The nurse is performing a physical assessment on a newly admitted patient. Select subjective or objective for the findings below.
Pulse 68 bpm
7 x 4 cm scar on the left lower abdomen.
Blood pressure 148/92
History of allergies
Last menstrual period
Shortness of breath
Pain 8/10
Brawny edema in lower extremities.
Temperature 101 SF
Use of medications at home
The Correct Answer is {"A":{"answers":"B"},"B":{"answers":"B"},"C":{"answers":"B"},"D":{"answers":"A"},"E":{"answers":"A"},"F":{"answers":"B"},"G":{"answers":"A"},"H":{"answers":"B"},"I":{"answers":"B"},"J":{"answers":"A"}}
Subjective data are based on what the patient reports. These include personal history and symptoms (e.g., allergies, menstrual period, pain level, and medication use).
Objective data are measurable facts that are observed or measured by the nurse, such as vital signs, physical findings (e.g., scars, edema), and lab results (e.g., temperature, blood pressure).
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. This category refers to non-urgent problems, which does not apply here as the client is showing signs of severe distress and requires immediate attention.
B. Central cyanosis, a low heart rate (bradycardia), and low blood pressure are life-threatening signs that necessitate immediate intervention to stabilize the patient.
C. This is not a routine or minor situation. The client is in critical condition and requires urgent intervention.
D. While second-level priorities are important, this patient has life-threatening signs requiring first-level priority, immediate action, and stabilization.
Correct Answer is A
Explanation
A. The ballottement test involves pressing on the knee joint to check for the presence of fluid, which can indicate joint effusion.
B. The McMurray test is used to assess for meniscal tears, not for fluid around the patella.
C. The Tinel sign is used to assess for nerve compression, not fluid accumulation.
D. The Phalen test is used to diagnose carpal tunnel syndrome, not to assess for joint effusion.
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