CNA and nursing exam practice

Reported vs observed: reading subjective and objective data

A resident who says her leg hurts has given you a report. Nobody has found an injury. Many exam answers quietly turn a report into a finding, and they read like good charting. This guide shows how to catch it.

1. Find who supplied the information

Words like states, reports, says, complains of and according to tell you the information came from the person. That is subjective information: it is real and it matters, but it is what they said, not what was measured.

Words like observed, measured, counted, temperature of and blood pressure of tell you someone saw or measured it. That is objective information.

2. Check whether the answer kept the source

Compare each answer choice with the original sentence. Does the choice still say who reported it? Does it keep the condition, such as 'when she stands'? Or has 'the resident states her leg hurts' become 'the resident has a leg injury'?

The second version deletes who said it, and adds a diagnosis nobody made. It sounds more professional, which is exactly why it is tempting.

3. Try one question

An original reading exercise written by LexyRead, not an official exam item.

Read the source

A care note says, 'The resident reports that the room felt noisy during the night.' The note contains no sound measurement.

Which restatement preserves who supplied the information?

According to the resident, the room felt noisy at night.
Staff measured excessive noise throughout the night.
The room has a confirmed noise problem at all times.
The resident refused to sleep in the room.

See the answer and why it works

According to the resident, the room felt noisy at night.

'According to the resident' keeps the report attributed to its source. The other choices add a measurement, a confirmation that lasts all the time, or a refusal that the note never mentions.

4. Three ways a report gets stretched

A report becomes a fact: 'states her back hurts' becomes 'has a back injury.' One time becomes a pattern: 'ate two bites at breakfast today' becomes 'has a poor appetite.' A cause appears: 'is dizzy when standing' becomes 'is dizzy because of a medication.'

Each of these can sound like good charting. Each one adds something the original never said. When you see a stronger, more confident answer, ask what it added.

5. Keep the habit beyond the exam

The same skill matters in real documentation: chart what was seen, measured, done or reported, and keep reports attributed to the person who gave them. Follow your program's instruction and your facility's policies for how to document.

For practice, take a sentence from your notes and write two versions: one that keeps the source, and one that turns it into a finding. Seeing both side by side makes the difference easier to spot next time.