Author Question: A new nurse is concerned with identifying outcomes pertaining to client social interactions and ... (Read 28 times)

asmith134 · **on:** Jul 19, 2018

A new nurse is concerned with identifying outcomes pertaining to client social interactions and
client self-control. The nurse's mentor should suggest

a. using the DSM-IV-TR.
b. daily discussions with the mentor.
c. referring to the Nursing Outcomes Classification reference.
d. searching the Internet for hints.

Question 2

The nurse notes the following entry on the client's plan of care: Outcome: Client will demonstrate
suicide self-control.

Interventions: Initiate suicide precautions. Allow client to retain personal
belongings. Allow client to leave unit unsupervised.. Which principles of planning a nursing
intervention to facilitate achievement of identified client outcomes are violated? (More than one
answer may be correct.)
A. Feasibility
B. Evidence basis
C. Appropriateness
D. Within the capability of the nurse

tennis14576 · **Reply #1 on:** Jul 19, 2018

Answer to Question 1

ANS: C
The Nursing Outcomes Classification is a comprehensive list of standardized outcomes, definitions,
and measures to describe client outcomes influenced by nursing practice. Two categories found in
the classification include social interaction and self-control. Option A: The DSM-IV-TR contains
diagnostic information. Option B: Daily discussions with the mentor might be helpful but would not
yield the quantity of information found in the Nursing Outcomes Classification. Option D: This
option would not provide the focused information found in the Nursing Outcomes Classification.

Answer to Question 2

ANS:
B, C
Rationale: All interventions are not supported by evidence. Evidence supports removing personal
property that can be used to attempt self-harm. Evidence also supports restricting the client to the
unit and closely supervising client activity while on the psychiatric unit. If the client leaves the unit,
staff would accompany the client on a one-to-one basis. The interventions are inappropriate because
they do not provide a safe environment for the client. Option A: The interventions are feasible
although misguided. Option D: The interventions are within the capability of the nurse, but a nurse
using good judgment would question them.