,Chapter 01: The Nursing Process and Patient-Centered Care
v v v v v v v
McCuistion: Pharmacology: A Patient-Centered Nursing Process Approach, 11th Edition
v v v v v v v v
MULTIPLE CHOICE v
1. All of the following would be considered subjective data, EXCEPT:
v v v v v v v v v
a. Patient-reported health history v v
b. Patient-reported signs and symptoms of their illness v v v v v v
c. Financial barriers reported by the patient’s caregiver v v v v v v
d. Vital signs obtained from the medical record
v v v v v v
ANS: v D
Subjective data is based on what patients or family members communicate to the
v v v v v v v v v v v v
vnurse. Patient- reported health history, signs and symptoms, and caregiver reported
v v v v v v v v v v
vfinancial barriers would be considered subjective data. Vital signs obtained from the
v v v v v v v v v v v
vmedical record would be considered objective data.
v v v v v v
DIF: Cognitive Level: Understanding (Comprehension) v v v TOP: Nursing v
vProcess: Planning MSC: v v NCLEX: Management v
vof Client Care
v v
2. The nurse is using data collected to define a set of interventions to achieve the
v v v v v v v v v v v v v v
v most desirable outcomes. Which of the following steps is the nurse applying?
v v v v v v v v v v v
a. Recognizing cues (assessment) v v
b. Analyze cues & prioritize hypothesis (analysis) v v v v v
c. Generate solutions (planning) v v
d. Take action (nursing interventions) v v v
ANS: v C
When generating solutions (planning), the nurse identifies expected outcomes
v v v v v v v v
v and uses the patient’s problem(s) to define a set of interventions to achieve the
v v v v v v v v v v v v v
vmost desirable outcomes. Recognizing cues (assessment) involves the gathering of
v v v v v v v v v
vcues (information) from the patient about their health and lifestyle practices, which
v v v v v v v v v v v
vare important facts that aid the nurse in making clinical care decisions.
v v v v v v v v v v v
vPrioritizing hypothesis is used to organize and rank the patient problem(s) identified.
v v v v v v v v v v v
vFinally, taking action involves implementation of nursing interventions to accomplish
v v v v v v v v v
vthe expected outcomes.
v v
DIF: Cognitive Level: Understanding v v
(Comprehension) TOP: Nursing Process:
v v v v
vNursing Intervention v
MSC: NCLEX: Management of Client Care
v v v v v v
3. A 5-year-old child with type 1 diabetes mellitus has had repeated hospitalizations for
v v v v v v v v v v v v
vepisodes of hyperglycemia. The parents tell the nurse that they can’t keep track of
v v v v v v v v v v v v v
v everything that has to be done to care for their child. The nurse reviews
v v v v v v v v v v v v v
v medications, diet, and symptom management with the parents and draws up a daily
v v v v v v v v v v v v
v checklist for the family to use. These activities are completed in which step of
v v v v v v v v v v v v v
v the nursing process?
v v
a. Recognizing cues (assessment) v v
b. Analyze cues & prioritize hypothesis (analysis) v v v v v
, c. Generate solutions (planning) v v
d. Take action (nursing interventions)
v v v
ANS: v D
Taking action through nursing interventions is where the nurse provides patient health
v v v v v v v v v v v
vteaching, drug administration, patient care, and other interventions necessary to assist
v v v v v v v v v v
v the patient in accomplishing expected outcomes.
v v v v v
DIF: Cognitive Level: Understanding v v
v(Comprehension) TOP: Nursing Process: v v v
v Nursing Intervention v
MSC: NCLEX: Management of Client Care
v v v v v v
4. The nurse is preparing to administer a medication and reviews the patient’s
v v v v v v v v v v v
v chart for drug allergies, serum creatinine, and blood urea nitrogen (BUN)
v v v v v v v v v v
v levels. The nurse’s actions are reflective of which of the following?
v v v v v v v v v v
a. Recognizing cues (assessment) v v
b. Analyze cues & prioritize hypothesis (analysis) v v v v v
c. Take action (nursing interventions)
v v v
d. Generate solutions (planning) v v
ANS: v A
Recognizing cues (assessment) involves gathering subjective and objective information
v v v v v v v v
vabout the patient and the medication. Laboratory values from the patient’s chart
v v v v v v v v v v v
vwould be considered collection of objective data.
v v v v v v
DIF: Cognitive Level: Understanding (Comprehension) v v v
TOP: Nursing Process: Assessment MSC: NCLEX: Management of Client Care v v v v v v v v
5. Which of the following would be correctly categorized as objective data?
v v v v v v v v v v
a. A list of herbal supplements regularly used provided by the patient.
v v v v v v v v v v
b. Lab values associated with the drugs the patient is taking.
v v v v v v v v v
c. The ages and relationship of all household members to the patient.
v v v v v v v v v v
d. Usual dietary patterns and food intake.
v v v v v
ANS: v B
Objective data are measured and detected by another person and would include lab
v v v v v v v v v v v v
vvalues. The other examples are subjective data.
v v v v v v
DIF: Cognitive Level: Understanding (Comprehension) v v v
TOP: Nursing Process: Assessment MSC: NCLEX: Management of Client Care v v v v v v v v
6. The nurse reviews a patient’s database and learns that the patient lives alone,
v v v v v v v v v v v v
v is forgetful, and does not have an established routine. The patient will be sent
v v v v v v v v v v v v v
v home with three new medications to be taken at different times of the day. The
v v v v v v v v v v v v v v
v nurse develops a daily medication chart and enlists a family member to put the
v v v v v v v v v v v v v
v patient’s pills in a pill organizer. This is an example of which element of the
v v v v v v v v v v v v v v
v nursing process? v
a. Recognizing cues (assessment) v v
b. Analyze cues & prioritize hypothesis (analysis) v v v v v
c. Take action (nursing interventions)
v v v
, d. Generate solutions (planning) v v
ANS: v C
Taking action (nursing interventions) involves education and patient care in order to
v v v v v v v v v v v
assist the patient to accomplish the goals of treatment.
v v v v v v v v v
DIF: Cognitive Level: Applying v v
(Application) TOP: Nursing
v v v
Process:
v
Nursing Intervention MSC: NCLEX: v v
Management of Client Care v v v
7. A patient who is hospitalized for chronic obstructive pulmonary disease (COPD)
v v v v v v v v v v
wants to go home. The nurse and the patient discuss the patient’s situation and
v v v v v v v v v v v v v v
decide that the patient may go home when able to perform self-care without dyspnea
v v v v v v v v v v v v v v
and hypoxia. This is an example of which phase of the nursing process?
v v v v v v v v v v v v v
a. Recognizing cues (assessment) v v
b. Analyze cues & prioritize hypothesis (analysis) v v v v v
c. Take action (nursing interventions) v v v
d. Generate solutions (planning) v v
ANS: v D
Generating solutions (planning) involves defining a set of interventions to
v v v v v v v v v
achieve the most desirable outcomes, which, for this patient, means being able
v v v v v v v v v v v v
to perform self-care activities without dyspnea and hypoxia.
v v v v v v v v
DIF: Cognitive Level: Understanding (Comprehension)
v v v v TOP: v Nursing v Process:
Planning MSC: NCLEX: Management of Client Care
v v v v v v v
8. A patient will be sent home with a metered-dose inhaler, and the nurse is
v v v v v v v v v v v v v
providing teaching. Which is a correctly written expected outcome for this
v v v v v v v v v v v
process?
v
a. The nurse will demonstrate the correct use of a metered-dose inhaler to the patient.
v v v v v v v v v v v v v
b. The nurse will teach the patient how to administer medication
v v v v v v v v v
with a metered-dose inhaler.
v v v v
c. The patient will know how to self-administer the medication using
v v v v v v v v v
the metered- dose inhaler.
v v v v
d. The patient will independently administer the medication using the
v v v v v v v v
metered- dose inhaler at the end of the session.
v v v v v v v v v
ANS: v D
Expected outcomes must be patient-centered and clearly state the outcome with a
v v v v v v v v v v v
reasonable deadline and should identify components for evaluation.
v v v v v v v v
DIF: Cognitive Level: Applying (Application)
v v v v TOP: v Nursing v Process:
Planning MSC: NCLEX: Management of Client Care
v v v v v v v
9. The nurse is generating solutions (planning) for a patient who has chronic lung
v v v v v v v v v v v v
disease and hypoxia. The patient has been admitted for increased oxygen needs
v v v v v v v v v v v v
above a baseline of 2 L/min. The nurse generates an expected outcomes stating,
v v v v v v v v v v v v v
“The patient will have oxygen saturations of
v v v v v v v
>95% on room air at the time of discharge from the hospital.” What is wrong with this
v v v v v v v v v v v v v v v v
vgoal?
a. It cannot be evaluated.
v v v
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller HIGRADES. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $16.99. You're not tied to anything after your purchase.