Nokea
Which of the following patient care concerns is clearly a nursing responsibility?
- A. prescribing medications
- B. monitoring health status changes
- C. ordering diagnostic examinations
- D. performing surgical procedures
Correct Answer: B
Rationale: Monitoring health status changes is a core nursing responsibility, as it involves assessing and tracking patient conditions, unlike prescribing medications or performing surgeries, which are medical responsibilities.
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A student is reviewing a patients chart before giving care. She notes the following diagnoses in the contents of the chart: appendicitis and acute pain. Which of the diagnoses is a medical diagnosis?
- A. neither appendicitis nor acute pain
- B. both appendicitis and acute pain
- C. appendicitis
- D. acute pain
Correct Answer: C
Rationale: Appendicitis is a medical diagnosis made by a physician, while acute pain is a nursing diagnosis based on patient symptoms.
A nurse completes a health history and physical assessment for an adolescent before he begins football practice. Based on findings, the nurse recommends reinforcing health habits. What conclusion did the nurse reach after interpreting and analyzing the data?
- A. no problem
- B. possible problem
- C. actual problem
- D. clinical problem
Correct Answer: A
Rationale: Recommending reinforcement of health habits suggests no immediate problem was identified, indicating a 'no problem' conclusion.
A nurse develops a plan of care to meet the needs of a patient who has had a large loss of blood after a snowmobile crash. The interventions include administering and monitoring the patients physiologic response to intravenous fluids and blood. What has the nurse focused care on?
- A. a medical diagnosis
- B. a nursing diagnosis
- C. a collaborative problem
- D. a goal for care
Correct Answer: C
Rationale: This scenario describes a collaborative problem, as it involves joint interventions between nursing and medical care, such as administering fluids and blood.
A nurse observes a new mother tenderly holding and softly talking to her baby. What does this observation tell the nurse about the babys strengths?
- A. Nothing; this observation is not important.
- B. The mother is just behaving as all mothers do.
- C. A baby is not capable of having strengths.
- D. Nurturing is a strength for developing infants.
Correct Answer: D
Rationale: Positive maternal interaction, such as nurturing, supports the infant's emotional and developmental strengths.
The nurse takes a patients vital signs and finds the pulse rate to be 120 beats/min. What would the nurse do next to interpret and analyze this pulse rate?
- A. Compare the patients pulse rate to the standard range.
- B. Notify the patients healthcare provider.
- C. Document the pulse in the appropriate chart page.
- D. Ask another nurse to verify the pulse rate.
Correct Answer: A
Rationale: Comparing the pulse rate to the standard range is the next step to determine if it is abnormal and requires further action.