Which of the following is an example of a nursing diagnosis?

Skin breakdown

Elevated blood pressure

Anxiety

Ineffective breathing pattern

Answer and Explanation

The Correct Answer is D

A. Skin breakdown: This is a medical problem or symptom, but it is not a structured nursing diagnosis.

B. Elevated blood pressure: This is a clinical finding rather than a nursing diagnosis.

C. Anxiety: While anxiety is a medical condition, a complete nursing diagnosis should describe the specific effects on the patient, such as "Anxiety related to hospitalization as evidenced by restlessness and increased heart rate."

D. Ineffective breathing pattern: This is a standardized nursing diagnosis as defined by NANDA (North American Nursing Diagnosis Association). It refers to altered respiratory function that nurses can assess and manage.

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Correct Answer is B

Explanation

A. Dopamine: Dopamine is mainly involved in motivation, pleasure, and movement. Deficiencies are linked to Parkinson’s disease and schizophrenia rather than sleep and memory issues.

B. Serotonin: Serotonin plays a major role in regulating sleep, mood, and cognitive function. Low serotonin levels are associated with depression, sleep disturbances, and memory problems.

C. Norepinephrine: Norepinephrine is involved in alertness and the fight-or-flight response. While it affects attention and arousal, its deficiency is less directly linked to sleep dysregulation and memory loss.

D. Histamine: Histamine is primarily involved in wakefulness and allergic responses. While it plays a role in arousal, it is not the primary neurotransmitter for sleep regulation and memory.

A. "The goal for your pain is 0 on a 0 to 10 scale." B. "It is better not to have visitors if you are in pain." C. "You will be given the lowest strength pain medication first. D. “It is important that you request pain medication before the pain gets too severe."

Correct Answer is D

Explanation

A. "The goal for your pain is 0 on a 0 to 10 scale.": A pain score of 0 may not always be realistic postoperatively. The goal is pain control, not complete elimination.

B. "It is better not to have visitors if you are in pain.": Social support can be beneficial in pain management, and visitors should not necessarily be restricted unless the patient finds them distressing.

C. "You will be given the lowest strength pain medication first.": Pain management is individualized, and stronger analgesics may be needed initially, especially after surgery.

D. "It is important that you request pain medication before the pain gets too severe.": Preemptive pain management helps prevent pain from becoming severe and difficult to control. Patients should be encouraged to ask for medication before pain intensifies.

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Which of the following is an example of a nursing diagnosis?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has sleep dysregulation, poor memory, and poor concentration. Which of the following neurotransmitters should the nurse identify as being responsible for the client's manifestations?

Correct Answer is B

Explanation

In teaching the patient about postoperative pain management, which statement by the nurse is best?

Correct Answer is D

Explanation

A school nurse is planning a presentation about identifying potential warning signs of suicide for high school students. Which of the following examples of behaviors should the nurse include in the teaching?

The nurse provides care to a patient who is recovering from facial trauma who requires high-flow oxygen therapy. Which method of oxygen delivery does the nurse recognize as best for this patient?

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Which patient finding indicates the need for further monitoring rather than discharge home after an outpatient surgical procedure?

The nurse performs in-line suctioning when the patient experiences a decrease in oxygen saturation and bradycardia. Which nursing action is best?

Which of the following is not a common side effect of antidepressant medications?

Which entry made my nurse most accurately documents a client's mood?

A nurse is reviewing the arterial blood gas (ABG) results of a client who the provider suspects has metabolic acidosis. Which of the following results should the nurse expect to see?