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NR 304: ATI WEEK 7 FINAL Q&A
Questions:
1. Define subjective and objective data. Give three examples of each and state if the findings are
documented in the history or physical examination findings.
a. Subjective data= things that the patient states
i. Pain
ii. Back hurts
iii. Headache
b. Subjective data= things that can be observed or measured.
i. Lab results
ii. Temperature
iii. Blood pressure
2. List five actions a nurse should take when assessing a patient with a potentially critical
hemodynamic state. Put your actions in priority order of 1-5.
a. LOC
b. Respiratory rate
c. Blood pressure
d. Heart rate
3. What does the priority setting ABC mean? How does the nurse use this mnemonic in patient
assessment? If a patient has a slow or rapid respiratory rate, is airway the primary concern?
a. ABC= Airway, Breathing, Circulation
b. If airway is compromised, then they won’t be able to breath and circulation will then be
affected.
c. Yes, because if the airway is causing the respiration to change it needs to be addressed
or they’ll eventually not be able to breath
4. What is HIPAA? Describe one situation when the nurse must adhere to HIPAA.
a. Health Insurance Portability and Accountability Act, which establishes policies and
procedures for maintaining the privacy and the security of individually identifiable
health information.
b. A nurse will use it when she has her patient’s information and not talking about the
patient outside the room or using patient’s personal information to other people.
5. Describe the process of taking a pulse. What is a normal pulse? What are qualities of a normal
pulse? What is the first action a nurse should take when the pulse is not as expected?
a. Pulses should be palpable (2+), if not feet should still have good color and be warm.
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6. What is dehydration? List three subjective and three objective findings of dehydration. List the
expected vital signs of a patient who is dehydrated.
a. Excessive loss of water from the body tissues accompanied by a disturbance of body
electrolytes
i. Subjective findings: thirsty, headache, lethargic
ii. Objective findings: skin turgor, color of urine (more concentrated) , low blood
pressure
1. HR
2. Fever
3. blood pressure
7. How is fluid volume deficit related to dehydration? How would concentrations of some solutes
(solids) change with dehydration? Why?
a. Body fluids have decreased volume but normal osmolality
b. With dehydration the concentration increases, and urine becomes darker because
there’s not enough water in the urine to dilute it.
8. What is an undesirable response of the body to a fever?
a. Sweating, chills, shivering, headache, muscle aches, loss of appetite, irritable,
dehydration, general weakness
Why is this undesirable? What effect does it have?
a. can cause hypothermia
b. flu or cold that can lead to bed rest and have all the undesirable symptoms
9. What is the most serious skin cancer? What is one risk factor for this cancer and one teaching
item to address with your patient? Describe this most serious skin cancer below.
a. Malignant Melanoma
b. UV exposure and reducing exposure and wearing sunscreen
c. Potentially lethal lesions that are the malignant transformation of melanocytes. May
arise from preexisting nevus or de novo. Usually brown; can be tan, black, pink-red,
purple, or mixed pigmentation. Often irregular or notched borders. May have scaling,
flaking, oozing texture. Common locations: trunk and back; legs in women; and palms,
soles of feet, and nails in Blacks. Risk factors are UV radiation from sun exposure and
indoor tanning and family history. Rates are increasing in White men over 55 years and
White women of all ages. Melanoma is the most common cancer in women ages 25-29
years and 2nd most common (after breast cancer) in women ages 30-34 years.
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NR 304: ATI WEEK 7 FINAL Q&A
Questions:
1. Define subjective and objective data. Give three examples of each and state if the findings are
documented in the history or physical examination findings.
a. Subjective data= things that the patient states
i. Pain
ii. Back hurts
iii. Headache
b. Subjective data= things that can be observed or measured.
i. Lab results
ii. Temperature
iii. Blood pressure
2. List five actions a nurse should take when assessing a patient with a potentially critical
hemodynamic state. Put your actions in priority order of 1-5.
a. LOC
b. Respiratory rate
c. Blood pressure
d. Heart rate
3. What does the priority setting ABC mean? How does the nurse use this mnemonic in patient
assessment? If a patient has a slow or rapid respiratory rate, is airway the primary concern?
a. ABC= Airway, Breathing, Circulation
b. If airway is compromised, then they won’t be able to breath and circulation will then be
affected.
c. Yes, because if the airway is causing the respiration to change it needs to be addressed
or they’ll eventually not be able to breath
4. What is HIPAA? Describe one situation when the nurse must adhere to HIPAA.
a. Health Insurance Portability and Accountability Act, which establishes policies and
procedures for maintaining the privacy and the security of individually identifiable
health information.
b. A nurse will use it when she has her patient’s information and not talking about the
patient outside the room or using patient’s personal information to other people.
5. Describe the process of taking a pulse. What is a normal pulse? What are qualities of a normal
pulse? What is the first action a nurse should take when the pulse is not as expected?
a. Pulses should be palpable (2+), if not feet should still have good color and be warm.
1
, 2
6. What is dehydration? List three subjective and three objective findings of dehydration. List the
expected vital signs of a patient who is dehydrated.
a. Excessive loss of water from the body tissues accompanied by a disturbance of body
electrolytes
i. Subjective findings: thirsty, headache, lethargic
ii. Objective findings: skin turgor, color of urine (more concentrated) , low blood
pressure
1. HR
2. Fever
3. blood pressure
7. How is fluid volume deficit related to dehydration? How would concentrations of some solutes
(solids) change with dehydration? Why?
a. Body fluids have decreased volume but normal osmolality
b. With dehydration the concentration increases, and urine becomes darker because
there’s not enough water in the urine to dilute it.
8. What is an undesirable response of the body to a fever?
a. Sweating, chills, shivering, headache, muscle aches, loss of appetite, irritable,
dehydration, general weakness
Why is this undesirable? What effect does it have?
a. can cause hypothermia
b. flu or cold that can lead to bed rest and have all the undesirable symptoms
9. What is the most serious skin cancer? What is one risk factor for this cancer and one teaching
item to address with your patient? Describe this most serious skin cancer below.
a. Malignant Melanoma
b. UV exposure and reducing exposure and wearing sunscreen
c. Potentially lethal lesions that are the malignant transformation of melanocytes. May
arise from preexisting nevus or de novo. Usually brown; can be tan, black, pink-red,
purple, or mixed pigmentation. Often irregular or notched borders. May have scaling,
flaking, oozing texture. Common locations: trunk and back; legs in women; and palms,
soles of feet, and nails in Blacks. Risk factors are UV radiation from sun exposure and
indoor tanning and family history. Rates are increasing in White men over 55 years and
White women of all ages. Melanoma is the most common cancer in women ages 25-29
years and 2nd most common (after breast cancer) in women ages 30-34 years.
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