NURS 121 PrepU Chapter 18

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

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

A nurse caring for an older adult client who has dementia observes another nurse putting restraints on the client without a health care provider's order. The client is agitated and not cooperating. What would be the best initial action of the first nurse in this situation?

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

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.

Which nursing action would be most effective in helping a client learn self-care behaviors?

Model self-care behaviors for the client.

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?

Physical changes

Which nursing action reflects evaluation?

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

The nurse should evaluate client outcomes at which time?

as early as possible

The nurse is caring for a client with congestive heart failure. The nurse manager informs the nurse that the client was enrolled in a clinical trial to assess whether a 10-minute walk, 3 times per day, leads to expedited discharge. Which type of evaluation best describes what the researchers are examining?

outcome

The nurse should evaluate client outcomes at which time?

As early as possible

Which is a psychomotor client goal?

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

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?

Continue the plan of care.

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

Document reassessment of pain after medication administration.

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?

Surveillance

A client who was admitted to the acute care unit with angina pectoris is no longer having chest pain. Based on this assessment, what does the nurse decide to do with the plan of care for chest pain?

Terminate the plan of care related to the nursing diagnosis of chest pain.

Which characteristic is the most important indicator of high-quality nursing practice?

The nurse considers the individual needs of clients.

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.

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.

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?

encourage the client to ask questions

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

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

"The client will demonstrate cast care prior to discharge" is which type of evaluative statement?

psychomotor

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

standards

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?

Encourage the client to ask questions.

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 health care provider asks for the nurse's perspective of the situation. Which standard for establishing and sustaining healthy work environments does this action represent?

true collaboration

While evaluating a client's plan of care, the nurse would be most likely to identify which problem as being associated with the implementation phase?

Nurses are not aware of client priorities and the plan of care

An older adult client who is recovering from a stroke is scheduled to be transferred to the rehabilitation unit in the morning. The client is tearful and reports feeling lonely and abandoned in the hospital unit. The family visits daily, and flowers and cards are in the room. Documentation in the chart indicates that the client's pastor has been by twice in the past week to visit. Which nursing diagnosis and outcome criteria need to be addressed immediately for this client?

Ineffective Coping; verbalizes support systems.

A facility has participated in the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey and received the results. A nurse is part of the team reviewing the information. For which areas should the nurse expect the survey to provide information? Select all that apply.

Facility cleanliness Courteous treatment Pain control

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.

Which nursing action reflects evaluation?

The nurse assesses urine output following administration of a diuretic.

A nurse is evaluating nursing care and client outcomes by using a retrospective evaluation. Which action would the nurse perform in this approach?

The nurse devises a postdischarge questionnaire to evaluate client satisfaction.

Why are quality-assurance programs important in nursing

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

"Measurable qualities, attributes, or characteristics that identify knowledge or health status" defines:

criteria