NUR265 FINAL UPDATED ACTUAL
Questions and CORRECT Answers
subjective - CORRECT ANSWER what the client tells you
objective - CORRECT ANSWER what is observed, things that can be measured
primary data collection - CORRECT ANSWER that client telling me, right from client, or
from my own assessment
secondary data collection - CORRECT ANSWER family member or another nurse tells
you data; data from source that isn't you or client
general survery - CORRECT ANSWER physical appearance, body structure, mobility,
behavior
complete assessment - CORRECT ANSWER full physical assessment; info about client's
full history, past medical history, diseases, meds they're on; provides baseline; annual physical,
admission assessment, initial home visit
focused assessment - CORRECT ANSWER focusing on primary complaint; focused on
one area
follow-up assessment - CORRECT ANSWER after being diagnosed to manage condition;
on a specific disease or post-op
inspection - CORRECT ANSWER looking, using sight to gather info
palpation - CORRECT ANSWER feeling, using sense of touch to gather info; light to
deep; assess temp w back of hand; textures w fingertips; tender areas last
,percussion - CORRECT ANSWER tapping (usu abdomen) to learn about underlying
structures using sound
flatness percussion - CORRECT ANSWER bone or muscle
dullness percussion - CORRECT ANSWER heart, liver, spleen
resonance percussion - CORRECT ANSWER air filled lungs (hollow)
hyperresonance percussion - CORRECT ANSWER emphysematous lung (hyperinflated)
tympany percussion - CORRECT ANSWER air filled stomach (drum like)
auscultation - CORRECT ANSWER listening w a stethoscope
first level priority - CORRECT ANSWER emergent/life-threatening; if you don't do
something, client is going to die; ABCs (airway, breathing, circulation)
bell - CORRECT ANSWER hollow side of stethoscope (for one I have, just don't press as
hard with diaphragm); picks up murmur and other vascular sounds; to listen to carotids - listen
for bruit
diaphragm - CORRECT ANSWER for BP, apical pulse, press harder with stethoscope I
have
second level priority - CORRECT ANSWER urgent, necessitating prompt intervention;
acute pain, mental status change, safety risk
, third level priority - CORRECT ANSWER need attention, but not priority; problems with
lack of knowledge, mobility, rest, coping, chronic pain
gender role - CORRECT ANSWER how society expected one to dress, think, act based on
their sex assigned at birth
gender - CORRECT ANSWER social construct of norms, behaviors, and roles that varies
between societies and over time, its how your identity related to societys idea of being a man,
woman, neither, mix; can be different than culture's ideas and expectations for sex one is
assigned at birth
gender identity - CORRECT ANSWER our sense of being male, female, some
combination of the two, or neither; can be same or different than assigned sex at birth
cultural and spiritual interventions - CORRECT ANSWER pt's practices, perceptions of
healthcare/treatments; how religion plays a role in their care; therapeutic communication
therapeutic communication - CORRECT ANSWER creates nonjudgmental environment
and encourages open communication; body language, tone of voice, sensory alterations,
language barrier, internal and eternal factors all play a role
layers of the skin - CORRECT ANSWER epidermis, dermis, subcutaneous
epidermis - CORRECT ANSWER surface layer of skin; combo of dead cells on outside
and live cells on inside
dermis - CORRECT ANSWER middle layer; composed of connective tissue that contains
blood vessels, hair follicles, and sebaceous & sweat glands
subcutaneous - CORRECT ANSWER innermost layer containing adipose (fat) tissue
Questions and CORRECT Answers
subjective - CORRECT ANSWER what the client tells you
objective - CORRECT ANSWER what is observed, things that can be measured
primary data collection - CORRECT ANSWER that client telling me, right from client, or
from my own assessment
secondary data collection - CORRECT ANSWER family member or another nurse tells
you data; data from source that isn't you or client
general survery - CORRECT ANSWER physical appearance, body structure, mobility,
behavior
complete assessment - CORRECT ANSWER full physical assessment; info about client's
full history, past medical history, diseases, meds they're on; provides baseline; annual physical,
admission assessment, initial home visit
focused assessment - CORRECT ANSWER focusing on primary complaint; focused on
one area
follow-up assessment - CORRECT ANSWER after being diagnosed to manage condition;
on a specific disease or post-op
inspection - CORRECT ANSWER looking, using sight to gather info
palpation - CORRECT ANSWER feeling, using sense of touch to gather info; light to
deep; assess temp w back of hand; textures w fingertips; tender areas last
,percussion - CORRECT ANSWER tapping (usu abdomen) to learn about underlying
structures using sound
flatness percussion - CORRECT ANSWER bone or muscle
dullness percussion - CORRECT ANSWER heart, liver, spleen
resonance percussion - CORRECT ANSWER air filled lungs (hollow)
hyperresonance percussion - CORRECT ANSWER emphysematous lung (hyperinflated)
tympany percussion - CORRECT ANSWER air filled stomach (drum like)
auscultation - CORRECT ANSWER listening w a stethoscope
first level priority - CORRECT ANSWER emergent/life-threatening; if you don't do
something, client is going to die; ABCs (airway, breathing, circulation)
bell - CORRECT ANSWER hollow side of stethoscope (for one I have, just don't press as
hard with diaphragm); picks up murmur and other vascular sounds; to listen to carotids - listen
for bruit
diaphragm - CORRECT ANSWER for BP, apical pulse, press harder with stethoscope I
have
second level priority - CORRECT ANSWER urgent, necessitating prompt intervention;
acute pain, mental status change, safety risk
, third level priority - CORRECT ANSWER need attention, but not priority; problems with
lack of knowledge, mobility, rest, coping, chronic pain
gender role - CORRECT ANSWER how society expected one to dress, think, act based on
their sex assigned at birth
gender - CORRECT ANSWER social construct of norms, behaviors, and roles that varies
between societies and over time, its how your identity related to societys idea of being a man,
woman, neither, mix; can be different than culture's ideas and expectations for sex one is
assigned at birth
gender identity - CORRECT ANSWER our sense of being male, female, some
combination of the two, or neither; can be same or different than assigned sex at birth
cultural and spiritual interventions - CORRECT ANSWER pt's practices, perceptions of
healthcare/treatments; how religion plays a role in their care; therapeutic communication
therapeutic communication - CORRECT ANSWER creates nonjudgmental environment
and encourages open communication; body language, tone of voice, sensory alterations,
language barrier, internal and eternal factors all play a role
layers of the skin - CORRECT ANSWER epidermis, dermis, subcutaneous
epidermis - CORRECT ANSWER surface layer of skin; combo of dead cells on outside
and live cells on inside
dermis - CORRECT ANSWER middle layer; composed of connective tissue that contains
blood vessels, hair follicles, and sebaceous & sweat glands
subcutaneous - CORRECT ANSWER innermost layer containing adipose (fat) tissue
