NUR 3632 Foundations Exam 2 Study
Questions With Correct Answers
A |nurse |is |planning |care |for |a |male |adolescent |patient |who |is |admitted |to |the |hospital |for |
treatment |of |a |drug |overdose. |Which |nursing |actions |are |related |to |the |outcome |identification
|and |planning |step |of |the |nursing |process? |Select |all |that |apply.
The |nurse |formulates |nursing |diagnoses.
The |nurse |identifies |expected |patient |outcomes.
The |nurse |selects |evidence-based |nursing |interventions.
The |nurse |explains |the |nursing |care |plan |to |the |patient.
The |nurse |assesses |the |patient's |mental |status.
The |nurse |evaluates |the |patient's |outcome |achievement. |- |CORRECT |ANSWER✔✔-b, |c, |d. |
During |the |outcome |identification |and |planning |step |of |the |nursing |process, |the |nurse |works |
in |partnership |with |the |patient |and |family |to |establish |priorities, |identify |and |write |expected |
patient |outcomes, |select |evidence-based |nursing |interventions, |and |communicate |the |plan |of |
nursing |care. |Although |all |these |steps |may |overlap, |formulating |and |validating |nursing |
diagnoses |occurs |most |frequently |during |the |diagnosing |step |of |the |nursing |process. |Assessing
|mental |status |is |part |of |the |assessment |step, |and |evaluating |patient |outcomes |occurs |during |
the |evaluation |step |of |the |nursing |process.
A |nurse |on |a |busy |surgical |unit |relies |on |informal |planning |to |provide |appropriate |nursing |
responses |to |patients |in |a |timely |manner. |What |are |examples |of |this |type |of |planning? |Select |
all |that |apply.
A |nurse |sits |down |with |a |patient |and |prioritizes |existing |diagnoses.
A |nurse |assesses |a |woman |for |postpartum |depression |during |routine |care.
A |nurse |plans |interventions |for |a |patient |who |is |diagnosed |with |epilepsy.
A |busy |nurse |takes |time |to |speak |to |a |patient |who |received |bad |news.
,A |nurse |reassesses |a |patient |whose |PRN |pain |medication |is |not |working.
A |nurse |coordinates |the |home |care |of |a |patient |being |discharged. |- |CORRECT |ANSWER✔✔-b, |
d, |e. |Informal |planning |is |a |link |between |identifying |a |patient's |strength |or |problem |and |
providing |an |appropriate |nursing |response. |This |occurs, |for |example, |when |a |busy |nurse |first |
recognizes |postpartum |depression |in |a |patient, |takes |time |to |assess |a |patient |who |received |
bad |news |about |tests, |or |reassesses |a |patient |for |pain. |Formal |planning |involves |prioritizing |
diagnoses, |formally |planning |interventions, |and |coordinating |the |home |care |of |a |patient |being
|discharged.
3. |When |helping |a |patient |turn |in |bed, |the |nurse |notices |that |his |heels |are |reddened |and |
plans |to |place |him |on |precautions |for |skin |breakdown. |This |is |an |example |of |what |type |of |
planning?
Initial |planning
Standardized |planning
Ongoing |planning
Discharge |planning |- |CORRECT |ANSWER✔✔-c. |Ongoing |planning |is |problem |oriented |and |has |
as |its |purpose |keeping |the |plan |up |to |date |as |new |actual |or |potential |problems |are |identified. |
Initial |planning |addresses |each |problem |listed |in |the |prioritized |nursing |diagnoses |and |
identifies |appropriate |patient |goals |and |the |related |nursing |care. |Standardized |care |plans |are |
prepared |plans |of |care |that |identify |the |nursing |diagnoses, |outcomes, |and |related |nursing |
interventions |common |to |a |specific |population |or |health |problem. |During |discharge |planning, |
the |nurse |uses |teaching |and |counseling |skills |effectively |to |help |the |patient |and |family |
develop |sufficient |knowledge |of |the |health |problem |and |the |therapeutic |regimen |to |carry |out |
necessary |self-care |behaviors |competently |at |home.
. |A |nurse |is |prioritizing |the |following |patient |diagnoses |according |to |Maslow's |hierarchy |of |
human |needs:
(1) |Disturbed |Body |Image
(2) |Ineffective |Airway |Clearance
(3) |Spiritual |Distress
(4) |Impaired |Social |Interaction
,Which |answer |choice |below |lists |the |problems |in |order |of |highest |priority |to |lowest |priority |
based |on |Maslow's |model?
2, |4, |1, |3
3, |1, |4, |2
2, |4, |3, |1
3, |2, |4, |1 |- |CORRECT |ANSWER✔✔-a. |2, |4, |1, |3. |Because |basic |needs |must |be |met |before |a |
person |can |focus |on |higher |ones, |patient |needs |may |be |prioritized |according |to |Maslow's |
hierarchy: |(1) |physiologic |needs, |(2) |safety |needs, |(3) |love |and |belonging |needs, |(4) |self-
esteem |needs, |and |(5) |self-actualization |needs. |#2 |is |an |example |of |a |physiologic |need, |#4 |is |
an |example |of |a |love |and |belonging |need, |#1 |is |an |example |of |a |self-esteem |need, |and |#3 |is |
an |example |of |a |self-actualization |need.
. |A |nurse |is |using |critical |pathway |methodology |for |choosing |interventions |for |a |patient |who |is
|receiving |chemotherapy |for |breast |cancer. |Which |nursing |actions |are |characteristics |of |this |
system |being |used |when |planning |care? |Select |all |that |apply.
The |nurse |uses |a |minimal |practice |standard |and |is |able |to |alter |care |to |meet |the |patient's |
individual |needs.
The |nurse |uses |a |binary |decision |tree |for |stepwise |assessment |and |intervention.
The |nurse |is |able |to |measure |the |cause-and-effect |relationship |between |pathway |and |patient |
outcomes.
The |nurse |uses |broad, |research-based |practice |recommendations |that |may |or |may |not |have |
been |tested |in |clinical |practice.
The |nurse |uses |preprinted |provider |orders |used |to |expedite |the |order |process |after |a |practice |
standard |has |been |validated |through |research.
The |nurse |uses |a |decision |tree |that |provides |intense |specificity |and |no |provider |flexibility. |- |
CORRECT |ANSWER✔✔-a, |c. |A |critical |pathway |represents |a |sequential, |interdisciplinary, |
minimal |practice |standard |for |a |specific |patient |population |that |provides |flexibility |to |alter |
care |to |meet |individualized |patient |needs. |It |also |offers |the |ability |to |measure |a |cause-and-
effect |relationship |between |pathway |and |patient |outcomes. |An |algorithm |is |a |binary |decision |
tree |that |guides |stepwise |assessment |and |intervention |with |intense |specificity |and |no |
provider |flexibility. |Guidelines |are |broad, |research-based |practice |recommendations |that |may |
or |may |not |have |been |tested |in |clinical |practice, |and |an |order |set |is |a |preprinted |provider |
, order |used |to |expedite |the |order |process |after |a |practice |standard |has |been |validated |through
|analytical |research.
A |nurse |is |identifying |outcomes |for |a |patient |who |has |a |leg |ulcer |related |to |diabetes. |An |
example |of |an |affective |outcome |for |this |patient |is:
Within |1 |day |after |teaching, |the |patient |will |list |three |benefits |of |continuing |to |apply |moist |
compresses |to |leg |ulcer |after |discharge.
By |6/12/15, |the |patient |will |correctly |demonstrate |application |of |wet-to-dry |dressing |on |leg |
ulcer.
By |6/19/15, |the |patient's |ulcer |will |begin |to |show |signs |of |healing |(e.g., |size |shrinks |from |3″ |to
|2.5″).
By |6/12/15, |the |patient |will |verbalize |valuing |health |sufficiently |to |practice |new |health |
behaviors |to |prevent |recurrence |of |leg |ulcer. |- |CORRECT |ANSWER✔✔-d. |Affective |outcomes |
describe |changes |in |patient |values, |beliefs, |and |attitudes. |Cognitive |outcomes |(a) |describe |
increases |in |patient |knowledge |or |intellectual |behaviors; |psychomotor |outcomes |(b) |describe |
the |patient's |achievement |of |new |skills. |c |is |an |outcome |describing |a |physical |change |in |the |
patient.
A |nurse |is |preparing |a |clinical |outcome |for |a |32-year-old |female |runner |who |is |recovering |
from |a |stroke |that |caused |right-sided |paresis. |An |example |of |this |type |of |outcome |is:
After |receiving |3 |weeks |of |physical |therapy, |patient |will |demonstrate |improved |movement |on |
the |right |side |of |her |body.
By |8/15/15, |patient |will |be |able |to |use |right |arm |to |dress, |comb |hair, |and |feed |herself.
Following |physical |therapy, |patient |will |begin |to |gradually |participate |in |walking/running |
events.
By |8/15/15, |patient |will |verbalize |feeling |sufficiently |prepared |to |participate |in |running |events.
|- |CORRECT |ANSWER✔✔-a. |Clinical |outcomes |describe |the |expected |status |of |health |issues |at |
certain |points |in |time, |after |treatment |is |complete. |Functional |outcomes |(b) |describe |the |
person's |ability |to |function |in |relation |to |the |desired |usual |activities. |Quality-of-life |outcomes |
(c) |focus |on |key |factors |that |affect |someone's |ability |to |enjoy |life |and |achieve |personal |goals. |
Affective |outcomes |(d) |describe |changes |in |patient |values, |beliefs, |and |attitudes.
Questions With Correct Answers
A |nurse |is |planning |care |for |a |male |adolescent |patient |who |is |admitted |to |the |hospital |for |
treatment |of |a |drug |overdose. |Which |nursing |actions |are |related |to |the |outcome |identification
|and |planning |step |of |the |nursing |process? |Select |all |that |apply.
The |nurse |formulates |nursing |diagnoses.
The |nurse |identifies |expected |patient |outcomes.
The |nurse |selects |evidence-based |nursing |interventions.
The |nurse |explains |the |nursing |care |plan |to |the |patient.
The |nurse |assesses |the |patient's |mental |status.
The |nurse |evaluates |the |patient's |outcome |achievement. |- |CORRECT |ANSWER✔✔-b, |c, |d. |
During |the |outcome |identification |and |planning |step |of |the |nursing |process, |the |nurse |works |
in |partnership |with |the |patient |and |family |to |establish |priorities, |identify |and |write |expected |
patient |outcomes, |select |evidence-based |nursing |interventions, |and |communicate |the |plan |of |
nursing |care. |Although |all |these |steps |may |overlap, |formulating |and |validating |nursing |
diagnoses |occurs |most |frequently |during |the |diagnosing |step |of |the |nursing |process. |Assessing
|mental |status |is |part |of |the |assessment |step, |and |evaluating |patient |outcomes |occurs |during |
the |evaluation |step |of |the |nursing |process.
A |nurse |on |a |busy |surgical |unit |relies |on |informal |planning |to |provide |appropriate |nursing |
responses |to |patients |in |a |timely |manner. |What |are |examples |of |this |type |of |planning? |Select |
all |that |apply.
A |nurse |sits |down |with |a |patient |and |prioritizes |existing |diagnoses.
A |nurse |assesses |a |woman |for |postpartum |depression |during |routine |care.
A |nurse |plans |interventions |for |a |patient |who |is |diagnosed |with |epilepsy.
A |busy |nurse |takes |time |to |speak |to |a |patient |who |received |bad |news.
,A |nurse |reassesses |a |patient |whose |PRN |pain |medication |is |not |working.
A |nurse |coordinates |the |home |care |of |a |patient |being |discharged. |- |CORRECT |ANSWER✔✔-b, |
d, |e. |Informal |planning |is |a |link |between |identifying |a |patient's |strength |or |problem |and |
providing |an |appropriate |nursing |response. |This |occurs, |for |example, |when |a |busy |nurse |first |
recognizes |postpartum |depression |in |a |patient, |takes |time |to |assess |a |patient |who |received |
bad |news |about |tests, |or |reassesses |a |patient |for |pain. |Formal |planning |involves |prioritizing |
diagnoses, |formally |planning |interventions, |and |coordinating |the |home |care |of |a |patient |being
|discharged.
3. |When |helping |a |patient |turn |in |bed, |the |nurse |notices |that |his |heels |are |reddened |and |
plans |to |place |him |on |precautions |for |skin |breakdown. |This |is |an |example |of |what |type |of |
planning?
Initial |planning
Standardized |planning
Ongoing |planning
Discharge |planning |- |CORRECT |ANSWER✔✔-c. |Ongoing |planning |is |problem |oriented |and |has |
as |its |purpose |keeping |the |plan |up |to |date |as |new |actual |or |potential |problems |are |identified. |
Initial |planning |addresses |each |problem |listed |in |the |prioritized |nursing |diagnoses |and |
identifies |appropriate |patient |goals |and |the |related |nursing |care. |Standardized |care |plans |are |
prepared |plans |of |care |that |identify |the |nursing |diagnoses, |outcomes, |and |related |nursing |
interventions |common |to |a |specific |population |or |health |problem. |During |discharge |planning, |
the |nurse |uses |teaching |and |counseling |skills |effectively |to |help |the |patient |and |family |
develop |sufficient |knowledge |of |the |health |problem |and |the |therapeutic |regimen |to |carry |out |
necessary |self-care |behaviors |competently |at |home.
. |A |nurse |is |prioritizing |the |following |patient |diagnoses |according |to |Maslow's |hierarchy |of |
human |needs:
(1) |Disturbed |Body |Image
(2) |Ineffective |Airway |Clearance
(3) |Spiritual |Distress
(4) |Impaired |Social |Interaction
,Which |answer |choice |below |lists |the |problems |in |order |of |highest |priority |to |lowest |priority |
based |on |Maslow's |model?
2, |4, |1, |3
3, |1, |4, |2
2, |4, |3, |1
3, |2, |4, |1 |- |CORRECT |ANSWER✔✔-a. |2, |4, |1, |3. |Because |basic |needs |must |be |met |before |a |
person |can |focus |on |higher |ones, |patient |needs |may |be |prioritized |according |to |Maslow's |
hierarchy: |(1) |physiologic |needs, |(2) |safety |needs, |(3) |love |and |belonging |needs, |(4) |self-
esteem |needs, |and |(5) |self-actualization |needs. |#2 |is |an |example |of |a |physiologic |need, |#4 |is |
an |example |of |a |love |and |belonging |need, |#1 |is |an |example |of |a |self-esteem |need, |and |#3 |is |
an |example |of |a |self-actualization |need.
. |A |nurse |is |using |critical |pathway |methodology |for |choosing |interventions |for |a |patient |who |is
|receiving |chemotherapy |for |breast |cancer. |Which |nursing |actions |are |characteristics |of |this |
system |being |used |when |planning |care? |Select |all |that |apply.
The |nurse |uses |a |minimal |practice |standard |and |is |able |to |alter |care |to |meet |the |patient's |
individual |needs.
The |nurse |uses |a |binary |decision |tree |for |stepwise |assessment |and |intervention.
The |nurse |is |able |to |measure |the |cause-and-effect |relationship |between |pathway |and |patient |
outcomes.
The |nurse |uses |broad, |research-based |practice |recommendations |that |may |or |may |not |have |
been |tested |in |clinical |practice.
The |nurse |uses |preprinted |provider |orders |used |to |expedite |the |order |process |after |a |practice |
standard |has |been |validated |through |research.
The |nurse |uses |a |decision |tree |that |provides |intense |specificity |and |no |provider |flexibility. |- |
CORRECT |ANSWER✔✔-a, |c. |A |critical |pathway |represents |a |sequential, |interdisciplinary, |
minimal |practice |standard |for |a |specific |patient |population |that |provides |flexibility |to |alter |
care |to |meet |individualized |patient |needs. |It |also |offers |the |ability |to |measure |a |cause-and-
effect |relationship |between |pathway |and |patient |outcomes. |An |algorithm |is |a |binary |decision |
tree |that |guides |stepwise |assessment |and |intervention |with |intense |specificity |and |no |
provider |flexibility. |Guidelines |are |broad, |research-based |practice |recommendations |that |may |
or |may |not |have |been |tested |in |clinical |practice, |and |an |order |set |is |a |preprinted |provider |
, order |used |to |expedite |the |order |process |after |a |practice |standard |has |been |validated |through
|analytical |research.
A |nurse |is |identifying |outcomes |for |a |patient |who |has |a |leg |ulcer |related |to |diabetes. |An |
example |of |an |affective |outcome |for |this |patient |is:
Within |1 |day |after |teaching, |the |patient |will |list |three |benefits |of |continuing |to |apply |moist |
compresses |to |leg |ulcer |after |discharge.
By |6/12/15, |the |patient |will |correctly |demonstrate |application |of |wet-to-dry |dressing |on |leg |
ulcer.
By |6/19/15, |the |patient's |ulcer |will |begin |to |show |signs |of |healing |(e.g., |size |shrinks |from |3″ |to
|2.5″).
By |6/12/15, |the |patient |will |verbalize |valuing |health |sufficiently |to |practice |new |health |
behaviors |to |prevent |recurrence |of |leg |ulcer. |- |CORRECT |ANSWER✔✔-d. |Affective |outcomes |
describe |changes |in |patient |values, |beliefs, |and |attitudes. |Cognitive |outcomes |(a) |describe |
increases |in |patient |knowledge |or |intellectual |behaviors; |psychomotor |outcomes |(b) |describe |
the |patient's |achievement |of |new |skills. |c |is |an |outcome |describing |a |physical |change |in |the |
patient.
A |nurse |is |preparing |a |clinical |outcome |for |a |32-year-old |female |runner |who |is |recovering |
from |a |stroke |that |caused |right-sided |paresis. |An |example |of |this |type |of |outcome |is:
After |receiving |3 |weeks |of |physical |therapy, |patient |will |demonstrate |improved |movement |on |
the |right |side |of |her |body.
By |8/15/15, |patient |will |be |able |to |use |right |arm |to |dress, |comb |hair, |and |feed |herself.
Following |physical |therapy, |patient |will |begin |to |gradually |participate |in |walking/running |
events.
By |8/15/15, |patient |will |verbalize |feeling |sufficiently |prepared |to |participate |in |running |events.
|- |CORRECT |ANSWER✔✔-a. |Clinical |outcomes |describe |the |expected |status |of |health |issues |at |
certain |points |in |time, |after |treatment |is |complete. |Functional |outcomes |(b) |describe |the |
person's |ability |to |function |in |relation |to |the |desired |usual |activities. |Quality-of-life |outcomes |
(c) |focus |on |key |factors |that |affect |someone's |ability |to |enjoy |life |and |achieve |personal |goals. |
Affective |outcomes |(d) |describe |changes |in |patient |values, |beliefs, |and |attitudes.
