CORRECTLY
When does the general survey begin ? - Answers The second the nurse meets the client
What 5 characteristics does the general survey include ? - Answers 1. physical appearance
2. Hygiene
3. Body structure
4. Body movement
5. Emotional, mental status, and behavior
The general survey includes... - Answers everything in the room (patient and environment)
What is the backbone of nursing ? - Answers The assessment
What is the first part of the nursing process ? - Answers assessment
What are the 5 parts of the nursing process ? - Answers 1. assessment
2. diagnosis
3. planning
4. implementing
5. evaluation
What is subjective data ? - Answers data that the patient states
What is objective data ? - Answers data that is observed
What is a primary source? - Answers Information from the patient
What is a secondary source? - Answers Information from the patients family, friend's or significant
other
What are the three parts of the health assessment ? - Answers 1. Nursing history interview
2. behavioral assessment
3. physical examination
What are open ended questions? - Answers Questions that require more than a yes or no answer
What are closed ended questions? - Answers yes or no answers
What are some techniques to enhance data collection ? - Answers active listening
clarification
restatement
interpretation
facilitate
What does the physical assessment do ? - Answers supports or denies what the patient is saying
What are some purposes of the physical examination ? - Answers gather baseline data
support or refute subjective data
confirm nursing diagnosis
make clinical decisions
evaluate outcomes of care
Restlessness could be the result of ? - Answers an impending respiratory emergency
What are the ABC's? - Answers Airway
Breathing
Circulation
Documentation should do what ? - Answers tell a story
Documentation should be what three things? - Answers 1. complete
2. accurate
3. descriptive
If it is not charted it is ...? - Answers not done
When should documenting be done? - Answers right after seeing the patient
What is the EMR? - Answers electronic medical record
What is a comprehensive assessment ? - Answers a detailed history and physical examination upon
arrival, full assessment
What is a problem- based/focused assessment? - Answers more detailed assessment based on focus
of a specific problem
What is an episodic/ follow up assessment? - Answers assessment following up with a previous
problem
What is a shift assessment ? - Answers an assessment done early in the shift to know what baseline is