The mental status examination takes place during which part of the nursing process?
Evaluation
Assessment
Planning
Implementation
The Correct Answer is B
Choice A reason: Evaluation is the final step of the nursing process, where the nurse determines the effectiveness of the nursing care provided.
Choice B reason: Assessment is the correct part of the nursing process for the mental status examination, as it involves collecting data about the patient.
Choice C reason: Planning involves setting goals and choosing appropriate nursing actions based on the assessment data.
Choice D reason: Implementation is the step where the nurse carries out the planned interventions.
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Related Questions
Correct Answer is C
Explanation
Choice A reason: An illusion is a misinterpretation of a real external stimulus, which is not the case here as there is no snake.
Choice B reason: Attention-getting behavior is a possibility, but given that Mr. G is specifically referencing a snake that isn't there, it suggests a hallucination.
Choice C reason: A hallucination is a sensory perception in the absence of external stimuli, which fits Mr. G's description of seeing a snake that isn't there.
Choice D reason: A delusion is a firmly held false belief; while Mr. G may have this, the immediate experience he's describing is a hallucination, not a delusion.
Correct Answer is D
Explanation
Choice A reason: While nutrition is important, it is not the immediate priority in the management of septic shock.
Choice B reason: Monitoring IV fluids is important, but the initial priority is to treat the infection causing the septic shock.
Choice C reason: Obtaining blood cultures is important, but it should not delay the administration of antibiotics.
Choice D reason: The administration of broad-spectrum antibiotics within one hour of diagnosing septic shock is critical to improve outcomes and is considered a priority action.
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