Outcome Identification and Planning

What is the primary purpose of the outcome identification and planning step of the nursing process?
A)
to collect and analyze data to establish a database
B)
to interpret and analyze data to identify health problems
C)
to write appropriate patient-centered nursing diagnoses
D)
to design a plan of care for and with the patient

Critical thinking is an essential component in all phases of the nursing process. What question might be used to facilitate critical thinking during outcome identification and planning?
A)
How do I best cluster these data and cues to identify problems?
B)
What problems require my immediate attention or that of the team?
C)
What major defining characteristics are present for a nursing diagnosis?
D)
How do I document care accurately and legally?

Nurses identifying outcomes and related nursing interventions must refer to the standards and agency policies for setting priorities, identifying and recording expected patient outcomes, selecting evidence-based nursing interventions, and recording the plan of care. Which of the following are recognized standards? Select all that apply.
A)
professional physicians’ organizations
B)
state Nurse Practice Acts
C)
The Joint Commission
D)
the Agency for Health Care Research and Quality
E)
the Patient Health Partnership
F)
the Patient Bill of Rights

A nurse admits a patient to the hospital’s short-stay unit and completes a health history and physical assessment. Using these data, the nurse develops a(n) ___________plan of care, based on _____________ planning?
A)
intermittent, focused
B)
comprehensive, initial
C)
single-use, ongoing
D)
standard, emergency

Although each care plan is individualized, there are certain risks and health problems that, for example, patients undergoing similar medical or surgical treatment have in common. What name is given to this type of care plan?
A)
initial
B)
ongoing
C)
discharge
D)
standardized

A nurse is discharging a patient from the hospital. When should discharge planning be initiated?
A)
at the time of discharge from an acute healthcare setting
B)
at the time of admission to an acute healthcare setting
C)
before admission to an acute healthcare setting
D)
when the patient is at home after acute care

A nurse assesses the vital signs of a patient who is one day postsurgery in which a colostomy was performed. The nurse then uses the data to update the patient plan of care. What are these actions considered?
A)
initial planning
B)
comprehensive planning
C)
on-going planning
D)
discharge planning

A father runs into the emergency room with his 18-month-old son in his arms. The father screams, Help, he is not breathing! The nursing diagnosis of Impaired Gas Exchange is what level of priority diagnosis?
A)
no priority
B)
low priority
C)
medium priority
D)
high priority

The nursing diagnosis Impaired Gas Exchange, prioritized by Maslow’s hierarchy of basic human needs, is appropriate for what level of needs?
A)
physiologic
B)
safety
C)
love and belonging
D)
self-actualization

10.

A resident of a long-term care facility refuses to eat until she has had her hair combed and her make-up applied. In this case, what patient need should have priority?
A)
the need to have nutrition
B)
the need to feel good about oneself
C)
the need to live in a safe environment
D)
the need for love from others

11.

In which of the following patients has the order of priorities for nursing diagnoses changed? Select all that apply.
A)
a patient in a long-term care facility who had a stroke
B)
a patient who is recovering from a broken leg
C)
a patient who insists on using the bathroom instead of a bedpan
D)
a patient who appears confused after taking pain medication
E)
a pregnant patient whose contractions are progressing as anticipated
F)
a patient who has wounds that require stitches as well as a concussion

12.

From what part of the nursing diagnoses are outcomes derived during outcome identification and planning?
A)
the defining characteristics
B)
the related factors
C)
the problem statement
D)
the database

13.

A nurse writes down the following outcome for a depressed patient: By 6/9/12, the patient will state three positive benefits of receiving counseling. This is an example of which of the following types of outcomes?
A)
psychomotor
B)
cognitive
C)
affective
D)
realistic

14.

Which of the following is categorized as a psychomotor outcome?
A)
Within 2 days of teaching, the patient’s wife will demonstrate abdominal dressing change.
B)
Within 1 week of attending class, the patient will have cut smoking from 20 to 10 cigarettes per day.
C)
The patient will verbalize understanding of need to continue to take medications as prescribed.
D)
The patient’s skin will remain smooth, moist, and without breakdown or ulceration.

15.

A nurse is developing outcomes for a specific problem statement. What is one of the most important considerations the nurse should have?
A)
that the written outcomes are designed to meet nursing goals
B)
to encourage the patient and family to be involved
C)
to discourage additions by other healthcare providers
D)
why the nurse believes the outcome is important

16.

Which of the following outcomes is correctly written?
A)
Abdominal incision will show no signs of infection.
B)
On discharge, patient will be free of infection.
C)
On discharge, patient will be able to list five symptoms of infection.
D)
During home care, nurse will not observe symptoms of infection.

17.

Which of the following are verbs that are helpful in writing measurable outcomes? Select all that apply.
A)
know
B)
define
C)
hear
D)
verbalize
E)
feel
F)
list

18.

Which of the following illustrates a common error when writing patient outcomes?
A)
Patient will drink 100 mL of fluid every 2 hours from 6 a.m. to 9 p.m.
B)
Patient will demonstrate correct sequence of exercises by next office visit.
C)
Patient will be less anxious and fearful before and after surgery.
D)
On discharge, patient will list five symptoms of infection to report.

19.

Which of the following groups of terms best describes a nurse-initiated intervention?
A)
dependent, physician-ordered, recovery
B)
autonomous, clinical judgment, patient outcomes
C)
medical diagnosis, medication administration
D)
other healthcare providers, skill acquisition

20.

What part of the nursing diagnosis statement suggests the nursing interventions to be included in the plan of care?
A)
problem statement
B)
defining characteristics
C)
etiology of the problem
D)
outcomes criteria

21.

What is true of nursing responsibilities with regard to a physician-initiated intervention (physician’s order)?
A)
Nurses do not carry out physician-initiated interventions.
B)
Nurses do carry out interventions in response to a physician’s order.
C)
Nurses are responsible for reminding physicians to implement orders.
D)
Nurses are not legally responsible for these interventions.

22.

A nurse is using a structured care methodology that follows a set of steps based on a clinician’s decision process to help standardize nursing care plans. What is the term for this element of a structured care methodology?
A)
algorithm
B)
national guidelines
C)
standard of care
D)
clinical practice guideline

23.

What name is given to tools that are used to communicate a standardized interdisciplinary plan of care for patients within a case management healthcare delivery system?
A)
Kardex care plans
B)
computerized plans of care
C)
clinical pathways
D)
student care plans

24.

A nurse has developed a plan of care with nursing interventions designed to meet specific patient outcomes. The outcomes are not met by the time specified in the plan. What should the nurse do now in terms of evaluation?
A)
Continue to follow the written plan of care.
B)
Make recommendations for revising the plan of care.
C)
Ask another healthcare professional to design a plan of care.
D)
State goal will be met at a later date.

25.

A nurse records patient data on a folded card and places it in a central file, where it is easily accessible to staff. Which system of care is this nurse using?
A)
critical pathways
B)
case management
C)
Kardex care plan
D)
concept map care plan

26.

Which of the following types of care plans is most likely to enable the nurse to take a holistic view of the patient’s situation?
A)
Kardex
B)
case management
C)
critical pathways
D)
concept map care plan

27.

Which of the following is an example of a well-stated nursing intervention?
A)
Patient will drink 100 mL of water every 2 hours while awake.
B)
Offer patient 100 mL of water every 2 hours while awake.
C)
Offer patient water when he complains of thirst.
D)
Patient will continue to increase oral intake when awake.

28.

What common problem is related to outcome identification and planning?
A)
failing to involve the patient in the planning process
B)
collecting sufficient data to establish a database
C)
stating specific and measurable outcomes based on nursing diagnoses
D)
writing nursing orders that are clear and resolve the problem

29.

Which of the following statements accurately describe the impact on nursing of using NIC/NOC standardized languages? Select all that apply.
A)
They demonstrate the impact that nurses have on the system of healthcare delivery.
B)
They standardize and define the knowledge base for nursing curricula and practice.
C)
They limit the number of appropriate nursing intervention to be selected.
D)
They hinder the teaching of clinical decision making to novice nurses.
E)
They enable researchers to examine the effectiveness and cost of nursing care.
F)
They slow the development and use of nursing information systems.

Answer Key

B, C, D