321 Practice Questions – Evaluation – Flashcards
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When a nursing supervisor evaluates the staff nurse's performance with a group of clients to whom the staff nurse has provided nursing care, the supervisor is performing which type of evaluation? a) Outcome evaluation b) Process evaluation c) Summary evaluation d) Structure evaluation
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b
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_______ evaluation focuses on the nurse's performance and whether the nursing care provided was appropriate and competent.
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process
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The nurse participates in a quality assurance program. Data from the previous year indicates a 2% reduction in the number of repeat admissions for clients who underwent hip replacement surgery. The nurse recognizes this is which type of evaluation? a) Structure evaluation b) Outcome evaluation c) Design evaluation d) Process evaluation
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b
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The primary purpose for evaluating data about a client's care according to a functional health approach is to a) Evaluate the need for healthcare consultations b) Revise or modify the nursing care plan c) Determine implementation of medical orders d) Meet accreditation standards
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b
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_______ evaluation may use postdischarge questionnaires and client interviews, or chart reviews after the client has been discharged.
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retrospective
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_______ evaluation occurs while the client is receiving care and may include the following: direct observation of nursing care and client interviews; and direct observation of chart reviews during hospitalization.
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concurrent
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Which statement related to the evaluation of outcome attainment for a client is correct? a) Celebrating outcome achievement with a client often interferes with attainment of future goals. b) Evaluation of the client's attainment of outcome goals is determined by the nurse and physician. c) The nurse should initially evaluate the plan of care at the time of the client's discharge. d) Collecting data related to outcome attainment requires the nurse to know when to collect the data based upon established time criteria.
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d
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The nurse is collecting data on a client presenting to the medical short-stay unit for a 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? a) Physiologic outcome b) Affective outcome c) Cognitive outcome d) Psychomotor outcome
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b
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_______ outcomes pertain to changes in client values, beliefs, and attitudes and are more complex to evaluate. Changes in behaviors, such as the cessation of smoking or nutritional changes that lead to weight loss, are examples of this.
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affective
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_______ outcomes involve an increase in client knowledge and are evaluated by asking the client to repeat information or perform a skill.
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cognitive
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_______ outcomes describe the client's achievement of a new skill.
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psychomotor
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_______ outcomes result in physical changes and are evaluated through physical assessment.
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physiologic
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Select all answer choices that apply. Which activity does the nurse perform during the evaluating stage? Select all that apply. a) Increases the frequency of repositioning from every two hours to every one hour. b) Validates with the client the problem of constipation. c) Identifies smoking and sedentary lifestyle as risk factors for hypertension. d) Collects data to determine the number of catheter-associated infections on the nursing unit. e) Sets a goal of ambulating from bed to room door and back to bed.
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a, d
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During the _______ stage, the nurse modifies the plan of care if desired outcomes are not achieved (increased frequency of repositioning) and collects data, such as number of infections, to monitor quality and effectiveness of nursing practice.
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evaluation
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During the _______ stage, the nurse identifies factors contributing to the client's health problem, such as smoking and sedentary lifestyle, and validates the identified health problems (such as constipation) with the clients.
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diagnosis
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The nurse establishes plan priorities and sets goals with the client and family during the _______ and _______.
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outcome identification, planning
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The ability to describe the rationale and technique for blood glucose monitoring indicates that the client has achieved a _______ outcome. Demonstration of the technique constitutes a psychomotor outcome, while the expression of a desire for change is an affective outcome. The maintenance of healthy blood sugars is a physiologic outcome.
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cognitive
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The ability to describe the rationale and technique for blood glucose monitoring indicates that the client has achieved a cognitive outcome. Demonstration of the technique constitutes a _______ outcome, while the expression of a desire for change is an affective outcome. The maintenance of healthy blood sugars is a physiologic outcome.
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psychomotor
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The ability to describe the rationale and technique for blood glucose monitoring indicates that the client has achieved a cognitive outcome. Demonstration of the technique constitutes a psychomotor outcome, while the expression of a desire for change is an _______ outcome. The maintenance of healthy blood sugars is a physiologic outcome.
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affective
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The ability to describe the rationale and technique for blood glucose monitoring indicates that the client has achieved a cognitive outcome. Demonstration of the technique constitutes a psychomotor outcome, while the expression of a desire for change is an affective outcome. The maintenance of healthy blood sugars is a ________ outcome.
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physiologic
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The Joint Commission is conducting an accreditation visit at the hospital. What is the focus of the evaluation being conducted? a) Magnet status b) Peer review c) Quality assurance d) Quality improvement
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c
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Accreditation by the Joint Commission evaluates _______, which is an externally driven process, demonstrating nursing excellence by meeting professional standards of care.
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quality assurance
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_______ is an internally driven continuous process, focusing on the processes of client care.
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quality improvement
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_______ is a process whereby individual nurses improve their professional performance through the evaluation of one staff member by another staff member on the same level of the hierarchy.
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peer review
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_______ is awarded by the American Nurses Credentialing Center, recognizing health care organizations for their excellence in nursing.
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magnet status
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Which nursing action reflects evaluation? a) The nurse assesses the client's response to pain medication. b) The nurse performs a colostomy irrigation. c) The nurse identifies that the client has wound drainage. d) The nurse sets an anxiety level of 3 or less with the client.
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a
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Examples of _______ include assessing the client's response to pain medication.
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evaluation
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The focus of ______ is recognition of a client health problem that can be prevented or resolved by independent nursing intervention, such as a wound infection.
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diagnosing
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Setting an anxiety rating with the client is an example of _______.
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planning
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Performing colostomy irrigation is an example of _______.
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implementation
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_______ outcomes demonstrate increases in client knowledge, such as strategies for minimizing leakage of an ileostomy bag.
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cognitive
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_______ outcomes demonstrate increases in client knowledge, such as listing side effects of medications, identifying signs and symptoms of hypoglycemia, and describing progressive muscle relaxation.
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cognitive
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The nurse has contacted the physician regarding a client who is experiencing shortness of breath, tachycardia, and hypotension. The nurse conveys information using SBAR. Which standard for establishing and sustaining healthy work environments does this action represent? a) Skilled communication b) Meaningful recognition c) True collaboration d) Effective decision making
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a
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_______ requires health team members to communicate in a respectful, non-intimidating manner with colleagues.
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skilled communication
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_______ is a standardized communication technique in the healthcare setting, using a concise, structured format to share client information.
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SBAR
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______ involves lack of knowledge and skill to perform a particular task, such as administering packed red blood cells through an existing IV infusing 5% dextrose in water.
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incompetence
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_______ are unintended errors, such as administering a medication at the wrong time and providing a meal tray to a NPO client.
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mistakes
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Failure to flush the nasogastric tube between medications is an example of _______.
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breaking rules
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A nurse is caring for a client who is recovering from stroke. Which of the following would the nurse perform in the evaluation phase? a) Setting priorities b) Revising the plan of care c) Reassessing the client d) Recording actions
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b
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Which nursing action is an example of incompetence? a) The nurse administers phenytoin (Dilantin) at 7 am instead of when ordered at 9 am. b) The nurse fails to flush the nasogastric tube between medications. c) The nurse provides a breakfast tray to the client who is NPO. d) The nurse administers packed red blood cells through an existing IV infusing 5% dextrose in water.
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d
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The nurse has responded to a client's request to view her medical chart by arranging a meeting between the client, the clinical nurse leader, and her primary care physician. The nurse is exemplifying which of the following characteristics of quality health care? a) Individualization b) Science c) Information d) Cooperation
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c
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The Institute of Medicine's Committee on Quality Health Care in America has identified aspects of care that clients can reasonably expect. One of these expectations is ________, which is manifested by allowing clients access to their medical records. Other characteristics that clients can expect are knowledge-based care (science), coordination between professionals (cooperation), and respect for client choices and preferences (individualization).
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information
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The Institute of Medicine's Committee on Quality Health Care in America has identified aspects of care that clients can reasonably expect. One of these expectations is information, which is manifested by allowing clients access to their medical records. Other characteristics that clients can expect are knowledge-based care (_______), coordination between professionals (cooperation), and respect for client choices and preferences (individualization).
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science
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The Institute of Medicine's Committee on Quality Health Care in America has identified aspects of care that clients can reasonably expect. One of these expectations is information, which is manifested by allowing clients access to their medical records. Other characteristics that clients can expect are knowledge-based care (science), coordination between professionals (_______), and respect for client choices and preferences (individualization).
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cooperation
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The Institute of Medicine's Committee on Quality Health Care in America has identified aspects of care that clients can reasonably expect. One of these expectations is information, which is manifested by allowing clients access to their medical records. Other characteristics that clients can expect are knowledge-based care (science), coordination between professionals (cooperation), and respect for client choices and preferences (________).
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individualization
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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 is which type of evaluation? a) Design evaluation b) Process evaluation c) Outcome evaluation d) Structure evaluation
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b
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________ evaluation focuses on the nature and sequence of activities carried out by nurses implementing the nursing process, such as the timing of nursing care plan creation.
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process
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________ evaluation focuses on measurable changes in the health status of clients.
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outcome
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________ evaluation focuses on the environment in which care is provided.
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structure
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Select all answer choices that apply. Which activity does the nurse engage in during evaluation? Select all that apply. a) Collect data to determine whether desired outcomes are met. b) Adjust the time frame to achieve the desired outcomes. c) Assess the effectiveness of planned strategies. d) Initiate activities to achieve the desired outcomes. e) Involve the client and family in formulating desired outcomes.
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a, b, c
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The nurse establishes desired outcomes with the client and family during the _________ and _______ stage. The nurse initiates activities to achieve the desired outcomes during the implementation stage. During the evaluation stage, the nurse collects data to determine whether desired outcomes are met, assesses the effectiveness of planned strategies, and adjusts the time frame to achieve the desired outcomes.
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outcome identification, planning
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The nurse establishes desired outcomes with the client and family during the outcome identification and planning stage. The nurse initiates activities to achieve the desired outcomes during the ________ stage. During the evaluation stage, the nurse collects data to determine whether desired outcomes are met, assesses the effectiveness of planned strategies, and adjusts the time frame to achieve the desired outcomes.
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implementation
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The nurse establishes desired outcomes with the client and family during the outcome identification and planning stage. The nurse initiates activities to achieve the desired outcomes during the implementation stage. During the ________ stage, the nurse collects data to determine whether desired outcomes are met, assesses the effectiveness of planned strategies, and adjusts the time frame to achieve the desired outcomes.
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evaluation
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Select all answer choices that apply. Which nursing action reflects the evaluation stage? Select all that apply. a) The nurse documents the client's response to suctioning. b) The nurse sets an anxiety level of 3 or less with the client. c) The nurse identifies that the client has developed a pressure ulcer. d) The nurse performs tracheostomy care using sterile technique. e) The nurse determines the client did not lose the expected two pounds.
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a, e
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Examples of ________ include documenting the client's response to suctioning and making a judgment that the client did not reach the expected outcome of a two-pound loss. The focus of diagnosing is recognition of a client health problem that can be prevented or resolved by independent nursing intervention, such as a pressure ulcer. Setting an anxiety rating with the client is an example of planning. Performing tracheostomy care is an example of implementation.
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evaluation
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Examples of evaluation include documenting the client's response to suctioning and making a judgment that the client did not reach the expected outcome of a two-pound loss. The focus of ________ is recognition of a client health problem that can be prevented or resolved by independent nursing intervention, such as a pressure ulcer. Setting an anxiety rating with the client is an example of planning. Performing tracheostomy care is an example of implementation.
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diagnosis
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Examples of evaluation include documenting the client's response to suctioning and making a judgment that the client did not reach the expected outcome of a two-pound loss. The focus of diagnosing is recognition of a client health problem that can be prevented or resolved by independent nursing intervention, such as a pressure ulcer. Setting an anxiety rating with the client is an example of ________. Performing tracheostomy care is an example of implementation.
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planning
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Examples of evaluation include documenting the client's response to suctioning and making a judgment that the client did not reach the expected outcome of a two-pound loss. The focus of diagnosing is recognition of a client health problem that can be prevented or resolved by independent nursing intervention, such as a pressure ulcer. Setting an anxiety rating with the client is an example of planning. Performing tracheostomy care is an example of ________.
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implementation
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The nurse assesses urine output following administration of a diuretic. Which step of the nursing process does this nursing action reflect? a) Assessment b) Implementation c) Outcome identification d) Evaluation
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d
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Identifying the kind and amount of nursing services required is a possible solution for: a) Clients who fail to communicate their needs. b) Nurses who are bored. c) Inadequate staffing. d) Nurses frustrated with substandard care.
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c
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The nurse observes a nursing colleague enter an isolation room without appropriate personal protective equipment. According to the study Silence Kills: The Seven Crucial Conversations for Healthcare, of which type of crucial conversation category is this an example? a) Poor teamwork b) Incompetence c) Mistakes d) Broken rules
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d
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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 falls-risk assessment tools for use on their units. What step does this represent in the performance improvement process? a) Assessing the change b) Implementing a change c) Discovery of the problem d) Planning a strategy using indicators
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d
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________ of assessment tools is an example of planning a strategy using indicators. The discovery of the problem has already occurred, and the process has moved to the second step of planning. Upon acceptance of a falls-risk assessment tool, the process will move to the implementation phase, and after the tool has been used for a period of time, the process will be assessed.
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evaluation
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Evaluation of assessment tools is an example of planning a strategy using indicators. The discovery of the problem has already occurred, and the process has moved to the second step of ________. Upon acceptance of a falls-risk assessment tool, the process will move to the implementation phase, and after the tool has been used for a period of time, the process will be assessed.
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planning
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Evaluation of assessment tools is an example of planning a strategy using indicators. The discovery of the problem has already occurred, and the process has moved to the second step of planning. Upon acceptance of a falls-risk assessment tool, the process will move to the ________ phase, and after the tool has been used for a period of time, the process will be assessed.
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implementation
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A _______ is a method of evaluating nursing care that involves reviewing patient records to assess the outcomes of nursing care or the process by which these outcomes were achieved.
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nursing audit
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An _______ evaluation focuses on health status changes in the patient while structure evaluation addresses the environment in which care is provided.
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outcome
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A ________ evaluation addresses performance expectations during the various stages of the nursing process.
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process
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True/False: It is most beneficial for the manager to frame incident reports as sources of improvement, which can improve both client care and the work environment. Punitive follow-up by demotion, probation, or removal is likely to create reluctance among staff to complete incident reports. Cross-referencing incident reports with client satisfaction reports is unlikely to result in substantial improvements to the unit's care and culture.
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true
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Select all answer choices that apply. Which client outcome is a physiologic outcome? Select all that apply. a) The client self-administers insulin subcutaneously. b) The client's HA1c is 7.4%. c) The client rates his or her pain rating as 6. d) The client's blood pressure is 118/74. e) The client describes manifestations of wound infection.
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b, c, d
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An older adult client has lost significant muscle mass during her recovery from a systemic infection. As a result, she has not yet met the outcomes for mobility and activities of daily living that are specified in her nursing plan of care. How should her nurses best respond to this situation? a) Continue the plan of care with the aim of helping the client achieve the outcomes. b) Replace the client's individualized plan of care with a clinical pathway. c) Terminate the plan of care since it does not accurately reflect the client's abilities. d) Modify the plan of care to better reflect the client's current functional ability.
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a
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True/False: Nurses regularly evaluate clients' progression toward the achievement of outcomes that are specified in plans of care. When clients need more time to achieve desired outcomes, it is appropriate to continue with the existing plan of care. It is not necessary to terminate the plan of care and modification may be premature. Abandoning the plan and replacing it with a clinical pathway is counterproductive to the continuity of care.
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true
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Upon evaluation of the client's plan of care, the nurse determines that the expected outcomes have been achieved. Based upon this response, the nurse will do what? a) Terminate the plan of care. b) Modify the plan of care. c) Continue the plan of care. d) Re-evaluate the plan of care.
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a
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The nurse is giving a shift report to the oncoming nurse who will be caring for a client with a portacath access device. The oncoming nurse states, "I have never taken care of a client with a portacath. Would you give me the basics, so I know what to do?" Which standard for establishing and sustaining healthy work environments is the oncoming nurse breaching? a) Appropriate staffing b) Skilled communication c) True collaboration d) Effective decision making
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a
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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? a) Effective decision making b) Appropriate staffing c) Meaningful recognition d) True collaboration
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a
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The nurse is conducting a peer review of a nursing colleague. Which action by the nurse is an example of peer review? a) The nurse seeks feedback from the nurse manager regarding job performance for the previous year. b) The nurse seeks information from the unlicensed nursing personnel regarding the family's response to the nurse's teaching. 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 six weeks of orientation.
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d
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When a nursing supervisor evaluates the staff nurse's performance with a group of clients to whom the staff nurse has provided nursing care, the supervisor is performing which type of evaluation? a) Outcome evaluation b) Process evaluation c) Structure evaluation d) Summary evaluation
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b
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A nursing student asks the clinical instructor to explain the difference between quality improvement and quality assurance. Which response by the clinical instructor is appropriate? a) "Quality improvement focuses on organization structure and individuals." b) "Quality improvement focuses on processes, data, and statistical thinking." c) "Quality assurance is concerned with patient satisfaction." d) "Quality assurance promotes empowerment and collaboration."
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b
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The nurse reports for a day shift and learns that the unit is understaffed due to several sick calls. The charge nurse has arranged for two unlicensed assistive personnel to be available due to the nursing shortage on this morning. The nurse is aware that this shortage has the potential to affect the nursing care delivered on the unit on this day. What type of variable has the nurse identified as potentially affecting the care delivery? a) Patient variable b) Legal variable c) Nurse variable d) Healthcare system variable
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d
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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 preceptor provides feedback to the new graduate nurse after six weeks of orientation. c) The new graduate nurse consults the policies and procedures of the institution prior to skill implementation. d) The nurse seeks information from the unlicensed nursing personnel regarding the family's response to the nurse's education.
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c
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________ are the levels of performance accepted and expected by the nursing staff and other health team members, such as institutional policies and procedures.
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standards
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The nurse preceptor providing feedback to the new graduate nurse after six weeks of orientation is an example of ________.
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peer review
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The nurse manager providing the staff nurse feedback regarding job performance for the previous year is typical of an annual _______.
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employee review
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Quality improvement focuses on processes, data, statistical thinking, and patient satisfaction and promotes empowerment and collaboration.
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quality improvement
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_______ focuses on organization structure and individuals and is externally driven.
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quality assurance
