Which of the following are approved nursing diagnoses? (Select all that apply)

Insufficient knowledge

Pupils round, reactive to light and accommodation

Pain

Impaired gas exchange

Answer and Explanation

Correct Answer : A,C,D

Choice A reason: This is correct because it is an approved nursing diagnosis that describes a lack of cognitive information related to a specific topic.

Choice B reason: This is incorrect because it is not an approved nursing diagnosis, but rather a data or assessment finding that describes the condition of the client’s pupils.

Choice C reason: This is correct because it is an approved nursing diagnosis that describes an unpleasant sensory and emotional experience associated with actual or potential tissue damage.

Choice D reason: This is correct because it is an approved nursing diagnosis that describes a decrease in oxygenation and/or elimination of carbon dioxide at the alveolar-capillary membrane.

Choice E reason: This is incorrect because it is not an approved nursing diagnosis, but rather a medical diagnosis that describes a malignant neoplasm of any body part.

Choice F reason: This is incorrect because it is not an approved nursing diagnosis, but rather a medical diagnosis that describes a dysfunction of the kidneys.

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Correct Answer is D

Explanation

Choice A reason: “I am sure they are all beef hot dogs. Would you like me to get a substitution from the kitchen?” is not the best response by the PN. This response shows false reassurance, which is a communication technique that involves minimizing or dismissing the other person’s feelings or situation. It also shows assumption, which is a communication barrier that involves making judgments or guesses about what the other person thinks or feels. It does not respect the client’s dietary preferences, and may sound patronizing or condescending. Therefore, this choice is incorrect.

Choice B reason: “I don’t understand why that should make a diﬀerence.” is not the best response by the PN. This response shows lack of knowledge, which is a communication barrier that involves being unaware or ignorant of the other person’s culture, beliefs, or values. It also shows indiﬀerence, which is a communication barrier that involves showing no interest or concern for the other person’s feelings or situation. It does not respect the client’s dietary preferences, and may sound rude or oﬀensive. Therefore, this choice is incorrect.

Choice C reason: “So you don’t want anything to eat, then?” is not the best response by the PN. This response shows closed-ended questioning, which is a communication technique that involves asking questions that require a yes or no answer or a specific piece of information. It also shows sarcasm, which is a communication barrier that involves using irony or mockery to hurt or ridicule the other person. It does not respect the client’s dietary preferences, and may sound hostile or aggressive. Therefore, this choice is incorrect.

Choice D reason: “I respect your dietary preferences. Let me see what else I can oﬀer you.” is the best response by the PN. This response shows respect, which is a value or attitude that involves showing consideration, appreciation, and recognition for the other person as a unique and holistic person. It also shows support, which is a communication technique that involves providing emotional or practical assistance to the other person, and helping them cope with their situation or problem. It respects the client’s dietary preferences, and shows that the PN is caring, helpful, and empathetic. Therefore, this choice is correct.

A. Select one answer B. Symptoms C. Urinary retention D. Signs of ﬂuid overload

Correct Answer is A

Explanation

Choice A reason: This is correct because symptoms are subjective or objective manifestations of a health problem that are perceived or reported by the client.

Choice B reason: This is incorrect because urinary retention is a specific condition that involves the inability to empty the bladder completely, which is not related to the data presented.

Choice C reason: This is incorrect because signs of ﬂuid overload are opposite to the data presented, such as edema, weight gain, crackles in the lungs, and distended neck veins.

Choice D reason: This is incorrect because data clustering is a process of grouping related data together to identify paterns and potential problems, not a type of data itself.

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Which of the following are approved nursing diagnoses? (Select all that apply)

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Naxlex Comprehensive Predictor Exams

A client of the Islamic faith refuses to eat a hot dog on his tray because he is afraid that it may contain pork products. Which of the following is the best response by the Practical Nurse (PN)?

Correct Answer is D

Explanation

During a physical examination, the Practical Nurse (PN) discovers that the client demonstrates signs of ﬂushed, dry, hot skin; dry oral mucus membranes; and temperature elevation. The PN will treat these data as the basis of a nursing diagnosis plan, as they represent:

Correct Answer is A

Explanation

What should the nurse do with linens that have been soiled by a client with hepatitis?

In what step of the nursing process do the client and the nurse develop the goals? (Select all that apply)

The basis for designing and selecting nursing interventions to meet client needs is the:

The nurse is preparing to explain an upcoming procedure to an English-speaking Latino client. The nurse determines that the best way to verbally communicate with this client is to:

The husband of a client who has a Sengstaken-Blakemore tube states to the nurse, “I thought having this tube down her nose the first time would convince my wife to quit drinking.” The nurse should make which response to the client’s husband? Select one answer

A client is to be discharged from an acute care facility after treatment for right leg thrombophlebitis. The nurse notes that the client’s leg is pain free, without redness or edema. The nurse’s actions reﬂect which phase of the nursing process? Select one answer

When writing expected outcomes, the Practical Nurse (PN) should adhere to accepted criteria, such as which of the following? (Select all that apply)

The Practical Nurse recognizes the communication technique of receiving information and examining responses to