Nokea
Which step of the nursing process is concerned with identifying physical findings?
- A. Assessment
- B. Diagnosis
- C. Planning
- D. Implementation
- E. Evaluation
Correct Answer: A
Rationale: Assessment is the step where nurses collect data, including physical findings, through observation, interviews, and examinations to establish a baseline for patient care.
You may also like to solve these questions
Improvement in a patient's health problem is measured by how much progress the patient makes toward the goal, which is set by the nurse.
- A. TRUE
- B. FALSE
Correct Answer: B
Rationale: False. Goals are set collaboratively with the patient, not solely by the nurse, to ensure patient-centered care.
To assess bowel sounds, which assessment technique will you use?
- A. Inspection
- B. Palpation
- C. Auscultation
- D. Percussion
Correct Answer: C
Rationale: Auscultation is used to listen to bowel sounds with a stethoscope, assessing gastrointestinal function.
You are assisting the nurse practitioner (NP) with her assessment of an elderly, confused woman. You watch as the NP places her hand on the woman's back and then taps her own middle finger with her other hand. This assessment technique is called
- A. Inspection
- B. Palpation
- C. Auscultation
- D. Percussion
Correct Answer: D
Rationale: Percussion involves tapping to assess underlying structures, as described in the NP's technique.
By using a problem statement, the cause of the problem, and the defining characteristics of the problem, nursing diagnoses help identify interventions to address the problem.
- A. TRUE
- B. FALSE
Correct Answer: A
Rationale: True. Nursing diagnoses include a problem statement, etiology, and defining characteristics to guide targeted interventions.
Nursing diagnoses all contain the modifier 'risk for.'
- A. TRUE
- B. FALSE
Correct Answer: B
Rationale: False. Only potential problems use 'risk for'; actual problems and wellness diagnoses do not.