Which information obtained during a history and physical examination should the nurse document as subjective data?

Loss of appetite

Wound appearance

Heart rate

Cyanosis

Answer and Explanation

The Correct Answer is A

A. Loss of appetite: Subjective data are based on the client’s personal experiences, feelings, and perceptions. Loss of appetite is reported by the client and reflects their subjective experience.

B. Wound appearance: The appearance of a wound is observable and measurable, making it objective data that the nurse can assess through inspection.

C. Heart rate: Heart rate is measured using vital signs and instruments, making it objective data rather than a subjective report from the client.

D. Cyanosis: Cyanosis is a visible physical sign indicating decreased oxygenation. It is observed by the nurse, so it is considered objective data.

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Correct Answer is C

Explanation

A. The client's learning needs: While understanding learning needs is important for education and long-term management, it is not an immediate priority in an emergency situation where safety and urgent interventions are critical.

B. The client's age and sex: Age and sex are relevant for assessment and risk stratification, but they do not directly address immediate safety concerns or guide urgent care decisions in an emergency.

C. The client's allergies: Allergies are critical to identify immediately because they can cause life-threatening reactions if the client is exposed to certain medications, foods, or substances during emergency treatment. This information directly impacts safe and effective care.

D. The client's medical history: Knowing medical history is valuable for understanding the client’s overall health, but in an emergency, information that prevents immediate harm, such as allergies, takes precedence over detailed historical data.

A. Discuss with the client their risk factors for developing CAD. B. Have the client start exercising for at least 30 minutes a day. C. Encourage the client to attend a support group for CAD. D. Instruct the client to begin following a heart-healthy diet.

Correct Answer is A

Explanation

A. Discuss with the client their risk factors for developing CAD: Family history is a significant non-modifiable risk factor for coronary artery disease. Educating the client about their personal risk helps raise awareness and supports prevention strategies tailored to their needs.

B. Have the client start exercising for at least 30 minutes a day: While exercise is important for cardiovascular health, recommending a specific regimen without first assessing the client’s overall health, readiness, and risk factors may be unsafe.

C. Encourage the client to attend a support group for CAD: Support groups can be beneficial for individuals already diagnosed with CAD, but the client in this scenario has a family history and may not need immediate support group involvement.

D. Instruct the client to begin following a heart-healthy diet: Diet modification is an effective preventive measure, but it should be introduced as part of a broader discussion on risk factors and individualized planning rather than as an immediate directive.

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Which information obtained during a history and physical examination should the nurse document as subjective data?

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Naxlex Comprehensive Predictor Exams

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Explanation

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Correct Answer is A

Explanation

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