ATI LPN
Timby's Introductory Medical-Surgical Nursing Thirteenth, North American Edition
Chapter 3 : The Nursing Process Questions
Question 1 of 5
A nurse is creating a plan of care and has identified several problems for the client including a collaborative problem. Which statement distinguishes a collaborative problem from a problem-focused nursing diagnosis?
Correct Answer: B
Rationale: Collaborative problems denote complications with a physiologic origin and differ from nursing diagnoses, which address client responses to various circumstances and are managed by nursing interventions. Related risk factors and defining characteristics are parts of a nursing diagnosis, not a collaborative problem. A nursing diagnosis describes a client's response to a physiologic condition or the environment and can be addressed by nursing interventions (independent or health care provider prescribed). Secondary risk factors can provide a more in-depth explanation of the cause of a problem in a nursing diagnosis. Collaborative problems do not have secondary risk factors.
Question 2 of 5
An RN has developed a plan of care for a client and shares the plan with the LPN. Which intervention(s) can the LPN perform in the implementation phase for this client? Select all that apply.
Correct Answer: A,B,E
Rationale: The role of the LPN in the implementation phase is to provide basic therapeutic and preventive nursing measures, provide client education, and record information. Exchanging information with the prescribing provider and making referrals are within the scope of practice of an RN.
Question 3 of 5
Which of the following is a true statement about critical thinking in nursing?
Correct Answer: A
Rationale: In nursing, critical thinking involves purposeful, outcome-directed thinking. Critical thinking makes judgments based on evidence rather than conjecture. Providing a foundation for evaluation and quality improvement and showing trends and patterns in client status are functions served by documentation.
Question 4 of 5
Which of the following is involved in the implementation step of the nursing process?
Correct Answer: B
Rationale: The implementation step in the nursing process involves documenting nursing care and client responses. Planning involves selecting nursing interventions, documenting the plan of care, and identifying measurable outcomes.
Question 5 of 5
Which of the following is an important element of implementation?
Correct Answer: D
Rationale: An important element of implementation is documentation. The client database includes all the information obtained from the medical and nursing history. Physical examination and diagnostic studies are not an important element of implementation. Critical thinking is intentional, contemplative, and outcome-directed thinking. Developing good critical thinking skills will make nurses more efficient and effective at resolving situations necessitating multiple interventions. Nursing orders are specific nursing directions so that all healthcare team members understand what to do for the client; therefore, they are not an important element of implementation.