Chapter 06: Nursing Assessment
1. When collecting subjective and objective data for a database in a patients
home, it is important to
a. Ask the patient to turn off the television
b. Ask the social worker to verify the collected data
c. Collect a 24 -hour diet recall
d. Evaluate the c are provided by the physician
CORRECT ANSWER: A
Feedback:
Distractions such as a television should be minimized.
2. A nurse is asking questions about a patients sexual history. It is important
for the nurse to
a. Evaluate the patients past history of sex ual dysfunction
b. Provide a time that enhances openness
c. Collect data in a quiet, private environment
d. Pull the curtains in a semiprivate room
CORRECT ANSWER: C
Feedback:
An assessment is best performed in a quiet, private setting that lends
itself to the discussion of sensitive, personal, and confidential
information.
,3. An unconscious patient is brought to the emergency department. Which of
the following assessments should be implemented first?
a. The patients airway should be assessed.
b. The nurse should determine the reason for admission.
c. The nurse should review the patients medications.
d. The patients past medical history is assessed.
CORRECT ANSWER: A
Feedback:
Emergency assessment takes place in life -threatening situations in
which the preservati on of life is the top priorit y. Often, the patients
difficult y involves airway, breathing, and circulatory problems.
4. A nurse practitioner has a private practice in conjunction with a physician.
She is providing psychiatric care to a woman who has a past history of
being abused by her husband. During the last visit, she stated that she was
planning to leave her husband. On the next visit in 2 weeks, the nurse
practitioner will assess her patients commitment to changing her life
situation and her abilit y to feel empowered. What t ype of assessment is
the nurse practitioner implementing?
a. Complete
b. Focus
c. Time-lapsed
d. Emergency
CORRECT ANSWER: C
Feedback:
, Like the focus assessment, the time -lapsed reassessment determines the
status of problems already ide ntified. Because of varying time intervals
between reassessments, a complete review of all functional health
patterns is carried out.
5. During data collection the nurse may validate data by which method?
(Select all that apply )
a. Comparing cues to normal function
b. Referring to textbooks, journals, and research reports
c. Checking consistency of cues
d. Clarifying the patients statements
e. Seeking consensus with colleagues about inferences
CORRECT ANSWER: A, B, C, D, E
Feedback:
These methods of validating data and inferences are necessary before
cues are clustered and anal yzed for identification of nursing dia gnoses.
6. When making an inference from the cues obtained during an assessment, it
is important for the nurse to keep what in mind?
a. Validate inferences with the patient
b. Do not share inferences with the patient
c. Document all inferences
d. Avoid making any i nferences
CORRECT ANSWER: A
Feedback:
1. When collecting subjective and objective data for a database in a patients
home, it is important to
a. Ask the patient to turn off the television
b. Ask the social worker to verify the collected data
c. Collect a 24 -hour diet recall
d. Evaluate the c are provided by the physician
CORRECT ANSWER: A
Feedback:
Distractions such as a television should be minimized.
2. A nurse is asking questions about a patients sexual history. It is important
for the nurse to
a. Evaluate the patients past history of sex ual dysfunction
b. Provide a time that enhances openness
c. Collect data in a quiet, private environment
d. Pull the curtains in a semiprivate room
CORRECT ANSWER: C
Feedback:
An assessment is best performed in a quiet, private setting that lends
itself to the discussion of sensitive, personal, and confidential
information.
,3. An unconscious patient is brought to the emergency department. Which of
the following assessments should be implemented first?
a. The patients airway should be assessed.
b. The nurse should determine the reason for admission.
c. The nurse should review the patients medications.
d. The patients past medical history is assessed.
CORRECT ANSWER: A
Feedback:
Emergency assessment takes place in life -threatening situations in
which the preservati on of life is the top priorit y. Often, the patients
difficult y involves airway, breathing, and circulatory problems.
4. A nurse practitioner has a private practice in conjunction with a physician.
She is providing psychiatric care to a woman who has a past history of
being abused by her husband. During the last visit, she stated that she was
planning to leave her husband. On the next visit in 2 weeks, the nurse
practitioner will assess her patients commitment to changing her life
situation and her abilit y to feel empowered. What t ype of assessment is
the nurse practitioner implementing?
a. Complete
b. Focus
c. Time-lapsed
d. Emergency
CORRECT ANSWER: C
Feedback:
, Like the focus assessment, the time -lapsed reassessment determines the
status of problems already ide ntified. Because of varying time intervals
between reassessments, a complete review of all functional health
patterns is carried out.
5. During data collection the nurse may validate data by which method?
(Select all that apply )
a. Comparing cues to normal function
b. Referring to textbooks, journals, and research reports
c. Checking consistency of cues
d. Clarifying the patients statements
e. Seeking consensus with colleagues about inferences
CORRECT ANSWER: A, B, C, D, E
Feedback:
These methods of validating data and inferences are necessary before
cues are clustered and anal yzed for identification of nursing dia gnoses.
6. When making an inference from the cues obtained during an assessment, it
is important for the nurse to keep what in mind?
a. Validate inferences with the patient
b. Do not share inferences with the patient
c. Document all inferences
d. Avoid making any i nferences
CORRECT ANSWER: A
Feedback:
