Fundamentals of Nursing Nursing Process Questions

Fundamentals of Nursing Nursing Process Questions Related

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A nurse is using assessment data gathered about a patient and combining critical thinking to develop a nursing diagnosis. What is the nurse doing?

  • A. Assigning clinical cues
  • B. Defining characteristics
  • C. Diagnostic reasoning NursingStoreRN
  • D. Diagnostic labeling
Correct Answer: C

Rationale: The correct answer is C: Diagnostic reasoning. The nurse is utilizing assessment data to analyze and interpret the information to develop a nursing diagnosis. This involves critical thinking skills to make conclusions and create a plan of care.

A: Assigning clinical cues - This choice is incorrect as it refers to identifying objective and subjective data during assessment, not the process of analyzing and synthesizing data to form a diagnosis.

B: Defining characteristics - This choice is incorrect as it typically refers to the specific manifestations or symptoms associated with a particular nursing diagnosis, not the process of diagnosing itself.

D: Diagnostic labeling - This choice is incorrect as it refers to the final step in the nursing diagnosis process where the nurse assigns a label to the identified problem, not the overall process of diagnostic reasoning.

You may also like to solve these questions

Which method of data collection will the nurse use to establish a patient’s database?

  • A. Reviewing the current literature to determine evidence-based nursing actions
  • B. Checking orders for diagnostic and laboratory tests
  • C. Performing a physical examination
  • D. Ordering medications
Correct Answer: C

Rationale: The correct answer is C: Performing a physical examination. This method allows the nurse to directly gather patient data through observation, palpation, percussion, and auscultation. It helps in assessing the patient's overall health status, identifying any abnormalities, and establishing a baseline for further care. Reviewing literature (A) helps in evidence-based practice but does not directly collect patient data. Checking orders for tests (B) and ordering medications (D) involve actions based on data collected rather than collecting the data itself.

Which method of data collection will the nurse use to establish a patient’s database?

  • A. Reviewing the current literature to determine evidence-based nursing actions
  • B. Checking orders for diagnostic and laboratory tests
  • C. Performing a physical examination
  • D. Ordering medications
Correct Answer: C

Rationale: The correct answer is C: Performing a physical examination. This method allows the nurse to gather comprehensive data about the patient's health status, including vital signs, physical appearance, and potential health issues. It provides valuable information for developing an individualized care plan. Reviewing literature (A) is important but not for establishing a patient's database. Checking orders (B) and ordering medications (D) are part of the treatment process and do not directly contribute to establishing the initial patient database.

Which method of data collection will the nurse use to establish a patient’s database?

  • A. Reviewing the current literature to determine evidence-based nursing actions
  • B. Checking orders for diagnostic and laboratory tests
  • C. Performing a physical examination
  • D. Ordering medications
Correct Answer: C

Rationale: The correct answer is C: Performing a physical examination. This method allows the nurse to collect objective data directly from the patient, which is crucial in establishing a comprehensive patient database. By assessing the patient's physical condition, the nurse can gather vital information such as vital signs, overall health status, and potential areas of concern. Reviewing literature (A) and checking orders for tests (B) may provide additional insights but are not direct data collection methods. Ordering medications (D) is a treatment intervention, not a data collection method.

Mrs. Zeno continues to become a weaker despite .treatment with neostigmine. Edrophonium HCL is ordered:

  • A. For its synergestic effect
  • B. Because of the client's resistance to
  • C. To rule out cholinergic crisis Neostigmine
  • D. To confirm the diagnosis of myasthenia
Correct Answer: C

Rationale: The correct answer is C: To rule out cholinergic crisis Neostigmine. Edrophonium HCL is a short-acting cholinesterase inhibitor used to differentiate between myasthenic crisis and cholinergic crisis, as both conditions present similarly with muscle weakness. Administering edrophonium HCL will help determine if the patient's worsening weakness is due to excessive cholinergic stimulation from neostigmine (cholinergic crisis) or inadequate acetylcholine at the neuromuscular junction (myasthenic crisis). This step is crucial for proper management, as treating cholinergic crisis with more cholinesterase inhibitors like neostigmine can worsen symptoms.

Incorrect choices:
A: For its synergistic effect - Edrophonium HCL does not have a synergistic effect with neostigmine.
B: Because of the client's resistance to - Resistance to neostigmine is not a reason to administer edrophonium H

Through which of the ff body fluids has transmission of HIV been established? Choose all that apply

  • A. Saliva
  • B. Sweat
  • C. Tears f. Breastmilk
  • D. Blood g. Urine
Correct Answer: C

Rationale: The correct answer is C: Tears and F: Breastmilk. HIV transmission has been established through breastmilk due to the presence of the virus in the milk. Tears can also transmit HIV if they contain blood from an HIV-positive individual. Saliva, sweat, and urine do not typically contain enough HIV to transmit the virus. Blood is a well-known mode of HIV transmission due to the high viral load present in blood. Therefore, choices A, B, D, and G are incorrect as they do not have sufficient levels of the virus to transmit HIV.

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