Which of the following reflects the diagnosis phase?
A) The nurse identifies that the client does not tolerate activity.
B) The nurse performs wound care using sterile technique.
C) The nurse sets a tolerable pain rating with the client.
D) The nurse documents the client's response to pain medication.
Ans: A
Recognition of a client health problem that can be prevented or resolved by independent nursing intervention, such as activity intolerance, is the focus of diagnosing. Performing wound care is an example of implementation. Setting a tolerable pain rating with the client is an example of planning. Documenting the client's response to pain medication is an example of evaluation.
You might also like to view...
Select the priority nursing diagnosis for a client with a Global Assessment of Functioning (GAF) score of 10
1. Risk for Impaired Social Interaction 2. Risk for Injury 3. Knowledge Deficit 4. Risk for Communication Deficit
Which of the following is the most common sexually transmitted disease (STD)?
a. Chlamydia b. Gonorrhea c. HIV d. Syphilis
The community health nurse usually works in which area?
1. Providing care to a client who is recovering from an illness 2. Providing care for individuals in their homes 3. Health promotion and illness prevention 4. Planning care related to Medicare reimbursement
A mother is concerned that an 8-month-old baby has had two ear infections. What question should the nurse ask the mother to help determine the cause of the ear infections?
A) Does the baby have a bottle of formula in the crib each night? B) Is the baby teething? C) Are the baby's scalp and hair shampooed often? D) Are you supplementing the baby's home-prepared formula with vitamin C?