A nursing student in clinical asks her instructor what the primary purpose of nursing diagnoses is?

What is the appropriate response by the instructor?

Mutually establish desired outcomes of the plan of care

Guide selection of nursing interventions to meet expected outcomes

Establish a database of information for future comparison

Evaluate the effectiveness of the established plan of care

Answer and Explanation

The Correct Answer is B

A. Mutually establish desired outcomes of the plan of care:

While establishing desired outcomes is an important part of the nursing process, nursing diagnoses themselves do not necessarily focus on mutually establishing these outcomes. Nursing diagnoses help identify health problems and needs, which then guide the development of outcomes during the planning phase.

B. Guide selection of nursing interventions to meet expected outcomes:

This is the correct answer. Nursing diagnoses help determine the specific needs and problems a patient is facing. Once identified, nursing interventions can be chosen to address these needs and work towards achieving expected outcomes.

C. Establish a database of information for future comparison:

Establishing a database of information is more related to the assessment phase of the nursing process. Nursing diagnoses are formulated based on the analysis of the collected data and serve to guide subsequent steps in the nursing process, particularly planning and intervention.

D. Evaluate the effectiveness of the established plan of care:

Evaluating the effectiveness of the established plan of care is part of the later stages of the nursing process. Nursing diagnoses help in planning and implementing interventions, and evaluating their effectiveness comes after these interventions have been carried out.

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Correct Answer is ["0.7"]

Explanation

To calculate the amount of hydroxyzine (Vistaril) to administer, use the formula:

D (desired dose) / H (have dose) x Q (quantity) = X (amount to give)

In this case, D = 35 mg, H = 50 mg/mL, and Q = 1 mL. Plug in the values and solve for X:

35 mg / 50 mg/mL x 1 mL = 0.7 mL

Therefore, the amount of hydroxyzine (Vistaril) to administer is 0.7 mL.

A. Auscultating lung sounds B. Obtaining the client’s temperature C. Assessing the strength of peripheral pulses D. Obtaining information about the client’s respirations E. Asking the client about a family history of any illness or disease

Correct Answer is ["A","B","D"]

Explanation

A. Auscultating lung sounds:

Auscultating lung sounds is essential to assess for any abnormal sounds such as wheezing, crackles, or diminished breath sounds, which can provide information about the extent and nature of lung congestion.

B. Obtaining the client’s temperature:

Obtaining the client's temperature is important to assess for the presence of fever, which is a common symptom associated with respiratory infections.

C. Assessing the strength of peripheral pulses:

Assessing peripheral pulses is not directly related to cold, cough, and lung congestion symptoms. This type of assessment is more relevant in cardiovascular or peripheral vascular assessments.

D. Obtaining information about the client’s respirations:

Assessing the rate, depth, and rhythm of respirations is crucial when dealing with respiratory symptoms. This information helps determine the severity and nature of the respiratory distress.

E. Asking the client about a family history of any illness or disease:

Family history is important for a comprehensive health assessment, but for the focused assessment of a cold, cough, and lung congestion, obtaining information about the current symptoms and associated factors takes precedence.

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A nursing student in clinical asks her instructor what the primary purpose of nursing diagnoses is? What is the appropriate response by the instructor?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Ordered: Hydroxyzine (Vistaril) 35 mg IM stat Available: Hydroxyzine (Vistaril) 50 mg/mL Administer: ____ ml

Correct Answer is ["0.7"]

Explanation

The clinic nurse prepares to perform a focused assessment on a client who is complaining of symptoms of a cold, a cough, and lung congestion. Which should the nurse include for this type of assessment? (Select all that apply)

Correct Answer is ["A","B","D"]

Explanation

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Ordered: Digoxin (Lanoxin) 0.25 mg Available: Digoxin (Lanoxin) 0.125 mg per tablet Administer: _____tab(s)

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A nursing student in clinical asks her instructor what the primary purpose of nursing diagnoses is?

What is the appropriate response by the instructor?