When the nurse is developing a care plan for a terminally ill patient, what might be a realistic goal?

a. The patient will remain pain-free.
b. The patient will function optimally.
c. The patient will spend time out of bed.
d. The patient will demonstrate improved nutritional status.


ANS: B
The goal of the care plan for a terminally ill patient is to assist the patient to function optimally. The other options are not realistic.

Nursing

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The nurse is caring for a client with suspected severe sepsis. What does the nurse prepare to do within 3 hours of the client being identified as being at risk? (Select all that apply.)

a. Administer antibiotics. b. Draw serum lactate levels. c. Infuse vasopressors. d. Measure central venous pressure. e. Obtain blood cultures.

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A nurse in the pediatric clinic suspects a patient is the victim of child abuse. What action takes priority?

A. Ask a coworker to confirm the suspicions. B. Confront the parents with this information. C. Document the findings in the child's chart. D. Report the suspicions according to state law.

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The five rights of delegation are right task, right circumstance, right person, right direction and communication, and right ____

a. Interaction b. Outcome c. Supervision d. Time

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Which one of the following is a NANDA International nursing diagnosis label?

1. Frequent urination 2. Coughing and dyspnea 3. Risk for impaired parenting 4. Abnormal hygienic care practices

Nursing