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Week 2
Planning
Question | Answer |
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The immobile patient has a goal of maintaining tissue integrity. Why does the nurse consult the Nursing Outcomes Classification (NOC) when evaluating the achievement of the goal? | To determine the level of goal achievement |
The patient is being scheduled for knee surgery. When does the nurse expect the care planning process to begin? | When the patient is contacted by the office nurse to schedule surgery. |
The patient is admitted after an automobile accident and now has paraplegia. Following Maslow’s Hierarchy of Needs, which nursing diagnosis has the highest priority? | Impaired Urinary Elimination |
A patient is admitted to the hospital with pneumonia. He has diabetes and a partial thickness pressure ulcer on his sacrum. He hasn’t had a bowel movement in 3 days. Which nursing diagnosis should be the highest priority? | Impaired Gas Exchange |
The nurse is identifying a goal related to weight loss for an obese patient. In order for the patient to be successful with the goal, what should the nurse do? | Ask the patient what he would like to achieve. |
The patient needs to lose 60 pounds. What should the nurse do? | Consider the patient’s social and cultural factors that might be influencing her priorities. |
What is an example of a long-term goal for the patient? | Achieve wound healing in 3 weeks. |
Why would the nurse use a conceptual care map (CCM) to develop a plan of care? | Provides a quick, yet comprehensive, overview of the patient’s status and plan. |
A nurse is discussing short-term goals with a patient in the rehab unit. Why is it important for the nurse to include the patient in the goal-setting phase? | Provides motivation for the patient to achieve goals. |