Which diagnosis will the nurse document in a patient's care plan that is NANDA-I approved?
Acute pain
Sore throat
Sleep apnea
Heart failure
The Correct Answer is A
A. "Acute pain" is a NANDA-I approved nursing diagnosis that identifies a specific condition that nursing interventions can address.
B. "Sore throat" is a symptom rather than a nursing diagnosis and does not appear in NANDA-I.
C. "Sleep apnea" is classified as a medical diagnosis and not as a nursing diagnosis within NANDA-I.
D. "Heart failure" is also a medical diagnosis and not an approved nursing diagnosis, as it describes a condition rather than the patient's response or nursing concerns.
Free Nursing Test Bank
- Free Pharmacology Quiz 1
- Free Medical-Surgical Quiz 2
- Free Fundamentals Quiz 3
- Free Maternal-Newborn Quiz 4
- Free Anatomy and Physiology Quiz 5
- Free Obstetrics and Pediatrics Quiz 6
- Free Fluid and Electrolytes Quiz 7
- Free Community Health Quiz 8
- Free Promoting Health across the Lifespan Quiz 9
- Free Multidimensional Care Quiz 10
View Related questions
Correct Answer is B
Explanation
A. Atelectasis is prevented primarily through deep breathing exercises and respiratory interventions, not passive ROM.
B. Passive ROM and splinting help prevent joint contractures by maintaining joint mobility and alignment, so the absence of contractures indicates successful prevention.
C. Pressure ulcers are avoided through regular repositioning and skin care rather than passive ROM alone.
D. Renal calculi are primarily prevented through hydration and diet, not passive ROM or splinting.
Correct Answer is ["A","C","D","E"]
Explanation
A. Communication signs for airborne precautions are necessary to inform staff and visitors about the required precautions for TB, which is spread via airborne transmission.
B. A surgical mask is not adequate for TB; instead, an N95 respirator is required to filter out the airborne particles effectively.
C. The N95 respirator, gown, gloves, and eyewear are essential personal protective equipment for caring for a patient with tuberculosis. The N95 respirator specifically protects against inhaling infectious particles.
D. Negative-pressure airflow in the room is critical for tuberculosis patients to prevent airborne contaminants from spreading to other areas of the facility.
E. A private room is required to isolate the patient and reduce the risk of transmission to other patients and staff.
F. A communication sign for droplet precautions is not applicable as tuberculosis is primarily transmitted via airborne routes, not droplet transmission.