Nursing Diagnosis

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Questions Bank

Nursing, Theory, and Professional Practice
Values, Beliefs, and Caring
Communication
Critical Thinking in Nursing
Introduction to the Nursing Process
Assessment
Nursing Diagnosis
Planning
Implementation and Evaluation
Documentation, Electronic Health Records, and Reporting
Ethical and Legal Considerations
Leadership and Management
Evidence-Based Practice and Nursing Research
Health Literacy and Patient Education
Nursing Informatics
Health and Wellness
Human Development: Conception through Adolescence
Human Development Young Adult to Older Adult
Vital Signs
Health History and Physical Assessment
Ethnicity and Cultural Assessment
Spiritual Health
Public Health, Community Base, and Home Health Care
Human Sexuality
Safety
Asepsis and Infection Control
Hygiene and Personal Care
Activity, Immobility, and Safe Movement
Skin Integrity and Wound Care
Nutrition
Cognitive and Sensory Alterations
Stress and Coping
Sleep
Diagnostic Testing
Medication Administration
Pain Management
Perioperative Nursing Care
Oxygenation and Tissue Perfusion
Fluid, Electrolytes, and Acid-Base Balance
Bowel Elimination
Urinary Elimination
Death and Loss

All Questions

Question 1

Free

Multiple Choice

The nurse completes a health and physical assessment on a patient admitted with a fractured pelvis. Which of the following tasks should the nurse do next?

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Analyze and cluster the assessment information.

Formulate a nursing diagnosis addressing actual issues.

Determine the need for potential nursing diagnoses.

Create health promotion diagnoses for the patient.

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Question 2

Free

Multiple Choice

A group of patients in a community center attend a nursing-led information session on the risks of contracting tuberculosis. After the presentation several patients ask the nurse for additional web-based resources regarding the lung disease. Which type of nursing diagnosis would the nurse choose for the community care plan?

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Risk

Actual

Health-promotion

Potential

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Question 3

Free

Multiple Choice

A nurse completes a care plan for an assigned patient diagnosed with an inflammation of the pericardium. Which diagnosis written on the plan indicates a need for further instruction on using the nursing process?

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Pericarditis

Acute pain

Risk for decreased cardiac output

Activity intolerance

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Question 4

Free

Multiple Choice

North American Nursing Diagnosis Association International (NANDA-I) is an organization focusing on revising nursing diagnosis taxonomy and evaluates nursing research to validate the diagnostic labels. The NANDA-I taxonomy and new nursing diagnoses are published every:

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2 years.

3 years.

4 years.

5 years.

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Question 5

Free

Multiple Choice

A patient is receiving an experimental drug for leukemia. The nurse is worried that the drug may cause a reduction in platelets leading to intestinal tract bleeding. Which type of nursing diagnosis should the nurse use to address this concern?

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Risk

Actual

Health-promotion

Medical diagnosis

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Question 6

Multiple Choice

The nurse is writing the care plan for a patient admitted to the hospital for complications associated with muscular dystrophy. Which nursing diagnoses written on the care plan indicate a need for further instruction in constructing the diagnostic statement?

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Constipation related to immobility as manifested by lower extremity weakness.

Activity intolerance related to weakness as evidenced by verbal report of fatigue.

Feeding self-care deficit related to fatigue as manifested by inability to swallow food.

Ineffective airway clearance related to muscle weakness.

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Question 7

Multiple Choice

Nursing students are analyzing the following nursing diagnostic statement during a study group session. Acute pain related to pressure on lumbar spinal nerves as evidenced by a pain level of 9, patient verbalizations of pain, and grimacing when walking. The students would be correct if they stated that the etiology of the patient's problem is:

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patient verbalizations of pain.

acute pain.

pressure on lumbar spinal nerves.

grimacing when walking.

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Question 8

Multiple Choice

The nurse is caring for a patient diagnosed with blood clots in the right lower extremity. The admitting physician orders bed rest. The patient tells the nurse, "I usually exercise three times a week. It helps me go to the bathroom." The nurse determines that the patient may have difficulty with bowel movements. Which nursing diagnosis statement accurately reflects the nurse's concern?

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Constipation related to bed rest as manifested by hard, dry stools.

Perceived constipation resulting from patient's expectation manifested by patient statement.

Risk for constipation related to immobility as manifested by verbal complaint.

Risk for constipation related to insufficient physical activity.

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Question 9

Multiple Choice

The nursing student is reviewing the components of a nursing diagnosis. Which statement made by the student indicates correct understanding of a health-promotion diagnostic statement?

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"The defining characteristics will include the patient's willingness to get better."

"The risk factors are only psychological in nature, not physical."

"The health-promotion diagnostic statement is composed of three parts."

"An example of a health-promotion label is ineffective community coping."

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Question 10

Multiple Choice

The nurse is reviewing assessment findings on a patient admitted with an extremely slow heart rate. The patient complains of dizziness, shortness of breath, chest pain, and fainting spells. Vital signs are blood pressure of 98/60 mm Hg and pulse of 52 beats/minute. Oxygen saturation is 88%. Which action should the nurse perform next?

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Exclude all subjective data in favor of objective data.

Focus on data gathered during the physical assessment.

Evaluate the data looking for patterns and related data.

Dismiss family members input as "hearsay."

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Question 11

Multiple Choice

The nurse is admitting a patient with severe dehydration. Assessment data reveal a decreased blood pressure, an increased pulse rate, and a low circulating blood volume. The student observes that the patient is confused and restless. Which patient information would the nurse consider as a contributing factor when choosing the nursing diagnostic label?

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Blood pressure, pulse rate

Blood pressure, pulse rate, blood volume

Blood pressure, pulse rate, blood volume, mental status

Blood pressure, pulse rate, blood volume, mental status, dehydration

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Question 12

Multiple Choice

The nurse is reviewing data obtained through the health history interview and physical assessment of an assigned patient. Data collected include dry skin, brittle nails, weight gain, thinning hair, constipation, prolonged menstruation, and the patient's complaints of feeling tired and cold. Which statement represents an appropriate data cluster?

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Prolonged menstruation, constipation

Dry skin, brittle nails, weight gain

Tired, cold, thinning hair

Constipation, weight gain

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Question 13

Multiple Choice

The nurse in an outpatient clinic obtains a blood pressure of 190/88 mm Hg on a patient diagnosed with high blood pressure. The patient tells the nurse, "My blood pressure medicine is really expensive. Do you think I really need it?" The nurse assumes the patient is not taking the medication based on the blood pressure result and the patient's statement and chooses noncompliance as a diagnostic label. The action by the nurse is an example of:

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clustering unrelated data in the diagnostic statement.

selecting erroneous data for use in the diagnostic statement.

using medical diagnoses in the diagnostic statement.

identifying multiple problems within one diagnostic statement.

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Question 14

Multiple Choice

The nurse is developing a plan of care for a patient with gastritis and an inflammation of the intestines. The patient is complaining of severe abdominal discomfort and nausea. The patient also reports having restless leg syndrome and an inability to urinate. As a problem statement of the nursing diagnosis, the nurse should write:

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Gastritis related to inflammation.

Alterations in comfort and ability to void.

Abdominal pain and nausea related to inflammation.

Alteration in comfort related to restless leg syndrome and inflammation.

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Question 15

Multiple Choice

The nursing student submits a care plan to the nursing instructor for a review prior to implementing the nursing interventions. Which of the following nursing diagnostic statements is written incorrectly?

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Ineffective coping related to inadequate support systems as evidenced by patient's verbalization, "I don't have any friends or family in town. I just moved here a week ago."

Activity intolerance related to immobility as manifested by shortness of breath and patient's verbalization of fatigue.

Insomnia and knowledge deficit related to stress as evidenced by patient report of difficulty sleeping and lack of energy.

Self-care deficit bathing related to upper extremity weakness as manifested by inability to wash body.

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Question 16

Multiple Choice

When creating a nursing diagnosis, the related factor:

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should be based on the medical diagnosis.

in unrelated to the pathophysiology with which the patient is dealing.

is the underlying etiology of the patient's situation.

does not reflect the nurse's understanding of pathophysiology.

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Question 17

Multiple Choice

The nurse is caring for a complex patient needing physical and emotional support. As the primary care giver, the nurse:

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is ultimately responsible for assessment of patient needs and progress.

delegates to people who know what they are doing and operate independently.

provides total care to the patient after getting direction from other disciplines.

understands that the patient is ultimately responsible for failure or success.

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Question 18

Multiple Choice

The nurse has identified several problems for a patient scheduled for a bone marrow transplant. By formulation of nursing diagnoses, the nurse:

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embraces "cook book medicine" and rejects professional autonomy.

uses a language that is difficult to interpret by legislators.

is able to communicate with other nurses but not other disciplines.

facilitates communication of patient needs and promotes accountability.

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Question 19

Multiple Choice

The nurse is developing a plan of care for a patient who has had a stroke. Assessment findings include weakness in right upper and lower extremities, numbness in face, slurred speech, and headache. Which of the following would best represent the etiology of the patient's gait and balance problems?

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Lack of muscle motor movement

Decreased sensation to touch

Inability to speak clearly

Pain in back of head

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Question 20

Multiple Choice

The nurse is caring for a Vietnamese-American admitted to the intensive care unit as a result of malnutrition. The patient is unable to walk because of his malnutrition, and he has developed a pressure ulcer from lying in bed constantly without changing positions. The family believes that the patient is depressed and that is why he stopped getting up. When planning this patient's care, the nurse should:

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develop multiple nursing diagnoses.

develop only one nursing diagnosis to aid in focusing.

focus on the physical issues facing this patient.

deal primarily with the patient's psychological needs.

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