A nurse is documenting assessment findings on a client. Which of the following entries should the nurse identify as subjective data?

(Select All that Apply.)

A. The MDS forms are used to comprehensively document various aspects of a resident's health, including their cognitive abilities, physical health, functional status, and other relevant factors. This data is essential for creating individualized care plans, ensuring compliance with regulations, and monitoring changes in residents' conditions over time.
B. The MDS forms are not completed by the provider each month. Instead, they are typically completed at specific intervals, such as upon admission, quarterly, and when there are significant changes in the resident's condition.
C. The MDS forms themselves do not come with an analysis of prescribed medications. While medication management is an important aspect of resident care, the MDS focuses on broader assessments of health and functional status rather than detailed medication analysis.
D. The MDS forms are not faxed to health care providers. Instead, the MDS documentation is used internally within the facility for care planning and regulatory compliance, and the data may be submitted electronically to regulatory bodies as required.

A. The hospital supervisor is responsible for overseeing the day-to-day operations of the hospital, including staff management. However, in the immediate chain of command, the supervisor might not be the first point of contact for specific unit issues unless the concern escalates beyond the unit level.
B. The charge nurse is the immediate supervisor on the unit and is usually the first point of contact for issues related to staff behavior or performance. Reporting the concern to the charge nurse is appropriate because they have the responsibility to oversee the staff on the unit, address concerns, and ensure the safety and well-being of both patients and staff. The charge nurse can assess the situation and take appropriate action, such as further investigation or reporting to higher authorities.
C. The unit director is responsible for overall management and administration of the unit, including staff issues. While the unit director is a higher level of authority than the charge nurse, it is often appropriate to first report to the charge nurse, who is closer to the situation and can address it more immediately.
D. The Chief Nursing Officer (CNO) is a top executive responsible for nursing practices across the entire hospital or healthcare system. Reporting directly to the CNO is generally not the first step in the chain of command for concerns about a coworker’s impairment.