Ch 18: Evaluating

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.

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"

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 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 nursing audit B) An accreditation inspection C) A structure evaluation D) A process evaluation

A) A nursing audit

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

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 overhears a coworker telling a somewhat offensive joke to a client. Which nursing action is indicated? A) Report what was overheard to the charge nurse. B) Discuss the occurrence with the coworker. C) Apologize to the client for the coworker's behavior. D) Investigate whether the coworker and client have a previous relationship.

B) Discuss the occurrence with the coworker.

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.

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

A) Document reassessment of pain after medication administration.

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

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) Discovering a problem D) Assessing the change

C) Discovering a problem

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.

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.

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

C) True collaboration

A nurse evaluates clients prior to discharge from a hospital setting. Which action is the most important act of evaluation performed by the nurse? A) The nurse evaluates the client's goal/outcome achievement. B) The nurse evaluates the plan of care. C) The nurse evaluates the competence of nurse practitioners. D) The nurse evaluates the types of health care services available to the client.

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

The nurse is reassessing a client with leukemia who has received several packed red blood cell transfusions over the past week. Which question should the nurse ask the client to evaluate the treatment? A) Have you had any fevers? B) Have you experienced any tenderness in your joints? C) Have you noticed any bruising? D) Have you experienced any headaches?

A) Have you had any fevers?

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

C) standards.

Which is a psychomotor client goal? A) By 18AUG2015, the client will value health sufficiently to quit smoking. B) By 18AUG2015, the client will demonstrate improved motion in the left arm. C) By 18AUG15, the client will list three foods that are low in salt. D) By 18AUG2015, the client will learn three exercises designed to strengthen leg muscles.

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

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) Affective B) Cognitive C) Psychomotor D) Physiologic

A) Affective

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

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

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

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.

All of the activities listed are related to evaluation, but which activity is the priority concern for nurses? A) Measuring client outcome achievement B) Helping targeted groups of clients to achieve their specific outcomes C) Meeting the care needs of clients D) Measuring the competence of individual nurses

C) Meeting the care needs of clients

While evaluating a client's plan of care, the nurse would be most likely identify which problem as being associated with the implementation phase? A) Nursing orders are superficial. B) Outcomes are incorrectly developed. C) Nurses are not aware of client priorities and the plan of care. D) A long-term goal is vague and generalized.

C) Nurses are not aware of client priorities and the plan of care.

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) Cognitive B) Psychomotor C) Physical changes D) Affective

C) Physical changes

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.

A new mother is having difficulty breastfeeding a newborn infant. A goal was established stating that the baby 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. The nurse evaluates the original goal as: A) met. B) partially met. C) completely unmet. D) inappropriately chosen for this client.

C) completely unmet.

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.

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

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

A nurse is evaluating nursing care and client outcomes by using a retrospective evaluation. Which action would the nurse perform in this approach? A) The nurse directly observes the nursing care being provided. B) The nurse reviews the client chart while the client is being cared for. C) The nurse interviews the client while the client is receiving the care. D) The nurse devises a postdischarge questionnaire to evaluate client satisfaction.

D) The nurse devises a postdischarge questionnaire to evaluate client satisfaction.

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

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

The primary purpose for evaluating data about a client's care according to a functional health approach is to: A) meet accreditation standards. B) determine implementation of medical orders. C) evaluate the need for health care consultations. D) revise or modify the client care plan.

D) 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: A) process. B) outcome. C) goal. D) subjective. E) structure.

E) structure.

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

A) Peer review

"The client will demonstrate cast care prior to discharge" is which type of evaluative statement? A) Psychomotor B) Cognitive C) Affective D) Physical changes

A) Psychomotor

Before discharge the client will demonstrate aseptic dressing changes. This is an example of which type of evaluative statement? A) Psychomotor B) Cognitive C) Affective D Physical changes

A) Psychomotor

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 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.

"The client will verbalize appropriate cast care on discharge" represents which type of outcome? A) Psychomotor B) Cognitive C) Affective D) Physical change

B) Cognitive

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? A) Terminate the plan of care. B) Continue the plan of care. C) Promptly modify the plan of care. D) Suggest increasing the pain medication.

B) Continue the plan of care.

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

B) Nurses