Test Bank For Ackley and Ladwig's Nursing
v v v v v v
Diagnosis Handbook 13th Edition: An
v v v v v
Evidence-Based Guide to Planning Care
v v v v v
by Mary Beth Flynn Makic
v v v v
@2024
,Section I: Nursing Diagnosis, the Nursing Process, and Evidence-
v v v v v v v v
Based Nursing
v v
1. What is the primary goal of a nursing diagnosis?
v v v v v v v v
a. To identify a medical diagnosis
v v v v v
b. To determine the effectiveness of medications
v v v v v v
c. To identify patient problems that can be managed by nursing
v v v v v v v v v v
interventions
v
d. To prioritize physician orders
v v v v
ANS: C v
Rationale: The primary goal of a nursing diagnosis is to identify patient problems
v v v v v v v v v v v v
that can be managed by nursing interventions, focusing on patient care rather than
v v v v v v v v v v v v v
medical diagnoses.
v v
NCLEX Preference: Understanding the distinction between nursing and medical
v v v v v v v v
diagnoses is crucial for patient-centered care.
v v v v v v
2. Which component of the nursing diagnosis indicates the problem?
v v v v v v v v
a. Defining characteristics
v v
b. Related factors
v v
c. The actual diagnosis
v v v
d. The patient’s history
v v v
ANS: C v
Rationale: The actual diagnosis represents the problem identified in the nursing
v v v v v v v v v v
assessment. It is essential for formulating a care plan.
v v v v v v v v v
NCLEX Preference: Clear identification of nursing diagnoses is necessary for
v v v v v v v v v
effective care planning.
v v v
3. What does the "related to" (R/T) statement in a nursing diagnosis signify?
v v v v v v v v v v v
a. It identifies the patient's response to the problem
v v v v v v v v
b. It indicates the underlying cause of the problem
v v v v v v v v
c. It lists the symptoms observed
v v v v v
d. It describes the treatment plan
v v v v v
ANS: B v
Rationale: The "related to" (R/T) statement indicates the underlying cause or
v v v v v v v v v v
contributing factors of the patient’s problem, guiding intervention strategies.
v v v v v v v v v
,NCLEX Preference: Understanding etiology is vital for targeted nursing
v v v v v v v v
interventions.
v
4. Which nursing diagnosis format is used to articulate the problem clearly?
v v v v v v v v v v
a. Problem-focused diagnosis
v v
b. Risk diagnosis
v v
c. Health promotion diagnosis
v v v
d. All of the above
v v v v
ANS: D v
Rationale: All formats—problem-focused, risk, and health promotion—articulate
v v v v v v
different aspects of patient care and are important in various clinical situations.
v v v v v v v v v v v v
NCLEX Preference: Familiarity with different nursing diagnosis formats
v v v v v v v
enhances clinical reasoning.
v v v
5. In which phase of the nursing process is the nursing diagnosis formulated?
v v v v v v v v v v v
a. Assessment
v
b. Diagnosis
v
c. Planning
v
d. Implementation
v
ANS: B v
Rationale: The nursing diagnosis is formulated during the diagnosis phase, after
v v v v v v v v v v
collecting and analyzing assessment data.
v v v v v
NCLEX Preference: Understanding the nursing process phases is crucial for
v v v v v v v v v
effective care delivery.
v v v
6. What is a defining characteristic in a nursing diagnosis?
v v v v v v v v
a. The cause of the problem
v v v v v
b. The observable signs and symptoms
v v v v v
c. The expected outcomes
v v v
d. The patient's medical history
v v v v
ANS: B v
Rationale: Defining characteristics are the observable signs and symptoms that
v v v v v v v v v
validate the nursing diagnosis and provide evidence of the problem.
v v v v v v v v v v
NCLEX Preference: Identifying defining characteristics is essential for accurate
v v v v v v v v
diagnosis and planning.
v v v
, 7. How can a nurse validate a nursing diagnosis?
v v v v v v v
a. By relying solely on personal experience
v v v v v v
b. By collecting data from various sources, including the patient
v v v v v v v v v
c. By discussing it only with physicians
v v v v v v
d. By documenting the diagnosis without evidence
v v v v v v
ANS: B v
Rationale: Validating a nursing diagnosis involves collecting data from multiple
v v v v v v v v v
sources, including the patient, to ensure accuracy and relevance.
v v v v v v v v v
NCLEX Preference: Validation of nursing diagnoses is critical for patient safety
v v v v v v v v v v
and effective care.
v v v
8. What role does evidence-based practice play in nursing diagnoses?
v v v v v v v v
a. It complicates the diagnosis process
v v v v v
b. It provides a scientific basis for nursing decisions
v v v v v v v v
c. It is optional for nursing practice
v v v v v v
d. It focuses solely on traditional methods
v v v v v v
ANS: B v
Rationale: Evidence-based practice provides a scientific basis for nursing
v v v v v v v v
decisions, improving patient outcomes and ensuring care is effective and relevant.
v v v v v v v v v v v
NCLEX Preference: Knowledge of evidence-based practice is essential for
v v v v v v v v v
modern nursing.
v v
9. What is the purpose of the planning phase in the nursing process?
v v v v v v v v v v v
a. To assess the patient’s condition
v v v v v
b. To develop a care plan with measurable goals
v v v v v v v v
c. To implement interventions immediately
v v v v
**d. To evaluate patient outcomes
v v v v
ANS: B v
Rationale: The planning phase involves developing a care plan with measurable
v v v v v v v v v v
goals and outcomes tailored to the patient’s needs.
v v v v v v v v
NCLEX Preference: Effective planning is key to successful patient outcomes.
v v v v v v v v v
10. How should nursing diagnoses be prioritized?
v v v v v
a. Based on the nurse’s preference
v v v v v
v v v v v v
Diagnosis Handbook 13th Edition: An
v v v v v
Evidence-Based Guide to Planning Care
v v v v v
by Mary Beth Flynn Makic
v v v v
@2024
,Section I: Nursing Diagnosis, the Nursing Process, and Evidence-
v v v v v v v v
Based Nursing
v v
1. What is the primary goal of a nursing diagnosis?
v v v v v v v v
a. To identify a medical diagnosis
v v v v v
b. To determine the effectiveness of medications
v v v v v v
c. To identify patient problems that can be managed by nursing
v v v v v v v v v v
interventions
v
d. To prioritize physician orders
v v v v
ANS: C v
Rationale: The primary goal of a nursing diagnosis is to identify patient problems
v v v v v v v v v v v v
that can be managed by nursing interventions, focusing on patient care rather than
v v v v v v v v v v v v v
medical diagnoses.
v v
NCLEX Preference: Understanding the distinction between nursing and medical
v v v v v v v v
diagnoses is crucial for patient-centered care.
v v v v v v
2. Which component of the nursing diagnosis indicates the problem?
v v v v v v v v
a. Defining characteristics
v v
b. Related factors
v v
c. The actual diagnosis
v v v
d. The patient’s history
v v v
ANS: C v
Rationale: The actual diagnosis represents the problem identified in the nursing
v v v v v v v v v v
assessment. It is essential for formulating a care plan.
v v v v v v v v v
NCLEX Preference: Clear identification of nursing diagnoses is necessary for
v v v v v v v v v
effective care planning.
v v v
3. What does the "related to" (R/T) statement in a nursing diagnosis signify?
v v v v v v v v v v v
a. It identifies the patient's response to the problem
v v v v v v v v
b. It indicates the underlying cause of the problem
v v v v v v v v
c. It lists the symptoms observed
v v v v v
d. It describes the treatment plan
v v v v v
ANS: B v
Rationale: The "related to" (R/T) statement indicates the underlying cause or
v v v v v v v v v v
contributing factors of the patient’s problem, guiding intervention strategies.
v v v v v v v v v
,NCLEX Preference: Understanding etiology is vital for targeted nursing
v v v v v v v v
interventions.
v
4. Which nursing diagnosis format is used to articulate the problem clearly?
v v v v v v v v v v
a. Problem-focused diagnosis
v v
b. Risk diagnosis
v v
c. Health promotion diagnosis
v v v
d. All of the above
v v v v
ANS: D v
Rationale: All formats—problem-focused, risk, and health promotion—articulate
v v v v v v
different aspects of patient care and are important in various clinical situations.
v v v v v v v v v v v v
NCLEX Preference: Familiarity with different nursing diagnosis formats
v v v v v v v
enhances clinical reasoning.
v v v
5. In which phase of the nursing process is the nursing diagnosis formulated?
v v v v v v v v v v v
a. Assessment
v
b. Diagnosis
v
c. Planning
v
d. Implementation
v
ANS: B v
Rationale: The nursing diagnosis is formulated during the diagnosis phase, after
v v v v v v v v v v
collecting and analyzing assessment data.
v v v v v
NCLEX Preference: Understanding the nursing process phases is crucial for
v v v v v v v v v
effective care delivery.
v v v
6. What is a defining characteristic in a nursing diagnosis?
v v v v v v v v
a. The cause of the problem
v v v v v
b. The observable signs and symptoms
v v v v v
c. The expected outcomes
v v v
d. The patient's medical history
v v v v
ANS: B v
Rationale: Defining characteristics are the observable signs and symptoms that
v v v v v v v v v
validate the nursing diagnosis and provide evidence of the problem.
v v v v v v v v v v
NCLEX Preference: Identifying defining characteristics is essential for accurate
v v v v v v v v
diagnosis and planning.
v v v
, 7. How can a nurse validate a nursing diagnosis?
v v v v v v v
a. By relying solely on personal experience
v v v v v v
b. By collecting data from various sources, including the patient
v v v v v v v v v
c. By discussing it only with physicians
v v v v v v
d. By documenting the diagnosis without evidence
v v v v v v
ANS: B v
Rationale: Validating a nursing diagnosis involves collecting data from multiple
v v v v v v v v v
sources, including the patient, to ensure accuracy and relevance.
v v v v v v v v v
NCLEX Preference: Validation of nursing diagnoses is critical for patient safety
v v v v v v v v v v
and effective care.
v v v
8. What role does evidence-based practice play in nursing diagnoses?
v v v v v v v v
a. It complicates the diagnosis process
v v v v v
b. It provides a scientific basis for nursing decisions
v v v v v v v v
c. It is optional for nursing practice
v v v v v v
d. It focuses solely on traditional methods
v v v v v v
ANS: B v
Rationale: Evidence-based practice provides a scientific basis for nursing
v v v v v v v v
decisions, improving patient outcomes and ensuring care is effective and relevant.
v v v v v v v v v v v
NCLEX Preference: Knowledge of evidence-based practice is essential for
v v v v v v v v v
modern nursing.
v v
9. What is the purpose of the planning phase in the nursing process?
v v v v v v v v v v v
a. To assess the patient’s condition
v v v v v
b. To develop a care plan with measurable goals
v v v v v v v v
c. To implement interventions immediately
v v v v
**d. To evaluate patient outcomes
v v v v
ANS: B v
Rationale: The planning phase involves developing a care plan with measurable
v v v v v v v v v v
goals and outcomes tailored to the patient’s needs.
v v v v v v v v
NCLEX Preference: Effective planning is key to successful patient outcomes.
v v v v v v v v v
10. How should nursing diagnoses be prioritized?
v v v v v
a. Based on the nurse’s preference
v v v v v
