Care Planning, Intervention, and Treatment Principles
This domain tests clinical reasoning from problem identification through measurable goals, prioritized interventions, and evaluation. The strongest answers show why an action comes first, not just what the action is.
From assessment to plan
Build a problem list from validated data and distinguish nursing diagnoses from medical diagnoses. Write goals that are specific, measurable, achievable, relevant, and time-bound. Each intervention needs a rationale and an expected response. Evaluation compares the actual outcome with the goal and decides whether to continue, modify, or discontinue the plan. Patient preferences, culture, literacy, and resources belong in the plan, not after it.
Prioritization and intervention types
Prioritize airway, breathing, circulation, and immediate safety before comfort or routine care. Independent interventions are within the practitioner's authority, such as positioning, education, and fall precautions. Dependent interventions require an order, such as medication administration. Collaborative interventions require coordinated action across disciplines. Medication administration follows the rights: right patient, drug, dose, route, time, documentation, and reason. Informed consent requires capacity, disclosure, comprehension, and voluntariness; the provider obtains consent, and the nurse verifies and witnesses it.
Worked example
Two patients call at once: one has new inspiratory stridor after a procedure, and the other requests a scheduled pain medication. Reasoning: stridor suggests upper airway obstruction and is an airway emergency. The nurse stays with the stridor patient, calls for help, and positions the patient upright while preparing for emergency equipment. The pain medication can be delegated to another qualified nurse or given once the airway is stable. Airway always outranks scheduled comfort measures.
Traps that cost marks
- Writing goals that cannot be measured or timed.
- Intervening before completing an adequate assessment.
- Choosing a comfort intervention over an airway or circulation threat.
- Omitting evaluation from the plan.
- Confusing a nursing diagnosis with a medical diagnosis.
- Assuming the nurse obtains informed consent rather than verifying it.