Bates 13th Edition
Study online at https://quizlet.com/_e0glxu
1. REF: p. 741
MSC: Client Needs: Health Promotion and Maintenance
13. A 50-year-old woman calls the clinic because she has noticed some
changes in her body and breasts and wonders if these changes could be
attributable to the hormone replacement therapy (HRT) she started 3 months
earlier. The nurse should tell her:
a HRT is at such a low dose that side effects are very unusual.
b HRT has several side effects, including fluid retention, breast tenderness,
and vaginal bleeding.
c Vaginal bleeding: ANS: B
Side effects of HRT include fluid retention, breast pain, and vaginal bleeding. The
other responses are not correct.
2. CHAPTER 1 Foundations for Clinical Proficiency
1. After completing an initial assessment of a patient, the nurse has charted
that his respirations are eupneic and his pulse is 58 beats per minute. These
types of data would be:
a. Objective.
b. Reflective.
c. Subjective.
d. Introspective.: ANS: A
Objective data are what the health professional observes by inspecting, percussing,
palpating,
and auscultating during the physical examination. Subjective data is what the person
says about
him or herself during history taking. The terms reflective and introspective are not
used to
describe data.
3. 2. A patient tells the nurse that he is very nervous, is nauseated, and feels
hot. These types of
data would be:
a. Objective.
b. Reflective.
c. Subjective.
d. Introspective.: ANS: C
Subjective data are what the person says about him or herself during history taking.
Objective
data are what the health professional observes by inspecting, percussing, palpating,
and
, Bates 13th Edition
Study online at https://quizlet.com/_e0glxu
auscultating during the physical examination. The terms reflective and introspective
are not used
to describe data.
4. 3. The patients record, laboratory studies, objective data, and subjective
data combine to form
the:
a. Data base.
b. Admitting data.
c. Financial statement.
d. Discharge summary.: ANS: A
Together with the patients record and laboratory studies, the objective and subjective
data form
the data base. The other items are not part of the patients record, laboratory studies,
or data.
5. 4. When listening to a patients breath sounds, the nurse is unsure of a sound
that is heard. The
nurses next action should be to:
a. Immediately notify the patients physician.
b. Document the sound exactly as it was heard.
c. Validate the data by asking a coworker to listen to the breath sounds.
d. Assess again in 20 minutes to note whether the sound is still present.: ANS:
C
When unsure of a sound heard while listening to a patients breath sounds, the nurse
validates the
data to ensure accuracy. If the nurse has less experience in an area, then he or she
asks an expert
to listen.
6. 5. The nurse is conducting a class for new graduate nurses. During the
teaching session, the
nurse should keep in mind that novice nurses, without a background of skills
and experience
from which to draw, are more likely to make their decisions using:
a Intuition.
b A set of rules.
c Articles in journals.
d Advice from supervisors.: ANS: B
Novice nurses operate from a set of defined, structured rules. The expert practitioner
uses
intuitive links.
, Bates 13th Edition
Study online at https://quizlet.com/_e0glxu
7. 6. Expert nurses learn to attend to a pattern of assessment data and act
without consciously labeling it. These responses are referred to as:
a Intuition.
b The nursing process.
c Clinical knowledge.
d Diagnostic reasoning.: ANS: A
Intuition is characterized by pattern recognition expert nurses learn to attend to a
pattern of assessment data and act without consciously labeling it. The other options
are not correct.
8. 7. The nurse is reviewing information about evidence-based practice (EBP).
Which statement
best reflects EBP?
a EBP relies on tradition for support of best practices.
b EBP is simply the use of best practice techniques for the treatment of
patients.
c EBP emphasizes the use of best evidence with the clinicians experience.
d The patients own preferences are not important with EBP.: ANS: C
EBP is a systematic approach to practice that emphasizes the use of best evidence
in combination
with the clinicians experience, as well as patient preferences and values, when
making decisions
about care and treatment. EBP is more than simply using the best practice tech-
niques to treat
patients, and questioning tradition is important when no compelling and supportive
research
evidence exists.
9. 8. The nurse is conducting a class on priority setting for a group of new
graduate nurses. Which is an example of a first-level priority problem?
a Patient with postoperative pain
b Newly diagnosed patient with diabetes who needs diabetic teaching
c Individual with a small laceration on the sole of the foot
d Individual with shortness of breath and respiratory distress: ANS: D
First-level priority problems are those that are emergent, life threatening, and imme-
diate (e.g.,
establishing an airway, supporting breathing, maintaining circulation, monitoring
abnormal vital
signs) (see Table 1-1).
10. 9. When considering priority setting of problems, the nurse keeps in mind
that second-level priority problems include which of these aspects?
, Bates 13th Edition
Study online at https://quizlet.com/_e0glxu
a Low self-esteem
b Lack of knowledge
c Abnormal laboratory values
d Severely abnormal vital signs: ANS: C
Second-level priority problems are those that require prompt intervention to forestall
further
deterioration (e.g., mental status change, acute pain, abnormal laboratory values,
risks to safety
or security) (see Table 1-1).
11. 10. Which critical thinking skill helps the nurse see relationships among
the data?
a Validation
b Clustering related cues
c Identifying gaps in data
d Distinguishing relevant from irrelevant: ANS: B
Clustering related cues helps the nurse see relationships among the data.
12. 11. The nurse knows that developing appropriate nursing interventions for
a patient relies on the appropriateness of the diagnosis.
a Nursing
b Medical
c Admission
d Collaborative: ANS: A
An accurate nursing diagnosis provides the basis for the selection of nursing inter-
ventions to achieve outcomes for which the nurse is accountable. The other items
do not contribute to the development of appropriate nursing interventions.
13. 12. The nursing process is a sequential method of problem solving that
nurses use and includes which steps?
a Assessment, treatment, planning, evaluation, discharge, and follow-up
b Admission, assessment, diagnosis, treatment, and discharge planning
c Admission, diagnosis, treatment, evaluation, and discharge planning
d Assessment, diagnosis, outcome identification, planning, implementation,
and evaluation: ANS: D
The nursing process is a method of problem solving that includes assessment,
diagnosis, outcome identification, planning, implementation, and evaluation.
14. 13. A newly admitted patient is in acute pain, has not been sleeping well
lately, and is having difficulty breathing. How should the nurse prioritize these
problems?
a Breathing, pain, and sleep
b Breathing, sleep, and pain
Study online at https://quizlet.com/_e0glxu
1. REF: p. 741
MSC: Client Needs: Health Promotion and Maintenance
13. A 50-year-old woman calls the clinic because she has noticed some
changes in her body and breasts and wonders if these changes could be
attributable to the hormone replacement therapy (HRT) she started 3 months
earlier. The nurse should tell her:
a HRT is at such a low dose that side effects are very unusual.
b HRT has several side effects, including fluid retention, breast tenderness,
and vaginal bleeding.
c Vaginal bleeding: ANS: B
Side effects of HRT include fluid retention, breast pain, and vaginal bleeding. The
other responses are not correct.
2. CHAPTER 1 Foundations for Clinical Proficiency
1. After completing an initial assessment of a patient, the nurse has charted
that his respirations are eupneic and his pulse is 58 beats per minute. These
types of data would be:
a. Objective.
b. Reflective.
c. Subjective.
d. Introspective.: ANS: A
Objective data are what the health professional observes by inspecting, percussing,
palpating,
and auscultating during the physical examination. Subjective data is what the person
says about
him or herself during history taking. The terms reflective and introspective are not
used to
describe data.
3. 2. A patient tells the nurse that he is very nervous, is nauseated, and feels
hot. These types of
data would be:
a. Objective.
b. Reflective.
c. Subjective.
d. Introspective.: ANS: C
Subjective data are what the person says about him or herself during history taking.
Objective
data are what the health professional observes by inspecting, percussing, palpating,
and
, Bates 13th Edition
Study online at https://quizlet.com/_e0glxu
auscultating during the physical examination. The terms reflective and introspective
are not used
to describe data.
4. 3. The patients record, laboratory studies, objective data, and subjective
data combine to form
the:
a. Data base.
b. Admitting data.
c. Financial statement.
d. Discharge summary.: ANS: A
Together with the patients record and laboratory studies, the objective and subjective
data form
the data base. The other items are not part of the patients record, laboratory studies,
or data.
5. 4. When listening to a patients breath sounds, the nurse is unsure of a sound
that is heard. The
nurses next action should be to:
a. Immediately notify the patients physician.
b. Document the sound exactly as it was heard.
c. Validate the data by asking a coworker to listen to the breath sounds.
d. Assess again in 20 minutes to note whether the sound is still present.: ANS:
C
When unsure of a sound heard while listening to a patients breath sounds, the nurse
validates the
data to ensure accuracy. If the nurse has less experience in an area, then he or she
asks an expert
to listen.
6. 5. The nurse is conducting a class for new graduate nurses. During the
teaching session, the
nurse should keep in mind that novice nurses, without a background of skills
and experience
from which to draw, are more likely to make their decisions using:
a Intuition.
b A set of rules.
c Articles in journals.
d Advice from supervisors.: ANS: B
Novice nurses operate from a set of defined, structured rules. The expert practitioner
uses
intuitive links.
, Bates 13th Edition
Study online at https://quizlet.com/_e0glxu
7. 6. Expert nurses learn to attend to a pattern of assessment data and act
without consciously labeling it. These responses are referred to as:
a Intuition.
b The nursing process.
c Clinical knowledge.
d Diagnostic reasoning.: ANS: A
Intuition is characterized by pattern recognition expert nurses learn to attend to a
pattern of assessment data and act without consciously labeling it. The other options
are not correct.
8. 7. The nurse is reviewing information about evidence-based practice (EBP).
Which statement
best reflects EBP?
a EBP relies on tradition for support of best practices.
b EBP is simply the use of best practice techniques for the treatment of
patients.
c EBP emphasizes the use of best evidence with the clinicians experience.
d The patients own preferences are not important with EBP.: ANS: C
EBP is a systematic approach to practice that emphasizes the use of best evidence
in combination
with the clinicians experience, as well as patient preferences and values, when
making decisions
about care and treatment. EBP is more than simply using the best practice tech-
niques to treat
patients, and questioning tradition is important when no compelling and supportive
research
evidence exists.
9. 8. The nurse is conducting a class on priority setting for a group of new
graduate nurses. Which is an example of a first-level priority problem?
a Patient with postoperative pain
b Newly diagnosed patient with diabetes who needs diabetic teaching
c Individual with a small laceration on the sole of the foot
d Individual with shortness of breath and respiratory distress: ANS: D
First-level priority problems are those that are emergent, life threatening, and imme-
diate (e.g.,
establishing an airway, supporting breathing, maintaining circulation, monitoring
abnormal vital
signs) (see Table 1-1).
10. 9. When considering priority setting of problems, the nurse keeps in mind
that second-level priority problems include which of these aspects?
, Bates 13th Edition
Study online at https://quizlet.com/_e0glxu
a Low self-esteem
b Lack of knowledge
c Abnormal laboratory values
d Severely abnormal vital signs: ANS: C
Second-level priority problems are those that require prompt intervention to forestall
further
deterioration (e.g., mental status change, acute pain, abnormal laboratory values,
risks to safety
or security) (see Table 1-1).
11. 10. Which critical thinking skill helps the nurse see relationships among
the data?
a Validation
b Clustering related cues
c Identifying gaps in data
d Distinguishing relevant from irrelevant: ANS: B
Clustering related cues helps the nurse see relationships among the data.
12. 11. The nurse knows that developing appropriate nursing interventions for
a patient relies on the appropriateness of the diagnosis.
a Nursing
b Medical
c Admission
d Collaborative: ANS: A
An accurate nursing diagnosis provides the basis for the selection of nursing inter-
ventions to achieve outcomes for which the nurse is accountable. The other items
do not contribute to the development of appropriate nursing interventions.
13. 12. The nursing process is a sequential method of problem solving that
nurses use and includes which steps?
a Assessment, treatment, planning, evaluation, discharge, and follow-up
b Admission, assessment, diagnosis, treatment, and discharge planning
c Admission, diagnosis, treatment, evaluation, and discharge planning
d Assessment, diagnosis, outcome identification, planning, implementation,
and evaluation: ANS: D
The nursing process is a method of problem solving that includes assessment,
diagnosis, outcome identification, planning, implementation, and evaluation.
14. 13. A newly admitted patient is in acute pain, has not been sleeping well
lately, and is having difficulty breathing. How should the nurse prioritize these
problems?
a Breathing, pain, and sleep
b Breathing, sleep, and pain
