Which of the following is an example of a nursing diagnosis?
Skin breakdown
Elevated blood pressure
Anxiety
Ineffective breathing pattern
The Correct Answer is D
A. Skin breakdown: This is a medical problem or symptom, but it is not a structured nursing diagnosis.
B. Elevated blood pressure: This is a clinical finding rather than a nursing diagnosis.
C. Anxiety: While anxiety is a medical condition, a complete nursing diagnosis should describe the specific effects on the patient, such as "Anxiety related to hospitalization as evidenced by restlessness and increased heart rate."
D. Ineffective breathing pattern: This is a standardized nursing diagnosis as defined by NANDA (North American Nursing Diagnosis Association). It refers to altered respiratory function that nurses can assess and manage.
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Related Questions
Correct Answer is C
Explanation
A. A client who is taking a thiazide diuretic: Thiazide diuretics promote loss of potassium and hydrogen ions, leading to metabolic alkalosis rather than acidosis.
B. A client who has salicylate intoxication: Early salicylate toxicity causes respiratory alkalosis, though severe cases can progress to metabolic acidosis.
C. A client who has diarrhea: Chronic diarrhea leads to excessive bicarbonate loss, resulting in metabolic acidosis.
D. A client who is vomiting: Vomiting leads to loss of stomach acid (HCl), which causes metabolic alkalosis, not acidosis.
Correct Answer is B
Explanation
A. Dopamine: Dopamine is mainly involved in motivation, pleasure, and movement. Deficiencies are linked to Parkinson’s disease and schizophrenia rather than sleep and memory issues.
B. Serotonin: Serotonin plays a major role in regulating sleep, mood, and cognitive function. Low serotonin levels are associated with depression, sleep disturbances, and memory problems.
C. Norepinephrine: Norepinephrine is involved in alertness and the fight-or-flight response. While it affects attention and arousal, its deficiency is less directly linked to sleep dysregulation and memory loss.
D. Histamine: Histamine is primarily involved in wakefulness and allergic responses. While it plays a role in arousal, it is not the primary neurotransmitter for sleep regulation and memory.
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