Chapter 15: Evaluating

A nursing student asks the clinical instructor to explain the difference between quality improvement and quality assurance. Which response by the clinical instructor is appropriate? a) "Quality improvement focuses on organization structure and individuals." b) "Quality assurance is concerned with client satisfaction." c) "Quality improvement focuses on processes, data, and statistical thinking." d) "Quality assurance promotes empowerment and collaboration."

"Quality improvement focuses on processes, data, and statistical thinking."

The client identifies three strategies for minimizing leakage of an ileostomy bag. This is an example of what type of outcome? a) Psychomotor outcome b) Cognitive outcome c) Affective outcome d) Physiologic outcome

Cognitive outcome

Which statement related to the evaluation of outcome attainment for a client is correct? a) Evaluation of the client's attainment of outcome goals is determined by the nurse and physician. b) The nurse should initially evaluate the plan of care at the time of the client's discharge. c) Collecting data related to outcome attainment requires the nurse to know when to collect the data, based upon established time criteria. d) Celebrating outcome achievement with a client often interferes with attainment of future goals.

Collecting data related to outcome attainment requires the nurse to know when to collect the data, based upon established time criteria.

A nurse manager notes an increase in the frequency of client falls during the last month. To promote a positive working environment, how would the nurse manager most effectively deal with this problem? a) Reprimand the nursing personnel responsible for the clients when the falls occurred. b) Determine if client falls have increased on other nursing units in the hospital. c) Institute a new policy on the prevention of client falls on the unit. d) Investigate the circumstances that contributed to client falls.

Investigate the circumstances that contributed to client falls.

The client demonstrates stair climbing using a quad cane. What type of outcome is this an example of? a) Cognitive outcome b) Physiologic outcome c) Affective outcome d) Psychomotor outcome

Psychomotor outcome

Which client outcome is a psychomotor outcome? Select all that apply. a) The client describes how to empty a Jackson-Pratt drain. b) The client reports imagery is effective in controlling anxiety. c) The client identifies five low sodium foods. d) The client catheterizes self, using clean technique. e) The client measures capillary blood sugar level.

e) • The client measures capillary blood sugar level. d) • The client catheterizes self, using clean technique.

Priority setting is based on the information obtained during reassessment. Priority setting is used to rank nursing diagnoses. Each of the following contributes to priority setting except which of the following? a) Time and resources b) Feedback from the family c) Finances of the client d) The client's condition

Finances of the client

Which of the following is the most important indicator of quality nursing care? a) The nurse takes measures to ensure accurate medication administration. b) The nurse considers the individual needs of clients. c) The nurse follows the policies and procedures of the institution. d) The nurse is organized and efficient in client care.

The nurse considers the individual needs of clients.

The terms "criteria" and "standard" are often used interchangeably but actually have distinct, separate definitions. "The levels of performance accepted by, and expected of, nursing staff or other health team members" is known as: a) evidence-based practice. b) evaluation. c) standards. d) criteria.

standards.

The Joint Commission is conducting an accreditation visit at the hospital. What is the focus of the evaluation being conducted? a) Quality assurance b) Peer review c) Magnet status d) Quality improvement

Quality assurance

A male client has been recently diagnosed with diabetes after receiving emergency treatment for a hyperglycemic episode. Which of the client's actions indicates that he has achieved a cognitive outcome in the management of his new health problem? a) The client's blood sugars have been maintained within acceptable range in the days prior to discharge. b) The client can demonstrate the correct technique for using his new glucometer. c) The client expresses a desire to change the way that he eats and the amount of exercise he performs. d) The client is able to explain when and why he needs to check his blood sugar.

The client is able to explain when and why he needs to check his blood sugar.

Which client outcome is a cognitive outcome? Select all that apply. a) The client identifies signs and symptoms of hypoglycemia. b) The client reports cycling 30 minutes three times each week. c) The client correctly ambulates with a walker. d) The client lists the side effects of digoxin (Lanoxin). e) The client describes how to perform progressive muscle relaxation.

• The client identifies signs and symptoms of hypoglycemia. • The client lists the side effects of digoxin (Lanoxin). • The client describes how to perform progressive muscle relaxation.

The nurse is orienting a new client to the facility. The client is told that her preferences and choices would be sought and honored. This represents which expectation of the health care environment? a) Individualization b) Safety c) Transparency d) Control

Individualization

Nurses are involved in many types of evaluation. All of the following are activities that are related to evaluation, but which of the following is the priority concern for nurses? a) Measuring the competence of individual nurses b) Measuring patient outcome achievement c) Patients and their care d) Helping targeted groups of patients to achieve their specific outcomes

Patients and their care

A group of nurses of the orthopedic floor of a hospital wish to improve their clinical performance. The nurse manager suggests a program in which the nurses will evaluate each other and provide feedback for improved performance. The nurses know that this program is termed which of the following? a) Quality and Safety Educatin for Nurses (QSEN) b) Peer review c) American Association of Critical-Care Nurses (AACN) d) Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS)

Peer review

The mother brings her infant into the clinic. The infant is two months old and has not been gaining weight appropriately. The outcome statement on the plan of care states "The infant will double birth weight by 6 months of age." This is an example of what type of outcome statement? a) Affective b) Psychomotor c) Cognitive d) Physical changes

Physical changes

At the beginning of prenatal care, the goal for the client was to gain 25 pounds by the end of the pregnancy. At 30 weeks of pregnancy, the client has only gained 1 pound. Which statement(s) would help the nurse most appropriately interpret this data? a) It is too early to evaluate if the goal has been achieved. The client has 10 more weeks of pregnancy. b) The client has partially achieved the determined goal. The nurse should revise the goal to reflect a more realistic outcome. c) The client is progressing toward achieving the goal. The plan should be continued. d) The client is not achieving the goal. The nurse should determine the reasons the client has not been gaining weight.

The client is not achieving the goal. The nurse should determine the reasons the client has not been gaining weight.

Which nurse is using criteria to determine expected standards of performance? a) The new graduate nurse consults the policies and procedures of the institution prior to skill implementation. b) The nurse preceptor provides feedback to the new graduate nurse after 6 weeks of orientation. c) The nurse seeks information from the unlicensed assistive personnel (UAP) regarding the family's response to the nurse's education. d) The nurse manager provides the staff nurse feedback regarding job performance for the previous year.

The new graduate nurse consults the policies and procedures of the institution prior to skill implementation.

One of the outcomes that has been identified in the care of a client with a new suprapubic catheter is that he will demonstrate the correct technique for cleaning his insertion site and changing his catheter prior to discharge. When should this outcome be evaluated? a) throughout the client's hospital admission b) once the primary care physician has written a discharge order c) when the client is discharged d) during the first home health care visit

throughout the client's hospital admission