ATI LPN
Foundations and Adult Health Nursing Test Bank
Chapter 5 : Nursing Process and Critical Thinking Questions
Question 1 of 5
A patient with a urinary tract infection is assessed using a clinical pathway. When a projected outcome is not met by a predetermined date it is determined that what has occurred?
Correct Answer: B
Rationale: A variance occurs when a projected outcome is not met.
Question 2 of 5
During a physical examination the nurse discovers that the patient demonstrates signs of flushed dry hot skin; dry oral mucous membranes; and temperature elevation. The nurse should treat this data as the basis of a patient problem plan. What does this data represent?
Correct Answer: B
Rationale: The nurse organizes data, and those that are related are referred to as clustering. These are also signs of fluid overload.
Question 3 of 5
What type of assessment is performed continuously throughout nurse-patient contact?
Correct Answer: C
Rationale: Focused assessments are performed continuously throughout nurse-patient contact based on the nursing care plan.
Question 4 of 5
What assists the nurse in the identification of patient problems?
Correct Answer: C
Rationale: Data clustering assists the nurse in determining patient problems.
Question 5 of 5
What organized approach might the nurse use when performing a complete physical examination?
Correct Answer: B
Rationale: A head-to-toe format provides a systematic approach.