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Test Bank for Critical Care Nursing 8th Edition by Urden

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By: Urden

Edition: 8th Edition

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Resource Type: Test bank

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Test Bank For Critical Care Nursing 8th Edition By Urden

Sample Questions 

Chapter 04: Genetic Issues

Urden: Critical Care Nursing, 8th Edition

MULTIPLE CHOICE

  1. What is a genetic variant that exists in greater than 1% of the population termed?
a. Genetic mutation
b. Genetic polymorphism
c. Genetic deletion
d. Tandem repeat

ANS:  B

When a genetic variant occurs frequently and is present in 1% or more of the population, it is described as a genetic polymorphism. The term genetic mutation refers to a change in the DNA genetic sequence that can be inherited that occurs in less than 1% of the population. Genetic material in the chromosome can also be deleted and new information from another chromosome can be inserted or can be a tandem repeat (multiple repeats of the same sequence).

PTS:   1                    DIF:    Cognitive Level: Remembering      REF:   p. 43

OBJ:   Nursing Process Step: General        TOP:   Genetics in Critical Care

MSC:  NCLEX: Health Promotion and Maintenance

  1. Which type of genetic disorder occurs when there is an interaction between genetic and environmental factors such as that which occurs with type 2 diabetes?
a. Chromosome
b. Mitochondrial
c. Multifactorial disorders
d. Allele dysfunction

ANS:  C

In multifactorial disorders there is an interaction between vulnerable genes and the environment. Cardiovascular atherosclerotic diseases and type 2 diabetes are examples of multifactorial disorders that result from an interaction of genetic and environmental factors.

PTS:   1                    DIF:    Cognitive Level: Understanding     REF:   p. 46

OBJ:   Nursing Process Step: General        TOP:   Genetics in Critical Care

MSC:  NCLEX: Health Promotion and Maintenance

  1. Prader-Willi syndrome (PWS) is a rare genetic disorder in which genes on chromosome 15 (q11.2-13) are deleted. What type of disorder is PWS?
a. Chromosome disorder
b. Mitochondrial disorder
c. Complex gene disorder
d. Multifactorial disorder

ANS:  A

Prader-Willi syndrome (PWS) is a chromosome disorder as a result of several missing genes on chromosome 15. In chromosome disorders, the entire chromosome or very large segments of the chromosome are damaged, missing, duplicated, or otherwise altered.

PTS:   1                    DIF:    Cognitive Level: Applying              REF:   p. 45

OBJ:   Nursing Process Step: General        TOP:   Genetics in Critical Care

MSC:  NCLEX: Health Promotion and Maintenance

  1. A family pedigree is used to determine whether a disease has a genetic component. What does a proband indicate in a family pedigree?
a. The disease being mother related or father related
b. The first person in the family who was diagnosed with the disorder
c. Who in the family is the xy band
d. The disease genotype including locus

ANS:  B

For nurses, it is important to ask questions that elucidate which family members are affected versus those who are unaffected and then to identify the individuals who may carry the gene in question but who do not have symptoms (carriers). The proband is the name given to the first person diagnosed in the family pedigree. Homozygous versus heterozygous determines if the disorder is carried by a gene from one or both parents. The xy band determines if the disorder is carried through the sex genes. A disease locus is the genetic address of the disorder.

PTS:   1                    DIF:    Cognitive Level: Remembering      REF:   p. 46

OBJ:   Nursing Process Step: General        TOP:   Genetics in Critical Care

MSC:  NCLEX: Health Promotion and Maintenance

  1. Philadelphia translocation is a specific chromosomal abnormality that occurs from a reciprocal translocation between chromosomes 9 and 22, where parts of these two chromosomes switch places. This abnormality is associated with which disease?
a. Hemophilia A
b. Chronic myelogenous leukemia
c. Obesity
d. Marfan syndrome

ANS:  B

Philadelphia chromosome or Philadelphia translocation is a specific chromosomal abnormality associated with chronic myelogenous leukemia. It occurs from a reciprocal translocation between chromosomes 9 and 22, where parts of these two chromosomes switch places. Hemophilia A is a sex-linked inheritance. Obesity is being studied with the FTO gene on chromosome 16. Marfan syndrome is classified as a single-gene disorder.

PTS:   1                    DIF:    Cognitive Level: Remembering      REF:   p. 42

OBJ:   Nursing Process Step: General        TOP:   Genetics in Critical Care

MSC:  NCLEX: Health Promotion and Maintenance

  1. What was the goal of the Human Genome Project?
a. Identifying haplotype tags
b. Exposing untaggable SNPs and recombination hot spots
c. Producing a catalog of human genome variation
d. Mapping all the human genes

ANS:  D

The Human Genome Project was a huge international collaborative project that began in 1990 with the goal of making a map of all the human genes (the genome). The final genome sequence was published in 2003. The HapMap project was to identify haplotype tags. The Genome-Wide Association Studies was used to expose untaggable SNPs and recombination hot spots. The 1000 Genomes project was used to map all the human genes.

PTS:   1                    DIF:    Cognitive Level: Remembering      REF:   p. 49

OBJ:   Nursing Process Step: General        TOP:   Genetics in Critical Care

MSC:  NCLEX: Health Promotion and Maintenance

  1. The patient is placed under general anesthesia for a carotid endarterectomy. During the surgery, the patient develops muscle contracture with skeletal muscle rigidity, acidosis, and elevated temperature. What is a possible cause for malignant hyperthermia?
a. Polymorphism in RYR1 at chromosome 19q13.1
b. Variant in the VKOR1 gene
c. Variant in the cytochrome P450 enzyme CYP2C9 gene
d. Halothane overdose

ANS:  A

Individuals with polymorphisms in the ryanodine receptor gene (RYR1) at chromosome 19q13.1 are at risk of a rare pharmacogenetic condition known as malignant hyperthermia. In affected individuals, exposure to inhalation anesthetics and depolarizing muscle relaxants during general anesthesia induces life-threatening muscle contracture with skeletal muscle rigidity, acidosis, and elevated temperature. Warfarin is being researched as a variant in the VKOR1 gene and in the cytochrome P450 enzyme CYP2C9 gene.

PTS:   1                    DIF:    Cognitive Level: Evaluating            REF:   p. 53|Box 4-3

OBJ:   Nursing Process Step: Diagnosis     TOP:   Genetics in Critical Care

MSC:  NCLEX: Health Promotion and Maintenance

  1. What is the study of heredity particularly as it relates to the transfer heritable physical characteristics called?
a. Chromatids
b. Karyotype
c. Genetics
d. Histones

ANS:  C

Genetics refers to the study of heredity, particularly as it relates to the ability of individual genes to transfer heritable physical characteristics. Each somatic chromosome, also called an autosome, is made of two strands, called chromatids, which are joined near the center. A karyotype is the arrangement of human chromosomes from largest to smallest. A specialized class of proteins called histones organizes the double-stranded DNA into what looks like a tightly coiled telephone cord.

PTS:   1                    DIF:    Cognitive Level: Remembering      REF:   p. 54

OBJ:   Nursing Process Step: General        TOP:   Genetics in Critical Care

MSC:  NCLEX: Health Promotion and Maintenance

  1. Each chromosome consists of an unbroken strand of DNA inside the nucleus of the cell. What is the arrangement of human chromosomes termed?
a. Chromatids
b. Karyotype
c. Genomics
d. Histones

ANS:  B

karyotype is the arrangement of human chromosomes from largest to smallest. Each somatic chromosome, also called an autosome, is made of two strands, called chromatids, which are joined near the center. Genomics refers to the study of all of the genetic material within cells and encompasses the environmental interaction and impact on biologic and physical characteristics. A specialized class of proteins called histones organizes the double-stranded DNA into what looks like a tightly coiled telephone cord.

PTS:   1                    DIF:    Cognitive Level: Remembering      REF:   p. 39

OBJ:   Nursing Process Step: General        TOP:   Genetics in Critical Care

MSC:  NCLEX: Health Promotion and Maintenance

  1. What is the study of all the genetic material within the cell and its impact on biologic and physical characteristics called?
a. Chromatids
b. Karyotype
c. Genomics
d. Histones

ANS:  C

Genomics refers to the study of all of the genetic material within cells and encompasses the environmental interaction and impact on biologic and physical characteristics. Each somatic chromosome, also called an autosome, is made of two strands, called chromatids, which are joined near the center. A karyotype is the arrangement of human chromosomes from largest to smallest. A specialized class of proteins called histones organizes the double-stranded DNA into what looks like a tightly coiled telephone cord.

PTS:   1                    DIF:    Cognitive Level: Remembering      REF:   p. 39

OBJ:   Nursing Process Step: General        TOP:   Genetics in Critical Care

MSC:  NCLEX: Health Promotion and Maintenance

  1. A specialized class of proteins that organizes the double-stranded DNA into what looks like a tightly coiled telephone cord is known which of the following?
a. Chromatids
b. Karyotype
c. Genomics
d. Histones

ANS:  D

A specialized class of proteins called histones organizes the double-stranded DNA into what looks like a tightly coiled telephone cord. Genomics refers to the study of all of the genetic material within cells and encompasses the environmental interaction and impact on biologic and physical characteristics. Each somatic chromosome, also called an autosome, is made of two strands, called chromatids, which are joined near the center. A karyotype is the arrangement of human chromosomes from largest to smallest.

PTS:   1                    DIF:    Cognitive Level: Remembering      REF:   p. 39

OBJ:   Nursing Process Step: General        TOP:   Genetics in Critical Care

MSC:  NCLEX: Health Promotion and Maintenance

  1. To achieve a consistent distance across the width of the DNA strand, the nucleotide base guanine (G) can only be paired with what other genetic material?
a. Adenine (A)
b. Thymine (T)
c. Cytosine (C)
d. Sex chromosome X

ANS:  C

Four nucleotide bases—adenine (A), thymine (T), guanine (G), and cytosine (C)—comprise the “letters” in the genetic DNA “alphabet.” The bases in the double helix are paired T with A and G with C. The nucleotide bases are designed so that only G can pair with C and only T can pair with A to achieve a consistent distance across the width of the DNA strand. The TA and GC combinations are known as base pairs.

PTS:   1                    DIF:    Cognitive Level: Evaluating            REF:   p. 40

OBJ:   Nursing Process Step: Diagnosis     TOP:   Genetics in Critical Care

MSC:  NCLEX: Health Promotion and Maintenance

  1. Why are monozygotic twins separated at birth used to study the effects of genetics versus environment?
a. They share an identical genome.
b. They have different sex chromosomes.
c. They have mirror chromosomes.
d. They have identical health issues.

ANS:  A

Studies of identical twins offer a unique opportunity to investigate the association of genetics, environment, and health. Identical twins are monozygotic and share an identical genome. Monozygotic twins are the same sex. Studies occur much less frequently today because tremendous efforts are made to keep siblings together when they are adopted. Genetics can be stable in a study group, but the environment and health issues are dynamic even in a controlled study group.

PTS:   1                    DIF:    Cognitive Level: Remembering      REF:   p. 48

OBJ:   Nursing Process Step: General        TOP:   Genetics in Critical Care

MSC:  NCLEX: Health Promotion and Maintenance

  1. The process that is used to make polypeptide chains that constitute proteins can be written as:
a. RNA ® DNA ® protein.
b. DNA ® RNA ® protein.
c. Protein ® RNA ® DNA.
d. Protein ® DNA ® RNA.

ANS:  B

The nucleotides A, T, C, and G can be thought of as “letters” of a genetic alphabet that are combined into three-letter “words” that are transcribed (written) by the intermediary of ribonucleic acid (RNA). The RNA translates the three-letter words into the amino acids used to make the polypeptide chains that constitute proteins. This process may be written as DNA ® RNA ® protein.

PTS:   1                    DIF:    Cognitive Level: Remembering      REF:   p. 41

OBJ:   Nursing Process Step: Diagnosis     TOP:   Genetics in Critical Care

MSC:  NCLEX: Health Promotion and Maintenance

  1. What are the studies called that are done on large, extended families who have several family members affected with a rare disease?
a. Genetic association
b. Genetic epidemiology
c. Kinships
d. Phenotypes

ANS:  C

In genetic epidemiologic research of a rare disease, it can be a challenge to find enough people to study. One method is to work with large, extended families, known as kinships, which have several family members affected with the disease. Genetic association studies are usually conducted in large, unrelated groups based on demonstration of a phenotype (disease trait or symptoms) and associated genotype. Genetic epidemiology represents the fusion of epidemiologic studies and genetic and genomic research methods. Phenotypes are different at different stages of a disease and are influenced by medications, environmental factors, and gene–gene interaction.

PTS:   1                    DIF:    Cognitive Level: Remembering      REF:   p. 48

OBJ:   Nursing Process Step: Diagnosis     TOP:   Genetics in Critical Care

MSC:  NCLEX: Health Promotion and Maintenance

  1. What is an example of direct-to-consumer genomic testing?
a. Genetic testing through amniocentesis
b. Paternity testing from buccal swabs of the child and father
c. Biopsy of a lump for cancer
d. Drug testing using hair follicles

ANS:  B

An example of direct-to-consumer testing is paternity testing from buccal swabs of the child and father. Genetic testing can be done through biopsies and amniocentesis, but they are performed in a facility by a medical professional. Drug testing and genomic testing are two different tests and are unrelated.

PTS:   1                    DIF:    Cognitive Level: Evaluating            REF:   p. 53

OBJ:   Nursing Process Step: Diagnosis     TOP:   Genetics in Critical Care

MSC:  NCLEX: Health Promotion and Maintenance

  1. What was the Genetic Information Nondiscrimination Act (GINA) of 2008 designed to prevent from happening?
a. Abuse of genetic information in employment and health insurance decisions
b. Genetic counselors from reporting results to the health insurance companies
c. Mandatory genetics testing of all individuals with certain diseases
d. Information sharing between biobanks that are studying the same genetic disorders

ANS:  A

The Genetic Information Nondiscrimination Act (GINA) of 2008 is an essential piece of legislation designed to prevent abuse of genetic information in employment and health insurance decisions in the United States. One of the paramount concerns in the genomic era is to protect the privacy of individuals’ unique genetic information. Many countries have established biobanks as repositories of genetic material, and many tissue samples are stored in medical center tissue banks. Some people who may be at risk for a disorder disease will not be tested because they fear that a positive result may affect their employability. GINA also mandates that genetic information about an individual and his or her family has the same protections as health information.

PTS:   1                    DIF:    Cognitive Level: Remembering      REF:   p. 53

OBJ:   Nursing Process Step: Diagnosis     TOP:   Genetics in Critical Care

MSC:  NCLEX: Health Promotion and Maintenance

MULTIPLE RESPONSE

  1. Which patients would be candidates for genetic testing for long QT syndrome (LQTS)? (Select all that apply.)
a. Patients with prolonged QT interval during a cardiac and genetic work-up
b. Family history of positive genotype and negative phenotype
c. Patients diagnosed with torsades de pointes
d. Family history of sudden cardiac death
e. Family history of bleeding disorders
f. Family history of obesity

ANS:  A, B, C, D

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DescriptionBy: Urden Edition: 8th Edition Format: Downloadable ZIP Fille Resource Type: Test bank Duration: Unlimited downloads Delivery: Instant DownloadBy: McKinney Edition: 5th Edition Format: Downloadable ZIP Fille Resource Type: Test bank Duration: Unlimited downloads Delivery: Instant DownloadBy: Woo Edition: 4th Edition Format: Downloadable ZIP Fille Resource Type: Test bank Duration: Unlimited downloads Delivery: Instant DownloadEdition: 9th Edition Format: Downloadable ZIP Fille Resource Type: Test bank Duration: Unlimited downloads Delivery: Instant DownloadEdition: 1st Edition Format: Downloadable ZIP Fille Resource Type: Test bank Duration: Unlimited downloads Delivery: Instant DownloadBy: Perry Edition: 9th Edition Format: Downloadable ZIP Fille Resource Type: Test bank Duration: Unlimited downloads Delivery: Instant Download
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Test Bank For Critical Care Nursing 8th Edition By Urden

Sample Questions 

Chapter 04: Genetic Issues Urden: Critical Care Nursing, 8th Edition MULTIPLE CHOICE
  1. What is a genetic variant that exists in greater than 1% of the population termed?
a. Genetic mutation
b. Genetic polymorphism
c. Genetic deletion
d. Tandem repeat
ANS:  B When a genetic variant occurs frequently and is present in 1% or more of the population, it is described as a genetic polymorphism. The term genetic mutation refers to a change in the DNA genetic sequence that can be inherited that occurs in less than 1% of the population. Genetic material in the chromosome can also be deleted and new information from another chromosome can be inserted or can be a tandem repeat (multiple repeats of the same sequence). PTS:   1                    DIF:    Cognitive Level: Remembering      REF:   p. 43 OBJ:   Nursing Process Step: General        TOP:   Genetics in Critical Care MSC:  NCLEX: Health Promotion and Maintenance
  1. Which type of genetic disorder occurs when there is an interaction between genetic and environmental factors such as that which occurs with type 2 diabetes?
a. Chromosome
b. Mitochondrial
c. Multifactorial disorders
d. Allele dysfunction
ANS:  C In multifactorial disorders there is an interaction between vulnerable genes and the environment. Cardiovascular atherosclerotic diseases and type 2 diabetes are examples of multifactorial disorders that result from an interaction of genetic and environmental factors. PTS:   1                    DIF:    Cognitive Level: Understanding     REF:   p. 46 OBJ:   Nursing Process Step: General        TOP:   Genetics in Critical Care MSC:  NCLEX: Health Promotion and Maintenance
  1. Prader-Willi syndrome (PWS) is a rare genetic disorder in which genes on chromosome 15 (q11.2-13) are deleted. What type of disorder is PWS?
a. Chromosome disorder
b. Mitochondrial disorder
c. Complex gene disorder
d. Multifactorial disorder
ANS:  A Prader-Willi syndrome (PWS) is a chromosome disorder as a result of several missing genes on chromosome 15. In chromosome disorders, the entire chromosome or very large segments of the chromosome are damaged, missing, duplicated, or otherwise altered. PTS:   1                    DIF:    Cognitive Level: Applying              REF:   p. 45 OBJ:   Nursing Process Step: General        TOP:   Genetics in Critical Care MSC:  NCLEX: Health Promotion and Maintenance
  1. A family pedigree is used to determine whether a disease has a genetic component. What does a proband indicate in a family pedigree?
a. The disease being mother related or father related
b. The first person in the family who was diagnosed with the disorder
c. Who in the family is the xy band
d. The disease genotype including locus
ANS:  B For nurses, it is important to ask questions that elucidate which family members are affected versus those who are unaffected and then to identify the individuals who may carry the gene in question but who do not have symptoms (carriers). The proband is the name given to the first person diagnosed in the family pedigree. Homozygous versus heterozygous determines if the disorder is carried by a gene from one or both parents. The xy band determines if the disorder is carried through the sex genes. A disease locus is the genetic address of the disorder. PTS:   1                    DIF:    Cognitive Level: Remembering      REF:   p. 46 OBJ:   Nursing Process Step: General        TOP:   Genetics in Critical Care MSC:  NCLEX: Health Promotion and Maintenance
  1. Philadelphia translocation is a specific chromosomal abnormality that occurs from a reciprocal translocation between chromosomes 9 and 22, where parts of these two chromosomes switch places. This abnormality is associated with which disease?
a. Hemophilia A
b. Chronic myelogenous leukemia
c. Obesity
d. Marfan syndrome
ANS:  B Philadelphia chromosome or Philadelphia translocation is a specific chromosomal abnormality associated with chronic myelogenous leukemia. It occurs from a reciprocal translocation between chromosomes 9 and 22, where parts of these two chromosomes switch places. Hemophilia A is a sex-linked inheritance. Obesity is being studied with the FTO gene on chromosome 16. Marfan syndrome is classified as a single-gene disorder. PTS:   1                    DIF:    Cognitive Level: Remembering      REF:   p. 42 OBJ:   Nursing Process Step: General        TOP:   Genetics in Critical Care MSC:  NCLEX: Health Promotion and Maintenance
  1. What was the goal of the Human Genome Project?
a. Identifying haplotype tags
b. Exposing untaggable SNPs and recombination hot spots
c. Producing a catalog of human genome variation
d. Mapping all the human genes
ANS:  D The Human Genome Project was a huge international collaborative project that began in 1990 with the goal of making a map of all the human genes (the genome). The final genome sequence was published in 2003. The HapMap project was to identify haplotype tags. The Genome-Wide Association Studies was used to expose untaggable SNPs and recombination hot spots. The 1000 Genomes project was used to map all the human genes. PTS:   1                    DIF:    Cognitive Level: Remembering      REF:   p. 49 OBJ:   Nursing Process Step: General        TOP:   Genetics in Critical Care MSC:  NCLEX: Health Promotion and Maintenance
  1. The patient is placed under general anesthesia for a carotid endarterectomy. During the surgery, the patient develops muscle contracture with skeletal muscle rigidity, acidosis, and elevated temperature. What is a possible cause for malignant hyperthermia?
a. Polymorphism in RYR1 at chromosome 19q13.1
b. Variant in the VKOR1 gene
c. Variant in the cytochrome P450 enzyme CYP2C9 gene
d. Halothane overdose
ANS:  A Individuals with polymorphisms in the ryanodine receptor gene (RYR1) at chromosome 19q13.1 are at risk of a rare pharmacogenetic condition known as malignant hyperthermia. In affected individuals, exposure to inhalation anesthetics and depolarizing muscle relaxants during general anesthesia induces life-threatening muscle contracture with skeletal muscle rigidity, acidosis, and elevated temperature. Warfarin is being researched as a variant in the VKOR1 gene and in the cytochrome P450 enzyme CYP2C9 gene. PTS:   1                    DIF:    Cognitive Level: Evaluating            REF:   p. 53|Box 4-3 OBJ:   Nursing Process Step: Diagnosis     TOP:   Genetics in Critical Care MSC:  NCLEX: Health Promotion and Maintenance
  1. What is the study of heredity particularly as it relates to the transfer heritable physical characteristics called?
a. Chromatids
b. Karyotype
c. Genetics
d. Histones
ANS:  C Genetics refers to the study of heredity, particularly as it relates to the ability of individual genes to transfer heritable physical characteristics. Each somatic chromosome, also called an autosome, is made of two strands, called chromatids, which are joined near the center. A karyotype is the arrangement of human chromosomes from largest to smallest. A specialized class of proteins called histones organizes the double-stranded DNA into what looks like a tightly coiled telephone cord. PTS:   1                    DIF:    Cognitive Level: Remembering      REF:   p. 54 OBJ:   Nursing Process Step: General        TOP:   Genetics in Critical Care MSC:  NCLEX: Health Promotion and Maintenance
  1. Each chromosome consists of an unbroken strand of DNA inside the nucleus of the cell. What is the arrangement of human chromosomes termed?
a. Chromatids
b. Karyotype
c. Genomics
d. Histones
ANS:  B A karyotype is the arrangement of human chromosomes from largest to smallest. Each somatic chromosome, also called an autosome, is made of two strands, called chromatids, which are joined near the center. Genomics refers to the study of all of the genetic material within cells and encompasses the environmental interaction and impact on biologic and physical characteristics. A specialized class of proteins called histones organizes the double-stranded DNA into what looks like a tightly coiled telephone cord. PTS:   1                    DIF:    Cognitive Level: Remembering      REF:   p. 39 OBJ:   Nursing Process Step: General        TOP:   Genetics in Critical Care MSC:  NCLEX: Health Promotion and Maintenance
  1. What is the study of all the genetic material within the cell and its impact on biologic and physical characteristics called?
a. Chromatids
b. Karyotype
c. Genomics
d. Histones
ANS:  C Genomics refers to the study of all of the genetic material within cells and encompasses the environmental interaction and impact on biologic and physical characteristics. Each somatic chromosome, also called an autosome, is made of two strands, called chromatids, which are joined near the center. A karyotype is the arrangement of human chromosomes from largest to smallest. A specialized class of proteins called histones organizes the double-stranded DNA into what looks like a tightly coiled telephone cord. PTS:   1                    DIF:    Cognitive Level: Remembering      REF:   p. 39 OBJ:   Nursing Process Step: General        TOP:   Genetics in Critical Care MSC:  NCLEX: Health Promotion and Maintenance
  1. A specialized class of proteins that organizes the double-stranded DNA into what looks like a tightly coiled telephone cord is known which of the following?
a. Chromatids
b. Karyotype
c. Genomics
d. Histones
ANS:  D A specialized class of proteins called histones organizes the double-stranded DNA into what looks like a tightly coiled telephone cord. Genomics refers to the study of all of the genetic material within cells and encompasses the environmental interaction and impact on biologic and physical characteristics. Each somatic chromosome, also called an autosome, is made of two strands, called chromatids, which are joined near the center. A karyotype is the arrangement of human chromosomes from largest to smallest. PTS:   1                    DIF:    Cognitive Level: Remembering      REF:   p. 39 OBJ:   Nursing Process Step: General        TOP:   Genetics in Critical Care MSC:  NCLEX: Health Promotion and Maintenance
  1. To achieve a consistent distance across the width of the DNA strand, the nucleotide base guanine (G) can only be paired with what other genetic material?
a. Adenine (A)
b. Thymine (T)
c. Cytosine (C)
d. Sex chromosome X
ANS:  C Four nucleotide bases—adenine (A), thymine (T), guanine (G), and cytosine (C)—comprise the “letters” in the genetic DNA “alphabet.” The bases in the double helix are paired T with A and G with C. The nucleotide bases are designed so that only G can pair with C and only T can pair with A to achieve a consistent distance across the width of the DNA strand. The TA and GC combinations are known as base pairs. PTS:   1                    DIF:    Cognitive Level: Evaluating            REF:   p. 40 OBJ:   Nursing Process Step: Diagnosis     TOP:   Genetics in Critical Care MSC:  NCLEX: Health Promotion and Maintenance
  1. Why are monozygotic twins separated at birth used to study the effects of genetics versus environment?
a. They share an identical genome.
b. They have different sex chromosomes.
c. They have mirror chromosomes.
d. They have identical health issues.
ANS:  A Studies of identical twins offer a unique opportunity to investigate the association of genetics, environment, and health. Identical twins are monozygotic and share an identical genome. Monozygotic twins are the same sex. Studies occur much less frequently today because tremendous efforts are made to keep siblings together when they are adopted. Genetics can be stable in a study group, but the environment and health issues are dynamic even in a controlled study group. PTS:   1                    DIF:    Cognitive Level: Remembering      REF:   p. 48 OBJ:   Nursing Process Step: General        TOP:   Genetics in Critical Care MSC:  NCLEX: Health Promotion and Maintenance
  1. The process that is used to make polypeptide chains that constitute proteins can be written as:
a. RNA ® DNA ® protein.
b. DNA ® RNA ® protein.
c. Protein ® RNA ® DNA.
d. Protein ® DNA ® RNA.
ANS:  B The nucleotides A, T, C, and G can be thought of as “letters” of a genetic alphabet that are combined into three-letter “words” that are transcribed (written) by the intermediary of ribonucleic acid (RNA). The RNA translates the three-letter words into the amino acids used to make the polypeptide chains that constitute proteins. This process may be written as DNA ® RNA ® protein. PTS:   1                    DIF:    Cognitive Level: Remembering      REF:   p. 41 OBJ:   Nursing Process Step: Diagnosis     TOP:   Genetics in Critical Care MSC:  NCLEX: Health Promotion and Maintenance
  1. What are the studies called that are done on large, extended families who have several family members affected with a rare disease?
a. Genetic association
b. Genetic epidemiology
c. Kinships
d. Phenotypes
ANS:  C In genetic epidemiologic research of a rare disease, it can be a challenge to find enough people to study. One method is to work with large, extended families, known as kinships, which have several family members affected with the disease. Genetic association studies are usually conducted in large, unrelated groups based on demonstration of a phenotype (disease trait or symptoms) and associated genotype. Genetic epidemiology represents the fusion of epidemiologic studies and genetic and genomic research methods. Phenotypes are different at different stages of a disease and are influenced by medications, environmental factors, and gene–gene interaction. PTS:   1                    DIF:    Cognitive Level: Remembering      REF:   p. 48 OBJ:   Nursing Process Step: Diagnosis     TOP:   Genetics in Critical Care MSC:  NCLEX: Health Promotion and Maintenance
  1. What is an example of direct-to-consumer genomic testing?
a. Genetic testing through amniocentesis
b. Paternity testing from buccal swabs of the child and father
c. Biopsy of a lump for cancer
d. Drug testing using hair follicles
ANS:  B An example of direct-to-consumer testing is paternity testing from buccal swabs of the child and father. Genetic testing can be done through biopsies and amniocentesis, but they are performed in a facility by a medical professional. Drug testing and genomic testing are two different tests and are unrelated. PTS:   1                    DIF:    Cognitive Level: Evaluating            REF:   p. 53 OBJ:   Nursing Process Step: Diagnosis     TOP:   Genetics in Critical Care MSC:  NCLEX: Health Promotion and Maintenance
  1. What was the Genetic Information Nondiscrimination Act (GINA) of 2008 designed to prevent from happening?
a. Abuse of genetic information in employment and health insurance decisions
b. Genetic counselors from reporting results to the health insurance companies
c. Mandatory genetics testing of all individuals with certain diseases
d. Information sharing between biobanks that are studying the same genetic disorders
ANS:  A The Genetic Information Nondiscrimination Act (GINA) of 2008 is an essential piece of legislation designed to prevent abuse of genetic information in employment and health insurance decisions in the United States. One of the paramount concerns in the genomic era is to protect the privacy of individuals’ unique genetic information. Many countries have established biobanks as repositories of genetic material, and many tissue samples are stored in medical center tissue banks. Some people who may be at risk for a disorder disease will not be tested because they fear that a positive result may affect their employability. GINA also mandates that genetic information about an individual and his or her family has the same protections as health information. PTS:   1                    DIF:    Cognitive Level: Remembering      REF:   p. 53 OBJ:   Nursing Process Step: Diagnosis     TOP:   Genetics in Critical Care MSC:  NCLEX: Health Promotion and Maintenance MULTIPLE RESPONSE
  1. Which patients would be candidates for genetic testing for long QT syndrome (LQTS)? (Select all that apply.)
a. Patients with prolonged QT interval during a cardiac and genetic work-up
b. Family history of positive genotype and negative phenotype
c. Patients diagnosed with torsades de pointes
d. Family history of sudden cardiac death
e. Family history of bleeding disorders
f. Family history of obesity
ANS:  A, B, C, D
Chapter 01: Foundations of Maternity, Women’s Health, and Child Health Nursing

McKinney: Evolve Resources for Maternal-Child Nursing, 5th Edition

MULTIPLE CHOICE
  1. Which factor significantly contributed to the shift from home births to hospital births in the early 20th century?
a. Puerperal sepsis was identified as a risk factor in labor and delivery.
b. Forceps were developed to facilitate difficult births.
c. The importance of early parental-infant contact was identified.
d. Technologic developments became available to physicians.
ANS:  D Technologic developments were available to physicians, not lay midwives. So in-hospital births increased in order to take advantage of these advancements. Puerperal sepsis has been a known problem for generations. In the late 19th century, Semmelweis discovered how it could be prevented with improved hygienic practices. The development of forceps is an example of a technology advance made in the early 20th century but is not the only reason birthplaces moved. Unlike home births, early hospital births hindered bonding between parents and their infants. PTS:   1                    DIF:    Cognitive Level: Knowledge/Remembering REF:   p. 1                OBJ:   Integrated Process: Teaching-Learning MSC:  Client Needs: Safe and Effective Care Environment
  1. Family-centered maternity care developed in response to
a. demands by physicians for family involvement in childbirth.
b. the Sheppard-Towner Act of 1921.
c. parental requests that infants be allowed to remain with them rather than in a nursery.
d. changes in pharmacologic management of labor.
ANS:  C As research began to identify the benefits of early extended parent-infant contact, parents began to insist that the infant remain with them. This gradually developed into the practice of rooming-in and finally to family-centered maternity care. Family-centered care was a request by parents, not physicians. The Sheppard-Towner Act of 1921 provided funds for state-managed programs for mothers and children. The changes in pharmacologic management of labor were not a factor in family-centered maternity care. PTS:   1                    DIF:    Cognitive Level: Knowledge/Remembering REF:   p. 2                OBJ:   Integrated Process: Teaching-Learning MSC:  Client Needs: Psychosocial Integrity
  1. Which setting for childbirth allows the least amount of parent-infant contact?
a. Labor/delivery/recovery/postpartum room
b. Birth center
c. Traditional hospital birth
d. Home birth
ANS:  C In the traditional hospital setting, the mother may see the infant for only short feeding periods, and the infant is cared for in a separate nursery. The labor/delivery/recovery/postpartum room setting allows increased parent-infant contact. Birth centers are set up to allow an increase in parent-infant contact. Home births allow an increase in parent-infant contact. PTS:   1                    DIF:    Cognitive Level: Knowledge/Remembering REF:   p. 2                OBJ:   Nursing Process: Planning MSC:  Client Needs: Health Promotion and Maintenance
  1. As a result of changes in health care delivery and funding, a current trend seen in the pediatric setting is
a. increased hospitalization of children.
b. decreased number of children living in poverty.
c. an increase in ambulatory care.
d. decreased use of managed care.
ANS:  C One effect of managed care has been that pediatric health care delivery has shifted dramatically from the acute care setting to the ambulatory setting in order to provide more cost-efficient care. The number of hospital beds being used has decreased as more care is given in outpatient settings and in the home. The number of children living in poverty has increased over the past decade. One of the biggest changes in health care has been the growth of managed care. PTS:   1                    DIF:    Cognitive Level: Knowledge/Remembering REF:   p. 5                OBJ:   Nursing Process: Planning MSC:  Client Needs: Safe and Effective Care Environment
  1. The Women, Infants, and Children (WIC) program provides
a. well-child examinations for infants and children living at the poverty level.
b. immunizations for high-risk infants and children.
c. screening for infants with developmental disorders.
d. supplemental food supplies to low-income pregnant or breastfeeding women.
ANS:  D WIC is a federal program that provides supplemental food supplies to low-income women who are pregnant or breastfeeding and to their children until age 5 years. Medicaid’s Early and Periodic Screening, Diagnosis, and Treatment Program provides for well-child examinations and for treatment of any medical problems diagnosed during such checkups. Children in the WIC program are often referred for immunizations, but that is not the primary focus of the program. Public Law 99-457 is part of the Individuals with Disabilities Education Act that provides financial incentives to states to establish comprehensive early intervention services for infants and toddlers with, or at risk for, developmental disabilities. PTS:   1                    DIF:    Cognitive Level: Comprehension   REF:   p. 8 OBJ:   Integrated Process: Teaching-Learning MSC:  Client Needs: Health Promotion and Maintenance
  1. In most states, adolescents who are not emancipated minors must have the permission of their parents before
a. treatment for drug abuse.
b. treatment for sexually transmitted diseases (STDs).
c. accessing birth control.
d. surgery.
ANS:  D Minors are not considered capable of giving informed consent, so a surgical procedure would require consent of the parent or guardian. Exceptions exist for obtaining treatment for drug abuse or STDs or for getting birth control in most states. PTS:   1                    DIF:    Cognitive Level: Knowledge/Remembering REF:   p. 17              OBJ:   Nursing Process: Planning MSC:  Client Needs: Safe and Effective Care Environment
  1. The maternity nurse should have a clear understanding of the correct use of a clinical pathway. One characteristic of clinical pathways is that they
a. are developed and implemented by nurses.
b. are used primarily in the pediatric setting.
c. set specific time lines for sequencing interventions.
d. are part of the nursing process.
ANS:  C Clinical pathways are standardized, interdisciplinary plans of care devised for patients with a particular health problem. They are used to identify patient outcomes, specify time lines to achieve those outcomes, direct appropriate interventions and sequencing of interventions, include interventions from a variety of disciplines, promote collaboration, and involve a comprehensive approach to care. They are developed by multiple health care professionals and reflect interdisciplinary care. They can be used in multiple settings and for patients throughout the life span. They are not part of the nursing process but can be used in conjunction with the nursing process to provide care to patients. PTS:   1                    DIF:    Cognitive Level: Knowledge/Remembering REF:   p. 7                OBJ:   Nursing Process: Planning MSC:  Client Needs: Safe and Effective Care Environment
  1. The fastest growing group of homeless people is
a. men and women preparing for retirement.
b. migrant workers.
c. single women and their children.
d. intravenous (IV) substance abusers.
ANS:  C Pregnancy and birth, especially for a teenager, are important contributing factors for becoming homeless. People preparing for retirement, migrant workers, and IV substance abusers are not among the fastest growing groups of homeless people. PTS:   1                    DIF:    Cognitive Level: Knowledge/Remembering REF:   p. 14              OBJ:   Nursing Process: Assessment MSC:  Client Needs: Physiologic Integrity
  1. A nurse wishes to work to reduce infant mortality in the United States. Which activity would this nurse most likely participate in?
a. Creating pamphlets in several different languages using an interpreter.
b. Assisting women to enroll in Medicaid by their third trimester.
c. Volunteering to provide prenatal care at community centers.
d. Working as an intake counselor at a women’s shelter.
ANS:  C Prenatal care is vital to reducing infant mortality and medical costs. This nurse would most likely participate in community service providing prenatal care outreach activities in community centers, particularly in low-income areas. Pamphlets in other languages, enrolling in Medicaid, and working at a women’s shelter all might impact infant mortality, but the greatest effect would be from assisting women to get consistent prenatal care. PTS:   1                    DIF:    Cognitive Level: Application/Applying REF:   p. 14              OBJ:   Nursing Process: Implementation MSC:  Client Needs: Health Promotion and Maintenance
  1. The intrapartum woman sees no need for a routine admission fetal monitoring strip. If she continues to refuse, what is the first action the nurse should take?
a. Consult the family of the woman.
b. Notify the provider of the situation.
c. Document the woman’s refusal in the nurse’s notes.
d. Make a referral to the hospital ethics committee.
ANS:  B Patients must be allowed to make choices voluntarily without undue influence or coercion from others. The physician, especially if unaware of the patient’s decision, should be notified immediately. Both professionals can work to ensure the mother understands the rationale for the action and the possible consequences of refusal. The woman herself is the decision-maker, unless incapacitated. Documentation should occur but is not the first action. This situation does not rise to the level of an ethical issue so there is no reason to call the ethics committee. PTS:   1                    DIF:    Cognitive Level: Application/Applying REF:   p. 18              OBJ:   Nursing Process: Implementation MSC:  Client Needs: Safe and Effective Care Environment
  1. Which statement is true regarding the “quality assurance” or “incident” report?
a. The report assures the legal department that no problem exists.
b. Reports are a permanent part of the patient’s chart.
c. The nurse’s notes should contain, “Incident report filed, and copy placed in chart.”
d. This report is a form of documentation of an event that may result in legal action.
ANS:  D An incident report is used when something occurs that might result in legal action, such as a patient fall or medication error. It warns the legal department that there may be a problem in a particular patient’s care. Incident reports are not part of the patient’s chart; thus the nurses’ notes should not contain any reference to them. PTS:   1                    DIF:    Cognitive Level: Knowledge/Remembering REF:   p. 18              OBJ:   Integrated Process: Communication and Documentation MSC:  Client Needs: Safe and Effective Care Environment
  1. Elective abortion is considered an ethical issue because
a. abortion law is unclear about a woman’s constitutional rights.
b. the Supreme Court ruled that life begins at conception.
c. a conflict exists between the rights of the woman and the rights of the fetus.
d. it requires third-party consent.
ANS:  C

Test Bank for Pharmacotherapeutics for Advanced Practice Nurse Prescribers 4th Edition by Woo

Chapter 1. The Role of the Nurse Practitioner   Multiple Choice Identify the choice that best completes the statement or answers the question.   ____    1.   Nurse practitioner prescriptive authority is regulated by:
1. The National Council of State Boards of Nursing
2. The U.S. Drug Enforcement Administration
3. The State Board of Nursing for each state
4. The State Board of Pharmacy
    ____    2.   The benefits to the patient of having an Advanced Practice Registered Nurse (APRN) prescriber include:
1. Nurses know more about Pharmacology than other prescribers because they take it both in their basic nursing program and in their APRN program.
2. Nurses care for the patient from a holistic approach and include the patient in decision making regarding their care.
3. APRNs are less likely to prescribe narcotics and other controlled substances.
4. APRNs are able to prescribe independently in all states, whereas a physician’s assistant needs to have a physician supervising their practice.
    ____    3.   Clinical judgment in prescribing includes:
1. Factoring in the cost to the patient of the medication prescribed
2. Always prescribing the newest medication available for the disease process
3. Handing out drug samples to poor patients
4. Prescribing all generic medications to cut costs
    ____    4.   Criteria for choosing an effective drug for a disorder include:
1. Asking the patient what drug they think would work best for them
2. Consulting nationally recognized guidelines for disease management
3. Prescribing medications that are available as samples before writing a prescription
4. Following U.S. Drug Enforcement Administration guidelines for prescribing
    ____    5.   Nurse practitioner practice may thrive under health-care reform because of:
1. The demonstrated ability of nurse practitioners to control costs and improve patient outcomes
2. The fact that nurse practitioners will be able to practice independently
3. The fact that nurse practitioners will have full reimbursement under health-care reform
4. The ability to shift accountability for Medicaid to the state level
  Chapter 1. The Role of the Nurse Practitioner Answer Section   MULTIPLE CHOICE  
  1. ANS:  3                     PTS:   1
 
  1. ANS:  2                     PTS:   1
 
  1. ANS:  1                     PTS:   1
 
  1. ANS:  2                     PTS:   1
 
  1. ANS:  1                     PTS:   1

Test Bank for Pharmacology and the Nursing Process 9th Edition

Contents Chapter 01: The Nursing Process and Drug Therapy................................................................................. 4 Chapter 02: Pharmacologic Principles...................................................................................................... 8 Chapter 03: Lifespan Considerations...................................................................................................... 14 Chapter 04: Cultural, Legal, and Ethical Considerations.......................................................................... 20 Chapter 05: Medication Errors: Preventing and Responding .................................................................. 26 Chapter 06: Patient Education and Drug Therapy................................................................................... 29 Chapter 07: Over-the-Counter Drugs and Herbal and Dietary Supplements ........................................... 34 Chapter 08: Gene Therapy and Pharmacogenomics............................................................................... 38 Chapter 09: Photo Atlas of Drug Administration .................................................................................... 41 Chapter 10: Analgesic Drugs.................................................................................................................. 50 Chapter 11: General and Local Anesthetics............................................................................................ 57 Chapter 12: Central Nervous System Depressants and Muscle Relaxants............................................... 61 Chapter 13: Central Nervous System Stimulants and Related Drugs....................................................... 66 Chapter 14: Antiepileptic Drugs............................................................................................................. 70 Chapter 15: Antiparkinson Drugs.............................................................................................................76 Chapter 16: Psychotherapeutic Drugs.................................................................................................... 81 Chapter 17: Substance Use Disorder...................................................................................................... 88 Chapter 18: Adrenergic Drugs................................................................................................................ 93 Chapter 19: Adrenergic-Blocking Drugs.................................................................................................. 98 Chapter 20: Cholinergic Drugs ............................................................................................................. 103 Chapter 21: Cholinergic-Blocking Drugs............................................................................................... 108 Chapter 22: Antihypertensive Drugs.................................................................................................... 113 Chapter 23: Antianginal Drugs............................................................................................................. 119 Chapter 24: Heart Failure Drugs........................................................................................................... 125 Chapter 25: Antidysrhythmic Drugs..................................................................................................... 131 Chapter 26: Coagulation Modifier Drugs.............................................................................................. 137 Chapter 27: Antilipemic Drugs............................................................................................................. 143 Chapter 28: Diuretic Drugs................................................................................................................... 148 Chapter 29: Fluids and Electrolytes...................................................................................................... 154 Chapter 30: Pituitary Drugs.................................................................................................................. 160 Chapter 31: Thyroid and Antithyroid Drugs.......................................................................................... 163 Chapter 32: Antidiabetic Drugs............................................................................................................ 168 Chapter 33: Adrenal Drugs................................................................................................................... 177 Chapter 34: Women’s Health Drugs..................................................................................................... 181 Chapter 35: Men’s Health Drugs.......................................................................................................... 188 Chapter 36: Antihistamines, Decongestants, Antitussives, and Expectorants ....................................... 193 Chapter 37: Respiratory Drugs............................................................................................................. 198 Chapter 38: Antibiotics Part 1.............................................................................................................. 204 Chapter 39: Antibiotics Part 2.............................................................................................................. 211 Chapter 40: Antiviral Drugs.................................................................................................................. 216 Chapter 41: Antitubercular Drugs ........................................................................................................ 221 Chapter 42: Antifungal Drugs............................................................................................................... 226 Chapter 43: Antimalarial, Antiprotozoal, and Anthelmintic Drugs ........................................................ 231 Chapter 44: Anti-inflammatory and Antigout Drugs............................................................................. 236 Chapter 45: Antineoplastic Drugs Part 1: Cancer Overview and Cell Cycle–Specific Drugs..................... 242 Chapter 46: Antineoplastic Drugs Part 2: Cell Cycle–Nonspecific Drugs and Miscellaneous Drugs......... 248 Chapter 47: Biologic Response–Modifying and Antirheumatic Drugs ................................................... 253 Chapter 48: Immunosuppressant Drugs............................................................................................... 258 Chapter 49: Immunizing Drugs............................................................................................................. 263 Chapter 50: Acid-Controlling Drugs...................................................................................................... 268 Chapter 51: Bowel Disorder Drugs....................................................................................................... 274 Chapter 52: Antiemetic and Antinausea Drugs..................................................................................... 281 Chapter 53: Vitamins and Minerals...................................................................................................... 286 Chapter 54: Anemia Drugs................................................................................................................... 292 Chapter 55: Nutritional Supplements................................................................................................... 299 Chapter 56: Dermatologic Drugs.......................................................................................................... 304 Chapter 57: Ophthalmic Drugs............................................................................................................. 310 Chapter 58: Otic Drugs ............................

Medical-Surgical Nursing: Making Connections to Practice 1st edition Hoffman, Sullivan Test Bank

 

Chapter 1: Foundations for Medical-Surgical Nursing

Multiple Choice Identify the choice that best completes the statement or answers the question.

____ 1. The medical-surgical nurse identifies a clinical practice issue and wants to determine if there is sufficient evidence to support a change in practice. Which type of study provides the strongest evidence to support a practice change? 1) Randomized control study 2) Quasi-experimental study 3) Case-control study 4) Cohort study

____ 2. The medical-surgical unit recently implemented a patient-centered care model. Which action implemented by the nurse supports this model? 1) Evaluating care 2) Assessing needs 3) Diagnosing problems 4) Providing compassion

____ 3. Which action should the nurse implement when providing patient care in order to support The Joint Commission’s (TJC) National Patient Safety Goals (NPSG)? 1) Silencing a cardiorespiratory monitor 2) Identifying each patient using one source 3) Determining patient safety issues upon admission 4) Decreasing the amount of pain medication administered

____ 4. Which interprofessional role does the nurse often assume when providing patient care in an acute care setting? 1) Social worker 2) Client advocate 3) Care coordinator 4) Massage therapist

____ 5. The medical-surgical nurse wants to determine if a policy change is needed for an identified clinical problem. Which is the first action the nurse should implement? 1) Developing a question 2) Disseminating the findings 3) Conducting a review of the literature 4) Evaluating outcomes of practice change

____ 6. The nurse is evaluating the level of evidence found during a recent review of the literature. Which evidence carries the lowest level of support for a practice change? 1) Level IV 2) Level V 3) Level VI 4) Level VII

____ 7. The nurse is reviewing evidence from a quasi-experimental research study. Which level of evidence should the nurse identify for this research study? 1) Level ITestBankWorld.org 2) Level II 3) Level III 4) Level IV

____ 8. Which level of evidence should the nurse identify when reviewing evidence from a single descriptive research study? 1) Level IV 2) Level V 3) Level VI 4) Level VII

____ 9. Which statement should the nurse make when communicating the “S” in the SBAR approach for effective communication? 1) “The patient presented to the emergency department at 0200 with lower left abdominal pain.” 2) “The patient rated the pain upon admission as a 9 on a 10-point numeric scale.” 3) “The patient has no significant issues in the medical history.” 4) “The patient was given a prescribed opioid analgesic at 0300.” ____ 10. The staff nurse is communicating with the change nurse about the change of status of the patient. The nurse would begin her communication with which statement if correctly using the SBAR format? 1) “The patient’s heartrate is 110.” 2) “I think this patient needs to be transferred to the critical care unit.” 3) “The patient is a 68-year-old male patient admitted last night.” 4) “The patient is complaining of chest pain.” ____ 11. Which nursing action exemplifies the Quality and Safety Education for Nursing (QSEN) competency of safety? 1) Advocating for a patient who is experiencing pain 2) Considering the patient’s culture when planning care 3) Evaluating patient learning style prior to implementing discharge instructions 4) Assessing the right drug prior to administering a prescribed patient medication ____ 12. Which type of nursing is the root of all other nursing practice areas? 1) Pediatric nursing 2) Geriatric nursing 3) Medical-surgical nursing 4) Mental health-psychiatric nursing ____ 13. Which did the Nursing Executive Center of The Advisory Board identify as an academic-practice gap for new graduate nurses? 1) Patient advocacy 2) Patient education 3) Disease pathophysiology 4) Therapeutic communication ____ 14. Which statement regarding the use of the nursing process in clinical practice is accurate? 1) “The nursing process is closely related to clinical decision-making.” 2) “The nursing process is used by all members of the interprofessional team to plan care.” 3) “The nursing process has 4 basic steps: assessment, planning, implementation, evaluation.” 4) “The nursing process is being replaced by the implementation of evidence-based practice.”TestBankWorld.org ____ 15. Which is the basis of nursing care practices and protocols? 1) Assessment 2) Evaluation 3) Diagnosis 4) Research ____ 16. Which is a common theme regarding patient dissatisfaction related to care provided in the hospital setting? 1) Space in hospital rooms 2) Medications received to treat pain 3) Time spent with the health-care team 4) Poor quality food received from dietary ____ 17. The nurse manager is preparing a medical-surgical unit for The Joint Commission (TJC) visit With the nurse manager presenting staff education focusing on TJC benchmarks, which of the following topics would be most appropriate? 1) Implementation of evidence-based practice 2) Implementation of patient-centered care 3) Implementation of medical asepsis practices 4) Implementation of interprofessional care ____ 18. Which aspect of patient-centered care should the nurse manager evaluate prior to The Joint Commission site visit for accreditation? 1) Visitation rights 2) Education level of staff 3) Fall prevention protocol 4) Infection control practices ____ 19. The medical-surgical nurse is providing patient care. Which circumstance would necessitate the nurse verifying the patient’s identification using at least two sources? 1) Prior to delivering a meal tray 2) Prior to passive range of motion 3) Prior to medication administration 4) Prior to documenting in the medical record ____ 20. The nurse is providing care to several patients on a medical-surgical unit. Which situation would necessitate the nurse to use SBAR during the hand-off process? 1) Wound care 2) Discharge to home 3) Transfer to radiology 4) Medication education Multiple Response Identify one or more choices that best complete the statement or answer the question. ____ 21. The staff nurse is teaching a group of student nurses the situations that necessitate hand-off communication. Which student responses indicate the need for further education related to this procedure? Select all that apply. 1) “A hand-off is required prior to administering a medication.” 2) “A hand-off is required during change of shift.” 3) “A hand-off is required for a patient is transferred to the surgical suite.”TestBankWorld.org 4) “A hand-off is required whenever the nurse receives a new patient assignment.” 5) “A hand-off is required prior to family visitation.” ____ 22. Which actions by the nurse enhance patient safety during medication administration? Select all that apply. 1) Answering the call bell while transporting medications for a different patient 2) Identifying the patient using two sources prior to administering the medication 3) Holding a medication if the patient’s diagnosis does not support its use 4) Administering the medication two hours after the scheduled time 5) Having another nurse verify the prescribed dose of insulin the patient is to receive ____ 23. The medical-surgical nurse assumes care for a patient who is receiving continuous cardiopulmonary monitoring. Which actions by the nurse enhance safety for this patient? Select all that apply. 1) Silencing the alarm during family visitation 2) Assessing the alarm parameters at the start of the shift 3) Responding to the alarm in a timely fashion 4) Decreasing the alarm volume to enhance restful sleep 5) Adjusting alarm parameters based on specified practitioner prescription ____ 24. The nurse is planning an interprofessional care conference for a patient who is approaching discharge from the hospital. Which members of the interprofessional team should the nurse invite to attend? Select all that apply. 1) Physician 2) Pharmacist 3) Unit secretary 4) Social worker 5) Home care aide ____ 25. The nurse manager wants to designate a member of the nursing team as the care coordinator for a patient who will require significant care during the hospitalization. Which skills should this nurse possess in order to assume this role? Select all that apply. 1) Effective clinical reasoning 2) Effective communication skills 3) Effective infection control procedures 4) Effective documentation 5) Effective intravenous skillsTestBankWorld.org Chapter 1: Foundations for Medical-Surgical Nursing Answer Section MULTIPLE CHOICE 1. ANS: 1 Chapter number and title: 1, Foundations for Medical Surgical Practice Chapter learning objective: Discussing the incorporation of evidence-based practices into medical-surgical nursing Chapter page reference: 003-004 Heading: Evidence-Based Nursing Care Integrated Processes: Nursing Process: Planning Client Need: Safe and Effective Care Environment/Management of Care Cognitive level: Comprehension [Understanding] Concept: Evidence-Based Practice Difficulty: Easy Feedback 1 Systematic reviews of randomized control studies (Level I) are the highest level of evidence because they include data from selected studies that randomly assigned participants to control and experimental groups. The lower the numerical rating of the level of evidence indicates the highest level of evidence; therefore, this type of study provides the strongest evidence to support a practice change. 2 Quasi-experimental studies are considered Level III; therefore, this study does not provide the strongest evidence to support a practice change. 3 Case-control studies are considered Level IV; therefore, this study does not provide the strongest evidence to support a practice change. 4 Cohort studies are considered Level IV; therefore, this study does not provide the strongest evidence to support a practice change. PTS: 1 CON: Evidence-Based Practice 2. ANS: 4 Chapter number and title: 1, Foundations of Medical-Surgical Practice Chapter learning objective: Explaining the importance of patient-centered care in the management of medical-surgical patients Chapter page reference: 004-005 Heading: Patient-Centered Care in the Medical-Surgical Setting Integrated Processes: Caring Client Need: Psychosocial Integrity Cognitive level: Application [Applying] Concept: Nursing Roles Difficulty: Moderate Feedback 1 Evaluation is a step in the nursing process; however, this is not an action that supports the patient-centered care model. 2 Assessment is a step in the nursing process; however, this is not an action that supports the patient-centered care model.TestBankWorld.org 3 Diagnosis is a step in the nursing process; however, this is not an action that supports the patient-centered care model. 4 Compassion is a competency closely associated with patient-centered care; therefore, this action supports the patient-centered model of care. PTS: 1 CON: Nursing Roles 3. ANS: 3 Chapter number and title: 1, Foundations of Medical-Surgical Nursing Practice Chapter learning objective: Discussing implications to medical-surgical nurses of Quality and Safety Education for Nurses (QSEN) competencies Chapter page reference: 005-006 Heading: Patient Safety Outcomes Integrated Processes: Nursing Process: Implementation Client Need: Safe and Effective Care Environment/Management of Care Cognitive level: Application [Applying] Concept: Safety Difficulty: Moderate Feedback 1 Safely using alarms is a NPSG identified by TJC. Silencing a cardiorespiratory monitor is not nursing action that supports this NPSG. 2 Patient identification using two separate resources is a NPSG identified by TJC. Identifying a patient using only one source does not support this NPSG. 3 Identification of patient safety risks is a NPSG identified by the TJC. Determining patient safety issues upon admission supports this NPSG. 4 Safe use of medication is a NPSG identified by the TJC. Decreasing the amount of pain medication administered does not support this NPSG. PTS: 1 CON: Safety 4. ANS: 3 Chapter number and title: 1, Foundations of Medical-Surgical Nursing Practice Chapter learning objective: Describing the role and competencies of medical-surgical nursing Chapter page reference: 006-007 Heading: Interprofessional Collaboration and Communication Integrated Processes: Nursing Process: Implementation Client Need: Safe and Effective Care Environment/Management of Care Cognitive level: Comprehension [Understanding] Concept: Nursing Roles Difficulty: Easy Feedback 1 The nurse does not often assume the interprofessional role of social worker when providing patient care in an acute care setting. 2 The nurse does not often assume the interprofessional role of client advocate role when providing patient care in an acute care setting. 3 The nurse often assumes the interprofessional role of care coordinator when providing patient care in an acute care setting. 4 The nurse does not often assume the interprofessional role of massage therapist when providing patient care in an acute care setting.TestBankWorld.org PTS: 1 CON: Nursing Roles 5. ANS: 1 Chapter number and title: 1, Foundations of Medical-Surgical Practice Chapter learning objective: Discussing the incorporation of evidence-based practices into medical-surgical nursing Chapter page reference: 003 Heading: Box 1.3 Steps of Evidence-Based Practice Integrated Processes: Nursing Process: Implementation Client Need: Safe and Effective Care Environment/Management of Care Cognitive level: Analysis [Analyzing] Concept: Evidence-Based Practice Difficulty: Difficult Feedback 1 The first step of evidence-based practice is to develop a question based on the clinical issue. 2 The last step of evidence-based practice is to disseminate findings. 3 The second step of evidence-based practice is to conduct a review of the literature, or current evidence, available. 4 The fifth step of evidence-based practice is to evaluate the outcomes associated with the practice change. PTS: 1 CON: Evidence-Based Practice 6. ANS: 4 Chapter number and title: 1, Foundations of Medical-Surgical Nursing Practice Chapter learning objective: Discussing the incorporation of evidence-based practices into medical-surgical nursing Chapter page reference: 004 Heading: Box 1.4 Evaluating Levels of Evidence Integrated Processes: Nursing Process: Planning Client Need: Safe and Effective Care Environment/Management of Care Cognitive level: Comprehension [Understanding] Concept: Evidence-Based Practice Difficulty: Easy Feedback 1 The lower the numeric value of the evidence the greater the support for a change in practice. Level IV evidence does not carry the lowest level of support for a practice change. 2 The lower the numeric value of the evidence the greater the support for a change in practice. Level V evidence does not carry the lowest level of support for a practice change. 3 The lower the numeric value of the evidence the greater the support for a change in practice. Level VI evidence does not carry the lowest level of support for a practice change. 4 The lower the numeric value of the evidence the greater the support for a change in practice. Level VII evidence carries the lowest level of support for a practice change.

Chapter 01: Using Evidence in Practice Perry et al.: Clinical Nursing Skills & Techniques, 9th Edition   MULTIPLE CHOICE  
  1. Evidence-based practice is a problem-solving approach to making decisions about patient care that is grounded in:
a. the latest information found in textbooks.
b. systematically conducted research studies.
c. tradition in clinical practice.
d. quality improvement and risk-management data.
    ANS:   B The best evidence comes from well-designed, systematically conducted research studies described in scientific journals. Portions of a textbook often become outdated by the time it is published. Many health care settings do not have a process to help staff adopt new evidence in practice, and nurses in practice settings lack easy access to risk-management data, relying instead on tradition or convenience. Some sources of evidence do not originate from research. These include quality improvement and risk-management data; infection control data; retrospective or concurrent chart reviews; and clinicians’ expertise. Although non–research-based evidence is often very valuable, it is important that you learn to rely more on research-based evidence.   DIF:    Cognitive Level: Comprehension       REF:    Text reference: p. 2 OBJ:    Discuss the benefits of evidence-based practice. TOP:    Evidence-Based Practice                   KEY:   Nursing Process Step: Assessment MSC:   NCLEX: Safe and Effective Care Environment (management of care)  
  1. When evidence-based practice is used, patient care will be:
a. standardized for all.
b. unhampered by patient culture.
c. variable according to the situation.
d. safe from the hazards of critical thinking.
    ANS:   C Using your clinical expertise and considering patients’ cultures, values, and preferences ensures that you will apply available evidence in practice ethically and appropriately. Even when you use the best evidence available, application and outcomes will differ; as a nurse, you will develop critical thinking skills to determine whether evidence is relevant and appropriate.   DIF:    Cognitive Level: Application             REF:    Text reference: p. 2 OBJ:    Discuss the benefits of evidence-based practice. TOP:    Evidence-Based Practice                   KEY:   Nursing Process Step: Assessment MSC:   NCLEX: Safe and Effective Care Environment (management of care)  
  1. When a PICOT question is developed, the letter that corresponds with the usual standard of care is:
a. P.
b. I.
c. C.
d. O.
    ANS:   C C = Comparison of interest. What standard of care or current intervention do you usually use now in practice? P = Patient population of interest. Identify your patient by age, gender, ethnicity, disease, or health problem. I = Intervention of interest. What intervention (e.g., treatment, diagnostic test, and prognostic factor) do you think is worthwhile to use in practice? O = Outcome. What result (e.g., change in patient’s behavior, physical finding, and change in patient’s perception) do you wish to achieve or observe as the result of an intervention?   DIF:    Cognitive Level: Knowledge             REF:    Text reference: p. 3 OBJ:    Develop a PICO question.                 TOP:    PICO KEY:   Nursing Process Step: Implementation MSC:   NCLEX: Safe and Effective Care Environment (management of care)  
  1. A well-developed PICOT question helps the nurse:
a. search for evidence.
b. include all five elements of the sequence.
c. find as many articles as possible in a literature search.
d. accept standard clinical routines.
    ANS:   A The more focused a question that you ask is, the easier it is to search for evidence in the scientific literature. A well-designed PICOT question does not have to include all five elements, nor does it have to follow the PICOT sequence. Do not be satisfied with clinical routines. Always question and use critical thinking to consider better ways to provide patient care.   DIF:    Cognitive Level: Analysis                  REF:    Text reference: p. 3 OBJ:    Describe the six steps of evidence-based practice. TOP:    Evidence-Based Practice                   KEY:   Nursing Process Step: Implementation MSC:   NCLEX: Safe and Effective Care Environment (management of care)  
  1. The nurse is not sure that the procedure the patient requires is the best possible for the situation. Utilizing which of the following resources would be the quickest way to review research on the topic?
a. CINAHL
b. PubMed
c. MEDLINE
d. The Cochrane Database
    ANS:   D The Cochrane Community Database of Systematic Reviews is a valuable source of synthesized evidence (i.e., pre-appraised evidence). The Cochrane Database includes the full text of regularly updated systematic reviews and protocols for reviews currently happening. MEDLINE, CINAHL, and PubMed are among the most comprehensive databases and represent the scientific knowledge base of health care.   DIF:    Cognitive Level: Synthesis                REF:    Text reference: p. 4 OBJ:    Describe the six steps of evidence-based practice. TOP:    Evidence-Based Practice                   KEY:   Nursing Process Step: Implementation MSC:   NCLEX: Safe and Effective Care Environment (management of care)  
  1. The nurse is getting ready to develop a plan of care for a patient who has a specific need. The best source for developing this plan of care would probably be:
a. The Cochrane Database.
b. MEDLINE.
c. NGC.
d. CINAHL.
    ANS:   C The National Guidelines Clearinghouse (NGC) is a database supported by the Agency for Healthcare Research and Quality (AHRQ). It contains clinical guidelines—systematically developed statements about a plan of care for a specific set of clinical circumstances involving a specific patient population. The NGC is a valuable source when you want to develop a plan of care for a patient. The Cochrane Community Database of Systematic Reviews, MEDLINE, and CINAHL are all valuable sources of synthesized evidence (i.e., pre-appraised evidence).   DIF:    Cognitive Level: Synthesis                REF:    Text reference: p. 4 OBJ:    Describe the six steps of evidence-based practice. TOP:    Evidence-Based Practice                   KEY:   Nursing Process Step: Implementation MSC:   NCLEX: Safe and Effective Care Environment (management of care)  
  1. The nurse has done a literature search and found 25 possible articles on the topic that she is studying. To determine which of those 25 best fit her inquiry, the nurse first should look at:
a. the abstracts.
b. the literature reviews.
c. the “Methods” sections.
d. the narrative sections.
    ANS:   A An abstract is a brief summary of an article that quickly tells you whether the article is research based or clinically based. An abstract summarizes the purpose of the study or clinical query, the major themes or findings, and the implications for nursing practice. The literature review usually gives you a good idea of how past research led to the researcher’s question. The “Methods” or “Design” section explains how a research study is organized and conducted to answer the research question or to test the hypothesis. The narrative of a manuscript differs according to the type of evidence-based article—clinical or research.   DIF:    Cognitive Level: Application             REF:    Text reference: p. 7 OBJ:    Discuss elements to review when critiquing the scientific literature. TOP:    Randomized Controlled Trials           KEY:   Nursing Process Step: Implementation MSC:   NCLEX: Safe and Effective Care Environment (management of care)  
  1. The nurse wants to determine the effects of cardiac rehabilitation program attendance on the level of postmyocardial depression for individuals who have had a myocardial infarction. The type of study that would best capture this information would be a:
a. randomized controlled trial.
b. qualitative study.
c. case control study.
d. descriptive study.
    ANS:   B Qualitative studies examine individuals’ experiences with health problems and the contexts in which these experiences occur. A qualitative study is best in this case of an individual nurse who wants to examine the effectiveness of a local program. Randomized controlled trials involve close monitoring of control groups and treatment groups to test an intervention against the usual standard of care. Case control studies typically compare one group of subjects with a certain condition against another group without the condition, to look for associations between the condition and predictor variables. Descriptive studies focus mainly on describing the concepts under study.   DIF:    Cognitive Level: Synthesis                REF:    Text reference: p. 6 OBJ:    Discuss ways to apply evidence in nursing practice. TOP:    Randomized Controlled Trials           KEY:   Nursing Process Step: Implementation MSC:   NCLEX: Safe and Effective Care Environment (management of care)  
  1. Six months after an early mobility protocol was implemented, the incidence of deep vein thrombosis in patients was decreased. This is an example of what stage in the EBP process?
a. Asking a clinical question
b. Applying the evidence
c. Evaluating the practice decision
d. Communicating your results
    ANS:   C After implementing a practice change, your next step is to evaluate the effect. You do this by analyzing the outcomes data that you collected during the pilot project. Outcomes evaluation tells you whether your practice change improved conditions, created no change, or worsened conditions.   DIF:    Cognitive Level: Application             REF:    Text reference: p. 9 OBJ:    Discuss ways to apply evidence in nursing practice. TOP:    Evidence-Based Practice                   KEY:   Nursing Process Step: Evaluation MSC:   NCLEX: Safe and Effective Care Environment (safety and infection control)   MULTIPLE RESPONSE  
  1. To use evidence-based practice appropriately, you need to collect the most relevant and best evidence and to critically appraise the evidence you gather. This process also includes: (Select all that apply.)
a. asking a clinical question.
b. applying the evidence.
c. evaluating the practice decision.
d. communicating your results.
    ANS:   A, B, C, D
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