NURS 100 FINAL EXAM QUESTIONS WITH VERIFIED ANSWERS LATEST 2023/2024 GRADED A+

NURS 100 FINAL EXAM QUESTIONS WITH VERIFIED ANSWERS LATEST 2023/2024 GRADED A+. The nurse is providing discharge teaching for an older-adult patient who will need tube feedings at home. The spouse is the only source of care and states “I will not be able to perform the feedings due to arthritis.” Which action should the nurse take? Arrange for home care. A nurse is assessing threats concerning the family. Which areas will the nurse include in the assessment? (Select all that apply.) Homelessness Domestic violence Presence of illness Changing economic status A nurse is assessing the realms of family life. Which processes will the nurse assess? (Select all that apply.) Developmental Interactive Integrity Coping A nurse is focusing on the interactive processes of family life and is asking the patient questions. Match the questions the nurse will ask to the interactive process. Who is the “peacekeeper” of the family? Roles How are house rules established? Family nurturing How often does the family hug each other? Intimacy expression Who at your workplace is close to the family? Social suppor Chapter 16—Nursing Assessment 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? Completes a comprehensive database A nurse is using the problem-oriented approach to data collection. Which action will the nurse take first? Focus on the patient’s presenting situation. 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? Ask the NAP to record the patient’s vital signs before administering medications. The nurse is gathering data on a patient. Which data will the nurse report as objective data? Respirations 16 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? The patient is apprehensive about discharge. Which method of data collection will the nurse use to establish a patient’s database? Performing a physical examination 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? Perform a thorough nursing health history. 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? Consider cultural differences during this assessment. A nurse has already set the agenda during a patient-centered interview. What will the nurse do next? Ask about the chief concerns or problems. The nurse is attempting to prompt the patient to elaborate on the reports of daytime fatigue. Which question should the nurse ask? “What reasons do you think are contributing to your fatigue?” A nurse is conducting a nursing health history. Which component will the nurse address? Patient expectations 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 no correlation has been noted between having a leg cast and developing restless sleep. Which action would have been best for the nurse to take? Ask the patient about usual sleep patterns and the onset of having difficulty resting. The nurse begins a shift assessment by examining a surgical dressing that is saturated with serosanguineous drainage on a patient who had open abdominal surgery yesterday (or 1 day ago). Which type of assessment approach is the nurse using? Problem-oriented assessment Which statement by a nurse indicates a good understanding about the differences between data validation and data interpretation? “Validation involves comparing data with other sources for accuracy.” Which scenario best illustrates the nurse using data validation when making a nursing clinical decision for a patient? The nurse determines to remove a wound dressing when the patient reveals the time of the last dressing change and notices old and new drainage. While completing an admission database, the nurse is interviewing a patient who states “I am allergic to latex.” Which action will the nurse take first? Ask the patient to describe the type of reaction. A patient verbalizes a low pain level of 2 out of 10 but exhibits extreme facial grimacing while moving around in bed. What is the nurse’s initial action in response to these observations? Ask the patient about the facial grimacing with movement. The nurse is interviewing a patient with a hearing deficit. Which area should the nurse use to conduct this interview? The patient’s room with the door closed A new nurse is completing an assessment on an 80-year-old patient who is alert and oriented. The patient’s daughter is present in the room. Which action by the nurse will require follow-up by the charge nurse? The nurse speaks only to the patient’s daughter. A nurse is completing an assessment. Which findings will the nurse report as subjective data? (Select all that apply.) Patient describing excitement about discharge Patient’s expression of fear regarding upcoming surgery A nurse is completing an assessment using the PQRST to obtain data about the patient’s chest pain. Match the questions to the components of the PQRST that the nurse will be using. Where is the pain located? Radiate What causes the pain? Provokes Does it come and go? Time What does the pain feel like? Quality What is the rating on a scale of 0 to 10? Severity Chapter 18—Planning Nursing Care The nurse completes a thorough assessment of a patient and analyzes the data to identify nursing diagnoses. Which step will the nurse take next in the nursing process? Planning A patient’s plan of care includes the goal of increasing mobility this shift. As the patient is ambulating to the bathroom at the beginning of the shift, the patient suffers a fall. Which initial action will the nurse take next to revise the plan of care? Assess the patient. Which information indicates a nurse has a good understanding of a goal? It is a broad statement describing a desired change in a patient’s behavior. A nurse is developing a care plan for a patient with a pelvic fracture on bed rest. Which goal statement is realistic for the nurse to assign to this patient? Patient will increase activity level this shift. The following statements are on a patient’s nursing care plan. Which statement will the nurse use as an outcome for a goal of care? The patient will verbalize a decreased pain level less than 3 on a 0 to 10 scale by the end of this shift. A charge nurse is reviewing outcome statements using the SMART approach. Which patient outcome statement will the charge nurse praise to the new nurse? The patient will feed self at all mealtimes today without reports of shortness of breath. A nursing assessment for a patient with a spinal cord injury leads to several pertinent nursing diagnoses. Which nursing diagnosis is the highest priority for this patient? Reflex urinary incontinence The new nurse is caring for six patients in this shift. After completing their assessments, the nurse asks where to begin in developing care plans for these patients. Which statement is an appropriate suggestion by another nurse? “Begin with the highest priority diagnoses, then select appropriate interventions.” A patient’s son decides to stay at the bedside while his father is confused. When developing the plan of care for this patient, what should the nurse do? Involve the son in the plan of care as much as possible. A nurse is caring for a patient with a nursing diagnosis of Constipation related to slowed gastrointestinal motility secondary to pain medications. Which outcome is most appropriate for the nurse to include in the plan of care? Patient will have one soft, formed bowel movement by end of shift. The nurse performs an intervention for a collaborative problem. Which type of intervention did the nurse perform? Interdependent A registered nurse administers pain medication to a patient suffering from fractured ribs. Which type of nursing intervention is this nurse implementing? Dependent Which action indicates the nurse is using a PICOT question to improve care for a patient? Implements interventions based on scientific research A nurse is developing a care plan. Which intervention is most appropriate for the nursing diagnostic statement Risk for loneliness related to impaired verbal communication? Provide the patient with a writing board each shift. A nurse is completing a care plan. Which intervention is most appropriate for the nursing diagnostic statement Impaired skin integrity related to shearing forces? Turn the patient every 2 hours, even hours. A patient has reduced muscle strength following a left-sided stroke and is at risk for falling. Which intervention is most appropriate for the nursing diagnostic statement Risk for falls? Assist patient into and out of bed every 4 hours or as tolerated. Which action will the nurse take after the plan of care for a patient is developed? Communicate the plan to all health care professionals involved in the patient’s care. A nurse is preparing to make a consult. In which order, beginning with the first step, will the nurse take? Identify the problem. Identify > Contact > Provide > Avoid > Discuss // ICPAD Contact the right professional, with the appropriate knowledge and expertise. Provide the consultant with relevant information about the problem. Avoid bias by not providing a lot of information based on opinion to the consultant. Discuss the findings and recommendation. A hospital’s wound nurse consultant made a recommendation for nurses on the unit about how to care for the patient’s dressing changes. Which action should the nurses take next? Include dressing change instructions and frequency in the care plan.