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A nurse is gathering subjective data when admitting a patient. Which assessment finding reported by the patient is considered subjective data?
- A. Complains of diplopia
- B. Is experiencing nystagmus
- C. Demonstrates facial grimacing
- D. Has a generalized rash
Correct Answer: A
Rationale: Symptoms are subjective indications of illness that are perceived by the patient. Examples of symptoms are pain, nausea, vertigo, pruritus, diplopia, numbness, and anxiety. The nurse is unaware of symptoms unless the patient describes the sensation. Symptoms are referred to as subjective data. Diplopia is the only subjective assessment finding. All other options are examples of objective data.
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When assessing a female for risk factors associated with coronary artery disease what information should the nurse include?
- A. Family history of illness
- B. Diet
- C. Smoking
- D. Exercise
- E. Number of pregnancies
Correct Answer: A,B,C,D
Rationale: With the exception of information relative to pregnancies, all options would be informative about risk for heart disease.
A condition in which there is a lack of appetite resulting in the inability to eat is known as ____.
Correct Answer: anorexia
Rationale: Anorexia is a lack of appetite resulting in the inability to eat. It can occur in many disease conditions.
During a head-to-toe assessment the nurse assesses the patient's perineal area. Which area should the nurse assess next?
- A. Chest
- B. Arms
- C. Abdomen
- D. Legs and feet
Correct Answer: D
Rationale: When performing a head-to-toe assessment, the nurse begins with a neurologic assessment, then assesses the skin, hair, head, and neck, including the eyes, ears, nose, and mouth. The chest, back, arms, abdomen, perineal area, legs, and feet are examined in that order.
Which are infectious diseases?
- A. Measles
- B. Pneumonia
- C. Hay fever
- D. Tuberculosis
- E. Osteoarthritis
- F. Acquired immunodeficiency syndrome
Correct Answer: A,B,D,F
Rationale: Infectious diseases result from the invasion of microorganisms into the body. Examples of infectious diseases include acquired immunodeficiency syndrome (AIDS), tuberculosis, measles, and pneumonia. Hay fever is a manifestation of an allergic reaction, and osteoarthritis is an example of a degenerative disease.
During the nursing interview several histories are taken. What is the history that involves data concerning habits and lifestyle patterns?
- A. Family history
- B. Environmental history
- C. Past health history
- D. Psychosocial history
Correct Answer: C
Rationale: The nurse identifies habits and lifestyle patterns under the past health history.