathophysiologic needs
ANS B
Page 1 of 17
,The NANDA I taxonomy identifies human response patterns. Functional components of health
patterns are limited to activity, fluid volume, nutrition, self care, and sensory perception. Basic
human needs comprise less than merely health patterns. Pathophysiologic needs are not part of
the scope of NANDA I.
DIF Cognitive Level Knowledge REF pp. 37-38 OBJ 5 TOP
Nursing Process Step Diagnosis
MSC NCLEX Client Needs Category Physiological Integrity
3. Which task is included in the assessment step of the nursing process?
a. Establishing patient goals/outcomes
b. Implementing the nursing care plan (NCP)
c. Measuring goal/outcome achievement
d. Collecting and communicating data
ANS D
Data are collected and communicated in the assessment phase of the nursing process.
Establishing goals is the function of planning. Implementing the NCP is the function
of implementation. Measuring outcome achievement is the function of evaluation.
DIF Cognitive Level Comprehension REF dm. 36 OBJ 2 | 3
TOP Nursing Process Step Assessment
MSC NCLEX Client Needs Category Health Promotion and Maintenance
4. Which statement regarding nursing diagnoses is accurate?
a. Nursing diagnoses remain the same for as long as the disease is present.
b. Nursing diagnoses are written to identify disease states.
c. Nursing diagnoses describe patient problems that nurses treat.
Page 2 of 17
, d. Nursing diagnoses identify causes related to illness.
ANS C
Diagnostic statements identify problems a nurse is independently able to treat within the scope
of professional practice. Nursing diagnoses vary with the changing condition of the patient. The
response patterns are unique to the patient and are not disease specific. Nursing diagnoses
describe the patients human response pattern.
DIF Cognitive Level Comprehension REF pp. 37-38 OBJ 5
TOP Nursing Process Step Diagnosis
MSC NCLEX Client Needs Category Physiological Integrity
5. What do the classification systems NIC and NOC provide?
a. Individualized data banks of treatments related to disease processes
b. Standardized language for reporting and analyzing nursing care delivery
c. A measure for cost containment within medical institutions
d. Specialized interventions for rare diseases
ANS B
Nursing classification systems such as NIC and NOC are designed to provide a standardized
language for reporting and analyzing nursing care delivery that is individualized for each
patient. Standardized terminology assists practitioners in the implementation of the five phases
of the nursing process. Classification systems are not related to disease process and are not
used for financial purposes. Classification systems include interventions for all health
conditions.
DIF Cognitive Level Knowledge REF dm. 34 OBJ 11
TOP Nursing Process Step Implementation
MSC NCLEX Client Needs Category Safe, Effective Care Environment
Page 3 of 17
