Chapter 15 Evaluating

Chapter 15  Evaluating

Complete Chapter Questions And Answers
 

Sample Questions

1.
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.
Ans:
A

Feedback:

The nurse will terminate the plan of care when each expected outcome has been achieved. Modifying the plan of care is necessary if there are difficulties in achieving the outcomes. Re-evaluating each step of the nursing process is a step in the modification of a plan of care. Continuing the plan of care occurs if more time is needed to achieve the outcomes.

2.
Nursing care and client outcomes may be evaluated by use of a retrospective evaluation process. Which of the following is an example of a retrospective evaluation process?
A)
Postdischarge questionnaire.
B)
Direct observation of nursing care.
C)
Client interview during hospitalization.
D)
Review of client’s chart during hospitalization.
Ans:
A

Feedback:

Retrospective evaluation may use postdischarge questionnaires and client interviews, or chart reviews after the client has been discharged. Concurrent 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.

3.
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)
Terminate the plan of care since it does not accurately reflect the client’s abilities.
C)
Modify the plan of care to better reflect the client’s current functional ability.
D)
Replace the client’s individualized plan of care with a clinical pathway.
Ans:
A

Feedback:

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.

4.
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)
Information
B)
Science
C)
Cooperation
D)
Individualization
Ans:
A

Feedback:

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 (individualization).

5.
Nurses have identified the following outcome in the care of a client who is recovering from a stroke: “Client will ambulate 100 feet without the use of mobility aids by 12/12/2011.” Several nurses have evaluated the client’s progression towards this outcome at various points during her care. Which of the following evaluative statements is most appropriate?
A)
“12/12/2011 – Outcome partially met. Patient ambulated 75 feet without the use of mobility aids”
B)
“12/12/2011 – Outcome unmet. Patient’s ambulation remains inadequate.”
C)
“12/10/2011 Outcome met, but with the use of a quad cane to assist ambulation.”
D)
“12/14/2011 Outcome met.”
Ans:
A

Feedback:

An evaluative statement should include both the decision about how well the outcome was met along with data that support this decision. Characterizing the client’s ambulation as “inadequate” is not sufficiently precise. Stating that this outcome was met with the use of a cane contradicts the original terms of the outcome.