Test Bank For Ackley and Ladwig's Nursing
sx sx sx sx sx sx sx
Diagnosis Handbook 13th Edition: An Evide
sx sx sx sx sx
nce-Based Guide to Planning Care
sx sx sx sx
by Mary Beth Flynn Makic
sx sx sx sx
@2024
,Section I: Nursing Diagnosis, the Nursing Process, and Evidence-
sx sx sx sx sx sx sx sx
Based Nursing
sx sx
1. What is the primary goal of a nursing diagnosis?
sx sx sx sx sx sx sx sx
a. To identify a medical diagnosis
sx sx sx sx sx
b. To determine the effectiveness of medications
sx sx sx sx sx sx
c. To identify patient problems that can be managed by nursing
sx sx sx sx sx sx sx sx sx sx sx
interventions
d. To prioritize physician orders
sx sx sx sx
ANS: C sx
Rationale: The primary goal of a nursing diagnosis is to identify patient problems
sx sx sx sx sx sx sx sx sx sx sx sx s
that can be managed by nursing interventions, focusing on patient care rather than
x sx sx sx sx sx sx sx sx sx sx sx sx
medical diagnoses.
sx sx
NCLEX Preference: Understanding the distinction between nursing and medical
sx sx sx sx sx sx sx sx sx
diagnoses is crucial for patient-centered care.
sx sx sx sx sx
2. Which component of the nursing diagnosis indicates the problem?
sx sx sx sx sx sx sx sx
a. Defining characteristics
sx sx
b. Related factors
sx sx
c. The actual diagnosis
sx sx sx
d. The patient’s history
sx sx sx
ANS: C sx
Rationale: The actual diagnosis represents the problem identified in the nursing as
sx sx sx sx sx sx sx sx sx sx sx
sessment. It is essential for formulating a care plan.
sx sx sx sx sx sx sx sx
NCLEX Preference: Clear identification of nursing diagnoses is necessary for effec
sx sx sx sx sx sx sx sx sx sx
tive care planning.
sx sx
3. What does the "related to" (R/T) statement in a nursing diagnosis signify?
sx sx sx sx sx sx sx sx sx sx sx
a. It identifies the patient's response to the problem
sx sx sx sx sx sx sx sx
b. It indicates the underlying cause of the problem
sx sx sx sx sx sx sx sx
c. It lists the symptoms observed
sx sx sx sx sx
d. It describes the treatment plan
sx sx sx sx sx
ANS: B sx
Rationale: The "related to" (R/T) statement indicates the underlying cause or cont
sx sx sx sx sx sx sx sx sx sx sx
ributing factors of the patient’s problem, guiding intervention strategies.
sx sx sx sx sx sx sx sx
,NCLEX Preference: Understanding etiology is vital for targeted nursing intervent
sx sx sx sx sx sx sx sx sx
ions.
4. Which nursing diagnosis format is used to articulate the problem clearly?
sx sx sx sx sx sx sx sx sx sx
a. Problem-focused diagnosis
sx sx
b. Risk diagnosis
sx sx
c. Health promotion diagnosis
sx sx sx
d. All of the above
sx sx sx sx
ANS: D sx
Rationale: All formats—problem-focused, risk, and health promotion—
sx sx sx sx sx sx
articulate different aspects of patient care and are important in various clinical sit
sx sx sx sx sx sx sx sx sx sx sx sx
uations.
NCLEX Preference: Familiarity with different nursing diagnosis formats enhanc
sx sx sx sx sx sx sx sx
es clinical reasoning.
sx sx
5. In which phase of the nursing process is the nursing diagnosis formulated?
sx sx sx sx sx sx sx sx sx sx sx
a. Assessment
sx
b. Diagnosis
sx
c. Planning
sx
d. Implementation
sx
ANS: B sx
Rationale: The nursing diagnosis is formulated during the diagnosis phase, after c
sx sx sx sx sx sx sx sx sx sx sx
ollecting and analyzing assessment data.
sx sx sx sx
NCLEX Preference: Understanding the nursing process phases is crucial for effe
sx sx sx sx sx sx sx sx sx sx
ctive care delivery.
sx sx
6. What is a defining characteristic in a nursing diagnosis?
sx sx sx sx sx sx sx sx
a. The cause of the problem
sx sx sx sx sx
b. The observable signs and symptoms
sx sx sx sx sx
c. The expected outcomes
sx sx sx
d. The patient's medical history
sx sx sx sx
ANS: B sx
Rationale: Defining characteristics are the observable signs and symptoms that va
sx sx sx sx sx sx sx sx sx sx
lidate the nursing diagnosis and provide evidence of the problem.
sx sx sx sx sx sx sx sx sx
NCLEX Preference: Identifying defining characteristics is essential for accurate dia
sx sx sx sx sx sx sx sx sx
gnosis and planning. sx sx
, 7. How can a nurse validate a nursing diagnosis?
sx sx sx sx sx sx sx
a. By relying solely on personal experience
sx sx sx sx sx sx
b. By collecting data from various sources, including the patient
sx sx sx sx sx sx sx sx sx
c. By discussing it only with physicians
sx sx sx sx sx sx
d. By documenting the diagnosis without evidence
sx sx sx sx sx sx
ANS: B sx
Rationale: Validating a nursing diagnosis involves collecting data from multiple s
sx sx sx sx sx sx sx sx sx sx
ources, including the patient, to ensure accuracy and relevance.
sx sx sx sx sx sx sx sx
NCLEX Preference: Validation of nursing diagnoses is critical for patient safety
sx sx sx sx sx sx sx sx sx sx sx
and effective care.
sx sx
8. What role does evidence-based practice play in nursing diagnoses?
sx sx sx sx sx sx sx sx
a. It complicates the diagnosis process
sx sx sx sx sx
b. It provides a scientific basis for nursing decisions
sx sx sx sx sx sx sx sx
c. It is optional for nursing practice
sx sx sx sx sx sx
d. It focuses solely on traditional methods
sx sx sx sx sx sx
ANS: B sx
Rationale: Evidence- sx
based practice provides a scientific basis for nursing decisions, improving patient
sx sx sx sx sx sx sx sx sx sx sx
outcomes and ensuring care is effective and relevant. NCLEX Preference: Know
sx sx sx sx sx sx sx sx sx sx
ledge of evidence-based practice is essential for modern nursing.
sx sx sx sx sx sx sx sx
9. What is the purpose of the planning phase in the nursing process?
sx sx sx sx sx sx sx sx sx sx sx
a. To assess the patient’s condition
sx sx sx sx sx
b. To develop a care plan with measurable goals
sx sx sx sx sx sx sx sx
c. To implement interventions immediately
sx sx sx sx
**d. To evaluate patient outcomes
sx sx sx sx
ANS: B sx
Rationale: The planning phase involves developing a care plan with measurable g
sx sx sx sx sx sx sx sx sx sx sx
oals and outcomes tailored to the patient’s needs.
sx sx sx sx sx sx sx
NCLEX Preference: Effective planning is key to successful patient outcomes.
sx sx sx sx sx sx sx sx sx
10. How should nursing diagnoses be prioritized?
sx sx sx sx sx
a. Based on the nurse’s preference
sx sx sx sx sx
sx sx sx sx sx sx sx
Diagnosis Handbook 13th Edition: An Evide
sx sx sx sx sx
nce-Based Guide to Planning Care
sx sx sx sx
by Mary Beth Flynn Makic
sx sx sx sx
@2024
,Section I: Nursing Diagnosis, the Nursing Process, and Evidence-
sx sx sx sx sx sx sx sx
Based Nursing
sx sx
1. What is the primary goal of a nursing diagnosis?
sx sx sx sx sx sx sx sx
a. To identify a medical diagnosis
sx sx sx sx sx
b. To determine the effectiveness of medications
sx sx sx sx sx sx
c. To identify patient problems that can be managed by nursing
sx sx sx sx sx sx sx sx sx sx sx
interventions
d. To prioritize physician orders
sx sx sx sx
ANS: C sx
Rationale: The primary goal of a nursing diagnosis is to identify patient problems
sx sx sx sx sx sx sx sx sx sx sx sx s
that can be managed by nursing interventions, focusing on patient care rather than
x sx sx sx sx sx sx sx sx sx sx sx sx
medical diagnoses.
sx sx
NCLEX Preference: Understanding the distinction between nursing and medical
sx sx sx sx sx sx sx sx sx
diagnoses is crucial for patient-centered care.
sx sx sx sx sx
2. Which component of the nursing diagnosis indicates the problem?
sx sx sx sx sx sx sx sx
a. Defining characteristics
sx sx
b. Related factors
sx sx
c. The actual diagnosis
sx sx sx
d. The patient’s history
sx sx sx
ANS: C sx
Rationale: The actual diagnosis represents the problem identified in the nursing as
sx sx sx sx sx sx sx sx sx sx sx
sessment. It is essential for formulating a care plan.
sx sx sx sx sx sx sx sx
NCLEX Preference: Clear identification of nursing diagnoses is necessary for effec
sx sx sx sx sx sx sx sx sx sx
tive care planning.
sx sx
3. What does the "related to" (R/T) statement in a nursing diagnosis signify?
sx sx sx sx sx sx sx sx sx sx sx
a. It identifies the patient's response to the problem
sx sx sx sx sx sx sx sx
b. It indicates the underlying cause of the problem
sx sx sx sx sx sx sx sx
c. It lists the symptoms observed
sx sx sx sx sx
d. It describes the treatment plan
sx sx sx sx sx
ANS: B sx
Rationale: The "related to" (R/T) statement indicates the underlying cause or cont
sx sx sx sx sx sx sx sx sx sx sx
ributing factors of the patient’s problem, guiding intervention strategies.
sx sx sx sx sx sx sx sx
,NCLEX Preference: Understanding etiology is vital for targeted nursing intervent
sx sx sx sx sx sx sx sx sx
ions.
4. Which nursing diagnosis format is used to articulate the problem clearly?
sx sx sx sx sx sx sx sx sx sx
a. Problem-focused diagnosis
sx sx
b. Risk diagnosis
sx sx
c. Health promotion diagnosis
sx sx sx
d. All of the above
sx sx sx sx
ANS: D sx
Rationale: All formats—problem-focused, risk, and health promotion—
sx sx sx sx sx sx
articulate different aspects of patient care and are important in various clinical sit
sx sx sx sx sx sx sx sx sx sx sx sx
uations.
NCLEX Preference: Familiarity with different nursing diagnosis formats enhanc
sx sx sx sx sx sx sx sx
es clinical reasoning.
sx sx
5. In which phase of the nursing process is the nursing diagnosis formulated?
sx sx sx sx sx sx sx sx sx sx sx
a. Assessment
sx
b. Diagnosis
sx
c. Planning
sx
d. Implementation
sx
ANS: B sx
Rationale: The nursing diagnosis is formulated during the diagnosis phase, after c
sx sx sx sx sx sx sx sx sx sx sx
ollecting and analyzing assessment data.
sx sx sx sx
NCLEX Preference: Understanding the nursing process phases is crucial for effe
sx sx sx sx sx sx sx sx sx sx
ctive care delivery.
sx sx
6. What is a defining characteristic in a nursing diagnosis?
sx sx sx sx sx sx sx sx
a. The cause of the problem
sx sx sx sx sx
b. The observable signs and symptoms
sx sx sx sx sx
c. The expected outcomes
sx sx sx
d. The patient's medical history
sx sx sx sx
ANS: B sx
Rationale: Defining characteristics are the observable signs and symptoms that va
sx sx sx sx sx sx sx sx sx sx
lidate the nursing diagnosis and provide evidence of the problem.
sx sx sx sx sx sx sx sx sx
NCLEX Preference: Identifying defining characteristics is essential for accurate dia
sx sx sx sx sx sx sx sx sx
gnosis and planning. sx sx
, 7. How can a nurse validate a nursing diagnosis?
sx sx sx sx sx sx sx
a. By relying solely on personal experience
sx sx sx sx sx sx
b. By collecting data from various sources, including the patient
sx sx sx sx sx sx sx sx sx
c. By discussing it only with physicians
sx sx sx sx sx sx
d. By documenting the diagnosis without evidence
sx sx sx sx sx sx
ANS: B sx
Rationale: Validating a nursing diagnosis involves collecting data from multiple s
sx sx sx sx sx sx sx sx sx sx
ources, including the patient, to ensure accuracy and relevance.
sx sx sx sx sx sx sx sx
NCLEX Preference: Validation of nursing diagnoses is critical for patient safety
sx sx sx sx sx sx sx sx sx sx sx
and effective care.
sx sx
8. What role does evidence-based practice play in nursing diagnoses?
sx sx sx sx sx sx sx sx
a. It complicates the diagnosis process
sx sx sx sx sx
b. It provides a scientific basis for nursing decisions
sx sx sx sx sx sx sx sx
c. It is optional for nursing practice
sx sx sx sx sx sx
d. It focuses solely on traditional methods
sx sx sx sx sx sx
ANS: B sx
Rationale: Evidence- sx
based practice provides a scientific basis for nursing decisions, improving patient
sx sx sx sx sx sx sx sx sx sx sx
outcomes and ensuring care is effective and relevant. NCLEX Preference: Know
sx sx sx sx sx sx sx sx sx sx
ledge of evidence-based practice is essential for modern nursing.
sx sx sx sx sx sx sx sx
9. What is the purpose of the planning phase in the nursing process?
sx sx sx sx sx sx sx sx sx sx sx
a. To assess the patient’s condition
sx sx sx sx sx
b. To develop a care plan with measurable goals
sx sx sx sx sx sx sx sx
c. To implement interventions immediately
sx sx sx sx
**d. To evaluate patient outcomes
sx sx sx sx
ANS: B sx
Rationale: The planning phase involves developing a care plan with measurable g
sx sx sx sx sx sx sx sx sx sx sx
oals and outcomes tailored to the patient’s needs.
sx sx sx sx sx sx sx
NCLEX Preference: Effective planning is key to successful patient outcomes.
sx sx sx sx sx sx sx sx sx
10. How should nursing diagnoses be prioritized?
sx sx sx sx sx
a. Based on the nurse’s preference
sx sx sx sx sx