NURSING CARE PLANS
DIAGNOSES, INTERVENTIONS, AND
OUTCOMES
11TH EDITION
• AUTHOR(S)MEG GULANICK;
JUDITH L. MYERS
TEST BANK
Reference: Using Nursing Care Plans to Individualize and
Improve Care — What is a Nursing Care Plan?
Stem:
A newly hired RN is reviewing a patient’s care plan for a client
admitted with dehydration, weakness, and poor appetite. The
RN notices that the care plan lists priorities, outcomes, and
,interventions tied to the patient’s current assessment findings.
The charge nurse asks why the care plan is important in daily
practice.
Options:
A. It replaces the need for ongoing nursing assessment once the
plan is written.
B. It provides a framework for individualized nursing care and
evaluation.
C. It is used only to document physician-prescribed treatments.
D. It is completed at admission and rarely changed afterward.
Correct Answer: B
Rationales:
B is correct. A nursing care plan organizes assessment data,
priorities, interventions, and outcomes so care can be
individualized and evaluated over time. It supports the nursing
process and clinical judgment.
A is incorrect. Assessment is ongoing and must continue after
the plan is written.
C is incorrect. Nursing care plans focus on nursing problems and
nursing actions, not only physician orders.
D is incorrect. Care plans should be updated as the patient’s
condition and response change.
Teaching Point: Care plans guide individualized, ongoing nursing
care and evaluation.
,Citation: Gulanick, M., & Myers, J. (2026). Nursing Care Plans:
Diagnoses, Interventions, and Outcomes (11th ed.). Chapter 1:
Using nursing care plans to individualize and improve care.
2) Prioritizing nursing diagnoses
Reference: Prioritizing Nursing Diagnoses
Stem:
A postoperative patient reports incisional pain rated 8/10, is
restless, and has a respiratory rate of 30/min with an oxygen
saturation of 88% on room air. The patient also states, “I feel
scared and do not want to move.” Which nursing diagnosis
should the nurse prioritize?
Options:
A. Acute Pain
B. Anxiety
C. Impaired Gas Exchange
D. Deficient Knowledge
Correct Answer: C
Rationales:
C is correct. Oxygen saturation of 88% and tachypnea indicate
an immediate breathing problem, which takes priority over pain
or anxiety. Priority setting follows ABCs and safety.
A is incorrect. Pain is important, but it is not more urgent than a
breathing problem.
B is incorrect. Anxiety may be contributing, but it is not the top
,priority when oxygenation is compromised.
D is incorrect. Teaching needs are not urgent compared with
impaired oxygenation.
Teaching Point: Airway and breathing problems outrank pain,
anxiety, and teaching needs.
Citation: Gulanick, M., & Myers, J. (2026). Nursing Care Plans:
Diagnoses, Interventions, and Outcomes (11th ed.). Chapter 1:
Prioritizing nursing diagnoses.
3) Individualizing the care plan
Reference: Individualizing a Care Plan
Stem:
A patient with heart failure is admitted for fluid overload. The
nurse notices that the patient is hard of hearing, speaks limited
English, and prefers evening teaching when a family member is
present. The nurse wants the care plan to reflect the patient’s
needs.
Options:
A. Use the standard heart failure teaching sheet for all patients.
B. Delay education until discharge to avoid confusion.
C. Schedule teaching with an interpreter and the family
member present.
D. Provide only written instructions to reduce the patient’s
stress.
,Correct Answer: C
Rationales:
C is correct. The plan is individualized when it reflects hearing,
language, and family support needs. This improves
understanding and patient-centered care.
A is incorrect. Standard teaching alone does not address this
patient’s barriers.
B is incorrect. Education should begin early and be adapted, not
postponed unnecessarily.
D is incorrect. Written instructions alone are not enough when
language and hearing barriers exist.
Teaching Point: Individualize care by matching teaching to
language, hearing, and family support needs.
Citation: Gulanick, M., & Myers, J. (2026). Nursing Care Plans:
Diagnoses, Interventions, and Outcomes (11th ed.). Chapter 1:
Individualizing a care plan.
4) Writing measurable outcomes
Reference: How to Use Nursing Care Plans: Diagnoses,
Interventions, and Outcomes
Stem:
A nurse is writing an outcome for a patient with activity
intolerance. The patient becomes short of breath after walking
to the bathroom and needs frequent rest periods. Which
outcome is best written?
,Options:
A. The patient will improve activity tolerance.
B. The patient will walk more often.
C. The patient will ambulate 50 feet with oxygen saturation ≥
94% and no more than mild dyspnea by the end of the shift.
D. The patient will understand the importance of exercise.
Correct Answer: C
Rationales:
C is correct. This outcome is specific, measurable, time-limited,
and tied to assessment findings. It allows evaluation of whether
the plan worked.
A is incorrect. “Improve” is vague and cannot be measured
clearly.
B is incorrect. It lacks specificity and a measurable standard.
D is incorrect. Understanding is a teaching goal, not a functional
outcome for activity tolerance.
Teaching Point: Good outcomes are specific, measurable, and
time-limited.
Citation: Gulanick, M., & Myers, J. (2026). Nursing Care Plans:
Diagnoses, Interventions, and Outcomes (11th ed.). Chapter 1:
How to use nursing care plans.
5) Revising the care plan
Reference: Clinical Judgment Challenge
,Stem:
A patient with postoperative pain was given prescribed
analgesia and repositioned. Two hours later, the patient still
rates pain as 8/10, is grimacing, and is unable to deep breathe
or cough effectively. What should the nurse do next?
Options:
A. Document that the intervention was effective.
B. Reassess the pain and revise the care plan.
C. Remove pain as a nursing diagnosis.
D. Encourage the patient to ignore the pain and rest.
Correct Answer: B
Rationales:
B is correct. Unrelieved pain means the current interventions
were not effective, so reassessment and care-plan revision are
needed. This reflects evaluation and clinical judgment.
A is incorrect. The data show the intervention did not achieve
the desired outcome.
C is incorrect. The diagnosis remains relevant because the
problem persists.
D is incorrect. Pain should not be dismissed; it should be
reassessed and managed safely.
Teaching Point: Ineffective outcomes require reassessment and
care-plan revision.
,Citation: Gulanick, M., & Myers, J. (2026). Nursing Care Plans:
Diagnoses, Interventions, and Outcomes (11th ed.). Chapter 1:
Clinical judgment challenge.
6) Patient-centered care planning
Reference: A Focus on Optimizing Care
Stem:
A patient with chronic kidney disease says, “I do not want to
take a shower in the morning because I feel weak then. I do
better in the afternoon.” The nurse is planning daily hygiene
care. What is the best action?
Options:
A. Insist on morning hygiene to keep the schedule consistent.
B. Modify the care plan to provide hygiene in the afternoon.
C. Cancel hygiene care until the patient is stronger.
D. Ask the family to decide the bathing time.
Correct Answer: B
Rationales:
B is correct. Optimizing care means tailoring the plan to the
patient’s energy pattern and preferences when safe. This
supports comfort, independence, and participation.
A is incorrect. A rigid schedule ignores patient needs and
weakens individualized care.
C is incorrect. Hygiene should not be eliminated if it can be
safely adjusted.
,D is incorrect. Family input may help, but the patient’s
preference should guide the plan when possible.
Teaching Point: Patient preferences should shape safe,
individualized care when possible.
Citation: Gulanick, M., & Myers, J. (2026). Nursing Care Plans:
Diagnoses, Interventions, and Outcomes (11th ed.). Chapter 1: A
focus on optimizing care.
7) Quality and safety in nursing
Reference: Quality and Safety in Nursing
Stem:
An older adult admitted after a fall is taking medications that
cause dizziness and reports needing help to stand. The nurse is
updating the care plan. Which intervention best supports
quality and safety?
Options:
A. Encourage independent ambulation to preserve self-esteem.
B. Keep the bed in the lowest position and implement fall
precautions.
C. Wait until the patient falls again before changing the plan.
D. Limit all mobility for the entire admission.
Correct Answer: B
Rationales:
B is correct. Fall precautions directly reduce injury risk and
, reflect safety-focused nursing care planning.
A is incorrect. Safety comes before promoting independence
when fall risk is high.
C is incorrect. Care plans should be updated proactively, not
after another injury.
D is incorrect. Total immobility can create other complications
and is not always necessary.
Teaching Point: Safety interventions belong in the care plan
before harm occurs.
Citation: Gulanick, M., & Myers, J. (2026). Nursing Care Plans:
Diagnoses, Interventions, and Outcomes (11th ed.). Chapter 1:
Quality and safety in nursing.
8) Use of nursing care plans during handoff
Reference: How to Use Nursing Care Plans
Stem:
During shift report, a nurse tells the oncoming nurse that a
patient is at risk for skin breakdown, has a turning schedule,
and is being monitored for redness over the sacrum. What is
the primary purpose of sharing this information from the care
plan?
Options:
A. To replace bedside assessment for the next nurse
B. To communicate prioritized nursing needs and planned
interventions
DIAGNOSES, INTERVENTIONS, AND
OUTCOMES
11TH EDITION
• AUTHOR(S)MEG GULANICK;
JUDITH L. MYERS
TEST BANK
Reference: Using Nursing Care Plans to Individualize and
Improve Care — What is a Nursing Care Plan?
Stem:
A newly hired RN is reviewing a patient’s care plan for a client
admitted with dehydration, weakness, and poor appetite. The
RN notices that the care plan lists priorities, outcomes, and
,interventions tied to the patient’s current assessment findings.
The charge nurse asks why the care plan is important in daily
practice.
Options:
A. It replaces the need for ongoing nursing assessment once the
plan is written.
B. It provides a framework for individualized nursing care and
evaluation.
C. It is used only to document physician-prescribed treatments.
D. It is completed at admission and rarely changed afterward.
Correct Answer: B
Rationales:
B is correct. A nursing care plan organizes assessment data,
priorities, interventions, and outcomes so care can be
individualized and evaluated over time. It supports the nursing
process and clinical judgment.
A is incorrect. Assessment is ongoing and must continue after
the plan is written.
C is incorrect. Nursing care plans focus on nursing problems and
nursing actions, not only physician orders.
D is incorrect. Care plans should be updated as the patient’s
condition and response change.
Teaching Point: Care plans guide individualized, ongoing nursing
care and evaluation.
,Citation: Gulanick, M., & Myers, J. (2026). Nursing Care Plans:
Diagnoses, Interventions, and Outcomes (11th ed.). Chapter 1:
Using nursing care plans to individualize and improve care.
2) Prioritizing nursing diagnoses
Reference: Prioritizing Nursing Diagnoses
Stem:
A postoperative patient reports incisional pain rated 8/10, is
restless, and has a respiratory rate of 30/min with an oxygen
saturation of 88% on room air. The patient also states, “I feel
scared and do not want to move.” Which nursing diagnosis
should the nurse prioritize?
Options:
A. Acute Pain
B. Anxiety
C. Impaired Gas Exchange
D. Deficient Knowledge
Correct Answer: C
Rationales:
C is correct. Oxygen saturation of 88% and tachypnea indicate
an immediate breathing problem, which takes priority over pain
or anxiety. Priority setting follows ABCs and safety.
A is incorrect. Pain is important, but it is not more urgent than a
breathing problem.
B is incorrect. Anxiety may be contributing, but it is not the top
,priority when oxygenation is compromised.
D is incorrect. Teaching needs are not urgent compared with
impaired oxygenation.
Teaching Point: Airway and breathing problems outrank pain,
anxiety, and teaching needs.
Citation: Gulanick, M., & Myers, J. (2026). Nursing Care Plans:
Diagnoses, Interventions, and Outcomes (11th ed.). Chapter 1:
Prioritizing nursing diagnoses.
3) Individualizing the care plan
Reference: Individualizing a Care Plan
Stem:
A patient with heart failure is admitted for fluid overload. The
nurse notices that the patient is hard of hearing, speaks limited
English, and prefers evening teaching when a family member is
present. The nurse wants the care plan to reflect the patient’s
needs.
Options:
A. Use the standard heart failure teaching sheet for all patients.
B. Delay education until discharge to avoid confusion.
C. Schedule teaching with an interpreter and the family
member present.
D. Provide only written instructions to reduce the patient’s
stress.
,Correct Answer: C
Rationales:
C is correct. The plan is individualized when it reflects hearing,
language, and family support needs. This improves
understanding and patient-centered care.
A is incorrect. Standard teaching alone does not address this
patient’s barriers.
B is incorrect. Education should begin early and be adapted, not
postponed unnecessarily.
D is incorrect. Written instructions alone are not enough when
language and hearing barriers exist.
Teaching Point: Individualize care by matching teaching to
language, hearing, and family support needs.
Citation: Gulanick, M., & Myers, J. (2026). Nursing Care Plans:
Diagnoses, Interventions, and Outcomes (11th ed.). Chapter 1:
Individualizing a care plan.
4) Writing measurable outcomes
Reference: How to Use Nursing Care Plans: Diagnoses,
Interventions, and Outcomes
Stem:
A nurse is writing an outcome for a patient with activity
intolerance. The patient becomes short of breath after walking
to the bathroom and needs frequent rest periods. Which
outcome is best written?
,Options:
A. The patient will improve activity tolerance.
B. The patient will walk more often.
C. The patient will ambulate 50 feet with oxygen saturation ≥
94% and no more than mild dyspnea by the end of the shift.
D. The patient will understand the importance of exercise.
Correct Answer: C
Rationales:
C is correct. This outcome is specific, measurable, time-limited,
and tied to assessment findings. It allows evaluation of whether
the plan worked.
A is incorrect. “Improve” is vague and cannot be measured
clearly.
B is incorrect. It lacks specificity and a measurable standard.
D is incorrect. Understanding is a teaching goal, not a functional
outcome for activity tolerance.
Teaching Point: Good outcomes are specific, measurable, and
time-limited.
Citation: Gulanick, M., & Myers, J. (2026). Nursing Care Plans:
Diagnoses, Interventions, and Outcomes (11th ed.). Chapter 1:
How to use nursing care plans.
5) Revising the care plan
Reference: Clinical Judgment Challenge
,Stem:
A patient with postoperative pain was given prescribed
analgesia and repositioned. Two hours later, the patient still
rates pain as 8/10, is grimacing, and is unable to deep breathe
or cough effectively. What should the nurse do next?
Options:
A. Document that the intervention was effective.
B. Reassess the pain and revise the care plan.
C. Remove pain as a nursing diagnosis.
D. Encourage the patient to ignore the pain and rest.
Correct Answer: B
Rationales:
B is correct. Unrelieved pain means the current interventions
were not effective, so reassessment and care-plan revision are
needed. This reflects evaluation and clinical judgment.
A is incorrect. The data show the intervention did not achieve
the desired outcome.
C is incorrect. The diagnosis remains relevant because the
problem persists.
D is incorrect. Pain should not be dismissed; it should be
reassessed and managed safely.
Teaching Point: Ineffective outcomes require reassessment and
care-plan revision.
,Citation: Gulanick, M., & Myers, J. (2026). Nursing Care Plans:
Diagnoses, Interventions, and Outcomes (11th ed.). Chapter 1:
Clinical judgment challenge.
6) Patient-centered care planning
Reference: A Focus on Optimizing Care
Stem:
A patient with chronic kidney disease says, “I do not want to
take a shower in the morning because I feel weak then. I do
better in the afternoon.” The nurse is planning daily hygiene
care. What is the best action?
Options:
A. Insist on morning hygiene to keep the schedule consistent.
B. Modify the care plan to provide hygiene in the afternoon.
C. Cancel hygiene care until the patient is stronger.
D. Ask the family to decide the bathing time.
Correct Answer: B
Rationales:
B is correct. Optimizing care means tailoring the plan to the
patient’s energy pattern and preferences when safe. This
supports comfort, independence, and participation.
A is incorrect. A rigid schedule ignores patient needs and
weakens individualized care.
C is incorrect. Hygiene should not be eliminated if it can be
safely adjusted.
,D is incorrect. Family input may help, but the patient’s
preference should guide the plan when possible.
Teaching Point: Patient preferences should shape safe,
individualized care when possible.
Citation: Gulanick, M., & Myers, J. (2026). Nursing Care Plans:
Diagnoses, Interventions, and Outcomes (11th ed.). Chapter 1: A
focus on optimizing care.
7) Quality and safety in nursing
Reference: Quality and Safety in Nursing
Stem:
An older adult admitted after a fall is taking medications that
cause dizziness and reports needing help to stand. The nurse is
updating the care plan. Which intervention best supports
quality and safety?
Options:
A. Encourage independent ambulation to preserve self-esteem.
B. Keep the bed in the lowest position and implement fall
precautions.
C. Wait until the patient falls again before changing the plan.
D. Limit all mobility for the entire admission.
Correct Answer: B
Rationales:
B is correct. Fall precautions directly reduce injury risk and
, reflect safety-focused nursing care planning.
A is incorrect. Safety comes before promoting independence
when fall risk is high.
C is incorrect. Care plans should be updated proactively, not
after another injury.
D is incorrect. Total immobility can create other complications
and is not always necessary.
Teaching Point: Safety interventions belong in the care plan
before harm occurs.
Citation: Gulanick, M., & Myers, J. (2026). Nursing Care Plans:
Diagnoses, Interventions, and Outcomes (11th ed.). Chapter 1:
Quality and safety in nursing.
8) Use of nursing care plans during handoff
Reference: How to Use Nursing Care Plans
Stem:
During shift report, a nurse tells the oncoming nurse that a
patient is at risk for skin breakdown, has a turning schedule,
and is being monitored for redness over the sacrum. What is
the primary purpose of sharing this information from the care
plan?
Options:
A. To replace bedside assessment for the next nurse
B. To communicate prioritized nursing needs and planned
interventions
