PrepU Chapter 18: Evaluating

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 3/2 C. On 3/3 D. At the client's direction

A. At the completion of each meal

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. Psychomotor C. Educational D. Maintenance

A. Surveillance

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. structure. E. goal.

A. subjective.

Prior to the first visit following gastrectomy, the client will have a weight loss of 10 lb (4.5 kg). This is an example of which type of evaluative statement? A. Affective B. Psychomotor C. Cognitive D. Physical changes

D. Physical changes

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

B. Client data that support how the outcome was met C. Description of how the client outcome was met

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

B. a cognitive outcome.

"The levels of performance accepted by and expected of nursing staff or other health team members" defines: A. evidence-based practice. B. criteria. C. standards. D. evaluation.

C. standards.

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

B. The client identifies signs and symptoms of hypoglycemia. C. The client lists the side effects of digoxin. D. The client describes how to perform progressive muscle relaxation.

Which nursing action reflects evaluation? A. The nurse performs colostomy irrigation. B. The nurse sets an anxiety level of 3 or less with the client. C. The nurse assesses the client's response to pain medication. D. The nurse identifies that the client has wound drainage.

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

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. Encourage the client to ask questions. B. Incorporate therapeutic use of self. C. Help the client with skin care. D. Coordinate client activities.

A. Encourage the client to ask questions.

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

A. QI programs may be mandated by some governmental agencies. B. QI focuses on processes rather than individuals. C. QI's focus is on ensuring excellence in care. E. QI determines whether nursing standards are being upheld.

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. Safety B. Control C. Transparency D. Individualization

A. Safety

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

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

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

B. The client lists the side effects of digoxin. C. The client describes how to perform progressive muscle relaxation. D. The client identifies signs and symptoms of hypoglycemia.

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. Appropriate staffing B. True collaboration C. Effective decision making D. Skilled communication

B. True collaboration

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 evaluation process will take place? A. A structure evaluation B. A process evaluation C. A nursing audit D. An accreditation inspection

C. A nursing audit

The nurse is preparing to evaluate the goals set for a newborn and mother. What physiologic goals will the nurse evaluate for effectiveness? Select all that apply. A. By 4/6/20, the parents will list appropriate resources in case questions arise after discharge. B. Before discharge, the parents will demonstrate confidence in bathing and feeding their baby. C. Before discharge, the baby with a birth weight of 7 lb, 6 oz (3.3 kg) will have reached a target weight of 8 lb (3.6 kg). D. By 4/6/20, the newborn will demonstrate 2 hours of sleep prior to breastfeeding at night. E. Before discharge, the parents of the baby will verbalize decreased anxiety about taking care of a newborn. F. By 4/6/20, the mother will demonstrate a pain rating of 0 on a 0 to 10 scale.

C. Before discharge, the baby with a birth weight of 7 lb, 6 oz (3.3 kg) will have reached a target weight of 8 lb (3.6 kg). D. By 4/6/20, the newborn will demonstrate 2 hours of sleep prior to breastfeeding at night. F. By 4/6/20, the mother will demonstrate a pain rating of 0 on a 0 to 10 scale.

A nurse has been providing discharge teaching to a client with type 1 diabetes. Which outcome indicates that the teaching has been effective? A. Before discharge, the client will understand proper foot care and eye care. B. By a certain date, the client will talk to a dietitian regarding information for a diabetic diet. C. By a certain date, the client will verbalize signs and symptoms of hypoglycemia. D. Before discharge, the client will attempt to administer a subcutaneous injection.

C. By a certain date, the client will verbalize signs and symptoms of hypoglycemia.

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

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

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

C. Document reassessment of pain after medication administration.

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

C. Nurses

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 Education for Nurses (QSEN) B. Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) C. Peer review D. American Association of Critical-Care Nurses (AACN)

C. Peer review

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 manager provides the staff nurse feedback regarding job performance for the previous year. 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.

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 nurse and client identify nursing diagnoses and appropriate interventions. C. The nurse and client measure achievement of planned outcomes of care. D. The client and family have met health care goals and no longer need care.

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

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

D. "Demonstrated steps"

A client reports to the nurse quitting smoking 6 months ago after being diagnosed with lung cancer. The nurse recognizes this change in behavior is which type of outcome? A. Psychomotor B. Physiologic C. Cognitive D. Affective

D. Affective

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

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. Planning a strategy using indicators B. Implementing a change C. Assessing the change D. Discovering a problem

D. Discovering a problem

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

D. The client demonstrates administration of insulin.

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 expresses a desire to change the way that the client eats and exercises. B. The client has maintained blood glucose levels within acceptable range in the days prior to discharge. C. The client can demonstrate the correct technique for using a new glucometer. D. The client is able to explain when and why the client needs to check the blood glucose level.

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

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. inappropriately chosen for this client. C. met. D. completely unmet.

D. 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? A. once the primary care physician has written a discharge order B. during the first home health care visit C. when the client is discharged D. throughout the client's hospital admission

D. throughout the client's hospital admission