Test Bank
For Ackley and Ladwig’s Nursing Diagnosis Handbook: An Evidence-Based Guide to Planning
Care 13th Edition (2025/2026). Mary Beth Flynn Makic - All Chapters 1-30 PLUS Nursing
Outcomes Classification (NOC), 6th edition Outcome Labels and Definitions
,Section I: Nursing Diagnosis, the Nursing Process, and Evidence- Based Nursing
p7 p7 p7 p7 p7 p7 p7 p7 p7 p7
1. What is the primary goal of a nursing diagnosis?
p7 p7 p7 p7 p7 p7 p7 p7
a. To identify a medical diagnosis
p7 p7 p7 p7 p7
b. To determine the effectiveness of medications
p7 p7 p7 p7 p7 p7
c. To identify patient problems that can be managed by nursing
p7 p7 p7 p7 p7 p7 p7 p7 p7 p7
interventions
p7
d. To prioritize physician orders
p7 p7 p7 p7
ANS: C p7
Rationale: The primary goal of a nursing diagnosis is to identify patient problems
p7 p7 p7 p7 p7 p7 p7 p7 p7 p7 p7 p7
that can be managed by nursing interventions, focusing on patient care rather
p7 p7 p7 p7 p7 p7 p7 p7 p7 p7 p7 p7
than medical diagnoses.
p7 p7 p7
NCLEX Preference: Understanding the distinction between nursing and medical
p7 p7 p7 p7 p7 p7 p7 p7
diagnoses is crucial for patient-centered care.
p7 p7 p7 p7 p7 p7
2. Which component of the nursing diagnosis indicates the problem?
p7 p7 p7 p7 p7 p7 p7 p7
a. Defining characteristics
p7 p7
b. Related factors
p7 p7
c. The actual diagnosis
p7 p7 p7
d. The patient’s history
p7 p7 p7
ANS: C p7
Rationale: The actual diagnosis represents the problem identified in the nursing
p7 p7 p7 p7 p7 p7 p7 p7 p7 p7
assessment. It is essential for formulating a care plan.
p7 p7 p7 p7 p7 p7 p7 p7 p7
NCLEX Preference: Clear identification of nursing diagnoses is necessary for
p7 p7 p7 p7 p7 p7 p7 p7 p7
effective care planning.
p7 p7 p7
3. What does the "related to" (R/T) statement in a nursing diagnosis signify?
p7 p7 p7 p7 p7 p7 p7 p7 p7 p7 p7
a. It identifies the patient's response to the problem
p7 p7 p7 p7 p7 p7 p7 p7
b. It indicates the underlying cause of the problem
p7 p7 p7 p7 p7 p7 p7 p7
c. It lists the symptoms observed
p7 p7 p7 p7 p7
d. It describes the treatment plan
p7 p7 p7 p7 p7
ANS: B p7
Rationale: The "related to" (R/T) statement indicates the underlying cause or
p7 p7 p7 p7 p7 p7 p7 p7 p7 p7
contributing factors of the patient’s problem, guiding intervention strategies.
p7 p7 p7 p7 p7 p7 p7 p7 p7
,NCLEX Preference: Understanding etiology is vital for targeted nursing
p7 p7 p7 p7 p7 p7 p7 p7
interventions.
p7
4. Which nursing diagnosis format is used to articulate the problem clearly?
p7 p7 p7 p7 p7 p7 p7 p7 p7 p7
a. Problem-focused diagnosis
p7 p7
b. Risk diagnosis
p7 p7
c. Health promotion diagnosis
p7 p7 p7
d. All of the above
p7 p7 p7 p7
ANS: D p7
Rationale: All formats—problem-focused, risk, and health promotion—articulate
p7 p7 p7 p7 p7 p7
different aspects of patient care and are important in various clinical situations.
p7 p7 p7 p7 p7 p7 p7 p7 p7 p7 p7 p7
NCLEX Preference: Familiarity with different nursing diagnosis formats
p7 p7 p7 p7 p7 p7 p7
enhances clinical reasoning.
p7 p7 p7
5. In which phase of the nursing process is the nursing diagnosis formulated?
p7 p7 p7 p7 p7 p7 p7 p7 p7 p7 p7
a. Assessment
p7
b. Diagnosis
p7
c. Planning
p7
d. Implementation
p7
ANS: B p7
Rationale: The nursing diagnosis is formulated during the diagnosis phase, after
p7 p7 p7 p7 p7 p7 p7 p7 p7 p7
collecting and analyzing assessment data.
p7 p7 p7 p7 p7
NCLEX Preference: Understanding the nursing process phases is crucial for
p7 p7 p7 p7 p7 p7 p7 p7 p7
effective care delivery.
p7 p7 p7
6. What is a defining characteristic in a nursing diagnosis?
p7 p7 p7 p7 p7 p7 p7 p7
a. The cause of the problem
p7 p7 p7 p7 p7
b. The observable signs and symptoms
p7 p7 p7 p7 p7
c. The expected outcomes
p7 p7 p7
d. The patient's medical history
p7 p7 p7 p7
ANS: B p7
Rationale: Defining characteristics are the observable signs and symptoms that
p7 p7 p7 p7 p7 p7 p7 p7 p7
validate the nursing diagnosis and provide evidence of the problem.
p7 p7 p7 p7 p7 p7 p7 p7 p7 p7
NCLEX Preference: Identifying defining characteristics is essential for accurate
p7 p7 p7 p7 p7 p7 p7 p7
diagnosis and planning.
p7 p7 p7
, 7. How can a nurse validate a nursing diagnosis?
p7 p7 p7 p7 p7 p7 p7
a. By relying solely on personal experience
p7 p7 p7 p7 p7 p7
b. By collecting data from various sources, including the patient
p7 p7 p7 p7 p7 p7 p7 p7 p7
c. By discussing it only with physicians
p7 p7 p7 p7 p7 p7
d. By documenting the diagnosis without evidence
p7 p7 p7 p7 p7 p7
ANS: B p7
Rationale: Validating a nursing diagnosis involves collecting data from multiple
p7 p7 p7 p7 p7 p7 p7 p7 p7
sources, including the patient, to ensure accuracy and relevance.
p7 p7 p7 p7 p7 p7 p7 p7 p7
NCLEX Preference: Validation of nursing diagnoses is critical for patient safety
p7 p7 p7 p7 p7 p7 p7 p7 p7 p7
and effective care.
p7 p7 p7
8. What role does evidence-based practice play in nursing diagnoses?
p7 p7 p7 p7 p7 p7 p7 p7
a. It complicates the diagnosis process
p7 p7 p7 p7 p7
b. It provides a scientific basis for nursing decisions
p7 p7 p7 p7 p7 p7 p7 p7
c. It is optional for nursing practice
p7 p7 p7 p7 p7 p7
d. It focuses solely on traditional methods
p7 p7 p7 p7 p7 p7
ANS: B p7
Rationale: Evidence-based practice provides a scientific basis for nursing
p7 p7 p7 p7 p7 p7 p7 p7
decisions, improving patient outcomes and ensuring care is effective and relevant.
p7 p7 p7 p7 p7 p7 p7 p7 p7 p7 p7
NCLEX Preference: Knowledge of evidence-based practice is essential for
p7 p7 p7 p7 p7 p7 p7 p7 p7
modern nursing.
p7 p7
9. What is the purpose of the planning phase in the nursing process?
p7 p7 p7 p7 p7 p7 p7 p7 p7 p7 p7
a. To assess the patient’s condition
p7 p7 p7 p7 p7
b. To develop a care plan with measurable goals
p7 p7 p7 p7 p7 p7 p7 p7
c. To implement interventions immediately
p7 p7 p7 p7
**d. To evaluate patient outcomes
p7 p7 p7 p7
ANS: B p7
Rationale: The planning phase involves developing a care plan with measurable
p7 p7 p7 p7 p7 p7 p7 p7 p7 p7
goals and outcomes tailored to the patient’s needs.
p7 p7 p7 p7 p7 p7 p7 p7
NCLEX Preference: Effective planning is key to successful patient outcomes.
p7 p7 p7 p7 p7 p7 p7 p7 p7
10. How should nursing diagnoses be prioritized?
p7 p7 p7 p7 p7
a. Based on the nurse’s preference
p7 p7 p7 p7 p7