Introduction to health assessment (module 1)

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?

Arrive at conclusions about the client's health

A client comes to the walk-in clinic with reports of abdominal pain and diarrhea. While taking the client's vital signs, the nurse is implementing which phase of the nursing process?

Assessment

The nurse is preparing to meet a client in the clinic for the first time. After reviewing the client's record, the nurse should?

Avoid premature judgements about the client

To arrive at a nursing diagnosis or a collaborative problem, the nurse goes through the step analysis of data. After proposing possible nursing diagnoses, the should the nurse do next?

Check for the presence of defining characteristics

When evaluating an elderly client's blood pressure (BP) of 140/80 mmHg, the nurse does which of the following before determining whether the BP is normal or represents hypertension?

Compare this reading against defined standards

When a client first enters the hospital for an elective surgical procedure, the nurse should perform what type of assessment?

Comprehensive

Although the assessment phase of the nursing process precedes the other phases, the assessment phase is?

Continous

Nurse Gina, is an EMT, she immediately identifies a distressed person and rapidly assesses her breathing status and blood circulation. She is performing a(n)?

Emergency Assessment

Nurse Romina, performed a physical exam to a student who was going through a routine check-up before the start of the school year. She is doing a(n)?

Focused or Problem-oriented Assessment

Following the Nursing Process, the result of a nursing assessment is the?

Formulation of a Nursing Diagnosis

A systematic, rational method of planning and providing individualized nursing care?

Nursing Process

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)?

Ongoing or Partial Assessment

Student Nurse Nico assisted in the recovery of patient Z.A. in the Male Medical Ward, he has been taking the patients vital signs every 30 mins. He is correct when he understands that he is doing a(n)?

Ongoing or Partial Assessment

When documenting clinical data, which of the following would you consider as physical assessment?

Patient has palpable lymph nodes on the neck

A medical examination differs from a comprehensive nursing examination in that the medical examination focuses primarily on the client's?

Physiological status

The nurse who documents on the client's care plan the outcome goal "Anxiety will be relieved within 20 to 40 minutes following administration of lorazepam (Ativan)" is engaged in which step of the nursing process?

Planning

To prepare for the assessment of a client visiting a neighborhood health care clinic, the nurse should first:

Review the client's health care record

The nurse is measuring the client's urine output and straining the urine to assess for stones. Which of the following should the nurse record as objective data?

The client's urine output was 450 mL

The nurse has documented the following outcome goal in the care plan: "The client will transfer from bed to chair with two-person assist." The charge nurse tells the nurse to add which of the following to complete the goal?

Target time

Nurse Karen, performed a physical exam to a student who was going through a routine check-up before the start of the school year. She is doing a(n)

Initial Comprehensive Assessment