A discharge goal for a client is to have improved mobility. Which outcome statement did the nurse write appropriately?

Client will have freer movement in daily activities.

Client will ambulate without a walker by 6 weeks.

Client will not fall.

Client will ambulate frequently in the house.

Answer and Explanation

The Correct Answer is B

An appropriate outcome statement for a client with a discharge goal of improved mobility should be specific, measurable, achievable, relevant, and time-bound. In this case, the outcome statement "Client will ambulate without a walker by 6 weeks" meets these criteria. It specifies the desired outcome (ambulating without a walker), provides a measurable goal (6 weeks), is achievable and relevant to the client's goal of improved mobility, and includes a time frame for achieving the goal. The other statements are not specific or measurable enough to be considered appropriate outcome statements.

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Correct Answer is D

Explanation

A normal state of awareness is characterized by being aware of oneself and one's surroundings. In this case, a nurse would document the client's condition as being "aware of self and environment" to indicate that the client has a normal state of awareness.

A. Stage II pressure ulcer B. Stage IV pressure ulcer C. Stage I pressure ulcer D. Stage III pressure ulcer

Correct Answer is A

Explanation

A stage II pressure ulcer is a wound that presents as a shallow open ulcer with a red-pink wound bed and partial thickness loss of dermis. This type of wound is caused by unrelieved pressure on the skin, resulting in damage to the underlying tissue. In this scenario, the nurse notes an area of tissue injury on the client's sacral area that matches the description of a stage II pressure ulcer. Stage I pressure ulcers are characterized by non-blanchable erythema of intact skin, while stage III and IV pressure ulcers involve full-thickness tissue loss and may expose underlying muscle, bone, or other structures.

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A discharge goal for a client is to have improved mobility. Which outcome statement did the nurse write appropriately?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

How would a nurse document the condition in which a client has a normal state of awareness?

Correct Answer is D

Explanation

While performing a bed bath, the nurse notes an area of tissue injury on the client's sacral area. The wound presents as a shallow open ulcer with a red-pink wound bed and partial thickness loss of dermis. What is the correct name of this wound?

Correct Answer is A

Explanation

When a labor and delivery nurse tells a co-worker that a client of Asian descent probably did not want any pain medication because "Asian women typically are stoic," the nurse is expressing a belief known as what?

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The nurse is admitting a new client to the unit. The nurse notes that this client would need an alternate meal choice when the menu specified pork for a meal. Members of which cultural group might request an alternative meal choice?

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