In the PES format, what does the 'S' represent?

• A. Signs and symptoms
• B. Severity
• C. Support
• D. Symptoms only

Answer: (A)

In this format, the S stands for Signs and Symptoms—the evidence that supports the nursing diagnosis. It includes all the data that show the problem is present, combining what the patient reports (subjective symptoms) with what you observe (objective signs). This data anchors the diagnosis in reality, guiding care decisions.

Why this is the best fit: the format uses Problem, Etiology, and Signs/Symptoms to organize the diagnosis. Sign and symptom data provide the concrete basis for the diagnosis, rather than focusing on a severity label or on something like “support.” Including both signs and symptoms ensures you capture the full picture of how the problem manifests.

For example, if the diagnosis is acute pain related to tissue injury, the Signs and Symptoms might include a patient rating pain as 8/10, guarding, facial grimacing, or resting inactivity. These elements show both the patient’s experience and observable responses, which justify the nursing diagnosis.