The mental status examination takes place during which part of the nursing process?

Evaluation

Assessment

Planning

Implementation

Answer and Explanation

The Correct Answer is B

Choice A reason: Evaluation is the final step of the nursing process, where the nurse determines the effectiveness of the nursing care provided.

Choice B reason: Assessment is the correct part of the nursing process for the mental status examination, as it involves collecting data about the patient.

Choice C reason: Planning involves setting goals and choosing appropriate nursing actions based on the assessment data.

Choice D reason: Implementation is the step where the nurse carries out the planned interventions.

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Correct Answer is C

Explanation

Choice A reason: Lying prone may be part of the care plan but is not specifically aimed at promoting ambulation.

Choice B reason: Coordination exercises are important but secondary to building the strength necessary for using mobility aids.

Choice C reason: Building upper body strength is essential for a patient who has had an above-the-knee amputation to be able to use assistive devices for ambulation effectively.

Choice D reason: Maintaining residual limb elevation is important for reducing swelling but does not directly promote ambulation.

A. The client's unconscious need to manipulate others B. The client's delusion that cleaning is necessary C. The client's wish to decrease the time available for interaction with others D. The client's attempt to decrease anxiety

Correct Answer is D

Explanation

Choice A reason: OCD is not characterized by an unconscious need to manipulate others but by anxiety-driven compulsions.

Choice B reason: While clients with OCD may feel a need to clean due to contamination fears, it is not a delusion but rather an obsession that drives the compulsion.

Choice C reason: The repetitive cleaning is not typically a conscious choice to decrease social interaction but a compulsion to alleviate anxiety.

Choice D reason: Repetitive behaviors in OCD, such as cleaning, are attempts to decrease the anxiety caused by obsessive thoughts.

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The mental status examination takes place during which part of the nursing process?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is providing care for a patient after an above-the-knee amputation due to diabetes complications. Which nursing care is essential for promoting ambulation?

Correct Answer is C

Explanation

A nurse is collecting data from a client who has obsessive-compulsive disorder (OCD) and observes that the client demonstrates constant repetitive cleaning. The nurse should realize that the client's repetitive behaviors occur due to which of the following?

Correct Answer is D

Explanation

Debridement is:

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