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The nurse completes a health and physical assessment on a patient admitted with a
fractured pelvis. Which task would the nurse do next?
a. Create health promotion diagnoses for the patient.
b. Analyze and cluster the assessment information.
c. Determine the need for risk nursing diagnoses.
d. Formulate a nursing diagnosis addressing a focused problem.
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b. Analyze and cluster the assessment information.
The nurse identifies which examples listed indicate objective data? (Select all that
apply.)
a. Wound size—3 cm × 2 cm
b. Platelet count—350,000 mm3
, c. Respirations—24 breaths/min
d. Reports severe abdominal pain.
e. Temperature—98.4 °F (36.8 °C)
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a, b, c , e
The nurse is completing the health history on a patient admitted for cardiac
rehabilitation. The nurse recognizes that the health history is conducted in which step
of the nursing process?
a. Implementation
b. Diagnosis
c. Assessment
d. Evaluation
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c. Assessment
Which patient issue should the nurse address first?
a. Pain
b. Absence of pulse
c. Hunger
d. Decreased self-esteem
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