Which question best guides decisions to modify a care plan when goals are not met?

• A. Were the desired patient outcomes met?
• B. Were the nursing interventions appropriate & effective?
• C. Do the outcomes and/or interventions need to be modified?
• D. Was the plan implemented exactly as written?

Answer: (C)

When goals aren’t met, the next step is to adjust the plan based on what the current results show. The best guiding question is whether the outcomes and/or interventions need modification. This focuses your attention on closing the gap between where the patient is and where you want them to be, by deciding if you should revise the expected outcomes, change the actions you’re taking, or both. It reflects the iterative nature of care planning: evaluate, then modify to better fit the patient’s status and preferences. Looking at whether outcomes were met tells you the result but not how to move forward; evaluating whether interventions were appropriate focuses on actions but doesn’t directly address updating the plan; and checking if the plan was implemented as written assesses fidelity, not effectiveness. In practice, you use this question to guide adjustments, such as redefining goals, adding or changing interventions, or altering timelines, to steer progress toward the desired outcomes.