47. When evaluating the effectiveness of a client's nursing care, the nurse first reviews the expected outcomes identified in the plan of care. Which action should the nurse take next?

Review related professional standards of care.

Obtain current client data to compare with expected outcomes.

Determine if the expected outcomes were realistic.

Modify the nursing interventions to achieve the client's goals.

Answer and Explanation

The Correct Answer is B

A. Review related professional standards of care: While standards of care guide best practices, evaluating effectiveness of care focuses first on comparing actual client data with the expected outcomes, not professional benchmarks.

B. Obtain current client data to compare with expected outcomes: This is the next logical step after reviewing expected outcomes. Evaluating effectiveness requires assessing the client's current condition to determine if goals have been met.

C. Determine if the expected outcomes were realistic: Assessing the realism of goals is part of care planning and revision, but not the immediate next step when evaluating outcomes. It comes later if goals are not met.

D. Modify the nursing interventions to achieve the client's goals: Interventions are modified only after determining whether the original interventions were effective, which requires reviewing client progress and comparing it to the expected outcomes.

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Correct Answer is D

Explanation

A. "Why do you allow your boss to get you so upset?": This response may come across as judgmental and places blame on the client, which can shut down communication rather than promote openness and trust in the nurse-client relationship.

B. "How do you feel when your boss does not listen to your suggestions?": While this is an open-ended question, it directs the client to focus narrowly on emotions without first acknowledging their overall experience or offering empathy for their situation.

C. "Maybe you should use a different approach with your boss.": Offering unsolicited advice prematurely can make the client feel misunderstood. It may also discourage further sharing by shifting the focus to problem-solving too quickly rather than validating feelings.

D. "It must be difficult for you to work in a situation that makes you feel so unhappy.": This is the best response because it conveys empathy and acknowledges the client's emotional experience. It encourages the client to continue expressing feelings in a supportive and nonjudgmental environment.

A. Proceed with teaching the client how to walk with the crutches. B. Confer with the physical therapist for correct crutch size. C. Assess the client for signs of diminished circulation in the hands D. Ask the client to sit down while the crutch length is adjusted

Correct Answer is A

Explanation

A. Proceed with teaching the client how to walk with the crutches: A space of about two to three finger-widths between the top of the crutch and the axilla is the correct fit. This prevents pressure on the axillary nerves and allows for safe use, so it is appropriate to move forward with ambulation teaching.

B. Confer with the physical therapist for correct crutch size: Consultation is unnecessary at this point since the crutches appear to be appropriately sized based on the standard axillary gap.

C. Assess the client for signs of diminished circulation in the hands: While monitoring circulation is important, there is no indication of a problem at this stage. The crutch fit appears correct, so circulation is unlikely to be compromised.

D. Ask the client to sit down while the crutch length is adjusted: Adjustment is not needed if the crutch height already allows the standard three finger-width space from the axilla, indicating proper fit.

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47. When evaluating the effectiveness of a client's nursing care, the nurse first reviews the expected outcomes identified in the plan of care. Which action should the nurse take next?

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Naxlex Comprehensive Predictor Exams

A client tells the nurse how they hate the way their boss orders them around and never listens to their suggestions. Which response is best for the nurse to provide?

Correct Answer is D

Explanation

A client with a sprained ankle is seen at the clinic and is given a pair of crutches. When the client stands with the aid of the crutches, the nurse notes a space of three finger-widths between the top of the crutch and the client's axilla. Which action should the nurse take?

Correct Answer is A

Explanation

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