Choice A reason:

The nurse should compare the client's blood pressure readings with the expected outcomes to evaluate the effectiveness of the plan of care. This is the first step in the evaluation process, according to the nursing process framework. Comparing the actual outcomes with the expected outcomes allows the nurse to determine if the plan of care was successful or if it needs to be modified.

Choice B reason:

The nurse should identify the factors that influenced the client's blood pressure control, such as medication adherence, lifestyle changes, stress levels, and comorbidities. This is an important step in the evaluation process, but it is not the first one. The nurse should first compare the outcomes before analyzing the factors that affected them.

Choice C reason:

The nurse should document the results of the evaluation in the client's chart to communicate the findings to other members of the health care team and to provide evidence of quality care. This is also an essential step in the evaluation process, but it is not the first one. The nurse should document after comparing and analyzing the outcomes.

Choice D reason:

The nurse should modify the plan of care based on the evaluation findings to improve the client's blood pressure control and prevent complications. This is the final step in the evaluation process, after comparing, analyzing, and documenting the outcomes. The nurse should revise the plan of care as needed to meet the client's changing needs and goals.

Choice A reason:

The client has achieved partial resolution of the problem. This statement is not accurate because it implies that the client's problem is no longer present or significant, which is not the case for COPD. COPD is a chronic and progressive disease that causes irreversible lung damage and airflow limitation. The client may have improved symptoms or reduced exacerbations, but the problem is still present and requires ongoing management.

Choice B reason:

The client has met all the goals and no longer needs nursing care. This statement is not correct because it suggests that the client has fully recovered from COPD, which is not possible. COPD is a lifelong condition that cannot be cured, only managed. The client will always need nursing care to monitor their condition, prevent complications, educate them on self-care, and provide emotional support.

Choice C reason:

The client has not made any progress and requires a different approach. This statement is not valid because it indicates that the client has failed to respond to the current plan of care, which may not be true. COPD is a variable disease that can have periods of stability and exacerbation. The client may have made some progress in achieving their goals, such as improving their gas exchange, airway clearance, breathing pattern, activity tolerance, or quality of life. A different approach may not be necessary unless the client's condition worsens or does not improve despite optimal treatment.

Choice D reason:

The client has shown improvement but needs more time to reach the goals. This statement is the best one to make because it reflects the realistic and positive outcome of the evaluation for a client with COPD. COPD is a complex and chronic disease that requires long-term and individualized care. The client may have shown improvement in some aspects of their condition, such as reducing their dyspnea, cough, or sputum production, increasing their oxygen saturation, or enhancing their exercise capacity. However, they may still need more time to reach their full potential or maintain their progress. The nurse should acknowledge the client's improvement but also encourage them to continue with their plan of care and follow-up. I hope this answer helps you with your question. If you need more information on COPD or nursing care plans, you can check out these.

Choice A reason:

This statement is incorrect because it does not relate an outcome to an intervention. The client's weight loss may be due to increased diuretic therapy, but it is not clear how this is an outcome of the nurse's actions. A better statement would be: "The client's weight has decreased by 2 kg since discharge as a result of the nurse's education on diuretic therapy and daily weight monitoring.".

Choice B reason:

This statement is incorrect because it does not relate an outcome to an intervention. The client's dyspnea may be due to noncompliance with fluid restriction, but it is not clear how this is an outcome of the nurse's actions. A better statement would be: "The client's dyspnea has worsened despite the nurse's education on fluid restriction and sodium intake.".

Choice C reason:

This statement is incorrect because it does not relate an outcome to an intervention. The client's edema may have improved due to elevation of the lower extremities, but it is not clear how this is an outcome of the nurse's actions. A better statement would be: "The client's edema has improved as a result of the nurse's instruction on elevating the lower extremities and wearing compression stockings.".

Choice D reason:

This statement is correct because it relates an outcome to an intervention. The client's fatigue may have decreased due to participation in a cardiac rehabilitation program, which is an intervention that the nurse can facilitate or recommend for a client with heart failure. This statement shows that the nurse is evaluating the effectiveness of the intervention and the client's progress.

Choice A reason:

This choice is incorrect because the problem is not resolved by the client's self-report of feeling happier and more hopeful. The nurse should assess other indicators of improvement, such as mood, affect, cognition, behavior, and functioning. Feeling happier and more hopeful may be a sign of progress, but it does not mean that the problem is completely resolved.

Choice B reason:

This choice is incorrect because the problem is not ongoing if the client has been receiving psychotherapy and antidepressant medication for 6 weeks. The nurse should expect some degree of improvement in the client's symptoms and functioning after this period of treatment. Suicidal thoughts and low self-esteem are serious concerns, but they may not reflect the current problem status of the client.

Choice C reason:

This choice is correct because the problem is improved if the client shows increased interest in social activities and hobbies. These are positive signs of recovery from depression, as they indicate that the client is experiencing more pleasure, motivation, and engagement in life. The nurse should acknowledge and reinforce these improvements, as well as monitor the client's response to treatment.

Choice D reason:

This choice is incorrect because the problem is not potential if the client has already been diagnosed with depression and is receiving treatment. The client is at risk for relapse and adverse effects of medication, but these are not problems that need to be addressed at this stage. The nurse should focus on evaluating the effectiveness of the current treatment plan and providing education and support to the client

Choice A:

The client will demonstrate correct use of a glucometer by discharge. This is not an example of evaluative criteria or standards, but rather an expected outcome. Evaluative criteria or standards are the attributes or measures that are used to determine if the expected outcomes have been met. Expected outcomes are the specific, measurable, and realistic statements of goal attainment that are derived from the nursing diagnoses.

Choice B:

The client will maintain blood glucose levels between 70 and 130 mg/dL. This is an example of evaluative criteria or standards, because it specifies a measurable and objective indicator of the patient's progress toward the goal of managing diabetes mellitus. Blood glucose levels are a common evaluative measure for patients with diabetes mellitus.

Choice C:

The nurse will administer insulin as prescribed and monitor for adverse effects. This is not an example of evaluative criteria or standards, but rather a nursing intervention. Nursing interventions are the actions or treatments that nurses perform to help patients achieve the expected outcomes. Evaluative criteria or standards are not about what the nurse does, but about what the patient achieves.

Choice D:

The client will report increased energy and improved appetite after 2 weeks of treatment. This is an example of evaluative criteria or standards, because it specifies a measurable and subjective indicator of the patient's progress toward the goal of improving quality of life with diabetes mellitus. Patient-reported outcomes are a valid and reliable source of evaluative data.

Choice E:

The nurse will provide education on dietary modifications and physical activity. This is not an example of evaluative criteria or standards, but rather a nursing intervention. Nursing interventions are the actions or treatments that nurses perform to help patients achieve the expected outcomes. Evaluative criteria or standards are not about what the nurse does, but about what the patient achieves.