1.
A nurse on a postsurgical unit is admitting a client following the client's
u q uq.uqluq uq.uqluq uq.uqluq uq.uqluq uq.uqluq uq.uqluq .uqluq uq.uqluq uq.uqluq uq.uqluq uq.uqluq
cholecystectomy(gall bladder removal). What is the overall purpose of assessment f
u q u q u q u q u q u q u q u q u q u q
orthis client?
u q
A) Collecting accurate data uq u q
, B) Assisting the primary care provider uq u q uq u q
C) Validating previous dataD uq u q .l
M
) aking clinical judgments
uqu q .lju .lju
2.
A client has presented to the emergency department (ED) with complaints of
u q u q u q u q u q u q uq u q u q u q u q
abdominalpain. Which member of the care team would most likely be responsibl u q u q u q u q u q u q u q u q u q uq u q
e forcollecting the subjective data on the client during the initial comprehensive
u q u q u q uq u q u q u q u q uq u q u q u
qassessment?
A) Gastroenterologist .l
B) ED nurse .lju
C) Admissions clerk uq
D) Diagnostic technician uq
3.
The nurse has completed an initial assessment of a newly admitted client and is
uqu q uqu q uqu q uqu q uqu q uqu q uqu q uqu q uqu q uqu q uqu q uqu q uqu q
applyingthe nursing process to plan the client's care. What principle should the nu
u q uq u q u q u q u q u q u q uq u q uq uq
rse apply whenu sing the nursing process?
u q uq juuququququ q uq u q u q
A) Each step is independent of the others. uq uq uq uq uq uq
B) It is ongoing and continuous.
.lju .lju .lju .lju
C) It is used primarily in acute care settings.
uq u q uq uq u q uq u q
D) It involves independent nursing actions.
u q u q u q u q
4.
The nurse who provides care at an ambulatory clinic is preparing to meet a client and
uq uq uq uq uq uq uq uq uq uq uq uq uq uq uq
perform a comprehensive health assessment. Which of the following actions should thenu
uq uq uq uq uq uq uq uq uq uq u q
rse perform first? u q u q
A) Review the client's medical record. ju .lju .lju .lju
B) Obtain basic biographic data. uq uq u q
C) Consult clinical resources explaining the client's diagnosis. u q u q u q u q u q u q
D) Validate information with the client. uq uq uq uq
5.
Which of the following client situations would the nurse interpret as
u q u q u q u q u q u q u q u q u q u q
requiring anemergency assessment? .l uq
A) A pediatric client with severe sunburn
uq uq uq uq uq
B) A client needing an employment physiA
uq uq uq uq u q
cacllCie)nt who overdosed on acetaminophen
.lju .luqu q .lju j.lu .lju .lju
D) A distraught client who wants a pregnancy test
uq u q u q uq uq u q uq
,6.
In response to a client's query, the nurse is explaining the differences between the
u q u q u q u q u q u q u q u q u q u q u q u q u q
physician's medical exam and the comprehensive health assessment performed
u q u q u q u q u q u q u q u q u
qby the nurse. The nurse should describe the fact that the nursing assessmen
u q u q u q u q u q u q u q u q u q u q u q u q
t focuses on which aspect of the client's situation?
u q u q .l j u q u q u q u q
A) Current physiologic
uququ q uq
statusEB f)fect of health on functional status
luquququququququququququq .lju .lju .lju .lju .lju
C) Past medical history uq u q
D) Motivation for adherence to treatment uq uq uq u q
7.
After teaching a group of students about the phases of the nursing process,
u q u q u q u q u q u q u q u q u q u q u q u q
the instructordetermines that the teaching was successful when the students identi
uq u q u q u q u q u q u q u q u q u q
fywhich phase as being foundational to all other phases?
u q u q u q u q u q u q u q u q
A) Assessment
B) Planning
C) Implementation
D) Evaluation
8.
The nurse has completed the comprehensive health assessment of a client w
u q u q u q u q u q u q u q u q u q u q u q
ho
has beenadmitted for the treatment of community-
uq u q u q u q u q u q
acquired pneumonia. Following the completion of this assessment, the nurs
u q u q u q uq u q u q u q u q u q
e periodically performs a
u q u q u q
partial assessmen rimarily for which reason?
u q uq u q u q
tp .l
A) Reassess previously detected problems .lju .lju .lju
B) Provide information for the client's record uq u q uq uq uq
C) Address areas previously omitted uq u q uq
D) Determine the need for crisis intervention uq u q u q uq uq
9.
The nurse is working in an ambulatory care clinic that is located in a busy,
u q u q u q u q u q u q uq u q u q u q u q u q u q u q
inner-
cityneighborhood. Which client would the nurse determine to be in most n u q u q u q u q u q u q u q u q u q u q u q
eed of an emergency assessment?
u q uq u q u q
A) A 14-year- uq
old girl who is crying because she thinks she is pregnAan4t5B-
u q u q uq u q uq u q uq u q uq u q .lju l
)year-old man with chest pain and diaphoresis for 1 hour
.lju j.lu .lju .lju j.lu .lju .lju j.lu .lju
C) A 3-year-old child with fever, rash, and sore throat
uq u q u q uq u q u q u q uq
D) A 20-year-old man with a 3-inch shallow laceration on his leg
uq u q uq uq u q uq uq u q u q uq
, 10.
A nurse has completed gathering some basic data about a client who has multi
u q u q u q u q u q u q u q u q u q u q u q u q u q
ple healthp roblems that stem from heavy alcohol use. The nurse has then r
u q juuququququ q u q u q u q u q uq u q u q u q u q u q u q
eflected on her personalfeelings about the client and his circumstances. The nurs
u q uq uq u q u q u q u q u q u q u q u q
e does this primarilyto accomplish which of the following?
u q u q u q u q u q uq u q u q
A) Determine if pertinent data has been omitted uq u q u q uq uq u q
B) Identify the need for refe uq u q u q uq
rrAalvCo)id biases and judgments
l .lju j.lu .lju
D) Construct a plan of care u q u q u q u q
11.
The nurse is collecting data from a client who has recently been diagnosed w
u q u q u q u q u q u q u q u q u q u q uq u q u q
ith type 1 diabetes and who will begin an educational program. The nurse is
u q .l u q u q u q u q u q u q u q u q u q u q u q u
qcollecting subjective and objective data. Which of the following would the nurs
uq u q uq u q uq u q uq u q uq uq uq
e categorize as objective data?
u q u q uq uq
A) Family history uq
B) Occupation
C) Appearance
D) History of present health concern uq u q u q uq
12.
An older adult client has been admitted to the hospital with failure to t
u q u q u q u q u q u q u q u q u q u q u q u q u q
hrive resulting from complications of diabetes. Which of the following
u q u q u q u q u q u q u q u q u q u q
would the nurse implement inresponse to a collaborative problem?
u q u q .l u q u q u q u q u q
A) Encourage the client to increase oral fluid intake. u q u q u q u q u q u q u q
B) Provide the client with a bedtime protein snack. uq uq uq uq uq uq uq
C) Assist the client with personal uq uq uq uq
hygieMnee.aDsu)re the client's blood glucose four times daily.
luquq uq .lju .lju .lju j.lu .lju .lju .lju
13.
The nurse at a busy primary care clinic is analyzing the data obtained f
u q u q u q u q u q u q u q u q u q u q u q u q u q
rom the following clients. For which clients would the nurse most likel
u q .l u q u q u q u q u q u q u q u q u q
y expect to facilitate ar eferral?
uq u q uq u q juuququq
A) An 80-year- uq
old client who lives with her daughAte5r0B -)year-
u q uq uq uq uq u q lju .luququ q
old client newly diagnosed with diabetes
.lju .lju .lju j.lu .lju
C) An adult presenting for an influenza vaccination
uq u q u q u q u q u q
D) A teenager seeking information about contraception
uq u q uq u q uq
14.
An instructor is reviewing the evolution of the nurse's role in health assessment
u q u q u q u q u q u q u q u q u q u q u q u q
. The instructor determines that the teaching was successful when the students
u q uq u q u q u q u q u q u q u q u q u q u
qidentify whichof the following as the major method used by nurses early in th
uq u q u q u q u q u q u q u q u q uq u q uq u q
e history of the profession?
u q uq uq uq
A) Natural senses ju
B) Biomedical knowledge u q
C) Simple technology uq
D) Critical pathways u q
Page uququ q 3
.
A nurse on a postsurgical unit is admitting a client following the client's
u q uq.uqluq uq.uqluq uq.uqluq uq.uqluq uq.uqluq uq.uqluq .uqluq uq.uqluq uq.uqluq uq.uqluq uq.uqluq
cholecystectomy(gall bladder removal). What is the overall purpose of assessment f
u q u q u q u q u q u q u q u q u q u q
orthis client?
u q
A) Collecting accurate data uq u q
, B) Assisting the primary care provider uq u q uq u q
C) Validating previous dataD uq u q .l
M
) aking clinical judgments
uqu q .lju .lju
2.
A client has presented to the emergency department (ED) with complaints of
u q u q u q u q u q u q uq u q u q u q u q
abdominalpain. Which member of the care team would most likely be responsibl u q u q u q u q u q u q u q u q u q uq u q
e forcollecting the subjective data on the client during the initial comprehensive
u q u q u q uq u q u q u q u q uq u q u q u
qassessment?
A) Gastroenterologist .l
B) ED nurse .lju
C) Admissions clerk uq
D) Diagnostic technician uq
3.
The nurse has completed an initial assessment of a newly admitted client and is
uqu q uqu q uqu q uqu q uqu q uqu q uqu q uqu q uqu q uqu q uqu q uqu q uqu q
applyingthe nursing process to plan the client's care. What principle should the nu
u q uq u q u q u q u q u q u q uq u q uq uq
rse apply whenu sing the nursing process?
u q uq juuququququ q uq u q u q
A) Each step is independent of the others. uq uq uq uq uq uq
B) It is ongoing and continuous.
.lju .lju .lju .lju
C) It is used primarily in acute care settings.
uq u q uq uq u q uq u q
D) It involves independent nursing actions.
u q u q u q u q
4.
The nurse who provides care at an ambulatory clinic is preparing to meet a client and
uq uq uq uq uq uq uq uq uq uq uq uq uq uq uq
perform a comprehensive health assessment. Which of the following actions should thenu
uq uq uq uq uq uq uq uq uq uq u q
rse perform first? u q u q
A) Review the client's medical record. ju .lju .lju .lju
B) Obtain basic biographic data. uq uq u q
C) Consult clinical resources explaining the client's diagnosis. u q u q u q u q u q u q
D) Validate information with the client. uq uq uq uq
5.
Which of the following client situations would the nurse interpret as
u q u q u q u q u q u q u q u q u q u q
requiring anemergency assessment? .l uq
A) A pediatric client with severe sunburn
uq uq uq uq uq
B) A client needing an employment physiA
uq uq uq uq u q
cacllCie)nt who overdosed on acetaminophen
.lju .luqu q .lju j.lu .lju .lju
D) A distraught client who wants a pregnancy test
uq u q u q uq uq u q uq
,6.
In response to a client's query, the nurse is explaining the differences between the
u q u q u q u q u q u q u q u q u q u q u q u q u q
physician's medical exam and the comprehensive health assessment performed
u q u q u q u q u q u q u q u q u
qby the nurse. The nurse should describe the fact that the nursing assessmen
u q u q u q u q u q u q u q u q u q u q u q u q
t focuses on which aspect of the client's situation?
u q u q .l j u q u q u q u q
A) Current physiologic
uququ q uq
statusEB f)fect of health on functional status
luquququququququququququq .lju .lju .lju .lju .lju
C) Past medical history uq u q
D) Motivation for adherence to treatment uq uq uq u q
7.
After teaching a group of students about the phases of the nursing process,
u q u q u q u q u q u q u q u q u q u q u q u q
the instructordetermines that the teaching was successful when the students identi
uq u q u q u q u q u q u q u q u q u q
fywhich phase as being foundational to all other phases?
u q u q u q u q u q u q u q u q
A) Assessment
B) Planning
C) Implementation
D) Evaluation
8.
The nurse has completed the comprehensive health assessment of a client w
u q u q u q u q u q u q u q u q u q u q u q
ho
has beenadmitted for the treatment of community-
uq u q u q u q u q u q
acquired pneumonia. Following the completion of this assessment, the nurs
u q u q u q uq u q u q u q u q u q
e periodically performs a
u q u q u q
partial assessmen rimarily for which reason?
u q uq u q u q
tp .l
A) Reassess previously detected problems .lju .lju .lju
B) Provide information for the client's record uq u q uq uq uq
C) Address areas previously omitted uq u q uq
D) Determine the need for crisis intervention uq u q u q uq uq
9.
The nurse is working in an ambulatory care clinic that is located in a busy,
u q u q u q u q u q u q uq u q u q u q u q u q u q u q
inner-
cityneighborhood. Which client would the nurse determine to be in most n u q u q u q u q u q u q u q u q u q u q u q
eed of an emergency assessment?
u q uq u q u q
A) A 14-year- uq
old girl who is crying because she thinks she is pregnAan4t5B-
u q u q uq u q uq u q uq u q uq u q .lju l
)year-old man with chest pain and diaphoresis for 1 hour
.lju j.lu .lju .lju j.lu .lju .lju j.lu .lju
C) A 3-year-old child with fever, rash, and sore throat
uq u q u q uq u q u q u q uq
D) A 20-year-old man with a 3-inch shallow laceration on his leg
uq u q uq uq u q uq uq u q u q uq
, 10.
A nurse has completed gathering some basic data about a client who has multi
u q u q u q u q u q u q u q u q u q u q u q u q u q
ple healthp roblems that stem from heavy alcohol use. The nurse has then r
u q juuququququ q u q u q u q u q uq u q u q u q u q u q u q
eflected on her personalfeelings about the client and his circumstances. The nurs
u q uq uq u q u q u q u q u q u q u q u q
e does this primarilyto accomplish which of the following?
u q u q u q u q u q uq u q u q
A) Determine if pertinent data has been omitted uq u q u q uq uq u q
B) Identify the need for refe uq u q u q uq
rrAalvCo)id biases and judgments
l .lju j.lu .lju
D) Construct a plan of care u q u q u q u q
11.
The nurse is collecting data from a client who has recently been diagnosed w
u q u q u q u q u q u q u q u q u q u q uq u q u q
ith type 1 diabetes and who will begin an educational program. The nurse is
u q .l u q u q u q u q u q u q u q u q u q u q u q u
qcollecting subjective and objective data. Which of the following would the nurs
uq u q uq u q uq u q uq u q uq uq uq
e categorize as objective data?
u q u q uq uq
A) Family history uq
B) Occupation
C) Appearance
D) History of present health concern uq u q u q uq
12.
An older adult client has been admitted to the hospital with failure to t
u q u q u q u q u q u q u q u q u q u q u q u q u q
hrive resulting from complications of diabetes. Which of the following
u q u q u q u q u q u q u q u q u q u q
would the nurse implement inresponse to a collaborative problem?
u q u q .l u q u q u q u q u q
A) Encourage the client to increase oral fluid intake. u q u q u q u q u q u q u q
B) Provide the client with a bedtime protein snack. uq uq uq uq uq uq uq
C) Assist the client with personal uq uq uq uq
hygieMnee.aDsu)re the client's blood glucose four times daily.
luquq uq .lju .lju .lju j.lu .lju .lju .lju
13.
The nurse at a busy primary care clinic is analyzing the data obtained f
u q u q u q u q u q u q u q u q u q u q u q u q u q
rom the following clients. For which clients would the nurse most likel
u q .l u q u q u q u q u q u q u q u q u q
y expect to facilitate ar eferral?
uq u q uq u q juuququq
A) An 80-year- uq
old client who lives with her daughAte5r0B -)year-
u q uq uq uq uq u q lju .luququ q
old client newly diagnosed with diabetes
.lju .lju .lju j.lu .lju
C) An adult presenting for an influenza vaccination
uq u q u q u q u q u q
D) A teenager seeking information about contraception
uq u q uq u q uq
14.
An instructor is reviewing the evolution of the nurse's role in health assessment
u q u q u q u q u q u q u q u q u q u q u q u q
. The instructor determines that the teaching was successful when the students
u q uq u q u q u q u q u q u q u q u q u q u
qidentify whichof the following as the major method used by nurses early in th
uq u q u q u q u q u q u q u q u q uq u q uq u q
e history of the profession?
u q uq uq uq
A) Natural senses ju
B) Biomedical knowledge u q
C) Simple technology uq
D) Critical pathways u q
Page uququ q 3
.
