The nurse begins a shift assessment by examining a surgical dressing that is saturated with serosanguineous drainage on a patient who had open abdominal surgery yesterday (or 1 day ago). Which type of assessment approach is the nurse using?

a. Gordon's Functional Health Patterns
b. Activity-exercise pattern assessment
c. General to specific assessment
d. Problem-oriented assessment


ANS: D
The nurse is not doing a complete, general assessment and then focusing on specific problem areas. Instead, the nurse focuses immediately on the problem at hand (dressing and drainage from surgery) and performs a problem-oriented assessment. Utilizing Gordon's Functional Health Patterns is an example of a structured database-type assessment technique that includes 11 patterns to assess. The nurse in this question is performing a specific problem-oriented assessment approach, not a general approach. The nurse is not performing an activity-exercise pattern assessment in this question.

Nursing

You might also like to view...

The recommended dosage of Naloxone for a child is 0.005 to 0.01 mg/kg q2-3min p.r.n. A safe effective dose for a child weighing 110 lb is _______________

a. 0.5 mcg b. 50 mcg c. 200 mcg d. 500 mcg

Nursing

A patient with diabetes is attending a class on the prevention of associated diseases. What action should the patient perform to reduce the risk of osteomyelitis?

A) Increase calcium and vitamin intake. B) Perform meticulous foot care. C) Exercise 3 to 4 times weekly for at least 30 minutes. D) Take corticosteroids as ordered.

Nursing

A patient with major depression has been place on phenelzine (Nardil). The nurse is instructing on dietary practices. Which food selection would be omitted from the diet?

A) Fruit salad B) Lobster C) Pork medallions D) Spinach and feta salad

Nursing

A concerned parent calls the school nurse because of changes in their 15-year-old adolescent's behavior

In counseling these parents,the nurse would inform the parents that the behavior that is most likely to be abnormal and indicate possible substance abuse is the adolescent's 1. buying baggy,oversized clothingat thrift shops and dying her hair black. 2. becoming very involved with friendsand in activities related to the basketball team that she is on;never seeming to be home;and,when she is home,preferring to be in her room with the door shut. 3. receiving numerous detentions latelyfrom teachers for sleeping in class. 4. becoming very moody,dramaticallycrying and weeping one minute and then cheerful and excited the next.

Nursing