1|P a g e
x x x x x
, CHAPTER 1 Foundations for Clinical Proficiency
x x x x
x MULTIPLE CHOICE x
1. After completing an initial assessment of a patient, the nurse has charted that his respirations are
x x x x x x x x x x x x x x x
eupneic and his pulse is 58 beats per minute. These types of data would be:
x x x x x x x x x x x x x x x
a. Objective.
b. Reflective.
c. Subjective.
d. Introspective.
ANS: A x
Objective data are what the health professional observes by inspecting, percussing, palpating, and
x x x x x x x x x x x x
auscultating during the physical examination. Subjective data is what the person says about him or
x x x x x x x x x x x x x x x
herself during history taking. The terms reflective and introspective are not used to describe data.
x x x x x x x x x x x x x x x
DIF: Cognitive Level: Understanding (Comprehension) REF: p. 2
x x x x x x x
MSC: Client Needs: Safe and Effective Care Environment: Management of Care
x x x x x x x x x x
2. A patient tells the nurse that he is very nervous, is nauseated, and feels hot. These types of data would
x x x x x x x x x x x x x x x x x x x
be:
x
a. Objective.
b. Reflective.
c. Subjective.
d. Introspective.
ANS: C x
Subjective data are what the person says about him or herself during history taking. Objective data are
x x x x x x x x x x x x x x x x
what the health professional observes by inspecting, percussing, palpating, and auscultating during
x x x x x x x x x x x x
the physical examination. The terms reflective and introspective are not used to describe data.
x x x x x x x x x x x x x x
DIF: Cognitive Level: Understanding (Comprehension) REF: p. 2
x x x x x x x
MSC: Client Needs: Safe and Effective Care Environment: Management of Care
x x x x x x x x x x
2|P a g e
x x x x x
,3. The patients record, laboratory studies, objective data, and subjective data combine to form the:
x x x x x x x x x x x x x
a. Data base. x
b. Admitting data. x
c. Financial statement. x
d. Discharge summary. x
ANS: A x
Together with the patients record and laboratory studies, the objective and subjective data form the data
x x x x x x x x x x x x x x x
base. The other items are not part of the patients record, laboratory studies, or data.
x x x x x x x x x x x x x x x
DIF: Cognitive Level: Remembering (Knowledge) REF: p. 2
x x x x x x x
MSC: Client Needs: Safe and Effective Care Environment: Management of Care
x x x x x x x x x x
4. When listening to a patients breath sounds, the nurse is unsure of a sound that is heard. The nurses next
x x x x x x x x x x x x x x x x x x x
action should be to:
x x x x
a. Immediately notify the patients physician. x x x x
b. Document the sound exactly as it was heard. x x x x x x x
c. Validate the data by asking a coworker to listen to the breath sounds.
x x x x x x x x x x x x
d. Assess again in 20 minutes to note whether the sound is still present.
x x x x x x x x x x x x
ANS: C x
When unsure of a sound heard while listening to a patients breath sounds, the nurse validates the data to
x x x x x x x x x x x x x x x x x x
ensure accuracy. If the nurse has less experience in an area, then he or she asks an expert to listen.
x x x x x x x x x x x x x x x x x x x x
DIF: Cognitive Level: Analyzing (Analysis) REF: p. 2
x x x x x x x
MSC: Client Needs: Safe and Effective Care Environment: Management of Care
x x x x x x x x x x
5. The nurse is conducting a class for new graduate nurses. During the teaching session, the nurse should
x x x x x x x x x x x x x x x x
keep in mind that novice nurses, without a background of skills and experience from which to draw,
x x x x x x x x x x x x x x x x x
are more likely to make their decisions using:
x x x x x x x x
a. Intuition.
b. A set of rules.
x x x
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x x x x x
, c. Articles in journals. x x
d. Advice from supervisors. x x
ANS: B x
Novice nurses operate from a set of defined, structured rules. The expert practitioner uses intuitive links.
x x x x x x x x x x x x x x x
x DIF: Cognitive Level: Understanding (Comprehension) REF: p. 3 MSC: Client Needs: General
x x x x x x x x x x x
6. Expert nurses learn to attend to a pattern of assessment data and act without consciously labeling it.
x x x x x x x x x x x x x x x x
These responses are referred to as:
x x x x x x
a. Intuition.
b. The nursing process.x x
c. Clinical knowledge. x
d. Diagnostic reasoning. x
ANS: A x
Intuition is characterized by pattern recognition expert nurses learn to attend to a pattern of assessment
x x x x x x x x x x x x x x x
xdata and act without consciously labeling it. The other options are not correct.
x x x x x x x x x x x x
DIF: Cognitive Level: Understanding (Comprehension) REF: p. 4 MSC: Client Needs: General
x x x x x x x x x x x
7. The nurse is reviewing information about evidence-based practice (EBP). Which statement best reflects
x x x x x x x x x x x x
EBP?
x
a. EBP relies on tradition for support of best practices.
x x x x x x x x
b. EBP is simply the use of best practice techniques for the treatment of patients.
x x x x x x x x x x x x x
c. EBP emphasizes the use of best evidence with the clinicians experience.
x x x x x x x x x x
d. The patients own preferences are not important with EBP.
x x x x x x x x
x ANS: C x
EBP is a systematic approach to practice that emphasizes the use of best evidence in combination with the
x x x x x x x x x x x x x x x x x
clinicians experience, as well as patient preferences and values, when making decisions about care and
x x x x x x x x x x x x x x x
treatment. EBP is more than simply using the best practice techniques to treat patients, and questioning
x x x x x x x x x x x x x x x x
tradition is important when no compelling and supportive research evidence exists.
x x x x x x x x x x x
DIF: Cognitive Level: Applying (Application) REF: p. 5
x x x x x x x
4|P a g e
x x x x x
x x x x x
, CHAPTER 1 Foundations for Clinical Proficiency
x x x x
x MULTIPLE CHOICE x
1. After completing an initial assessment of a patient, the nurse has charted that his respirations are
x x x x x x x x x x x x x x x
eupneic and his pulse is 58 beats per minute. These types of data would be:
x x x x x x x x x x x x x x x
a. Objective.
b. Reflective.
c. Subjective.
d. Introspective.
ANS: A x
Objective data are what the health professional observes by inspecting, percussing, palpating, and
x x x x x x x x x x x x
auscultating during the physical examination. Subjective data is what the person says about him or
x x x x x x x x x x x x x x x
herself during history taking. The terms reflective and introspective are not used to describe data.
x x x x x x x x x x x x x x x
DIF: Cognitive Level: Understanding (Comprehension) REF: p. 2
x x x x x x x
MSC: Client Needs: Safe and Effective Care Environment: Management of Care
x x x x x x x x x x
2. A patient tells the nurse that he is very nervous, is nauseated, and feels hot. These types of data would
x x x x x x x x x x x x x x x x x x x
be:
x
a. Objective.
b. Reflective.
c. Subjective.
d. Introspective.
ANS: C x
Subjective data are what the person says about him or herself during history taking. Objective data are
x x x x x x x x x x x x x x x x
what the health professional observes by inspecting, percussing, palpating, and auscultating during
x x x x x x x x x x x x
the physical examination. The terms reflective and introspective are not used to describe data.
x x x x x x x x x x x x x x
DIF: Cognitive Level: Understanding (Comprehension) REF: p. 2
x x x x x x x
MSC: Client Needs: Safe and Effective Care Environment: Management of Care
x x x x x x x x x x
2|P a g e
x x x x x
,3. The patients record, laboratory studies, objective data, and subjective data combine to form the:
x x x x x x x x x x x x x
a. Data base. x
b. Admitting data. x
c. Financial statement. x
d. Discharge summary. x
ANS: A x
Together with the patients record and laboratory studies, the objective and subjective data form the data
x x x x x x x x x x x x x x x
base. The other items are not part of the patients record, laboratory studies, or data.
x x x x x x x x x x x x x x x
DIF: Cognitive Level: Remembering (Knowledge) REF: p. 2
x x x x x x x
MSC: Client Needs: Safe and Effective Care Environment: Management of Care
x x x x x x x x x x
4. When listening to a patients breath sounds, the nurse is unsure of a sound that is heard. The nurses next
x x x x x x x x x x x x x x x x x x x
action should be to:
x x x x
a. Immediately notify the patients physician. x x x x
b. Document the sound exactly as it was heard. x x x x x x x
c. Validate the data by asking a coworker to listen to the breath sounds.
x x x x x x x x x x x x
d. Assess again in 20 minutes to note whether the sound is still present.
x x x x x x x x x x x x
ANS: C x
When unsure of a sound heard while listening to a patients breath sounds, the nurse validates the data to
x x x x x x x x x x x x x x x x x x
ensure accuracy. If the nurse has less experience in an area, then he or she asks an expert to listen.
x x x x x x x x x x x x x x x x x x x x
DIF: Cognitive Level: Analyzing (Analysis) REF: p. 2
x x x x x x x
MSC: Client Needs: Safe and Effective Care Environment: Management of Care
x x x x x x x x x x
5. The nurse is conducting a class for new graduate nurses. During the teaching session, the nurse should
x x x x x x x x x x x x x x x x
keep in mind that novice nurses, without a background of skills and experience from which to draw,
x x x x x x x x x x x x x x x x x
are more likely to make their decisions using:
x x x x x x x x
a. Intuition.
b. A set of rules.
x x x
3|P a g e
x x x x x
, c. Articles in journals. x x
d. Advice from supervisors. x x
ANS: B x
Novice nurses operate from a set of defined, structured rules. The expert practitioner uses intuitive links.
x x x x x x x x x x x x x x x
x DIF: Cognitive Level: Understanding (Comprehension) REF: p. 3 MSC: Client Needs: General
x x x x x x x x x x x
6. Expert nurses learn to attend to a pattern of assessment data and act without consciously labeling it.
x x x x x x x x x x x x x x x x
These responses are referred to as:
x x x x x x
a. Intuition.
b. The nursing process.x x
c. Clinical knowledge. x
d. Diagnostic reasoning. x
ANS: A x
Intuition is characterized by pattern recognition expert nurses learn to attend to a pattern of assessment
x x x x x x x x x x x x x x x
xdata and act without consciously labeling it. The other options are not correct.
x x x x x x x x x x x x
DIF: Cognitive Level: Understanding (Comprehension) REF: p. 4 MSC: Client Needs: General
x x x x x x x x x x x
7. The nurse is reviewing information about evidence-based practice (EBP). Which statement best reflects
x x x x x x x x x x x x
EBP?
x
a. EBP relies on tradition for support of best practices.
x x x x x x x x
b. EBP is simply the use of best practice techniques for the treatment of patients.
x x x x x x x x x x x x x
c. EBP emphasizes the use of best evidence with the clinicians experience.
x x x x x x x x x x
d. The patients own preferences are not important with EBP.
x x x x x x x x
x ANS: C x
EBP is a systematic approach to practice that emphasizes the use of best evidence in combination with the
x x x x x x x x x x x x x x x x x
clinicians experience, as well as patient preferences and values, when making decisions about care and
x x x x x x x x x x x x x x x
treatment. EBP is more than simply using the best practice techniques to treat patients, and questioning
x x x x x x x x x x x x x x x x
tradition is important when no compelling and supportive research evidence exists.
x x x x x x x x x x x
DIF: Cognitive Level: Applying (Application) REF: p. 5
x x x x x x x
4|P a g e
x x x x x
