The nurse is reviewing data obtained through the health history interview and physical assessment of an assigned patient

Question

Data collected include dry skin, brittle nails, weight gain, thinning hair, constipation, prolonged menstruation, and the patient's complaints of feeling tired and cold. Which statement represents an appropriate data cluster?
a.
Prolonged menstruation, constipation
b.
Dry skin, brittle nails, weight gain
c.
Tired, cold, thinning hair
d.
Constipation, weight gain

Answer 1

ANS: D
Clustering involves organizing patient assessment data into groupings with similar underlying causes. One patient may have several problems simultaneously, requiring the nurse to understand the potential relatedness of signs and symptoms from various body systems. The nurse combines an understanding of pathophysiology, normal structure and function, disease processes, and symptomatology to accurately cluster data. A person who has not had a bowel movement may experience weight gain. Skin, nails, and hair are components of the integumentary system. The subjective feelings of tired and cold are related and prolonged menstruation, as part of the reproductive system, is in a group by itself.