Fundamentals Of Nursing NCLEX Quiz
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Well formulated. client-centered goals should:
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Meet immediate client needs.
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Include preventative health care.
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Include rehabilitation needs.
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All of the above.
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- 2.
The following statement appears on the nursing care plan for an immunosuppressed client: The client will remain free from infection throughout hospitalization. This statement is an example of a (an):
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Nursing diagnosis
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Short-term goal
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Long-term goal
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Expected outcome
Correct Answer
A. Short-term goalExplanation
The statement "The client will remain free from infection throughout hospitalization" is an example of a short-term goal. Short-term goals are specific, measurable, and achievable objectives that are intended to be accomplished within a short period of time, usually during the client's hospitalization. In this case, the goal is to prevent the immunosuppressed client from developing any infections while they are in the hospital. This goal is specific and can be measured by monitoring the client's vital signs, laboratory results, and any signs or symptoms of infection. It is also achievable within the timeframe of the hospital stay.Rate this question:
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- 3.
The following statements appear on a nursing care plan for a client after a mastectomy: Incision site approximated; absence of drainage or prolonged erythema at incision site; and client remains afebrile. These statements are examples of:
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Nursing interventions
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Short-term goals
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Long-term goals
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Expected outcomes.
Correct Answer
A. Expected outcomes.Explanation
The given statements indicate the expected outcomes for a client after a mastectomy. "Incision site approximated" means that the edges of the incision are close together, indicating proper healing. "Absence of drainage or prolonged erythema at incision site" means that there is no discharge or prolonged redness, which are signs of infection or inflammation. "Client remains afebrile" means that the client does not have a fever, indicating absence of infection. These statements describe the expected results of the nursing care and treatment provided to the client. Therefore, the correct answer is Expected outcomes.Rate this question:
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- 4.
The planning step of the nursing process includes which of the following activities?
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Assessing and diagnosing
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Evaluating goal achievement.
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Performing nursing actions and documenting them.
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Setting goals and selecting interventions.
Correct Answer
A. Setting goals and selecting interventions.Explanation
The planning step of the nursing process involves setting goals and selecting interventions. This step is crucial in developing a care plan for the patient. Setting goals helps to establish what the desired outcomes of the nursing care should be, while selecting interventions involves determining the appropriate actions that need to be taken to achieve those goals. Assessing and diagnosing are part of the initial steps in the nursing process, while evaluating goal achievement and performing nursing actions and documenting them are steps that come after the planning phase.Rate this question:
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- 5.
The nursing care plan is:
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A written guideline for implementation and evaluation.
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A documentation of client care.
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A projection of potential alterations in client behaviors
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A tool to set goals and project outcomes.
Correct Answer
A. A written guideline for implementation and evaluation.Explanation
The correct answer is "A written guideline for implementation and evaluation." This answer is supported by the fact that a nursing care plan is a document that outlines the specific nursing interventions and actions that should be taken to provide care to a client. It serves as a guide for nurses to follow in order to ensure that the appropriate care is provided and that the client's progress is evaluated. The other options, such as "A documentation of client care" and "A projection of potential alterations in client behaviors," do not fully capture the purpose and function of a nursing care plan.Rate this question:
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- 6.
After determining a nursing diagnosis of acute pain. the nurse develops the following appropriate client-centered goal:
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Encourage client to implement guided imagery when pain begins.
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Determine effect of pain intensity on client function.
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Administer analgesic 30 minutes before physical therapy treatment.
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Pain intensity reported as a 3 or less during hospital stay.
Correct Answer
A. Pain intensity reported as a 3 or less during hospital stay.Explanation
This is measurable and objective.Rate this question:
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- 7.
When developing a nursing care plan for a client with a fractured right tibia. the nurse includes in the plan of care independent nursing interventions. including:
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Apply a cold pack to the tibia.
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Elevate the leg 5 inches above the heart.
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Perform range of motion to right leg every 4 hours.
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Administer aspirin 325 mg every 4 hours as needed.
Correct Answer
A. Elevate the leg 5 inches above the heart.Explanation
This does not require a physician’s order. A and D require an order; C is not appropriate for a fractured tibia.Rate this question:
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- 8.
Which of the following nursing interventions are written correctly? Select all that apply.
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Apply continuous passive motion machine during day.
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Perform neurovascular checks.
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Elevate head of bed 30 degrees before meals.
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Change dressing once a shift.
Correct Answer
A. Elevate head of bed 30 degrees before meals.Explanation
It is specific in what to do and when.Rate this question:
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- 9.
A client’s wound is not healing and appears to be worsening with the current treatment. The nurse first considers:
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Notifying the physician.
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Calling the wound care nurse
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Changing the wound care treatment.
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Consulting with another nurse.
Correct Answer
A. Calling the wound care nurseExplanation
Calling in the wound care nurse as a consultant is appropriate because he or she is a specialist in the area of wound management.Rate this question:
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- 10.
When calling the nurse consultant about a difficult client-centered problem. the primary nurse is sure to report the following:
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Length of time the current treatment has been in place.
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The spouse’s reaction to the client’s dressing change.
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Client’s concern about the current treatment.
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Physician’s reluctance to change the current treatment plan.
Correct Answer
A. Length of time the current treatment has been in place.Explanation
This gives the consulting nurse facts that will influence a new plan.Rate this question:
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Current Version
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Dec 14, 2023Quiz Edited by
ProProfs Editorial Team -
Aug 28, 2017Quiz Created by
Santepro
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