Question

when evaluating a clients plan of care, the nurse determines that a desired outcome was not achieved. which action should the nurse implement first?
a add additional nursing orders to the plan.
b establish a new nursing diagnosis.
c collaborate with the healthcare provider to make changes.
d note which actions were not implemented.

Explanation:

When a desired outcome is unmet, the first step is to assess why. The nurse must first verify if the planned interventions were actually carried out, as unimplemented actions are a common root cause. Other steps (adding orders, new diagnoses, collaborating with providers) come after identifying if non-implementation is the issue.

Answer:

D Note which actions were not implemented.