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