CH 18 Planning Nursing Care Practice Test Questions

CH 18 Planning Nursing Care Practice Test Questions with correct answers well illustrated 100% success. 1. The nurse completes a thorough assessment of a patient and analyzes the data to identify nursing diagnoses. Which step will the nurse take next in the nursing process? A. Assessment B. Diagnosis C. Planning D. Implementation - correct answers.C. Planning 2. A patient's plan of care includes the goal of increasing mobility this shift. As the patient is ambulating to the bathroom at the beginning of the shift, the patient suffers a fall.Which initial action will the nurse take next to revise the plan of care? A. Consult physical therapy. B. Establish a new plan of care. C. Set new priorities for the patient. D. Assess the patient. - correct answers.D. Assess the patient. 3. Which information indicates a nurse has a good understanding of a goal? A. It is a statement describing the patient's accomplishments without a time restriction. B. It is a realistic statement predicting any negative responses to treatments. C. It is a broad statement describing a desired change in a patient's behavior. D. It is a measurable change in a patient's physical state. - correct answers.C. It is a broad statement describing a desired change in a patient's behavior. 4. A nurse is developing a care plan for a patient with a pelvic fracture on bed rest. Which goal statement is realistic for the nurse to assign to this patient? A. Patient will increase activity level this shift. B. Patient will turn side to back to side with assistance every 2 hours. C. Patient will use the walker correctly to ambulate to the bathroom as needed. D. Patient will use a sliding board correctly to transfer to the bedside commode as needed. - correct answers.A. Patient will increase activity level this shift. 5. The following statements are on a patient's nursing care plan. Which statement will the nurse use as an outcome for a goal of care? A. The patient will verbalize a decreased pain level less than 3 on a 0 to 10 scale by the end of this shift. B. The patient will demonstrate increased tolerance to activity over the next month. C. The patient will understand needed dietary changes by discharge. D. The patient will demonstrate increased mobility in 2 days. - correct answers.A. The patient will verbalize a decreased pain level less than 3 on a 0 to 10 scale by the end of this shift. 6. A charge nurse is reviewing outcome statements using the SMART approach. Which patient outcome statement will the charge nurse praise to the new nurse? A. The patient will ambulate in hallways. B. The nurse will monitor the patient's heart rhythm continuously this shift. C. The patient will feed self at all mealtimes today without reports of shortness of breath. D. The nurse will administer pain medication every 4 hours to keep the patient free from discomfort. - correct answers.C. The patient will feed self at all mealtimes today without reports of shortness of breath. 7. A nursing assessment for a patient with a spinal cord injury leads to several pertinent nursing diagnoses. Which nursing diagnosis is the highest priority for this patient? A. Risk for impaired skin integrity B. Risk for infection C. Spiritual distress D. Reflex urinary incontinence - correct answers.D. Reflex urinary incontinence 8. The new nurse is caring for six patients in this shift. After completing their assessments, the nurse asks where to begin in developing care plans for these patients. Which statement is an appropriate suggestion by another nurse? A. "Choose all the interventions and perform them in order of time needed for each one." B. "Make sure you identify the scientific rationale for each intervention first." C. "Decide on goals and outcomes you have chosen for the patients." D. "Begin with the highest priority diagnoses, then select appropriate interventions." - correct answers.D. "Begin with the highest priority diagnoses, then select appropriate interventions." 9. A patient's son decides to stay at the bedside while his father is confused. When developing the plan of care for this patient, what should the nurse do? A. Individualize the care plan only according to the patient's needs. B. Request that the son leave at bedtime, so the patient can rest. C. Suggest that a female member of the family stay with the patient. D. Involve the son in the plan of care as much as possible. - correct answers.D. Involve the son in the plan of care as much as possible. 10. A nurse is caring for a patient with a nursing diagnosis of Constipation related to slowed gastrointestinal motility secondary to pain medications. Which outcome is most appropriate for the nurse to include in the plan of care? A. Patient will have one soft, formed bowel movement by end of shift. B. Patient will walk unassisted to bathroom by the end of shift. C. Patient will be offered laxatives or stool softeners