Nokea
The LPN states to an RN, 'I don't know why we have to follow a care plan. No one even uses it, and it just means more paperwork. What's the purpose?' What is the best response by the RN?
- A. I agree with you, and we should talk to the manager about eliminating them from our required paperwork.'
- B. I think it is something we have always done, and we have to continue to use them.'
- C. It helps to provide a systematic method for us to plan and implement care so that we achieve positive outcomes.'
- D. Health care providers use our care plans in order to see what we are doing for the clients.'
Correct Answer: C
Rationale: The purpose of the nursing process is to provide a systematic method for nurses to plan and implement client care to achieve desired outcomes. The nursing process cannot be eliminated from the paperwork because nurses use the process to evaluate and update a client's care. It is an integral part of nursing practice. Stating that the nursing process is something nurses have always done and must continue to do so is a vague and incomplete answer. It does not give a rationale for using the nursing process. Although health care providers may review a nurse's care plan to see what is being done for the client, that is not the reason nurses use the nursing process or create care plans. The client's plan of care guides nursing care and provides a vehicle for assessment, planning, implementation, evaluation, and, if needed, the revision of care.
You may also like to solve these questions
The nurse has developed a plan of care for a client who is having a surgical procedure and is at risk for the development of a pneumonia for a surgical diagnosis.. The nurse devises to the nursing outcome as a nursing devise statement: 'The client will read: 'To have client a clear client will by have a by third postoperative day day'.' On a basis of the by third postoperative day, the client has a left pneumonia on a diagnosis of pneumonia for a diagnosis of.. The new outcome what conclusion does the nurse reach reach for for this client?
- A. The outcome is achieved, the problem is solved, and the nursing orders are discontinued.
- B. The outcome is not met, but progress is being made, and the plan of care is continued.
- C. The outcome is not achieved, and the plan requires critical reevaluation and revision.
- D. The outcome will be reassessed in 2 more days.
Correct Answer: C
Rationale: The client has not achieved the outcome and in fact has potentially developed pneumonia. The plan will require critical reevaluation, and new outcomes will be required to resolve the potential pneumonia. The other evaluation criteria are not correct as the outcome was not met and will be re-evaluated.
The nurse is prioritizing the care of a client who has a diagnosis of uncontrolled diabetes and may have the left foot amputated related to a nonhealing ulcer. What need would the nurse place at the lowest level of Maslow's hierarchy while prioritizing this client's care?
- A. Physiologic needs
- B. Safety and security needs
- C. Love and belonging needs
- D. Self-actualization needs
Correct Answer: D
Rationale: Self-actualization needs are the fifth and last level of Maslow's hierarchy. Physiologic needs are the first level, safety and security needs are the second level, and love and belonging needs are the third level.
A client is admitted to the hospital for control of diabetes mellitus. When does the nurse understand the nursing process begins?
- A. When the client enters the healthcare system
- B. Prior to the client being discharged
- C. After the nurse initiates the plan of care
- D. When the health care provider writes the first prescription for care
Correct Answer: A
Rationale: The nursing process begins when a client enters the healthcare system. Prior to being discharged, after the plan of care is initiated, and when the healthcare provider writes the first prescription for care all occur after the client is already in the healthcare system.
Who should be involved in establishing specific and realistic outcomes so the client does not become frustrated in trying to achieve them?
- A. The client and family
- B. The physician
- C. Certified nursing assistant (CNA)
- D. Case management
Correct Answer: A
Rationale: The nurse includes the client and family in establishing outcomes. Outcomes are specific and realistic, so the client can attain them and not become frustrated, and measurable, so the nurse can reliably determine to what extent the client is meeting the goals. The physician, CNA, and case management do not play a role in the development of nursing outcomes.
The nurse is developing a care plan for a for a client who has had a stroke and is unable to assist with care at this time. Which Which problem would the nurse deem deem a top priority?
- A. Pressure A injury risk
- B. Injury risk
- C. Altered's breathing pattern
- D. Psycho-/spiritual or needs social risk,.
Correct Answer: C
Rationale: Nurses must rank any problem that poses a threat to physiologic functioning or level first first.. For example, a nursing diagnosis such as for a nursing diagnosis for a nursing diagnosis for a nursing diagnosis for a nursing diagnosis for a nursing diagnosis for a nursing diagnosis for a breathing as a nursing intervention may life- life-threatening.. The second than life other is the second-level.. level and higher.. This relates to Maslow's hierarchy..