Author Question: The nurse is caring for a newly admitted client with Methicillin-resistant Staphylococcus Aureus ... (Read 48 times)

formula1 · **on:** Jun 25, 2018

The nurse is caring for a newly admitted client with Methicillin-resistant Staphylococcus Aureus (MRSA). Which are appropriate goals for the initial health assessment?

Select all that apply.
1. Determine the client's current state of health and ongoing health-promotion activities.
2. Predict risks to current health status.
3. Use only objective data to determine client allergies.
4. Determine how frequently the client is able to change positions.
5. Identify health-promoting activities.

Question 2

The novice nurse working on a medical-surgical unit is preparing a plan of care for a client admitted for irritable bowel syndrome. The goal statement is, The client will resume normal bowel elimination patterns.

When reviewing the plan of care with the novice nurse, which statement by the preceptor is the most appropriate?
1. This plan of care has an appropriate goal statement which meets criteria.
2. This goal statement requires a time frame to be appropriate.
3. This goal statement is not reflective of the client's admitting diagnosis.
4. This care plan is accurate and will be placed in the client's medical record.

kristenb95 · **Reply #1 on:** Jun 25, 2018

Answer to Question 1

Correct Answer: 1, 5
Health assessment goals are to determine the client's current state of health and ongoing health-promotion activities. The initial health assessment includes both objective and subjective information and seeks to determine the potential an individual has to implement health-promoting activities. Health assessment activities are used to predict risks to health, and identify health status. This includes physical, social, cultural, environmental, and emotional factors including wellness behaviors, illness signs and symptoms, client strengths and weaknesses, and risk factors. The initial health assessment does not include using objective data to determine client allergies and is not part of the initial health assessment.

Answer to Question 2

Correct Answer: 2
This goal statement does not meet criteria as it lacks a time frame. Time frames are an important component of goal statements and provide guidelines for when to evaluate the achievement of the goal. The defining characteristics of the diagnosis and the etiology of the diagnosis are components of the diagnostic statement. The nurse's role in achieving the goal is not a component of the goal statement.