Head to Toe

Question 1

subjective or objective: What is told to you by another, or s/s that the client reports (not perceived by others)

Answer 1

subjective

Question 2

subjective or objective: facts determined by direct observation

Answer 2

objective

Question 3

Which phase of the nursing process requires skill in various methods of clinical observation and measurement?

Answer 3

data collection

Question 4

In preparing for the assessment, what are three major considerations?

Answer 4

Who is in the room, is an interpreter needed, is the environment appropriate

Question 5

When to perform comprehensive assessment

Answer 5

admission

Question 6

what is a shift assessment

Answer 6

head to toe but abbreviated

Question 7

Order of typical system assessment

Answer 7

inspection, palpation, auscultation, (percussion)

except for GI, where palpation is after auscultation

Question 8

5 Ps of rounding assessment

Answer 8

pain, personal needs, position, placemat, prevent falls