Question 1

The nurse recognizes measurable goal to have which characteristics?

Accepted Answer

A)  Specific 
B)  Concrete 
C)  Vague 
D)  Easy to judge 
E)  Nonspecific 
A)  Specific 
B)  Concrete 
C)  Vague 
D)  Easy to judge 
E)  Nonspecific A, B, D

Question 2

The nurse identifies which goal is written correctly for the Nursing diagnosis of activity intolerance related to imbalance between oxygen supply and demand?

Accepted Answer

A)  Patient will walk 1 mile without shortness of breath. 
B)  Patient will ambulate 100 feet with no shortness of breath on third day after treatment. 
C)  Patient will climb stairs without shortness of breath by day 2 of hospital stay. 
D)  Patient will tolerate activity. 
A)  Patient will walk 1 mile without shortness of breath. 
B)  Patient will ambulate 100 feet with no shortness of breath on third day after treatment. 
C)  Patient will climb stairs without shortness of breath by day 2 of hospital stay. 
D)  Patient will tolerate activity. B

Question 3

Since in the planning phase, the significance of developing organized plans of care for patients is important, the nurse must take seriously which of these responsibilities?

Accepted Answer

A)  Prioritizing patient needs 
B)  Developing mutually agreed-on goals 
C)  Determining outcome criteria 
D)  Identifying interventions 
E)  Implementation of the patient's plan of care 
A)  Prioritizing patient needs 
B)  Developing mutually agreed-on goals 
C)  Determining outcome criteria 
D)  Identifying interventions 
E)  Implementation of the patient's plan of care A, B, C, D

Question 4

The nurse is caring for a patient who has had abdominal surgery and has developed a slight temperature. The nurse identifies which statement to be a patient-centered goal?

Accepted Answer

A)  The patient's temperature will return to normal within 24 hours. 
B)  The nurse will medicate the patient for elevated temperature every 4 hours as needed. 
C)  Skin integrity will be maintained until the patient is ambulatory. 
D)  The patient will ambulate 10 feet by postoperative day 2. 
A)  The patient's temperature will return to normal within 24 hours. 
B)  The nurse will medicate the patient for elevated temperature every 4 hours as needed. 
C)  Skin integrity will be maintained until the patient is ambulatory. 
D)  The patient will ambulate 10 feet by postoperative day 2.

Question 5

The nurse knows that standardized care plans may be available and are utilized under which circumstance?

Accepted Answer

A)  They need to be individualized for each patient. 
B)  They are implemented without adjustment. 
C)  They remove the need for nurse involvement. 
D)  They do not require the use of Nursing diagnoses. 
A)  They need to be individualized for each patient. 
B)  They are implemented without adjustment. 
C)  They remove the need for nurse involvement. 
D)  They do not require the use of Nursing diagnoses.

Question 6

The nurse knows which response to be an example of a measurable goal?

Accepted Answer

A)  "The patient will be able to lift 10 lb. by the end of week one." 
B)  "The patient will be able to lift weights by the end of the week." 
C)  "The patient will be able to lift his normal weight amount." 
D)  "The patient will be able to lift an acceptable amount of weight by week one." 
A)  "The patient will be able to lift 10 lb. by the end of week one." 
B)  "The patient will be able to lift weights by the end of the week." 
C)  "The patient will be able to lift his normal weight amount." 
D)  "The patient will be able to lift an acceptable amount of weight by week one."

Question 7

The nurse recognizes that patient goals include which characteristic?

Accepted Answer

A)  They are considered short-term if achieved within a month of identification. 
B)  They always have established time parameters, such as "long-term" or "short-term." 
C)  They are mutually acceptable to the nurse, patient, and family. 
D)  They can be vague to facilitate flexibility when evaluating achievement. 
A)  They are considered short-term if achieved within a month of identification. 
B)  They always have established time parameters, such as "long-term" or "short-term." 
C)  They are mutually acceptable to the nurse, patient, and family. 
D)  They can be vague to facilitate flexibility when evaluating achievement.

Question 8

The nurse recognizes which is a correctly written example of a short-term goal?

Accepted Answer

A)  The patient will lose 50 lb in 1 year. 
B)  Patient will ambulate 1 mile without shortness of breath. 
C)  Patient will be able to change the colostomy bag in 6 weeks. 
D)  The patient will eat 75% of all meals for the next three days. 
A)  The patient will lose 50 lb in 1 year. 
B)  Patient will ambulate 1 mile without shortness of breath. 
C)  Patient will be able to change the colostomy bag in 6 weeks. 
D)  The patient will eat 75% of all meals for the next three days.

Question 9

The nurse recognizes that by involving the patient in planning care, which patient results occur?

Accepted Answer

A)  Being aware of identified needs 
B)  Accepting that not all goals are measurable 
C)  Embracing mutually agreed-on goals 
D)  Feeling a sense of empowerment 
E)  Overcoming unrealistic goals 
A)  Being aware of identified needs 
B)  Accepting that not all goals are measurable 
C)  Embracing mutually agreed-on goals 
D)  Feeling a sense of empowerment 
E)  Overcoming unrealistic goals

Question 10

The nurse is formulating the patient's care plan. In determining when to evaluate the patient's progress, the nurse is aware that evaluations should be carried out within which parameters?

Accepted Answer

A)  They must be done at the end of every shift. 
B)  They should be done at least every 24 hours. 
C)  They depend on intervention and patient condition. 
D)  They are always done at time of discharge. 
A)  They must be done at the end of every shift. 
B)  They should be done at least every 24 hours. 
C)  They depend on intervention and patient condition. 
D)  They are always done at time of discharge.

Question 11

The nurse identifies which statement to be accurate regarding discharge planning?

Accepted Answer

A)  "It may decrease the incidence of patients who need to return to the hospital." 
B)  "It increases complications and readmissions in most cases." 
C)  "It adapts to the situation as the patient's conditions changes." 
D)  "It should begin as soon as the patient is discharged home." 
A)  "It may decrease the incidence of patients who need to return to the hospital." 
B)  "It increases complications and readmissions in most cases." 
C)  "It adapts to the situation as the patient's conditions changes." 
D)  "It should begin as soon as the patient is discharged home."

Question 12

The nurse is formulating a plan of care for a patient. In this phase of the nursing process, the nurse should complete which actions?

Accepted Answer

A)  Prioritize Nursing diagnoses. 
B)  Determine short- and long-term goals. 
C)  Identify outcome indicators. 
D)  List nursing interventions. 
E)  Gather assessment data. 
A)  Prioritize Nursing diagnoses. 
B)  Determine short- and long-term goals. 
C)  Identify outcome indicators. 
D)  List nursing interventions. 
E)  Gather assessment data.

Question 13

The nurse recognizes which action to be a dependent nursing intervention?

Accepted Answer

A)  Utilizing heel protectors 
B)  Preadmission teaching 
C)  Medication reconciliation 
D)  Oxygen administration via mask 
A)  Utilizing heel protectors 
B)  Preadmission teaching 
C)  Medication reconciliation 
D)  Oxygen administration via mask

Question 14

Setting priorities among identified Nursing diagnoses is the first step in the planning process. The nurse knows this prioritization includes which action?

Accepted Answer

A)  Monitoring patient responses 
B)  Carrying out the health care provider's plan of care 
C)  Providing all interventions 
D)  Collaborating with other disciplines 
A)  Monitoring patient responses 
B)  Carrying out the health care provider's plan of care 
C)  Providing all interventions 
D)  Collaborating with other disciplines

Question 15

The nurse demonstrates a thorough understanding of the planning phase of the nursing process when making which statement?

Accepted Answer

A)  "Patients should be included in the planning process." 
B)  "Patient families should not interfere in the planning process." 
C)  "The planning process should focus on short-term goals only." 
D)  "Planning is the first phase of the nursing process." 
A)  "Patients should be included in the planning process." 
B)  "Patient families should not interfere in the planning process." 
C)  "The planning process should focus on short-term goals only." 
D)  "Planning is the first phase of the nursing process."

Question 16

Which assessment made by the nurse should be addressed first?

Accepted Answer

A)  Reddened area to coccyx 
B)  Decreased urinary output 
C)  Shortness of breath 
D)  Drainage from surgical incision 
A)  Reddened area to coccyx 
B)  Decreased urinary output 
C)  Shortness of breath 
D)  Drainage from surgical incision

Question 17

The nurse is caring for a patient who has undergone abdominal surgery. The patient stated prior to surgery that "I don't think I'll be able to handle this if I get a colostomy. I wouldn't know how to manage it." The patient is complaining of severe surgical pain and has an order for morphine sulfate. The nurse is correct when addressing which Nursing diagnosis first?

Accepted Answer

A)  Pain 
B)  Alteration in body image 
C)  Knowledge deficit 
D)  Risk for falls 
A)  Pain 
B)  Alteration in body image 
C)  Knowledge deficit 
D)  Risk for falls

Question 18

The nurse understands that discharge planning begins at what point in the patient's hospitalization?

Accepted Answer

A)  The day before discharge 
B)  Upon admission 
C)  Prior to admission 
D)  Day of discharge 
A)  The day before discharge 
B)  Upon admission 
C)  Prior to admission 
D)  Day of discharge

Question 19

The nurse recognizes which term identifies nursing interventions that originate from the health care provider orders?

Accepted Answer

A)  Dependent 
B)  Independent 
C)  Collaborative 
D)  Nursing interventions classifications 
A)  Dependent 
B)  Independent 
C)  Collaborative 
D)  Nursing interventions classifications

Question 20

The nurse recognizes that physical therapy, speech therapy, home health care, and personal care are examples of which type of interventions?

Accepted Answer

A)  Collaborative interventions 
B)  Dependent nursing interventions 
C)  Independent nursing interventions 
D)  Assessment interventions 
A)  Collaborative interventions 
B)  Dependent nursing interventions 
C)  Independent nursing interventions 
D)  Assessment interventions

Exam 8: Planning

The nurse recognizes measurable goal to have which characteristics?

The nurse identifies which goal is written correctly for the Nursing diagnosis of activity intolerance related to imbalance between oxygen supply and demand?

Since in the planning phase, the significance of developing organized plans of care for patients is important, the nurse must take seriously which of these responsibilities?

The nurse is caring for a patient who has had abdominal surgery and has developed a slight temperature. The nurse identifies which statement to be a patient-centered goal?

The nurse knows that standardized care plans may be available and are utilized under which circumstance?

The nurse knows which response to be an example of a measurable goal?

The nurse recognizes that patient goals include which characteristic?

The nurse recognizes which is a correctly written example of a short-term goal?

The nurse recognizes that by involving the patient in planning care, which patient results occur?

The nurse is formulating the patient's care plan. In determining when to evaluate the patient's progress, the nurse is aware that evaluations should be carried out within which parameters?

The nurse identifies which statement to be accurate regarding discharge planning?

The nurse is formulating a plan of care for a patient. In this phase of the nursing process, the nurse should complete which actions?

The nurse recognizes which action to be a dependent nursing intervention?

Setting priorities among identified Nursing diagnoses is the first step in the planning process. The nurse knows this prioritization includes which action?

The nurse demonstrates a thorough understanding of the planning phase of the nursing process when making which statement?

Which assessment made by the nurse should be addressed first?

The nurse understands that discharge planning begins at what point in the patient's hospitalization?

The nurse recognizes which term identifies nursing interventions that originate from the health care provider orders?

The nurse recognizes that physical therapy, speech therapy, home health care, and personal care are examples of which type of interventions?

Nursing, Theory, and Professional Practice

Values, Beliefs, and Caring

Communication

Critical Thinking in Nursing

Introduction to the Nursing Process

Assessment

Nursing Diagnosis

Implementation and Evaluation

Documentation, Electronic Health Records, and Reporting

Ethical and Legal Considerations

Leadership and Management

Evidence-Based Practice and Nursing Research

Health Literacy and Patient Education

Nursing Informatics

Health and Wellness

Human Development: Conception Through Adolescence

Human Development: Young Adult Through Older Adult

Vital Signs

Health History and Physical Assessment

Ethnicity and Cultural Assessment

Spiritual Health

Public Health, Community-Based, and Home Health Care

Human Sexuality

Safety

Asepsis and Infection Control

Hygiene and Personal Care

Activity, Immobility, and Safe Movement

Skin Integrity and Wound Care

Nutrition

Cognitive and Sensory Alterations

Stress and Coping

Sleep

Diagnostic Testing

Medication Administration

Pain Management

Perioperative Nursing Care

Oxygenation and Tissue Perfusion

Fluid, Electrolytes, and Acid-Base Balance

Bowel Elimination

Urinary Elimination

Death and Loss

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