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As the nurse initiates the general survey examination, you know data collection for this portion of the
review of systems (ROS) begins:
a)As soon as the nurse begins to talk with the patient.
b)As soon as the nurse begins to obtain the vital signs of the patient.
c)As soon as the nurse touches the patient.
d)As soon as the nurse sees the patient. ✔Correct Answer-d) As soon as the nurse sees the patient
Which of the following patient situations would you interpret as requiring an emergency
assessment?
a) A patient in need of an employment physical who is due to start work this week.
b) A patient who is unresponsive to voice commands and is suspected of a drug overdose.
c) A patient with sunburn who enters the the clinic in a wheelchair.
d) A patient who missed her last period and is concerned that she may be pregnant. ✔Correct
Answer-b) A patient who is unresponsive to voice commands and suspected of a drug overdose.
You are the nurse caring for Mrs. Jones, a 65 y/o female admitted for hip surgery. At 0200 you
administer pain medication to Mrs. Jones. At 0300, you enter her room to ask her about her pain
level. What step of the nursing process are you performing?
a) Diagnosis
b) Evaluation
c) Intervention
d) Assessment ✔Correct Answer-b) Evaluation
Your nursing faculty instructor instructs you to obtain objective data from your laboratory partner.
Which of the following indicates the best way from which you can obtain objective data?
a) Inspection
b) Asking open-ended questions
c) Completing the medical history section of their health history form
,d) Utilizing good Interviewing techniques ✔Correct Answer-a) Inspection
The nurse just interviewed her patient to obtain information related to complaints of a skin problem.
Which of the following documentation in the nurses notes represents subjective data?
a) Skin is warm, dry, and intact.
b) No lesions or rashes are noted.
c) Patient states she is not having any itching, redness, or rashes.
d) Large lesion noted lateral aspect R anterior arm, intact, no bleeding. ✔Correct Answer-c) Patient
states she is not having an itching, redness, or rashes
Which of the following is an example of a symptom?
a) Potassium level of 4.3 mEq/l
b) Increased respirations
c) Chest pain
d) Sweating ✔Correct Answer-c) Chest pain
During an assessment in the Emergency Department (ED) the nurse utilizes the CAGE assessment
tool. The patient answers YES to two of the questions. What does this indicate?
a)The patient may be a victim of domestic violence and should be assessed further for abuse
b) The patient may have a problem with alcohol and should be assessed further for alcohol abuse
c) The patient has no identifiable issues
d) The patient may be depressed and should be assessed further for suicidal ideations ✔Correct
Answer-b) The patient may have a problem with alcohol and should be assessed further for alcohol
abuse.
Which type of assessment and database is most appropriate for a person being admitted to a new
long-term care nursing facility?
a) Complete
b) Emergency
c) Episodic
d) Follow-up ✔Correct Answer-a) Complete
The nurse is caring for an elderly patient and he suspects elder abuse. Which of the following actions
is most appropriate?
, a) Notify the authorities of the suspected abuse
b) Confront the caretakers about the suspicions of abuse
c) Ask the patient if it is ok to call the authorities
d) Collect proof of the abuse before alerting the authorities ✔Correct Answer-a) Notify the
authorities of the suspected abuse
An example of an open-ended question or statement is:
a) On a scale of 0 - 10 what level is your pain now?
b) You are upset about your level of pain, right?
c) Tell me more about your pain.
d) I can see you are very uncomfortable. ✔Correct Answer-c) Tell me more about your pain.
You enter your patient's room to perform their physical assessment examination. To perform a
proper examination you know the first technique you will utilize is:
a) Palpation
b) Percussion
c) Inspection
d) Auscultation ✔Correct Answer-c) Inspection
As you prepare to perform a physical assessment on your patient you consider your assigned
readings. Based on your readings which statement below reflects the most correct action when
performing patient examinations?
a) Follow the same examination sequence, regardless of the patient's age or condition
b) Always organize the assessment to ensure the patient does not need to change positions too
frequently
c) Always begin your assesment from the right side of the patient's bed
d) Always examine painful or tender areas first ✔Correct Answer-b) Always organize the
assessment to ensure the patient does not need to change positions too frequently
You are working in the Emergency Department and are preparing to assess a patient who presents
with complaints of severe chest pain. Which of the following represents the best way for you to
begin your assessment of this patient?
a) First, obtain a thorough medical, surgical, and family history from the patient or a family member
b) The order of the assessment does not really matter as long as all areas and systems are assessed