Kozier Chapter 14

The nurse, as a member of the quality assurance committee, evaluates what components of care? A: Structure, process, and outcome B: Outcomes, client satisfaction, and evaluation of level of care C: Client care improvement, evidence-based practices, and outcome evaluations D: Internal assessment, care plans, and methods of reimbursement

A: Structure, process, and outcome

The nurse determines that the plan of care is not effective and that modification is needed. The nurse reviews which of the following prior to altering the plan of care? (select all that apply) A: Are goals realistic? B: Are nuring diagnoses relevant and accurate? C: Are data complete, accurate, and validated? D: Did the client agree that outcomes were not met? E: Do new nursing diagnoses require new goals?

A: Are goals realistic? B: Are nuring diagnoses relevant and accurate? C: Are data complete, accurate, and validated? E: Do new nursing diagnoses require new goals?

When performing an effective evaluation, the nurse compares current assessment findings to data from the: (select all that apply) A: Assessment phase B: Diagnosing phase C: Implementing phase D: Documentation phase E: Planning phase

A: Assessment phase E: Planning phase

The primary purpose of the evaluating phase of the care planning process is to determine whether: A: Desired outcomes have been met B: Nursing activities were carried out C: Nursing activities were effective D: Client's condition has changed

A: Desired outcomes have been met

The nurse ensures positive client outcomes by using what skills? A: Interpersonal B: Technical C: Activity D: Problem Solving E: Psychomotor

A: Interpersonal B: Technical D: Problem Solving

The main purpose for the nurse to use a checklist for care plan evaluation is: A: It identifies areas that require the nurse's further examination B: To determine if the care plan was effective C: It stays within a timeframe and does not look beyond the due date of interventions D: To see if all interventions were carried out

A: It identifies areas that require the nurse's further examination

The nurse preceptor tells the student to request assistance if: (select all that apply) A: It would cause less stress on the client B: The student is unsure of how to perform the activity C: Implementing an activity alone would be unsafe D: The student has already done the intervention three times and does not want to do it again E: Other nurses are not busy

A: It would cause less stress on the client B: The student is unsure of how to perform the activity C: Implementing an activity alone would be unsafe

Which of the following demonstrates appropriate use of guidelines in implementing nursing interventions? (select all that apply) A: No interventios should be carried out without the nurse having clear rationales B: Always follow the primary care provider's orders exactly, without variation C: Encourage all clients to be as dependent as desired and allow the nurse to perform care for them D: When possible, give the client options in how interventions will be implemented E: Each intervention should be accompanied by client teaching

A: No interventios should be carried out without the nurse having clear rationales D: When possible, give the client options in how interventions will be implemented E: Each intervention should be accompanied by client teaching

The quality assurance staff of a hospital is conducting a study to determine infection rates in postoperative clients. What type of quality assurance program is this? A: Outcome evaluation B: Quality improvement C: Structure evaluation D: Process evaluation

A: Outcome evaluation

The nurse develops a quality assurance (QA) program to evaluate and promote excellence in the health care provided to clients and recognizes the need for what components of care evaluation to meet this goal? A: Process evaluation B: Nurse-client ratios C: Outcome evaluation D: Structure evaluation E: Number of incident reports

A: Process evaluation C: Outcome evaluation D: Structure evaluation

When initiating the implementation phase of the nursing process, the first step the nurse performs is: A: Reassessing the client B: Determining the need for assistance C: Carrying out nursing interventions D: Documenting interventions

A: Reassessing the client

The nursing unit has decided to do a nursing audit to determine the time from client admission until the admission history is fully completed. Which of the following methods would be appropriate for the nursing unit to use? (select all that apply) A: Reviewing clinical records B: Interviewing the family C: Conducting peer reviews D: Directly observing nursing care E: Interviewing the client

A: Reviewing clinical records D: Directly observing nursing care

Which of the following is true regarding the relationship of implementing to the other phases of the nursing process? A: The findings from the assessing phase are reconfirmed in the implementing phase B: After implementing, the nurse moves to the diagnosing phase C: The nurse's need for involvement of other health care team members in implementing occurs during the planning phase D: Once all interventions have been completed, evaluating can begin

A: The findings from the assessing phase are reconfirmed in the implementing phase

The nurse may need to revise or modify a goal statement if: A: The nursing diagnosis was inaccurate B: Nursing goals are appropriate C: All databases are complete D: The client has not met the goal

A: The nursing diagnosis was inaccurate**

If the nurse planned to evaluate the length of time clients must wait for a nurse to respond to a client need reported over the intercom system on each shift, which process does this reflect? A: Structure evaluation B: Process evaluation C: Outcome evaluation D: Audit

B: Process evaluation

Quality improvement is different than quality assurance. The main difference is that: A: Quality improvement reports are published. Quality assurance reports are internal. B: Quality improvement aims to evaluate and improve the quality of health care based on internal assessment C: Quality improvement follows organizational structure and quality assurance follows client care D: Quality improvement is internal and quality assurance is external

B: Quality improvement aims to evaluate and improve the quality of health care based on internal assessment

Consider the following nursing diagnosis for a client who is on bed rest. Risk for Impaired Skin Integrity related to bed rest. The nursing interventions are derived from the etiologic portion of the nursing diagnosis, which includes: A: Select high-protein foods at each meal B: Turn and reposition every 2 hours C: Offer a back rub from time to time D: Provide a daily bath

B: Turn and reposition every 2 hours

The nurse recognizes which of the following actions as an example of an outcome evaluation? A: A survey is conducted to analyze patterns of staffing B: An audit is conducted to determine the number of postoperative infections C: A nurse checks a client's blood pressure before administering a new antihypertensive medication D: Nursing documentation is reviewed for compliance with hospital standards

B: An audit is conducted to determine the number of postoperative infections

Effective evaluation of the client's response to nursing care requires: A: Judging conclusions about a problem status B: Collecting data for comparison to goals C: Performing interventions appropriately D: Determining when other phases were implemented

B: Collecting data for comparison to goals

Which of the following represents application of the components of evaluating? A: Goal achievement must be written as either completely met or unmet B: Data related to expected outcomes must be collected C: If the outcome was achieved, conclude that the plan was effective D: After determining that the outcome was not met, start over with a new nursing care plan

B: Data related to expected outcomes must be collected

The nurse understands that the implementation phase of the nursing process concludes with: A: Assessing the outcome of implementation B: Implementing the nursing interventions C: Reassessing the client D: Determining the nurse's need for assistance

B: Implementing the nursing interventions

The client has a high-priority nursing diagnosis for Risk for Impaired Skin Integrity related to the need for several weeks of imposed bed rest. The nurse evaluates the client after 1 week and finds the skin integrity is not impaired. When the care plan is reviewed, the nurse should perform which of the following? A: Delete the diagnosis since the problem has not occurred B: Keep the diagnosis since the risk factors are still present C: Modify the nursing diagnosis to Impaired Mobility D: Demote the nursing diagnosis to a lower priority

B: Keep the diagnosis since the risk factors are still present

The nurse documents that the goal or desired outcome was met, partially met, or not met. What part of the evaluation statement is the nurse documenting? A: Supporting data B: Planning C: Conclusion D: Collecting data

C: Conclusion

Prior to making modifications to the care plan, the nurse must: A: Identify other nursing diagnoses B: Complete the admission assessment C: Identify if the interventions chosen were appropriately implemented D: Determine if the client's input was used to choose the nursing diagnoses

C: Identify if the interventions chosen were appropriately implemented

The care plan calls for administration of a medication plus client education on diet and exercise for high blood pressure. The nurse finds the blood pressure extremely elevated. The client is very distressed with this finding. Which nursing skill of implementing would be needed most? A: Cognitive B: Intellectual C: Interpersonal D: Psychomotor

C: Interpersonal

The nursing team on a specific unit decides to determine if client call bells are answered in a timely manner. This will be measured by someone on the team documenting time from call bell ringing to nurse response. This reflects what type of quality assurance process? A: Structure evaluation B: Outcome evaluation C: Process evaluation D: Audit

C: Process evaluation

When initiating the implementation phase of the nursing process, the nurse performs which of the following phases first? A: Carrying out nursing interventions B: Determining the need for assistance C: Reassessing the client D: Documenting interventions

C: Reassessing the client

When implementing nursing interventions, the nurse displays cognitive skills by: A: Performing nursing procedures appropriately B: Using strong verbal skills C: Using critical thinking D: Conveying cultural sensitivity

C: Using critical thinking

An element of quality improvement, rather than quality assurance, is which of the following? A: Focus is on individual outcomes B: Evaluates organizational structures C: Aims to confirm that quality exists D: Plans corrective actions for problems

D: Plans corrective actions for problems

The evaluation statement is written by the nurse on the care plan or in the nurse's notes and consists of: A: Outcome evaluation and process B: Process evaluation and conclusions C: Structure evaluation and conclusion D: Conclusion and supporting data

D: Conclusion and supporting data

What are the two parts in a nursing evaluation statement? A: Conclusion and implementation B: Implementation and data analysis C: Implementation and summary D: Conclusion and supporting data

D: Conclusion and supporting data

Which of the following accurately explain how the nurse chooses a nursing intervention? A: Interventions are nurse-initiated activities only B: Interventions are chosen to alleviate or reduce the impact of the client's medical diagnosis C: Most interventions are part of the nurse's dependent role D: Interventions focus on the etiology of the nursing diagnosis

D: Interventions focus on the etiology of the nursing diagnosis

Under what circumstances is it considered acceptable practice for the nurse to document a nursing activity before it is carried out? A: When the activity is routine (e.g., raising the bed rails) B: When the activity occurs at regular intervals (e.g., turning the client in bed) C: When the activity is to be carried out immediately (e.g., a stat medication) D: It is never acceptable

D: It is never acceptable

The nurse utilizes interpersonal skills when: A: Turning the client in bed B: Transferring a bilateral amputee from bed to chair using a Hoyer lift C: Applying Buck's traction D: Orienting a new colleague

D: Orienting a new colleague