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A nurse is assisting with the plan of care for a client. Which of the following activities should the nurse include in the implementation phase of the nursing process?

A.

Establishing the priorities of client care.

B.

Comparing the client's current laboratory values to previous results.

C.

Asking the client about the presence of pain.

D.

Reinforcing teaching about the client's diagnosis.

Answer and Explanation

The Correct Answer is D

A. Establishing the priorities of client care is part of the planning phase, not the implementation phase.  

 

B. Comparing laboratory values is an assessment activity that occurs before planning and implementing care.  

 

C. Asking the client about pain is an assessment activity used to gather information rather than an implementation task.  

 

D. Reinforcing teaching about the client's diagnosis is an action that occurs during the implementation phase, as it involves executing the care plan and providing direct client education.


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Correct Answer is B

Explanation

A. While connecting the client with others may provide support, it does not directly address the client’s frustrations or concerns about their therapy.

B. Asking the provider to speak with the client directly can facilitate communication about their concerns and may help address their frustrations regarding the plan of care.

C. Threatening the client with consequences for leaving is not appropriate and may increase their frustration and disengagement from care.

D. It is important to respect the client’s autonomy and right to leave, so informing them they cannot leave is not appropriate or legal without proper discharge procedures being followed.

Correct Answer is B

Explanation

A. Offering suggestions demonstrates a directive approach rather than a laissez-faire style, which typically involves minimal guidance.

B. Encouraging the AP to decide how they would like to divide client care tasks exemplifies laissez-faire leadership, as it empowers team members to make decisions independently.

C. Instructing the AP to report hourly indicates a more authoritarian leadership style, as it sets specific expectations for accountability.

D. Providing constructive criticism suggests active involvement in guiding the AP’s performance, contrasting with the hands-off approach of laissez-faire leadership.

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