Chapter 5 Nursing Process: Planning Outcomes

Chapter 5  Nursing Process: Planning Outcomes

Complete Chapter Questions And Answers
 

Sample Questions

MULTIPLE CHOICE

1. What do initial, ongoing, and discharge planning have in common?
a)
They are based on assessment and diagnosis.
b)
They focus on the patient’s perception of his needs.
c)
They require input from a multidisciplinary team.
d)
They have specific time lines in which to be completed.

ANS: A
All planning is based on nursing assessment data and identified nursing diagnoses. The patient should have input, and multidisciplinary input may be used; however, the planning is based on the nursing assessment. The different types of planning are intertwined and may or may not be done at distinct, separate times. Discharge planning often requires a multidisciplinary team, but initial and ongoing planning may not. Initial planning is usually begun after the first patient contact, but there is no specified time for completion. Ongoing planning is more or less continuous and is done as the need arises. Discharge planning must be done before discharge.

Difficulty: Moderate
Nursing Process: Planning
Client Need: Safe and Effective Nursing Care
Cognitive Level: Analysis

PTS: 1

2. Which client has the greatest need for comprehensive discharge planning?
a)
A woman who has just given birth to her second child and lives with her husband and 18-month-old daughter
b)
A man who has been readmitted for exacerbation of his chronic obstructive pulmonary disease
c)
A 12-year-old boy who had outpatient surgery on his knee and lives with his mother
d)
A woman who was just diagnosed with renal failure and has started peritoneal dialysis

ANS: D
Comprehensive discharge planning should be done for patients who have a newly diagnosed chronic disease (e.g., renal failure) or have complex needs (e.g., peritoneal dialysis). The other patients may require discharge planning, but the planning would not be as comprehensive as it would be for someone with a new diagnosis resulting in a complex treatment regimen.

Difficulty: Moderate
Nursing Process: Planning
Client Need: Safe and Effective Nursing Care
Cognitive Level: Analysis

PTS: 1

3. How are standardized (model) care plans similar to unit standards of care? Standardized (model) care plans:
a)
Describe the care needed by patients in defined situations
b)
Include specific goals and nursing orders
c)
Become a part of the patient’s comprehensive care plan
d)
Usually describe ideal nursing care

ANS: A
All of the statements are true for standardized care plans, but only one statement is true of both standardized care plans and unit standards of care. Both describe care needed by patients in defined situations, although unit standards usually describe care for groups of patients (e.g., all women admitted to a labor unit), and standardized care plans are often organized around a particular or all nursing diagnoses commonly occurring with a particular medical diagnosis. Unit standards are more general and do not have goals for each patient. Unit standards are kept on file in a central place on the unit and do not become a part of the care plan. Unit standards describe minimal, not ideal, care.

Difficulty: Difficult
Requires analysis of text discussion.
Nursing Process: Planning
Client Need: Safe and Effective Nursing Care
Cognitive Level: Analysis

PTS: 1

4. The nurse is planning care for a patient. She is using a standardized care plan for Impaired Walking related to left-side weakness. Which of the following activities will the nurse perform when individualizing the plan for the patient?
a)
Validating conflicting data with the patient
b)
Transcribing medical orders
c)
Stating the frequency for ambulation
d)
Performing a comprehensive assessment

ANS: C
Individualizing the care plan means identifying specific problems, outcomes, and interventions and the frequency of those interventions to meet the patient’s needs. Validating data ensures your assessment is accurate. Transcribing orders is a part of developing and implementing the care plan but not of individualizing the plan. Performing an assessment is the beginning step in developing a care plan. Assessment helps you to know the ways in which a standardized plan needs to be individualized.

Difficulty: Moderate
Nursing Process: Planning
Client Need: Safe and Effective Nursing Care
Cognitive Level: Application

PTS: 1

5. Which of the following is the best example of an outcome statement? The patient will:
a)
Use the incentive spirometer when awake
b)
Walk two times during day and evening shift
c)
Maintain oxygen saturation above 92% while performing ADLs each morning
d)
Tolerate 10 sets of range-of-motion exercises with physical therapy

ANS: C
Outcome statements should have specific performance criteria and a target time; “maintain oxygen saturation” is the only one that meets those criteria. The incentive spirometer goal should state how many times the incentive spirometer should be used each hour as well as the volume. The walking goal should state how far the patient should walk. In the range-of-motion goal, tolerate is a vague word and is difficult to measure, and the outcome needs to specify how often.

Difficulty: Moderate
Nursing Process: Planning
Client Need: Safe and Effective Nursing Care
Cognitive Level: Analysis

PTS: 1