A nurse is collecting data from a client who is postoperative. Which of the following findings should the nurse identify as objective data?(Select All that Apply.)

The client is reporting nausea.

The client's urine output has been 150 mL over the past 3 hr.

The client states they are experiencing "extreme pain".

The client's current blood pressure is below their preoperative reading.

The client's right calf is swollen and warm to the touch.

Answer and Explanation

Correct Answer : B,D,E

A.   It reflects the client’s personal feelings and experiences regarding their condition. Since it is based on
the client's report rather than measurable findings, it does not qualify as objective data.
B.   It provides measurable information about the client's urine output, which can be quantified and observed by the nurse. Objective data is factual and can be verified by anyone observing the situation.
C.   Like the nausea report, this statement is based on the client’s personal experience and perception of
pain. It cannot be measured objectively, making it subjective.
D.   Blood pressure readings are measurable and can be objectively compared to preoperative values. This information provides concrete data regarding the client's current condition.
E.   The observations of swelling and warmth can be directly assessed and are factual findings that can be confirmed by the nurse during the physical examination.

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Correct Answer is A

Explanation

A. Using a designated interpreter ensures that communication is accurate and professional, minimizing the risk of misunderstandings. Facilities often have protocols for accessing interpreters who are trained to handle medical conversations, making this the safest choice.
B. While electronic translating services can be useful, they are not always reliable for medical situations. These services may lack the necessary context for medical terminology and nuances, and they may not ensure confidentiality or accuracy.
C. Involving the client’s partner as an interpreter can lead to issues of accuracy, bias, and confidentiality. The partner may not fully understand medical terminology, and there is a potential for miscommunication or emotional involvement that could affect the interpretation.
D. While this option may seem helpful, it is not ideal. Using a colleague as an interpreter can compromise the confidentiality and professionalism of the interaction. Additionally, the colleague may not have the training necessary to accurately convey medical information, and there might be a conflict of interest.

A. Esteem B. Self-actualization C. Safety D. Physiological

Correct Answer is C

Explanation

A. Esteem needs involve feelings of self-worth, accomplishment, and recognition. While losing a home can impact self-esteem, the immediate concerns for the couple are more fundamental and related to their basic needs for safety and security.
B. Self-actualization refers to the realization of one's potential, personal growth, and peak experiences. This level of need is focused on personal fulfillment and growth, which is not relevant to the immediate crisis the couple is facing after losing their home.
C. Safety needs encompass the need for security, stability, and protection from harm. After losing their home in a fire, the couple's primary concerns will likely involve finding safe shelter, addressing immediate safety concerns, and securing their well-being.
D. Physiological needs include the basic requirements for human survival, such as food, water, shelter, and warmth. While these needs are critical, the loss of their home primarily impacts their safety needs at this moment.

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A nurse is collecting data from a client who is postoperative. Which of the following findings should the nurse identify as objective data?(Select All that Apply.)

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Naxlex Comprehensive Predictor Exams

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Correct Answer is A

Explanation

A nurse in a community health clinic is interviewing a couple who just lost their house in a fire. Using the priority framework of Maslow's hierarchy of needs, which category should the nurse identify for the clients' situation?

Correct Answer is C

Explanation

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