A Practical Nurse (PN) is planning on leaving the room of a patient with a tracheotomy. The PN ensures that the client has which of the following means of communication before leaving the room?

Choice A reason: Client O2 saturation will be maintained at 95% the entire day is an example of an expected outcome that adheres to accepted criteria. An expected outcome is a measurable and realistic goal that the client should achieve as a result of the nursing interventions. Accepted criteria for writing expected outcomes include being client- centered, specific, observable, measurable, time-limited, and realistic. This outcome meets all these criteria, as it focuses on the client’s condition, states a specific value and time frame, and can be observed and measured.

Therefore, this choice is correct.

Choice B reason: Client will observe safety guidelines while smoking is not an example of an expected outcome that adheres to accepted criteria. This outcome is not specific, observable, or measurable, as it does not state what the safety guidelines are, how they will be observed, or how they will be evaluated. It is also not realistic, as smoking is a harmful behavior that should be discouraged or eliminated, not made safer. Therefore, this choice is incorrect.

Choice C reason: PN will assess vital signs every day is not an example of an expected outcome that adheres to accepted criteria. This outcome is not client-centered, as it focuses on the nurse’s action, not the client’s condition or response. It is also not an outcome, but rather an intervention or activity that the nurse will perform to monitor the client’s status. Therefore, this choice is incorrect.

Choice D reason: Client will take part in one activity daily for the next 90 days is an example of an expected outcome that adheres to accepted criteria. This outcome is client-centered, specific, observable, measurable, time-limited, and realistic, as it focuses on the client’s participation, states a specific frequency and duration, and can be observed and measured. It also implies a positive change in the client’s behavior or lifestyle that may improve their health or well- being. Therefore, this choice is correct.

Choice A reason: This is incorrect because it shows that the nurse is not using a systematic and evidence-based approach to care. The nurse’s notes are a form of documentation, not a source of planning.

Choice B reason: This is correct because it shows that the nurse is using a systematic and evidence-based approach to care. The nursing diagnosis is a clinical judgment that identifies the client’s actual or potential health problems or needs and provides the basis for selecting appropriate interventions.

Choice C reason: This is incorrect because it shows that the nurse is not using a holistic and individualized approach to care. The doctor’s orders are a form of prescription, not a source of planning.

Choice D reason: This is incorrect because it shows that the nurse is confusing the outcome with the process. The care plan is a written document that outlines the goals, interventions, and evaluation of care, not a source of planning.