Chapter 18

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

cognitive

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

standards

Which nurse is using criteria to determine expected standards of performance?

the new graduate nurse consults the policies and procedures of the institution prior to skill implementation

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 infant 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."

Which is a psychomotor client goal?

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

A nurse manager attempts to achieve performance improvement in the emergency department of a busy inner-city hospital. Which nursing actions follow Haase and Miller's recommended steps in performance improvement? Select all that apply.

The nurse discovers that there is a problem with the triage system that is in place in the ER. The nurse calls a meeting of the ER interdisciplinary team to effect change in the triage process. The nurse organizes a task force to implement change in the triage process of a busy ER. The nurse meets with the ER staff to assess changes made to the triage process.

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

nurses

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 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

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

The nurse participates in a quality assurance program and reviews evaluation data for the previous month. The data indicates a nursing plan was developed within 8 hours of admission for 97% of all admissions. The nurse recognizes this as which type of evaluation?

process evaluation

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

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

Why are quality-assurance programs important in nursing?

they enable nursing to be accountable for the quality of care

Which statement regarding the difference between data collected for assessment and data collected for evaluation is correct?

Data collected for assessment identify client health issues, whereas data collected for evaluation determine whether client outcomes are being achieved.

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 client with a new diagnosis of diabetes will be discharged on insulin therapy. Which client psychomotor outcome does the nurse expect after client education?

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?

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

The client identifies three strategies for minimizing leakage of an ileostomy bag. This is an example of:

a cognitive outcome

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

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

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?

finances of the client

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

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

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

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?

true collaboration

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

document reassessment of pain after medication administration

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

quality assurance

A nurse manager is preparing for a visit from The Joint Commission. The nurse manager determines that this visit reflects which type of evaluation?

retrospective evaluation

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

the nurse considers the individual needs of clients

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

The nurse in a burn intensive care unit (BICU) is caring for a 3-year-old child who was burned with scalding hot water. The client has burns covering 75% of the body. The client's condition is critical but stable. At 1000, the nurse reassesses the client and finds that the client is agitated and pulling at the endotracheal tube. Which is the nurse's priority intervention for this client at this time?

ensuring that the endotracheal tube is secure

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?

evaluate the use of current pain relief measures

The nurse determines that a client has not met the goal of consuming at least 80% of each meal served by a designated date. Which response(s) by the nurse would be appropriate regarding this lack of goal attainment? Select all that apply.

Do you think it is possible that you will be able to eat 80% of the food served here? What kinds of things have we been doing to increase your appetite? Do you think you could meet the goal if we check on it in one week or so?

Which are cognitive client outcomes? Select all that apply.

The client lists the side effects of digoxin. The client describes how to perform progressing muscle relaxation. The client identifies 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?

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

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:

peer review