ATI PN PHARMACOLOGY PROCTORED COMPLETE SOLUTION
(Detail Solutions)
1. A nurse is providing nursing care to patients after completing a care
plan from nursing diagnoses. In which step of the nursing process is the
nur
...
ATI PN PHARMACOLOGY PROCTORED COMPLETE SOLUTION
(Detail Solutions)
1. A nurse is providing nursing care to patients after completing a care
plan from nursing diagnoses. In which step of the nursing process is the
nurse?
a. Assessment
b. Planning
c. Implementation
d. Evaluation
ANS: C
Implementation, the fourth step of the nursing process, formally begins after a
nurse develops a plan of care. With a care plan based on clear and relevant
nursing diagnoses, a nurse initiates interventions that are designed to assist the
patient in achieving the goals and expected outcomes needed to support or
improve the patient’s health status. The nurse gathers data during the
assessment phase and mutually sets goals and prioritizes care during the
planning phase. During the evaluation phase, the nurse determines the
achievement of goals and effectiveness of interventions.
2. The nurse is teaching a new nurse about protocols. Which
information from the new nurse indicates a correct understanding of the
teaching?
a. Protocols are guidelines to follow that replace the nursing care plan.
Protocols assist the clinician in making decisions and choosing
b. interventions for specific health care problems or conditions.
Protocols are policies designating each nurse’s duty according to
c. standards of care and a code of ethics.
Protocols are prescriptive order forms that help individualize the plan
d. of care.
ANS: B
A clinical practice guideline or protocol is a systematically developed set of
statements that helps nurses, physicians, and other health care providers make
decisions about appropriate health care for specific clinical situations. This
guideline establishes interventions for specific health care problems or
conditions. The protocol does not replace the nursing care plan. Evidencebased
guidelines from protocols can be incorporated into an individualized
plan of care. A clinical guideline is not the same as a hospital policy. Standing
orders contain orders for the care of a specific group of patients. A protocol is
not a prescriptive order form like a standing order.
1
3. The standing orders for a patient include acetaminophen 650 mg every
4 hours prn for headache. After assessing the patient, the nurse identifies the
need for headache relief and determines that the patient has not had
acetaminophen in the past 4 hours. Which action will the nurse take next?
a. Administer the acetaminophen.
b. Notify the health care provider to obtain a verbal order.
c. Direct the nursing assistive
personnel to give the
acetaminophen. Perform a pain
assessment only
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