Outcome ID and Goals

Question 1

What is the difference between a goal and an expected outcome?

Answer 1

An outcome is more specific and measurable. Hence, an outcome is used to evaluate the extent to which a goal has been met

Question 2

In which phase are the outcomes and goals are set, along with how these outcomes are met and evaluated?

Answer 2

The outcome identification phase

Question 3

In which step does the nurse establish priorities.
Identify and write expected patient outcomes?
Select evidence-based nursing interventions?
Communicate the care plan?

Answer 3

Outcome Identification and Planning Step

Question 4

A formal care plan has multiple functions. Select all that apply.
1. Individualize care that minimizes outcome achievement
2. . Does not set priorities
3. Facilitate communication among nursing personnel and colleagues
4. Promote continuity of high-quality, cost-effective care
5. Evaluate patient response to nursing care
6. Create a record used for evaluation, research, reimbursement, and legal reasons
7. Promote nurse’s professional development

Answer 4

3, 4, 5, 6, & 7

Question 5

What are three goals for a successful care plan? Can you name them?

Answer 5

Be familiar with standards and agency policies for setting priorities, identifying and recording expected patient outcomes, selecting evidence-based nursing interventions, and recording the care plan.
Remember that the goal of patient-centered care is to keep the patient and the patient’s interests and preferences central in every aspect of planning and outcome identification.
Keep the “big picture” in focus: What are the discharge goals for this patient, and how should this direct each shift’s interventions?

Question 6

Nursing interventions are based on what type of evidence?

Answer 6

Evidenced Based Research

Question 7

What are the three (3) phases of care planning ?

Answer 7

Initial
Ongoing
Discharge

Question 8

What or which nurse begins the initial plan (POC)?

Answer 8

The nurse who does the nursing history & physical assessment

Question 9

What or which nurse identifies appropriate patient goals and related nursing care ?

Answer 9

The nurse who does the nursing history & physical assessment

Question 10

Which nurse develops the patient or client problems listed in a nursing diagnosis?

Answer 10

The nurse who does the nursing history & physical assessment

Question 11

What type of planning, is involved in these steps: Carried out by any nurse who interacts with patient
Keeps the plan up to date, manages risk factors, promotes function
States of nursing diagnoses more clearly
Develops new diagnoses
Makes outcomes more realistic and develops new outcomes as needed
Identifies nursing interventions to accomplish patient goals

Answer 11

Ongoing planning

Question 12

Which type of planning begins on the day of admission?

Answer 12

Discharge Planning

Question 13

Which nursing action would most likely occur during the ongoing planning stage of the comprehensive care plan?
A. The nurse collects new data and uses them to update the plan and resolve health problems.
B. The nurse uses teaching and counseling skills to help the patient carry out self-care behaviors at home.
C. The nurse who performs the admission nursing history develops a patient care plan.
D. The nurse who first performed the physical assessment starts the planning

Answer 13

Answer: A. The nurse collects new data and uses them to update the plan and resolve health problems.

Rationale: In the ongoing planning stage, any nurse who interacts with the patient updates the plan to facilitate the resolution of health problems, manage risk factors, and promote function. Teaching and counseling are the key to discharge planning. The nurse performing the admission nursing history consults standardized care plans during initial planning to formulate the initial care plan.

Question 14

Teaching the patient/client and family about how to empty a Jackson-Pratt drain and wound care are done in which phase or planning?

Answer 14

Discharge Planning

Question 15

A nursing diagnosis is based on what?

Answer 15

Priorities

Question 16

What is the highest hierarchy of human needs?

Answer 16

Physiologic needs

Question 17

What is the lowest hierarchy of human needs?

Answer 17

Self-actualization needs

Question 18

A nurse is preparing a discharge summary for a client who has had knee arthroplasty and is going home. Which of the following information about the client should the nurse include in the discharge summary? Select all that apply
1. Advance directives’ status
2. Instructions for diet and medications
3. Follow-up care
4. Most recent vital signs
5. Contact information for the home health agency

Answer 18

2,3,5 (1 & 4 are not options, is necessary for a transfer to a rehab, 4-vital signs are important for a transfer situation-not for going home

Question 19

Learning to establish priorities is a responsibility for a nurse, True or False?

Answer 19

True

Question 20

By the second post -op day, a patient has not achieved satisfactory pain relief, as evidenced by the patient stating his pain level in his abdominal incision is a 9 out of 10 1 hour after receiving pain medication. Based on the evaluation, which of the following actions should the nurse take, according to the nursing process?
1. Reassess the patient to determine the reasons for inadequate pain relief.
2. Wait to see if the pain lessens during the next 25 hours.
3. Change the plan of care to provide different pain relief interventions.
4. Teach the patient about the plan of care for managing the pain.

Answer 20

1. You will need further data from the patient as to why they have not achieved satisfactory pain relief. Reassess is the priority.

Question 21

There are four categories of outcomes, which one describes the change in the patient’s physical condition or physiology ?

Answer 21

Physiologic

Question 22

Describe an affective outcome.

Answer 22

Changes in patient values, beliefs, and attitudes

Question 23

Which category describes patient’s achievement of new skills?

Answer 23

Psychomotor

Question 24

Cognitive: describes decreases in patient knowledge or intellectual behaviors, True or False

Answer 24

False, Cognitive: describes increases in patient knowledge or intellectual behaviors

Question 25

A nurse is discussing the nursing process with a newly licensed nurse. Which of the following statements by the new nurse should identify as appropriate for the planning step of the nursing process? Which statement is the evaluation step? Select two answers 1. I will determine the most important patient problems that we should address. 2. I will review the past medical history on the patient's record to get more information. 3. I will carry out the new prescriptions from the provider. 4. I will ask the patient if their nausea has resolved?

Answer 25

1. Prioritize the patient's problems during the planning step. 4. Gathering information about the patient's problem & resolution is the evaluation step.

Question 26

What type of outcomes is this ? : describe the expected status of health issues at certain points in time, after treatment is complete. They address whether the problems are resolved or to what degree they are improved-

Answer 26

Clinical outcomes

Question 27

What outcome is described as the focus on key factors that affect someone’s ability to enjoy life and achieve personal goals.

Answer 27

Quality of Life

Question 28

True or False Functional outcomes describe the person’s ability to function in relation to the desired usual activities.

Answer 28

True

Question 29

Which outcome is an affective outcome? A. By 6/09/19, the patient will correctly demonstrate the procedure for washing her newborn baby. B. By 6/09/19, the patient will list three benefits of eating a healthy diet. C. By 6/09/19, the patient will use a walker to ambulate the hallway. D. By 6/09/19, the patient will verbalize valuing his health enough to stop smoking.

Answer 29

D.Answer: D. By 6/09/19, the patient will verbalize valuing his health enough to stop smoking. Rationale: An affective outcome describes changes in patient values, beliefs, and attitudes. Answers A and C are psychomotor outcomes (learning a new skill) and Answer B is a cognitive outcome (increase in patient knowledge).

Question 30

A charge nurse is observing a new nurse caring for a patient who reports pain. The new nurse checked the patient's medication administration record (MAR) and noted the last dose of pain medication was 6 (six) hours ago. The prescription reads every 4 hr PRN for pain. The new nurse administered the pain medication and checked with the patient 40 minutes later, when the patient reports' improvement. The new nurse left out which of the following steps of the nursing process? 1. Assessment 2. Planning 3. Intervention 4. Evaluation

Answer 30

1. The new nurse should have used the assessment step by asking the patient to evaluate the severity of pain on a 0 to 10 scale. Also, it is important to ask about the characteristics of the pain & assessed for any changes that might have contributed to worsening pain. The planning step is used by evidence of checking to see it was the appropriate time to give the Rx. The intervention is giving the Rx. & Last, the new nurse did evaluate the therapeutic effect of the Rx.

Question 31

Name the parts of a Measurable Outcome. There are five parts.

Answer 31

Subject Verb Do not use:know, understand, learn, become aware Do use: define, verbalize, explain, apply, identify, select, demonstrate, list, prepare, design, choose. Conditions Performance criteria Target time Ex. By 10/30/2022 the patient will identify delayed wound healing by explaining three symptoms of wound infection

Question 32

True or False, A smart goal always has a time bound.

Answer 32

True

Question 33

Is this an example of a smart goal? Patient will demonstrate the use of an incentive spirometer when short of breath by using it for 10 times Yes or No

Answer 33

No - because the time is open - it should reflect by HS is an example

Question 34

Name the six (6) characteristics of outcomes-One way to remember is this is: Sally Eats Popcorn Toast Every Evening

Answer 34

Safe: avoiding injury Effective: avoiding overuse and under use Patient-centered: responding to patient preferences, needs, and values Timely: reducing waits and delays Efficient: avoiding waste Equitable: providing care that does not vary in quality to all recipients

Question 35

What are Common Errors in Writing Patient Outcomes?

Answer 35

Expressing patient outcome as nursing intervention Using verbs that are not observable or measurable Including more than one patient behavior or manifestation in short-term outcomes Writing vague outcomes

Question 36

What is an intervention? Are they treatments alone? Yes or No why or why not

Answer 36

Treatments based upon clinical judgement and knowledge a nurse performs to enhance patient outcomes An action for the nurse to carry out the care plan and to meet the outcomes

Question 37

Is an action necessary in an intervention? Yes or No

Answer 37

Yes, an action is a requirement in a care plan necessary to meet an outcome.

Question 38

Can a nurse intervention be completed without a physician order? Yes or No

Answer 38

Yes

Question 39

Who can carry out a physician-initiated: actions ?

Answer 39

A nurse only with a physician order

Question 40

Collaborative: treatments initiated by other providers and carried out by a physician. True or False

Answer 40

False (carried out by a nurse)

Question 41

What are nurse -initiated interventions - think of the word independent nursing functions-there are five ?

Answer 41

Monitor health status. Reduce risks. Resolve, prevent, or manage a problem. Facilitate independence or assist with ADLs. Promote optimum sense of physical, psychological, and spiritual well-being.