A nurse is working with an RN to admit a new client. Which of the following steps of the nursing process is the nurse using when assisting to formulate goals for a positive outcome?
Planning
Evaluation
Data collection
Implementation
The Correct Answer is A
Choice A reason: This statement is correct because planning is the step of the nursing process that involves formulating goals and outcomes for a positive outcome. The nurse and the RN should collaborate with the client and other members of the healthcare team to identify the client's needs, priorities, and preferences, and develop a plan of care that is realistic, measurable, and client centered.
Choice B reason: This statement is incorrect because evaluation is the step of the nursing process that involves measuring the effectiveness of the plan of care and the achievement of the goals and outcomes. The nurse and the RN should compare the actual results with the expected results, and determine if the plan of care needs to be modified, continued, or terminated.
Choice C reason: This statement is incorrect because data collection is the step of the nursing process that involves gathering information about the client's health status, history, and environment. The nurse and the RN should use various sources and methods of data collection, such as interviewing, observing, examining, and reviewing records, and organize and document the data in a systematic and accurate way.
Choice D reason: This statement is incorrect because implementation is the step of the nursing process that involves carrying out the plan of care and providing the interventions. The nurse and the RN should perform the actions that are necessary to achieve the goals and outcomes, such as administering medications, providing education, or coordinating referrals, and document the interventions and the client's response.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: Client's skin is pale and diaphoretic is not included in the subjective component, but in the objective component. The objective component records the measurable and observable data that the nurse collects from the client, such as vital signs, physical examination findings, and laboratory results.
Choice B reason: Client reports chest pain after mowing lawn this morning is included in the subjective component. The subjective component records the data that the client verbalizes or expresses, such as symptoms, feelings, preferences, and beliefs.
Choice C reason: Client administered nitroglycerin 0.3 mg SL for chest pain is not included in the subjective component, but in the plan component. The plan component records the interventions and actions that the nurse implements or plans to implement for the client, such as medications, treatments, referrals, and education.
Choice D reason: Client's blood pressure is 182/98 mm Hg is not included in the subjective component, but in the objective component. The objective component records the measurable and observable data that the nurse collects from the client, such as vital signs, physical examination findings, and laboratory results.
Correct Answer is C
Explanation
Choice A reason: Use of restraints is not included in the outcome category, but in the process category. The process category measures the nursing interventions and activities that affect the client's health outcomes. Use of restraints is a nursing intervention that can have negative effects on the client's physical and psychological wellbeing, such as injuries, infections, agitation, and depression.
Choice B reason: Client admissions is not included in the outcome category, but in the structure category. The structure category measures the characteristics and resources of the health care setting that affect the quality of care. Client admissions is a characteristic that reflects the volume and complexity of the client population and the demand for nursing services.
Choice C reason: Hospital readmissions is included in the outcome category. The outcome category measures the results and consequences of the nursing care provided to the clients. Hospital readmissions is a result that indicates the effectiveness and continuity of the nursing care. A high rate of hospital readmissions can suggest poor quality of care, inadequate discharge planning, or lack of follow-up care.
Choice D reason: Staffing is not included in the outcome category, but in the structure category. The structure category measures the characteristics and resources of the health care setting that affect the quality of care. Staffing is a resource that reflects the quantity and quality of the nursing staff, such as the number, education, experience, and skill mix of the nurses.
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