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Exam (elaborations)

OVERALL EVALUATION

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OVERALL EVALUATION Strengths Clear alignment with ADPIE framework Strong emphasis on clinical judgment over recall Consistent use of priority frameworks (ABCs, safety) Scenarios reflect realistic nursing practice Distractors are mostly plausible and clinically grounded Areas for Refinement To increase discrimination index (high vs. low performers): Increase cognitive conflict in distractors Reduce “obvious” correct answers Tighten stems to force prioritization under ambiguity Integrate more competing priorities in single items

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Institution
NCLEX RN
Course
NCLEX RN

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NURSING CARE PLANS
DIAGNOSES, INTERVENTIONS, AND
OUTCOMES
11TH EDITION
• AUTHOR(S)MEG GULANICK;
JUDITH L. MYERS



TEST BANK
1) Individualizing a Nursing Care Plan
Reference: Chapter 1 — What is a nursing care plan? /
Individualizing a care plan
Stem:
A postoperative patient with a history of chronic heart failure is
admitted after abdominal surgery. The unit’s standard care plan
includes routine ambulation, incentive spirometry, and pain

,reassessment every 4 hours. During assessment, the nurse finds
crackles in both lower lobes, 2+ ankle edema, and shortness of
breath when lying flat.
Which action best reflects individualizing the care plan?
A. Continue the standard care plan because it is evidence-based
B. Add interventions focused on fluid volume and respiratory
status
C. Remove all ambulation goals until discharge
D. Delay changes until the provider updates the orders
Correct Answer: B
Rationale — Correct Answer:
The patient’s assessment data indicate needs beyond routine
postoperative care. Individualizing the plan means tailoring
interventions to current findings, such as monitoring respiratory
status, positioning, daily weights, and edema management. This
reflects patient-centered planning and clinical judgment.
Rationales — Incorrect Options:
A. Standard plans are starting points, but they must be modified
using assessment data.
C. Ambulation may still be important; the issue is to adapt the
plan, not eliminate routine mobility goals.
D. Nurses revise the nursing care plan independently based on
assessment data; they do not wait for provider orders to
individualize nursing interventions.

,Teaching Point:
Care plans must change with patient assessment, not stay
generic.
Citation:
Gulanick, M., & Myers, J. (2026). Nursing Care Plans: Diagnoses,
Interventions, and Outcomes (11th ed.). Chapter 1:
Individualizing a care plan.


2) Purpose of a Nursing Care Plan
Reference: Chapter 1 — What is a nursing care plan?
Stem:
A new graduate asks why the unit uses nursing care plans when
the electronic health record already contains provider orders
and daily notes. The preceptor wants to explain the main
purpose of the nursing care plan.
Which statement is best?
A. It documents only the tasks the nurse has completed
B. It organizes nursing diagnoses, interventions, and expected
outcomes
C. It replaces all interdisciplinary communication
D. It is mainly used for billing and reimbursement
Correct Answer: B
Rationale — Correct Answer:
A nursing care plan is a structured guide for nursing practice. It

, links assessment findings to nursing diagnoses, interventions,
and measurable outcomes so care is organized, individualized,
and evaluable. That is the core purpose of the care plan.
Rationales — Incorrect Options:
A. Documentation of tasks is only one small part of nursing
documentation.
C. Care plans support communication but do not replace
interdisciplinary collaboration.
D. Billing is not the primary nursing purpose of the care plan.
Teaching Point:
A care plan connects assessment data to nursing action and
outcomes.
Citation:
Gulanick, M., & Myers, J. (2026). Nursing Care Plans: Diagnoses,
Interventions, and Outcomes (11th ed.). Chapter 1: What is a
nursing care plan?


3) Priority Nursing Diagnosis
Reference: Chapter 1 — Prioritizing nursing diagnoses
Stem:
A hospitalized older adult reports pain rated 7/10, has a blood
pressure of 88/54 mm Hg, and is difficult to arouse after
receiving antihypertensive medication and an opioid. The nurse
must choose the priority nursing diagnosis.
Which diagnosis should the nurse prioritize?

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Institution
NCLEX RN
Course
NCLEX RN

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Uploaded on
March 19, 2026
Number of pages
393
Written in
2025/2026
Type
Exam (elaborations)
Contains
Questions & answers

Subjects

  • clinically accurate
  • appropr
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