. After completing an initial assessment of a patient, the nurse has
charted that his respirations are eupneic and his pulse is 58 beats
per minute. These types of data would be:
A. objective
B. reflective
C. subjective
D. Introspective
C
A patient tells the nurse that he is very nervous, is nauseated, and
feels hot. These types of data would be:
A. Objective
B. Reflective
C. subjective
D. Introspective
A
The patients record, laboratory studies, objective data, and
subjective data combine to form the:
a.Data base.
b. Admitting data.
c. Financial statement.
d. Discharge summary.
C
When listening to a patients breath sounds, the nurse is unsure of a
sound that is heard. The nurses next action should be to:
a. Immediately notify the patients physician.
b. Document the sound exactly as it was heard.
c. Validate the data by asking a coworker to listen to the breath
sounds.
d. Assess again in 20 minutes to note whether the sound is still
present.
,B
The nurse is conducting a class for new graduate nurses. During the
teaching session, the nurse should keep in mind that novice nurses,
without a background of skills and experience from which to draw, are
more likely to make their decisions using:
a. Intuition.
b. A set of rules.
c.Articles in journals.
d. Advice from supervisors
A
Expert nurses learn to attend to a pattern of assessment data and act
without consciously labeling it. These responses are referred to as:
a.Intuition.
b. The nursing process.
c. Clinical knowledge.
d. Diagnostic reasoning.
C
The nurse is reviewing information about evidence-based practice
(EBP). Which statement best reflects EBP?
a. EBP relies on tradition for support of best practices.
b. EBP is simply the use of best practice techniques for the
treatment of patients.
c. EBP emphasizes the use of best evidence with the clinicians
experience.
d. The patients own preferences are not important with EBP.
D
The nurse is conducting a class on priority setting for a group of
new graduate nurses. Which is an example of a first-level priority
problem?
a. Patient with postoperative pain
b. Newly diagnosed patient with diabetes who needs diabetic teaching
, c. Individual with a small laceration on the sole of the foot
d. Individual with shortness of breath and respiratory distress
C
When considering priority setting of problems, the nurse keeps in
mind that second-level priority problems include which of these
aspects?
a. Low self-esteem
b. Lack of knowledge
c. Abnormal laboratory values
d. Severely abnormal vital signs
B
. Which critical thinking skill helps the nurse see relationships
among the data?
a. Validation
b. Clustering related cues
c. Identifying gaps in data
d. Distinguishing relevant from irrelevant
A
The nurse knows that developing appropriate nursing interventions for
a patient relies on the appropriateness of the __________ diagnosis.
a. Nursing
b. Medical
c. Admission
d. Collaborative
D
The nursing process is a sequential method of problem solving that
nurses use and includes which steps?
a. Assessment, treatment, planning, evaluation, discharge, and
follow-up