1
NR 226/ NR226 EXAM 1: FUNDAMENTALS:
PATIENT CARE GUIDE | QUESTIONS &
ANSWERS|(NEW 2026/ 2027 UPDATE) 100%
CORRECT (VERIFIED SOLUTIONS)
A nurse assesses a patient who comes to the pulmonary clinic. "I see that it's
been over 6 months since you've been in, but your appointment was for every 2
months. Tell me about that. Also I see from your last visit that the doctor
recommended routine exercise. Can you tell me how successful you have been
following his plan?" The nurse's assessment covers which of Gordon's functional
health patterns?
A. Value-belief pattern
B. Cognitive-perceptual pattern
C. Coping-stress-tolerance pattern
D. Health perception-health management pattern ANSWER: D. Health
perception-health management pattern
-The nurse is attempting to learn about the patient's self-report of health
practices, clinic appointments, and exercise plan designed to improve his health.
The nurse asks a patient, "Describe for me your typical diet over a 24-hour day.
What foods do you prefer? Have you noticed a change in your weight recently?"
This series of questions would likely occur during which phase of a patient-
centered interview?
A. Setting the stage
B. Gathering information about the patient's chief concerns
C. Collecting the assessment
D. Termination ANSWER: C. Collecting the assessment
, 2
-The nurse is focusing on the patient's nutritional status and asking specific
questions to assess his diet history.
What type of interview techniques does the nurse use when asking these
questions, "Do you have pain or cramping?" "Does the pain get worse when you
walk?" (Select all that apply.)
A. Active listening
B. Open-ended questioning
C. Closed-ended questioning
D. Problem-oriented questioning ANSWER: C & D
-The nurse's technique is to ask a closed-ended question using a problem
oriented approach. The patient gives a specific answer to broaden the nurse's
knowledge about the character of his pain.
What technique(s) best encourage(s) a patient to tell his or her full story? (Select
all that apply.)
A. Active listening
B. Back channeling
C. Validating
D. Use of open-ended questions
E. Use of closed-ended questions ANSWER: A, B, & D
-Active listening allows the patient to speak and shows the nurse's respect for
what he or she has to say. Back channeling reinforces interest in what the patient
has to say and shows the nurse's desire to hear the full story. Using open-ended
questions encourages the patient to tell his or her story and actively describe his
or her health status. Validation simply confirms accuracy of data collected.
Closed-ended questions do not encourage storytelling.
A nurse gathers the following assessment data. Which of the following cues
form(s) a pattern suggesting a problem? (Select all that apply.)
A. The skin around the wound is tender to touch.
B. Fluid intake for 8 hours is 800 mL.
C. Patient has a heart rate of 78 and regular.
D. Patient has drainage from surgical wound.
E. Body temperature is 101° F (38.3° C).
F. Patient asks, "I'm worried that I won't return to work when I planned."
ANSWER: A, D, & E
, 3
-These form a pattern of a problem with wound healing. Fluid intake of 800 mL in
8 hours and having a heart rate of 78 are normal findings. The patient indicating
some worry about not returning to work when planned may suggest a problem,
but more cues are needed to see a pattern that would allow the nurse to clearly
identify the problem.
The nurse makes the following statement during a change of shift report to
another nurse. "I assessed Mr. Diaz, my 61-year-old patient from Chile. He fell at
home and hurt his back 3 days ago. He has some difficulty turning in bed, and he
says that he has pain that radiates down his leg. He rates his pain at a 6, but I
don't think it's that severe. You know that back patients often have chronic pain.
He seems fine when talking with his family. Have you cared for him before?"
What does the nurse's conclusion suggest?
A. The nurse is making an accurate clinical inference.
B. The nurse has gathered cues to identify a potential problem area.
C. The nurse has allowed stereotyping to influence her assessment.
D. The nurse wants to validate her information with the other nurse.
ANSWER: C. The nurse has allowed stereotyping to influence her
assessment
-The nurse is applying a stereotype about patients with back pain. An accurate
clinical inference would not include the nurse's opinion. The cues suggest that
the patient has acute pain, which the nurse is rejecting. Validation would involve
having another nurse also assess the patient for pain.
A nurse checks a patient's intravenous (IV) line in his right arm and sees
inflammation where the catheter enters the skin. She uses her finger to apply
light pressure (i.e., palpation) just above the IV site. The patient tells her the area
is tender. The nurse checks to see if the IV line is running at the correct rate. This
is an example of what type of assessment?
A. Agenda setting
B. Problem-focused
C. Objective
D. Use of a structured database format ANSWER: B. Problem-focused
-The nurse saw the inflammation and gathered additional information to
determine if a problem existed with the IV site. The data were not all objective;
the patient's report of tenderness is subjective. Setting an agenda is an interview
technique. The nurse was not using a structured format for her assessment.
, 4
Which of the following are examples of data validation? (Select all that apply.)
A. The nurse assesses the patient's heart rate and compares the value with the
last value entered in the medical record.
B. The nurse asks the patient if he is having pain and then asks the patient to rate
the severity.
C. The nurse observes a patient reading a teaching booklet and asks the patient if
he has questions about its content.
D. The nurse obtains a blood pressure value that is abnormal and asks the charge
nurse to repeat the measurement.
E. The nurse asks the patient to describe a symptom by saying, "Go on."
ANSWER: A & D
-Validation involves comparing data with another source. By asking the patient
about pain and then having it rated the nurse collects two assessment findings.
The nurse asking an open-ended question about the patient's understanding of
the booklet is not data validation. Telling the patient to "go on" is back
channeling.
A patient tells the nurse during a visit to the clinic that he has been sick to his
stomach for 3 days and he vomited twice yesterday. Which of the following
responses by the nurse is an example of probing?
A. So you've had an upset stomach and began vomiting—correct?
B. Have you taken anything for your stomach?
C. Is anything else bothering you?
D. Have you taken any medication for your vomiting? ANSWER: C. Is
anything else bothering you?
-A probing question encourages a full description without trying to control the
direction of the patient's story. It requires further open-ended statements.
Confirming an upset stomach and vomiting is an example of summarizing
findings. The questions about medications taken are examples of closed-ended
questions that control the patient's response and do not ensure a full objective
view from the patient.
The nurse is assessing the character of a patient's migraine headache and asks,
"Do you feel nauseated when you have a headache?" The patient's response is
"yes." In this case the finding of nausea is which of the following?
A. An objective finding
B. A clinical inference
NR 226/ NR226 EXAM 1: FUNDAMENTALS:
PATIENT CARE GUIDE | QUESTIONS &
ANSWERS|(NEW 2026/ 2027 UPDATE) 100%
CORRECT (VERIFIED SOLUTIONS)
A nurse assesses a patient who comes to the pulmonary clinic. "I see that it's
been over 6 months since you've been in, but your appointment was for every 2
months. Tell me about that. Also I see from your last visit that the doctor
recommended routine exercise. Can you tell me how successful you have been
following his plan?" The nurse's assessment covers which of Gordon's functional
health patterns?
A. Value-belief pattern
B. Cognitive-perceptual pattern
C. Coping-stress-tolerance pattern
D. Health perception-health management pattern ANSWER: D. Health
perception-health management pattern
-The nurse is attempting to learn about the patient's self-report of health
practices, clinic appointments, and exercise plan designed to improve his health.
The nurse asks a patient, "Describe for me your typical diet over a 24-hour day.
What foods do you prefer? Have you noticed a change in your weight recently?"
This series of questions would likely occur during which phase of a patient-
centered interview?
A. Setting the stage
B. Gathering information about the patient's chief concerns
C. Collecting the assessment
D. Termination ANSWER: C. Collecting the assessment
, 2
-The nurse is focusing on the patient's nutritional status and asking specific
questions to assess his diet history.
What type of interview techniques does the nurse use when asking these
questions, "Do you have pain or cramping?" "Does the pain get worse when you
walk?" (Select all that apply.)
A. Active listening
B. Open-ended questioning
C. Closed-ended questioning
D. Problem-oriented questioning ANSWER: C & D
-The nurse's technique is to ask a closed-ended question using a problem
oriented approach. The patient gives a specific answer to broaden the nurse's
knowledge about the character of his pain.
What technique(s) best encourage(s) a patient to tell his or her full story? (Select
all that apply.)
A. Active listening
B. Back channeling
C. Validating
D. Use of open-ended questions
E. Use of closed-ended questions ANSWER: A, B, & D
-Active listening allows the patient to speak and shows the nurse's respect for
what he or she has to say. Back channeling reinforces interest in what the patient
has to say and shows the nurse's desire to hear the full story. Using open-ended
questions encourages the patient to tell his or her story and actively describe his
or her health status. Validation simply confirms accuracy of data collected.
Closed-ended questions do not encourage storytelling.
A nurse gathers the following assessment data. Which of the following cues
form(s) a pattern suggesting a problem? (Select all that apply.)
A. The skin around the wound is tender to touch.
B. Fluid intake for 8 hours is 800 mL.
C. Patient has a heart rate of 78 and regular.
D. Patient has drainage from surgical wound.
E. Body temperature is 101° F (38.3° C).
F. Patient asks, "I'm worried that I won't return to work when I planned."
ANSWER: A, D, & E
, 3
-These form a pattern of a problem with wound healing. Fluid intake of 800 mL in
8 hours and having a heart rate of 78 are normal findings. The patient indicating
some worry about not returning to work when planned may suggest a problem,
but more cues are needed to see a pattern that would allow the nurse to clearly
identify the problem.
The nurse makes the following statement during a change of shift report to
another nurse. "I assessed Mr. Diaz, my 61-year-old patient from Chile. He fell at
home and hurt his back 3 days ago. He has some difficulty turning in bed, and he
says that he has pain that radiates down his leg. He rates his pain at a 6, but I
don't think it's that severe. You know that back patients often have chronic pain.
He seems fine when talking with his family. Have you cared for him before?"
What does the nurse's conclusion suggest?
A. The nurse is making an accurate clinical inference.
B. The nurse has gathered cues to identify a potential problem area.
C. The nurse has allowed stereotyping to influence her assessment.
D. The nurse wants to validate her information with the other nurse.
ANSWER: C. The nurse has allowed stereotyping to influence her
assessment
-The nurse is applying a stereotype about patients with back pain. An accurate
clinical inference would not include the nurse's opinion. The cues suggest that
the patient has acute pain, which the nurse is rejecting. Validation would involve
having another nurse also assess the patient for pain.
A nurse checks a patient's intravenous (IV) line in his right arm and sees
inflammation where the catheter enters the skin. She uses her finger to apply
light pressure (i.e., palpation) just above the IV site. The patient tells her the area
is tender. The nurse checks to see if the IV line is running at the correct rate. This
is an example of what type of assessment?
A. Agenda setting
B. Problem-focused
C. Objective
D. Use of a structured database format ANSWER: B. Problem-focused
-The nurse saw the inflammation and gathered additional information to
determine if a problem existed with the IV site. The data were not all objective;
the patient's report of tenderness is subjective. Setting an agenda is an interview
technique. The nurse was not using a structured format for her assessment.
, 4
Which of the following are examples of data validation? (Select all that apply.)
A. The nurse assesses the patient's heart rate and compares the value with the
last value entered in the medical record.
B. The nurse asks the patient if he is having pain and then asks the patient to rate
the severity.
C. The nurse observes a patient reading a teaching booklet and asks the patient if
he has questions about its content.
D. The nurse obtains a blood pressure value that is abnormal and asks the charge
nurse to repeat the measurement.
E. The nurse asks the patient to describe a symptom by saying, "Go on."
ANSWER: A & D
-Validation involves comparing data with another source. By asking the patient
about pain and then having it rated the nurse collects two assessment findings.
The nurse asking an open-ended question about the patient's understanding of
the booklet is not data validation. Telling the patient to "go on" is back
channeling.
A patient tells the nurse during a visit to the clinic that he has been sick to his
stomach for 3 days and he vomited twice yesterday. Which of the following
responses by the nurse is an example of probing?
A. So you've had an upset stomach and began vomiting—correct?
B. Have you taken anything for your stomach?
C. Is anything else bothering you?
D. Have you taken any medication for your vomiting? ANSWER: C. Is
anything else bothering you?
-A probing question encourages a full description without trying to control the
direction of the patient's story. It requires further open-ended statements.
Confirming an upset stomach and vomiting is an example of summarizing
findings. The questions about medications taken are examples of closed-ended
questions that control the patient's response and do not ensure a full objective
view from the patient.
The nurse is assessing the character of a patient's migraine headache and asks,
"Do you feel nauseated when you have a headache?" The patient's response is
"yes." In this case the finding of nausea is which of the following?
A. An objective finding
B. A clinical inference
