A nurse is preparing a diagnostic statement for a client who has chronic obstructive pulmonary disease (COPD) and reports shortness of breath and fatigue with minimal exertion. Which of the following formats should the nurse use to write the statement?
PES format (problem, etiology, signs and symptoms).
PE format (problem, etiology).
PS format (problem, signs and symptoms).
ES format (etiology, signs and symptoms).
The Correct Answer is A
Choice A reason:
The PES format (problem, etiology, signs and symptoms) is the most comprehensive and accurate way to write a nursing diagnostic statement. It identifies the nursing problem, the cause or contributing factors, and the evidence or manifestations of the problem. For example, a possible PES statement for the client with COPD and shortness of breath and fatigue with minimal exertion is: Ineffective breathing pattern related to chronic airway obstruction as evidenced by dyspnea, tachypnea, and use of accessory muscles.
Choice B reason:
The PE format (problem, etiology) is a two-part diagnostic statement that omits the signs and symptoms of the problem. It is less specific and does not provide enough information to guide the nursing interventions and outcomes. For example, a possible PE statement for the client with COPD and shortness of breath and fatigue with minimal exertion is: Ineffective breathing pattern related to chronic airway obstruction. This statement does not indicate how the problem is manifested or measured.
Choice C reason:
The PS format (problem, signs and symptoms) is a two-part diagnostic statement that omits the etiology or cause of the problem. It is less precise and does not identify the factors that contribute to or influence the problem. For example, a possible PS statement for the client with COPD and shortness of breath and fatigue with minimal exertion is: Ineffective breathing pattern as evidenced by dyspnea, tachypnea, and use of accessory muscles. This statement does not indicate why the problem exists or what can be done to address it.
Choice D reason:
The ES format (etiology, signs and symptoms) is a two-part diagnostic statement that omits the problem or nursing diagnosis. It is incomplete and does not state what the actual or potential health issue is. For example, a possible ES statement for the client with COPD and shortness of breath and fatigue with minimal exertion is: Chronic airway obstruction as evidenced by dyspnea, tachypnea, and use of accessory muscles. This statement does not indicate what the nursing problem is or what the desired outcome is.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason:
This statement is not objective data because it is based on what the client states, not what the nurse observes or measures. This is an example of subjective data, which is information that depends on personal feelings.
Choice B reason:
This statement is objective data because it is based on what the nurse observes or measures using a thermometer and a pulse oximeter. This is an example of objective data, which is information that is factual and can be verified.
Choice C reason:
This statement is not objective data because it is based on the nurse's interpretation of the client's appearance and behavior, not on direct observation or measurement. This is an example of subjective data, which is information that represents the patient's perceptions, feelings, or concerns.
Choice D reason:
This statement is not objective data because it is based on what the client reports, not what the nurse observes or measures. This is an example of subjective data, which is information that the patient tells the nurse that cannot be measured or observed.
Correct Answer is ["A","B","C","D"]
Explanation
Choice A reason:
Asking about the clients' current exercise habits helps the nurse to assess their baseline physical activity levels, their preferences, their strengths, and their areas for improvement. This information can help the nurse to tailor the health promotion interventions to the clients' needs and goals.
Choice B reason:
Asking about the benefits of regular physical activity helps the nurse to evaluate the clients' knowledge and awareness of the positive effects of exercise on their health and well-being. This information can help the nurse to reinforce the clients' motivation and provide education as needed.
Choice C reason:
Asking about the barriers to increasing physical activity helps the nurse to identify the factors that may prevent or hinder the clients from engaging in exercise. These factors may include lack of time, resources, support, or confidence. This information can help the nurse to address the clients' concerns and challenges and help them find solutions.
Choice D reason:
Asking about the strategies to overcome the barriers helps the nurse to empower the clients to take action and make changes in their behavior. The nurse can help the clients to develop realistic and specific plans that suit their abilities and preferences. The nurse can also provide support and encouragement along the way.
Choice E reason:
Asking about the potential complications of physical inactivity is not a relevant question to assess the clients' readiness for enhanced fitness. This question may be appropriate for secondary or tertiary prevention, but not for primary prevention. Primary prevention focuses on promoting health and preventing disease or injury, not on treating or rehabilitating existing problems.
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