3.What intellectual, technical, interpersonal, and/or
ethical/legal competencies are most likely to bring
about the desired outcome?
Intellectual: knowledge of appropriate information
necessary to implement the nursing interventions
that effectively meet the nursing needs of a toddler
with physical and developmental delays
Technical: ability to competently adapt procedures
and equipment to meet the needs of patients across
the life span
Interpersonal: ability to work collaboratively with
members of the healthcare team to implement the
interdisciplinary plan of care
Ethical/Legal: ability to participate as a trusted and
effective patient advocate
4.What resources might be helpful for this family?
Social services, community services, counseling
servicesCHAPTER 16
PRACTICING FOR NCLEX
MULTIPLE CHOICE QUESTIONS
1.a 2.c 3.b 4.d 5.b
6.d 7.d 8.d
ALTERNATE-FORMAT QUESTIONS
Multiple Response Questions
1.a, d, e
2.a, b, c
3.c, e, f
4.a, b, d
5.b, c, f
6.a, d, fDEVELOPING YOUR KNOWLEDGE BASE
FILL-IN-THE-BLANKS
1.Terminate, modify, continue
2.Patient
3.Outcome achievement
4.Criteria
5.Standards
6.Clinical practice guidelines (CPGs)
7.Quality assurance programs
8.Structure
9.Nursing audit
MATCHING EXERCISES
1.e 2.c 3.a 4.d 5.b
6.a 7.b 8.b 9.a 10.a
SHORT ANSWER
1.Sample answers:
a.Cognitive goals: Ask the patient to repeat the
information or ask the patient to apply the new
knowledge to his/her everyday situations.b.Psychomotor goals: Ask the patient to
demonstrate the new skill.
c. Affective goals: Observe the patient’s behavior
and conversation for signs that the goals are
achieved.- a.Identifying evaluative criteria: Evaluative criteria
are the patient goals/outcomes developed during
the planning step and must be identified to deter-
mine whether they can be met by the patient.
b.Determining whether goals and criteria are met:
Because evaluative criteria reflect desired changes
or outcomes in patient behavior, and because
nursing actions are directed toward these
outcomes, they become the core of evaluation to
determine whether the plan has been effective.
c. Terminating, continuing, or modifying the plan:
Reviewing each step of the nursing process helps
to determine whether goals have been met and
whether the plan should be terminated, contin-
ued, or modified.
3.Sample answers:
a.Patient: Is the patient motivated to learn new
health behaviors?
b.Nurse: Do the nurses come to work well rested
and ready to help their patients?
c. Healthcare system: Is a healthy nurse-to-patient
ratio important to the institution?
4.The nurse should reevaluate each preceding step of
the nursing process for accuracy. After this is done,
it may become necessary to collect new assessment
data, add or revise diagnoses, modify or rewrite
patient goals/outcomes, and change the nursing
orders. In addition, patient evaluations may have to
be targeted more frequently. - a.Structure: An audit focused on the environment
in which care is provided. Evaluation is based on
physical facilities and equipment, organizational
characteristics, policies and procedures, fiscal
resources, and personnel resources.
b.Process: An audit that focuses on the nature
and sequence of activities carried out by the
nurse implementing the nursing process. Eval-
uation is based on acceptable levels of perform-
ance of nursing actions related to patient
assessment, diagnosis, planning, implementa-
tion, and evaluation.
c.Outcome: Outcome evaluations focus on meas-
urable and demonstrable changes in the health
status of the patient or the results of nursing
care. - a.Delete or modify the nursing diagnosis: After
evaluating the data, the nurse may decide the
nursing diagnosis is inadequate and delete or
change the diagnosis.
b.Make the goal statement more realistic: The nurse
should determine the effectiveness of the goal
and adjust the goal to meet the patient’s needs.
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