Chapter 29 : Toileting Self Care Deficit Ackley and Ladwig’s Nursing Diagnosis Handbook: An Evidence -Based Guide to Planning Care 13th Edition , (2024) Test Bank Multiple Choice Question 1 of 5 During assessment, the nurse identifies that a client needs assistance with ambulation. Which of the following would the nurse identify as the most relevant defining characteristic for this client’s nursing diagnosis of toileting self -care deficit? a. Inabilit y to manipulate clothing for toileting b. Inability to get to toilet or commode c. Inability to carry out proper to ilet hygiene d. Inability to wash hands after toileting Correct b. Inability to get to toilet or commode Ambulation difficulties would most likely lead to a client not being able to get to the bathroom or to the commode easily. There is no information to suggest the client cannot mani pulate clothing, wash hands, or carry out hygiene activities. DIF: Cognitive Level: Analysis/Analyzing TOP: Nursing Process: Diagnosis MSC: Physiological Integrity: Basic Care and Comfort Question 2 of 5 The nurse is developing a plan of care for a client who uses a wheelchair and requires toileting assistance. The nurse recognizes that there is a toileting self -care deficit related to which of the following? a. Fatigue b. Decreased motivation c. Impaired transfer ability d. Environmental factors Correct
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