NURSING 1800 EXAM 1 QUESTIONS
AND ANSWERS WITH COMPLETE
SOLUTIONS 100% CORRECT RATED A+
Question: What are the primary stages of the nursing process?
Answer: The process follows a systematic cycle often remembered by the
acronym ADPIE:
1. Assess
2. Diagnose
3. Plan
4. Implement (Intervene)
5. Evaluate ✔✔
Question: What occurs during the "Assessment" phase?
Answer: This is the data collection stage. The nurse gathers comprehensive
information about the patient’s health by reviewing medical records,
performing a physical exam (noting signs like shortness of breath or skin
color), and monitoring vital signs. It involves gathering both subjective and
objective information. ✔✔
Question: How is "Subjective Data" defined?
Answer: This includes information provided directly by the patient or their
family members that cannot be independently measured. It describes the
patient’s feelings or perceptions, such as a patient stating, "My pain level is a 6
out of 10." ✔✔
Question: How is "Objective Data" defined?
Answer: This consists of observable and measurable facts obtained through
examination or testing. Examples include blood pressure readings, heart rate, or
results from an EKG. ✔✔
Question: What is the goal of the "Diagnosis" phase?
Answer: In this stage, the nurse analyzes the collected data to identify actual or
potential health problems. Unlike a medical diagnosis, a nursing diagnosis
focuses on the patient’s response to health conditions, such as "anxiety" or
"impaired physical mobility." ✔✔
Question: What takes place during the "Planning" phase?
,Answer: The nurse establishes priorities and develops measurable goals for the
patient’s recovery. This involves deciding which nursing interventions (such as
specific therapies or treatments) will best help the patient reach the desired
health outcomes. ✔✔
Question: What happens during the "Implementation" (Intervention)
phase?
Answer: This is the action phase where the nurse carries out the previously
developed plan. Examples include administering prescribed medications,
providing oxygen therapy, or repositioning a patient for better comfort. ✔✔
Question: What is the purpose of the "Evaluation" phase?
Answer: The nurse assesses the patient’s progress to determine if the
interventions were successful and if the goals were met. This stage also
involves checking for new issues or side effects and adjusting the care plan if
the original approach was ineffective. ✔✔
what is the normal range for when taking body temperature ?
96.7 - 100.5 degrees F
what are the modes of taking temperature?
axillary - armpit
rectal
tympanic - ear
temporal-forehead
how do you check the pulse rate?
count how many beats in one minute
what is the normal range for an Adults pulse rate?
60-100 beats per minute
what reflects the heartbeat?
the pulse
,what is the peripheral pulse?
pulse located away from the heart
what is the central pulse?
apical pulse located at the apex of the heart ( midclavicular , 5th intercostal
space)
what is a regular pulse rhythm?
pressure is equal with each pulse, and theyre equal intervals between beats
what is a irregular pulse rhythm?
unequal intervals between beats
if irregular we assess the apical pulse
what does a palpated pulse mean?
we measure the pulse using our fingers or hands
palpated means using our hands to measure
what does auscultated pulse mean?
listening to sounds usually with a stethoscope
5th intercostal space for adults
and
4th intercostal space for children
what is a apical pulse?
pulse taken at the apex of the heart with a stethoscope and is the most accurate
place for reading
where is the apical pulse located?
Midclavicular line, 5th intercostal space
, what does it mean when a pulse reading is documented as 0 ?
absent , unable to palpate
what does it mean when a pulse reading is documented as 1?
diminished or weak
what does it mean when a pulse reading is documented as 2?
brisk, normal
what does it mean when a pulse reading is documented as 3?
bounding
what is the apical - radial pulse?
when two people count simultaneously 1 at the apex of the heart and 1 at the
wrist
this is to assess the presence of a pulse difference when their shouldnt be
where is the temporal pulse?
side of forehead
where is the carotid pulse?
side of neck
where is the brachial pulse?
inner elbow
where is the radial pulse?
Thumb side of wrist
AND ANSWERS WITH COMPLETE
SOLUTIONS 100% CORRECT RATED A+
Question: What are the primary stages of the nursing process?
Answer: The process follows a systematic cycle often remembered by the
acronym ADPIE:
1. Assess
2. Diagnose
3. Plan
4. Implement (Intervene)
5. Evaluate ✔✔
Question: What occurs during the "Assessment" phase?
Answer: This is the data collection stage. The nurse gathers comprehensive
information about the patient’s health by reviewing medical records,
performing a physical exam (noting signs like shortness of breath or skin
color), and monitoring vital signs. It involves gathering both subjective and
objective information. ✔✔
Question: How is "Subjective Data" defined?
Answer: This includes information provided directly by the patient or their
family members that cannot be independently measured. It describes the
patient’s feelings or perceptions, such as a patient stating, "My pain level is a 6
out of 10." ✔✔
Question: How is "Objective Data" defined?
Answer: This consists of observable and measurable facts obtained through
examination or testing. Examples include blood pressure readings, heart rate, or
results from an EKG. ✔✔
Question: What is the goal of the "Diagnosis" phase?
Answer: In this stage, the nurse analyzes the collected data to identify actual or
potential health problems. Unlike a medical diagnosis, a nursing diagnosis
focuses on the patient’s response to health conditions, such as "anxiety" or
"impaired physical mobility." ✔✔
Question: What takes place during the "Planning" phase?
,Answer: The nurse establishes priorities and develops measurable goals for the
patient’s recovery. This involves deciding which nursing interventions (such as
specific therapies or treatments) will best help the patient reach the desired
health outcomes. ✔✔
Question: What happens during the "Implementation" (Intervention)
phase?
Answer: This is the action phase where the nurse carries out the previously
developed plan. Examples include administering prescribed medications,
providing oxygen therapy, or repositioning a patient for better comfort. ✔✔
Question: What is the purpose of the "Evaluation" phase?
Answer: The nurse assesses the patient’s progress to determine if the
interventions were successful and if the goals were met. This stage also
involves checking for new issues or side effects and adjusting the care plan if
the original approach was ineffective. ✔✔
what is the normal range for when taking body temperature ?
96.7 - 100.5 degrees F
what are the modes of taking temperature?
axillary - armpit
rectal
tympanic - ear
temporal-forehead
how do you check the pulse rate?
count how many beats in one minute
what is the normal range for an Adults pulse rate?
60-100 beats per minute
what reflects the heartbeat?
the pulse
,what is the peripheral pulse?
pulse located away from the heart
what is the central pulse?
apical pulse located at the apex of the heart ( midclavicular , 5th intercostal
space)
what is a regular pulse rhythm?
pressure is equal with each pulse, and theyre equal intervals between beats
what is a irregular pulse rhythm?
unequal intervals between beats
if irregular we assess the apical pulse
what does a palpated pulse mean?
we measure the pulse using our fingers or hands
palpated means using our hands to measure
what does auscultated pulse mean?
listening to sounds usually with a stethoscope
5th intercostal space for adults
and
4th intercostal space for children
what is a apical pulse?
pulse taken at the apex of the heart with a stethoscope and is the most accurate
place for reading
where is the apical pulse located?
Midclavicular line, 5th intercostal space
, what does it mean when a pulse reading is documented as 0 ?
absent , unable to palpate
what does it mean when a pulse reading is documented as 1?
diminished or weak
what does it mean when a pulse reading is documented as 2?
brisk, normal
what does it mean when a pulse reading is documented as 3?
bounding
what is the apical - radial pulse?
when two people count simultaneously 1 at the apex of the heart and 1 at the
wrist
this is to assess the presence of a pulse difference when their shouldnt be
where is the temporal pulse?
side of forehead
where is the carotid pulse?
side of neck
where is the brachial pulse?
inner elbow
where is the radial pulse?
Thumb side of wrist
