Chapter 18: Evaluating PrepU

A mother brings an infant into the clinic for a well-baby visit. The mother reports being concerned at discharge from the hospital after giving birth about being able to get the infant to latch on for breastfeeding. Now, however, the mother reports success with breastfeeding. and the nurse finds that the baby is gaining weight appropriately. Which is an appropriate evaluative statement for this client?

"8FEB2016. Goal met. Mother reports that breastfeeding is going well with the infant eating every 2-3 hours and attaching to the nipple easily. Infant is gaining weight."

When recording or documenting outcome attainment in the chart, nurses are to be very clear with the descriptions used. Which term is appropriate?

"Demonstrated steps"

A client is administered an anxiolytic. Which nursing action demonstrates the nurse evaluating the client?

Asking whether the client feels less anxious 30 minutes after administering the medicine

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?

At the completion of each meal

Which is a psychomotor client goal?

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

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

A nurse overhears a coworker telling a somewhat offensive joke to a client. Which nursing action is indicated?

Discuss the occurrence with the coworker.

Which action should the nurse take during the evaluation phase of the nursing process?

Document reassessment of pain after medication administration.

The nurse is assessing the self-care capabilities of a client who will be discharged from the hospital. Which are barriers this client will likely face in meeting established nursing goals pertaining to self-care? Select all that apply.

Poor communication skills Debilitating illness Inadequate emotional coping skills Family's lack of interest in the plan of care

The Joint Commission is conducting an accreditation visit at the hospital. What is the focus of the evaluation being conducted?

Quality Assurance

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?

Quality by inspection

Which action should the nurse take when client data indicate that the stated goals have not been achieved?

Review each preceding step of the nursing process.

Which action should the nurse perform in the evaluation phase?

Revise the plan of care

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.

Which of the following best summarizes the evaluation step of the nursing process?

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

Which nursing action reflects evaluation?

The nurse assesses the client's response to pain

Which nursing action reflects evaluation?

The nurse assesses urine output following administration of a diuretic.

A nurse evaluates clients prior to discharge from a hospital setting. Which action is the most important act of evaluation performed by the nurse?

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

Why are quality-assurance programs important in nursing?

They enable nursing to be accountable for the quality of care.

What outcome does the nurse hope to achieve by evaluating the plan of care of a client who is being discharged?

To direct future nurse-client interactions

"The client will verbalize appropriate cast care on discharge" represents which type of outcome?

cognitive

Identifying the kind and amount of nursing services required is a possible solution for:

inadequate staffing

The nursing staff on a hospital unit uses peer review to improve professional performance. Who performs the review?

nurses

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

Before discharge the client will demonstrate aseptic dressing changes. This is an example of which type of evaluative statement?

psychomotor

The primary purpose for evaluating data about a client's care according to a functional health approach is to:

revise or modify the client care plan.

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:

structure

Which are psychomotor outcomes? Select all that apply.

Accurately drawing up insulin The client will safely ambulate using a walker.

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?

Another registered nurse with critical care certification

To improve quality care for clients, there are four steps that the nurse recognizes as being crucial for the process. Place them in the correct order. Use all options.

Discover a problem. Plan a strategy using indicators. Implement a change. Evaluate a change.

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?

Discovering a problem

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:

completely unmet.

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?

throughout the client's hospital admission (it is important to evaluate the client early and frequently, even if outcome time specifies "by time of discharge")

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

"The levels of performance accepted by and expected of nursing staff or other health team members" defines:

standards