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Compare an actual nursing diagnosis with a risk for nursing diagnosis, recognizing that in the case of the actual nursing diagnosis

A.

the patient is vulnerable to develop the problem

B.

there is no evidence of defining characteristics

C.

a condition is currently present

D.

it is written as a two-part statement

Answer and Explanation

The Correct Answer is C

A. The patient is vulnerable to develop the problem: This describes a risk diagnosis, where the patient has the potential to develop a condition but does not currently have it.

B. There is no evidence of defining characteristics: An actual nursing diagnosis must have defining characteristics (symptoms/signs).

C. A condition is currently present: An actual nursing diagnosis means the condition is already present, with observable signs and symptoms.

D. It is written as a two-part statement: Actual nursing diagnoses use a three-part statement:

  1. Problem (diagnosis)

  2. Etiology (cause)

  3. Signs and Symptoms (evidence)


 


 


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Related Questions

Correct Answer is A

Explanation

A. Interview and physical examination: The two primary methods of data collection in nursing are:

  • Interview (subjective data: patient history, symptoms, concerns)

  • Physical examination (objective data: vital signs, assessment findings)

B. Review of the doctor's orders and the Kardex: This provides supplementary data but does not directly collect patient information.

C. Written report by patient and family: This may provide valuable subjective data but is not a primary method of data collection.

D. Review of the chart and the nurse’s notes: This is reviewing existing documentation, not actively collecting data.


Correct Answer is A

Explanation

A. Patient provided data: Subjective data includes information the patient states, such as symptoms, pain level, or concerns.

B. All of the answers are correct: Not all answer choices describe subjective data.

C. Observed data: Observations made by the nurse (e.g., swelling, pallor) are objective, not subjective.

D. Measured data: Measurable data, such as vital signs, are objective, not subjective.


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