Exam 2 NUR 109 questions with correct answers

Exam 2 NUR 109 questions with correct
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answers

Which are examples of nursing diagnoses? *Select All
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That Apply.*|\




1. Risk for impaired skin/tissue integrity
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2. Ineffective impulse control
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3. Insufficient breast milk
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4. Renal failure
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5. Emphysema with chronic obstructive pulmonary
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disease (COPD) - CORRECT ANSWERS ✔✔*1. Risk for
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impaired skin/tissue integrity* |\ |\




*2. Ineffective impulse control*
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*3. Insufficient breast milk*
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Rationales
Option 1: Nursing diagnoses often address risks, for
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example, that a client may be prone to skin impairment.
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Option 2: |\




Nursing diagnoses address the health status of clients,
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which often includes how effectively they deal with their
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environment.

,Option 3: |\




Nursing diagnoses address the health status of clients
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and include terminology such as "deficient" and
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"insufficient." In this case, the diagnosis addresses a
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problem but not the pathology of it. |\ |\ |\ |\ |\ |\




Option 4: |\




Direct terms such as renal failure name the illness or
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disease, which is a medical diagnosis. |\ |\ |\ |\ |\




Option 5: |\




A diagnosis of emphysema with COPD is a medical
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diagnosis.


When working with a postoperative bariatric client, how
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can the nurse promote client participation and adherence
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to the nursing plan? *Select All That Apply.*
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1. Ensure the client feels comfortable asking questions.
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2. Keep the instructions simple, clear, and as specific as
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possible.
3. Determine if the client's goals for weight loss are the
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same as those in the nursing plan.
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4. Help the client set realistic goals.
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5. Carry out goal implementation and interventions even
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when client doesn't "feel like it." - CORRECT ANSWERS
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,✔✔*1. Ensure the client feels comfortable asking
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questions.*
*2. Keep the instructions simple, clear, and as specific as
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possible.*
*3. Determine if the client's goals for weight loss are the
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same as those in the nursing plan.*
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*4. Help the client set realistic goals.*
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Rationales
Option 1: It is important that the client understands
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instructions and feels comfortable asking questions for |\ |\ |\ |\ |\ |\ |\



clarification.
Option 2: |\




By keeping instructions clear, simple, and specific, the
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client will be able to demonstrate understanding of what
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is expected.
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Option 3: |\




In order for the client to be successful in reaching goals
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and outcomes, he or she must have the same goals and
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focus as the nursing plan.
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Option 4: |\




Realistic goals are instrumental to compliance and
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adherence in order to yield positive outcomes. |\ |\ |\ |\ |\ |\




Option 5: |\

, If the client doesn't want to engage in interventions, the
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nurse should apply critical thinking skills to determine
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why and plan ways to get past this obstacle.
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Which statement correctly identifies an outcome goal
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from the nursing diagnosis of "potential for skin
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breakdown related to immobility"? |\ |\ |\




1. The client will have increased mobility.
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2. The client will understand strategies for preventing skin
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breakdown.
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3. The client will be moved periodically throughout the
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shift.
4. The client's skin will remain intact and healthy. -
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CORRECT ANSWERS ✔✔*4. The client's skin will remain |\ |\ |\ |\ |\ |\ |\ |\



intact and healthy.* |\ |\




Rationales
Option 1: This is a goal statement for a nursing diagnosis
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of impaired mobility. It does not address skin breakdown.
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Option 2: |\




This is a goal statement for a nursing diagnosis of
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knowledge deficit. This does not address skin breakdown. |\ |\ |\ |\ |\ |\ |\




Option 3: |\