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⚠️ HIGH-YIELD IMPROVEMENTS

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⚠️ HIGH-YIELD IMPROVEMENTS 1. Add More Objective + Subjective Data in Some Stems A few stems rely slightly more on context than explicit assessment cues. Example (Item 1): “fatigue, poor appetite, anxiety…” Improve by adding: Vital signs, behavior, or function level Refined Stem Example: “…reports fatigue, eats 25% of meals, and appears restless, stating ‘I feel overwhelmed by even small tasks.’” This strengthens clinical judgment linkage 2. Strengthen NANDA Language Where Applicable Some items imply diagnoses without explicitly aligning to NANDA-style phrasing. Example (Item 2): “Impaired gas exchange” good Consider reinforcing cues like: SpO₂ respiratory effort You did this well—just keep it consistent across all items. 3. Upgrade Some Distractors to Increase Difficulty A few distractors are slightly too easy to eliminate. Example (Item 6): D. “Reassure the patient that falls are common…” This is obviously incorrect. Stronger distractor: D. Re-educate the patient about fall precautions before implementing changes ️ Now it competes with B (action vs teaching priority) 4. Add Time-Bound Outcomes More Consistently You used this well in some items (e.g., #12), but not consistently. NCLEX prefers: Time-bound + measurable outcomes 5. Enhance Evaluation Questions (Very Good—Can Be Excellent) Items like #18 are strong. To push further: Include: “expected vs actual outcome comparison” “next step decision” Example upgrade: “…What is the nurse’s next best action?”

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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

A newly hired nurse asks why the unit uses written nursing care
plans when the electronic health record already contains orders
and progress notes. The preceptor explains that the care plan
should help the team focus on the patient’s needs, expected
results, and nursing actions. Which statement best describes
the primary purpose of a nursing care plan?

,Options:
A. To list all physician-prescribed treatments for the patient
B. To organize patient-centered nursing diagnoses,
interventions, and outcomes
C. To replace the need for ongoing nursing assessment
D. To document only abnormal findings for legal purposes
Correct Answer: B
Rationale — Correct Answer:
A nursing care plan organizes nursing diagnoses, interventions,
and outcomes in a patient-centered way. It helps the nurse
communicate priorities, guide care, and evaluate whether
interventions are effective.
Rationale — Incorrect Options:
A. Physician orders may be included in the overall plan of care,
but they are not the primary focus of a nursing care plan.
C. Care plans depend on ongoing assessment; they do not
replace it.
D. A care plan is broader than legal documentation of
abnormalities and should guide nursing action.
Teaching Point:
A care plan links assessment, nursing action, and measurable
outcomes.
Citation:
Gulanick, M., & Myers, J. (n.d.). Nursing Care Plans: Diagnoses,

,Interventions, and Outcomes (11th ed.). Chapter 1,
Introduction.


2) Reference: How to use nursing care plans: diagnoses,
interventions, and outcomes
Stem:
A patient with new-onset weakness reports, “I do not feel safe
walking to the bathroom alone.” The nurse identifies the
diagnosis, selects interventions, and writes an outcome. Which
care-plan component states what the nurse will do to promote
safety?
Options:
A. Nursing diagnosis
B. Expected outcome
C. Nursing intervention
D. Etiology
Correct Answer: C
Rationale — Correct Answer:
Nursing interventions are the actions the nurse performs to
address the diagnosis and support the outcome. In this case,
safety measures such as assisted ambulation and fall
precautions are interventions.
Rationale — Incorrect Options:
A. The diagnosis names the patient problem, not the action.
B. The outcome describes the desired result, not the nurse’s

, action.
D. Etiology describes the cause or related factor, not the
intervention.
Teaching Point:
Interventions are the “doing” part of the care plan.
Citation:
Gulanick, M., & Myers, J. (n.d.). Nursing Care Plans: Diagnoses,
Interventions, and Outcomes (11th ed.). Chapter 1, How to use
nursing care plans: diagnoses, interventions, and outcomes.


3) Reference: Individualizing a care plan
Stem:
A hospitalized older adult with hearing loss nods during
teaching but does not answer questions appropriately. The
nurse notices the patient reads at a low level and prefers
written instructions with large print. Which action best
individualizes the care plan?
Options:
A. Use the same standard teaching sheet given to all patients
B. Delay teaching until discharge instructions are printed
C. Adapt teaching materials and communication to the patient’s
hearing and literacy needs
D. Ask a family member to receive all teaching instead of the
patient
Correct Answer: C

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Institution
NCLEX RN
Course
NCLEX RN

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Uploaded on
March 19, 2026
Number of pages
391
Written in
2025/2026
Type
Exam (elaborations)
Contains
Questions & answers

Subjects

  • nursing scho
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