The nurse plans to assess a client's ability to think abstractly. Which question or statement is likely to provide the best information about the client's abstract thinking?

"Count backwards by 7, starting with 100."

"Has anyone come to visit you today?"

"In what year were you born?"

"What does, "The early bird catches the worm," mean?"

Answer and Explanation

The Correct Answer is D

A. "Count backwards by 7, starting with 100.": This question assesses concentration, attention span, and mathematical ability but does not evaluate abstract thinking. It is typically used in cognitive or mental status exams to assess focus and processing speed.

B. "Has anyone come to visit you today?": This is a straightforward question assessing recent memory or orientation but has no abstract component. It provides little insight into higher-order thinking or interpretation skills.

C. "In what year were you born?": This question evaluates remote memory, not abstract reasoning. It is factual and concrete, requiring only recollection, not interpretation or deeper thought.

D. "What does, 'The early bird catches the worm,' mean?": This is a proverb that requires interpretation beyond its literal meaning. Asking for its meaning helps assess abstract thinking by evaluating the client’s ability to understand figurative language and draw broader conclusions.

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Correct Answer is B

Explanation

A. Document the client's history that is directly related to current admission diagnoses:

While focusing on relevant history is important, a comprehensive health history should also include past medical, surgical, and family history to provide a full clinical picture. Limiting documentation to only current issues may omit key information.

B. Enter the information in the electronic medical record at the client's bedside:

Documenting at the bedside promotes accuracy, ensures real-time data entry, and allows the nurse to clarify details immediately with the client. This approach enhances communication, reduces errors, and supports patient-centered care.

C. Enter subjective data in the note section of the client's electronic medical record:

Subjective data should be appropriately recorded in designated fields within the health history or assessment section of the electronic record, not solely in the note section, to maintain organization and accessibility for all healthcare providers.

D. Document the assessment findings on the computer at the nursing station:

Waiting to chart at the nursing station increases the risk of memory lapses or incomplete documentation. It can lead to inaccuracies compared to bedside documentation, especially for complex or nuanced findings like those in seizure assessments.

A. Ask if the client took any pain medication at home. B. Use a standard pain assessment questionnaire and scale. C. Collect a urine sample and strain for granules or calculi. D. Observe for nonverbal signs to measure pain intensity.

Correct Answer is B

Explanation

A. Ask if the client took any pain medication at home: While this is important for evaluating pain management and potential medication interactions, it does not quantify the current pain level or guide immediate intervention. It should follow initial assessment.

B. Use a standard pain assessment questionnaire and scale: This is the priority initial intervention. A thorough and objective pain assessment helps the nurse determine the severity, location, and nature of the pain, which is critical for guiding further evaluation and management.

C. Collect a urine sample and strain for granules or calculi: Straining urine is important for diagnostic confirmation of kidney stones, but it is not the first action. Pain assessment should be completed first to guide symptom management and determine urgency.

D. Observe for nonverbal signs to measure pain intensity: Observing nonverbal cues is useful, especially if the client cannot verbalize their pain. However, since the client is alert and able to report symptoms, a structured pain scale provides more accurate and standardized data.

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The nurse plans to assess a client's ability to think abstractly. Which question or statement is likely to provide the best information about the client's abstract thinking?

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Naxlex Comprehensive Predictor Exams

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