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Which of the following would not be part of the nurses decision about care after evaluating the patients responses to the plan of care?
- A. terminate the plan of care
Correct Answer: D
Rationale: The options are incomplete, but based on standard nursing practice, transferring medical orders (D) is not part of evaluation decisions, which focus on continuing, modifying, or terminating the plan.
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A nurse has developed a plan of care for the nursing diagnosis Risk for Loneliness for a recently widowed man. When evaluating the plan, the man tells the nurse new information about his active social life. What would the nurse do next?
- A. Continue with the plan.
- B. Delete the nursing diagnosis.
- C. Tell the patient he is lonely.
- D. Adjust the time criteria.
Correct Answer: B
Rationale: New information indicating an active social life negates the risk for loneliness, so the diagnosis should be removed.
A nurse working in a hospital setting discovers problems with the delivery of nursing care on the pediatric unit. Which of the following suggestions from the Institute of Medicines Committee on Quality of Health Care in America (Kohn, Corrigan, & Donaldson, 2000) could help redesign and improve care? Select all that apply.
- A. Base care on continuous healing relationships.
- B. Customize care based on available resources.
- C. Keep the nurse as the source of control.
- D. Share knowledge and allow for free flow of information
- E. Practice evidence-based decision making
- F. Emphasize safety as a system property.
Correct Answer: A,D,E,F
Rationale: The Institute of Medicine emphasizes continuous healing relationships (A), knowledge sharing (D), evidence-based practice (E), and safety as a system property (F) to improve care quality.
A nurse is teaching a patient how to administer insulin, with the expected outcome that the patient will be able to self-administer the insulin injection. How would this outcome be evaluated?
- A. asking the patient to verbally repeat the steps of the injection
- B. asking the patient to demonstrate self-injection of insulin
- C. asking family members how much trouble the patient is having with injections
- D. asking the patient how comfortable he or she is with injections
Correct Answer: B
Rationale: Demonstration of the skill (self-injection) directly evaluates the psychomotor outcome of insulin administration.
A nurse is interested in improving patient care on the unit through performance improvement. What is the first step in this process?
- A. Discover the problem.
- B. Plan a strategy.
- C. Implement a change.
- D. Assess the change.
Correct Answer: A
Rationale: The first step in performance improvement is identifying or discovering the problem to address.
Which of the following best summarizes the evaluating step of the nursing process?
- A. The nurse completes a health assessment to establish a database.
- B. The patient and family have met healthcare goals and no longer need care.
- C. The nurse and patient identify nursing diagnoses and appropriate interventions.
- D. The nurse and patient measure achievement of planned outcomes of care.
Correct Answer: D
Rationale: Evaluation in the nursing process involves assessing whether the planned outcomes of care have been achieved, making option D the best summary.