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NSG 1100 > Unit 3: (Foundations of Assessment) > Flashcards

Unit 3: (Foundations of Assessment) Flashcards

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1
Q

A patient tells you that they have a headache. What type of data is this?

A

Subjective data, It is what the patient experiences and communicates.

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2
Q

Upon entering the room, the nurse notices the patient to have pale skin and is diaphoretic. What type of data is this?

A

Objective; Observable and measurable.

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3
Q

A lab report reports the patients RBC count. What type of data is this?

A

1) Objective; observable and measurable.

2) Variable; can change over time.

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4
Q

A patient was born on 01/25/1945. What type of data is this?

A

Constant data; does not change over time.

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5
Q

Lab reports indicate a patients blood type is ‘A negative’. What type of information is this?

A

Constant data; does not change over time.

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6
Q

The nursing assistant reports a patients temperature is 101.5 axillary. What type of data is this?

A

1) Objective; measurable.

2) Variable; can change over time.

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7
Q

What type of data reveals a patients feelings, thoughts, and beliefs?

A

Subjective Data

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8
Q

A family member reports the patient was hospitalized in January last year. What type of source is this?

A

Secondary source (those other than patient).

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9
Q

A patient states they live at home independently. What type of data source is this?

A

Primary (source=patient)

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10
Q

What type of data is obtained from patients? (Not ‘source’)

A

Patients report SUBJECTIVE data.

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11
Q

A co-worker reports that your patient was NPO last week. What type of data source is this?

A

Secondary source (those other than the patient).

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12
Q

The chart reveals a patients religious preference as: ‘Other’. What type of data source is this?

A

Secondary (those other than patient).

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13
Q

A patient reports they are fearful about surgery. What type of data source is this?

A

Primary (source=patient)

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14
Q

An organized conversation with a patient to obtain information is termed what?

A

Interview

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15
Q

A nurse reading current and past medical records is in what phase of the interview?

A

Preparatory phase.

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16
Q

True -or- False:

Nonverbal communication is less important than verbal communication.

A

False

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17
Q

When addressing patient during an interview, how should the patient be addressed?

A

Address by family name (Mr/Ms/Mrs) unless asked to be called by a less formal name.

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18
Q

What is the primary goal of the introduction phase of the interview?

A

Establish therapeutic relationship with the patient.

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19
Q

A nurse who is introducing them self and providing the purpose of the interview is in what phase of the interview?

A

Introduction Phase.

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20
Q

What type of atmosphere is best for a patient interview?

A

Private and relaxed.

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21
Q

Information obtained from the interview is __________________.

A

Confidential.

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22
Q

A nurse asks a patient about their upcoming surgery. What stage of the interview is the nurse in?

A

Working stage: gathering information needed for subjective database.

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23
Q

When in the working phase of the interview, what does the nurse focus on?

A

Focus on patients health status.

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24
Q

Summarizing highlights and key points are done in what phase of the interview?

A

Termination

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25
How do you terminate an interview?
1) Leave patient in a comfortable and safe environment. 2) Clue the interview is ending. 3) Thank the patient 4) Allow them the opportunity to ask final questions.
26
Give examples of biographical data.
Name, address, phone number, DOB...
27
What information provides the present concern/chief complaint?
Reason for seeking health care.
28
How do present concerns guide the assessment?
Present concerns should guide the assessment to gather the most relevant information. (Cardiopulmonary, GI, Neuro....)
29
How far into the past should the nurse assess a patients disease or condition?
Childhood-Present. (Pertaining to Present Concerns)
30
What information should be gathered in regards to family health history?
Genetic patterns of health, current state of health/chronic disease, and cause of death for deceased family.
31
A patient states they live in a fifth floor apartment with their daughter and grandson and two dogs. What information in their health history data is this pertaining to?
Environment (Home situation)
32
A patient exercises three times a week. What information in their health history data is this pertaining to?
Lifestyle (habits/acts that affect patients health).
33
A patient states they smoke a pack/day. What information in their health history data is this pertaining to?
Lifestyle (habits/acts that affect patients health).
34
A patient states they want their son present before surgery for support. What information in their health history data is this pertaining to?
Psychosocial (deals with stress/coping styles)
35
A patient states they do not have a primary care physician. What information in their health history data is this pertaining to?
Patterns of Healthcare
36
When inspecting a body part, what should the nurse compare?
Left and Right sides.
37
What is defined as the use of touch on the body to assess?
Palpation
38
Striking one object against another to produce sound waves and vibrations is defined as?
Percussion.
39
True or false: A nurse can use percussion to assess a patients abdomen.
False: Percussion is practiced by advanced practitioners.
40
What can the nurse assess with palpation?
Temperature, moisture, edema, and tenderness.
41
What is palpated last during an assessment? Why?
Painful areas are palpated last to prevent guarding.
42
What can be assessed with olfaction?
Breath, drains/drainage, bowel and bladder odors.
43
A nurse places the stethoscope on a patients gown to assess breath sounds. Why is this incorrect?
The stethoscope should be placed directly on skin, not on clothing.
44
While auscultating, the nurse notes a low sound. What is being identified? (Pitch, Intensity, Quality, or Duration)
Pitch (HIGH/LOW)
45
While auscultating, the nurse notes gurgling and swishing. What is being identified? (Pitch, Intensity, Quality, or Duration)
Quality
46
While auscultating, the nurse notes long sounds. What is being identified? (Pitch, Intensity, Quality, or Duration)
Duration
47
While auscultating, the nurse notes soft sounds. What is being identified? (Pitch, Intensity, Quality, or Duration)
Intensity/Amplitude.
48
What acronym is used as a guideline for assessment?
``` SOLER: S-Sit facing the patient. O- Open posture L- Lean toward patient E- Establish and maintain eye contact R- Relax ```
49
What does assessing the orientation of the patient do?
Gauges awareness of surroundings.
50
What does active listening require?
Hearing and Interpreting
51
Why is it important for the nurse to individualized attention to the patient?
If the nurse fails to give the patient individual/undivided attention, they may miss or misinterpret information.
52
How can a nurse encourage the patient to share information openly?
Allowing the patient to complete their comments and thoughts without interruption or interpretation.
53
Would a nurse wanting to obtain specific data ask open ended questions or close ended questions?
Close ended questions.
54
Would a nurse wanting a patient to share their feelings openly ask close ended questions or open ended questions?
Open ended questions.
55
What type of answers require more than yes/no?
Open ended questions.
56
What type of questions should be avoided, and why?
'WHY' questions because they make the patient defensive and suggest criticism.
57
What type of questions allow for short, specific information?
Close ended questions.
58
What type of questions may be useful with anxiety or communication difficulties/barriers.
Close ended questions.
59
What considerations should the nurse use when selecting terminology?
Consider age, knowledge, and culture.
60
What will speaking in at a rapid pace cause the patient to feel?
Frustration
61
A nurse who is aware of how their voice is rising and falling is monitoring what?
Cadence
62
How does tone affect your message?
Tone of voice affects the meaning of your message.
63
How can a nurse clarify their question or message?
Asking simple, brief questions. Selecting words that convey meaning. Match verbal to nonverbal.
64
What special considerations are made regarding the timing and relevance of verbal communication?
- Messages should be relevant and important to the situation at hand. - Consider the presence of others.
65
When looking for nonverbal communication, what area of the body should the nurse pay most attention to?
The face- most expressive with non verbal communication.
66
What form of nonverbal communication shows trust and willingness to communicate?
Eye contact
67
What considerations are made with space and nonverbal communication.
Nonverbal communication can cue how comfortable a person is with sharing their personal space.
68
How would a nurse communicate with patients who have language differences?
Interpreter, communication/picture board....
69
How would a nurse communicate with a patient with visual impairments?
Glasses/eye wear, large print, speak clearly....
70
How would a nurse communicate with a patient that has hearing impairment?
Ensure hearing aids are in and working, communication/picture boards, writing on paper, speaking slowly and clearly....
71
How would a nurse communicate with a patient that is cognitively impaired?
Choose words carefully-with appropriate meaning.....
72
How would a nurse communicate with a patient that has speech impairments?
Listen carefully, be patient, ask simple close ended questions to clarify and collect data....
73
How does nurse communicate with a patient that is unresponsive?
Speak clearly and explain who you are, and what you are doing....
74
A nurse is gathering vital signs, health history, and list of medications for a new admission. What assessment approach is the nurse using?
Initial=First
75
A patient is complaining of pain. The nurse asks the patient to identify the location and severity of the pain. What assessment approach is the nurse using?
Problem Focused Assessment
76
The nurse is administering medication and make many observations about the patient and environment. What type of assessment approach is the nurse using?
General Survey=ongoing
77
The patient has stopped breathing, and the nurse begins to assess pulses and airway. What assessment approach is the nurse using?
Emergency Assessment
78
The nurse is asking a patient specific questions to obtain information pertaining to their current health complaint. What assessment approach is the nurse using?
Problem-focused Assessment
79
A patient is admitted for surgery, and the nurse performs a head-to-toe assessment. What type of assessment approach is being used?
Initial Assessment
80
A patient complains they are having trouble breathing. The nurse auscultates the lungs for breath sounds. What type of assessment approach is being used?
Problem Focused Assessment

NSG 1100 (22 decks)

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