Chapter 1 - Book Qs, Blocks, Key Concepts, Pre-Quiz

Question 1

The three major frameworks to organize assessment findings include the functional assessment based on Gordon’s functional patterns, the systematic ___________ assessment, and body systems assessment.

Answer 1

head-to-toe

Question 2

T / F Five nursing values are used by the nurse to guide professional roles.

Answer 2

TRUE

Question 3

T / F The purpose of the nurse performing the health assessment is to discover symptoms that support the medical diagnosis.

Answer 3

FALSE

Question 4

T / F According to the American Nurses Association, the professional nurse’s role involves four broad areas that define nursing practice.

Answer 4

TRUE

Question 5

Evidence-based nursing provides individualized nursing care from best _____________ and scientific findings.

Answer 5

research

Question 6

There are 10 areas of focus in the U.S. Department of Health and Human Services Healthy People 2020 which provides strategies based on health promotion and ___________ reduction strategies.

Answer 6

risk

Question 7

Health assessment is the first step of the nursing process and includes the health assessment, which is _______________ data, and the physical assessment, which is ______________ data.

Answer 7

subjective, objective

Question 8

T / F The type of assessment used during a life-threatening situation is the focused assessment.

Answer 8

FALSE

Question 9

Diagnostic reasoning is a seven-step process of _____________________; the nurse gathers and clusters data, draws inferences, and develops nursing diagnoses.

Answer 9

critical thinking

Question 10

T / F The nursing process consists of three parts: assessment, planning, and evaluation.

Answer 10

FALSE

Question 11

Because all future care is based on the ____ _________, it is extremely important that its data is complete and accurate. This is one of the most important skills that you will use as a nurse.

Answer 11

health assessment

Question 12

review this a few times

Answer 12

Question 13

All life-threatening problems identified during the initial assessment require the initiation of ______ interventions:

• Provide assistance with circulation (cardiopulmonary resuscitation if needed).
• Open the patient’s airway.
• Assist the patient’s breathing.
• Protect the cervical spine if the patient is injured.
• Ensure that the disoriented or suicidal patient is safe.
• Provide pain management and sedation.

Answer 13

critical

Question 14

The role of the professional nurse is to promote ___, prevent ____, treat human _____, and _____ for patients.

Answer 14

health

illness

responses

advocate

Question 15

Nurses are providers, designers, managers, and coordinators of care as well as advocates and educators.

Answer 15

just read a couple times

Question 16

Nursing values include = name all 5

Answer 16

respect, unity, diversity, integrity, and excellence.

Question 17

Health can be conceptualized as a point between _____ and ______, as either a high or a low level of health.

Answer 17

wellness

illness

Question 18

Healthy People is a United States government initiative to focus on ____ promotion and ____ reduction strategies.

Answer 18

health

risk

Question 19

The four main goals of nursing are to

promote ____;

prevent ____;

treat human responses to health and illness;

and ______ for individuals, families, and communities.

Answer 19

health

illness

advocate

Question 20

Steps of the nursing process include ______, diagnosing, setting goals and outcomes, planning, ________, and evaluating.

Answer 20

assessing

intervening

Question 21

______ thinking is the key to resolving problems.

Answer 21

Critical

Question 22

__________ is a process by which nurses use critical thinking to cluster the assessment information and to draw inferences and propose diagnoses.

Answer 22

Diagnostic reasoning

Question 23

Types of assessments are _______, comprehensive, and focused assessments.

Answer 23

emergency

Question 24

Organizing frameworks for assessment include _______, head-to-toe, and ___ ______.

Answer 24

functional

body systems

Question 25

1) A patient is having adverse effects resulting from a medication. The nurse calls the primary care provider to request a change in the medication order. The nurse is functioning as a/an

educator.

advocate.

organizer.

counselor.

Answer 25

B. Advocate. Rationale: By voicing concerns about the patient, the nurse functions as an advocate to improve the quality of care.

Question 26

Nurses advocate for underserved populations to reduce health disparities. This promotes

autonomy.

altruism.

respect.

human dignity.

Answer 26

C. Respect. Rationale: When nurses treat individuals, families, and communities to improve the disparities present in the health care system, they promote respect and social justice.

Question 27

3) Nurses belong to the ANA as part of their:

ongoing professional responsibility.

role as manager of care.

wellness promotion for patients.

cultural education activities.

Answer 27

A. Ongoing professional responsibility. Rationale: Nurses continually learn and promote health as part of their ongoing professional responsibility.

Question 28

The purpose of health assessment is to

obtain subjective and objective data.

intervene to correct difficulties.

outline appropriate care.

determine whether interventions are effective.

Answer 28

A. Obtain subjective and objective data. Rationale: Health assessment is the method by which nurses gather subjective and objective data.

Question 29

The nurse documents the following information in a patient’s chart: “Cough and deep breathe every hour while awake.” This is an example of

evidence-based nursing.

priority setting.

comprehensive assessment.

nursing interventions.

Answer 29

D. Nursing interventions. Rationale: Nursing interventions are actions taken by the nurse to promote health. They usually begin with a verb and have a time frame.

Question 30

The nurse provides teaching about smoking cessation to a 20-year-old man. The nurse assesses that the patient is concerned because his father died from lung cancer. Which theory would the nurse most likely use when providing teaching to this patient?

Health belief model

Diagnostic reasoning model

Cultural competence model

Body systems model

Answer 30

A. Health belief model. Rationale: The nurse will use the health belief model to assess the patient’s perspective about the relationship between smoking and lung disease. The patient’s family experience, he may have some personal beliefs that influence his motivation to stop smoking, which the nurse must assess.

Question 31

Which of the following processes is the most important when providing nursing care to an ill patient?

Writing outcomes

Performing a focused assessment

Collecting objective data

Using critical thinking

Answer 31

D. Using critical thinking. Rationale: Assessment provides a solid foundation for care, but it is only one step in the nursing process. Critical thinking is used in all phases of the nursing process.

Question 32

A patient is admitted to a hospital for surgery for colon cancer. What type of assessment is the nurse most likely to perform on admission?

Emergency

Focused

Comprehensive

Illness

Answer 32

C. Comprehensive. Rationale: Because surgery involves all body systems, it is important to perform a comprehensive assessment.

Question 33

Which of the following are components of a comprehensive health assessment?

Nursing diagnoses

Goals and outcomes

Collaborative problems

Examination of body systems

Answer 33

D. Examination of body systems. Rationale: In a comprehensive assessment, the nurse collects subjective and objective data. These include a history of the current problem, medical history, and common symptoms, as well as a head-to-toe physical examination.

Question 34

The nurse conducts the health history based on the patient’s responses to the medical diagnosis. This type of framework is based on the

functional framework.

objective framework.

coordinator framework.

collaborative framework.

Answer 34

A. Functional framework. Rationale: It is based on the functional framework. In the medical model, the provider evaluates the medical diagnosis, such as myocardial infarction. The provider may order some diagnostic tests to evaluate the extent of damage. The nurse assesses the patient’s response to the myocardial infarction, such as fluid retention or arrhythmias. Additionally, the nurse assesses functional abilities, such as coping, role performance, and activity tolerance.

Question 35

T/ F

A health assessment includes both a health history and a physical assessment.

Answer 35

True

Rationale: A health assessment is made up of the following two parts: a health history and a physical assessment.

Question 36

When are focused assessments conducted?

A. At different ages across the lifespan

B. After specific treatments are given

C. When a patient is in the acute care setting

D. Only in the outpatient setting

Answer 36

B. After specific treatments are given

Rationale: Patients also have focused assessments following treatments to monitor their effectiveness.

Question 37

Which physical assessment framework promotes critical thinking?

A. Functional

B. Head-to-toe

C. Comprehensive

D. Body systems

Answer 37

D. Body systems

Rationale: A body systems approach is a logical tool for organizing data when documenting and communicating findings. This method promotes critical thinking and allows nurses to analyze findings as they cluster similar data.