TEST BANK TEST BANK LIPPINCOTTS Q&A REVIEW FOR NCLEX-RN 10TH EDITION

TEST BANK LIPPINCOTTS Q&A REVIEW FOR NCLEX-RN 10TH EDITION LIPPINCOTT'S Q&A REVIEW FOR NCLEX-RN 10TH EDITION By DIANE M. BILLINGS, EdD, RN, FAAN ISBN 978-1-60831-125-5 (alk. paper) 1084 PAGES Lippincoflt's Q&A Review for NCLEX-RN® TENTH EDITION Diane M. Billings, EdD, RN, FAAN Chancellor's Professor Emeritus Indiana University School of Nursing • . Wolters Kluwer I Lippincott Williams & Wilkins Health Philadelphia • Baltimore • New York • London Buenos Aires • Hong Kong· Sydney • Tokyo Publisher Chris Burghardt Acquisitions Editor Bill Lamsback Art Director Brett MacNaughton Editorial Product Manager Annette Ferran Production Manager Beth Martz Design Coordinator Joan Wendt Manufacturing Manager Beth J. Welsh The clinical treatments described and recommended in this publication are based on research and consultation with nursing, medical, and legal authorities. To the best of our knowledge, these procedures reflect currently accepted practice. Nevertheless, they cannot be considered absolute and universal recommendations. For individual applications, all recommendations must be considered in light of the patient's clinical condition and, before administration of new or infrequently used drugs, in light of the latest package-insert information. The authors and publisher disclaim any responsibility for any adverse effects resulting from the suggested procedures, from any undetected errors, or from the reader's misunderstanding of the text. © 2011 by Wolters Kluwer Health I Lippincott Williams & Wilkins. All rights reserved. This book is protected by copyright. No part of it may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means-electronic, mechanical, photocopy, recording, or otherwise-without prior written permission of the publisher, except for brief quotations embodied in critical articles and reviews and testing and evaluation materials provided by publisher to instructors whose schools have adopted its accompanying textbook. For information, write Lippincott Williams & Wilkins, 323 Norristown Road, Suite 200, Ambler, PA . BILLINGSQ&A9E Library of Congress Cataloging-in-Publication Data Billings, Diane McGovern. Lippincott's Q & A review for NCLEX-RN I Diane M. Billings. - 10th ed. p. ;em. Other title: Lippincott's Q and A review for NCLEX-RN Other title: Q & A review for NCLEX-RN Includes bibliographical references and index. ISBN 978-1-60831-125-5 (alk. paper) 1. Nursing-Examinations, questions, etc. 2. National Council Licensure Examination for Registered Nurses-Study guides. I. Title. II. Title: Lippincott's Q and A review for NCLEX-RN. III. Title: Q & A review for NCLEX-RN. [DNLM: 1. Nursing Care-Examination Questions. WY 18.2] RT55.M29 2011 610. 73076-dc22 9 Desiree Hensel, PhD, RNC-NIC, CNE Assistant Professor Contributors Sharon Vinten, MSN, RN, WHNP, CNE Staff Nurse Indiana University School of Nursing Bloomington, Indiana Carolina's Health Care System Charlotte, North Carolina Margie A. Hull, MEd, APRN-BC, CNS, CDE Diabetes CNS, CDE Sandra Wood, MSN, APRN BC Clinical Assistant Professor Emerita Indiana University School of Nursing Indianapolis, Indiana Wishard Health Services Indianapolis, Indiana Lesley Milgram, RN, MSN Clinical Assistant Professor Indiana University School of Nursing Indianapolis, Indiana Lee Schwecke, BSN, MSN, EdD Associate Professor Emeritus Indiana University School of Nursing Staff Nurse, Psychiatric Pavilion Community Hospital North Indianapolis, Indiana Contributors to the Previous Edition Karen Bawel-Brinkley, RN, MS, MSN, PhD Carol Bostrom, RN, MSN, APRN, BC Judith A. Halstead, RN, DNS Margie Hull, MED, MSN, APRN-BC, CDE-RN Colleen M. O'Leary-Kelley, PhD, RN Virginia Richardson, RN, DNS, CPNP Pat Twedt, RN, MS Gayle Raux, PhD, RN, NP-C Lee W. Schwecke, RN, MSN, EdD Evelyn Stephenson, MSN, RNC Sharon Vinton, MSN, RNC, WNP, CNE Mary Ann Wehmer, RN, MSN, CNOR Sandra Wood, MSN, APRN, BC v Reviewers OB AND PEDS REVIEWERS Samantha H. Bishop, MN, RN, CPNP Assistant Professor of Nursing Division of Nursing and Health Sciences Gordon College Barnesville, Georgia Sally Boyster, MSN, CNE Coordinator/Professor Women's & Children's Nursing Rose State College Midwest City, Oklahoma Stephanie C. Butkus, MSN, RN, CPNP Assistant Professor Kettering College of Medical Arts Kettering, Ohio Darlene Nebel Cantu, RNC-NIC, C-EFM,BSN, MSN Assistant Professor San Antonio College San Antonio, Texas Online faculty in Masters Nursing Program University Of Phoenix Online faculty in RN to BSN Nursing Program Chamberlain College of Nursing Cynthia Chatham, BSN, MSN, DSN Associate Professor University of Southern Mississippi Gulf Coast Campus Long Beach, Mississippi Kim Cooper, MSN Nursing Department Program Chair Ivy Tech Community College Terre Haute, Indiana Elizabeth Di Fabio, MSN, BSN Nursing Instructor Anoka-Ramsey Community College Coon Rapids, Minnesota L. Sue Gabriel, EdD, MFS, MSN, RN, SANE-A, CFN Associate Professor Bryan LGH College of Health Sciences, School of Nursing Lincoln, Nebraska vi Rochelle Kuhn, RN, MS, CRNP Pediatric Nursing Instructor Frankford Hospital School of Nursing Philadelphia, Pennsy 1 vania Lucy Megginson, MSN, RN, PhD student Assistant Professor of Nursing Georgia Highlands College Rome, Georgia Linda Strong, MSN, RN, CPNP, CNE Assistant Professor, Pediatric Nursing Cuyahoga Community College Cleveland, Ohio PSYCH REVIEWERS Lois Angelo, MSN, APRN Assistant Professor of Nursing Massachusetts College of Pharmacy and Health Sciences Boston, Massachusetts Harlene Caroline, BSN, MS, PhD(c) Professor Curry College Milton, Massachusetts Edith Claros, RN, APRN-BC, PhD(c) Assistant Professor of Nursing Massachusetts College of Pharmacy School of Nursing Worcester, Massachusetts Brandy Mechling, RN, MSN, CNS, PhD student Lecturer University of North Carolina at Wilmington Wilmington, North Carolina Mitzi Grace Mitchell, BScN, BA, MHSc, MN, DNS, PhD(c), RN, GNC(c) Lecturer Y ark University Toronto, Ontario, Canada Veronica Garcia Walker, MSN, BSN, RN UT Clinical Faculty The University of Texas at Austin Austin, Texas MED-SURG REVIEWERS Marlys Bohn, BSN, MS, PhD Department Head, Nursing Student Services South Dakota State University Brookings, South Dakota Deborah A. Green, MSN, RN, BC Clinical Education Coordinator Clarian North Medical Center Carmel, Indiana Susan A. Lisko, DNP, RN, MSN, BSN Assistant Professor of Nursing Youngstown State University Youngtown, Ohio Gina Maiocco, PhD, RN, CCNS Assistant Professor/Coordinator Fast Track Program West Virginia University Morgantown, West Virginia Lisa Peden, BSN, MSN Associate Professor of Nursing Dalton State College Dalton, Georgia Reviewers Vii Wendy J. Waldspurger Robb, PhD, RN, CNE Director of the Graduate Nursing Program Assistant Professor Cedar Crest College Allentown, Pennsylvania Tami J. Rogers, DVM, MSN, BSN Professor of Nursing Valencia Community College Orlando, Florida JoAnn Evanko Thistlethwaite, RN, MNEd, ABD Assistant Professor Medical Surgical Nursing Indiana University of Pennsylvania Indiana, Pennsylvania Susan K. Tucker, RN, BSN, MSN, DNP Division Director of Nursing Gadsen State Community College Gadsen, AL Donna Williams, DNP, RN Nurse Faculty Itawamba Community College Fulton, MS Judith Young, CCRN, BSN, MSN Clinical Assistant Professor Indiana University School of Nursing Indianapolis, Indiana Preface Introduction to the O&A Review for NCLEX-RN® This exam review book, the accompanying CD-ROM, and the online study resources have been developed to help you prepare for the National Council Licensing Examination for Registered Nurses (NCLEX-RN®). You will also find this book helpful for review when preparing for course exams, final exams, NCLEX-RN assessment exams, or other standardized or competency exams. Study resources This review book includes multiple resources that you can use in any combination to meet your own study and test preparation plans: • More than 5,800 test questions using 8 different formats of question types including the new audio, video, and graphic option questions. • A CD-ROM with more than 1,300 questions with rationales for correct and incorrect answers that provides you with ample opportunity to experience test-taking using computeradministered questions and allows you to customize tests for specific review and practice • Questions written for all clinical areas of nursing (childbearing family and their neonate; nursing care of infants, children, and adolescents; nursing care of adults with medical and surgical health problems; and nursing care of clients with psychiatric disorders and mental health problems) • Questions organized by health problems to facilitate review for course-specific exams • Questions coded by client needs to assure practice in all areas of the NCLEX-RN test plan • Questions coded by cognitive level to guide study and test-taking at higher levels of the cognitive domain • Questions emphasizing integrative processes on the NCLEX-RN test plan • Questions with teaching feedback and rationales for both correct and incorrect answers viii • Questions using all types of question formats used on the licensing exam (multiple choice, multiple response, hot-spot, fill-in-the blank, drag-and-drop/ordered response, chart/exhibit, as well as graphic, audio, and video inclusion questions) • Questions primarily written at higher levels of the cognitive domain (analysis, synthesis, evaluation, and creation) • Questions emphasizing clinical decision making, clinical judgment, and management of care • Questions to provide practice for calculating drug dosages, intravenous drip rates, intake and output, and other questions requiring calculation and reporting of a numerical response to the question • Questions emphasizing current nursing practice in the areas of client safety, managing care quality, home care, health promotion, care of the older adult, cancer nursing, end-of-life care, perioperative care, community health nursing, and emergency and disaster nursing • Questions about managing care quality and safety at the end of each chapter • An entire chapter that explains the various test question formats and strategies for answering each type of test item and at each level of the cognitive domain • Six comprehensive tests of 180 questions each designed to resemble the testing format of the NCLEX-RN • A description of the current NCLEX-RN test plan • A study plan and checklist to guide systematic preparation for the licensing examination • Information about developing study skills, taking tests, and managing test anxiety • Tips for studying from students who have successfully passed the NCLEX-RN exam • Addresses, telephone numbers, and websites for the National Council of State Boards of Nursing, Inc., and each state board of nursing • Online resources for students, including tips for test-taking and downloadable NCLEX questions for your handheld media device Organization of the book The review book is organized in three sections. Each section is designed to build on the previous section. The first section of the book provides information about the licensing exam and how to prepare for and take high-stakes examinations. A full chapter is devoted to explaining the various types of test question formats and cognitive levels of questions used on the licensing exam; the chapter also provides examples of all types and levels of questions and strategies for answering them. In the second section of the book, there are four major units-nursing care of the childbearing family and their neonate; nursing care of infants, children, and adolescents; nursing care of adults with medical and surgical health problems; and nursing care of clients with psychiatric disorders and mental health problems. Within each unit, chapter tests are grouped according to health problems and include questions that are matched to the NCLEX-RN test plan. At the end of each chapter there is a section of questions about managing client safety and quality care. These questions are essential to test your understanding of important concepts about patient safety and quality. Because the test questions in this section are organized around health problems, this section is ideal for use when preparing for teachermade or commercially-prepared tests that focus on specific content in your curriculum. The third section of the book contains six comprehensive exams written to simulate the NCLEX-RN by placing test items in random order of content area. Each test presents a variety of situations commonly encountered in nursing practice, and includes test questions from all components of the NCLEX-RN test plan and all types of questions used on the licensing exam (except video and audio questions, which are found only on the CD). The CD-ROM Additionally, this review package includes a CDROM with more than 1,300 questions. The CD-ROM will allow you to practice with audio and video questions, so be sure to use this feature of this Q&A Review Book. The CD-ROM can be used in several ways. For example, you may take a test in the four content areas, arrange a test to present questions in random order, or select questions for particular review and practice. The program also enables you to print out test results to gauge your progress. The CD-ROM simulates the actual NCLEX-RN exam by formatting questions on a computer screen and requiring you to use the keyboard and mouse to enter answers to the questions. It also features a pop-up calculator for use Preface ix in answering questions that require you to calculate drug doses and drip rates for intravenous infusions. Using This Review Package for Preparing for Nursing Exams We suggest that you begin your review by using the practice exams in the book to identify areas of strength and areas in which you need further study. Each exam contains specific questions written in the style of the NCLEX-RN. Answers include rationales for both correct and incorrect answer options to reinforce learning. You may wish to score the results of each practice test and identify areas in which you need further review. To evaluate your results after completing each exam, divide the number of your correct responses by the total number of questions in the test and multiply by 100. For example, if you answered 72 of 90 items correctly, you would divide 72 by 90 and multiply by 100, for a result of 80%. If you answered more than 75% of the items in an area correctly, you are most likely prepared to answer questions in that area on the NCLEX-RN. If you answered fewer than 75% of the questions correctly, you need to determine why. Did you answer incorrectly because of lack of content knowledge or because you did not read carefully? Use this information to guide your study. After reviewing the specific content areas in the practice exams, take the comprehensive exams. These exams more realistically reflect the NCLEX-RN because each test presents a variety of situations commonly encountered in nursing practice and across all clinical disciplines. Underlying knowledge, skills, and abilities related to the basic sciences, fundamentals of nursing, pharmacology and other therapeutic measures, communicable diseases, legal and ethical considerations, and nutrition are included in items as needed to plan nursing care for individual clients or groups of clients. The comprehensive exams also include test items related to client safety and care quality. Next, use the CD-ROM to simulate taking computerized adaptive tests. Note how the questions are presented on the computer screen, and practice answering questions without using a pencil. Use the diagnostic features of the CD-ROM to identify areas for further study and develop your own customized test for focused review. And don't forget to check the online resources available at http:! study tips will provide you with a foundation to begin your exam preparation. The downloadable NCLEX questions can be put on your iPhone, allowing you to practice anytime and anywhere. Acknowledgments This book has been developed with the expertise of a team of nationally recognized test item writers. Thanks to Desiree Hensel, Margie Hull, Leslie Milgram, Lee Schwecke, Sharon Vinten, and Sandy Wood for developing questions to prepare students for test-taking success. Thanks also to the editorial staff at Lippincott Williams & Wilkins: Elizabeth Nieginski for launching this book and Bill Lamsback for guiding it to completion. Particular thanks goes X to developmental editor Annette Ferran for her keen eye for design and detail, her ability to locate resources for the new video, audio, and graphic questions, and her support throughout the development of this book. Diane M. Billings, EdD, RN, FAAN Chancellor's Professor Emeritus Indiana University School of Nursing About the Author Diane Billings, EdD, RN, FAAN, award-winning author and nursing educator, offers more than 35 years' experience teaching nursing from the associate through the graduate levels, with a special focus on the NCLEX-RN examination. Dr. Billings' NCLEX experience includes developing and teaching NCLEX review courses, integrating computer-based licensing exam review programs into nursing curricula, and designing NCLEX test questions. A nationally recognized test-item writer, her NCLEX preparation books have helped thousands of students pass the NCLEX-RN exam. T he Chancellor's Professor of Nursing at Indiana University since 2002, Dr. Billings is the recipient of the National League for Nursing's Award for Outstanding Leadership in Nursing Education, the President's Award for Distinguished Teaching at Indiana University, and the F ounders Award for Excellence in Teaching from Sigma T heta Tau, International. In addition to her best-selling NCLEX books, her book Teaching In Nursing: A Guide for Faculty won the 1998 AJN Book of the Year Award. She is a fellow in the American A cademy of Nursing. xi Contents Part 1 • Introduction to the NCLEX-RN® Licensing Examination and Preparation for Test-Taking 1 CHAPTER 1 The NCLEX-RN® Licensing Examination . . . . . . . . . 2 CHAPTER2 NCLEX-RN® Test Questions and Strategies for Answering Them . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 CHAPTER3 How to Prepare for and Take the NCLEX-RN® and Other Nursing Exams . . . . . . . . . . . . . . . . . . . . . . . 22 Part 2 • Practice Tests 29 CHAPTER 1 The Nursing Care of the Childbearing Family . . . . 30 Test 1: Ant epart al Care 30 Test 2: Complications of Pregnancy 61 Test 3:The Birth Experience 87 Test 4: Post partal Care 119 Test 5:The Neonatal Client 150 CHAPTER2 The Nursing Care of Children . . . . . . . . . . . . . . . . 180 Test 1: Health Promotion 180 Test 2:The Child with Respiratory Health Problems 196 Test 3:The Child with Cardiovascular and Hematologic Health Problems 213 Test 4:The Child with Health Problems of the Upper Gastrointest inal Tract 227 Test 5:The Child with Health Problems Involving Ingestion, Nutrit ion, or Diet 251 Test 6:The Child with Health Problems of the Urinary System 262 Test 7:The Child with Neurologic Health Problems 277 Test 8:The Child with Musculoskeletal Health Problems 296 Test 9:The Child with Dermatologic and Endocrine Health Problems 312 xii CHAPTER3 The Nursing Care of Adults with Medical and Surgical Health Problems . . . . . . . . . . . . . . . . . . . 321 Test 1: The Client with Cardiac Health Problems 321 Test 2:The Client with Vascular Disease 345 Test 3:The Client with Hemat ologic Health Problems 369 Test 4:The Client with Respirat ory Health Problems 396 Test 5:The Client with Upper Gastrointest inal Tract Health Problems 428 Test 6:The Client with Lower Gast roint estinal Tract Health Problems 443 Test 7:The Client with BiliaryTract Disorders 461 Test 8:The Client with Endocrine Health Problems 477 Test 9:The Client with UrinaryTract Health Problems 501 Test 10:The Client with Reproduct ive Health Problems 522 Test 11 :The Client with Neurologic Health Problems 549 Test 12:The Client with Musculoskeletal Health Problems 573 Test 13:The Client with Cancer 603 Test 14:The Client Having Surgery 640 Test 15: The Client with Health Problems of the Eyes, Ears, Nose, andThroat 667 Test 16:The Client with Health Problems of the Int egument ary System 680 Test 17: Responding t o Emergencies, Mass Casualt ies, and Disast ers 691 CHAPTER4 The Nursing Care of Clients with Psychiatric Disorders and Mental Health Problems . . . . . . . . 698 Test 1: Mood Disorders 698 Test 2: Schizophrenia, Other Psychoses, and Cognitive Disorders 731 Test 3: Personalit y Disorders, Subst ance-Related Disorders, Anxiety Disorders, and Anxiet y-Relat ed Disorders 761 Test 4: St ress, Crisis, Anger, and Violence 798 Test 5: Mental Health Problems of Children, Adolescent s, and Families 820 Part 3 • Postreview Tests 837 Comprehensive Test 1 838 Comprehensive Test 2 876 Comprehensive Test 3 912 Comprehensive Test 4 947 Comprehensive Test 5 984 Comprehensive Test 6 1021 Appendices 1063 Contents xiii This page intentionally left blank. Introduction to the NCLEX-RN® Licensing Examination and Preparation for Test-Taking 1 The NCLEX-RN® Licensing Examination Overview The National Council Licensure Examination for Registered Nurses (NCLEX-RNs®) is administered to graduates of nursing schools to test the knowledge, abilities, and skills necessary for entry-level safe and effective nursing practice. The examination is developed by the National Council of State Boards of Nursing, Inc. (NCSBN), an organization with representation from all state boards of nursing.1 The same examination is used in all 50 states, the District of Columbia, and United States possessions. The exam is also administered at international test centers worldwide.1 Students who have graduated from baccalaureate, diploma, and associate-degree programs in nursing must pass this examination to meet licensing requirements in the United States. The Test Plan The NCSBN prepares the test plan used to develop the licensing examination. The test plan is based on an analysis of current nursing practice and the skills, abilities, and processes nurses use to provide nursing care. Practice Analysis: T he Foundation of the Test Plan The NCLEX-RN test plan is based on the results of a practice analysis conducted every 3 years of the entry-level performance of newly licensed registered nurses and on expert judgment provided by members of the National Council's Examination Committee as well as a Job Analysis Panel of Experts.1• 2• 5 The job analysis asks newly graduated nurses to rank the nursing activities that they perform on a regular basis. The questions used on the test plan, therefore, include those activities that nurses commonly perform. For example, the 2008 RN practice analysis revealed that nursing practice commonly involved activities such as preparing and administering medications, using rights of medication administration; ensuring proper identification of client when providing care; applying 2 principles of infection control (e.g., hand hygiene, room assignment, isolation, aseptic/sterile technique, universal/standard precautions); performing emergency care procedures (e.g., cardiopulmonary resuscitation, abdominal thrust maneuver, respiratory support, automated, external defibrillator); recognizing signs and symptoms of complications and intervening appropriately when providing client care; reviewing pertinent data prior to medication administration (e.g., vital signs, lab results, allergies, potential interactions). Less commonly performed activities included providing care and/or support for a client with nonsubstance related dependencies; assisting client and staff to access resources regarding genetic issues; incorporating alternative/complementary therapies into client plan of care (e.g., music therapy, relaxation therapy), and performing post-mortem care. The National Council of State Boards of Nursing also used the findings from the Practice Analysis activity statements to generate knowledge statements, the knowledge needed by newly licensed nurses to provide safe care. 5 The findings of this second report are used to inform item development for the NCLEX-RN examination. Test Item Writers Nurse clinicians and nurse educators nominated by the Council of State Boards of Nursing to serve as item writers write the test questions on the NCLEX-RN exam. Because the item writers come from a variety of geographical areas and practice settings, the test items reflect nursing practice in all parts of the country. Test Plan Details Test plans, or test blueprints, are developed to indicate the components and the relative weights of the components that will be tested on an exam. Because exams test both content (knowledge) and process (critical thinking, synthesis of information, clinical decision-making), test plans usually have two or three dimensions. The test plan for the NCLEX-RN addresses two components of nursing TABLE 1.1 Test Plan Structure The framework of Client Needs was selected for the NCLEX-RN® examination because it provides a universal structure for defining nursing actions and competencies across all settings for all clients. Client Needs Four major categories of Client Needs organize the content of the NCLEX-RNTest Plan. Two of the four categories are further divided into a total of six subcategories that define the content contained within the two Client Needs categories. These categories and subcategories are: A. Safe, Effective Care Environment 1. Management of Care 2. Safety and Infection Control B. Health Promotion and Maintenance C. Psychosocial Integrity D. Physiological Integrity 1. Basic Care and Comfort 2. Pharmacological and Parenteral Therapies 3. Reduction of Risk Potential 4. Physiological Adaptation Integrated Concepts and Processes The following concepts and processes fundamental to the practice of nursing are integrated throughout the four major categories of Client Needs: • Nursing Process • Caring • Communication and Documentation • Teaching/Learning Copyright by the National Council of State Boards of Nursing, Inc. All rights reserved. care: (1) client needs categories and (2) integrated processes, such as the nursing process, caring, communication and documentation, and teaching/ learning. (See Table 1.1.) Representative items test knowledge of these components as they relate to specific health care situations in all of the four major areas of client needs. The questions developed for the test plan are written to test nursing knowledge and the ability to apply nursing knowledge to client situations. Client Needs The health needs of clients are grouped under four broad categories: (1) safe, effective care environment; (2) health promotion and maintenance; (3) psychosocial integrity; and (4) physiologic integrity. Two of these categories include subcategories of related and specified needs. (See Table 1.2.) The percentage of test items in each subcategory on the NCLEX-RN examination is shown in Figure 1.1. The NCLEX-RN® Licensing Examination 3 Understanding the category of client needs is key ( ) to recognizing the types of questions that are found on the licensing exam and the relative emphasis given to the category based on the percentage of questions from that category on the exam. Integrated Processes The NCLEX-RN test plan also is organized according to four integrated processes. These include the nursing process, caring, communication and documentation, and teaching/learning. (See Table 1.1 and Figure 1.1.) The Nursing Process The NCLEX-RN test plan includes questions from all steps of the nursing process. The five phases of the nursing process are: (1) assessment, (2) analysis, (3) planning, (4) implementation, and (5) evaluation. Assessment. Assessment involves establishing a database. The nurse gathers objective and subjective information about the client, and then verifies the data and communicates information gained from the assessment. Analysis. Analysis involves identifying actual or potential health care needs or problems based on assessment data. The nurse interprets the data, collects additional data as indicated, and identifies and communicates the client's nursing diagnoses. The nurse also determines the congruency between the client's needs and the ability of the health care team members to meet those needs. Planning. Planning involves setting outcomes and goals for meeting the client's needs and designing strategies to attain them. The nurse determines the goals of care, develops and modifies the plan, collaborates with other health team members for delivery of the client's care, and formulates expected outcomes of nursing interventions. Implementation. Implementation involves initiating and completing actions necessary to accomplish the defined goals. The nurse organizes and manages the client's care; performs or assists the client in performing activities of daily living; counsels and teaches the client, significant others, and health care team members; and provides care to attain the established client goals. The nurse also provides care to optimize the achievement of the client's health care goals; supervises, coordinates, and evaluates delivery of the client's care as provided by nursing staff; and records and exchanges information. Evaluation. Evaluation determines goal achievement. The nurse compares actual with expected outcomes of therapy, evaluates compliance with prescribed or proscribed therapy, and records and describes the client's response to therapy or care. The nurse also modifies the plan, as indicated, and reorders priorities. 4 Introduction to the NCLEX-RN® Licensing Examination and Preparation for Test-Taking TABLE 1.2 Categories and Subcategories of Client Needs A. Safe, Effective Care Environment 1. Management of Care- Providing and directing nursing care that enhances the care delivery setting to protect clients, family/significant others and health care personnel. Related content includes but is not limited to: • Advance Directives • Advocacy • Case Management • Client Rights • Collaboration with Multidisciplinary Team • Concepts of Management • Confidentiality/Information Security • Consultation • Continuity of Care • Delegation • Establishing Priorities • Ethical Practice • Informed Consent • Information Technology • Legal Rights and Responsibilities • Performance Improvement (Quality Improvement) • Referrals • Supervision 2. Safety and Infection Control- Protecting clients, family/significant others and health care personnel from health and environmental hazards. Related content includes but is not limited to: • Accident/Injury Prevention • Emergency Response Plan • Ergonomic Principles • Error Prevention • Handling Hazardous and Infectious Materials • Home Safety • Reporting of Incident/Event/Irregular OccurrenceNariance • Safe Use of Equipment • Security Plan • Standard Precautionsrrransmission-Based Precautions/Surgical Asepsis • Use of Restraints/Safety Devices B. Health Promotion and Maintenance The nurse provides and directs nursing care of the client and family/significant others that incorporates the knowledge of expected growth and development principles, prevention and/or early detection of health problems, and strategies to achieve optimal health. Related content includes but is not limited to: • Aging Process • Ante/Intra/Postpartum and Newborn Care • Developmental Stages and Transitions • Health and Well ness • Health Promotion/Disease Prevention • Health Screening • High Risk Behaviors • Lifestyle Choices • Principles of Teaching/Learning • Self-Care • Techniques of Physical Assessment C. Psychosocial Integrity The nurse provides and directs nursing care that promotes and supports the emotional, mental, and social well-being of the client and family/significant others experiencing stressful events, as well as clients with acute and chronic mental illness. Related content includes but is not limited to: • Abuse/Neglect • Behavioral Interventions • Chemical and Other Dependencies • Coping Mechanisms • Crisis Intervention • Cultural Diversity • End of Life Care • Family Dynamics • Grief and Loss • Mental Health Concepts • Religious and Spiritual Influences on Health • Sensory/Perceptual Alterations • Stress Management • Support Systems • Therapeutic Communication • Therapeutic Environment D. Physiological Integrity The NCLEX-RN® Licensing Examination 5 The nurse promotes physical health and wellness by providing care and comfort, reducing client risk potential, and managing health alterations. 1. Basic Care and Comfort-Providing comfort and assistance in the performance of activities of daily living. Related content includes but is not limited to: • Assistive Devices • Elimination • Mobility/Immobility • Non-Pharmacological Comfort Interventions • Nutrition and Oral Hydration • Personal Hygiene • Rest and Sleep 2. Pharmacological and Parenteral Therapies-Providing care related to the administration of medications and parenteral therapies. Related content includes but is not limited to: • Adverse Effects/Contrai ndications/Side Effects/1 nteractions • Blood and Blood Products • Central Venous Access Devices • Dosage Calculation • Expected Actions/Outcomes • Medication Administration • Parenteral/Intravenous Therapies • Pharmacologic Agents/Actions • Pharmacological Pain Management • Total Parenteral Nutrition 3. Reduction of Risk Potential-Reducing the likelihood that clients will develop complications or health problems related to existing conditions, treatments, or procedures. Related content includes but is not limited to: • Changes/Abnormalities in Vital Signs • Diagnostic Tests • Laboratory Values • Potential for Alterations in Body Systems • Potential for Complications of Diagnostic Tests/Treatments/Procedures • Potential for Complications from Surgical Procedures and Health Alterations • System Specific Assessments • Therapeutic Procedures 4. Physiological Adaptation- Managing and providing care for clients with acute, chronic, or life-threatening physical health conditions. Related content includes but is not limited to: • Alterations in Body Systems • Fluid and Electrolyte Imbalances • Hemodynamics • Illness Management • Medical Emergencies • Pathophysiology • Unexpected Response to Therapies Copyright by