A nurse is assessing a client who reports feeling stress and anxiety. The client appears restless and is pacing in the room. The client is alert and oriented to person, place, and time. Which of the following findings is subjective?
Alert
Restless
Anxiety
Pacing
The Correct Answer is C
Anxiety is a subjective emotional state characterized by feelings of worry, nervousness, or unease. If the client reports feeling anxious, this would be considered subjective because it is based on their own perception of their emotional state.
A. Alert refers to the client's level of consciousness and awareness of their surroundings.
B. Restlessness refers to a feeling of agitation or inability to stay still.
D. Pacing is an observable behavior where the client is walking back and forth in the room.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
The assessment phase of the nursing process involves gathering comprehensive data about the client's health status, including their medical history, current symptoms, and any factors that may impact their care.
A. The implementation phase of the nursing process involves carrying out the plan of care.
B. The planning phase involves developing a comprehensive plan of care based on the client's assessment data and identified needs.
C. The evaluation phase involves assessing the client's response to interventions and determining the effectiveness of the care provided.
Correct Answer is A
Explanation
This statement encourages the client to express their own perspectives, beliefs, and preferences regarding their health and well-being. It fosters client autonomy and acknowledges the importance of understanding the client's cultural context and values when developing a treatment plan. This statement aligns with the principles of the CFI tool.
C. This statement imposes the nurse's perspective on the client and may not be culturally sensitive.
D. This statement imposes the nurse's beliefs and assumptions on the client and may not be culturally sensitive.
B. This statement may not be appropriate without further exploration of the client's experiences, beliefs, and cultural context. It imposes Western diagnostic categories on the client without considering the cultural validity of these categories or the client's own explanatory model of illness.
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