Final answer:
The primary purpose of the outcome identification and planning step of the nursing process is to design a plan of care for and with the client.
Step-by-step explanation:
The primary purpose of the outcome identification and planning step of the nursing process is to design a plan of care for and with the client, which is option D. At this stage, the nurse collaborates with the client to establish goals and objectives that are client-centered and measurable. The plan of care includes specific interventions and actions to address the identified health problems and promote the well-being and recovery of the client.