,Chapter 01: Evidence-Based Assessment Jarvis: Physical Examination & Health
Assessment, 3rd Canadian edition
MULTIPLE CHOICE
1. After completing an initial assessment of a patient, the nurse has charted that
his respirations are 18 breaths per minute and his pulse is 58 beats per minute.
These types of data would be:
a. Objective
b. Reflective
c. Subjective
d. Introspective
ANS: A
Objective data are what the health professional observes by inspecting,
percussing, palpating, and auscultating during the physical examination.
Subjective data are what the person says about himself or herself during history
taking. The terms reflective and introspective are not used to describe data.
DIF: Cognitive Level: Understanding (Comprehension)
MSC: Client Needs: Safe and Effective Care Environment: Management of
Care
2. A patient tells the nurse that he is very nervous, is nauseated, and “feels hot.”
These types of data would be:
a. Objective
b. Reflective
c. Subjective
d. Introspective
ANS: C
Subjective data are what the person says about himself or herself during history
taking. Objective data are what the health professional observes by inspecting,
percussing, palpating, and auscultating during the physical examination. The
terms reflective and introspective are not used to describe data.
DIF: Cognitive Level: Understanding (Comprehension)
MSC: Client Needs: Safe and Effective Care Environment: Management of
Care
3. The patient’s record, laboratory studies, objective data, and subjective data
combine to form the:
, a. Database
b. Admitting data
c. Financial statement
d. Discharge summary
ANS: A
Together with the patient’s record and laboratory studies, the objective and
subjective data form the database. The other items are not part of the patient’s
record, laboratory studies, or data.
DIF: Cognitive Level: Remembering (Knowledge)
MSC: Client Needs: Safe and Effective Care Environment: Management of
Care
4. When listening to a patient’s breath sounds, the nurse is unsure of a sound that
is heard. The nurse’s next action should be to:
a. Immediately notify the patient’s physician.
b. Document the sound exactly as it was heard.
c. Validate the data by asking a coworker to listen to the breath sounds.
d. Assess again in 20 minutes to note whether the sound is still present.
ANS: C
When unsure of a sound heard while listening to a patient’s breath sounds, the
nurse validates the data to ensure accuracy. If the nurse has less experience in an
area, then he or she asks an expert to listen.
DIF: Cognitive Level: Analyzing (Analysis)
MSC: Client Needs: Safe and Effective Care Environment: Management of
Care
5. The nurse is conducting a class for new graduate nurses. During the teaching
session, the nurse should keep in mind that novice nurses, with less
experience, are more likely to base their decisions on: a. Intuition
b. Clear-cut rules
c. Articles in journals
d. Advice from supervisors
ANS: B
, Novice nurses operate from a set of defined, structured rules. Expert
practitioners use critical thinking and their substantial background of
experiences.
DIF: Cognitive Level: Understanding (Comprehension) MSC: Client Needs:
General
6. Expert nurses assess and make decisions through the use of:
a. Critical thinking
b. The nursing process
c. Clinical knowledge
d. Diagnostic reasoning
ANS: A
Critical thinking is a multidimensional, dynamic, and interactive thinking
process by which expert nurses assess and make decisions in the clinical area.
DIF: Cognitive Level: Understanding (Comprehension) MSC: Client Needs: General
7. The nurse is reviewing information about evidence-informed practice (EIP).
Which statement best reflects EIP?
a. EIP relies on tradition for support of best practices.
b. EIP is simply the use of best practice techniques for the treatment of patients.
c. EIP emphasizes the use of best and most appropriate evidence with clinician
expertise and patient preference.
d. The patient’s own preferences are not important in EIP.
ANS: C
EIP is a problem-solving approach to decision making that emphasizes the use
of best available evidence in combination with the clinician’s experience,
patient preferences and values, and comprehensive assessment to determine the
best outcomes in care and treatment. EIP is more than simply using the best
practice techniques to treat patients, and questioning tradition is important when
no compelling and supportive research evidence exists.
DIF: Cognitive Level: Applying (Application)
MSC: Client Needs: Safe and Effective Care Environment: Management of
Care
Assessment, 3rd Canadian edition
MULTIPLE CHOICE
1. After completing an initial assessment of a patient, the nurse has charted that
his respirations are 18 breaths per minute and his pulse is 58 beats per minute.
These types of data would be:
a. Objective
b. Reflective
c. Subjective
d. Introspective
ANS: A
Objective data are what the health professional observes by inspecting,
percussing, palpating, and auscultating during the physical examination.
Subjective data are what the person says about himself or herself during history
taking. The terms reflective and introspective are not used to describe data.
DIF: Cognitive Level: Understanding (Comprehension)
MSC: Client Needs: Safe and Effective Care Environment: Management of
Care
2. A patient tells the nurse that he is very nervous, is nauseated, and “feels hot.”
These types of data would be:
a. Objective
b. Reflective
c. Subjective
d. Introspective
ANS: C
Subjective data are what the person says about himself or herself during history
taking. Objective data are what the health professional observes by inspecting,
percussing, palpating, and auscultating during the physical examination. The
terms reflective and introspective are not used to describe data.
DIF: Cognitive Level: Understanding (Comprehension)
MSC: Client Needs: Safe and Effective Care Environment: Management of
Care
3. The patient’s record, laboratory studies, objective data, and subjective data
combine to form the:
, a. Database
b. Admitting data
c. Financial statement
d. Discharge summary
ANS: A
Together with the patient’s record and laboratory studies, the objective and
subjective data form the database. The other items are not part of the patient’s
record, laboratory studies, or data.
DIF: Cognitive Level: Remembering (Knowledge)
MSC: Client Needs: Safe and Effective Care Environment: Management of
Care
4. When listening to a patient’s breath sounds, the nurse is unsure of a sound that
is heard. The nurse’s next action should be to:
a. Immediately notify the patient’s physician.
b. Document the sound exactly as it was heard.
c. Validate the data by asking a coworker to listen to the breath sounds.
d. Assess again in 20 minutes to note whether the sound is still present.
ANS: C
When unsure of a sound heard while listening to a patient’s breath sounds, the
nurse validates the data to ensure accuracy. If the nurse has less experience in an
area, then he or she asks an expert to listen.
DIF: Cognitive Level: Analyzing (Analysis)
MSC: Client Needs: Safe and Effective Care Environment: Management of
Care
5. The nurse is conducting a class for new graduate nurses. During the teaching
session, the nurse should keep in mind that novice nurses, with less
experience, are more likely to base their decisions on: a. Intuition
b. Clear-cut rules
c. Articles in journals
d. Advice from supervisors
ANS: B
, Novice nurses operate from a set of defined, structured rules. Expert
practitioners use critical thinking and their substantial background of
experiences.
DIF: Cognitive Level: Understanding (Comprehension) MSC: Client Needs:
General
6. Expert nurses assess and make decisions through the use of:
a. Critical thinking
b. The nursing process
c. Clinical knowledge
d. Diagnostic reasoning
ANS: A
Critical thinking is a multidimensional, dynamic, and interactive thinking
process by which expert nurses assess and make decisions in the clinical area.
DIF: Cognitive Level: Understanding (Comprehension) MSC: Client Needs: General
7. The nurse is reviewing information about evidence-informed practice (EIP).
Which statement best reflects EIP?
a. EIP relies on tradition for support of best practices.
b. EIP is simply the use of best practice techniques for the treatment of patients.
c. EIP emphasizes the use of best and most appropriate evidence with clinician
expertise and patient preference.
d. The patient’s own preferences are not important in EIP.
ANS: C
EIP is a problem-solving approach to decision making that emphasizes the use
of best available evidence in combination with the clinician’s experience,
patient preferences and values, and comprehensive assessment to determine the
best outcomes in care and treatment. EIP is more than simply using the best
practice techniques to treat patients, and questioning tradition is important when
no compelling and supportive research evidence exists.
DIF: Cognitive Level: Applying (Application)
MSC: Client Needs: Safe and Effective Care Environment: Management of
Care
