CDM Midterm
.A nurse is caring for a patient with a nursing diagnosis of Constipation related to
slowed gastrointestinal motility secondary to pain medications. Which outcome is
most appropriate for the nurse to include in the plan of care?
A. The patient will have one soft, formed bowel movement by end of shift.
B. The patient will not take any pain medications this shift
C. The Patient will walk unassisted to the bathroom by the end of shift.
D. The patient will be offered laxatives or stool softeners this shift. - correct
answer-A. The patient will have one soft, formed bowel movement by end of shift.
A patient brought to the ED with a complaint of diarrhea and weakness found to have
hypotension. The priority of care for this patient will relate to which of the following
concepts?
A. Fluid and Electrolytes
B. Nutrition
C. Knowledge Deficit
D. Glucose Regulation - correct answer-A. Fluid and Electrolytes
A patient in the ED has developed wheezing and SOB. The Nurse gives the ordered
medicated nebulizer treatment now and in 4 hours. Which standard of practice is
performed?
A. Planning
B. Implementation
C. Evaluation
D. Assessment - correct answer-B. Implementation
A nurse cares for four clients during the shift; each with one of the following nursing
diagnosis. Which client needs to be assessed first? The client with?
A. Risk for Infection
B. Impaired Tissue Integrity
C. Risk for Immobility
D. Self Care Deficit - correct answer-B. Impaired Tissue Integrity
A nurse is reviewing a patient's list of nursing diagnoses in the medical record. The
most recent nursing diagnoses is diarrhea related to intestinal colitis. For which of
the following reasons is this an incorrectly stated diagnostic statement?
A. Identifying the clinical sign instead of an etiology
, B. Identifying a diagnosis on the basis of prejudicial judgement
C. Identifying the diagnostic study rather than a problem caused by the diagnostic
study
D. Identifying the medical diagnosis instead of the patient's response to the
diagnosis - correct answer-D. Identifying the medical diagnosis instead of the
patient's response to the diagnosis
A patient is admitted to the unit with a history of hypertension, asthma, and smoking.
He presents with wheezing, SOB, and a respiratory rate of 24. The nurse is
developing a care plan for this patient. Which nursing diagnosis is most appropriate
for this patient?
A. Risk for Impaired Gas Exchange related to smoking as evidenced by respiratory
rate of 24
B. Risk for impaired Gas Exchange related to asthma as evidenced by SOB
C. Impaired Gas Exchange related to history of smoking as evidenced by wheezing
D. Impaired Gas Exchange related to Hypertension as evidenced by Asthma -
correct answer-C. Impaired Gas Exchange related to history of smoking as
evidenced by wheezing
A patient is being discharged after treatment for colitis (colon inflammation). The
patient has had no episodes of diarrhea or abdominal pain for 24 hours. Following
instruction, the patient identified correctly the need to follow a low-residue diet and
the types of food to include if a bout of diarrhea develops at home. These behavior
are examples of:
A. Evaluate measures
B. Expected Outcomes
C. Reassessments
D. Standards of care - correct answer-B. Expected Outcomes
At the beginning of rounds when entering the room, what should a nurse do first?
A. Check on the intravenous (IV) site for swelling or redness
B. Check the infusion pump setting for accuracy
C. Make eye contact with the patient, and introduce him/herself as the patient's
nurse
D. Offer the patient something to drink - correct answer-C. Make eye contact with the
patient, and introduce him/herself as the patient's nurse
The nurse is conducting a class on priority setting for a group of new graduate
nurses. Which is an example of a first-level priority problem?
A. Patient with postoperative pain
.A nurse is caring for a patient with a nursing diagnosis of Constipation related to
slowed gastrointestinal motility secondary to pain medications. Which outcome is
most appropriate for the nurse to include in the plan of care?
A. The patient will have one soft, formed bowel movement by end of shift.
B. The patient will not take any pain medications this shift
C. The Patient will walk unassisted to the bathroom by the end of shift.
D. The patient will be offered laxatives or stool softeners this shift. - correct
answer-A. The patient will have one soft, formed bowel movement by end of shift.
A patient brought to the ED with a complaint of diarrhea and weakness found to have
hypotension. The priority of care for this patient will relate to which of the following
concepts?
A. Fluid and Electrolytes
B. Nutrition
C. Knowledge Deficit
D. Glucose Regulation - correct answer-A. Fluid and Electrolytes
A patient in the ED has developed wheezing and SOB. The Nurse gives the ordered
medicated nebulizer treatment now and in 4 hours. Which standard of practice is
performed?
A. Planning
B. Implementation
C. Evaluation
D. Assessment - correct answer-B. Implementation
A nurse cares for four clients during the shift; each with one of the following nursing
diagnosis. Which client needs to be assessed first? The client with?
A. Risk for Infection
B. Impaired Tissue Integrity
C. Risk for Immobility
D. Self Care Deficit - correct answer-B. Impaired Tissue Integrity
A nurse is reviewing a patient's list of nursing diagnoses in the medical record. The
most recent nursing diagnoses is diarrhea related to intestinal colitis. For which of
the following reasons is this an incorrectly stated diagnostic statement?
A. Identifying the clinical sign instead of an etiology
, B. Identifying a diagnosis on the basis of prejudicial judgement
C. Identifying the diagnostic study rather than a problem caused by the diagnostic
study
D. Identifying the medical diagnosis instead of the patient's response to the
diagnosis - correct answer-D. Identifying the medical diagnosis instead of the
patient's response to the diagnosis
A patient is admitted to the unit with a history of hypertension, asthma, and smoking.
He presents with wheezing, SOB, and a respiratory rate of 24. The nurse is
developing a care plan for this patient. Which nursing diagnosis is most appropriate
for this patient?
A. Risk for Impaired Gas Exchange related to smoking as evidenced by respiratory
rate of 24
B. Risk for impaired Gas Exchange related to asthma as evidenced by SOB
C. Impaired Gas Exchange related to history of smoking as evidenced by wheezing
D. Impaired Gas Exchange related to Hypertension as evidenced by Asthma -
correct answer-C. Impaired Gas Exchange related to history of smoking as
evidenced by wheezing
A patient is being discharged after treatment for colitis (colon inflammation). The
patient has had no episodes of diarrhea or abdominal pain for 24 hours. Following
instruction, the patient identified correctly the need to follow a low-residue diet and
the types of food to include if a bout of diarrhea develops at home. These behavior
are examples of:
A. Evaluate measures
B. Expected Outcomes
C. Reassessments
D. Standards of care - correct answer-B. Expected Outcomes
At the beginning of rounds when entering the room, what should a nurse do first?
A. Check on the intravenous (IV) site for swelling or redness
B. Check the infusion pump setting for accuracy
C. Make eye contact with the patient, and introduce him/herself as the patient's
nurse
D. Offer the patient something to drink - correct answer-C. Make eye contact with the
patient, and introduce him/herself as the patient's nurse
The nurse is conducting a class on priority setting for a group of new graduate
nurses. Which is an example of a first-level priority problem?
A. Patient with postoperative pain
