First and foremost, make sure your Manager understands what she is being evaluated on: did you establish measurable goals with objectives to achieve those goals over the past month, six months, nine months, and year. This should match what the evaluation form entails. If it doesn't then the person being evaluated could feel your review is more subjective than objective. Second, you want to make sure you highlight the strengths demonstrated during the evaluation process - give examples, such as, "I like the way you answer your residents' concerns." Or, "You also document things well and file incident reports on time." Or, you know she handles daily tasks and here is where she may need to improve on that.
I think a lot of people get edgy when they know they are meeting to be reviewed - as though standing at the Pearly Gates waiting to see if the gates will open warmly or not. It can be emotional. Oftentimes, it is the way something is phrased that creates tension and ill will. Be factual and not judgmental and understand you are human and employees are human. Too many times, annual reviews are linked to a raise and in my opinion, this is not a great thing. Reviews then become the source of fear.
Last, the annual review should never be the first time someone is told his job performance is not up to par and company standards. If it is, then shame on the evaluator. After you have said what you said and she has a chance to respond, and if emotional it is perfectly okay to hand it to her and ask her for her written response within 24-48 hours. Each of you should still sign your review. If there is room for improvement, so to speak, you can certainly outline an Action Plan and a timeline for improvement to occur.