Deck 20: Evaluation

Question 1

The primary purpose of the nursing evaluation process is to:
1) Determine the effectiveness of the nursing care provided
2) Identify interventions that are ineffective in achieving client goals
3) Establish the progress the client is making towards health and wellness
4) Critique the nurse's ability to implement appropriate nursing interventions

Answer 1

1
The evaluation process determines the effectiveness of nursing care.The remaining options are all examples of evaluation but do not reflect the primary purpose of nursing evaluation.

Question 2

Which of the following questions,asked by a nurse,best reflects an understanding of effective evaluation?
1) "Do you feel confident in the use of your glucometer?"
2) "Have you been following your low carbohydrate diet?"
3) "Any questions regarding the tests you are scheduled for today?"
4) "May we review what we discussed earlier about your medications?"

Answer 2

4
In effective evaluation,the nurse compares client behavior and responses that were assessed before delivering nursing interventions with behavior and responses that occur after administering nursing care.The answer shows direct client knowledge related to the material previously discussed,while the other options reflect close-ended questions that require only a yes or no answer.

Question 3

The nurse formulates a diagnosis of knowledge deficit related to complications of pregnancy.One outcome criterion is that the client can state five symptoms that indicate a possible problem that should be reported.The client is able to tell the nurse three symptoms.The evaluation statement would be:
1) Goal met;client able to state three symptoms
2) Goal not met;client able to list three symptoms
3) Goal not met;client unable to list five symptoms
4) Goal partially met;client able to state three symptoms

Answer 3

4
The client is showing changes but does not yet meet criteria set;therefore,the goal is partially met.The client's response,being able to state three symptoms,does not meet or exceed the outcome criteria of being able to state five symptoms.The client's response,being able to list three symptoms,demonstrates some change.If the client were showing no progress,then the goal would not be met.If the client were showing no progress,then the goal would not be met.However,this client's response does indicate some change.

Question 4

A nurse is providing care for a client receiving normal saline when the IV infiltrates.Which of the following nursing actions represents the evaluation phase of the nursing process?
1) IV is discontinued.
2) Warm compress applied to IV site.
3) Site reinspected for presence of swelling.
4) IV site observed as having significant swelling.

Question 5

Which of the following statements best defines quality improvement (performance improvement)?
1) The assessment of the delivery system responsible for the implementation of client-oriented interventions
2) Integration of evidence-based practice research into the delivery process used to implement client-oriented interventions
3) High-priority evaluation process directed towards differentiating between good and poor intervention delivery by providers
4) An ongoing evaluation of interventions that is used to improve the delivery of health care for the purpose of managing the client's needs

Question 6

Which of the following statements best reflects a goal based on a clinical standard of practice?
1) Client will lose 10 pounds in 90 days.
2) Client will walk 30 feet with minimal assistance.
3) Client's peripheral intravenous site will be free of redness.
4) Client's chronic pain will be managed with oral medication by discharge.

Question 7

The primary reason for documenting discontinued portions of the care plan when a client goal has been met is to ensure:
1) Effective use of both nursing time and resources
2) Delivery of both timely and relevant nursing care
3) Concrete evidence of successful outcome achievement
4) Minimal ineffective communication among the nursing staff

Question 8

The nurse has determined the following outcome for a client with a skin impairment: "Erythema will be reduced in 3 days." Evaluation will specifically focus on:
1) Selection of appropriate wound care
2) Notation of the odor and color of drainage
3) Inspection of the color and condition of the area
4) Measurement of the diameter of the ulceration daily

Question 9

A client shares with the nurse that they have,"almost reached the goal of smoking only one-half pack of cigarettes a day." The best example of a nursing intervention to correct this unmet outcome is:
1) Discuss with the client the desire to comply with the ordered therapy
2) Suggest that the client use another smoking cessation tool to achieve the goal
3) Reevaluate the time frame originally decided upon for achievement of the goal
4) Suggest that the strength of the prescribed nicotine patches be increased to 21 mg

Question 10

The client smokes two packs of cigarettes per day.The nurse works with the client,and they agree that he will smoke one cigarette less each week until he is down to one pack per day.In 3 weeks,the client is smoking two and a half packs of cigarettes per day.This is an example of:
1) A realistic goal
2) A compliant client
3) A negative evaluation
4) A nonmeasurable goal

Question 11

The nurse has identified a nursing diagnosis of knowledge deficit regarding the need to monitor blood glucose levels daily.Which of the following statements best reflects the client's understanding of the need for therapy?
1) Client agrees to test blood glucose levels 4 times a day.
2) Client records blood glucose levels for a 3-week period.
3) Client is observed testing his blood glucose level before breakfast.
4) Client is able to demonstrate the proper technique for performing a finger stick.

Question 12

Which of the following nursing notes demonstrates the best evaluation of nursing interventions regarding the care provided?
1) "Pressure ulcer located on left heel has shown improvement."
2) "Pressure ulcer located on left heel has responded to treatment."
3) "Pressure ulcer on left heel is no longer producing purulent drainage."
4) "Pressure ulcer on left heel has not enlarged in size within the last 24 hours."

Question 13

The client is able to ambulate without signs or symptoms of shortness of breath.Which statement by the nurse is the best example of an objective evaluation of the client's goal attainment?
1) "Client has no pain after ambulating."
2) "Client has no manifestations of nausea while up in hall."
3) "Client walked well and did not have any problem when up."
4) "Client has no evidence of respiratory distress when ambulating."

Question 14

Based on the following outcome criterion determined by the nurse: "Client will independently complete necessary assessments prior to administration of digoxin (cardiotonic)" the nurse will evaluate the client's ability to:
1) Assess the respiratory rate
2) Palpate the radial pulse
3) Review dietary habits
4) Inspect color of the skin

Question 15

Which of the following outcomes best reflects a nurse-sensitive client outcome?
1) Client will consume 75% of all meals.
2) Client will perform personal hygiene daily.
3) Client will experience no falls during hospitalization.
4) Client will report lessened anxiety regarding surgical procedure.

Question 16

The client has a nursing diagnosis of impaired gas exchange as a result of excessive secretions.An outcome for the client is that the airways will be free of secretions.A positive evaluation will focus upon the client's:
1) Respiratory rate
2) Complaint of chest pain
3) Lungs clear bilaterally on auscultation
4) Ability to perform incentive spirometry

Question 17

Which of the following statements made by a client's family is the most reliable for use in the evaluation of a client's outcome?
1) "Mom has been eating 90% of all of her meals since she's been home."
2) "My daughter is in much less pain now that she is going to physical therapy."
3) "My husband has been less depressed since he's been on that antidepressant pill."
4) "Mom has been so much better since she's been able to get up and walk by herself."

Question 18

The nurse begins to auscultate the client's lungs.While listening,the nurse notices fresh bloody drainage oozing from the abdominal dressing.The nurse stops auscultating and applies direct pressure to the wound site.This is an example of:
1) Performing a nursing assessment
2) Reorganizing the nursing diagnoses
3) Implementing nursing interventions
4) Critically analyzing client assessment data

Question 19

When modifying a care plan to meet a client whose status has changed significantly over the past few days,the nurse should:
1) Redevelop the entire client care plan
2) Focus on changing the nursing diagnoses and goals
3) Perform a complete reassessment of all client factors
4) Add more nursing interventions from a standardized plan of care

Question 20

The nurse caring for an immobile client with a pressure ulcer implements an intervention that requires repositioning the client every 2 hours.Which of the following represents the best evaluation method for this intervention?
1) No additional pressure ulcers are noted over a 1-week period.
2) Client expresses a decrease in pressure ulcer related pain within 1 week.
3) The client's pressure ulcer shows a decrease in size over a 1-week period.
4) The turning schedule is initiated to reflect appropriate positioning for a 1-week period.

Question 21

When a client goal is unmet,which of the following nursing actions is most appropriate?
1) Reevaluation of the original client goal
2) Selection of new but appropriate interventions
3) Evaluation of the client's ability and motivation to be compliant
4) Repetition of the entire nursing process regarding the nursing diagnosis

Question 22

Which of the following nursing actions should be initiated first when dealing with the following unmet client goal: "Client will lose 10 pounds in 3 months?"
1) Interview the client to identify reasons why the goal was not met.
2) Assess the client for possible physical reasons for failure to lose the weight.
3) Discuss with the client whether they were truly motivated to lose the weight.
4) Re-evaluate whether it was realistic for the client to lose 10 pounds in 3 months.