ATI LPN
Foundations and Adult Health Nursing Test Bank
Chapter 5 : Nursing Process and Critical Thinking Questions
Question 1 of 5
What is an appropriate outcome statement for a patient with a patient problem of ineffective airway clearance related to thick secretions?
Correct Answer: A
Rationale: The patient goal would be to improve airway clearance. Coughing more frequently within 3 days and performing deep-breathing exercises four times daily do not directly relate to the problem of thick secretions. Breathing better within 3 days is too vague.
Question 2 of 5
What is the primary purpose of nursing interventions?
Correct Answer: B
Rationale: Nursing orders are necessary to provide instructions for all caregivers.
Question 3 of 5
What documentation reflects implementation?
Correct Answer: C
Rationale: Implementation is the nurse carrying out nursing orders to promote outcome achievement.
Question 4 of 5
Which nursing intervention is complete and correct?
Correct Answer: B
Rationale: Nursing orders must be signed, dated, and have specific designation as to who will perform intervention and specifics about time or frequency of the intervention.
Question 5 of 5
A patient with a urinary tract infection is assessed using a clinical pathway. When a projected outcome is not met by a predetermined date it is determined that what has occurred?
Correct Answer: B
Rationale: A variance occurs when a projected outcome is not met.