Stage 6 — Evaluate outcomes. Review the shift trend and select the best evaluation and handoff plan. Improvement does not mean that Patient A's PE or Patient D's delirium risk has resolved.
Trend
Choose your responses, then check the answer.
Explanation
Outcome evaluation The strategy was effective but requires continued follow-up. Patient A's oxygenation and heart rate improved after prompt recognition, escalation, confirmed PE diagnosis, and anticoagulation, but right ventricular strain and bleeding risk require monitored care. Patient D had no fall or line removal after safety support, yet the acute mental-status change still requires ongoing delirium evaluation. The handoff must communicate both active risks and the outcomes of delegated care for every client remaining on the unit.
Step 1 — Evaluate goals, not task completion alone Patient A improved physiologically, Patient B's established plan was completed and evaluated, Patient C's pain improved, and Patient D remained safe. These findings support effective coordination.
Step 2 — Identify unresolved risk Acute PE with right ventricular strain still requires hospitalization, anticoagulant surveillance, and monitoring for deterioration. Absence of a fall does not resolve Patient D's acute confusion or its cause.
Step 3 — Handoff the active problems Communicate Patient A's oxygen, anticoagulation, bleeding, hemodynamic, and respiratory plan and Patient D's cognitive baseline change, evaluation, and safety plan. Include pending follow-up for Patient C and any client not discharged.
NCLEX rule Evaluation asks what improved, what remains unsafe, and what the next nurse must continue.
Scenario (Stage 6 — Evaluate outcomes)The RN reviews physiologic, safety, pain, teaching, and delegation outcomes before handoff.
Clinical judgment targetDistinguish successful initial management from complete resolution and hand off unresolved risks.
PE clinical trajectory — Serial oxygenation, heart rate, blood pressure, symptoms, right ventricular status, and treatment complications used to detect improvement or deterioration.
Delirium follow-up — Ongoing assessment of an acute cognitive change and its reversible causes even when immediate fall-prevention measures are effective.
Continuity-of-care handoff — Communication of active diagnoses, treatment, response, unresolved risks, pending work, and contingency triggers to the receiving nurse.