Nurs 222 Chapter 18 CoursePoint

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

b) Description of how the client outcome was met. d) Client data that support how the outcome was met.

The nurse and client have written the following outcome measure: "The client will eat at least 80% of each meal offered by 3/2." When should the nurse collect information to evaluate this outcome? a) On 3/2 b) On 3/3 c) At the completion of each meal d) At the client's direction

c) At the completion of each meal

The nurse is assessing the client's behavioral response to a nursing intervention. This type of evaluation is known as: a) structural evaluation b) behavior modification c) outcome evaluation d) process evaluation

c) outcome evaluation

The client identifies three strategies for minimizing leakage of an ileostomy bag. This is an example of: a) an affective outcome b) a psychomotor outcome c) a physiologic outcome d) a cognitive outcome

d) a cognitive outcome

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

d) revise or modify the client care plan.

A nurse caring for an older adult client who has dementia observes another nurse putting restraints on the client without a physician's order. The client is agitated and not cooperating. What would be the best initial action of the first nurse in this situation? a) Report the nurse applying the restraints to the supervisor. b) File an incident report and have the second nurse sign it. c) Confront the nurse and explain how this could be dangerous for the client. d) Contact the physician for an order for the restraints.

c) Confront the nurse and explain how this could be dangerous for the client.

A nurse is evaluating nursing care and client outcomes by using a retrospective evaluation. Which action would the nurse perform in this approach? a) The nurse directly observes the nursing care being provided. b) The nurse reviews the client chart while the client is being cared for. c) The nurse interviews the client while the client is receiving the care. d) The nurse devises a pos-tdischarge questionnaire to evaluate client satisfaction.

d) The nurse devises a post-discharge questionnaire to evaluate client satisfaction.

A large university hospital has commissioned a multidisciplinary group to review client records following discharge to evaluate client outcomes and the character and quality of nursing care that clients receive. Which type of evauation process will take place? a) A nursing audit b) An accreditation inspection c) A structure evaluation d) A process evaluation

a) A nursing audit

The nurse should evaluate client outcomes at which time? a) As early as possible b) The day of discharge c) Within 24 hours after identifying them d) Several days after discharge

a) As early as possible

"The client will demonstrate cast care prior to discharge" is which type of evaluative statement? a) Psychomotor b) Cognitive c) Affective d) Physical changes

a) Psychomotor

Which is a psychomotor client goal? a) By 18AUG2015, the client will value health sufficiently to quit smoking. b) By 18AUG2015, the client will demonstrate improved motion in the left arm. c) By 18AUG15, the client will list three foods that are low in salt. d) By 18AUG2015, the client will learn three exercises designed to strengthen leg muscles.

b) By 18AUG2015, the client will demonstrate improved motion in the left arm.

Which action is appropriate when evaluating a client's responses to a plan of care? a) Reinforce the plan of care when each expected outcome is achieved. b) Terminate the plan if there are difficulties achieving the goals/outcomes. c) Continue the plan of care if more time is needed to achieve the goals/outcomes. d) Terminate the plan of care upon client discharge.

c) Continue the plan of care if more time is needed to achieve the goals/outcomes.

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

c) Quality assurance

The health care team has convened to discuss the care of an end-of-life client who is not able to achieve an acceptable level of comfort. The physician asks for the nurse's perspective of the situation. Which standard for establishing and sustaining healthy work environments does this action represent? a) Skilled communication b) Effective decision making c) True collaboration d) Appropriate staffing

c) True collaboration

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: a) structure evaluation b) process evaluation c) outcome evaluation d) nursing audit

c) outcome evaluation

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) when the client is discharged b) during the first home health care visit c) throughout the client's hospital admission d) once the primary care physician has written a discharge order

c) throughout the client's hospital admission

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

d) Finances of the client

Which action should the nurse perform in the evaluation phase? a) Carry out treatment procedures b) Set priorities for care c) Record interventions d) Revise the plan of care

d) Revise the plan of care

The nurse is caring for a postoperative client who reports ineffective pain management with pain rated a 7 on a 0-10 rating scale. Based on the information provided by the client, which step should the nurse take first to modify the care plan? a) Create a new nursing diagnosis to reflect new goals. b) Evaluate the use of current pain relief measures. c) Request a stronger analgesic from the provider. d) Provide additional relief with non-pharmacologic measures.

b) Evaluate the use of current pain relief measures.

A group of nurses on 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. This program is termed: a) Quality and Safety Educatin for Nurses (QSEN) b) Peer review c) Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) d) American Association of Critical-Care Nurses (AACN)

b) Peer review

A client with a new diagnosis of diabetes will be discharged on insulin therapy. Which client psychomotor outcome does the nurse expect after client education? a) The client reports testing blood sugar before meals. b) The client demonstrates administration of insulin. c) The client identifies signs and symptoms of hypoglycemia. d) The client identifies correct insulin injection sites.

b) The client demonstrates administration of insulin.

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

b) The nurse considers the individual needs of clients.

A nurse on the unit fails to help a colleague ambulate a client even though there is time to do so. Which are appropriate responses by the nurse who required assistance with the client? Select all that apply. a) "We all have to work together as a team to provide quality care for our clients." b) "Never mind, I will get someone else to help." c) "This client is in need of our assistance, and everyone who is free should come together for improved client outcomes." d) "Please come and help and work together with me as a team." e) "If you don't assist me with client care, you may as well go home."

a) "We all have to work together as a team to provide quality care for our clients." c) "This client is in need of our assistance, and everyone who is free should come together for improved client outcomes." d) "Please come and help and work together with me as a team."

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

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

Which action should the nurse take during the evaluation phase of the nursing process? a) Document reassessment of pain after medication administration. b) Provide the client with a follow-up appointment after discharge. c) Have the client give input into plan of care upon admission. d) Discontinue the indwelling urinary catheter per the provider's order.

a) Document reassessment of pain after medication administration.

Which are major premises of a quality-improvement (QI) program? Select all that apply. a) QI determines whether nursing standards are being upheld. b) QI programs may be mandated by some governmental agencies. c) QI focuses on processes rather than individuals. d) QeI should ideally be performed 1 or 2 times per year. e) QI's focus is on ensuring excellence in care.

a) QI determines whether nursing standards are being upheld. b) QI programs may be mandated by some governmental agencies. c) QI focuses on processes rather than individuals. e) QI's focus is on ensuring excellence in care.

The nurse manager observes one of the unit nurses failing to wash hands on entering a client room. Hospital protocol is to wash hands before and after entering a client room. This scenario is an example of which approach to quality assurance? a) Quality by inspection b) Quality as opportunity c) Quality by perception d) Quality as initiative

a) Quality by inspection

A nurse is working as part of a quality assurance team that uses the American Nurses Association model. The team is evaluating the resources of the facility as well as the physical facilities and equipment. Which type of evaluation is the team engaged in? a) Structure evaluation b) Process evaluation c) Outcome evaluation d) Quality by inspection

a) Structure evaluation

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

a) The client is able to explain when and why the client needs to check the blood glucose level.

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

a) The client lists the side effects of digoxin. b) The client describes how to perform progressive muscle relaxation. d) The client identifies signs and symptoms of hypoglycemia.

A nurse evaluates clients prior to discharge from a hospital setting. Which action is the most important act of evaluation performed by the nurse? a) The nurse evaluates the client's goal/outcome achievement. b) The nurse evaluates the plan of care. c) The nurse evaluates the competence of nurse practitioners. d) The nurse evaluates the types of health care services available to the client.

a) The nurse evaluates the client's goal/outcome achievement.

Identifying the kind and amount of nursing services required is a possible solution for: a) inadequate staffing b) clients who fail to communicate their needs c) nurses who are bored d) nurses frustrated with substandard care

a) inadequate staffing

A client comes into the clinic for a routine postoperative visit. While the nurse is assessing the level of pain, the client states that there is occasional discomfort but that pain levels have improved daily since returning home from the hospital. What should the nurse's response be regarding the client's plan of care? a) Terminate the plan of care. b) Continue the plan of care. c) Promptly modify the plan of care. d) Suggest increasing the pain medication.

b) Continue the plan of care.

"The client will verbalize appropriate cast care on discharge" represents which type of outcome? a) Psychomotor b) Cognitive c) Affective d) Physical change

b) Cognitive

The nurse participates in a quality assurance program and reviewing evaluation data from the previous year. Which should the nurse recognize as an example of outcome evaluation? a) A 4% increase in the number of baccalaureate-prepared nurses employed in the facility. b) Bed occupancy rates of 97% in the critical care areas and 92% in the non-critical care areas. c) A 2% reduction in the number of repeat admissions for clients who underwent hip replacement surgery. d) A rate of 98% of clients admitted to the hospital who had a nursing history completed within 24 hours after admission.

c) A 2% reduction in the number of repeat admissions for clients who underwent hip replacement surgery.

Which statement regarding the difference between data collected for assessment and data collected for evaluation is correct? a) There is no difference between data collected for assessment and data collected for evaluation. b) Data collected for assessment relate to the client health history, whereas data collected for evaluation identify the actions of physician orders. c) Data collected for assessment identify client health issues, whereas data collected for evaluation determine whether client outcomes are being achieved. d) Data collected for assessment are part of the client's health record but are not further used for client care.

c) Data collected for assessment identify client health issues, whereas data collected for evaluation determine whether client outcomes are being achieved.

The nurse in a burn intensive care unit (BICU) is caring for a 3-year-old child who was burned with scalding hot water. The client has burns covering 75% of the body. The client's condition is critical but stable. At 1000, the nurse reassesses the client and finds that the client is agitated and pulling at the endotracheal tube. Which is the nurse's priority intervention for this client at this time? a) Providing medication for agitation. b) Repositioning to prevent pressure injuries. c) Ensuring that the endotracheal tube is secure. d) Changing the dressing to prevent infection.

c) Ensuring that the endotracheal tube is secure.

Before discharge the client will demonstrate aseptic dressing changes. This is an example of which type of evaluative statement? a) Cognitive b) Affective c) Psychomotor d) Physical changes

c) Psychomotor

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

c) The client measures capillary blood glucose level. d) The client self-catheterizes using clean technique.

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

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

A new mother is having difficulty breastfeeding a newborn infant. A goal was established stating that the baby would be nursing every 2 to 3 hours by age 1 week. The mother presents to the follow-up center at 1 week and reports having discontinued breastfeeding. The nurse evaluates the original goal as: a) met b) partially met c) completely unmet d) inappropriately chosen for this client

c) completely unmet

When recording or documenting outcome attainment in the chart, nurses are to be very clear with the descriptions used. Which term is appropriate? a) "Inadequate skills" b) "Great response" c) "Extremely well-mannered" d) "Demonstrated steps"

d) "Demonstrated steps"

Which authoritative statements guide current professional nursing practice? a) National Institutes of Health publications b) Nursing Interventions Classification c) Risk Appraisal Index d) American Nurses Association Standards of Nursing Practice

d) American Nurses Association Standards of Nursing Practice

For a client with a self-care deficit, the long-term goal is that the client will be able to dress oneself by the end of the 6-week therapy. For best results, when should the nurse evaluate the client's progress toward this goal? a) When the client is discharged b) At the end of the 6-week therapy c) Only when the client shows some progress d) As soon as possible

d) As soon as possible

All of the activities listed are related to evaluation, but which activity is the priority concern for nurses? a) Measuring client outcome achievement b) Helping targeted groups of clients to achieve their specific outcomes c) Measuring the competence of individual nurses d) Meeting the care needs of clients

d) Meeting the care needs of clients

A hospital is evaluating its policies and procedures. What type of evaluation is the hospital conducting? a) Outcome b) Process c) Quality d) Structure

d) Structure

While auscultating a client's lung sounds, the nurse notes crackles in the left lower lobe, which were not present at the start of the shift. The nurse is engaged in which type of nursing intervention? a) Educational b) Psychomotor c) Maintenance d) Surveillance

d) Surveillance

Which of the following best summarizes the evaluation step of the nursing process? a) The nurse completes a health assessment to establish a database. b) The client and family have met health care goals and no longer need care. c) The nurse and client identify nursing diagnoses and appropriate interventions. d) The nurse and client measure achievement of planned outcomes of care.

d) The nurse and client measure achievement of planned outcomes of care.

Which nursing action reflects evaluation? a) The nurse identifies that the client has wound drainage. b) The nurse sets an anxiety level of 3 or less with the client. c) The nurse performs colostomy irrigation. d) The nurse assesses the client's response to pain medication.

d) The nurse assesses the client's response to pain medication.

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

d) The nurse assesses urine output following administration of a diuretic.