Chapter 7. Implementation & Evaluation

Chapter 7. Implementation & Evaluation

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

Multiple Choice

Identify the choice that best completes the statement or answers the question.

 

____    1.         A physician prescribes oral aripiprazole 10 mg daily for a client with schizophrenia. This medication is unfamiliar to the nurse, and she cannot find it in the hospital formulary or other references. How should she proceed?

1)

Administer the medication as prescribed.

2)

Hold the medication and notify the prescriber.

3)

Consult with a pharmacist before administering it.

4)

Ask the patient’s nurse for information about the medication.

 

ANS:   3

The nurse must recognize when she does not have the knowledge or skill needed to implement an order. Because the nurse is unfamiliar with the medication, that does not mean she should hold it and delay patient treatment. It is wisest to first consult with the pharmacist for information before administering the medication to ensure safe practice. Administering the medication as prescribed, without knowing its expected actions and side effects, at the least prevents adequate reassessment; at the most, it is dangerous. Holding the medication and notifying the prescriber prevents the client from receiving timely treatment—many drugs are less effective if a consistent schedule is not maintained. Asking another nurse to administer the medication is also unsafe because it cannot be assumed that the other nurse has the correct knowledge. In addition, the nurse caring for the client must assess for adverse reactions to the medication.

 

PTS:    1          DIF:    Moderate         REF:    p. 118

KEY:   Nursing process: Implementation | Client need: SECE | Cognitive level: Analysis

 

 

 

____    2.         Which task can be delegated to nursing assistive personnel (NAP)?

1)

Turn and reposition the client every 2 hours.

2)

Assess the client’s skin condition.

3)

Change pressure ulcer dressings every shift.

4)

Apply hydrocolloid dressing to the pressure ulcer.

 

ANS:   1

The nurse can delegate turning the client every 2 hours to the NAP. Assessing the client’s skin condition, changing pressure ulcer dressings, and applying a hydrocolloid dressing to a pressure ulcer are all interventions that require nursing knowledge and judgment.

 

PTS:    1          DIF:    Moderate         REF:    pp. 122–124

KEY:   Nursing process: Implementation | Client need: SECE | Cognitive level: Application

 

 

 

____    3.         The nurse has just finished documenting that he removed a patient’s nasogastric tube. Which is the next logical step in the nursing process?

1)

Assessment

2)

Planning

3)

Evaluation

4)

Diagnosis

 

ANS:   3

The implementation phase ends when you document nursing actions on the client’s chart. Implementation evolves into the evaluation step when you document the client’s response to your interventions. As a general rule, the steps in order are as follows: assessment diagnosis, planning outcomes, planning interventions, implementation, and evaluation.

 

PTS:    1          DIF:    Easy    REF:    p. 125

KEY:   Nursing process: Implementation | Client need: SECE | Cognitive level: Comprehension

 

 

 

____    4.         Which nursing intervention is best individualized to meet the needs of a specific client?

1)

Suction the client every 2 hours per unit policy.

2)

Use incentive spirometry every hour while awake per postoperative protocols.

3)

Institute swallowing precautions.

4)

Move client out of bed to the chair daily; client prefers to be out of bed for dinner.

 

ANS:   4

Positioning the client in the chair for meals considers the client’s desire to be out of bed for dinner, so it is obviously individualized. An intervention performed according to unit policy or protocols is not necessarily individualized. “Institute swallowing precautions” does not provide instructions for the specific actions needed to do that for “this particular” client.

 

PTS:    1          DIF:    Moderate         REF:    p. 118; high-level question, answer not given verbatim

KEY:   Nursing process: Planning interventions | Client need: SECE | Cognitive level: Application