NCLEX Review: What is ADPIE & The Nursing Process?

2018 Draft

ADPIE is an acronym that stands for assessment, diagnosis, planning, implementation and evaluation. These are the steps of the nursing process, which are steps to providing proper care to your patient. The nursing process (ADPIE) is one of the ultimate things you’ll be expected to learn and master in nursing school, and for that matter, as a future nurse!

Learn about ADPIE: The Nursing Process

ADPIE, aka the nursing process, is a huge staple in the nursing world. It is vital that you have a strong foundation of it in order to be a successful future nurse, so that’s why we’re here to break it down for you. The nursing process does involve a lot of critical thinking skills, and since many nursing test questions are based on this concept, it’ll make your whole life easier once you understand it for good!

Now remember; the acronym ADPIE stands for:

  • Assessment
  • Diagnosis
  • Planning
  • Implementation
  • Evaluation

The funny thing is that we actually use ADPIE in everyday situations without even realizing it. Once you see how simple it is to think about, it will be easier to break it down during your exams. Let’s take a non-nursing example here to show you what we mean.


So you wake up on Monday morning after a late night of studying for your nursing exam, and you know that you’re going to need an extra big cup of coffee. Because it took a little longer to brew, you’re running 10 minutes late to class. You pour that delicious, warm drink into your thermos, frantically throw it in your backpack, and book it to school. When you finally make it to class, you grab your computer out of your bag and open it up, but it won’t turn on. What do you do first?

Well, first, you’re going to assess the situation. Why isn’t the computer turning on? Why is it all wet? And why is your thermos empty and everything smells like coffee?

This is the stage at which you are playing detective. You are strictly gathering data here. So similarly, in nursing, this would be the stage where you first go in to see your patient, the beginning the assessment. This is where we collect all the data about the patient, both objective and subjective.

These would be things like your first impression and vitals. What does the patient look like? Is skin their pale? Are they groaning in pain? Are their vitals stable? Is their breathing labored? Are they angry, scared, confused or delirious? Do they have a history of heart problems? What kind of medication are they taking?

These are all observations and data collection that you would take into account when doing an assessment on a patient. This is the first step in the process, and gathering all this information will allow you to move further into the process, with the next step being your nursing diagnosis.


Now the “D” in ADPIE stands for diagnosis, and that brings us to our next step after gathering that data that we were just presented with.

Well,” you say to yourself, “it seems to me from all my evidence here, that my coffee must’ve leaked out onto my computer, and therefore my computer is not working because it has gotten soaked with coffee!” Good deduction, detective!

So just like that, in our clinical assessment, we make a nursing diagnosis, where we identify actual or potential medical /health risks. The nursing diagnosis is developed by NANDA and should be prioritized based on Maslow’s hierarchy of needs. This diagnosis is key to the next step in the process: making a care plan.


Now that brings us to “P” in the acronym, which stands for planning.

When you look at your computer and have figured out what’s going on, you now have to make a quick plan. What are you going to do to fix the problem? You decide here that you need to run to get this computer fixed by a professional. “Lets see,” you think, “I have to call to see if the store is open, make an appointment, find out if my computer was backed up, leave school, take the bus to 33rd street, walk two blocks…”

So when we apply that to nursing, we make a plan based on the assessment and nursing diagnosis of our patient. This is where you would set SMART goals, which is an acronym that stands for specific, measurable, attainable, realistic and timely short-and long-term goals for the patient. From here, we can move on to the implementation part of the process.


Then comes the “I” in ADPIE; the implementation portion of the process. This is the action part of your plan; where you actually get up and bolt to the computer store to fix this, fast!

Notice here the difference between the planning stage and the implementation stage. In the planning stage, you are simply forming the plan. The implementation stage is where you act on that specific plan.

So when we take this back into nursing, this is where we implement our plan for our patient. This is the action portion of the process, where our plans our carried out. This is the step where we actually intervene to help them, like physcially giving drugs, educate, monitor, etc. After this step, we must evaluate the outcome.


And finally, we evaluate; the “E” in the ADPIE nursing process. This is the final step,  where you are done carrying out your plan. Here’s where you are waiting anxiously at the computer store, and the person helping you comes out to tell you, “Well my friend, it’s your lucky day. It was almost too late, but we saved your computer and it works like it’s brand new again. Now remember, keep liquids far away!”


This is where you ask yourself as a nurse, were we successful in making in meeting the desired outcome? Did the plan work or is it in the process of being successful?

If goals were not met, we need to reassess and begin the process over, noting why the goals weren’t met, and make changes to the new plan of care to make sure new goals will be completed.

The Nursing Process and Exam Questions

The nursing process is very relevant in nursing exams, as well as the NCLEX®. Have you ever been stuck on a question in a test, wondering which answer to choose because they all look correct? Well, a good tip to keep in mind is that many exam questions are actually just asking you to identify a part of the nursing process!

When you come to a question that makes you feel stumped, look for some keywords to make you realize the exam is asking you an assessment question, which might be: Assess, collect, determine, gather, identify, observe, do first.

If words like these are in the question, you most likely want to look at answers that involve an assessment of the patient.

Remember: Assessments are always the first step in the processa. Interventions, the fourth step, should not be implemented until an assessment has been done. This is something to burn into your brain for those exams when you are asked about priorities! This is a common mistake. You wouldn’t run to the computer store the first moment your computer didn’t turn on without do some detective work, right? Just like you don’t give your patient medication before you find out what’s really going on.

Some keywords that will trigger you to think the exam is asking you an implementation or intervention question might be: Action, next, implement, intervention.

If words like these are in the question, you most likely want to look at answers that involve an intervention.

Words such as evaluation and interpretation in the question should make you think-you guessed it- that you should be choosing an evaluation option as the answer.

See how understanding how the nursing process can help you with those tricky questions? You just gotta break it down!

Now don’t forget; when you come upon these types of questions in exams, take a breath, read the question, and then, reread the entire question. After that, go ahead and calmly ask yourself, “Which part of the nursing process is this question asking me?”

Remember; you have to get the nursing process down as a fundamental concept in order to build your critical thinking skills and not only pass your exams, but to also become a great nurse; so make sure you understand it!


Marlee Liberman

Marlee Liberman, RN, Master Nursing Scholar

As a registered nurse, Marlee understands the struggles that nursing school throws at you – not to mention the overwhelming pressure preparing for the NCLEX®! Marlee brings a unique skill set and perspective to Picmonic with her previous degree in broadcast journalism, her creativity in video production, and her wandering nomad lifestyle. Her blend of talents provides her with the knack for simplifying complicated concepts and demystifying the world of nursing.

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