A nurse is meeting with a client who has been treated at a substance use disorder clinic for three months. The client has had two follow up appointments at the clinic since their first visit, has attended a community-based peer support group twice weekly, and has taken their prescribed medication as directed. The nurse is discussing the effectiveness of these interventions with the client. The nurse is completing which of the following phases of the nursing process?
Analysis/diagnosis
Evaluation
Implementation
Planning
The Correct Answer is B
A. Analysis/diagnosis involves identifying health problems based on assessment data.
B. Evaluation involves assessing the effectiveness of the interventions and progress towards goals, which is what the nurse is doing.
C. Implementation refers to carrying out the plan of care.
D. Planning involves setting goals and determining the best interventions, which precedes implementation and evaluation.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","B","C"]
Explanation
A. Bathing a client who had an amputation 2 days ago can be safely delegated to assistive personnel (AP) as it does not require specialized nursing knowledge.
B. Assisting a client to ambulate using a gait belt is within the scope of practice for assistive personnel (AP) and helps promote mobility.
C. Feeding a client who had a stroke 3 months ago can be delegated to assistive personnel (AP) as it involves activities of daily living.
D. Reviewing a low-sodium diet for a client with hypertension requires nursing judgment and should not be delegated to assistive personnel (AP).
E. Explaining oral hygiene to a client receiving chemotherapy requires nursing knowledge and should not be delegated to assistive personnel (AP).
Correct Answer is C
Explanation
A. Keeping silent is unethical and violates the Nurse Practice Acts.
B. Informing the police might be necessary eventually, but the initial report should be to the supervisor.
C. Reporting the incident to the supervisor is the correct and appropriate action according to the Nurse Practice Acts.
D. Discussing the incident with a colleague does not address the legal and ethical obligation to report.
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