To what does objective data refer when assessing a patient?

the provider's observed data

All of the answers are correct

the patient's perception of provided data

the patient's request for information

Answer and Explanation

The Correct Answer is A

A. The provider’s observed data: Objective data includes what the nurse or provider directly observes and measures, such as vital signs, lab results, and physical exam findings.

B. All of the answers are correct: Only option A is correct because C and D do not define objective data.

C. The patient’s perception of provided data: The patient’s perception is subjective data, not objective.

D. The patient’s request for information: A request for information is neither assessment data nor an objective finding.

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Correct Answer is B

Explanation

A. Not used by anyone else but the direct care providers: Health records are used by multiple healthcare team members, including billing departments, insurance providers, and legal entities when required.

B. Concise, legal records of all care given and responses: Health records document all care provided, patient responses, and medical decisions. They serve as legal records in case of disputes or audits.

C. Owned by the patient, who has a right to see the data any time he/she wishes: The healthcare facility owns the records, but patients have a right to request access under HIPAA and other legal provisions.

D. Confidential information and cannot be taken to court: Health records can be subpoenaed and used in legal cases, provided they comply with confidentiality laws.

A. it increases cost B. it promotes individualization of the medical record C. it improves legibility D. it minimizes the number of forms to be completed

Correct Answer is C

Explanation

A. It increases cost.: While initial implementation is costly, computerized charting ultimately reduces costs by improving efficiency and reducing errors.

B. It promotes individualization of the medical record.: Computerized systems standardize documentation rather than individualizing it. However, personalization can be added through specific notes.

C. It improves legibility.: Handwritten notes can be illegible, leading to errors. Computerized charting eliminates handwriting issues and ensures clarity.

D. It minimizes the number of forms to be completed.: While it may reduce paperwork, it does not necessarily minimize documentation, as structured data entry is still required.

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To what does objective data refer when assessing a patient?

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Naxlex Comprehensive Predictor Exams

Patient health care records are:

Correct Answer is B

Explanation

One benefit of computerized charting is that:

Correct Answer is C

Explanation

The primary source of assessment information is:

Which part of the medical record can be used as evidence in court?

During the shift, the nurse charts only additional treatments done or withheld, changes in patient condition, and new concerns. Charting these factors demonstrates which of the following type of charting?

Show that documentation of patient care by the nurse is very important by selecting from the following: (select all that apply)

JCAHO regulates standards of care to:

Subjective data provided by the patient included complaints of intermittent chest pain upon exertion. When performing a complete physical examination, the nurse might use an organized approach such as:

When discovering subjective data, recognize that they relate to:

Select the type of assessment which is performed continuously throughout nurse-patient contact: