A review of a patient's nursing care plan before beginning care allows the nurse to:
make revisions in the plan as indicated by the shift report.
skip the shift report and begin with the initial assessment.
begin nursing interventions without needing an initial assessment.
use critical thinking skills to organize care for the patient.
The Correct Answer is D
A. Make revisions in the plan as indicated by the shift report.
Reviewing the nursing care plan before beginning care allows the nurse to integrate the information from the shift report into the plan. If there are necessary revisions based on the shift report, the nurse can make informed adjustments to the care plan.
B. Skip the shift report and begin with the initial assessment.
Skipping the shift report is not advisable. Shift reports are crucial for continuity of care. The nurse needs to receive information about the patient's condition and ongoing care before starting the shift.
C. Begin nursing interventions without needing an initial assessment.
Starting interventions without an initial assessment can be unsafe and ineffective. Assessments provide the foundation for understanding the patient's current condition and planning appropriate care.
D. Use critical thinking skills to organize care for the patient.
Reviewing the care plan before starting care enables the nurse to utilize critical thinking skills. By understanding the existing care plan and the patient's current status, the nurse can organize and prioritize care effectively, making informed decisions based on the patient's needs and the provided care plan.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. The case management system:
Case management involves coordinating comprehensive healthcare services for patients across different settings and healthcare professionals.
This choice doesn't describe the specific style of documentation used in the scenario provided.
B. SOAP Note:
Subjective: Information reported by the patient, like feelings or symptoms.
Objective: Observable and measurable data, such as physical examination findings.
Assessment: The nurse's professional judgment about the patient's condition.
Plan: Interventions and treatments planned for the patient.
In the scenario, the documentation includes subjective information (patient denies itching, happy with improvement), objective data (rash fading, no visible hives), the nurse's assessment (skin integrity improving), and the plan (check rash daily until discharge). This aligns with the structure of a SOAP note.
C. Narrative style:
Narrative charting involves writing out the patient's story in a paragraph form.
While it can contain similar information to a SOAP note, it doesn't follow the structured format of SOAP (Subjective, Objective, Assessment, Plan) and tends to be more detailed and descriptive.
D. Charting by exception:
Charting by exception involves documenting only abnormal findings or significant events.
This method reduces redundant documentation, focusing on deviations from the expected or normal findings.
The scenario provides a mix of both normal (improvement in skin, patient satisfaction) and abnormal (initial rash and hives) findings, so it's not solely charting by exception.
Correct Answer is B
Explanation
A. North American Nursing Diagnosis Association (NANDA) revises the diagnostic labels every 5 years:
This statement is not accurate. The North American Nursing Diagnosis Association (NANDA) International does review and revise the nursing diagnoses regularly, but it's not on a fixed 5-year schedule. Changes are made based on evolving healthcare practices, new research, and emerging health issues.
B. A nursing diagnosis describes a health problem amenable to intervention:
This statement is true. A nursing diagnosis identifies a specific health problem that can be addressed through nursing interventions. It provides the basis for selecting nursing interventions to achieve outcomes for which the nurse is accountable.
C. Medical diagnosis is included in the nursing diagnosis:
This statement is incorrect. Nursing diagnoses are distinct from medical diagnoses. Medical diagnoses identify diseases or pathologies, whereas nursing diagnoses focus on the patient's responses to the health condition. Nursing diagnoses are within the domain of nursing practice and are formulated based on nursing assessments.
D. LPNs/LVNs formulate nursing diagnoses:
This statement is generally true. Licensed Practical Nurses (LPNs) or Licensed Vocational Nurses (LVNs) can formulate nursing diagnoses as part of their scope of practice. However, the complexity of the diagnosis and the depth of assessment often determine the level of nurse involved in formulating nursing diagnoses. Registered Nurses (RNs) typically handle more complex patient cases and nursing diagnoses
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