11/11/23,R6:40RP TestRBankR-
M RPhysicalRExaminationRandRHealthRAssessmentR8eR(byRJarvis)R1R…
TestRBank R-
RPhysicalRExaminationRand RHealthRAssessmentR 8eR(byRJarvis)R1 R
Chapter R 01:R Evidence-Based RAssessment
MULTIPLER CHOICE
1. After RcompletingRan RinitialRassessment R of R aRpatient, RtheRnurseRhas Rcharted Rthat Rhis Rrespiratio
ns R areR eupneic R and R his RpulseRis R 58 Rbeats Rper R minute. RTheseRtypes R of RdataR wouldR be:
a. Objective.
b. Reflective.
c. Subjective.
d. Introspective.
R ANS: RA
ObjectiveRdataRareRwhatRtheRhealth Rprofessional Robserves RbyRinspecting, Rpercussing, R palpating, R a
nd Rauscultating R during RtheR physical Rexamination. R SubjectiveR dataRis R what RtheRperson Rsays R abo
utRhim R or R herself Rduring Rhistory
taking. RTheRterms RreflectiveR andRintrospective R areRnotR used RtoRdescribeR data.RDIF:RCognitiveRLevel: RUnderstandi
ngR(Comprehension) R MSC:RClient R Needs:RSafeR andR EffectiveRCareR Environment: R Management R of RCare
2. ARpatientRtells R theR nurseRthat RheRis R veryR nervous, Ris R nauseated, R andRfeels R hot.R TheseRtypes R of RdataR wouldR be:
a. Objective.
b. Reflective.
c. Subjective.
d. Introspective.
R ANS: RC
SubjectiveRdataR areR whatRtheRpersonRsays R aboutR him R or Rherself RduringR historyRtaking. RObjectiv
eRdataR areR whatRtheR health Rprofessional Robserves R byR inspecting, Rpercussing, Rpalpating, R and Ra
uscultating Rduring RtheRphysical
examination. RTheRterms Rreflective R and Rintrospective RareRnotR used RtoRdescribeRdata. RDIF:R CognitiveRLevel: R Understanding
R(Comprehension) R MSC:R ClientR Needs:RSafeR and REffectiveR CareREnvironment: R Management R of RCare
3. TheRpatients Rrecord,RlaboratoryRstudies, RobjectiveRdata,R and RsubjectiveRdataRcombineRtoRformRthe:
a. DataR base.
b. AdmittingRdata.
TestRBank R- RPhysicalRExamination Rand RHealthRAssessment R 8eR(byRJarvis) R2
c. FinancialR statement.
d. DischargeRsummary
.R ANS: RA
Together R with RtheRpatients Rrecord RandRlaboratoryRstudies, RtheRobjectiveRand RsubjectiveRdataRformRtheRdataRbase. RTheRother Rit
ems R areRnotR partR of RtheR patients Rrecord, RlaboratoryRstudies, R or Rdata.RDIF:RCognitiveR Level: R Remembering R(Knowledge)
MSC:R ClientRNeeds: RSafeRand REffectiveRCareREnvironment: RManagement Rof RCare
4. When Rlistening RtoR aRpatients R breath Rsounds, RtheRnurseRis RunsureRof R aRsoundRthat Ris Rh
eard.RTheR nurses RnextR action Rshould RbeRto:
a. ImmediatelyRnotifyR theRpatients R physician.
b. Document RtheRsound R exactlyR as RitR was Rheard.
c. ValidateRtheRdataR byR asking R aRcoworker RtoRlisten RtoRtheRbreath Rsounds.
d. Assess RagainRin R20R minutes RtoRnoteR whether RtheRsoundRi
s RstillRpresent.R ANS: RC
When RunsureRof R aRsoundRheard RwhileRlistening RtoRaRpatients RbreathRsounds, R theRnurseR validates RtheRdataRtoR ensure
accuracy. RIf RtheRnurseRhas Rless R experienceRin Ran Rarea, Rthen RheRor RsheRasks R an RexpertRtoRlisten. RDIF: RCognitive RL
evel: RAnalyzing R(Analysis) R MSC: R ClientR Needs:RSafeR andREffectiveRCareR Environment: R Management R of RCare
5. TheR nurseRis Rconducting RaRclass Rfor Rnew R graduateRnurses. RDuringRtheRteaching Rsession, Rthe
RnurseRshould Rkeep R in RmindRthatR noviceRnurses,R withoutR aRbackgroundRof Rskills R and Rexperien
ceRfrom R whichRtoRdraw, R areRmoreRlikely
toRmakeRtheir Rdecisions R using:
a. Intuition.
b. ARsetR of R rules.
c. Articles R inRjournals.
d. AdviceRfrom Rsuperviso
rs.R ANS: RB
NoviceRnurses R operateRfrom R aRsetR of R defined, RstructuredRrules.RTheRexpert Rpractitioner Ruses RintuitiveRlinks. RDIF:RCognitiveRLe
vel:RUnderstanding R (Comprehension)
TestRBank R-
RPhysicalRExaminationRand RHealthRAssessmentR 8eR(byRJarvis)R3 R
MSC:RClientRNeeds: RGeneral
6. Expert Rnurses Rlearn RtoR attend RtoRaR pattern Rof R assessment R dataR and R actR without Rconsciousl
yRlabeling Rit.RTheseR responses R areRreferredRtoR as:
a. Intuition.
b. TheR nursingR process.
c. Clinical Rknowledge.
d. DiagnosticRreasoning
.R ANS: RA
IntuitionRis Rcharacterized RbyR pattern Rrecognitionexpert Rnurses Rlearn RtoR attend RtoRaRpattern Rof R assessment RdataR and
actR without RconsciouslyRlabeling Rit.RTheRother Roptions R areRnotRcorrect.RDIF: RCognitiveRLevel: RUnderstanding R(
Comprehension) R MSC:RClientRNeeds: RGeneral
7. TheRnurseRis Rreviewing Rinformation Rabout Revidence-based RpracticeR(EBP). RW hichRstatement R bestRreflects
EBP?
a. EBP Rrelies R onRtradition Rfor Rsupport R of RbestRpractices.
b. EBPRis RsimplyRtheR useR of R bestR practiceRtechniques Rfor RtheRtreatment R of Rpatients.
c. EBPR emphasizes RtheRuseR of RbestR evidenceR withRtheRclinicians R experience.
d. TheRpatients Rown Rpreferences RareRnot Rimportant R
with REBP.R ANS: RC
EBPRis R aRsystematic R approach RtoR practiceRthatR emphasizes RtheRuseRof RbestR evidenceRinRcom
binationRwith RtheR clinicians R experience, R as R wellR as R patientR preferences R and R values, R when Rmaki
ngRdecisions R aboutRcareRand R treatment. REBP Ris R moreRthanRsimplyR usingRtheRbestR practiceRte
chniques RtoRtreat Rpatients, R and Rquestioning
traditionRis Rimportant R whenRnoRcompelling Rand Rsupportive RresearchR evidence Rexists. RDIF:RCognitiveRLevel: RAp
plying R(Application) R MSC:R Client RNeeds:RSafeR and REffectiveRCareR Environment: R Management R of RCare
8. TheR nurseRis Rconducting RaRclass R on RpriorityRsetting Rfor RaR groupR of Rnew R graduateR nurses.
RW hichRis R anR exampleR of R aRfirst-level RpriorityRproblem?
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M RPhysicalRExaminationRandRHealthRAssessmentR8eR(byRJarvis)R1R…
a. Patient RwithRpostoperative Rpain
b. NewlyRdiagnosed R patient R with Rdiabetes R whoRneeds Rdiabetic Rt
eachingR TestRBankR-
RPhysicalRExamination RandRHealthRAssessmentR 8eR(byRJarvis)R4
c. IndividualRwith RaRsmallRlaceration RonRtheRsoleRof R theRfoot
d. Individual Rwith Rshortness Rof Rbreath Rand Rrespiratory
Rdistress R ANS: RD
First-level RpriorityRproblems RareRthoseRthatRareRemergent, RlifeRthreatening, R and RimmediateR(e.g.,R establishing Ran
airway, Rsupporting Rbreathing, Rmaintaining Rcirculation, Rmonitoring Rabnormal Rvital Rsigns). RDIF:RCognitiveRLevel: RUnderstanding R(Co
mprehension) R MSC:R ClientR Needs: RSafeR and REffectiveR CareR Environment: R Management R of RCare
9. When Rconsidering RpriorityRsetting Rof Rproblems, RtheRnurseRkeeps RinRmind Rthat Rsecond-
level RpriorityRproblems R includeR which R of RtheseR aspects?
a. Low Rself-esteem
b. Lack R of R knowledge
c. AbnormalRlaboratoryR values
d. SeverelyRabnormal Rvital Rs
igns R ANS: RC
Second-
level RpriorityR problems R areRthose RthatRrequireRpromptRintervention RtoRforestall Rfurther Rdeterioration R(e.g.,R mental Rstatus Rchange, R
acuteRpain,R abnormal RlaboratoryR values, Rrisks RtoRsafetyR or Rsecurity). RDIF: RCognitiveR Level: RUnderstanding R(Comprehension)
MSC:R ClientRNeeds: RSafeRand REffectiveRCareREnvironment: RManagement Rof RCare
10. WhichRcritical Rthinking RskillRhelps R theRnurseRseeRrelationships Ramong RtheRdata?
a. Validation
b. ClusteringR relatedR cues
c. Identifying Rgaps R in Rdata
d. DistinguishingRrelevantRfromRirrelev
antR ANS: RB
Clustering Rrelated Rcues Rhelps RtheRnurseRseeRrelationships RamongRtheRdata. R DIF:RCognitiveRLevel: RUnderstanding
R(Comprehension) R MSC:RClientRNeeds:R SafeR and REffectiveR CareREnvironment: R Management R of RCare
TestRBank R- RPhysicalRExamination Rand RHealthRAssessment R 8eR(byRJarvis) R5
11. TheRnurseRknows RthatRdeveloping RappropriateRnursing Rinterventions Rfor RaRpatien
tRrelies Ron RtheR appropriateness R of RtheR diagnosis.
a. Nursing
b. Medical
c. Admission
d. Collaborative
R ANS: RA
An RaccurateRnursing Rdiagnosis R provides RtheRbasis Rfor RtheRselectionRof Rnursing Rinterventions Rto
RachieveR outcomes R for Rwhich RtheRnurseRis R accountable. RTheRother Ritems RdoRnot RcontributeRt
oRtheRdevelopment R of R appropriate Rnursing R interventions. RDIF:R CognitiveRLevel: RUnderstanding R(
Comprehension)
MSC:R ClientRNeeds: RSafeRand REffectiveRCareREnvironment: RManagement Rof RCare
12. TheRnursing Rprocess Ris R aRsequential Rmethod Rof Rproblem Rsolving Rthat R nurses RuseRand Rincludes Rwhich Rsteps?
a. Assessment, Rtreatment, Rplanning, Revaluation, Rdischarge, RandRfollow-up
b. Admission, Rassessment, R diagnosis, Rtreatment, R and RdischargeRplanning
c. Admission,R diagnosis,R treatment, R evaluation, R andR dischargeR planning
d. Assessment, Rdiagnosis, Routcome Ridentification, Rplanning, Rimplementation, Rand R
evaluationR ANS: RD
TheR nursingR process Ris R aR method R of R problem Rsolving RthatRincludes R assessment, R diagnosis, R o
utcomeR identification, Rplanning, Rimplementation, Rand Revaluation. RDIF:RCognitive RLevel: RUnderstan
ding R(Comprehension) R MSC:RClient RNeeds: RSafeR andR EffectiveRCareR Environment: R Managemen
tR of RCare
13. ARnewlyR admitted RpatientRis RinRacuteRpain,R has R not Rbeen Rsleeping R well Rlately, R an
dRis Rhaving RdifficultyR breathing. RHow RshouldRtheRnurseRprioritizeRtheseR problems?
a. Breathing, R pain,R andR sleep
b. Breathing, R sleep,R andR pain
c. Sleep,R breathing,R andR pain
TestRBank R- RPhysicalRExamination Rand RHealthRAssessment R 8eR(byRJarvis) R6
d. Sleep,Rpain,R andRbreat
hingR ANS: RA
First-levelR priorityR problemsR areR immediateR priorities,R rememberingR theR ABCsR (airway,R breathing,R and
circulation), Rfollowed RbyRsecond-level Rproblems, R and Rthen Rthird-
level Rproblems. RDIF: RCognitiveRLevel: RAnalyzing R(Analysis) R MSC:R ClientR Needs:RSafeR and REffectiveR Car
eREnvironment: R Management R of RCare
14. WhichRof RtheseRwouldR beRformulatedRbyR aR nurseRusing Rdiagnostic Rreasoning?
a. NursingR diagnosis
b. MedicalRdiagnosis
c. Diagnostic Rhypothesis
d. Diagnostic Rassessme
ntR ANS: RC
Diagnostic RreasoningRcalls Rfor RtheRnurseRtoRformulateR a Rdiagnostic Rhypothesis; RtheRnursingRproc
ess Rcalls Rfor R aR nursingRdiagnosis. RDIF:RCognitiveR Level:RUnderstanding R(Comprehension)
MSC:R ClientRNeeds:RGeneral
15. BarriersR toRincorporatingR EBP R include:
a. Nurses Rlack R of Rresearch Rskills RinR evaluating RtheRqualityR of RresearchRstudies.
b. LackRof Rsignificant Rresearch Rstudies.
c. Insufficient R clinicalRskills R of R nurses.
d. InadequateRphysical Rassessment Rs
kills. R ANS: RA
As Rindividuals, R nurses Rlack Rresearch Rskills Rin Revaluating RtheRqualityR of RresearchRstudies, R areRis
olated Rfrom R other R colleagues R whoR areRknowledgeableRin Rresearch, R and RoftenRlack RtheRtimeRto
RvisitRtheRlibraryRtoRread Rresearch. RTheR other Rresponses R areRnot Rconsidered Rbarriers.RDIF:R C
ognitiveR Level: R Understanding R(Comprehension)
MSC:R ClientRNeeds:RGeneral
16. WhatRstep Rof RtheRnursing Rprocess Rincludes RdataRcollection RbyR health Rhistory, Rphysical R
examination, RandR interview?
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M RPhysicalRExaminationRandRHealthRAssessmentR8eR(byRJarvis)R1R…
TestRBank R- RPhysicalRExamination Rand RHealthRAssessment R 8eR(byRJarvis) R7
a. Planning
b. Diagnosis
c. Evaluation
d. Assessment
R ANS: RD
DataRcollection, Rincluding Rperforming RtheRhealth Rhistory, RphysicalRexamination, Rand Rinterview, Ris RtheRassessment
step Rof RtheRnursing Rprocess. R DIF: RCognitiveRLevel: RRemembering R(
Knowledge) R MSC:RClientR Needs: RGeneral
17. DuringR aRstaff Rmeeting, Rnurses Rdiscuss RtheR problems R withR accessing RresearchRstudies R
toRincorporateR evidence-
based RclinicalRdecisionRmakingRintoRtheir Rpractice. RW hichRsuggestion RbyRtheRnurseRmanager
RwouldR best R helpRtheseRproblems?
a. FormR aRcommitteeRtoRconduct Rresearch Rstudies.
b. PostRpublished Rresearch Rstudies Ron RtheRunits Rbulletin Rboards.
c. EncourageRtheRnurses RtoRvisit RtheRlibraryR toRreview Rstudies.
d. Teach RtheRnurses Rhow RtoRconduct R electronic Rsearches Rfor Rrese
arch Rstudies. R ANS: RD
Facilitating RsupportRfor REBP R would RincludeRteaching RtheRnurses R how RtoRconduct R electronic Rs
earches; RtimeRtoR visitRtheRlibraryR mayR not RbeRavailableRfor R manyRnurses. RActuallyRconductin
gRresearchRstudies R mayR beRhelpful Rin
theRlong-
run RbutRnot R an RimmediateRsolution RtoRreviewing Rexisting Rresearch. RDIF:R CognitiveRLevel: RApplyingR(Appli
cation) R MSC:R ClientR Needs:RSafeR and REffectiveR CareR Environment: R Management R of RCare
18. When Rreviewing RtheRconcepts R of Rhealth, RtheRnurseRrecalls RthatRtheRcomponents R of Rholi
stic Rhealth RincludeR whichR of Rthese?
a. DiseaseRoriginates Rfrom RtheRexternal Renvironment.
b. TheRindividual RhumanRis RaRclosed Rsystem.
c. Nurses R areRresponsibleRfor RaRpatients R healthRstate.
TestRBank R- RPhysicalRExamination Rand RHealthRAssessment R 8eR(byRJarvis) R8
d. Holistic Rhealth Rviews RtheRmind, Rbody,R and Rspirit Ras Rinte
rdependent. R ANS: RD
Consideration Rof RtheRwholeRperson Ris RtheRessenceRof R holistic Rhealth, R whichRviews RtheRmind,Rbody, R and Rspirit R as
interdependent. RTheRbasis R of Rdisease Roriginates Rfrom R bothRtheRexternalRenvironment R and Rfrom R withinRtheRperson.RBothRtheRin
dividualRhuman Rand RtheR external Renvironment RareRopen Rsystems, RcontinuallyRchanging Rand Radapting, R and Reach Rperson Ris Rres
ponsibleRfor Rhis Ror Rher Rown Rpersonal Rhealth Rstate. R DIF:RCognitiveRLevel: RUnderstanding R(Comprehension)
MSC:R ClientRNeeds: RSafeRand REffectiveRCareREnvironment: RManagement Rof RCare
19. TheRnurseRrecognizes RthatRtheRconcept Rof Rprevention Rin RdescribingRhealthRis R essentialRbecause:
a. DiseaseRcan RbeRprevented RbyRtreating RtheRexternal R environment.
b. TheRmajorityR of Rdeaths Ramong RAmericans Runder RageR65 Ryears RareRnot Rpreventable.
c. Prevention Rplaces RtheRemphasis Ron RtheRlinkR between Rhealth Rand Rpersonal Rbehavior.
d. TheRmeans RtoRprevention Ris Rthrough Rtreatment Rprovided RbyRprimaryRhealthRcar
eRpractitioners. R ANS:RC
ARnatural Rprogression RtoRprevention Rrounds RoutRtheRpresent Rconcept Rof Rhealth. RGuidelines RtoRprevention Rplace
theRemphasis Ron RtheRlink Rbetween RhealthRand Rpersonal Rbehavior. RDIF: RCognitive RLevel: RUnderstanding R(
Comprehension) R MSC:RClientRNeeds: RGeneral
20. TheRnurseRis Rperforming RaRphysical R assessment R onRaR newlyR admitted Rpatient. R An Rex
ampleRof R objectiveR information R obtained Rduring RtheRphysical R assessment R includes Rthe:
a. Patients R historyR of R allergies.
b. Patients RuseR of Rmedications R at Rhome.
c. LastRmenstrual Rperiod R1 Rmonth Rago.
d. 2 R5Rcm Rscar Ron RtheRright Rlower
Rforearm.R ANS: RD
ObjectiveRdataRareRtheRpatients Rrecord, RlaboratoryRstudies, R and Rcondition RthatRtheRhealth Rprofess
ional Robserves RbyR inspecting, Rpercussing, R palpating, Rand Rauscultating RduringRtheRphysicalR exami
nation. RTheRother Rresponses Rreflect R subjectiveR data. RDIF:RCognitiveR Level: R Applying R(Application)
TestR BankR-
RPhysical RExamination R and RHealth RAssessment R 8eR(byR Jarvis)R9R
MSC:RClientRNeeds:RSafeRandREffectiveRCareREnvironment: RManagem
entRof RCare
21. ARvisiting RnurseRis R makingRan Rinitial RhomeRvisit R for R aRpatient R whoRhas R manyRchronic R medical Rproblems. RW hich RtypeRof R d
ataR baseRis R most R appropriateR toRcollect RinRthis Rsetting?
a. ARfollow-up RdataRbaseRtoRevaluate Rchanges RatRappropriateRintervals
b. An Repisodic RdataRbaseRbecause Rof RtheRcontinuing, RcomplexR medicalRproblems R of Rthis R patient
c. ARcompleteRhealthRdataRbaseRbecauseRof RtheRnurses RprimaryRresponsibility Rfor
RmonitoringRtheR patients Rhealth
d. An RemergencyR dataRbaseR becauseRof RtheRneed RtoRcollect RinformationRand RmakeRac
curateR diagnoses R rapidly
ANS:RC
TheRcompleteRdataRbaseRis Rcollected RinRaR primaryRcare Rsetting, RsuchRas R aRpediatric R or Rfam
ilyRpracticeRclinic, R independent R or R groupR privateRpractice, RcollegeRhealth Rservice, R womens Rhea
lthRcareRagency, R visitingRnurseR agency,R or RcommunityR health R agency.RIn RtheseRsettings, Rthe
RnurseRis RtheRfirstRhealth Rprofessional RtoRseeRthe
patient RandRhas RtheRprimaryRresponsibility Rfor Rmonitoring RtheRpersons Rhealth Rcare. RDIF:RCognitiveRLevel: RApplyingR(Application)
MSC:R ClientRNeeds: RSafeRand REffectiveRCareREnvironment: RManagement Rof RCare
22. WhichRsituation Ris Rmost Rappropriate Rduring Rwhich RtheRnurseRperforms R aRfocused Ror R
problem-centered R history?
a. PatientR is R admitted RtoRaRlong-term RcareRfacility.
b. PatientR has RaRsuddenRand RsevereRshortness R of Rbreath.
c. Patient Ris R admitted RtoRtheRhospital Rfor RsurgeryRtheRfollowing Rday.
d. PatientRin Ran Routpatient Rclinic Rhas Rcold Rand Rinfluenza-
likeRsymptoms. R ANS: RD
InRaRfocusedR or Rproblem-
centered RdataRbase, RtheRnurse Rcollects R aRmini RdataR base,R which Ris Rsmaller Rin RscopeRthan R t
heRcompletedRdataRbase. RThis R miniRdataRbaseRprimarily Rconcerns R oneR problem, R oneRcueRcom
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M RPhysical
plex, R or R oneR bodyR system. RExamination
RDIF:R Cognitive RLevel: RApplyingRRandRHealthRAssessmentR8eR(byRJarvis)R1R…
(Application)
MSC:R ClientRNeeds: RSafeRand REffectiveRCareREnvironment: RManagement Rof RCare
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M RPhysicalRExaminationRandRHealthRAssessmentR8eR(byRJarvis)R1R…
TestRBank R-
RPhysicalRExaminationRand RHealthRAssessmentR 8eR(byRJarvis)R1 R
Chapter R 01:R Evidence-Based RAssessment
MULTIPLER CHOICE
1. After RcompletingRan RinitialRassessment R of R aRpatient, RtheRnurseRhas Rcharted Rthat Rhis Rrespiratio
ns R areR eupneic R and R his RpulseRis R 58 Rbeats Rper R minute. RTheseRtypes R of RdataR wouldR be:
a. Objective.
b. Reflective.
c. Subjective.
d. Introspective.
R ANS: RA
ObjectiveRdataRareRwhatRtheRhealth Rprofessional Robserves RbyRinspecting, Rpercussing, R palpating, R a
nd Rauscultating R during RtheR physical Rexamination. R SubjectiveR dataRis R what RtheRperson Rsays R abo
utRhim R or R herself Rduring Rhistory
taking. RTheRterms RreflectiveR andRintrospective R areRnotR used RtoRdescribeR data.RDIF:RCognitiveRLevel: RUnderstandi
ngR(Comprehension) R MSC:RClient R Needs:RSafeR andR EffectiveRCareR Environment: R Management R of RCare
2. ARpatientRtells R theR nurseRthat RheRis R veryR nervous, Ris R nauseated, R andRfeels R hot.R TheseRtypes R of RdataR wouldR be:
a. Objective.
b. Reflective.
c. Subjective.
d. Introspective.
R ANS: RC
SubjectiveRdataR areR whatRtheRpersonRsays R aboutR him R or Rherself RduringR historyRtaking. RObjectiv
eRdataR areR whatRtheR health Rprofessional Robserves R byR inspecting, Rpercussing, Rpalpating, R and Ra
uscultating Rduring RtheRphysical
examination. RTheRterms Rreflective R and Rintrospective RareRnotR used RtoRdescribeRdata. RDIF:R CognitiveRLevel: R Understanding
R(Comprehension) R MSC:R ClientR Needs:RSafeR and REffectiveR CareREnvironment: R Management R of RCare
3. TheRpatients Rrecord,RlaboratoryRstudies, RobjectiveRdata,R and RsubjectiveRdataRcombineRtoRformRthe:
a. DataR base.
b. AdmittingRdata.
TestRBank R- RPhysicalRExamination Rand RHealthRAssessment R 8eR(byRJarvis) R2
c. FinancialR statement.
d. DischargeRsummary
.R ANS: RA
Together R with RtheRpatients Rrecord RandRlaboratoryRstudies, RtheRobjectiveRand RsubjectiveRdataRformRtheRdataRbase. RTheRother Rit
ems R areRnotR partR of RtheR patients Rrecord, RlaboratoryRstudies, R or Rdata.RDIF:RCognitiveR Level: R Remembering R(Knowledge)
MSC:R ClientRNeeds: RSafeRand REffectiveRCareREnvironment: RManagement Rof RCare
4. When Rlistening RtoR aRpatients R breath Rsounds, RtheRnurseRis RunsureRof R aRsoundRthat Ris Rh
eard.RTheR nurses RnextR action Rshould RbeRto:
a. ImmediatelyRnotifyR theRpatients R physician.
b. Document RtheRsound R exactlyR as RitR was Rheard.
c. ValidateRtheRdataR byR asking R aRcoworker RtoRlisten RtoRtheRbreath Rsounds.
d. Assess RagainRin R20R minutes RtoRnoteR whether RtheRsoundRi
s RstillRpresent.R ANS: RC
When RunsureRof R aRsoundRheard RwhileRlistening RtoRaRpatients RbreathRsounds, R theRnurseR validates RtheRdataRtoR ensure
accuracy. RIf RtheRnurseRhas Rless R experienceRin Ran Rarea, Rthen RheRor RsheRasks R an RexpertRtoRlisten. RDIF: RCognitive RL
evel: RAnalyzing R(Analysis) R MSC: R ClientR Needs:RSafeR andREffectiveRCareR Environment: R Management R of RCare
5. TheR nurseRis Rconducting RaRclass Rfor Rnew R graduateRnurses. RDuringRtheRteaching Rsession, Rthe
RnurseRshould Rkeep R in RmindRthatR noviceRnurses,R withoutR aRbackgroundRof Rskills R and Rexperien
ceRfrom R whichRtoRdraw, R areRmoreRlikely
toRmakeRtheir Rdecisions R using:
a. Intuition.
b. ARsetR of R rules.
c. Articles R inRjournals.
d. AdviceRfrom Rsuperviso
rs.R ANS: RB
NoviceRnurses R operateRfrom R aRsetR of R defined, RstructuredRrules.RTheRexpert Rpractitioner Ruses RintuitiveRlinks. RDIF:RCognitiveRLe
vel:RUnderstanding R (Comprehension)
TestRBank R-
RPhysicalRExaminationRand RHealthRAssessmentR 8eR(byRJarvis)R3 R
MSC:RClientRNeeds: RGeneral
6. Expert Rnurses Rlearn RtoR attend RtoRaR pattern Rof R assessment R dataR and R actR without Rconsciousl
yRlabeling Rit.RTheseR responses R areRreferredRtoR as:
a. Intuition.
b. TheR nursingR process.
c. Clinical Rknowledge.
d. DiagnosticRreasoning
.R ANS: RA
IntuitionRis Rcharacterized RbyR pattern Rrecognitionexpert Rnurses Rlearn RtoR attend RtoRaRpattern Rof R assessment RdataR and
actR without RconsciouslyRlabeling Rit.RTheRother Roptions R areRnotRcorrect.RDIF: RCognitiveRLevel: RUnderstanding R(
Comprehension) R MSC:RClientRNeeds: RGeneral
7. TheRnurseRis Rreviewing Rinformation Rabout Revidence-based RpracticeR(EBP). RW hichRstatement R bestRreflects
EBP?
a. EBP Rrelies R onRtradition Rfor Rsupport R of RbestRpractices.
b. EBPRis RsimplyRtheR useR of R bestR practiceRtechniques Rfor RtheRtreatment R of Rpatients.
c. EBPR emphasizes RtheRuseR of RbestR evidenceR withRtheRclinicians R experience.
d. TheRpatients Rown Rpreferences RareRnot Rimportant R
with REBP.R ANS: RC
EBPRis R aRsystematic R approach RtoR practiceRthatR emphasizes RtheRuseRof RbestR evidenceRinRcom
binationRwith RtheR clinicians R experience, R as R wellR as R patientR preferences R and R values, R when Rmaki
ngRdecisions R aboutRcareRand R treatment. REBP Ris R moreRthanRsimplyR usingRtheRbestR practiceRte
chniques RtoRtreat Rpatients, R and Rquestioning
traditionRis Rimportant R whenRnoRcompelling Rand Rsupportive RresearchR evidence Rexists. RDIF:RCognitiveRLevel: RAp
plying R(Application) R MSC:R Client RNeeds:RSafeR and REffectiveRCareR Environment: R Management R of RCare
8. TheR nurseRis Rconducting RaRclass R on RpriorityRsetting Rfor RaR groupR of Rnew R graduateR nurses.
RW hichRis R anR exampleR of R aRfirst-level RpriorityRproblem?
about:blank 1/170
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M RPhysicalRExaminationRandRHealthRAssessmentR8eR(byRJarvis)R1R…
a. Patient RwithRpostoperative Rpain
b. NewlyRdiagnosed R patient R with Rdiabetes R whoRneeds Rdiabetic Rt
eachingR TestRBankR-
RPhysicalRExamination RandRHealthRAssessmentR 8eR(byRJarvis)R4
c. IndividualRwith RaRsmallRlaceration RonRtheRsoleRof R theRfoot
d. Individual Rwith Rshortness Rof Rbreath Rand Rrespiratory
Rdistress R ANS: RD
First-level RpriorityRproblems RareRthoseRthatRareRemergent, RlifeRthreatening, R and RimmediateR(e.g.,R establishing Ran
airway, Rsupporting Rbreathing, Rmaintaining Rcirculation, Rmonitoring Rabnormal Rvital Rsigns). RDIF:RCognitiveRLevel: RUnderstanding R(Co
mprehension) R MSC:R ClientR Needs: RSafeR and REffectiveR CareR Environment: R Management R of RCare
9. When Rconsidering RpriorityRsetting Rof Rproblems, RtheRnurseRkeeps RinRmind Rthat Rsecond-
level RpriorityRproblems R includeR which R of RtheseR aspects?
a. Low Rself-esteem
b. Lack R of R knowledge
c. AbnormalRlaboratoryR values
d. SeverelyRabnormal Rvital Rs
igns R ANS: RC
Second-
level RpriorityR problems R areRthose RthatRrequireRpromptRintervention RtoRforestall Rfurther Rdeterioration R(e.g.,R mental Rstatus Rchange, R
acuteRpain,R abnormal RlaboratoryR values, Rrisks RtoRsafetyR or Rsecurity). RDIF: RCognitiveR Level: RUnderstanding R(Comprehension)
MSC:R ClientRNeeds: RSafeRand REffectiveRCareREnvironment: RManagement Rof RCare
10. WhichRcritical Rthinking RskillRhelps R theRnurseRseeRrelationships Ramong RtheRdata?
a. Validation
b. ClusteringR relatedR cues
c. Identifying Rgaps R in Rdata
d. DistinguishingRrelevantRfromRirrelev
antR ANS: RB
Clustering Rrelated Rcues Rhelps RtheRnurseRseeRrelationships RamongRtheRdata. R DIF:RCognitiveRLevel: RUnderstanding
R(Comprehension) R MSC:RClientRNeeds:R SafeR and REffectiveR CareREnvironment: R Management R of RCare
TestRBank R- RPhysicalRExamination Rand RHealthRAssessment R 8eR(byRJarvis) R5
11. TheRnurseRknows RthatRdeveloping RappropriateRnursing Rinterventions Rfor RaRpatien
tRrelies Ron RtheR appropriateness R of RtheR diagnosis.
a. Nursing
b. Medical
c. Admission
d. Collaborative
R ANS: RA
An RaccurateRnursing Rdiagnosis R provides RtheRbasis Rfor RtheRselectionRof Rnursing Rinterventions Rto
RachieveR outcomes R for Rwhich RtheRnurseRis R accountable. RTheRother Ritems RdoRnot RcontributeRt
oRtheRdevelopment R of R appropriate Rnursing R interventions. RDIF:R CognitiveRLevel: RUnderstanding R(
Comprehension)
MSC:R ClientRNeeds: RSafeRand REffectiveRCareREnvironment: RManagement Rof RCare
12. TheRnursing Rprocess Ris R aRsequential Rmethod Rof Rproblem Rsolving Rthat R nurses RuseRand Rincludes Rwhich Rsteps?
a. Assessment, Rtreatment, Rplanning, Revaluation, Rdischarge, RandRfollow-up
b. Admission, Rassessment, R diagnosis, Rtreatment, R and RdischargeRplanning
c. Admission,R diagnosis,R treatment, R evaluation, R andR dischargeR planning
d. Assessment, Rdiagnosis, Routcome Ridentification, Rplanning, Rimplementation, Rand R
evaluationR ANS: RD
TheR nursingR process Ris R aR method R of R problem Rsolving RthatRincludes R assessment, R diagnosis, R o
utcomeR identification, Rplanning, Rimplementation, Rand Revaluation. RDIF:RCognitive RLevel: RUnderstan
ding R(Comprehension) R MSC:RClient RNeeds: RSafeR andR EffectiveRCareR Environment: R Managemen
tR of RCare
13. ARnewlyR admitted RpatientRis RinRacuteRpain,R has R not Rbeen Rsleeping R well Rlately, R an
dRis Rhaving RdifficultyR breathing. RHow RshouldRtheRnurseRprioritizeRtheseR problems?
a. Breathing, R pain,R andR sleep
b. Breathing, R sleep,R andR pain
c. Sleep,R breathing,R andR pain
TestRBank R- RPhysicalRExamination Rand RHealthRAssessment R 8eR(byRJarvis) R6
d. Sleep,Rpain,R andRbreat
hingR ANS: RA
First-levelR priorityR problemsR areR immediateR priorities,R rememberingR theR ABCsR (airway,R breathing,R and
circulation), Rfollowed RbyRsecond-level Rproblems, R and Rthen Rthird-
level Rproblems. RDIF: RCognitiveRLevel: RAnalyzing R(Analysis) R MSC:R ClientR Needs:RSafeR and REffectiveR Car
eREnvironment: R Management R of RCare
14. WhichRof RtheseRwouldR beRformulatedRbyR aR nurseRusing Rdiagnostic Rreasoning?
a. NursingR diagnosis
b. MedicalRdiagnosis
c. Diagnostic Rhypothesis
d. Diagnostic Rassessme
ntR ANS: RC
Diagnostic RreasoningRcalls Rfor RtheRnurseRtoRformulateR a Rdiagnostic Rhypothesis; RtheRnursingRproc
ess Rcalls Rfor R aR nursingRdiagnosis. RDIF:RCognitiveR Level:RUnderstanding R(Comprehension)
MSC:R ClientRNeeds:RGeneral
15. BarriersR toRincorporatingR EBP R include:
a. Nurses Rlack R of Rresearch Rskills RinR evaluating RtheRqualityR of RresearchRstudies.
b. LackRof Rsignificant Rresearch Rstudies.
c. Insufficient R clinicalRskills R of R nurses.
d. InadequateRphysical Rassessment Rs
kills. R ANS: RA
As Rindividuals, R nurses Rlack Rresearch Rskills Rin Revaluating RtheRqualityR of RresearchRstudies, R areRis
olated Rfrom R other R colleagues R whoR areRknowledgeableRin Rresearch, R and RoftenRlack RtheRtimeRto
RvisitRtheRlibraryRtoRread Rresearch. RTheR other Rresponses R areRnot Rconsidered Rbarriers.RDIF:R C
ognitiveR Level: R Understanding R(Comprehension)
MSC:R ClientRNeeds:RGeneral
16. WhatRstep Rof RtheRnursing Rprocess Rincludes RdataRcollection RbyR health Rhistory, Rphysical R
examination, RandR interview?
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M RPhysicalRExaminationRandRHealthRAssessmentR8eR(byRJarvis)R1R…
TestRBank R- RPhysicalRExamination Rand RHealthRAssessment R 8eR(byRJarvis) R7
a. Planning
b. Diagnosis
c. Evaluation
d. Assessment
R ANS: RD
DataRcollection, Rincluding Rperforming RtheRhealth Rhistory, RphysicalRexamination, Rand Rinterview, Ris RtheRassessment
step Rof RtheRnursing Rprocess. R DIF: RCognitiveRLevel: RRemembering R(
Knowledge) R MSC:RClientR Needs: RGeneral
17. DuringR aRstaff Rmeeting, Rnurses Rdiscuss RtheR problems R withR accessing RresearchRstudies R
toRincorporateR evidence-
based RclinicalRdecisionRmakingRintoRtheir Rpractice. RW hichRsuggestion RbyRtheRnurseRmanager
RwouldR best R helpRtheseRproblems?
a. FormR aRcommitteeRtoRconduct Rresearch Rstudies.
b. PostRpublished Rresearch Rstudies Ron RtheRunits Rbulletin Rboards.
c. EncourageRtheRnurses RtoRvisit RtheRlibraryR toRreview Rstudies.
d. Teach RtheRnurses Rhow RtoRconduct R electronic Rsearches Rfor Rrese
arch Rstudies. R ANS: RD
Facilitating RsupportRfor REBP R would RincludeRteaching RtheRnurses R how RtoRconduct R electronic Rs
earches; RtimeRtoR visitRtheRlibraryR mayR not RbeRavailableRfor R manyRnurses. RActuallyRconductin
gRresearchRstudies R mayR beRhelpful Rin
theRlong-
run RbutRnot R an RimmediateRsolution RtoRreviewing Rexisting Rresearch. RDIF:R CognitiveRLevel: RApplyingR(Appli
cation) R MSC:R ClientR Needs:RSafeR and REffectiveR CareR Environment: R Management R of RCare
18. When Rreviewing RtheRconcepts R of Rhealth, RtheRnurseRrecalls RthatRtheRcomponents R of Rholi
stic Rhealth RincludeR whichR of Rthese?
a. DiseaseRoriginates Rfrom RtheRexternal Renvironment.
b. TheRindividual RhumanRis RaRclosed Rsystem.
c. Nurses R areRresponsibleRfor RaRpatients R healthRstate.
TestRBank R- RPhysicalRExamination Rand RHealthRAssessment R 8eR(byRJarvis) R8
d. Holistic Rhealth Rviews RtheRmind, Rbody,R and Rspirit Ras Rinte
rdependent. R ANS: RD
Consideration Rof RtheRwholeRperson Ris RtheRessenceRof R holistic Rhealth, R whichRviews RtheRmind,Rbody, R and Rspirit R as
interdependent. RTheRbasis R of Rdisease Roriginates Rfrom R bothRtheRexternalRenvironment R and Rfrom R withinRtheRperson.RBothRtheRin
dividualRhuman Rand RtheR external Renvironment RareRopen Rsystems, RcontinuallyRchanging Rand Radapting, R and Reach Rperson Ris Rres
ponsibleRfor Rhis Ror Rher Rown Rpersonal Rhealth Rstate. R DIF:RCognitiveRLevel: RUnderstanding R(Comprehension)
MSC:R ClientRNeeds: RSafeRand REffectiveRCareREnvironment: RManagement Rof RCare
19. TheRnurseRrecognizes RthatRtheRconcept Rof Rprevention Rin RdescribingRhealthRis R essentialRbecause:
a. DiseaseRcan RbeRprevented RbyRtreating RtheRexternal R environment.
b. TheRmajorityR of Rdeaths Ramong RAmericans Runder RageR65 Ryears RareRnot Rpreventable.
c. Prevention Rplaces RtheRemphasis Ron RtheRlinkR between Rhealth Rand Rpersonal Rbehavior.
d. TheRmeans RtoRprevention Ris Rthrough Rtreatment Rprovided RbyRprimaryRhealthRcar
eRpractitioners. R ANS:RC
ARnatural Rprogression RtoRprevention Rrounds RoutRtheRpresent Rconcept Rof Rhealth. RGuidelines RtoRprevention Rplace
theRemphasis Ron RtheRlink Rbetween RhealthRand Rpersonal Rbehavior. RDIF: RCognitive RLevel: RUnderstanding R(
Comprehension) R MSC:RClientRNeeds: RGeneral
20. TheRnurseRis Rperforming RaRphysical R assessment R onRaR newlyR admitted Rpatient. R An Rex
ampleRof R objectiveR information R obtained Rduring RtheRphysical R assessment R includes Rthe:
a. Patients R historyR of R allergies.
b. Patients RuseR of Rmedications R at Rhome.
c. LastRmenstrual Rperiod R1 Rmonth Rago.
d. 2 R5Rcm Rscar Ron RtheRright Rlower
Rforearm.R ANS: RD
ObjectiveRdataRareRtheRpatients Rrecord, RlaboratoryRstudies, R and Rcondition RthatRtheRhealth Rprofess
ional Robserves RbyR inspecting, Rpercussing, R palpating, Rand Rauscultating RduringRtheRphysicalR exami
nation. RTheRother Rresponses Rreflect R subjectiveR data. RDIF:RCognitiveR Level: R Applying R(Application)
TestR BankR-
RPhysical RExamination R and RHealth RAssessment R 8eR(byR Jarvis)R9R
MSC:RClientRNeeds:RSafeRandREffectiveRCareREnvironment: RManagem
entRof RCare
21. ARvisiting RnurseRis R makingRan Rinitial RhomeRvisit R for R aRpatient R whoRhas R manyRchronic R medical Rproblems. RW hich RtypeRof R d
ataR baseRis R most R appropriateR toRcollect RinRthis Rsetting?
a. ARfollow-up RdataRbaseRtoRevaluate Rchanges RatRappropriateRintervals
b. An Repisodic RdataRbaseRbecause Rof RtheRcontinuing, RcomplexR medicalRproblems R of Rthis R patient
c. ARcompleteRhealthRdataRbaseRbecauseRof RtheRnurses RprimaryRresponsibility Rfor
RmonitoringRtheR patients Rhealth
d. An RemergencyR dataRbaseR becauseRof RtheRneed RtoRcollect RinformationRand RmakeRac
curateR diagnoses R rapidly
ANS:RC
TheRcompleteRdataRbaseRis Rcollected RinRaR primaryRcare Rsetting, RsuchRas R aRpediatric R or Rfam
ilyRpracticeRclinic, R independent R or R groupR privateRpractice, RcollegeRhealth Rservice, R womens Rhea
lthRcareRagency, R visitingRnurseR agency,R or RcommunityR health R agency.RIn RtheseRsettings, Rthe
RnurseRis RtheRfirstRhealth Rprofessional RtoRseeRthe
patient RandRhas RtheRprimaryRresponsibility Rfor Rmonitoring RtheRpersons Rhealth Rcare. RDIF:RCognitiveRLevel: RApplyingR(Application)
MSC:R ClientRNeeds: RSafeRand REffectiveRCareREnvironment: RManagement Rof RCare
22. WhichRsituation Ris Rmost Rappropriate Rduring Rwhich RtheRnurseRperforms R aRfocused Ror R
problem-centered R history?
a. PatientR is R admitted RtoRaRlong-term RcareRfacility.
b. PatientR has RaRsuddenRand RsevereRshortness R of Rbreath.
c. Patient Ris R admitted RtoRtheRhospital Rfor RsurgeryRtheRfollowing Rday.
d. PatientRin Ran Routpatient Rclinic Rhas Rcold Rand Rinfluenza-
likeRsymptoms. R ANS: RD
InRaRfocusedR or Rproblem-
centered RdataRbase, RtheRnurse Rcollects R aRmini RdataR base,R which Ris Rsmaller Rin RscopeRthan R t
heRcompletedRdataRbase. RThis R miniRdataRbaseRprimarily Rconcerns R oneR problem, R oneRcueRcom
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M RPhysical
plex, R or R oneR bodyR system. RExamination
RDIF:R Cognitive RLevel: RApplyingRRandRHealthRAssessmentR8eR(byRJarvis)R1R…
(Application)
MSC:R ClientRNeeds: RSafeRand REffectiveRCareREnvironment: RManagement Rof RCare
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