CH 18 Evaluating

A nurse assures a client newly admitted to the clinical unit that the client will not be harmed by any errors and can expect to be safe in the facility. This assurance represents which expectation of the health care environment? A) Individualization B) Safety C) Transparency D) Control

B

The nurse works as a client advocate for an older adult client admitted with hyponatremia. Which action can the nurse take to help the client advocate for oneself? A) Coordinate client activities. B) Incorporate therapeutic use of self. C) Encourage the client to ask questions. D) Help the client with skin care.

C

The client identifies three strategies for minimizing leakage of an ileostomy bag. This is an example of: A) A cognitive outcome. B) An affective outcome. C) A psychomotor outcome. D) A physiologic outcome.

A

A nurse is evaluating the outcome of the plan of care after teaching a client how to prepare and administer an insulin pen. Which type of outcome is the nurse addressing? A) Cognitive B) Affective C) Psychomotor D) Physiologic

C

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 demonstrates administration of insulin. B) The client identifies signs and symptoms of hypoglycemia. C) The client reports testing blood sugar before meals. D) The client identifies correct insulin injection sites.

A

A mother is bringing an infant into the clinic for a well-infant checkup. The infant's weight gain is on target for age. A correctly written evaluative statement for this client is: A) "8FEB2016. Goal met. The infant's weight gain is appropriate for age." B) "Goal met" C) "8FEB2016. Goal met." D) "Progressing well."

A

A nurse is following the rules recommended by the Institute of Medicine's Committee on Quality of Health Care in America to help redesign and improve client care. Which nursing actions are based on these rules? Select all that apply. A) The nurse acknowledges that continuous decrease in waste improves client care. B) The nurse customizes care based on availability of resources. C) The nurse customizes care based on client needs and values. D) The nurse promotes shared knowledge and the free flow of information. E) The nurse becomes the source of control for client care. F) The nurse bases care on evidence-based decision making.

A, C, D, and F

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) Confront the nurse and explain how this could be dangerous for the client. C) Contact the physician for an order for the restraints. D) File an incident report and have the second nurse sign it.

B

The client identifies three strategies for minimizing leakage of an ileostomy bag. This is an example of: A) An affective outcome. B) A cognitive outcome. C) A physiologic outcome. D) A psychomotor outcome.

B

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) Process evaluation. B) Nursing audit. C) Outcome evaluation. D) Structure evaluation.

C

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

C

Identifying the kind and amount of nursing services required is a possible solution for: A) Inadequate staffing. B) Nurses who are bored. C) Clients who fail to communicate their needs. D) Nurses frustrated with substandard care.

A

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

A and E

A nurse manager is conducting peer reviews of the staff on the critical care unit. Which person would the nurse manager select to evaluate a registered nurse who is certified in critical care? A) Another staff nurse from the medical-surgical unit B) Another registered nurse with critical care certification C) Another nurse manager D) One of the staff critical care physicians

B

Which client outcome is an example of a physiologic outcome? A) The client demonstrates active range-of-motion exercises with left upper extremity. B) The client's pulse oximetry reading is 97% on room air 30 minutes after removal of a nasal cannula. C) The client reports walking for 30 minutes each day. D) The client explains how to administer a vaginal cream.

B

A new mother is having difficulty breastfeeding a newborn. A goal was established stating that the infant 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 4 days ago. The nurse evaluates the original goal as: A) Partially met. B) Met. C) Completely unmet. D) Inappropriately chosen for this client.

C

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 competence of nurse practitioners. B) The nurse evaluates the types of health care services available to the client. C) The nurse evaluates the plan of care. D) The nurse evaluates the client's goal/outcome achievement.

D

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) During the first home health care visit B) When the client is discharged C) Throughout the client's hospital admission D) Once the primary care physician has written a discharge order

C

The Joint Commission is conducting an accreditation visit at the hospital. What is the focus of the evaluation being conducted? A) Peer review B) Magnet status C) Quality improvement D) Quality assurance

D

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

D

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 interviews the client while the client is receiving the care. C) The nurse devises a postdischarge questionnaire to evaluate client satisfaction. D) The nurse reviews the client chart while the client is being cared for.

C

"The client will verbalize appropriate cast care on discharge" represents which type of outcome? A) Cognitive B) Affective C) Physical change D) Psychomotor

A

The client outcome, "The mother will express confidence in being able to meet nutritional needs of the infant," is an example of which type of outcome statement? A) Affective B) Cognitive C) Physical D) Psychomotor

A

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) At the completion of each meal B) On 3/3 C) On 3/2 D) At the client's direction

A

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: A) Structure. B) Subjective. C) Goal. D) Outcome. E) Process.

A

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) Evaluate the use of current pain relief measures. B) Create a new nursing diagnosis to reflect new goals. C) Provide additional relief with non-pharmacologic measures. D) Request a stronger analgesic from the provider.

A

The nurse on a busy acute care floor identifies that several clients with heart failure are being readmitted within 2 weeks of discharge. Which step in performance improvement is the nurse demonstrating? A) Implementing a change B) Planning a strategy using indicators C) Assessing the change D) Discovering a problem

D

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) Nursing audit. B) Process evaluation. C) Outcome evaluation. D) Structure evaluation.

C

Which nurse is using criteria to determine expected standards of performance? A) The nurse seeks information from the unlicensed assistive personnel (UAP) regarding the family's response to the nurse's education. B) 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. D) The nurse manager provides the staff nurse feedback regarding job performance for the previous year.

C

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

D

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) Surveillance B) Educational C) Psychomotor D) Maintenance

A

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

C

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

C

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: A) Subjective. B) Process. C) Outcome. D) Goal. E) Structure.

E

A nurse is reviewing the plan of care for a client. Which should the nurse identify as problems related to the planning phase of the nursing process? Select all that apply. A) Long-term goals are vague. B) Outcomes are incorrectly developed. C) Nursing orders are superficial. D) The plan of care only contains standard knowledge that most nurses would implement if there was no plan of care. E) Database input does not reflect changes in a client's condition.

A, B, C, and D

Why are quality-assurance programs important in nursing? A) They facilitate increased enrollment in educational programs. B) They enable nursing to be accountable for the quality of care. C) They allow increased retention of qualified nurses. D) They specify how resources are used or not used.

B

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 identifies signs and symptoms of hypoglycemia. B) The client identifies correct insulin injection sites. C) The client demonstrates administration of insulin. D) The client reports testing blood sugar before meals.

C

A mother brings an infant into the clinic. The infant is 2 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 which type of outcome statement? A) Affective B) Cognitive C) Physical changes D) Psychomotor

C

Which action should the nurse take when client data indicate that the stated goals have not been achieved? A) Implement a standardized plan of care. B) Change the nursing orders. C) Review each preceding step of the nursing process. D) Collect more data for the database.

C

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

C

A client is administered an anxiolytic. Which nursing action demonstrates the nurse evaluating the client? A) Collecting data about the client's history with anxiety B) Devising a plan for the client to practice anti-anxiety exercises at home C) Assigning the client a new nursing diagnosis based on the client's controlled anxiety D) Asking whether the client feels less anxious 30 minutes after administering the medicine

D

A nurse overhears a coworker telling a somewhat offensive joke to a client. Which nursing action is indicated? A) Investigate whether the coworker and client have a previous relationship. B) Apologize to the client for the coworker's behavior. C) Report what was overheard to the charge nurse. D) Discuss the occurrence with the coworker.

D

For the second time this week, a nurse reports to the nurse manager failing to perform an ordered dressing change due to a lack of time. The nurse manager recognizes that the nurse normally is very punctual and known to provide good care for clients and that the unit census has been very high this week. However, the nurse manager knows that quality care must be provided and reports this occurrence. Which approach to quality assurance does this scenario represent? A) Quality as promotion B) Quality by design C) Quality by inspection D) Quality as opportunity

D

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

D

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

D

The nursing supervisor is presenting the staff nurses with yearly performance evaluations. What type of evaluation is the supervisor presenting to the staff? A) Structural B) Goal C) Technical D) Outcome E) Process

E