Medical-Surgical Nursing in Canada 5th Edition Lewi Test Bank
NURSINGTB.COM
, Medical-Surgical Nursing in Canada 5th Edition Lewi Test Bank
Chapter 01: Introduction to Medical-
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Surgical Nursing Practice in Canada Lewis: Medical-
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Surgical Nursing in Canada, 5th Canadian Edition
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MULTIPLE CHOICE mf
1. When caring f or clients using evidence-
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informed practice, which of t he following d oes t he nurse use?
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a. Clinical judgement based on experience mf mf mf mf
b. Evidence from a clinical research study mf mf mf mf mf
c. The best available evidence to guide clinical expertise
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d. Evaluation of data showing that the client outcomes are met mf mf mf mf mf mf mf mf mf
ANS: C m f
Evidence-
informed nursing practice is a continuous interactive process involving the explicit, conscient
mf mf mf mf mf mf mf mf mf mf mf
ious, and judicious consideration of t he best available evidence t o provide care. Four primary e
mf mf mf mf mf mf mf mf mf mf mf mf mf mf
lements are: (a) clinical state, setting, and circumstances; (b) client preferences and actions; (
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c) best research evidence; and (d) health care resources. Clinical judgement based on the nurse
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‘s clinical experience is part of EIP, but clinical decision making also should incorporate curr
mf mf mf mf mf mf mf mf mf mf mf mf mf mf
ent research and research-
mf mf mf
based guidelines. Evidence from one clinical research study does not provide an adequate su
mf mf mf mf mf mf mf mf mf mf mf mf mf
bstantiation for interventions. Evaluation of client outcomes is important, but interventions s
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hould be based on research from randomized control studies with a large number of subjects.
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DIF: Cognitive Level: Comprehension mf mf TOP: Nursing Process: Planning m f mf mf
2. Which of the following best expl a ins the nu r s e s ‘ primary use of the nursing process when
N R I G B.C M
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f mf m
f m
f m
f m
f mf mf m f mf mf mf mf mf mf mf
providing care to clients? USNT O mf mf mf
mf mf mf
a. To explain nursing interventions to other health care professionals
mf mf mf mf mf mf mf mf
b. As a problem-solving tool to identify and treat clients‘ health care needs
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c. As a scientific-based process of diagnosing the client‘s health care problems
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d. To establish nursing theory that incorporates the biopsychosocial nature of humans
mf mf mf mf mf mf mf mf mf mf
ANS: B m f
The nursing process is an assertive problem-
mf mf mf mf mf mf
solving approach to the identification and treatment of clients‘ problems. Diagnosis is only o
mf mf mf mf mf mf mf mf mf mf mf mf mf
ne phase of the nursing process. The primary use of the nursing process is in client care, not t
mf mf mf mf mf mf mf mf mf mf mf mf mf mf mf mf mf mf
o establish nursing t heory or explain nursing interventions to other health care professionals.
mf mf mf mf mf mf mf mf mf mf mf mf
DIF: Cognitive Level: Comprehension mf mf TOP: Nursing Process: Implementation
m f mf mf
3. The nurse is caring for a critically i ll client in the intensive care unit and plans an every 2 -
mf mf mf mf mf mf mf mf mf mf mf mf mf mf mf mf mf mf
hour turning schedule to prevent skin breakdown. Which type of nursing function is demonst
mf mf mf mf mf mf mf mf mf mf mf mf mf
rated with this turning schedule?
mf mf mf mf
a. Dependent
b. Cooperative
c. Independent
d. Collaborative
ANS: D m f
NURSINGTB.COM
, Medical-Surgical Nursing in Canada 5th Edition Lewi Test Bank
When implementing collaborative nursing actions, the nurse is responsible primarily for moni
mf mf mf mf mf mf mf mf mf mf mf
toring for complications of acute illness or providing care to prevent or treat complications. I
mf mf mf mf mf mf mf mf mf mf mf mf mf mf
ndependent nursing actions are focused on health promotion, illness prevention, and client ad
mf mf mf mf mf mf mf mf mf mf mf mf
vocacy. A dependent action would require a physician order to implement. Cooperative nursi
mf mf mf mf mf mf mf mf mf mf mf mf
ng f unctions are not described as one of t he formal nursing functions.
mf mf mf mf mf mf mf mf mf mf mf
DIF: Cognitive Level: Application mf mf TOP: Nursing Process: Implementation
m f mf mf
4. The nurse is caring for a client who has been admitted to the hospital for surgery and tells the
mf mf mf mf mf mf mf mf mf mf mf mf mf mf mf mf mf mf
nurse, ―I do not feel right about leaving my children with my neighbour.‖ Which action s
mf mf mf mf mf mf mf mf mf mf mf mf mf mf mf mf
hould the nurse take next? mf mf mf mf
a. Reassure t he client that these feelings are common for parents. mf mf mf mf mf mf mf mf mf
b. Have the client call the children to ensure that they are doing well.
mf mf mf mf mf mf mf mf mf mf mf mf
c. Call t he neighbour to determine whether adequate childcare is being provided.
mf mf mf mf mf mf mf mf mf mf
d. Gather more data about the client‘s feelings about the childcare arrangements.
mf mf mf mf mf mf mf mf mf mf
ANS: D m f
Since a complete assessment is necessary in order to identify a problem and choose an appro
mf mf mf mf mf mf mf mf mf mf mf mf mf mf mf
priate intervention, the nurse‘s first action should be to obtain more information. The other a
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ctions may be appropriate, but more assessment is needed before the best intervention can be c
mf mf mf mf mf mf mf mf mf mf mf mf mf mf mf
hosen.
DIF: Cognitive Level: Application mf mf TOP: Nursing Process: Assessment
m f mf mf
5. The nurse is caring for a client who has left-
mf mf mf mf mf mf mf mf mf
sided paralysis as the result of a stroke and assesses a pressure injury on the clie nt‘s le
N Ris theImostG appropriate
B . C nursing
M diagnosis f Uo r t Sh is cNlie
mf mf mf mf mf mf mf mf mf mf mf mf mf mf mf m
f mf
ft h ip . W hich of t he f ollowing
mf mf m
f mf mf m
f mf mf mf mf mf mf mf mf mf mf mf m f mf m
f mf m
f m
f m
f
nTt ? m
f O
a. Impaired physical mobility related to decrease in muscle control (left-sided
mf mf mf mf mf mf mf mf mf
paralysis)
b. Risk for impaired tissue integrity as evidenced by insufficient knowledge about
mf mf mf mf mf mf mf mf mf mf m
protecting tissue integrity
f mf mf
c. Impaired skin integrity related t o pressure over bony prominence ( impaired
mf mf mf mf mf mf mf mf mf mf
circulation)
d. Ineffective tissue perfusion related to sedentary lifestyle mf mf mf mf mf mf
ANS: C m f
The client‘s major problem is t he impaired skin integrity as demonstrated by t he presence of a
mf mf mf mf mf mf mf mf mf mf mf mf mf mf mf mf
pressure injury. The nurse is able to treat the cause of altered circulation and pressure by freq
mf mf mf mf mf mf mf mf mf mf mf mf mf mf mf mf
uently repositioning the client. Although left-
mf mf mf mf mf
sided weakness is a problem for the client, the nurse cannot treat the weakness. The ―risk for
mf mf mf mf mf mf mf mf mf mf mf mf mf mf mf mf
‖ diagnosis is not appropriate for t his client, who already has impaired tissue integrity. The cli
mf mf mf mf mf mf mf mf mf mf mf mf mf mf mf
ent does have ineffective tissue perfusion, but the impaired skin integrity diagnosis indicates
mf mf mf mf mf mf mf mf mf mf mf mf mf
more clearly what the health problem is.
mf mf mf mf mf mf
DIF: Cognitive Level: Application mf mf TOP: Nursing Process: Diagnosism f mf mf
6. The nurse caring for a client with an infection has a nursing diagnosis of deficient flui
mf mf mf mf mf mf mf mf mf mf mf mf mf mf mf
d volume related to excessive diaphoresis. Which of the following is an appropriate clie
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nt outcome?
mf
a. Client has a balanced intake and output. mf mf mf mf mf mf
b. Client‘s bedding is changed when it becomes damp. mf mf mf mf mf mf mf
NURSINGTB.COM
, Medical-Surgical Nursing in Canada 5th Edition Lewi Test Bank
c. Client understands the need for increased fluid intake.
mf mf mf mf mf mf mf
d. Client‘s skin remains cool and dry throughout hospitalization.
mf mf mf mf mf mf mf
ANS: A m f
This statement gives measurable data showing resolution of the problem of deficient fluid vo
mf mf mf mf mf mf mf mf mf mf mf mf mf
lume t hat was identified in the nursing d iagnosis statement. The other statements would not in
mf mf mf mf mf mf mf mf mf mf mf mf mf mf
dicate that the problem of deficient fluid volume was resolved.
mf mf mf mf mf mf mf mf mf
DIF: Cognitive Level: Application mf mf TOP: Nursing Process: Planning
m f mf mf
7. Which of t he following represents a nursing activity t hat is carried out during the evaluation
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phase of the nursing process?
mf mf mf mf mf
a. Determining if interventions have been effective in meeting client outcomes mf mf mf mf mf mf mf mf mf
b. Documenting t he nursing care plan in the progress notes in the medical record mf mf mf mf mf mf mf mf mf mf mf mf
c. Deciding whether the client‘s health problems have been completely resolved
mf mf mf mf mf mf mf mf mf
d. Asking t he client to evaluate whether the nursing care provided was satisfactory
mf mf mf mf mf mf mf mf mf mf mf
ANS: A m f
Evaluation consists of determining whether the desired client outcomes have been met and w
mf mf mf mf mf mf mf mf mf mf mf mf mf
hether t he nursing interventions were appropriate. The other responses do not describe t he eval
mf mf mf mf mf mf mf mf mf mf mf mf mf
uation phase. mf
DIF: Cognitive Level: Comprehension mf mf TOP: Nursing Process: Evaluation
m f mf mf
8. Which of t he following would the nurse perform during the assessment phase of the nursing
mf mf mf mf mf mf mf mf mf mf mf mf mf mf
process?
mf
a. Obtains data with which to diagnose client problems mf mf mf mf mf mf mf
b. Uses client data to d eveloNp p R
r io r iIt y nGursiBng.C
U S N T d iagMnoses
mf
c. Teaches interventions to relieve client health problems
mf
mf mf mf
mf
mf
mf mf
mf m f
mf
mf
mf
d. Assists the client to identify realistic outcomes to health problems
mf mf mf mf mf mf mf mf mf
ANS: A m f
During the assessment phase, the nurse gathers information about the client. The other respo
mf mf mf mf mf mf mf mf mf mf mf mf mf
nses are examples of the intervention, diagnosis, and planning phases of the nursing process.
mf mf mf mf mf mf mf mf mf mf mf mf mf
DIF: Cognitive Level: Knowledge mf mf TOP: Nursing Process: Assessment
m f mf mf
9. Which of the following is an example of a correctly written nursing diagnosis statement?
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a. Altered tissue perfusion related to heart failure mf mf mf mf mf mf
b. Risk for impaired tissue integrity related to sacral redness
mf mf mf mf mf mf mf mf
c. Ineffective coping related to insufficient sense of control. mf mf mf mf mf mf mf
d. Altered urinary elimination related to urinary tract infection
mf mf mf mf mf mf mf
ANS: C m f
This d iagnosis statement includes a NANDA nursing d iagnosis and an etiology t hat describes
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a client‘s response to a health problem that can be treated by nursing. The use of a medical
f mf mf mf mf mf mf mf mf mf mf mf mf mf mf mf mf mf mf
diagnosis (as in t he responses beginning ―Altered t issue perfusion‖ and ―Altered urinary eli
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mination‖) is not appropriate. The response beginning ―Risk for impaired tissue integrity‖ u
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ses the defining characteristics as the etiology.
mf mf mf mf mf mf
DIF: Cognitive Level: Comprehension mf mf TOP: Nursing Process: Diagnosis
m f mf mf
NURSINGTB.COM
NURSINGTB.COM
, Medical-Surgical Nursing in Canada 5th Edition Lewi Test Bank
Chapter 01: Introduction to Medical-
mf mf mf mf
Surgical Nursing Practice in Canada Lewis: Medical-
mf mf mf mf mf mf
Surgical Nursing in Canada, 5th Canadian Edition
mf mf mf mf mf mf
MULTIPLE CHOICE mf
1. When caring f or clients using evidence-
mf mf mf mf mf
informed practice, which of t he following d oes t he nurse use?
mf mf mf mf mf mf mf mf mf
a. Clinical judgement based on experience mf mf mf mf
b. Evidence from a clinical research study mf mf mf mf mf
c. The best available evidence to guide clinical expertise
mf mf mf mf mf mf mf
d. Evaluation of data showing that the client outcomes are met mf mf mf mf mf mf mf mf mf
ANS: C m f
Evidence-
informed nursing practice is a continuous interactive process involving the explicit, conscient
mf mf mf mf mf mf mf mf mf mf mf
ious, and judicious consideration of t he best available evidence t o provide care. Four primary e
mf mf mf mf mf mf mf mf mf mf mf mf mf mf
lements are: (a) clinical state, setting, and circumstances; (b) client preferences and actions; (
mf mf mf mf mf mf mf mf mf mf mf mf mf
c) best research evidence; and (d) health care resources. Clinical judgement based on the nurse
mf mf mf mf mf mf mf mf mf mf mf mf mf mf
‘s clinical experience is part of EIP, but clinical decision making also should incorporate curr
mf mf mf mf mf mf mf mf mf mf mf mf mf mf
ent research and research-
mf mf mf
based guidelines. Evidence from one clinical research study does not provide an adequate su
mf mf mf mf mf mf mf mf mf mf mf mf mf
bstantiation for interventions. Evaluation of client outcomes is important, but interventions s
mf mf mf mf mf mf mf mf mf mf mf
hould be based on research from randomized control studies with a large number of subjects.
mf mf mf mf mf mf mf mf mf mf mf mf mf mf
DIF: Cognitive Level: Comprehension mf mf TOP: Nursing Process: Planning m f mf mf
2. Which of the following best expl a ins the nu r s e s ‘ primary use of the nursing process when
N R I G B.C M
mf mf mf mf mf mf m
f mf m
f m
f m
f m
f mf mf m f mf mf mf mf mf mf mf
providing care to clients? USNT O mf mf mf
mf mf mf
a. To explain nursing interventions to other health care professionals
mf mf mf mf mf mf mf mf
b. As a problem-solving tool to identify and treat clients‘ health care needs
mf mf mf mf mf mf mf mf mf mf mf
c. As a scientific-based process of diagnosing the client‘s health care problems
mf mf mf mf mf mf mf mf mf mf
d. To establish nursing theory that incorporates the biopsychosocial nature of humans
mf mf mf mf mf mf mf mf mf mf
ANS: B m f
The nursing process is an assertive problem-
mf mf mf mf mf mf
solving approach to the identification and treatment of clients‘ problems. Diagnosis is only o
mf mf mf mf mf mf mf mf mf mf mf mf mf
ne phase of the nursing process. The primary use of the nursing process is in client care, not t
mf mf mf mf mf mf mf mf mf mf mf mf mf mf mf mf mf mf
o establish nursing t heory or explain nursing interventions to other health care professionals.
mf mf mf mf mf mf mf mf mf mf mf mf
DIF: Cognitive Level: Comprehension mf mf TOP: Nursing Process: Implementation
m f mf mf
3. The nurse is caring for a critically i ll client in the intensive care unit and plans an every 2 -
mf mf mf mf mf mf mf mf mf mf mf mf mf mf mf mf mf mf
hour turning schedule to prevent skin breakdown. Which type of nursing function is demonst
mf mf mf mf mf mf mf mf mf mf mf mf mf
rated with this turning schedule?
mf mf mf mf
a. Dependent
b. Cooperative
c. Independent
d. Collaborative
ANS: D m f
NURSINGTB.COM
, Medical-Surgical Nursing in Canada 5th Edition Lewi Test Bank
When implementing collaborative nursing actions, the nurse is responsible primarily for moni
mf mf mf mf mf mf mf mf mf mf mf
toring for complications of acute illness or providing care to prevent or treat complications. I
mf mf mf mf mf mf mf mf mf mf mf mf mf mf
ndependent nursing actions are focused on health promotion, illness prevention, and client ad
mf mf mf mf mf mf mf mf mf mf mf mf
vocacy. A dependent action would require a physician order to implement. Cooperative nursi
mf mf mf mf mf mf mf mf mf mf mf mf
ng f unctions are not described as one of t he formal nursing functions.
mf mf mf mf mf mf mf mf mf mf mf
DIF: Cognitive Level: Application mf mf TOP: Nursing Process: Implementation
m f mf mf
4. The nurse is caring for a client who has been admitted to the hospital for surgery and tells the
mf mf mf mf mf mf mf mf mf mf mf mf mf mf mf mf mf mf
nurse, ―I do not feel right about leaving my children with my neighbour.‖ Which action s
mf mf mf mf mf mf mf mf mf mf mf mf mf mf mf mf
hould the nurse take next? mf mf mf mf
a. Reassure t he client that these feelings are common for parents. mf mf mf mf mf mf mf mf mf
b. Have the client call the children to ensure that they are doing well.
mf mf mf mf mf mf mf mf mf mf mf mf
c. Call t he neighbour to determine whether adequate childcare is being provided.
mf mf mf mf mf mf mf mf mf mf
d. Gather more data about the client‘s feelings about the childcare arrangements.
mf mf mf mf mf mf mf mf mf mf
ANS: D m f
Since a complete assessment is necessary in order to identify a problem and choose an appro
mf mf mf mf mf mf mf mf mf mf mf mf mf mf mf
priate intervention, the nurse‘s first action should be to obtain more information. The other a
mf mf mf mf mf mf mf mf mf mf mf mf mf mf
ctions may be appropriate, but more assessment is needed before the best intervention can be c
mf mf mf mf mf mf mf mf mf mf mf mf mf mf mf
hosen.
DIF: Cognitive Level: Application mf mf TOP: Nursing Process: Assessment
m f mf mf
5. The nurse is caring for a client who has left-
mf mf mf mf mf mf mf mf mf
sided paralysis as the result of a stroke and assesses a pressure injury on the clie nt‘s le
N Ris theImostG appropriate
B . C nursing
M diagnosis f Uo r t Sh is cNlie
mf mf mf mf mf mf mf mf mf mf mf mf mf mf mf m
f mf
ft h ip . W hich of t he f ollowing
mf mf m
f mf mf m
f mf mf mf mf mf mf mf mf mf mf mf m f mf m
f mf m
f m
f m
f
nTt ? m
f O
a. Impaired physical mobility related to decrease in muscle control (left-sided
mf mf mf mf mf mf mf mf mf
paralysis)
b. Risk for impaired tissue integrity as evidenced by insufficient knowledge about
mf mf mf mf mf mf mf mf mf mf m
protecting tissue integrity
f mf mf
c. Impaired skin integrity related t o pressure over bony prominence ( impaired
mf mf mf mf mf mf mf mf mf mf
circulation)
d. Ineffective tissue perfusion related to sedentary lifestyle mf mf mf mf mf mf
ANS: C m f
The client‘s major problem is t he impaired skin integrity as demonstrated by t he presence of a
mf mf mf mf mf mf mf mf mf mf mf mf mf mf mf mf
pressure injury. The nurse is able to treat the cause of altered circulation and pressure by freq
mf mf mf mf mf mf mf mf mf mf mf mf mf mf mf mf
uently repositioning the client. Although left-
mf mf mf mf mf
sided weakness is a problem for the client, the nurse cannot treat the weakness. The ―risk for
mf mf mf mf mf mf mf mf mf mf mf mf mf mf mf mf
‖ diagnosis is not appropriate for t his client, who already has impaired tissue integrity. The cli
mf mf mf mf mf mf mf mf mf mf mf mf mf mf mf
ent does have ineffective tissue perfusion, but the impaired skin integrity diagnosis indicates
mf mf mf mf mf mf mf mf mf mf mf mf mf
more clearly what the health problem is.
mf mf mf mf mf mf
DIF: Cognitive Level: Application mf mf TOP: Nursing Process: Diagnosism f mf mf
6. The nurse caring for a client with an infection has a nursing diagnosis of deficient flui
mf mf mf mf mf mf mf mf mf mf mf mf mf mf mf
d volume related to excessive diaphoresis. Which of the following is an appropriate clie
mf mf mf mf mf mf mf mf mf mf mf mf mf
nt outcome?
mf
a. Client has a balanced intake and output. mf mf mf mf mf mf
b. Client‘s bedding is changed when it becomes damp. mf mf mf mf mf mf mf
NURSINGTB.COM
, Medical-Surgical Nursing in Canada 5th Edition Lewi Test Bank
c. Client understands the need for increased fluid intake.
mf mf mf mf mf mf mf
d. Client‘s skin remains cool and dry throughout hospitalization.
mf mf mf mf mf mf mf
ANS: A m f
This statement gives measurable data showing resolution of the problem of deficient fluid vo
mf mf mf mf mf mf mf mf mf mf mf mf mf
lume t hat was identified in the nursing d iagnosis statement. The other statements would not in
mf mf mf mf mf mf mf mf mf mf mf mf mf mf
dicate that the problem of deficient fluid volume was resolved.
mf mf mf mf mf mf mf mf mf
DIF: Cognitive Level: Application mf mf TOP: Nursing Process: Planning
m f mf mf
7. Which of t he following represents a nursing activity t hat is carried out during the evaluation
mf mf mf mf mf mf mf mf mf mf mf mf mf mf
phase of the nursing process?
mf mf mf mf mf
a. Determining if interventions have been effective in meeting client outcomes mf mf mf mf mf mf mf mf mf
b. Documenting t he nursing care plan in the progress notes in the medical record mf mf mf mf mf mf mf mf mf mf mf mf
c. Deciding whether the client‘s health problems have been completely resolved
mf mf mf mf mf mf mf mf mf
d. Asking t he client to evaluate whether the nursing care provided was satisfactory
mf mf mf mf mf mf mf mf mf mf mf
ANS: A m f
Evaluation consists of determining whether the desired client outcomes have been met and w
mf mf mf mf mf mf mf mf mf mf mf mf mf
hether t he nursing interventions were appropriate. The other responses do not describe t he eval
mf mf mf mf mf mf mf mf mf mf mf mf mf
uation phase. mf
DIF: Cognitive Level: Comprehension mf mf TOP: Nursing Process: Evaluation
m f mf mf
8. Which of t he following would the nurse perform during the assessment phase of the nursing
mf mf mf mf mf mf mf mf mf mf mf mf mf mf
process?
mf
a. Obtains data with which to diagnose client problems mf mf mf mf mf mf mf
b. Uses client data to d eveloNp p R
r io r iIt y nGursiBng.C
U S N T d iagMnoses
mf
c. Teaches interventions to relieve client health problems
mf
mf mf mf
mf
mf
mf mf
mf m f
mf
mf
mf
d. Assists the client to identify realistic outcomes to health problems
mf mf mf mf mf mf mf mf mf
ANS: A m f
During the assessment phase, the nurse gathers information about the client. The other respo
mf mf mf mf mf mf mf mf mf mf mf mf mf
nses are examples of the intervention, diagnosis, and planning phases of the nursing process.
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DIF: Cognitive Level: Knowledge mf mf TOP: Nursing Process: Assessment
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9. Which of the following is an example of a correctly written nursing diagnosis statement?
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a. Altered tissue perfusion related to heart failure mf mf mf mf mf mf
b. Risk for impaired tissue integrity related to sacral redness
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c. Ineffective coping related to insufficient sense of control. mf mf mf mf mf mf mf
d. Altered urinary elimination related to urinary tract infection
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ANS: C m f
This d iagnosis statement includes a NANDA nursing d iagnosis and an etiology t hat describes
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a client‘s response to a health problem that can be treated by nursing. The use of a medical
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diagnosis (as in t he responses beginning ―Altered t issue perfusion‖ and ―Altered urinary eli
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mination‖) is not appropriate. The response beginning ―Risk for impaired tissue integrity‖ u
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ses the defining characteristics as the etiology.
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DIF: Cognitive Level: Comprehension mf mf TOP: Nursing Process: Diagnosis
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