NURSING CARE PLANS
DIAGNOSES, INTERVENTIONS, AND
OUTCOMES
11TH EDITION
• AUTHOR(S)MEG GULANICK;
JUDITH L. MYERS
TEST BANK
Reference: Chapter 1 — Prioritizing nursing diagnoses
Clinical stem:
A postoperative patient reports incisional pain rated 8/10 and
asks for medication. While assessing the patient, the nurse
notes shallow respirations at 8/min and oxygen saturation of
88% on room air. The patient is drowsy but arousable. Which
nursing diagnosis should the nurse address first?
,Options:
A. Acute Pain
B. Impaired Gas Exchange
C. Anxiety
D. Deficient Knowledge
Correct answer: B. Impaired Gas Exchange
Rationale — Correct answer:
Impaired gas exchange is the priority because the patient has an
immediate breathing problem, shown by low oxygen saturation,
shallow respirations, and drowsiness. Using airway and
breathing priorities, the nurse must act on the most urgent
physiologic threat first.
Rationale — Incorrect options:
A. Acute pain is important, but it does not take priority over
compromised oxygenation.
C. Anxiety may be present, but it is not the most urgent
problem.
D. Deficient knowledge is not the priority when the patient
shows signs of respiratory compromise.
Teaching point:
ABCs and oxygenation come before pain, teaching, or
psychosocial concerns.
Citation:
Gulanick, M., & Myers, J. (2026). Nursing Care Plans: Diagnoses,
,Interventions, and Outcomes (11th ed.). Chapter 1: Prioritizing
nursing diagnoses.
2. Individualizing a care plan
Reference: Chapter 1 — Individualizing a care plan
Clinical stem:
A nurse is planning discharge teaching for an older adult newly
diagnosed with heart failure. The patient says, “I do not read
well, and my daughter helps me manage my medicines.” Which
nursing action best individualizes the care plan?
Options:
A. Use the same written handout given to all patients with heart
failure
B. Ask the daughter to attend teaching and use simple verbal
instructions
C. Tell the patient to read the material at home and call with
questions
D. Focus only on medication names because that is the most
important topic
Correct answer: B. Ask the daughter to attend teaching and
use simple verbal instructions
Rationale — Correct answer:
This response individualizes the care plan by matching teaching
to the patient’s learning needs and support system. It reflects
, patient-centered care and improves the likelihood of
understanding and follow-through.
Rationale — Incorrect options:
A. A standard handout may not match the patient’s literacy
level or learning needs.
C. This assumes the patient can read and self-teach, which is
unsafe.
D. Education should be broader than medication names and
adapted to the patient’s needs.
Teaching point:
Individualized care plans reflect the patient’s abilities,
preferences, and support systems.
Citation:
Gulanick, M., & Myers, J. (2026). Nursing Care Plans: Diagnoses,
Interventions, and Outcomes (11th ed.). Chapter 1:
Individualizing a care plan.
3. Writing a measurable outcome
Reference: Chapter 1 — How to use nursing care plans:
diagnoses, interventions, and outcomes
Clinical stem:
A nurse is writing an outcome for a patient with impaired
mobility after surgery. Which outcome is best written?
DIAGNOSES, INTERVENTIONS, AND
OUTCOMES
11TH EDITION
• AUTHOR(S)MEG GULANICK;
JUDITH L. MYERS
TEST BANK
Reference: Chapter 1 — Prioritizing nursing diagnoses
Clinical stem:
A postoperative patient reports incisional pain rated 8/10 and
asks for medication. While assessing the patient, the nurse
notes shallow respirations at 8/min and oxygen saturation of
88% on room air. The patient is drowsy but arousable. Which
nursing diagnosis should the nurse address first?
,Options:
A. Acute Pain
B. Impaired Gas Exchange
C. Anxiety
D. Deficient Knowledge
Correct answer: B. Impaired Gas Exchange
Rationale — Correct answer:
Impaired gas exchange is the priority because the patient has an
immediate breathing problem, shown by low oxygen saturation,
shallow respirations, and drowsiness. Using airway and
breathing priorities, the nurse must act on the most urgent
physiologic threat first.
Rationale — Incorrect options:
A. Acute pain is important, but it does not take priority over
compromised oxygenation.
C. Anxiety may be present, but it is not the most urgent
problem.
D. Deficient knowledge is not the priority when the patient
shows signs of respiratory compromise.
Teaching point:
ABCs and oxygenation come before pain, teaching, or
psychosocial concerns.
Citation:
Gulanick, M., & Myers, J. (2026). Nursing Care Plans: Diagnoses,
,Interventions, and Outcomes (11th ed.). Chapter 1: Prioritizing
nursing diagnoses.
2. Individualizing a care plan
Reference: Chapter 1 — Individualizing a care plan
Clinical stem:
A nurse is planning discharge teaching for an older adult newly
diagnosed with heart failure. The patient says, “I do not read
well, and my daughter helps me manage my medicines.” Which
nursing action best individualizes the care plan?
Options:
A. Use the same written handout given to all patients with heart
failure
B. Ask the daughter to attend teaching and use simple verbal
instructions
C. Tell the patient to read the material at home and call with
questions
D. Focus only on medication names because that is the most
important topic
Correct answer: B. Ask the daughter to attend teaching and
use simple verbal instructions
Rationale — Correct answer:
This response individualizes the care plan by matching teaching
to the patient’s learning needs and support system. It reflects
, patient-centered care and improves the likelihood of
understanding and follow-through.
Rationale — Incorrect options:
A. A standard handout may not match the patient’s literacy
level or learning needs.
C. This assumes the patient can read and self-teach, which is
unsafe.
D. Education should be broader than medication names and
adapted to the patient’s needs.
Teaching point:
Individualized care plans reflect the patient’s abilities,
preferences, and support systems.
Citation:
Gulanick, M., & Myers, J. (2026). Nursing Care Plans: Diagnoses,
Interventions, and Outcomes (11th ed.). Chapter 1:
Individualizing a care plan.
3. Writing a measurable outcome
Reference: Chapter 1 — How to use nursing care plans:
diagnoses, interventions, and outcomes
Clinical stem:
A nurse is writing an outcome for a patient with impaired
mobility after surgery. Which outcome is best written?
