Chapter 18: Evaluating

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

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

Which are components of an evaluative statement? Select all that apply. Description of how the client outcome was met Client's health history Name of the client's physician Client data that support how the outcome was met Client's health insurance information

Description of how the client outcome was met Client data that support how the outcome was met Explanation: An evaluative statement includes a description of how the client's outcome was met and the data that support that decision. The name of the physician, information on the client's health insurance, and the client's health history would only be included if they contributed to the client's outcome.

The nursing supervisor is evaluating how many clients each of the department nurses has been assigned for the shift. This type of evaluation would be considered: process. outcome. goal. subjective. structure.

Structure. Explanation: Availability of equipment, layout of physical facilities, nurse-client ratios, administrative support, and maintenance of nursing staff competence are some areas of concern for structure evaluation. Process, outcome, goal, and subjective evaluation address those respective categories.

Which action should the nurse perform in the evaluation phase? Carry out treatment procedures. Set priorities for care. Record interventions. Revise the plan of care.

Revise the plan of care. Explanation: The nurse should revise the plan of care during the evaluation phase. It provides the feedback mechanism that starts the entire chain of events again. Setting priorities is part of the planning phase. Carrying out treatment procedures and recording interventions are activities in the implementation phase of the nursing process.

A nurse manager attempts to achieve performance improvement in the emergency department of a busy inner-city hospital. Which nursing actions follow Haase and Miller's recommended steps in performance improvement? Select all that apply. The nurse discovers that there is a problem with the triage system that is in place in the emergency department. The nurse calls a meeting of the emergency department interdisciplinary team to effect change in the triage process. The nurse organizes a task force to implement change in the triage process of a busy emergency department. The nurse meets with the emergency department staff to assess changes made to the triage process. When the goal of making changes to the triage process in the emergency department is not met, the nurse discontinues efforts to force change. When met with resistance to change from the emergency department staff, the nurses involves management to force the changes.

The nurse discovers that there is a problem with the triage system that is in place in the emergency department. The nurse calls a meeting of the emergency department interdisciplinary team to effect change in the triage process. The nurse organizes a task force to implement change in the triage process of a busy emergency department. The nurse meets with the emergency department staff to assess changes made to the triage process. Explanation: Nurses committed to healthier clients, quality care, reduced costs, and the personal satisfaction of knowing that they are actually making a difference (versus merely wishing things were different) value performance improvement. The four steps, according to Haase & Miller, that are crucial in improving performance include:1. Discover a problem.2. Plan a strategy using indicators.3. Implement a change.4. Assess the change; if the outcome is not met, plan a new strategy.

The primary purpose for evaluating data about a client's care according to a functional health approach is to: meet accreditation standards. determine implementation of medical orders. evaluate the need for health care consultations. revise or modify the client care plan.

revise or modify the client care plan. Evaluation using the functional health approach provides a framework for organizing and evaluating data allowing the nurse to modify the client care plan. Evaluation has no influence upon meeting accreditation standards, implementation of medical orders, or the need for health care consultations.

The focus of a hospital's current quality assurance program is a comparison of the health status of clients on admission and with that at the time of discharge. This form of quality assurance is characteristic of: outcome evaluation. structure evaluation. process evaluation. nursing audit.

outcome evaluation.

The nursing staff on a hospital unit uses peer review to improve professional performance. Who performs the review? Unit manager Nurses Clients Visitors

Nurses

Which are cognitive client outcomes? Select all that apply. The client lists the side effects of digoxin. The client describes how to perform progressive muscle relaxation. The client identifies signs and symptoms of hypoglycemia. The client correctly ambulates with a walker. The client reports cycling 30 minutes three times each week.

The client lists the side effects of digoxin. The client describes how to perform progressive muscle relaxation. The client identifies signs and symptoms of hypoglycemia. Explanation: Cognitive outcomes demonstrate increases in client knowledge, such as listing side effects of medications, identifying signs and symptoms of hypoglycemia, and describing progressive muscle relaxation. Psychomotor outcomes describe the client's achievement of new skills, such as correct ambulation with a walker. An affective outcome involves changes in the client's values, beliefs, and attitude, such as the client's report of cycling.

Which nursing action reflects evaluation? The nurse identifies that the client does not tolerate activity. The nurse sets a tolerable pain rating with the client. The nurse auscultates the client's lungs and abdomen. The nurse assesses urine output following administration of a diuretic.

The nurse assesses urine output following administration of a diuretic. Explanation: Assessing the client's response to a diuretic medication is an example of evaluation. Recognition of a client health problem that can be prevented or resolved by independent nursing intervention, such as activity intolerance, is the focus of diagnosing. Auscultating the client's lungs and abdomen is an example of assessment. Setting a tolerable pain rating with the client is an example of planning.