NURS 198 EXAM 1 (ACTUAL) QUESTIONS WITH
COMPLETE SOLUTIONS.
A nurse conducts an initial comprehensive assessment for a client admitted
with a fever of unknown origin. Which area of assessment is primarily the
nurse's responsibility?
-Collect subjective data related to overall function
-Perform a musculoskeletal examination
-Take anthropometric measurements
-Obtain a 24-hour diet recall Answer - collect subjective data related to overall
function
An older adult client has been admitted to the hospital with failure to thrive
resulting from complications of diabetes. What would the nurse implement in
response to a collaborative problem? Answer - Measure the client's blood
glucose four times daily.
When performing the steps of the assessment phase of the nursing process,
which of the following would the nurse do first? Answer - collect subjective
data
The nurse performs an assessment on a newly admitted client. Data analysis
reveals temperature 100.9 F (38.3 C), BP 82/58 mm Hg, 02 Saturation 91% RA,
productive cough, lethargy, diaphoresis, WBC 15,000 mm3, Hemoglobin 9 g/dL,
Hematocrit 29%. What action should the nurse take next? Answer - develop
diagnosis
,A client admitted to the hospital with status asthmaticus suddenly develops the
following signs and symptoms: increased heart rate (105 bpm), increased
respiratory rate (24/min), O2 saturation 90% on 100% nonrebreather mask,
and sudden absence of wheezing. What action should the nurse take? Answer
- perform emergency assessment
A nurse provides care for a client with an elevated temperature. The client is
given the prescribed medication and the nurse checks the client's temperature
at repeated intervals. What step of the nursing process is the nurse using to
determine whether the client has achieved the outcome criteria of the
treatment? Answer - evaluation
A home health nurse is visiting a client who recently was hospitalized for repair
of a fractured hip. The client tells the nurse, "I have had a lot of pain in my
abdomen." What type of assessment would the nurse conduct? Answer -
focused
When planning a community program related to Healthy People 2030, the
critical first step involves Answer - defining the community
After assessment and documentation of the information obtained from the
client, the nurse needs to analyze the data collected. Which nursing actions
depend on accurate analysis of data during this phase of the nursing process?
Answer - - Identification of collaborative problems
- Identification of the need for referrals
- Formulation of nursing diagnosis/es
The nurse learns that a client is unable to sleep because of high anxiety. On
which category of health patterns should the nurse focus? Answer - coping-
stress-tolerance
, The nurse has been assigned to a group of clients on a medical surgical unit.
What is the best action of the nurse prior to receiving a report on these clients?
Answer - Conduct a brief review of the client's charts
While discussing health patterns, a client says, "I hate my job." In which
category should the nurse document and further assess this information?
Answer - role-relationship
The nurse is the primary care provider for a 21-year-old man who, as the result
of a brain injury suffered in a mountain-biking accident in his teens, has the
cognitive abilities of a 9-year-old. How should the nurse accommodate the
client's cognition and comprehension during assessment? Answer - Use the
client's family as a source of information
A client has just been admitted to the postsurgical unit from postanesthetic
recovery, and the nurse is in the introductory phase of the client interview.
Which of the following activities should the nurse perform first? Answer -
explain the purpose of the interview
During the working phase of an interview the nurse encourages the client to
continue and expand on the health issues. What technique is the nurse using?
Answer - active listening
A nurse is preparing to assess a client who is new to the clinic. When beginning
the collection of the client's data, what action should the nurse prioritize?
Answer - establishing a trusting relationship
During the review of systems, a client reports having difficulty with urination
and with establishing an erection. Which additional information should the
nurse recognize as the highest priority to assess at this time? Answer - sexual
history
COMPLETE SOLUTIONS.
A nurse conducts an initial comprehensive assessment for a client admitted
with a fever of unknown origin. Which area of assessment is primarily the
nurse's responsibility?
-Collect subjective data related to overall function
-Perform a musculoskeletal examination
-Take anthropometric measurements
-Obtain a 24-hour diet recall Answer - collect subjective data related to overall
function
An older adult client has been admitted to the hospital with failure to thrive
resulting from complications of diabetes. What would the nurse implement in
response to a collaborative problem? Answer - Measure the client's blood
glucose four times daily.
When performing the steps of the assessment phase of the nursing process,
which of the following would the nurse do first? Answer - collect subjective
data
The nurse performs an assessment on a newly admitted client. Data analysis
reveals temperature 100.9 F (38.3 C), BP 82/58 mm Hg, 02 Saturation 91% RA,
productive cough, lethargy, diaphoresis, WBC 15,000 mm3, Hemoglobin 9 g/dL,
Hematocrit 29%. What action should the nurse take next? Answer - develop
diagnosis
,A client admitted to the hospital with status asthmaticus suddenly develops the
following signs and symptoms: increased heart rate (105 bpm), increased
respiratory rate (24/min), O2 saturation 90% on 100% nonrebreather mask,
and sudden absence of wheezing. What action should the nurse take? Answer
- perform emergency assessment
A nurse provides care for a client with an elevated temperature. The client is
given the prescribed medication and the nurse checks the client's temperature
at repeated intervals. What step of the nursing process is the nurse using to
determine whether the client has achieved the outcome criteria of the
treatment? Answer - evaluation
A home health nurse is visiting a client who recently was hospitalized for repair
of a fractured hip. The client tells the nurse, "I have had a lot of pain in my
abdomen." What type of assessment would the nurse conduct? Answer -
focused
When planning a community program related to Healthy People 2030, the
critical first step involves Answer - defining the community
After assessment and documentation of the information obtained from the
client, the nurse needs to analyze the data collected. Which nursing actions
depend on accurate analysis of data during this phase of the nursing process?
Answer - - Identification of collaborative problems
- Identification of the need for referrals
- Formulation of nursing diagnosis/es
The nurse learns that a client is unable to sleep because of high anxiety. On
which category of health patterns should the nurse focus? Answer - coping-
stress-tolerance
, The nurse has been assigned to a group of clients on a medical surgical unit.
What is the best action of the nurse prior to receiving a report on these clients?
Answer - Conduct a brief review of the client's charts
While discussing health patterns, a client says, "I hate my job." In which
category should the nurse document and further assess this information?
Answer - role-relationship
The nurse is the primary care provider for a 21-year-old man who, as the result
of a brain injury suffered in a mountain-biking accident in his teens, has the
cognitive abilities of a 9-year-old. How should the nurse accommodate the
client's cognition and comprehension during assessment? Answer - Use the
client's family as a source of information
A client has just been admitted to the postsurgical unit from postanesthetic
recovery, and the nurse is in the introductory phase of the client interview.
Which of the following activities should the nurse perform first? Answer -
explain the purpose of the interview
During the working phase of an interview the nurse encourages the client to
continue and expand on the health issues. What technique is the nurse using?
Answer - active listening
A nurse is preparing to assess a client who is new to the clinic. When beginning
the collection of the client's data, what action should the nurse prioritize?
Answer - establishing a trusting relationship
During the review of systems, a client reports having difficulty with urination
and with establishing an erection. Which additional information should the
nurse recognize as the highest priority to assess at this time? Answer - sexual
history
