Test Bank For Fundamentals Of Nursing: Volumes 1 and 2 Set, 4th Edition
Preview Extract
Chapter 3. Assessment
Multiple Choice
Identify the choice that best completes the statement or answers the question.
____
1. The nurse is collecting data on a new patient at an adult clinic. Which data does the nurse need to
validate?
1. The clientโs weight is 185 lb (83.9 kg) at the clinic.
2. The clientโs liver function test results are elevated.
3. The client states that blood pressure (BP) of 160/94 mm Hg is typical.
4. The client reports eating processed foods on a low-sodium diet.
____
2. After collecting data on a client, the nurse reviews and sorts the information. Which example
includes both objective and subjective data?
1. The clientโs blood pressure reading is 132/68 mm Hg, and heart rate is 88
beats/min.
2. The clientโs cholesterol is elevated, and he admits to liking and eating fried food.
3. The client reports having trouble sleeping and admits drinking coffee in the
evening.
4. The client verbally reports having frequent headaches and taking aspirin for the
pain.
____
3. The nurse manager in an acute care facility is orienting new graduate nurses to a patient care unit.
While reviewing The Joint Commission standards, a discussion begins about assessment. Which
type of assessment is to be performed on all patients in compliance with The Joint Commission?
1. Nutritional status
2. Pain
3. Cultural
4. Wellness
____
4. The nurse is providing care for a variety of patients in an acute care facility. Which of the
following constitutes an ongoing assessment?
1. Obtaining a patientโs temperature 1 hour after giving acetaminophen
2. Examining a patientโs throat after soreness with swallowing is reported
3. Requesting a patient to rate pain intensity level using a scale of 0 to 10
4. Asking a patient the details of a plan to return to normal exercise activities
____
5. Each time the nurse comes into contact with a patient, a systematic observation is made. For which
reason is this type of assessment performed so frequently?
1. Time constraints support small portions of assessment at a time.
2. Validating an absence of change decreases the need to document.
3. Critical changes are less likely to occur with constant observation.
4. Repetition makes it less likely the nurse will miss an assessment area.
____
6. The nurse is obtaining the health history of a client. Which question is an example of the nurse
using an open-ended question?
1. โHave you had surgery before?โ
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2. โWhen was your last menstrual period?โ
3. โWhat happens when you have a headache?โ
4. โDo you have a family history of heart disease?โ
____
7. The nurse is interviewing a patient being admitted for gastrointestinal issues. The patient informs
the nurse that he has persistent vomiting and diarrhea. Which type of assessment is the nurse
performing by asking, โWhen did you first begin to have the vomiting and diarrhea?โ?
1. Comprehensive assessment
2. Ongoing focused assessment
3. Special needs assessment
4. Initial focused assessment
____
8. The nurse is currently performing the initial assessment on a newly admitted client. The nurse
receives notification of another clientโs admission to the unit. Which professional standard
influences the nurseโs decision about who will be assigned to perform the assessment of the second
client?
1. The state board for nursing-assistant testing
2. The American Nurses Association (ANA)
3. The facility policy and procedure committee
4. The bargaining committee for facility nurses
____
9. The nurse is obtaining information from a newly admitted patient during the initial nursing
assessment. Which difference does the nurse recognize between the nursing history and the
medical history?
1. A nursing history focuses on the patientโs responses and needs to the health
problem.
2. The same information is gathered in both; the difference is in who obtains the
information.
3. A nursing history is gathered by using a specific format.
4. A medical history collects more in-depth information.
____
10. During the initial assessment of a newly admitted client, the nurse asks about use of nutritional and
herbal supplements. For which reason is it important for the nurse to obtain this specific
information?
1. To determine what type of therapies are acceptable to the client
2. To identify whether the client has a nutrition deficiency
3. To help the nurse understand the clientโs cultural and spiritual beliefs
4. To be aware of potential interaction with prescribed medication
____
11. After completing an initial patient assessment, for which reason does the nurse utilize a nursing
assessment model?
1. To sort and cluster assessment data into specific categories
2. To organize assessment data according to body systems
3. To validate the use of the nursing process to collect data
4. To follow the American Nurses Association (ANA) Standards of Care
____
12. For which reason does the nurse use nondirective interviewing as an assessment technique?
1. Allows the nurse to have control of the interview
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2. Is an efficient way to interview a patient
3. Facilitates open communication
4. Helps focus the attention of patients who are anxious
____
13. A nursing instructor is guiding nursing students on best practices for interviewing patients. Which
of the following comments by a student would indicate a need for further instruction?
1. โMy patient is a young adult, so I plan to talk to her without her parents in the
room.โ
2. โBecause my patient is old enough to be my grandfather, I will address him with
โMr.โโ
3. โWhen reading my patientโs health record, I thought of a few questions to ask.โ
4. โWhen I give my patient his pain medication, I will have time to ask questions.โ
____
14. A patient comes to the urgent care clinic because of injury from stepping on a rusty nail. Which
type of assessment does the nurse perform?
1. Comprehensive
2. Ongoing
3. Initial focused
4. Special needs
____
15. The nurse is providing care to a patient who has left-sided weakness because of a recent stroke.
Which type of special needs assessment is most important for the nurse to perform?
1. Family
2. Functional
3. Community
4. Psychosocial
____
16. The nurse is interviewing a patient with a recent onset of migraine headaches. The patient is very
anxious and cannot seem to focus on what the nurse is saying. Which comment by the nurse is best
when beginning to gather data about the headaches?
1. โWhen did your migraines begin?โ
2. โTell me about your family history of migraines.โ
3. โWhat are the things that trigger your headaches?โ
4. โDescribe for me what your headaches feel like.โ
____
17. The nurse is conducting an assessment interview with a newly admitted client. When asking
open-ended questions, which action by the nurse indicates an active listening behavior?
1. Taking frequent notes
2. Asking for more details
3. Leaning toward the patient
4. Sitting comfortably with legs crossed
____
18. A nursing instructor asked his nursing students to discuss their experiences with charting
assessment data. Which comment by the student indicates the need for further teaching?
1. โI find it difficult to avoid using phrases like โthe patient tolerated the procedure
well.โโ
2. โItโs confusing to have to remember which abbreviations this hospital allows.โ
3. โI need to work on charting assessments and interventions right after they are
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done.โ
4. โMy patient was really quiet and didnโt say much, so I charted that he acted
depressed.โ
____
19. The nurse prefers to review patient data on a graphic flow sheet, when possible. Which situation is
the best example of the reason a graphic flowsheet is superior to other methods of recording data?
1. Provides easy documentation of routine vital signs
2. Visually reflects the patterns of a patientโs fever
3. Describes symptoms accompanying vital sign changes
4. Enables a quick check for patient tolerance of care
____
20. The nurse is aware that patient data are often difficult to analyze. Which is the most obvious
reason for using a framework for collecting and recording patient data?
1. Prioritizes collection of assessment data
2. Organizes and clusters data efficiently
3. Separates subjective and objective data
4. Identifies both primary and secondary data
____
21. The nurse is preparing to conduct an admission interview with an adult client who is alert and
oriented. The clientโs spouse and two children are visiting and are watching television. Which
action by the nurse is conducive to a successful interview?
1. Provide enough chairs for the family to sit facing the client.
2. Ask the clientโs preference for how to be addressed by the nurse.
3. Ask if the client is willing to answer questions after the family leaves.
4. Give the client the option of having the interview while the family watches
television.
____
22. The nurse obtains information from a patient during admission. The patient is noted to be alert and
oriented, be married, have a history of heart disease. Obtaining this information is an example of
which process?
1. Collecting data
2. Analyzing data
3. Categorizing data
4. Physical assessment
____
23. The nurse on a medical-surgical unit receives the third admission over a period of 1.5 hours. A
certified nursing assistant (CNA) offers to assist the nurse with the assessment process. Which
response by the nurse is the most appropriate?
1. โThank you. I am having a busy day, and I can use your help.โ
2. โIโm sorry, but nurses are responsible for all patient assessments.โ
3. โIf you start an assessment on the last patient, I will continue it later.โ
4. โIf you could obtain and record the vital signs, it would be a big help.โ
____
24. During the assessment process, the patient tells the nurse, โI am having numbness and tingling in
my right arm.โ Which type of data does the nurse recognize on the basis of the patientโs statement?
1. Subjective data
2. Objective data
3. Secondary data
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4. Comprehensive data
____
25. The nurse is performing an initial interview with an older adult patient. Which statement by the
patient indicates a need for a special needs assessment by the nurse?
1. โI donโt go to church as much as I used to, but I watch services on TV.โ
2. โI have fallen twice at home in the past 6 months, but I have not injured myself.โ
3. โI donโt eat much red meat anymore, but I get my protein from other foods.โ
4. โI had a toothache recently, so I made an appointment to see the dentist.โ
____
26. A patient comes to the emergency department to be evaluated after feeling ill at home. Which is
the first question the nurse asks in the initial nursing interview with the patient?
1. โDo you live alone?โ
2. โAre you having any pain?โ
3. โWhat is your past medical history?โ
4. โWhy did you come to the hospital today?โ
____
27. The patient comes to the emergency department complaining of chest pain. Which question by the
nurse will encourage the patient to provide the most details about the pain?
1. โWhen did your chest pain begin?โ
2. โOn a scale of 0 to 10, what is your pain level?โ
3. โCan you give a description of the pain you are having?โ
4. โHave you taken any medication for your pain?โ
____
28. Nurses are aware that documentation is essential in monitoring and validating appropriate patient
care. Which statement is the best example of high-quality nursing documentation?
1. โPatient breathing is normal. No pain noted. Urine output is adequate at this time.โ
2. โGood strength in both lower extremities. Ambulating with walker in the hall.โ
3. โStarted on solid foods. Ate 75% of dinner. No complaints of any nausea or
vomiting.โ
4. โPatient seems upset with visiting spouse. Physical assessment planned at a later
time.โ
Multiple Response
Identify one or more choices that best complete the statement or answer the question.
____
29. The nurse is conducting an interview with a patient in a clinic setting. Which questions will be
effective for obtaining information from the patient? Select all that apply.
1. โHow did this happen to you?โ
2. โWhat was your first symptom?โ
3. โWhy didnโt you seek healthcare earlier?โ
4. โWhen did you start having symptoms?โ
5. โWhy did you decide to seek help now?โ
Copyright ยฉ 2020 F. A. Davis Company
____
30. A nurse, with a large caseload of patients, needs to delegate some assessment tasks to other
members of the healthcare team. The nurse is unsure which tasks can be delegated to nursing
assistive personnel (NAP) and which are appropriate for a licensed practical nurse (LPN) instead
of a registered nurse (RN). Which sources does the nurse consult for clarification related to
delegation? Select all that apply.
1. Nurse practice act of the nurseโs state
2. American Medical Association (AMA) guidelines
3. Code of Ethics for Nurses
4. American Nurses Association (ANA) Scope and Standards of Practice
5. Facility policy and procedure guidelines
____
31. Which of the following are cues rather than inferences? Select all that apply.
1. Patient ate 50% of the meal.
2. Patient feels better today.
3. Patient states, โI slept well.โ
4. Patientโs white blood cell (WBC) count is 15,000/mm3.
5. Patient does not appear to be in pain.
____
32. Nurses use the professional standards of nursing assessment when formulating patient care. Which
statements regarding professional standards of nursing assessment are true? Select all that apply.
1. Assessment is a professional nursing responsibility.
2. Assessment helps the nurse identify problems and priorities.
3. Assessment helps the nurse formulate the medical diagnosis.
4. Assessment of pain is focused on patients indicating the presence of pain.
5. Assessments can be delegated according to state practice acts and agency policies.
____
33. The nurse recognizes which examples of objective data? Select all that apply.
1. Blood pressure of 120/80 mm Hg
2. Pain rated as 6 on a pain scale of 0 to 10
3. Moderate amount of yellow drainage from right ear
4. Spouse stating the client is not sleeping well at night
5. Patient reporting the presence of stomach pain
____
34. The nurse manager is reviewing documentation performed by newly hired nurses. Which of the
examples does the nurse manager recognize as high-quality nursing documentation? Select all that
apply.
1. Patient states, โI feel dizzy in the morning.โ
2. Patient is alert and oriented to person, place, and time.
3. Drainage from midline abdominal incision appears normal.
4. Patient appears angry and is refusing to talk to the spouse.
5. Patient expresses no complaints of pain at this time.
____
35. The nurse is conducting a patient interview in an acute care setting. Which statements made by the
nurse during the interview are appropriate? Select all that apply.
1. โYou shouldnโt be smoking cigarettes; you have already had one heart attack.โ
2. โWhy donโt you take your blood pressure medications? Your blood pressure
remains high.โ
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3. โI can see you are in pain. I will bring pain medication and complete the interview
later.โ
4. โIf it is a good time for you, we can complete your interview now.โ
5. โHave you noticed any changes in your ability to sleep or patterns of sleeping?โ
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Chapter 3. Assessment
Answer Section
MULTIPLE CHOICE
1. ANS: 4
Chapter: Chapter 3 Assessment
Objective: Describe circumstances in which you should validate data.
Page: 45 (V1)
Heading: Types and Sources of Data
Integrated Processes: Nursing Process
Client Need: Safe and Effective Care Environment: Management of Care
Cognitive Level: Analysis [Analyzing]
Concept: Patient-Centered Care
Difficulty: Moderate
1
2
3
4
Feedback
This is incorrect. Personal information that patients might be embarrassed about,
such as weight, is best validated with a scale.
This is incorrect. Validation is not necessary for laboratory data unless the nurse
suspects an error has been made in the results. Retesting needs a prescription
from the physician.
This is incorrect. If data, such as blood pressure, are gathered by using an
objective method, validation is not necessary. The patientโs comment does not
affect the validity of the data one way or another.
This is correct. Validation is done when the clientโs statements are inconsistent,
as in the client reporting consumption of processed foods on a low-sodium diet.
PTS: 1
CON: Patient-Centered Care
2. ANS: 2
Chapter: Chapter 3 Assessment
Objective: Identify the following types of data: subjective, objective, primary source, secondary
source.
Page: 45 (V1)
Heading: Types and Sources of Data
Integrated Processes: Nursing Process
Client Need: Safe and Effective Care Environment: Management of Care
Cognitive Level: Analysis [Analyzing]
Concept: Patient-Centered Care
Difficulty: Moderate
1
Feedback
This is incorrect. Objective data can be observed by someone other than the
patient (e.g., from physical assessments or laboratory and diagnostic tests).
Copyright ยฉ 2020 F. A. Davis Company
2
3
4
Subjective data are information given by the client. Blood pressure and heart
rate measurements are both objective.
This is correct. Elevated cholesterol is objective data, and the patientโs stated
food preference is subjective.
This is incorrect. When the patient verbally expresses trouble sleeping and the
consumption of coffee in the evening, all of the data are subjective.
This is incorrect. When the patient verbally reports frequent headaches and of
treating the pain with aspirin, all the data are subjective.
PTS: 1
CON: Patient-Centered Care
3. ANS: 2
Chapter: Chapter 3 Assessment
Objective: Name three requirements of The Joint Commission regarding patient assessment.
Page: 44 (V1)
Heading: What Do Professional Standards Say About Assessment?
Integrated Processes: Nursing Process
Client Need: Safe and Effective Care Environment: Management of Care
Cognitive Level: Analysis [Analyzing]
Concept: Patient-Centered Care
Difficulty: Moderate
1
2
3
4
Feedback
This is incorrect. The Joint Commission does not require assessment on
nutritional status unless cues indicate there are risk factors.
This is correct. The Joint Commission requires that assessments for pain and the
risk for falls be performed on all patients. Other special needs assessments
should be performed when cues indicate there are risk factors.
This is incorrect. The Joint Commission does not require a cultural assessment.
This is incorrect. The Joint Commission does not require a wellness assessment.
PTS: 1
CON: Patient-Centered Care
4. ANS: 1
Chapter: Chapter 3 Assessment
Objective: Describe and differentiate initial, ongoing, comprehensive, focused, and special needs
assessments.
Page: 45 (V1)
Heading: Types and Sources of Data
Integrated Processes: Nursing Process
Client Need: Safe and Effective Care Environment: Management of Care
Cognitive Level: Application [Applying]
Concept: Patient-Centered Care
Difficulty: Moderate
Feedback
1
This is correct. An ongoing assessment occurs when a previously identified
problem is being reassessedโfor example, taking an hourly temperature when a
Copyright ยฉ 2020 F. A. Davis Company
2
3
4
patient has a fever.
This is incorrect. Examining a patientโs throat is a focused assessment to explore
the possible source of pain with swallowing.
This is incorrect. Asking for a pain rating using a scale of 0 to 10 is a focused
assessment.
This is incorrect. Asking a patient for details of a plan to return to normal
exercise activities is a special needs assessment. There is no way to determine if
this assessment will be ongoing.
PTS: 1
CON: Patient-Centered Care
5. ANS: 4
Chapter: Chapter 3 Assessment
Objective: Describe and differentiate initial, ongoing, comprehensive, focused, and special needs
assessments.
Page: 46 (V1)
Heading: Nursing Assessment Skills
Integrated Processes: Nursing Process
Client Need: Safe and Effective Nursing Care Environment: Management of Care
Cognitive Level: Analysis [Analyzing]
Concept: Patient-Centered Care
Difficulty: Difficult
Feedback
1
This is incorrect. Systematic observation, like other types of assessment, is not
performed in a parameter of time constraints. Complete assessments at the
beginning of a shift are a vital tool to identify change.
2
This is incorrect. Systematic observation is a type of assessment focused on
patient well-being; it does not influence the need to document.
3
This is incorrect. In itself, systematic observation does not prevent critical
changes in a patientโs status; however, the process does alert the nurse to
changes in a timely manner.
4
This is correct. By making systematic observations each time the nurse is with a
patient, the nurse is less likely to miss an assessment area and/or overlook
changes in the patientโs status.
PTS: 1
CON: Patient-Centered Care
6. ANS: 3
Chapter: Chapter 3 Assessment
Objective: Compare open-ended and closed questions, including definitions, uses, advantages, and
disadvantages.
Page: 47 (V1)
Heading: Types of Interviews
Integrated Processes: Communication and Documentation
Client Need: Safe and Effective Nursing Care Environment: Management of Care
Cognitive Level: Application [Applying]
Concept: Communication
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Difficulty: Moderate
Feedback
1
This is incorrect. Questions that require a simple answer, such as a โyesโ or a
โno,โ are considered closed-ended questions. This question would be open
ended if the nurse asked, โWhat surgeries have you had?โ
2
This is incorrect. Questions that require a specific answer, such as a date, is
considered closed-ended question. This question would be open ended if the
nurse asked, โWhat can you tell me about your menstrual periods?โ
3
This is correct. Open-ended questionsโfor example, โWhat happens when you
have a headache?โโare broadly worded to encourage the patient to elaborate.
4
This is incorrect. Questions that require a simple answer, such as a โyesโ or a
โno,โ are considered closed-ended questions. This question would be open
ended if the nurse asked, โWho are your family members with heart disease?โ
PTS: 1
CON: Communication
7. ANS: 4
Chapter: Chapter 3 Assessment
Objective: Describe and differentiate initial, ongoing, comprehensive, focused, and special needs
assessments.
Page: 46 (V1)
Heading: Types of Assessment
Integrated Processes: Nursing Process
Client Need: Safe and Effective Care Environment: Management of Care
Cognitive Level: Analysis [Analyzing]
Concept: Patient-Centered Care
Difficulty: Difficult
Feedback
1
This is incorrect. A comprehensive assessment provides the nurse with holistic
information about the clientโs overall health status; enables identification of
client problems and strengths; enhances the nurseโs sensitivity to a patientโs
culture, values, beliefs, and economic situation; and uses the nursing skills of
observation, physical assessment, and interviewing.
2
This is incorrect. An ongoing focused assessment is used to evaluate the status
of existing problems and goals. The nurse performs ongoing focused assessment
periodically throughout the period of providing patient care.
3
This is incorrect. A special needs assessment is a type of focused assessment
that provides in-depth information about a particular area of client functioning
and often involves using a specially designed form. The nurse will perform a
special needs assessment any time assessment cues suggest risk factors or
problems for a client, such as nutrition status or pain management.
4
This is correct. An initial focused assessment is used to follow up on
client-reported symptoms or unusual findings during the first examination. The
nurse is seeking additional information about specific symptoms reported by the
patientโin this scenario, vomiting, and diarrhea.
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PTS: 1
CON: Patient-Centered Care
8. ANS: 2
Chapter: Chapter 3 Assessment
Objective: State the ANA position on delegating assessment.
Page: 44 (V1)
Heading: What Do Professional Standards Say About Assessment?
Integrated Processes: Nursing Process
Client Need: Safe and Effective Care Environment: Managing Care
Cognitive Level: Application [Applying]
Concept: Professionalism
Difficulty: Moderate
Feedback
1
This is incorrect. Most states have a method of testing for nursing assistant
personnel, but it is not necessarily the state board of nursing. Nurse aides or
other unlicensed assistive personnel (UAP) may collect certain information,
such as vital signs, pain reports, and finger stick blood glucose levels. However,
it is the professional nurseโs responsibility to assign those tasks, validate the
data collected, conduct the interview, and complete the physical assessment.
2
This is correct. The ANAโs Scope and Standards of Practice (2015), which
applies to professional nurses (registered nurses [RNs]), identifies assessment as
a professional responsibility. The Joint Commission, the National Council of
State Boards of Nursing (NCSBN), and nurse practice acts support the ANA
standard.
3
This is incorrect. Agency policies/procedures state which caregivers can collect
and document specified data within that agency/facility. However, the
parameters of professional standards are observed with the development of
agency policy/procedures.
4
This is incorrect. Bargaining committees for a facilityโs nurses will observe the
parameters of professional standards. Not all care facilities will have bargaining
committees.
PTS: 1
CON: Professionalism
9. ANS: 1
Chapter: Chapter 3 Assessment
Objective: Discuss the relationship between the nursing process and collaborative care.
Page: 49 (V1)
Heading: Interviewing to Obtain a Nursing Health History
Integrated Processes: Nursing Process
Client Need: Safe and Effective Nursing Care Environment: Management of Care
Cognitive Level: Comprehension [Understanding]
Concept: Patient-Centered Care
Difficulty: Moderate
1
Feedback
This is correct. A nursing history focuses on the patientโs responses to and
Copyright ยฉ 2020 F. A. Davis Company
2
3
4
perception of the illness/injury or health problem, the patientโs coping ability,
and the patientโs resources and support.
This is incorrect. A medical history focuses on the patientโs current and past
medical/surgical problems.
This is incorrect. Nursing history formats vary, depending on the patient, the
agency, and the patientโs needs. Both nursing and medical histories typically use
a specific format.
This is incorrect. A medical history does not necessarily contain more in-depth
information. A nursing history can be thorough, covering a wide range of topics,
including biographical data, reason(s) patient is seeking healthcare, history of
present illness, patientโs perception of health status and expectations for care,
past medical history, use of complementary modalities, and review of functional
ability associated with activities of daily living.
PTS: 1
CON: Patient-Centered Care
10. ANS: 4
Chapter: Chapter 3 Assessment
Objective: Identify the following types of data: subjective, objective, primary source, secondary
source.
Page: 49 (V1)
Heading: Interviewing to Obtain a Nursing Health History
Integrated Processes: Nursing Process
Client Need: Safe and Effective Care Environment: Safety and Infection Control
Cognitive Level: Analysis [Analyzing]
Concept: Patient-Centered Care
Difficulty: Difficult
1
2
3
4
Feedback
This is incorrect. The information alone does not specifically address the clientโs
acceptance of certain types of therapy.
This is incorrect. Physical assessment and laboratory tests are needed to assess a
nutritional deficiency.
This is incorrect. To identify the clientโs cultural and spiritual beliefs and well as
what therapies are acceptable to the client, the nurse would need more than just
information about nutritional and herbal supplements.
This is correct. Herbs and nutritional supplements can interact with prescription
medications, and complementary and alternative treatments can interfere with
conventional therapies.
PTS: 1
CON: Patient-Centered Care
11. ANS: 1
Chapter: Chapter 3 Assessment
Objective: Use nursing frameworks to organize data.
Page: 50 (V1)
Heading: How Can I Organize Data?
Copyright ยฉ 2020 F. A. Davis Company
Integrated Processes: Nursing Process
Client Need: Safe and Effective Nursing Care Environment: Management of Care
Cognitive Level: Analysis [Analyzing]
Concept: Professionalism
Difficulty: Difficult
1
2
3
4
Feedback
This is correct. Nursing assessment models categorize or cluster data into
functional health patterns, domains, or categories to make the data easier to use.
This is incorrect. None of the nursing assessment models cluster data according
to body systems.
This is incorrect. Assessment is the first step in the nursing process; however,
the nurse does not use the entire nursing process in data collection.
This is incorrect. The ANA Standards of Care describe a competent level of
clinical nursing practice based on the nursing process; nursing models are not
based on the ANA Standards of Care.
PTS: 1
CON: Professionalism
12. ANS: 3
Chapter: Chapter 3 Assessment
Objective: Describe the differences between directive and nondirective interviewing.
Page: 49 (V1)
Heading: Table 3-3: Comparison of Directive and Nondirective Interviews
Integrated Processes: Communication and Documentation
Client Need: Safe and Effective Care Environment: Management of Care
Cognitive Level: Comprehension [Understanding]
Concept: Patient-Centered Care
Difficulty: Easy
Feedback
1
This is incorrect. With the use of nondirective interviewing, the patient controls
the subject matter.
2
This is incorrect. Because nondirective interviewing puts the patient in control
of the subject matter, the process can be very time consuming (inefficient) and
produce information that is not relevant.
3
This is correct. Nondirective interviewing helps build rapport between the nurse
and the patient and facilitates the use of open communication.
4
This is incorrect. Directive interviewing is used to focus the attention of anxious
patients. The method focuses on obtaining factual, easily categorized
information. The process is especially useful in an emergency situation.
PTS: 1
CON: Patient-Centered Care
13. ANS: 4
Chapter: Chapter 3 Assessment
Objective: Discuss how to prepare for and conduct an interview.
Page: 50 (V1)
Copyright ยฉ 2020 F. A. Davis Company
Heading: Preparing for an Interview
Integrated Processes: Communication and Documentation
Client Need: Safe and Effective Nursing Care Environment: Management of Care
Cognitive Level: Application [Applying]
Concept: Patient-Centered Care
Difficulty: Moderate
1
2
3
4
Feedback
This is incorrect. It is appropriate to interview patients without family/friends
around; this decision does not require further instruction.
This is incorrect. In nearly every culture, addressing a patient with โMr.โ or
โMrs.โ shows respect and is, therefore, correct and does not require further
instruction.
This is incorrect. Reading the patientโs health record is appropriate preparation
for an interview. This decision does not require further instruction.
This is correct. A patient should be comfortable when interviewing. The pain
medication should have time to work before the nurse would consider
interviewing the patient, so asking questions when giving the medication is not a
good idea. This decision requires further instruction.
PTS: 1
CON: Patient-Centered Care
14. ANS: 3
Chapter: Chapter 3 Assessment
Objective: Describe and differentiate initial, ongoing, comprehensive, focused, and special needs
assessment.
Page: 47 (V1)
Heading: Focused Assessments
Integrated Processes: Nursing Process
Client Need: Safe and Effective Care Environment: Management of Care
Cognitive Level: Application [Applying]
Concept: Patient-Centered Care
Difficulty: Moderate
Feedback
1
This is incorrect. A comprehensive assessment is holistic and is usually done
upon the clientโs admission to a healthcare facility.
2
This is incorrect. An ongoing assessment is a follow-up procedure after an
initial database is completed or a problem is identified.
3
This is correct. An initial focused assessment is performed during a first
examination for specific abnormal findings.
4
This is incorrect. A special needs assessment is performed when there are cues
that more in-depth assessment is needed.
PTS: 1
CON: Patient-Centered Care
15. ANS: 2
Chapter: Chapter 3 Assessment
Copyright ยฉ 2020 F. A. Davis Company
Objective: Describe and differentiate initial, ongoing, comprehensive, focused, and special needs
assessments.
Page: 48 (V1)
Heading: Special Needs Assessments
Integrated Processes: Nursing Process
Client Need: Safe and Effective Care Environment: Management of Care
Cognitive Level: Analysis [Analyzing]
Concept: Patient-Centered Care
Difficulty: Moderate
Feedback
1
This is incorrect. A family assessment is helpful to evaluate the patientโs support
systems. This is probably the second-most important special needs assessment
for the nurse to make for this patient.
2
This is correct. A functional assessment is the most important assessment
because of discharge needs (e.g., self-care ability at home) and patient safety.
3
This is incorrect. A community assessment is helpful to evaluate community
services available to assist the patient. However, this is not the most important
special needs assessment.
4
This is incorrect. A psychosocial assessment is helpful to evaluate a patientโs
understanding of and coping with the recently diagnosed stroke. However, this
is not the most important special needs assessment for the nurse to perform.
PTS: 1
CON: Patient-Centered Care
16. ANS: 1
Chapter: Chapter 3 Assessment
Objective: Describe the differences between directive and nondirective interviewing.
Page: 47 (V1)
Heading: Table 3-3: Comparison of Directive and Nondirective Interviews
Integrated Processes: Communication and Documentation
Client Need: Safe and Effective Care Environment: Management of Care
Cognitive Level: Application [Applying]
Concept: Patient-Centered Care
Difficulty: Moderate
Feedback
1
This is correct. For someone who is anxious, it is best to use closed-ended
questions. A closed-ended question can be answered in one or very few words
and has a very specific answer.
2
This is incorrect. This statement requires the patient to give a detailed response,
which is not suitable for interviewing an anxious patient.
3
This is incorrect. Asking what triggers the patientโs migraine is an open-ended
question, which requires a detailed response. This is not suitable for
interviewing an anxious patient.
4
This is incorrect. Asking the patient for a description of how the headaches feel
requires a detailed response, which is not suitable for interviewing an anxious
patient.
Copyright ยฉ 2020 F. A. Davis Company
PTS: 1
CON: Patient-Centered Care
17. ANS: 3
Chapter: Chapter 3 Assessment
Objective: Discuss how to prepare for and conduct an interview.
Page: 49 (V1)
Heading: Interviewing to Obtain a Nursing Health History
Integrated Processes: Communication and Documentation
Client Need: Safe and Effective Care Environment: Management of Care
Cognitive Level: Comprehension [Understanding]
Concept: Communication
Difficulty: Easy
1
2
3
4
Feedback
This is incorrect. Taking frequent notes makes it difficult for the nurse to
maintain eye contact with the client.
This is incorrect. Asking for more details may seem like idle curiosity to the
client.
This is correct. The nurse is exhibiting active listening behaviors by leaning
toward the client; facing the patient; exhibiting an open, relaxed posture without
crossing the arms or legs; and maintaining eye contact.
This is incorrect. When the nurse is sitting with legs crossed, it may indicate to
the client that the nurse is not receptive to the client.
PTS: 1
CON: Communication
18. ANS: 4
Chapter: Chapter 3 Assessment
Objective: Describe circumstances in which you should validate data.
Page: 53 (V1)
Heading: How Should I Document Data?
Integrated Processes: Communication and Documentation
Client Need: Safe and Effective Care Environment: Management of Care
Cognitive Level: Analysis [Analyzing]
Concept: Communication
Difficulty: Moderate
1
2
3
4
Feedback
This is incorrect. Chart specific data, not vague phrases; the student is
acknowledging the importance of this.
This is incorrect. There are no universally accepted phrases, just
agency-approved abbreviations; the student is acknowledging the need to use
agency-approved abbreviations.
This is incorrect. The student is correct that charting should be completed as
soon after data collection as possible.
This is correct. When charting data, chart only what was observed, not what it
Copyright ยฉ 2020 F. A. Davis Company
meant. Inferences should not be made about a patientโs behavior during data
collection (โhe acted depressedโ), so this response reflects the studentโs lack of
knowledge and need for teaching.
PTS: 1
CON: Communication
19. ANS: 2
Chapter: Chapter 3 Assessment
Objective: Describe circumstances in which you should validate data.
Page: 53 (V1)
Heading: Tools for Recording Assessment Data
Integrated Processes: Communication and Documentation
Client Need: Safe and Effective Care Environment: Management of Care
Cognitive Level: Analysis [Analyzing]
Concept: Communication
Difficulty: Moderate
1
2
3
4
Feedback
This is incorrect. Flowsheets can be used to record various types of information,
such as routine documentation of vital signs.
This is correct. To easily and graphically see trends over time, the graphic
flowsheet is superior to other methods of documentation, allowing quick
assessment of patient changes in status. The pattern of a patientโs fever is the
best example of the superiority of a graphic flowsheet.
This is incorrect. A description of the symptoms accompanying changes in vital
signs is narrative information for which a graphic flowsheet may not be suitable.
This is incorrect. Patient tolerance of care is most likely to be documented in
narrative form and not on a graphic flowsheet.
PTS: 1
CON: Communication
20. ANS: 2
Chapter: Chapter 3 Assessment
Objective: Use nursing frameworks to organize data.
Page: 50 (V1)
Heading: How Can I Organize Data?
Integrated Processes: Nursing Process
Client Need: Safe and Effective Care Environment: Management of Care
Cognitive Level: Comprehension [Understanding]
Concept: Patient-Centered Care
Difficulty: Moderate
Feedback
1
This is incorrect. During the assessment phase, the nurse is collecting and
recording data, not prioritizing data.
2
This is correct. The major concept of a framework is to assist the nurse to
organize and cluster data to find patterns.
3
This is incorrect. A framework includes subjective and objective data but does
Copyright ยฉ 2020 F. A. Davis Company
4
not help the nurse to separate the two types of data.
This is incorrect. A framework includes primary and secondary data but does
not help the nurse to separate the two types of data.
PTS: 1
CON: Patient-Centered Care
21. ANS: 3
Chapter: Chapter 3 Assessment
Objective: Discuss how to prepare for and conduct an interview.
Page: 50 (V1)
Heading: Preparing for an Interview
Integrated Processes: Communication and Documentation
Client Need: Safe and Effective Care Environment: Management of Care
Cognitive Level: Application [Applying]
Concept: Communication
Difficulty: Moderate
1
2
3
4
Feedback
This is incorrect. Family members may offer information that may or may not
be pertinent and may distract the client from the interview. The presence of
family members may also inhibit full disclosure of information by the client.
This is incorrect. The nurse always needs to ask the clientโs preference for how
they are addressed. However, this action alone does not ensure a successful
interview.
This is correct. The interview should be done when the client is comfortable and
there are no distractions.
This is incorrect. The family watching television during the nurseโs interview of
the client may be distracting to both the nurse and the client.
PTS: 1
CON: Communication
22. ANS: 1
Chapter: Chapter 3 Assessment
Objective: Identify at least four components of a nursing health history.
Page: 49 (V1)
Heading: Interviewing to Obtain a Nursing Health History
Integrated Processes: Nursing Process
Client Need: Safe and Effective Care Environment: Management of Care
Cognitive Level: Comprehension [Understanding]
Concept: Patient-Centered Care
Difficulty: Easy
Feedback
1
This is correct. The nurse is collecting data on this patient; however, the data
provided indicate that further data collection is warranted.
2
This is incorrect. Data are analyzed to formulate nursing diagnoses and a plan of
care.
3
This is incorrect. After assessment, data are categorized to organize the
Copyright ยฉ 2020 F. A. Davis Company
4
information and add clarity.
This is incorrect. The information in the scenario indicates that a comprehensive
physical assessment has not been completed.
PTS: 1
CON: Patient-Centered Care
23. ANS: 4
Chapter: Chapter 3 Assessment
Objective: State the ANA position on delegating assessment.
Page: 47 (V1)
Heading: What Do Professional Standards Say About Assessment?
Integrated Processes: Nursing Process
Client Need: Safe and Effective Care Environment: Management of Care
Cognitive Level: Analysis [Analyzing]
Concept: Professionalism
Difficulty: Moderate
Feedback
1
This is incorrect. In making decisions about which parts of an assessment can be
delegated to the CNA, the nurse must consider agency policies and the
regulations of the state board of nursing.
2
This is incorrect. Certain assessment activities, such as vital signs, weighing the
client, and maintaining output and intake measures, can be assigned to qualified
CNAs.
3
This is incorrect. Nursing regulatory bodies specify that client assessment is the
responsibility of the registered nurse. Therefore, the CNA cannot be instructed
to start an assessment that will be completed by the nurse.
4
This is correct. In most states, the CNA can obtain vital signs and record them in
the patientโs chart; however, the ability to perform this task must first be
validated by the nurse. The nurse is also responsible for validating the
documentation of the information by the CNA.
PTS: 1
CON: Professionalism
24. ANS: 1
Chapter: Chapter 3 Assessment
Objective: Identify the following types of data: subjective, objective, primary source, secondary
source.
Page: 45 (V1)
Heading: Types and Sources of Data
Integrated Processes: Nursing Process
Client Need: Safe and Effective Care Environment: Management of Care
Cognitive Level: Analysis [Analyzing]
Concept: Professionalism
Difficulty: Moderate
1
Feedback
This is correct. The patientโs statement about experiencing numbness and
Copyright ยฉ 2020 F. A. Davis Company
2
3
4
tingling down the right arm is an example of subjective data because the
statement is in the patientโs own words.
This is incorrect. Objective data are overt and gathered by the nurse through
physical assessment, laboratory findings, or diagnostic testing results.
This is incorrect. Secondary data are obtained through a source other than the
patient, such as a family member
This is incorrect. There is not enough information in the patientโs statement to
categorize it as comprehensive data because the nurse would have to complete a
physical assessment and obtain all data.
PTS: 1
CON: Professionalism
25. ANS: 2
Chapter: Chapter 3 Assessment
Objective: Describe and differentiate initial, ongoing, comprehensive, focused, and special needs
assessments.
Page: 46 (V1)
Heading: Types of Assessment
Integrated Processes: Nursing Process
Client Need: Safe and Effective Care Environment: Management of Care
Cognitive Level: Analysis [Analyzing]
Concept: Patient-Centered Care
Difficulty: Moderate
Feedback
1
This incorrect. The patient verbalizes that he misses church but adds that he is
able to view services on television.
2
This is correct. An older adult who has fallen twice in 6 months has a safety
risk. There is no indication that a walker has been obtained. Falling and the risk
for falls require the nurse to perform a special needs assessment related to
functional status. The lack of injury does not diminish the need.
3
This is incorrect. The patient verbalizes eating less red meat but adds that
protein is obtained from other sources. The nurse may want to determine what
the other protein sources are before performing a special needs assessment.
4
This is incorrect. The client verbalizes a physiological concern regarding a
toothache, but the patient has addressed the issue by making an appointment to
see the dentist.
PTS: 1
CON: Patient-Centered Care
26. ANS: 4
Chapter: Chapter 3 Assessment
Objective: Describe the differences between directive and nondirective interviewing.
Page: 49 (V1)
Heading: Interviewing to Obtain a Nursing Health History
Integrated Processes: Nursing Process
Client Need: Safe and Effective Care Environment: Management of Care
Cognitive Level: Application [Applying]
Copyright ยฉ 2020 F. A. Davis Company
Concept: Professionalism
Difficulty: Moderate
Feedback
1
This is incorrect. It is appropriate to ask the patient about the home situation;
however, this question can be addressed later when taking the health history and
performing the physical assessment.
2
This is incorrect. It is appropriate to ask the patient about pain, but this question
can be addressed later when taking the health history and performing the
physical assessment or by following the patientโs lead.
3
This is incorrect. It is appropriate to ask the patient about the medical history;
however, this question can be addressed later when taking the health history and
performing the physical assessment.
4
This is correct. The nurse should first ask in the initial interview why the patient
is seeking nursing or medical assistance. This broad question will elicit the most
information because it is open ended.
PTS: 1
CON: Professionalism
27. ANS: 3
Chapter: Chapter 3 Assessment
Objective: Describe the differences between directive and nondirective interviewing.
Page: 49 (V1)
Heading: Interviewing to Obtain a Nursing Health History
Integrated Processes: Nursing Process
Client Need: Safe and Effective Care Environment: Safety and Infection Control
Cognitive Level: Analysis [Analyzing]
Concept: Professionalism
Difficulty: Moderate
Feedback
1
This is incorrect. Asking when the patientโs pain began will only elicit a short
answer specific to that question. Each question is asked in pain assessment;
however, the question that will elicit the most information is the one that asks
the patient to tell the nurse more about the pain.
2
This is incorrect. Asking to rate the level of pain on a scale of 0 to 10 will only
elicit a short answer; of greater importance is the description of the pain present
with chest pain.
3
This is correct. The most information is gained by asking the patient to tell the
nurse more about the pain. This is an open-ended question and will give the
nurse more information about the pain.
4
This is incorrect. Although asking the patient about medication taken for the
pain is appropriate, the question will elicit only a short answer with a limited
amount of information about the characteristics of the pain.
PTS: 1
CON: Professionalism
28. ANS: 3
Chapter: Chapter 3 Assessment
Copyright ยฉ 2020 F. A. Davis Company
Objective: Use assessment skills to gather data during a nursing assessment.
Page: 53 (V1)
Heading: How Should I Document Data?
Integrated Processes: Communication and Documentation
Client Need: Safe and Effective Care Environment: Management of Care
Cognitive Level: Analysis [Analyzing]
Concept: Communication
Difficulty: Moderate
Feedback
1
This is incorrect. Noting that patient breathing is normal and urine output is
adequate does not give enough information about either function.
2
This is incorrect. โGood strength in both lower extremitiesโ is vague as the word
good is subjective.
3
This is correct. โStarted on solid foods. Ate 75% of dinner. No complaints of
nausea or vomitingโ is clear, concrete, and specific.
4
This is incorrect. โPatient seems upsetโ does not give enough information and
involves an assumption by the nurse. Also, the nurse does not document what
things have not been done; this action can be used to show inadequate nursing
care if litigation is ever initiated.
PTS:
1
CON: Communication
MULTIPLE RESPONSE
29. ANS: 1, 2, 4
Chapter: Chapter 3 Assessment
Objective: Discuss how to prepare for and conduct an interview.
Page: 50 (V1)
Heading: Preparing for an Interview
Integrated Processes: Communication and Documentation
Client Need: Communication and Documentation
Cognitive Level: Analysis [Analyzing]
Concept: Communication
Difficulty: Difficult
1.
2.
3.
4.
5.
Feedback
This is correct. โHow,โ โwhat,โ and โwhenโ are acceptable lines of questioning. It
will be beneficial for the nurse to ascertain how a patientโs issue occurred.
This is correct. โHow,โ โwhat,โ and โwhenโ are acceptable lines of questioning.
This is incorrect. Asking โwhyโ can put the patient on the defensive and may suggest
disapproval, limiting the amount of information the patient is willing give.
Questioning the patientโs judgment for seeking care is inappropriate.
This is correct. โHow,โ โwhat,โ and โwhenโ are acceptable lines of questioning.
This is incorrect. Asking โwhyโ can put the patient on the defensive and may suggest
Copyright ยฉ 2020 F. A. Davis Company
disapproval, limiting the amount of information the patient is willing give. Why the
patient decided to seek help at this time is of least importance.
PTS: 1
CON: Communication
30. ANS: 1, 4
Chapter: Chapter 3 Assessment
Objective: State the ANA position on delegating assessment.
Page: 47 (V1)
Heading: What Do Professional Standards Say About Assessment?
Integrated Processes: Nursing Process
Client Need: Safe and Effective Care Environment: Management of Care
Cognitive Level: Analysis [Analyzing]
Concept: Professionalism
Difficulty: Difficult
1.
2.
3.
4.
5.
Feedback
This is correct. State nurse practice acts specify which portions of the assessment
can legally be completed by individuals with different credentials. The practice acts
will vary from state board to state board.
This is incorrect. The AMA provides guidelines and standards for physicians, not
nurses.
This is incorrect. The Code of Ethics for Nurses merely states that the nurse should
delegate tasks appropriately; it does not speak directly to the specific credentials of
personnel.
This is correct. The ANAโs Scope and Standards of Practice provides professional
guidance for determining who is ultimately responsible and qualified to collect
assessment data.
This is incorrect. The facility policy and procedure index should reflect the
professional nursing standards of practice; however, this is not the best source of
validating delegation guidelines.
PTS: 1
CON: Professionalism
31. ANS: 1, 3, 4
Chapter: Chapter 3 Assessment
Objective: Use assessment skills to gather data during a nursing assessment.
Page: 47 (V1)
Heading: Guidelines for Recording Assessment Data
Integrated Processes: Nursing Process
Client Need: Safe and Effective Care Environment: Management of Care
Cognitive Level: Analysis [Analyzing]
Concept: Patient-Centered Care
Difficulty: Difficult
1.
Feedback
This is correct. Cues are what the client says and what the nurse observes. The nurse
Copyright ยฉ 2020 F. A. Davis Company
2.
3.
4.
5.
can observe the percentage of the meal eaten by the client.
This is incorrect. When the nurse states, โThe patient feels better,โ the nurse is
making an inference. What did the nurse observe to validate that the client feels
better? Those observations are cues.
This is correct. Cues are what the client says and what the nurse observes. When the
client states, โI slept well,โ it is a verbal fact stated by the client and is a cue.
This is correct. A laboratory value is a factual statement and, therefore, a cue.
This is incorrect. When the nurse notes that the patient โdoes not appear to be in
pain,โ the nurse is making an inference. What validating cues does the nurse
recognize?
PTS: 1
CON: Patient-Centered Care
32. ANS: 1, 2, 5
Chapter: Chapter 3 Assessment
Objective: Discuss professional standards affecting nursing process (e.g., American Nurses
Association, The Joint Commission).
Page: 44 (V1)
Heading: What Do Professional Standards Say About Assessment?
Integrated Processes: Nursing Process
Client Need: Safe and Effective Care Environment: Management of Care
Cognitive Level: Analysis [Analyzing]
Concept: Patient-Centered Care
Difficulty: Difficult
1.
2.
3.
4.
5.
Feedback
This is correct. Assessment is a professional responsibility as designated by
professional standards.
This is correct. Assessment is a professional responsibility that assists the nurse to
identify problems and prioritize care.
This is incorrect. Assessment helps the nurse formulate a nursing diagnosis; a
medical diagnosis is not within the nurseโs scope of practice.
This is incorrect. All patients are assessed for pain.
This is correct. Parts of the assessment may be delegated, depending on state boards
of nursing and agency policies.
PTS: 1
CON: Patient-Centered Care
33. ANS: 1, 3
Chapter: Chapter 3 Assessment
Objective: Identify the following types of data: subjective, objective, primary source, secondary
source.
Page: 45 (V1)
Heading: Types and Sources of Data
Integrated Processes: Nursing Process
Client Need: Safe and Effective Care Environment: Management of Care
Cognitive Level: Analysis [Analyzing]
Copyright ยฉ 2020 F. A. Davis Company
Concept: Patient-Centered Care
Difficulty: Difficult
1.
2.
3.
4.
5.
Feedback
This is correct. A blood pressure reading is an example of objective data. Such data
are obtained by the nurse through assessment and can be validated.
This is incorrect. Pain that is rated on a scale of 0 to 10 is still considered subjective
because it is rated on the patientโs opinion. Objective data about pain includes
crying, grimacing, or posturing.
This is correct. The presence and description of drainage is an example of objective
data. Such data are obtained by the nurse through assessment and can be validated.
This is incorrect. The spouseโs statement about the patientโs quality of sleep is
indicative of secondary data, which is vague and subjective.
This is incorrect. The patientโs report about the presence of stomach pain is
subjective. Objective validation would include physical manifestations of pain.
PTS: 1
CON: Patient-Centered Care
34. ANS: 1, 2, 5
Chapter: Chapter 3 Assessment
Objective: Use assessment skills to gather data during a nursing assessment.
Page: 53 (V1)
Heading: How Should I Document Data?
Integrated Processes: Communication and Documentation
Client Need: Safe and Effective Care Environment: Management of Care
Cognitive Level: Analysis [Analyzing]
Concept: Communication
Difficulty: Difficult
1.
2.
3.
4.
5.
Feedback
This is correct. Recording the patientโs statement in the patientโs own words is an
example of high-quality documentation. The statement is not vague or subjective.
This is correct. When the nurse documents validation of orientation and the means of
evaluation, the documentation is an example of high-quality documentation.
This is incorrect. The statement regarding the patientโs incision is vague because
what is considered normal cannot be measured.
This is incorrect. Noting that the patient is angry and refuses to talk with the spouse
is subjective and unclear.
This is correct. Documentation that includes the patientโs response to an assessment
of pain is an example of high-quality documentation.
PTS: 1
CON: Communication
35. ANS: 3, 4, 5
Chapter: Chapter 3 Assessment
Objective: Discuss how to prepare for and conduct an interview.
Page: 49 (V1)
Copyright ยฉ 2020 F. A. Davis Company
Heading: Interviewing to Obtain a Nursing Health History
Integrated Processes: Communication and Documentation
Client Need: Safe and Effective Care Environment: Management of Care
Cognitive Level: Analysis [Analyzing]
Concept: Communication
Difficulty: Difficult
1.
2.
3.
4.
5.
Feedback
This is incorrect. Criticizing the patientโs behavior and citing a medical situation
diminishes the possibility of establishing a positive rapport between the patient and
the nurse.
This is incorrect. When the nurse asks a โwhyโ question, it is often offensive to the
patient. The nurse needs to use therapeutic communication skills to determine the
patientโs noncompliance with medical treatment.
This is correct. Observing that the patient is in pain, offering pain medication, and
postponing the interview are appropriate when performing the nursing interview.
Pain and use of medication will make the interview process more difficult and
possibly less accurate.
This is correct. Asking the patient about the timing of the interview is appropriate
and accommodating.
This is correct. Asking the patient about sleeping patterns is appropriate when
performing the nursing interview.
PTS:
1
CON: Communication
Copyright ยฉ 2020 F. A. Davis Company
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