WITH SOLUTIONS GRADED A+
◉ Steps of the Nursing Process. Answer: 1. Assessment
2. Diagnosis
3. Planning
4. Implementation
5. Evaluation
◉ Types of Assessments. Answer: o Initial Comprehensive
o Ongoing or Partial
o Emergency
◉ Preparing for Assessment. Answer: o Review client's record (learn
basic info.)
o Review client's status with other health care team members
o Reflect on own personal biases
o Educate about client's diagnosis and tests performed
◉ Steps in Data Analysis. Answer: 1. Identify abnormalities
2. Cluster data
,3. Draw inferences
4. Propose nursing diagnoses
5. Check defining characteristics
6. Confirm or rule out diagnoses
7. Document
◉ Data Clustering. Answer: occurs when related cues are grouped
together, also assists in identification of nursing diagnosis
◉ The nurse is completing an admission database entry and must
include priority nursing diagnoses for the plan of care. Which
statement describes a nursing diagnosis?
a. The collection of subjective and objective data
b. A clinical judgment about client responses to health difficulties.
Answer: b; A clinical judgment about client responses to health
difficulties
◉ A nurse is caring for three clients whose care involves complex
situations and multiple responsibilities. What is the key to resolving
problems for this nurse?. Answer: Critical Thinking
◉ After a health assessment the nurse determines that a client
would benefit from health promotion interventions. Which item
,should the nurse refer to when determining the best actions for the
client?
a. Healthy People 2020
b. the client's past medical history. Answer: a; Healthy People 2020
◉ Phases of an Interview. Answer: o Preparatory
o introductory
o working
o termination
◉ Working Phase. Answer: The nurse then listens, observes cues,
and uses critical thinking skills to interpret and validate information
received from the client. The nurse and client collaborate to identify
the client's problems and goals.
◉ Types of Nonverbal Communication. Answer: o Appearance
o Demeanor
o Facial Expression
o Attitude
o Silence
o Listening
◉ Types of Verbal Communication. Answer: o Open-ended questions
, o Close-ended questions
o Laundry List
o Rephrasing
o Well-placed phrases
o Inferring
o Providing info.
◉ Health History Components. Answer: o Biographical data
o Reasons for seeking health care
o History of present health concern
o Personal health history
o Family health history
o ROS for current health problems
o Lifestyle and health practices profile
o Developmental level
◉ A nurse on an oncology unit enters a client's room to auscultate
bowel sounds. What should the nurse do before auscultating?.
Answer: Disinfect the stethoscope before touching the client
◉ During an interview between a nurse and a client, the nurse and
the client collaborate to identify problems and goals. This occurs
during the phase of the interview termed.... Answer: working