The nurse observes the client as he paces the floor and talks to himself. The nurse documents this as "Client confused and agitated." This is an example of
An observation
A judgment
Subjective data
Objective data
The Correct Answer is B
Choice A rationale: An observation is a factual statement of what the nurse sees, hears, feels, or smells.
Choice B rationale: This is because the nurse is interpreting the client's behavior and not describing it objectively.
Choice C rationale: subjective data is information that the client tells the nurse, such as feelings, perceptions, or opinions.
Choice D rationale: Objective data is information that the nurse obtains through physical examination, tests, or measurements.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","B","C"]
Explanation
Choice A rationale: this response is dismissive of the patient’s feelings and concerns and does not acknowledge the patient’s reality and perspective. It implies that the patient is overreacting and may make the client feel judged and ignored.
Choice B rationale: this response is intrusive and prescriptive since the patient’s reasons and preferences are not considered. it assumes that the patient has a husband and that they have a good relationship together which may not be the case.
Choice C rationale: this response is accusatory and confrontational while implying that the patient’s behavior was wrong and unacceptable. Furthermore, it focuses on the past rather than the present or the future which is relevant in this case. It also makes the patient feel guilty and ashamed which may impair their ability to open up hence ineffective care.
Choice D rationale: This response is empathic and validating. It reflects the patient's feelings and shows understanding and compassion. It does not judge or minimize the patient's emotions, and it invites the patient to share more if they wish. This response could make the patient feel heard, supported, and respected.
Choice E rationale: this response encourages the patient to open up and express their thoughts and feelings. This makes the patient feel valued and empowered thus allowing them to share their feelings at their own pace.
Correct Answer is B
Explanation
Choice A rationale: this is the phase where the caregiver and client establish a rapport by introducing themselves while clarifying their roles and expectations. The caregiver also explains the purpose, scope, and limits of the services they provide.
Choice B rationale: the preparation phase occurs before the client and the caregiver meet and involves the care provider reviewing the client’s information, identifying their needs, and planning for their first contact.
Choice C rationale: This is the phase where the caregiver and the client end the therapeutic relationship, evaluate the outcomes, and plan for follow-up or referral.
Choice D rationale: this phase involves the caregiver and the client implementing interventions, monitoring their progress, and modifying their goals as needed to achieve their set objectives.
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