Planning

Primary purpose of outcome identification + planning step of the nursing process?

A) to collect and analyze data to establish a database
B) to interpret and analyze data to identify health problems
C) to write appropriate patient-centered nursing diagnoses
D) to design a plan of care for and with the patient

D) to design a plan of care for and with the patient
Critical thinking is an essential component in all phases of the nursing process. What question might be used to facilitate critical thinking during outcome identification and planning?

A) “How do I best cluster these data and cues to identify problems?”
B) “What problems require my immediate attention or that of the team?”
C) “What major defining characteristics are present for a nursing diagnosis?”
D) “How do I document care accurately and legally?”

B) “What problems require my immediate attention or that of the team?”
A nurse admits a patient to the hospital’s short-stay unit and completes a health history and physical assessment. Using these data, the nurse develops a(n) ___________plan of care, based on _____________ planning?
A) intermittent, focused
B) comprehensive, initial
C) single-use, ongoing
D) standard, emergency
B) comprehensive, initial
The nursing diagnosis Impaired Gas Exchange, prioritized by Maslow’s hierarchy of basic human needs, is appropriate for what level of needs?

A) physiologic
B) safety
C) love and belonging
D) self-actualization

A) physiologic
A resident of a long-term care facility refuses to eat until she has had her hair combed and her make-up applied. In this case, what patient need should have priority?
A) the need to have nutrition
B) the need to feel good about oneself
C) the need to live in a safe environment
D) the need for love from others
B) the need to feel good about oneself
Which of the following outcomes is correctly written?

A) Abdominal incision will show no signs of infection.
B) On discharge, patient will be free of infection.
C) On discharge, patient will be able to list five symptoms of infection.
D) During home care, nurse will not observe symptoms of infection.

C) On discharge, patient will be able to list five symptoms of infection.
Which of the following groups of terms best describes a nurse-initiated intervention?

A) dependent, physician-ordered, recovery
B) autonomous, clinical judgment, patient outcomes
C) medical diagnosis, medication administration
D) other healthcare providers, skill acquisition

B) autonomous, clinical judgment, patient outcomes
A nurse has developed a plan of care w nursing interventions designed to meet specific pt outcomes. The outcomes are not met by the time specified in the plan. What should the nurse do now in terms of evaluation?

A) Continue to follow the written plan of care.
B) Make recommendations for revising the plan of care.
C) Ask another healthcare professional to design a plan of care.
D) State “goal will be met at a later date.”

B) Make recommendations for revising the plan of care.
27. Which of the following is an example of a well-stated nursing intervention?

A) Patient will drink 100 mL of water every 2 hours while awake.
B) Offer patient 100 mL of water every 2 hours while awake.
C) Offer patient water when he complains of thirst.
D) Patient will continue to increase oral intake when awake.

B) Offer patient 100 mL of water every 2 hours while awake.
What common problem is related to outcome identification and planning?

A) failing to involve the pt in planning process
B) collecting sufficient data to establish a database
C) stating specific and measurable outcomes based on nursing diagnoses
D) writing nursing orders that are clear and resolve the problem

A) failing to involve the patient in the planning process
An 82 yo pt who resides in a nursing home has the following 3 nursing diagnoses: risk for fall, impaired physical mobility r/t pain, & wandering r/t cognitive impairment. The nursing staff identified several goals of care, including “The pt will achieve pain relief.” Which outcome is related to this goal?

Client will express fewer nonverbal signs of discomfort.
Client will follow a set care routine.
Client will walk correctly using a walker.
Client will exit a low bed without falling

Client will express fewer nonverbal signs of discomfort.
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