NURS 225
NURS 225/ NURS225– Nutrition |
WCU | 2026–2027 | Exam 2 with
Verified Questions and Answers
1.Clinical Judgement Model: Prioritize hypothesis: narrow problems down to
the most pressing problem
2.Clinical Judgement Model: generate solution: determine desired outcomes
and best solutions
3.Clinical Judgement Model: Take action: implement nursing interventions
based on plan/priority
4.Clinical Judgement Model: Evaluate outcomes: compare observed
outcomes to the desired or expected outcomes
5. Subjective Data: information from the patients point of view
6. Objective Data: observable/measurable data
7. Nursing Diagnosis: a clinical judgment about actual or potential health
problems
NURS
,8. medical diagnosis: deals with disease or medical condition
9. NANDA-I: a professional nursing organization that provides standardized
language to identify patient problems and plan customized care
10. Planning: create overall SMART goal
11. outcome criteria: how to achieve the goal based on statement
12. Nursing Interventions: Activities that the nurse plans and implements to
help the patient achieve identified outcomes
13. Patient saftey: healthcare provided in a safe manner and in a safe
community environment is essential for pt survival/ wellbeing
14. Adolescent Safety Concerns: independance, impulsivity, invincibility
motor vehicle saftey sexual health
15. Adult Safety Concerns: home, workplace, leisure motor vehicles fires
firearms workplace safety
16. Older Adult Safety Concerns: decline in physical/cognitive abilities
increased risk of falls medication side effects car accidents elder abuse
17. triaging patient priorities: airway: ensure pt is clear and open if
necessary
, 18. triaging patient priorities: respiration: assess for respiratory distress
19. triaging patient priorities: quality of respiration: assess rate, check for
signs of adequate air exchange, ascultate breath sounds
20. triaging patient priorities: pulse: identify a pulse and note its rate and
strength
21. triaging patient priorities: external bleeding: look for signs of
wounds/injuries
22. triaging patient priorities: blood pressure: obtain Bp
23. triaging patient priorities: neuro: consciousness, pupillary response,
state of extremities 33. Allergies: environmental medication food latex
34. Anaphylaxis: numbness or tingling around a body part, swelling,
increased work of breathing, tachycardia, and hypertension
35. Falls: common in older adults, post op patients and pt taking
psychotropic medication
36 Assess Fall Risk: -Nursing History and
physical exam -Risk Assessment Tools
-Braden Scale
, -fall assessment
- assess home environment
37. Seizure precautions: padded side rails
suction place pt on side
initiate recording of time of seizure
38. Restraints: used to limit mobility in
patients who pose safety threat to themselves,
medical staff 39. violent patients: predictable
patterns of behavior stay calm
redirect, deescalate, maintain distance
40. Fire safety: Code red
RACE
41. Needle stick injury: an accidental puncture wound caused by a used
hypodermic needle. it can transmit infection
42. Reporting incidents: accurately and objectively report