Questions: 2. The Nurse Christine, observe a patient who is very apprehensive over the operation. The patient is experiencing dyspnea, diaphoresis, and excessive preoperative. This Nursing Diagnosis? (A) Actual B. Probable C. Possible D. Risk 3. The Nurse Christine diagnosed Mrs. Rodna, who has undergone a knee surgery. The diagnosis is SELF ESTEEM DISTURBANCE R/T CHANGE IN BODY IMAGE, has not yet seen her lost leg, Christine already anticipated the diagnosis of Diagnosis? A. Actual B. Probable C. Possible D. Risk 4. Nurse Taina is about to make a diagnosis but very unsure because the patient experiencing is not specific with her diagnosis of POWERLESSNESS R/T ACCEPTING LOSS OF LOVED ONE. She then focuses on gathering data to confirm the diagnosis but her plans and interventions are already ongoing for the patient. What type of Diagnosis is this? A. Actual B. Probable C. Possible D. Risk 5. Nurse Taina knew that Mr. Gerald, has just undergone an operation on the diaphragm. She knew that this will contribute to some complications. She should develop what type of Nursing diagnosis? A. Actual B. Probable C. Possible D. Risk 6. Which of the following Nursing diagnosis is INCORRECT? A. Fluid volume deficit R/T Diarrhea B. High risk for injury R/T Absence of side rails C. Possible ineffective coping R/T Loss of loved one

2. The Nurse Christine, observe a patient who is very apprehensive over the operation. The patient is experiencing dyspnea, diaphoresis, and excessive preoperative. This Nursing Diagnosis?
(A) Actual
B. Probable
C. Possible
D. Risk

3. The Nurse Christine diagnosed Mrs. Rodna, who has undergone a knee surgery. The diagnosis is SELF ESTEEM DISTURBANCE R/T CHANGE IN BODY IMAGE, has not yet seen her lost leg, Christine already anticipated the diagnosis of Diagnosis?
A. Actual
B. Probable
C. Possible
D. Risk

4. Nurse Taina is about to make a diagnosis but very unsure because the patient experiencing is not specific with her diagnosis of POWERLESSNESS R/T ACCEPTING LOSS OF LOVED ONE. She then focuses on gathering data to confirm the diagnosis but her plans and interventions are already ongoing for the patient. What type of Diagnosis is this?
A. Actual
B. Probable
C. Possible
D. Risk

5. Nurse Taina knew that Mr. Gerald, has just undergone an operation on the diaphragm. She knew that this will contribute to some complications. She should develop what type of Nursing diagnosis?
A. Actual
B. Probable
C. Possible
D. Risk

6. Which of the following Nursing diagnosis is INCORRECT?
A. Fluid volume deficit R/T Diarrhea
B. High risk for injury R/T Absence of side rails
C. Possible ineffective coping R/T Loss of loved one
Transcript text: 2. The Nurse Christine, observe a patient who is very apprehensive over the operation. The patient is experiencing dyspnea, diaphoresis, and excessive preoperative. This Nursing Diagnosis? (A) Actual B. Probable C. Possible D. Risk 3. The Nurse Christine diagnosed Mrs. Rodna, who has undergone a knee surgery. The diagnosis is SELF ESTEEM DISTURBANCE R/T CHANGE IN BODY IMAGE, has not yet seen her lost leg, Christine already anticipated the diagnosis of Diagnosis? A. Actual B. Probable C. Possible D. Risk 4. Nurse Taina is about to make a diagnosis but very unsure because the patient experiencing is not specific with her diagnosis of POWERLESSNESS R/T ACCEPTING LOSS OF LOVED ONE. She then focuses on gathering data to confirm the diagnosis but her plans and interventions are already ongoing for the patient. What type of Diagnosis is this? A. Actual B. Probable C. Possible D. Risk 5. Nurse Taina knew that Mr. Gerald, has just undergone an operation on the diaphragm. She knew that this will contribute to some complications. She should develop what type of Nursing diagnosis? A. Actual B. Probable C. Possible D. Risk 6. Which of the following Nursing diagnosis is INCORRECT? A. Fluid volume deficit R/T Diarrhea B. High risk for injury R/T Absence of side rails C. Possible ineffective coping R/T Loss of loved one
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Solution

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  1. The answer is (A) Actual. An actual nursing diagnosis is used when there is evidence of the problem, such as the symptoms described: orthopnea, diaphoresis, and apprehension over the operation.

  2. The answer is (D) Risk. Since Mrs. Rodna has not yet seen her lost leg, the diagnosis of self-esteem disturbance related to a change in body image is anticipated, indicating a risk for this issue once she becomes aware of her body change.

  3. The answer is (C) Possible. Nurse Taina is unsure and is still gathering data, which suggests that the diagnosis is not confirmed but is a possibility. Therefore, it is a possible diagnosis.

  4. The answer is (D) Risk. Since Mr. Gerald has just undergone an operation on the diaphragm, Nurse Taina should anticipate potential complications, which makes it a risk diagnosis.

  5. The answer is (B) High risk for injury R/T Absence of side rails. This is incorrect because the absence of side rails is an environmental factor, not a patient condition, and should be addressed as a safety measure rather than a nursing diagnosis.

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