A nurse is performing an initial assessment on a new admission. Which of the following is part of the database?
1. Reports from physical therapy the client received as an outpatient.
2. Documentation of the nurse’s physical assessment.
3. Physician’s orders.
4. A list of current medications.
5. Information about the client’s cultural preferences.
6. Discharge instructions.
ANSWER
Correct Answer: 1,2,4,5
Rationale: The database is all the information about a client. It includes the nursing health history, physical assessment, the physician’s history and physical examination, results of laboratory and diagnostic tests, and material contributed by other health personnel.
Place an order in 3 easy steps. Takes less than 5 mins.