Chapter 14- Implementation and Evaluation Nursing School Test Banks

 

1.

A new mother is having difficulty breastfeeding her newborn infant. A goal was established stating the baby would be nursing every two to three hours by age 1 week. The mother presents to the follow-up center at 1 week and reports the she discontinued breastfeeding. The nurse evaluates the original goal as:

A)

Met

B)

Partially met

C)

Completely unmet

D)

Inappropriately chosen for this patient

Ans:

C

Feedback:

After collecting data, nurses form a comprehensive picture of the patients behavioral responses. The next activity is to make a judgment about goal attainment by comparing the patients actual behavioral responses to the predicted responses or predetermined outcome criteria developed in the planning phase.

2.

A patient with a recently fractured left femur has been reluctant to comply with his physical therapy for fear of the pain associated with movement. A goal for this patient is to attend therapy treatments three times each day. The nurse is evaluating the goal for this patient. The patient states, I dont like therapy, it hurts, but I have been going twice a day. The patient chart has an entry from the last shift nurse stating the patient went to therapy two times with encouragement. The nurse evaluates the goal as:

A)

Goal met

B)

Goal partially met

C)

Goal completely unmet

D)

New diagnoses have developed

E)

Goal revision needed

Ans:

B

Feedback:

After collecting data, nurses form a comprehensive picture of the patients behavioral responses. The next activity is to make a judgment about goal attainment by comparing the patients actual behavioral responses to the predicted responses or predetermined outcome criteria developed in the planning phase.

3.

The nurse is assessing the patients behavioral response to a nursing intervention. This type of evaluation is known as:

A)

Structural evaluation

B)

Behavior modification

C)

Outcome evaluation

D)

Process evaluation

E)

Goal evaluation

Ans:

C

Feedback:

Outcome evaluation, which focuses on the patient and the patients function, is currently receiving a great deal of emphasis. Outcome evaluation determines the extent to which the patients behavioral response to nursing intervention reflects the desired patient goal and outcome criteria.

4.

The nursing supervisor is presenting the staff nurse with her yearly performance evaluation. This type of evaluation would be called:

A)

outcome evaluation

B)

technical evaluation

C)

structural evaluation

D)

process evaluation

E)

goal evaluation

Ans:

D

Feedback:

Process evaluation focuses on the nurses performance and whether the nursing care provided was appropriate and competent. The phases of the nursing process are used as the framework for the evaluation of nursing care.

5.

The nursing supervisor is evaluating how many patients each of the department nurses has been assigned for the shift. This type of evaluation would be considered:

A)

process

B)

outcome

C)

goal

D)

subjective

E)

structure

Ans:

E

Feedback:

Availability of equipment, layout of physical facilities, nurse-patient ratios, administrative support, and maintenance of nursing staff competence are some areas of concern for structure evaluation.

6.

Which of the following describe the purpose of evaluation? Select all that apply.

A)

To examine the patients behavioral responses to nursing interventions

B)

To appraise the extent to which patient goals were attained or problems resolved

C)

To appraise involvement and collaboration of the patient, family members, nurses, and healthcare team members in healthcare decisions

D)

To ensure the plan of care was followed as it was originally prepared

E)

To collect subjective and objective data to make judgments about nursing care delivered

Ans:

A, B, C, E

Feedback:

Nurses always consider evaluation in light of how the patient responded or reacted to the planned course of action. Figure 14-4 illustrates the relationship of the activities of the evaluation phase to the other phases of the nursing process. There are several purposes for carrying out evaluation:

To examine the patients behavioral responses to nursing interventions; to compare the patients behavioral responses with predetermined outcome criteria; to appraise the extent to which patient goals were attained or problems resolved; to appraise involvement and collaboration of the patient, family members, nurses, and healthcare team members in healthcare decisions; to provide a basis for the revision of the plan of care evaluation; to collect subjective and objective data to make judgments about nursing care delivered; and to monitor the quality of nursing care and its effect on the patients health status (Alfaro-LeFevre, 2010; Carpenito-Moyet, 2009). Specific activities during this phase include the following: reviewing patient goals and outcome criteria, collecting data, measuring goal attainment, recording judgments or measurements of goal attainment, and revising or modifying the patients plan of care.

7.

After the nursing plan of care has been developed, the nurse knows:

A)

each encounter with the patient is an opportunity to reassess and revise the plan of care if necessary.

B)

the plan will be followed by other healthcare providers and filed with the patients chart upon discharge.

C)

the responsibility for the assessment of the patient has ended.

D)

care plans are rigid and do not change.

E)

the plan of care can only be changed by the nurse who developed it.

Ans:

A

Feedback:

During each encounter with patients, nurses assess function, ensuring prompt attention to emerging problems. Because a patients condition can change quickly and dramatically, astute nurses remain alert to subtle cues and inferences. As they initiate the plan of care, nurses must ensure that the planned interventions are still relevant.

8.

Which of the following are the two priority nursing diagnoses?

A)

Risk for infection

B)

Anxiety

C)

Acute Pain

D)

Ineffective Airway Clearance

E)

Feeding Self-Care Deficit

Ans:

C, D

Feedback:

While all are important diagnoses, respiratory function and pain are priority.

9.

The primary purpose for evaluating data about a patients care according to a functional health approach is to

A)

Meet accreditation standards

B)

Determine implementation of medical orders

C)

Evaluate the need for healthcare consultations

D)

Revise or modify the nursing care plan

Ans:

D

Feedback:

Evaluation using the functional health approach provides a framework for organizing and evaluating data.

10.

When a nursing supervisor evaluates the staff nurses performance with a group of patients to whom the staff nurse has provided nursing care, the supervisor is performing which type of evaluation?

A)

Outcome evaluation

B)

Summary evaluation

C)

Structure evaluation

D)

Process evaluation

Ans:

D

Feedback:

Process evaluation focuses on the nurses performance and whether the nursing care provided was appropriate and competent.

11.

When a charge nurse evaluates the need for additional staff nurses and additional monitoring equipment to meet the patients needs, the charge nurse is performing an evaluation termed

A)

Process evaluation

B)

Structure evaluation

C)

Outcome evaluation

D)

Summary evaluation

Ans:

B

Feedback:

Structure evaluation focuses on the attributes of the setting or surroundings where healthcare is provided.

12.

What guides professional practice?

A)

ANA Standards of Nursing Practice

B)

National Institutes of Health publications

C)

Nursing Intervention Classification

D)

Risk Appraisal Index

Ans:

A

Feedback:

Standards of care guide professional practice and serve as the framework for the evaluation practice.

13.

When the nurse prepares to discharge a patient, to evaluate the effectiveness of the nursing care, the nurse should determine whether the

A)

Physician orders have been completed

B)

Patients goals have been achieved

C)

Critical pathways are completed

D)

Documentation is thorough

Ans:

B

Feedback:

Evaluation is defined as the judgment of the effectiveness of nursing care to meet patient goals based on the patients behavioral responses. This phase involves a thorough, systematic review of the effectiveness of nursing interventions and a determination of patient goal achievement.

14.

When a nurse assesses a patient and notifies the physician that the patient is demonstrating abnormal breath sounds, the nurse is performing a nursing intervention termed

A)

Supportive

B)

Surveillance

C)

Collaborative

D)

Maintenance

Ans:

B

Feedback:

Surveillance nursing interventions include detecting changes from baseline data and recognizing abnormal responses.

15.

A nurse encourages a mother who has lost a child to attend the support group of parents with deceased children. This intervention is termed

A)

Surveillance

B)

Psychosocial

C)

Coordinating

D)

Technical

Ans:

B

Feedback:

Providing individual and group therapy is the nurses responsibility in various settings. Psychosocial nursing interventions focus on resolving emotional, psychological, or social problems.

16.

A patient has terminal cancer. The medical intern has ordered an upper GI x-ray. The patient states he does not want the x-ray. The nurse speaks to the intern about the patients refusal to have the x-ray. This is what type of intervention?

A)

Surveillance

B)

Supportive

C)

Coordinating

D)

Technical

Ans:

C

Feedback:

Coordination involves acting as a patient advocate, making referrals for follow-up care, collaborating with other healthcare team members, and ensuring that the patients schedule is therapeutic.

17.

Educating patients on their diabetic regimen of administering their insulin is the implementation of which skill?

A)

Intrinsic

B)

Technical

C)

Interpersonal

D)

Visual

Ans:

B

Feedback:

The administration of insulin is a technical skill. Technical competence means being able to use equipment, machines, and supplies in a particular specialty.

18.

The primary purpose of nursing implementation is to

A)

Improve the patients postoperative status

B)

Identify a need for collaborative consults

C)

Help the patient achieve optimal levels of health

D)

Implement the critical pathway for the patient

Ans:

C

Feedback:

The purpose of the nursing implementation phase is to help the patient achieve an optimal level of health.

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