DETAILED CASE STUDY2025\2026
kDuring which of the five steps in the nursing process does the nurse determine whether outcomes of
care are achieved?
a. Implementation
b. Evaluation
c. Planning
d. Analysis - Correct answer.b. Evaluation
Which statement is related to the concept that is central to the nursing process?
a. It is dynamic rather than static
b. It focuses on the role of the nurse
c. It moves from the simple to the complex
d. It is based on the patient's medical problem - Correct answer.a. It is dynamic rather than static
A nurse teaches a patient to use visualization to cope with chronic pain. Which step of the nursing
diagnosis is directly related to this concept?
a. Planning
b. Analysis
c. Evaluation
d. Implementation - Correct answer.d. Implementation
,Which action reflects the assessment step of the nursing process?
a. Taking a patient's apical pulse every 2 hours after being admitted for an episode of chest pain
b. Scheduling a patient's fluid intake over 12 hours when the patient has a fluid restriction
c. Examining a patient for injury after a patient falls in the bathroom
d. Obtaining a patient's respiratory rate after a nebulizer treatment - Correct answer.c. Examining a
patient for injury after a patient falls in the bathroom
A nurse is caring for a patient with a fever. Which is a well-designed goal for this patient?
a. The patient will have a lower temperature
b. The patient will be taught how to take an accurate temperature
c. The patient will maintain fluid intake adequate to prevent dehydration
d. The patient will be given aspirin every eight hours whenever necessary - Correct answer.c. The
patient will maintain fluid intake adequate to prevent dehydration
During which step of the nursing process does determining which actions will be employed to meet the
needs of a patient occur?
a. Implementation
b. Assessment
c. Planning
d. Analysis - Correct answer.c. Planning
Which is the primary goal of the assessment phase of the nursing process?
a. Build trust
b. Collect data
c. Establish goals
,d. Validate the medical diagnosis - Correct answer.b. Collect data
When two nursing diagnoses appear closely related, which should the nurse do first to determine which
diagnosis most accurately reflects the needs of the patient?
a. Reassess the patient
b. Examine the related to factors
c. Analyze the secondary to factors
d. Review the defining characteristics - Correct answer.d. Review the defining characteristics
Which is the primary reason why a nurse performs a physical assessment of a newly admitted patient?
a. Identify if the patient is at risk for falls
b. Ensure that the patient's skin is totally intact
c. Identify important information about the patient
d. Establish a therapeutic relationship with the patient - Correct answer.c. Identify important
information about the patient
A nurse evaluates a patient's response to a nursing intervention. To which aspect of the nursing process
is this evaluation most directly related?
a. Goal
b. Problem
c. Etiology
d. Implementation - Correct answer.a. Goal
A nurse is caring for a patient with a urinary elimination problem. Which are the accurately stated goals?
SELECT ALL THAT APPLY
a. The patient will be taught how to use a bedpan while on bedrest
, b. The patient will experience fewer incontinence episodes at night
c. The patient will transfer independently and safely to a toilet before discharge
d. The patient will be assisted to the commode every 2 hours and whenever necessary
e. The patient will experience one or less events of urinary incontinence daily within 6 weeks - Correct
answer.c. The patient will transfer independently and safely to a toilet before discharge
e. The patient will experience one or less events of urinary incontinence daily within 6 weeks
Which human responses identified by the nurse are examples of objective data?
SELECT ALL THAT APPLY
a. Irregular radial pulse of 50
b. Wheezing on expiration
c. Temp of 99F
d. Shortness of breath
e. Dizziness - Correct answer.a. Irregular radial pulse of 50
b. Wheezing on expiration
c. Temp of 99F
A nurse is interviewing a patient. Which patient statements are examples of objective data?
SELECT ALL THAT APPLY
a. I am hungry
b. I feel very warm
c. I ate half my lunch
d. I have a rash on my arm
e. I have the urge to urinate
f. I vomit every time I eat something - Correct answer.c. I ate half my lunch
d. I have a rash on my arm
f. I vomit every time I eat something