An elderly client was given a nursing diagnosis of risk for injury related to disorientation. Which statement would the nurse use as appropriate for an expected outcome? The client:

Question

1. Maintains continence on four out of five voidings.
2. Does not become lost or sustain injury during wanderings.
3. Sleeps through the night and stays awake most of the day.
4. Receives appropriate care consistent with his or her specific values and expected outcomes.

Answer 1

2. Does not become lost or sustain injury during wanderings.

Rationale:
The client "does not become lost or sustain injury during wanderings" is the correct answer because it relates to the diagnosis and is measurable. The client "maintains continence on four out of five voiding" is an incorrect answer because it does not relate to the diagnosis. The client "sleeps through the night and stays awake most of the day" is an incorrect answer because it does not relate to the diagnosis. The client "receives appropriate care consistent with his or her specific values and expected outcomes" is an incorrect answer because expected outcomes are unknown and not measurable.