A student health nurse is counseling a female college student who wants to lose 20 pounds. The nurse develops a plan to increase the student's activity level and decreased the consumption of the wrong types of foods and excess calories. The nurse plans to evaluate the student's weight loss monthly. When the student arrives for her first "weigh-in", the nurse discovers, the student has lost only 1 pound. Which is the best nursing response?
Congratulate the student and continue the plan of care
Terminate the plan of care since it is not working
Try giving the student more time to reach the targeted outcome
Modify the plan of care after discussing possible reasons for the student's partial success
A nurse uses the following classic elements of evaluation when caring for patients. Which item below places them in their correct sequence?
1. ❌ 2. ❌ 3. ❌ 4. ❌ 5. ❌
A new nurse who is being oriented to the subacute care unit is expected to follow existing standards when providing patient care. Which nursing actions are examples of these standards?
Monitoring patient status every hour
Using intuition to troubleshoot patient problems
Turning a patient on bed rest every 2 hours
Becoming a nurse mentor to a student nurse
Administering pain medication ordered by the physician
Becoming involved in community nursing events
A nurse is collecting evaluative data for a patient who is finished recovering chemotherapy for an osteosarcoma. Which nursing action represents this step of the nursing process?
The nurse collects data to identify health problems
The nurse collects data to identify patient strengths
The nurse collects data to justify terminating the plan of care
The nurse collects data to measure outcome achievement
A nurse writes the following outcome for a patient who is trying to stop smoking: The patient appreciates or values a healthy body sufficiently to stop smoking. This is an example of what type of outcome?
Cognitive
Psychomotor
Affective
Physical changes
A nurse writes the following outcome for a patient who is trying to lose weight: The patient can explain the relationship between weight loss, increased exercise, and decreased calorie intake. This is an example of what type of outcome?
Physical change
A nurse is writing an evaluative statement for a patient who is trying to lower her cholesterol through diet and exercise. Which evaluative statement is written correctly?
Outcome not met
1/21/15 - Patient reports no change in diet
Outcome not met. Patient reports no change in diet or activity level
1/21/15 - Outcome not met. Patient reports no change in diet or activity level
A nurse is attempting to improve care on the pediatric ward of a hospital. Which nursing improvements might the nurse employ when following the recommendations of the Institute of Medicine's Committee on Quality of Health Care in America?
Basing patient care on continuous healing relationships
Customizing care to reflect the competencies of the staff
Using evidence-based decision making
Having a charge nurse as the source of control
Using safety as a system priority
Recognizing the need for secrecy to protect patient privacy
A quality-assurance program reveals a higher incidence of falls and other safety violations on a particular unit. A nurse manager states, "We'd better find the folks responsible for these errors and see if we can replace them." This is an example of
Quality by inpection
Quality by punishment
Quality by surveillance
Quality by opportunity
After one nursing unit with an excellent safety record meets to review the findings of the audit, the nurse manager states, "We're doing well, but we can do better! Who's got an idea to foster increased patient well-being and satisfaction?" This is an example of leadership that values
Quality assurance
Quality imrovement
Process evaluation
Outcome evaluation
Patient are the core of evaluation.
Nurses should evaluate patient outcome achievement as as possible.
When failure to meet designated outcomes is detected , the plan of care can be to remedy the failure.
Interpreting evaluative data requires .
The object of practice is to look at an experience, it, and from it.
A male client has been recently diagnosed with diabetes after receiving emergency treatment for a hyperglycemic episode. Which of the client's actions indicates that he has achieved a cognitive outcome in the management of his new health problem?
The client is able to explain when and why he needs to check his blood sugar
The client expresses a desire to change the way that he eats and the amount of exercise he performs
The client's blood sugars have been maintained with acceptable range in the days prior to discharge
The client can demonstrate the correct technique for using his new glucometer
The nurse is collecting data on a client presenting to the medical short-stay unit for colonoscopy. A client reports to the nurse that he quit smoking six months ago after being diagnosed with lung cancer. The nurse recognizes this change in behavior is which type of outcome?
Psychomotor outcome
Cognitive outcome
Affective outcome
Physiologic outcome
The focus of a hospital's current quality assurance program is a comparison between the health status of clients upon admission and at the time of discharge. The form of quality assurance is characteristic of what?
Structure evaluation
Nursing audit
The ANA defines components of quality care: structure evaluation, process evaluation, and outcome evaluation. Which of the following best describes structure evaluation?
The nature/sequence of activities carried out by nurses implementing the nursing process
Measurable changes in the health status of the client or the end results of the nursing care provided
Demonstrable changes in a client's health status that consider the environment for care and the nursing actions provided
Standards that describe physical facilities and equipment; organizational characteristics, policies, and procedures; fiscal resources; and personnel resources
The Joint Commission is conducting an accreditation visit at the hospital. What is the focus of the evaluation being conducted?
Magnet status
Peer review
Quality review
Which nurse is using criteria to determine expected standards of performance?
The nurse seeks information from the unlicensed nursing personnel regarding the family's response to the nurse's education
The new graduate nurse consults the policies and procedures of the institution prior to skill implementation
The nurse manager provides the staff nurse feedback regarding job performance for the previous year
The nurse preceptor provides feedback to the new graduate nurse after 6 weeks of orientation
The nurse observes a nursing colleague enter an isolation room w/out appropriate personal protective equipment. According to the study Science Kills: The Seven Crucial Conversations for Healthcare, of which type of crucial conversation category is this an example?
Broken rules
Poor teamwork
Incompetence
Mistakes
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?
Once the primary care physician has written a discharge order
Throughout the client's hospital admission
When the client is discharged
During the first home health care visit
When the nurse prepares to discharge a client, and subsequently evaluate the effectiveness of the nursing care, the nurse should determine whether the
client's goals have been achieved
physician's orders have been completed
critical pathways are completed
documentation is thorough
Why are quality-assurance programs important in nursing?
They specify how resources are used or not used
They enable nursing to be accountable for the quality of care
They allow increased retention of qualified nurses
They facilitate increased enrollment in educational programs
The nursing staff on a hospital unit are using peer review to improve professional performance. Who performs the review?
Unit manager
Visitors
Nurses
Clients
Which nursing action reflects the evaluation stage?
The nurse documents the client's response to suctioning
The nurse performs tracheostomy care using sterile technique
The nurse sets an anxiety level of 3 or less with the client
The nurse determines the client did not loose the expected 2 pounds
The nurse identifies that the client has developed a pressure ulcer
The nurse manager on an orthopedic unit has determined that the nurses are not keeping the nursing diagnoses up to date on client care plans and, in turn, the nurses are not using the plan of care. What is a feasible approach to correcting this problem?
Delegate the updating of nursing diagnoses for all clients on the unit to one nurse for each shift
Develop a process for periodic review of care plans that focuses on deleting and updating the nursing diagnoses
Provide an in-service on interviewing and physical assessment skills; discuss the importance of these skills with the staff
Request that a staff development nurse instruct the nurses on concept mapping to use instead of care planning
Which expected client outcome is an example of a psychomotor outcome?
Rating pain as a 2 on a 10-point scale
Identifying signs and symptoms of infection
Accurately drawing up insulin
Safely ambulating using a walker
Reporting increased confidence in testing blood sugar
A hospital is evaluating its policies and procedures. What type of evaluation is the hospital conducting?
Outcome
Quality
Structure
Process
Which client outcome is an example of cognitive outcome?
The client identifies 3 strategies for minimizing leakage of an ileostomy bag
The client demonstrates how to take a radial pulse
The client's pulse ranges from 60 - 100 beats per minute
The client's finger stick blood sugar is greater than 70 and less than 110
Which statement related to the evaluation of outcome attainment for a client is correct?
Evaluation of the client's attainment of outcome goals is determined by the nurse and the physician
The nurse should initially evaluate the plan of care at the time of the client's discharge
Collecting data related to outcome attainment requires the nurse to know when to collect the data based upon established time criteria
Celebrating outcome achievement with a client often interferes with attainment of future goals
Identifying the kind and amount or nursing services required is a possible solution for
Nurses who are bored
Clients who fail to communicate their needs
Nurses frustrated with substandard care
Inadequate staffing
The client identifies 3 strategies for minimizing leakage of an ileostomy bag. This is an example of what type of outcome?
Which client outcome is a cognitive outcome?
The client describes how to perform progressive muscle relaxation
The client correctly ambulates with a walker
The client identifies signs and symptoms of hypoglycemia
The client lists the side effects of digoxin (Lanoxin)
The client reports cycling 30 minutes 3x each week
Which of the following nursing action reflects evaluation?
The nurse sets a tolerable pain rating with the client
The nurse assesses urine output following administration of a diuretic
The nurse identifies that the client does not tolerate activity
The nurse auscultates the client's lungs and abdomen
The administrators of a community hospital have determined that the number of client falls has increased over the last year. Nurse managers are invited from each hospital unit to evaluate fall risk assessment tools for use on their units. What step does this represent in the performance improvement process?
Implement a change
Discovery of the problem
Planning a strategy using indicators
Assessing the change
The nurse manager is holding a staff meeting and indicates that the unit is looking at a 3% budget cut for the coming year. The nurse manager asks the staff what they see as priorities for the unit, and solicits suggestions from the staff as to what budget areas might be reduced. Which standard for establishing and sustaining healthy work environments does this action represent?
true collaboration
effective decision making
appropriate staffing
meaningful recoginition
