Nokea
When discovering subjective data, recognize that they relate to:
- A. signs
- B. objective cues
- C. symptoms
- D. observable data
Correct Answer: C
Rationale: Subjective data relates to symptoms (C) reported by the patient, like pain or nausea. Signs (A), objective cues (B), and observable data (D) are objective, measurable findings.
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During the shift, the nurse charts only additional treatments done or withheld, changes in patient condition, and new concerns. Charting these factors demonstrates which of the following type of charting?
- A. block
- B. by exception
- C. focused
- D. SOAP
Correct Answer: B
Rationale: Charting by exception (B) documents only significant changes or deviations, not routine care. Block (A) covers entire shifts, focused (C) targets specific issues, and SOAP (D) follows a structured format.
Documenting the type of interventions carried out, the time care was given, and the signature of the care giver results in recording:
- A. patient's nursing problem
- B. interventions carried out to meet the patient's needs
- C. patient's medical problem
- D. the patient's response to the intervention carried out
Correct Answer: B
Rationale: Documenting interventions, time, and signature (B) records actions taken to address patient needs, ensuring accountability. A and C relate to diagnoses, and D focuses on outcomes, not interventions.
Select the proper order of the phases of the Nursing Process:
- A. Evaluation, planning, assessment, implementation
- B. Assessment, planning, implementation, evaluation
- C. Implementation, assessment, planning, evaluation
- D. Planning, evaluation, assessment, implementation
Correct Answer: B
Rationale: The nursing process follows a logical sequence: Assessment (data collection), Planning (developing goals and interventions), Implementation (executing the plan), and Evaluation (assessing effectiveness). Only option B lists this correct order.
Patient health care records are:
- A. not used by anyone else but the direct care providers
- B. concise, legal records of all care given and responses
- C. owned by the patient, who has a right to see the data any time he/she wishes
- D. confidential information and cannot be taken to court
Correct Answer: B
Rationale: Records (B) are legal, concise documentation of care and responses, used by multiple parties. A, C, and D are incorrect regarding usage, ownership, and legal status.
Select the type of assessment which is performed continuously throughout nurse-patient contact:
- A. focused
- B. body systems
- C. subjective
- D. complete
Correct Answer: A
Rationale: Focused assessments (A) are ongoing, targeting specific issues like pain or breathing during contact. Body systems (B), subjective (C), and complete (D) assessments are not continuous.