45. Complete the sentence by selecting from the drop-down lists. A nurse is assessing the gastrointestinal system of a client.
The nurse should document dropdown as objective data anddropdown as subjective data.
The Correct Answer is {"dropdown-group-2":"A","dropdown-group-3":"B"}
• Melena: Melena is an observable finding indicating dark, tarry stools, which the nurse can verify during the physical assessment. As an objective sign, it is measurable and detectable without relying on the client’s personal report. Documenting melena provides concrete evidence of gastrointestinal bleeding or other pathology.
• Stomach pain: Stomach pain is a subjective symptom because it is reported by the client and cannot be directly measured by the nurse. It reflects the client’s personal experience of discomfort and is essential to capture during assessment. Subjective data help guide further evaluation and treatment planning based on the client’s reported experience.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Evaluation: Evaluation involves determining whether the client has achieved desired outcomes or goals. Educating the client is an action, not the process of assessing whether the goals have been met.
B. Planning: Planning includes setting measurable goals and determining interventions to achieve them. While education may be part of the plan, the act of teaching occurs later in the process.
C. Implementation: Implementation is the phase of the nursing process where planned interventions are carried out. Teaching the client how to perform a blood glucose check is an active intervention, making this step part of implementation.
D. Assessment: Assessment involves collecting and analyzing client data to identify health status, risks, and needs. Education occurs after assessment, so teaching is not part of this step.
Correct Answer is D
Explanation
A. Asking closed-ended questions to direct the conversation: Closed-ended questions limit responses and can restrict the flow of information. Active listening involves open-ended questions that encourage the client to share more detailed thoughts and feelings.
B. Focus on typing notes while the client is speaking: Diverting attention to note-taking can signal disinterest and reduce the nurse’s ability to interpret verbal and nonverbal cues. Active listening requires full attention to the client.
C. Provide advice before the client has finished speaking: Interrupting with advice prevents the nurse from fully understanding the client’s perspective. Active listening involves allowing the client to express themselves completely before responding or offering guidance.
D. Maintain eye contact and nod to indicate understanding: Nonverbal cues such as eye contact, nodding, and facial expressions demonstrate attentiveness and understanding. These behaviors encourage the client to communicate openly and confirm that the nurse is actively listening.
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