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.)
Client reports dull, aching pain in lower right calf.
Client reports nausea following administration of pain medication.
Client's oral temperature is 38.4° C (101.2° F).
Client reports the rash on their back is itchy.
Client has a vesicular rash on their upper back.
Correct Answer : A,B,D
A. This is subjective data. The description of pain as "dull" and "aching" is based on the client's personal experience and cannot be measured directly by the nurse. Pain is a subjective symptom because it varies from person to person and is reported by the patient.
B. This is subjective data. Nausea is a feeling or sensation reported by the client and is based on their personal experience. The nurse relies on the client's report to assess this symptom, as it cannot be directly observed or measured.
C. This is objective data. The temperature reading is a measurable, quantifiable fact that can be directly observed and recorded by the nurse using a thermometer. It provides concrete evidence of the client's condition.
D. This is subjective data. Itchiness is a sensation reported by the client and is based on their personal experience. The nurse cannot measure itchiness directly; they rely on the client’s description to understand the symptom.
E. This is objective data. The presence of a vesicular rash is an observable finding that the nurse can see and document. It is a physical characteristic that can be directly assessed and recorded.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. This aligns with the "D" in IDEAL, which is to develop a discharge plan. The client's goals should be a central part of this plan.
B. While the discharge process is important, it's more about the steps involved in the discharge rather than a key area to discuss with the client.
C. While family input is valuable, the focus should be on the client's needs and goals.
D. Test results are important information for the client, but they are not one of the five key areas of the IDEAL toolkit.
Correct Answer is B
Explanation
A. This statement is partially correct but does not fully capture the purpose of the Press Ganey survey. While it is true that surveys are often administered to a sample of patients, the primary purpose is to gather feedback about patient satisfaction.
B. This statement accurately reflects the purpose of the Press Ganey survey. It is designed to collect feedback from patients about their experience with healthcare services.
C. While some healthcare facilities may still use paper surveys, many have transitioned to electronic surveys. This statement is not entirely accurate and does not reflect the core purpose of the survey.
D. This statement is incorrect. The Press Ganey survey is typically administered as a written or online questionnaire, not through a phone call.
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