All-in-One Nursing Care Planning
Resource
Medical-Surgical, Pediatric,
Maternity, and Psychiatric-Mental
Health
5th Edition
• Author(s)Pamela L. Swearingen;
Jacqueline Wright
TEST BANK
,1) MCQ
Clinical Scenario
A 58-year-old patient with newly diagnosed lung cancer says, “I
am overwhelmed and do not know what comes next.” The
patient has lost 7 kg in 2 months, reports poor appetite, and
avoids family visits because of fatigue.
Question Stem
Which nursing diagnosis is the priority for this patient?
Answer Options
A. Disturbed body image related to cancer diagnosis
B. Imbalanced nutrition: less than body requirements related to
decreased appetite
C. Anxiety related to uncertainty about treatment and prognosis
D. Social isolation related to withdrawal from family
Correct Answer
C. Anxiety related to uncertainty about treatment and
prognosis
Detailed Rationale
The patient’s statement shows emotional distress and
uncertainty, which are immediate concerns because anxiety can
impair coping, decision-making, and engagement in treatment.
While nutrition and social support are important, the patient’s
,expressed overwhelm indicates that anxiety is the priority
nursing diagnosis in this moment.
Incorrect Option Analysis
• A. Disturbed body image — possible, but there is no direct
evidence that body image is the immediate concern.
• B. Imbalanced nutrition — supported by weight loss, but
not the most urgent concern from the cues given.
• D. Social isolation — also possible, but the patient’s
verbalized distress suggests anxiety first.
Nursing Process Linkage
Nursing Diagnosis
Clinical Judgment Competencies
Recognize Cues, Prioritize Hypotheses
Difficulty Level
Moderate
Bloom’s Cognitive Level
Analyze
NCLEX Client Needs Category
Psychosocial Integrity
Nursing Diagnosis Integration
, Priority Nursing Diagnosis: Anxiety
Related Factors: Uncertainty about diagnosis/treatment
Defining Characteristics: Verbalization of overwhelm,
withdrawal, worry
Expected Outcome
The patient will verbalize reduced anxiety and identify at least
two coping strategies before the end of the teaching session.
Key Learning Objective
Identify the highest-priority psychosocial nursing diagnosis in a
newly diagnosed oncology patient.
2) SATA
Clinical Scenario
A patient receiving chemotherapy has a white blood cell count
of 2,000/mm³ and an absolute neutrophil count of 700/mm³.
Question Stem
Which nursing interventions should the nurse include in the
care plan? Select all that apply.
Answer Options
A. Instruct the patient to avoid fresh flowers and standing water
B. Teach the patient to report a temperature of 38°C (100.4°F)
Resource
Medical-Surgical, Pediatric,
Maternity, and Psychiatric-Mental
Health
5th Edition
• Author(s)Pamela L. Swearingen;
Jacqueline Wright
TEST BANK
,1) MCQ
Clinical Scenario
A 58-year-old patient with newly diagnosed lung cancer says, “I
am overwhelmed and do not know what comes next.” The
patient has lost 7 kg in 2 months, reports poor appetite, and
avoids family visits because of fatigue.
Question Stem
Which nursing diagnosis is the priority for this patient?
Answer Options
A. Disturbed body image related to cancer diagnosis
B. Imbalanced nutrition: less than body requirements related to
decreased appetite
C. Anxiety related to uncertainty about treatment and prognosis
D. Social isolation related to withdrawal from family
Correct Answer
C. Anxiety related to uncertainty about treatment and
prognosis
Detailed Rationale
The patient’s statement shows emotional distress and
uncertainty, which are immediate concerns because anxiety can
impair coping, decision-making, and engagement in treatment.
While nutrition and social support are important, the patient’s
,expressed overwhelm indicates that anxiety is the priority
nursing diagnosis in this moment.
Incorrect Option Analysis
• A. Disturbed body image — possible, but there is no direct
evidence that body image is the immediate concern.
• B. Imbalanced nutrition — supported by weight loss, but
not the most urgent concern from the cues given.
• D. Social isolation — also possible, but the patient’s
verbalized distress suggests anxiety first.
Nursing Process Linkage
Nursing Diagnosis
Clinical Judgment Competencies
Recognize Cues, Prioritize Hypotheses
Difficulty Level
Moderate
Bloom’s Cognitive Level
Analyze
NCLEX Client Needs Category
Psychosocial Integrity
Nursing Diagnosis Integration
, Priority Nursing Diagnosis: Anxiety
Related Factors: Uncertainty about diagnosis/treatment
Defining Characteristics: Verbalization of overwhelm,
withdrawal, worry
Expected Outcome
The patient will verbalize reduced anxiety and identify at least
two coping strategies before the end of the teaching session.
Key Learning Objective
Identify the highest-priority psychosocial nursing diagnosis in a
newly diagnosed oncology patient.
2) SATA
Clinical Scenario
A patient receiving chemotherapy has a white blood cell count
of 2,000/mm³ and an absolute neutrophil count of 700/mm³.
Question Stem
Which nursing interventions should the nurse include in the
care plan? Select all that apply.
Answer Options
A. Instruct the patient to avoid fresh flowers and standing water
B. Teach the patient to report a temperature of 38°C (100.4°F)
