A nurse is documenting data collection findings on a client. Which of the following entries should the nurse identify as subjective data? (Select All that Apply.)

Client reports the rash on their back is itchy

Client reports nausea following administration of pain medication.

Client has a raised, red rash on their upper back.

Client reports dull, aching pain in lower right calf.

Client's oral temperature is 38.4° C (101.2° F).

Answer and Explanation

Correct Answer : A,B,D

A.   This entry reflects the client’s personal experience and perception of the rash. It is not measurable and relies on the client’s description.

B.   This statement is also based on the client’s experience and feelings about their condition after taking medication. It is a personal report and not an observable finding.
C.   This is an observation made by the nurse. The description of the rash is measurable and can be documented as a physical finding.
D.   Similar to options A and B, this entry describes the client’s perception of pain. It is a personal
experience that cannot be directly measured.
E.   This is a measurable finding obtained through a thermometer. It provides concrete evidence of the
client’s condition and does not rely on the client’s report.

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Correct Answer is B

Explanation

A. Quality improvement focuses on the processes and systems within healthcare that enhance patient outcomes and improve care delivery. While the nurse's actions contribute to overall quality of care, this specific scenario does not directly relate to improving a process or system.
B. The nurse is demonstrating the competency of safety by ensuring the client’s bed is locked (preventing falls) and the call light is within reach (allowing the client to request help easily). These actions directly enhance the client's safety and prevent potential harm.
C. Teamwork and collaboration involve working effectively with other healthcare professionals to provide optimal care. While collaboration is essential in nursing, the actions described do not specifically pertain to working with other team members.
D. Patient-centered care focuses on respecting and responding to individual patient preferences, needs, and values. While ensuring the call light is within reach aligns with the principles of patient-centered care, the primary focus of the nurse’s actions is on safety.

A. Dispose of used razors in wastebaskets. B. Use two hands to recap a needle after administering a medication. C. Break needles on syringes before disposal. D. Replace sharps containers when they are full.

Correct Answer is D

Explanation

A. Used razors should never be disposed of in regular wastebaskets as they pose a significant risk for puncture injuries. Instead, they should be placed in a designated sharps container to prevent accidental cuts or injuries to anyone handling the waste.
B. The practice of using two hands to recap a needle is not recommended because it increases the risk of a needlestick injury. Instead, nurses should use a one-handed technique or a safety device designed for recapping needles to minimize the risk of injury.
C. Needles should not be broken off from syringes before disposal, as this can create sharp edges that can puncture the skin and lead to injuries. Instead, syringes with needles should be disposed of intact in a designated sharps container.
D. Sharps containers should be replaced when they are full to ensure safe disposal of needles and other sharp instruments. Overfilled containers can pose a risk of needlestick injuries and may not allow for proper disposal of new sharps.

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A nurse is documenting data collection findings on a client. Which of the following entries should the nurse identify as subjective data? (Select All that Apply.)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is providing care to a client. Prior to exiting the client's room, the nurse ensures the client's bed is locked and their call light is within reach. Which of the following QSEN competencies is the nurse demonstrating?

Correct Answer is B

Explanation

A nurse is assisting with teaching a newly licensed nurse about preventing puncture injuries. Which of the following instructions should the nurse include?

Correct Answer is D

Explanation

A nurse is reinforcing teaching with a newly licensed nurse about measuring body temperature in clients. The nurse should instruct to obtain an oral temperature in which of the following clients? (Select all that apply.)

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A licensed practical nurse wants to become more involved in nursing on a national level once they become a registered nurse. Which of the following organizations should the nurse join?

A nurse looks up information in a client's medical record but is not involved in the care of the client. The nurse is violating which of the following standards of professional performance?

A nurse is providing discharge instructions to a client who lives in subsidized housing and is concerned about being able to afford their medications. Which of the following factors should the nurse identify is affecting the client's health?

A nurse is instructing a client who has heart disease about ways to improve their health such as eating a heart healthy diet. Which of the following concepts is the nurse demonstrating to the client?

A nurse at a clinic is discussing with a newly licensed nurse social determinants of health (SDOH). Which of the following should the newly licensed nurse identify as an example of the social and community context determinant of health?

A nurse is preparing an in-service about communication for a group of staff nurses. Which of the following information should the nurse include when discussing the electronic mode of communication?