The nurse recognizes that which one of the following statements is true with regard to the for-mulation of nursing diagnoses?
1. The diagnosis should identify a "cause and effect" relationship.
2. The diagnosis must remain constant during the client's hospitalization.
3. The etiology of the diagnosis must be within the scope of the health care team's practice.
4. The diagnosis should include the problem and the related contributing conditions.
ANS: 4
The diagnosis should include the problem and the related contributing conditions is a true state-ment. Related factors are causative or other contributing conditions that have influenced the client's actual or potential response to the health problem and can be changed by nursing inter-ventions. The nursing diagnosis does not identify a "cause and effect" relationship; rather, it in-dicates that the etiology contributes to or is associated with the client's problem. The nursing di-agnosis does not have to remain constant during the client's hospitalization. It should change ac-cording to changes in the patient. The etiology or cause of the nursing diagnosis must be within the domain of nursing practice and a condition that responds to nursing interventions, not those of the entire health care team.
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The RN may delegate to LPNs/LVNs a variety of data-collecting tasks, including: Standard Text: Select all that apply
1. The focused assessment at the beginning of the shift. 2. The focused assessment at the end of the shift. 3. The focused assessment of a body part in relation to client complaints. 4. Specific assessment of the nursing intervention provided. 5. Determination of nursing diagnosis related to assessment data.
The basic concepts and fundamental moral principles that govern conduct are known as _________________________
ANS:
How does the mucus of the goblet cells and the cilia of the conducting airways protect the respiratory system from invasion from foreign particles?
a. The cilia move large particles up and out, while the goblet cells neutralize the smaller particles and carry them out of the body. b. The constant upward motion of the cilia propels the mucociliary blanket toward the pharynx where foreign matter may be expectorated. c. The mucociliary blanket coats foreign bodies, which are then attacked by the immune system. d. The mucociliary blanket traps foreign matter, which is moved toward the gastrointestinal tract by the cilia and expelled.
An older adult is sore from "doing too much in the yard yesterday." Which statement by the nurse best promotes healthy aging?
A) "It's time to start exercising and eating right." B) "Let's look at how we can improve your health so you can do more." C) "Of course you can't do as much as you did before, you need to pace yourself." D) "You need to act your age, and let others do that work."