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Chapter 16, 17, 18, 19 and 20: Nursing
Assessment Potter et al.: Fundamentals of
Nursing, 9th Edition MULTIPLE CHOICE:
QUESTIONS AND ANSWERS
1.The nurse is using critical thinking skills during the first phase of the nursing process. Which action indicates the nurse is in the first phase?
a.Completes a comprehensive database
b.Identifies pertinent nursing diagnoses
c.Intervenes based on priorities of patient care
d.Determines whether outcomes have been achieved
2.A nurse is using the problem-oriented approach to data collection. Which action will the
nurse take first?
a.Complete the questions in chronological order.
Focus on the patient’s presenting situation. Answers available at http://bit.ly/2wduMPJ
b.Make accurate interpretations of the data.
c.Conduct an observational overview.
3.After reviewing the database, the nurse discovers that the patient’s vital signs have not been recorded by the nursing assistive personnel (NAP). Which clinical decision should the
nurse make?
a.Administer scheduled medications assuming that the NAP would have reported abnormal
vital signs.
b.Have the patient transported to the radiology department for a scheduled x-ray, and review
vital signs upo
c.Ask the NAP to record the patient’s vital signs before administering medications.
d.Omit the vital signs because the patient is presently in no distress. 4.The nurse is gathering data on a patient. Which data will the nurse report as objective data?
a.States “doesn’t feel good”
b.Reports a headache
c.Respirations 16
d.Nauseated
5.A patient expresses fear of going home and being alone. Vital signs are stable and the
incision is nearly completely healed. What can the nurse infer from the subjective data?
a.The patient can now perform the dressing changes without help.
b.The patient can begin retaking all of the previous medications.
c.The patient is apprehensive about discharge.
d.The patient’s surgery was not successful.
Answers available at http://bit.ly/2wduMPJ
6.Which method of data collection will the nurse use to establish a patient’s database?
a.Reviewing the current literature to determine evidence-based nursing actions
b.Checking orders for diagnostic and laboratory tests
c.Performing a physical examination
d.Ordering medications
7.A nurse is gathering information about a patient’s habits and lifestyle patterns. Which
method of data collection will the nurse use that will best obtain this information?
a.Carefully review lab results.
b.Conduct the physical assessment.
Perform a thorough nursing health history. Answers available at http://bit.ly/2wduMPJ
c.Prolong the termination phase of the interview.
8.While interviewing an older female patient of Asian descent, the nurse notices that the
patient looks at the ground when answering questions. What should the nurse do? a.Consider cultural differences during this assessment.
b.Ask the patient to make eye contact to determine her affect.
c.Continue with the interview and document that the patient is depressed.
d.Notify the health care provider to recommend a psychological evaluation.
9.A nurse has already set the agenda during a patient-centered interview. What will the nurse
do next?
Begin with introductions. Answers available at http://bit.ly/2wduMPJ
a.Ask about the chief concerns or problems.
b.Explain that the interview will be over in a few minutes.
c.Tell the patient “I will be back to administer medications in 1 hour.”
10.The nurse is attempting to prompt the patient to elaborate on the reports of daytime
fatigue. Which question should the nurse ask?
a.“Is there anything that you are stressed about right now that I should know?” b.“What reasons do you think are contributing to your fatigue?”
c.“What are your normal work hours?” d.“Are you sleeping 8 hours a night?” 11.A nurse is conducting a nursing health history. Which component will the nurse address?
a.Nurse’s concerns
b.Patient expectations
c.Current treatment orders
Nurse’s goals for the patient Answers available at http://bit.ly/2wduMPJ
12.While the patient’s lower extremity, which is in a cast, is assessed, the patient tells the
nurse about an inability to rest at night. The nurse disregards this information, thinking that
Chapter 16, 17, 18, 19 and 20: Nursing
Assessment Potter et al.: Fundamentals of
Nursing, 9th Edition MULTIPLE CHOICE:
QUESTIONS AND ANSWERS
1.The nurse is using critical thinking skills during the first phase of the nursing process. Which action indicates the nurse is in the first phase?
a.Completes a comprehensive database
b.Identifies pertinent nursing diagnoses
c.Intervenes based on priorities of patient care
d.Determines whether outcomes have been achieved
2.A nurse is using the problem-oriented approach to data collection. Which action will the
nurse take first?
a.Complete the questions in chronological order.
Focus on the patient’s presenting situation. Answers available at http://bit.ly/2wduMPJ
b.Make accurate interpretations of the data.
c.Conduct an observational overview.
3.After reviewing the database, the nurse discovers that the patient’s vital signs have not been recorded by the nursing assistive personnel (NAP). Which clinical decision should the
nurse make?
a.Administer scheduled medications assuming that the NAP would have reported abnormal
vital signs.
b.Have the patient transported to the radiology department for a scheduled x-ray, and review
vital signs upo
c.Ask the NAP to record the patient’s vital signs before administering medications.
d.Omit the vital signs because the patient is presently in no distress. 4.The nurse is gathering data on a patient. Which data will the nurse report as objective data?
a.States “doesn’t feel good”
b.Reports a headache
c.Respirations 16
d.Nauseated
5.A patient expresses fear of going home and being alone. Vital signs are stable and the
incision is nearly completely healed. What can the nurse infer from the subjective data?
a.The patient can now perform the dressing changes without help.
b.The patient can begin retaking all of the previous medications.
c.The patient is apprehensive about discharge.
d.The patient’s surgery was not successful.
Answers available at http://bit.ly/2wduMPJ
6.Which method of data collection will the nurse use to establish a patient’s database?
a.Reviewing the current literature to determine evidence-based nursing actions
b.Checking orders for diagnostic and laboratory tests
c.Performing a physical examination
d.Ordering medications
7.A nurse is gathering information about a patient’s habits and lifestyle patterns. Which
method of data collection will the nurse use that will best obtain this information?
a.Carefully review lab results.
b.Conduct the physical assessment.
Perform a thorough nursing health history. Answers available at http://bit.ly/2wduMPJ
c.Prolong the termination phase of the interview.
8.While interviewing an older female patient of Asian descent, the nurse notices that the
patient looks at the ground when answering questions. What should the nurse do? a.Consider cultural differences during this assessment.
b.Ask the patient to make eye contact to determine her affect.
c.Continue with the interview and document that the patient is depressed.
d.Notify the health care provider to recommend a psychological evaluation.
9.A nurse has already set the agenda during a patient-centered interview. What will the nurse
do next?
Begin with introductions. Answers available at http://bit.ly/2wduMPJ
a.Ask about the chief concerns or problems.
b.Explain that the interview will be over in a few minutes.
c.Tell the patient “I will be back to administer medications in 1 hour.”
10.The nurse is attempting to prompt the patient to elaborate on the reports of daytime
fatigue. Which question should the nurse ask?
a.“Is there anything that you are stressed about right now that I should know?” b.“What reasons do you think are contributing to your fatigue?”
c.“What are your normal work hours?” d.“Are you sleeping 8 hours a night?” 11.A nurse is conducting a nursing health history. Which component will the nurse address?
a.Nurse’s concerns
b.Patient expectations
c.Current treatment orders
Nurse’s goals for the patient Answers available at http://bit.ly/2wduMPJ
12.While the patient’s lower extremity, which is in a cast, is assessed, the patient tells the
nurse about an inability to rest at night. The nurse disregards this information, thinking that
