Concept 9: Thermoregulation
1. The nursery nurse identifies a newborn at significant risk for hypothermic alteration in
thermoregulation because the patient is
large for gestational age.
low birth weight.
born at term.
Concept 2: Functional Ability
1. The nurse is assessing a patient's functional ability. Which activities most closely match the
definition of functional ability?
Healthy individual, works outside the home, uses a cane, well groom
Concept 6: Adherence
1. A patient has been newly diagnosed with hypertension. The nurse assesses the need to develop
a collaborative plan of care that includes a goal of adhering to the prescribed regimen. When
the nurse is plann
Concept 5: Motivation
1. The nurse is assessing a patient's personal traits using the Influential Characteristics on
Motivation tool. What assessment parameters will be included in this assessment?
a. Developmental, cognitive, an
Concept 7: Fluid and Electrolyte Balance
1. The nurse is admitting an older adult with decompensated congestive heart failure. The
nursing assessment reveals adventitious lung sounds, dyspnea, and orthopnea. The nurse
Concept 4: Culture
1. The nurse is triaging a hysterical patient in the ER. The patient is crying, with uncontrollable
spasms, trembling, and shouting. It is important to identify manifestation of illness in order to
Concept 1: Development
1. The nurse manager of a pediatric clinic could confirm that the new nurse recognized the
purpose of the HEADSS Adolescent Risk Profile when the new nurse responds that it is used
to assess for needs relat
Concept 3: Family Dynamics
1. The most appropriate initial nursing intervention when the nurse notes dysfunctional
interactions and lack of family support for a patient would be to
enforce hospital visiting policies.
Concept 8: Acid-Base Balance
1. The patient had diarrhea for 5 days and developed an acid-base imbalance. Which statement
would indicate that the nurse's teaching about the acid-base imbalance has been effective?
"To prevent anot
Concept 10: Cellular Regulation
1. The nurse would incorporate which of the following into the plan of care as a primary
prevention strategy for reduction of the risk for cancer?
Yearly mammography for women aged 40 years and old