Prep U: Chapter 18: Evaluating

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

a. Quality assurance

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.

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.

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 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. Terminate the plan of care upon client discharge. 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.

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. Psychomotor b. Cognitive c. Affective d. Physical changes

d. Physical changes

The nursing supervisor is presenting the staff nurses with yearly performance evaluations. What type of evaluation is the supervisor presenting to the staff? a. Outcome b. Technical c. Structural d. Process e. Goal

d. Process

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.

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

d. The nurse considers the individual needs of clients.

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.

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

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

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 nurse manager b. Another registered nurse with critical care certification c. One of the staff critical care physicians d. Another staff nurse from the medical-surgical unit

b. Another registered nurse with critical care certification

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. Psychomotor c. Affective d. Physiologic

b. Psychomotor

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.

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

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

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. Help the client with skin care. c. Coordinate client activities. d. Incorporate therapeutic use of self.

a. Encourage the client to ask questions.

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. Finances of the client b. The client's condition c. Time and resources d. Feedback from the family

a. Finances of the client

Quality improvement in care delivery requires which components? Select all that apply. a. Leadership commitment b. Continuous improvement c. Total client care by the nursing unit d. Focus on data collection e. Focus on the mission of the organization

a. Leadership commitment b. Continuous improvement d. Focus on data collection e. Focus on the mission of the organization

Which are psychomotor outcomes? Select all that apply. a. The client accurately draws up insulin. b. The client safely ambulates using a walker. c. The client identifies signs and symptoms of infection. d. The client rates pain as a 2 on a 0 to 10 pain rating scale. e. The client reports increased confidence in testing blood glucose level.

a. The client accurately draws up insulin. b. The client safely ambulates using a walker.

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 reports testing blood sugar before meals. c. The client identifies signs and symptoms of hypoglycemia. d. The client identifies correct insulin injection sites.

a. 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 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 identifies signs and symptoms of hypoglycemia. d. The client correctly ambulates with a walker. 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. c. The client identifies signs and symptoms of hypoglycemia.

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

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

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.

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. outcome evaluation. b. structure evaluation. c. process evaluation. d. nursing audit.

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

a. throughout the client's hospital admission

Which situations observed by a nurse should the nurse report to the nurse manager for quality assurance? Select all that apply. a. A nurse cleans a stethoscope between clients. b. A nurse assesses a client after sneezing into the nurse's hands. c. A nurse administers medications to the wrong client. d. A nurse delays answering call lights to an abusive client. e. A nurse refuses to provide care to a client with HIV.

b. A nurse assesses a client after sneezing into the nurse's hands. c. A nurse administers medications to the wrong client. d. A nurse delays answering call lights to an abusive client. e. A nurse refuses to provide care to a client with HIV.

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.