MIDTERM QUIZZES

The nurse has assessed the breath sounds of an adult client. The best way for the nurse to document these findings on a client is to write "the client's lung sounds were clear on both sides." "bilateral lung sounds clear." "client's lung sounds were auscultated with stethoscope and were clear on both sides." "after listening to client's lung sounds, both lungs appeared clear."

"bilateral lung sounds clear."

Before beginning a comprehensive health assessment of an adult client, the nurse should explain to the client that the purpose of the assessment is to Validate the data collected Arrive at conclusions about the client's health Document any physical symptoms the client may have Contribute to the medical diagnosis

Arrive at conclusions about the client's health

To arrive at a nursing diagnosis or a collaborative problem, the nurse goes thru the steps of analysis of data. After proposing possible nursing diagnoses, the nurse should next Document conclusions Cluster the data collected Draw inferences and identify problems Check for the presence of defining characteristics

Check for the presence of defining characteristics

Greet the client calmly, by name and not with references such as honey, sugar, mommy. Attitude Demeanor Appearance Laundry list

Demeanor

An assessment of a client who already has a complete recorded database in the system and returns to the health care agency with a specific health concern is referred to as a(n) Initial comprehensive assessment Focused or problem-oriented assessment Ongoing or partial assessment Emergency assessment

Focused or problem-oriented assessment

The depth and scope of nursing assessment has expanded significantly over the past several decades primarily because of An increase in the number of nurse practitioners. The growing elderly population with chronic illness. An increase in the number of baccalaureate programs in nursing. Rapid advances in biomedical knowledge and technology.

Rapid advances in biomedical knowledge and technology.

"What is your major health problem or concern at this time?" This question is applicable in which of the following? Family health history Personal health history Reason for seeking health care History of Present health concern

Reason for seeking health care

Open-ended forms are a type of initial assessment documentation form. True False

True

The nurse is preparing to document assessment findings in a client's record. The nurse should record how the data were collected. avoid slang terms or labels unless they are direct quotes. use the term "normal" to describe non pathologic findings. write in complete sentences with few abbreviations.

avoid slang terms or labels unless they are direct quotes

When a client first enters the hospital for an elective surgical procedure, the nurse should perform an assessment termed as_____. comprehensive entry. focused. exploratory.

comprehensive

If the nurse makes an error while documenting findings on a client's record, the nurse should draw a line through the error and have it witnessed. erase the error and make the correction. draw a line through the error, writing "error" and initialing. obliterate the error and make the correction.

draw a line through the error, writing "error" and initialing

An assessment form commonly used in long-term care facilities is the nursing minimum data set. One primary advantage to this type of assessment form is that it clusters all the nursing and medical diagnoses in one place. allows for individualization for each client in the health care setting. uses a flowchart format for easy documentation of objective data. establishes comparability of nursing data across clinical populations.

establishes comparability of nursing data across clinical populations

The result of a nursing assessment is the client's physiologic status formulation of nursing diagnoses prescription of treatment. documentation of the need for a referral.

formulation of nursing diagnoses

One advantage for an institution to use an integrated cued/checklist type of assessment data form is that it allows a comprehensive and thorough picture of the client's symptoms. may be easily used by different levels of caregivers, which enhances communication. provides for easy and rapid documentation across clinical settings and populations. includes the 11 health care patterns in an easily readable format.

may be easily used by different levels of caregivers, which enhances communication

While recording the subjective data of an adult client who complains of pain in his lower back, the nurse should include the location of the pain and the client's caregiver. pain relief measures. cause of the pain. client's occupation.

pain relief measures

The nurse is recording admission data for an adult client using a cued or checklist type of assessment form. This type of assessment form established comparability of data across populations. covers all the data that a client may provide. clusters the assessment data with nursing diagnoses. prevents missed questions during data collection.

prevents missed questions during data collection

One disadvantage of the open-ended assessment form is that it does not allow for individualization. ask standardized questions. requires a lot of time to complete. does not provide a total picture of the client.

requires a lot of time to complete