| Content | Test Bank for Fundamentals Of Nursing 9th Edition by Potter
Chapter 01: Nursing Today
Fundamentals of Nursing, 9th Edition
MULTIPLE CHOICE
1. Which nurse most likely kept records on sanitation techniques and the effects on health?
a. Florence Nightingale
b. Mary Nutting
c. Clara Barton
d. Lillian Wald
ANS: A
Nightingale was the first practicing nurse epidemiologist. Her statistical analyses connected poor
sanitation with cholera and dysentery. Mary Nutting, Clara Barton, and Lillian Wald came after
Nightingale, each contributing to the nursing profession in her own way. Mary Nutting was
instrumental in moving nursing education into universities. Clara Barton founded the American
Red Cross. Lillian Wald helped open the Henry Street Settlement.
2. The nurse prescribes strategies and alternatives to attain expected outcome. Which standard of
nursing practice is the nurse following?
a. Assessment
b. Diagnosis
c. Planning
d. Implementation
ANS: C
In planning, the registered nurse develops a plan that prescribes strategies and alternatives to
attain expected outcomes. During assessment, the registered nurse collects comprehensive data
pertinent to the patient’s health and/or the situation. In diagnosis, the registered nurse analyzes
the assessment data to determine the diagnoses or issues. During implementation, the registered
nurse implements (carries out) the identified plan.
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3. An experienced medical-surgical nurse chooses to work in obstetrics. Which level of
proficiency is the nurse upon initial transition to the obstetrical floor?
a. Novice
b. Proficient
c. Competent
d. Advanced beginner
ANS: A
A beginning nursing student or any nurse entering a situation in which there is no previous level
of experience (e.g., an experienced operating room nurse chooses to now practice in home
health) is an example of a novice nurse. A proficient nurse perceives a patient’s clinical situation
as a whole, is able to assess an entire situation, and can readily transfer knowledge gained from
multiple previous experiences to a situation. A competent nurse understands the organization and
specific care required by the type of patients (e.g., surgical, oncology, or orthopedic patients).
This nurse is a competent practitioner who is able to anticipate nursing care and establish longrange goals. A nurse who has had some level of experience with the situation is an advanced
beginner. This experience may only be observational in nature, but the nurse is able to identify
meaningful aspects or principles of nursing care.
4. A nurse assesses a patient’s fluid status and decides that the patient needs to drink more fluids.
The nurse then encourages the patient to drink more fluids. Which concept is the nurse
demonstrating?
a. Licensure
b. Autonomy
c. Certification
d. Accountability
ANS: B
Autonomy is an essential element of professional nursing that involves the initiation of
independent nursing interventions without medical orders. To obtain licensure in the United
States, the RN candidate must pass the NCLEX-RN®. Beyond the NCLEX-RN®, the nurse may
choose to work toward certification in a specific area of nursing practice. Accountability means
that you are responsible, professionally and legally, for the type and quality of nursing care
provided.
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5. A nurse prepares the budget and policies for an intensive care unit. Which role is the nurse
implementing?
a. Educator
b. Manager
c. Advocate
d. Caregiver
ANS: B
A manager coordinates the activities of members of the nursing staff in delivering nursing care
and has personnel, policy, and budgetary responsibility for a specific nursing unit or facility. As
an educator, you explain concepts and facts about health, describe the reason for routine care
activities, demonstrate procedures such as self-care activities, reinforce learning or patient
behavior, and evaluate the patient’s progress in learning. As a patient advocate, you protect your
patient’s human and legal rights and provide assistance in asserting these rights if the need arises.
As a caregiver, you help patients maintain and regain health, manage disease and symptoms, and
attain a maximal level function and independence through the healing process.
6. The nurse has been working in the clinical setting for several years as an advanced practice
nurse. However, the nurse has a strong desire to pursue research and theory development. To
fulfill this desire, which program should the nurse attend?
a. Doctor of Nursing Science degree (DNSc)
b. Doctor of Philosophy degree (PhD)
c. Doctor of Nursing Practice degree (DNP)
d. Doctor in the Science of Nursing degree (DSN)
ANS: B
Some doctoral programs prepare nurses for more rigorous research and theory development and
award the research-oriented Doctor of Philosophy (PhD) in nursing. Professional doctoral
programs in nursing (DSN or DNSc) prepare graduates to apply research findings to clinical
nursing. The DNP is a practice doctorate that prepares advanced practice nurses such as nurse
practitioners.
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7. A nurse attends a workshop on current nursing issues provided by the American Nurses
Association. Which type of education did the nurse receive?
a. Graduate education
b. Inservice education
c. Continuing education
d. Registered nurse education
ANS: C
Continuing education involves formal, organized educational programs offered by universities,
hospitals, state nurses associations, professional nursing organizations, and educational and
health care institutions. After obtaining a baccalaureate degree in nursing, you can pursue
graduate education leading to a master’s or doctoral degree in any number of graduate fields,
including nursing. Inservice education programs are instruction or training provided by a health
care facility or institution. Registered nurse education is the education preparation for an
individual intending to be an RN.
8. A nurse identifies gaps between local and best practices. Which Quality and Safety Education
for Nurses (QSEN) competency is the nurse demonstrating?
a. Safety
b. Patient-centered care
c. Quality improvement
d. Teamwork and collaboration
ANS: C
Quality improvement identifies gaps between local and best practices. Safety minimizes risk of
harm to patients and providers through both system effectiveness and individual performance.
Patient-centered care recognizes the patient or designee as the source of control and full partner
in providing compassionate and coordinated care based on respect for patient’s preferences,
values, and needs. Teamwork and collaboration allows effective functioning within nursing and
interprofessional teams, fostering open communication, mutual respect, and shared decision
making.
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9. A nurse has compassion fatigue. What is the nurse experiencing?
a. Lateral violence and intrapersonal conflict
b. Burnout and secondary traumatic stress
c. Short-term grief and single stressor
d. Physical and mental exhaustion
ANS: B
Compassion fatigue is a term used to describe a state of burnout and secondary traumatic stress.
Compassion fatigue may contribute to what is described as lateral violence (nurse-nurse
interactions, not intrapersonal). Frequent, intense, or prolonged exposure to grief and loss places
nurses at risk for developing compassion fatigue. Stressors, not a single stressor, contribute to
compassion fatigue. Physical and mental exhaustion describes burnout only.
10. A patient is scheduled for surgery. When getting ready to obtain the informed consent, the
patient tells the nurse, “I have no idea what is going to happen. I couldn’t ask any questions.”
The nurse does not allow the patient to sign the permit and notifies the health care provider of the
situation. Which role is the nurse displaying?
a. Manager
b. Patient educator
c. Patient advocate
d. Clinical nurse specialist
ANS: C
As a patient advocate, the nurse protects the patient’s human and legal rights, including the right
of the patient to understand procedures before signing permits. Although nurses can be
educators, it is the responsibility of the surgeon to provide education for the patient in
preparation for surgery, and it is the nurse’s responsibility to notify the health care provider if the
patient is not properly educated. Managers coordinate the activities of members of the nursing
staff in delivering nursing care, and clinical nurse specialists are experts in a specialized area of
nursing practice in a variety of settings. |
Chapter 01: Drug Definitions, Standards, and Information Sources
Willihnganz: Clayton’s Basic Pharmacology for Nurses, 18th Edition
MULTIPLE CHOICE
1.What is the name under which a drug is listed by the US Food and Drug Administration (FDA)?
| a. |
Brand |
| b. |
Nonproprietary |
| c. |
Official |
| d. |
Trademark |
ANS: C
The official name is the name under which a drug is listed by the FDA. The brand name, or trademark, is the name given to a drug by its manufacturer. The nonproprietary, or generic, name is provided by the United States Adopted Names Council
DIF: Cognitive Level: Knowledge REF: p. 2 OBJ: 1
NAT: NCLEX Client Needs Category: Safe, Effective Care Environment
TOP: Nursing Process Step: Assessment CON: Patient Education
- Which source contains information specific to nutritional supplements?
| a. |
USP Dictionary of USAN & International Drug Names |
| b. |
Natural Medicines Comprehensive Database |
| c. |
United States Pharmacopoeia/National Formulary (USP NF) |
| d. |
Drug Interaction Facts |
ANS: C
United States Pharmacopoeia/National Formulary contains information specific to nutritional supplements. USP Dictionary of USAN & International Drug Names is a compilation of drug names, pronunciation guide, and possible future FDA approved drugs; it does not include nutritional supplements. Natural Medicines Comprehensive Database contains evidence-based information on herbal medicines and herbal combination products; it does not include information specific to nutritional supplements. Drug Interaction Facts contains comprehensive information on drug interaction facts; it does not include nutritional supplements.
DIF: Cognitive Level: Knowledge REF: p. 2 | p. 3 OBJ: 3
NAT: NCLEX Client Needs Category: Physiological Integrity
TOP: Nursing Process Step: Assessment CON: Nutrition | Patient Education
3.What is the most comprehensive reference available to research a drug interaction?
| a. |
Drug Facts and Comparisons |
| b. |
Drug Interaction Facts |
| c. |
Handbook on Injectable Drugs |
| d. |
Martindale—The Complete Drug Reference |
ANS: B
First published in 1983, Drug Interaction Facts is the most comprehensive book available on drug interactions. In addition to monographs listing various aspects of drug interactions, this information is reviewed and updated by an internationally renowned group of physicians and pharmacists with clinical and scientific expertise.
DIF: Cognitive Level: Comprehension REF: p. 4 OBJ: 3
NAT: NCLEX Client Needs Category: Physiological Integrity
TOP: Nursing Process Step: Assessment CON: Safety | Patient Education | Clinical Judgment
4.The physician has written an order for a drug with which the nurse is unfamiliar. Which section of the Physicians’ Desk Reference (PDR) is most helpful to get information about this drug?
| a. |
Manufacturer’s section |
| b. |
Brand and Generic name section |
| c. |
Product category section |
| d. |
Product information section |
ANS: B
A physician’s order would include the brand and/or generic name of the drug. The alphabetic index in the PDR would make this section the most user-friendly. Based on a physician’s order, manufacturer’s information and classification information would not be known. The Manufacturer’s section is a roster of manufacturers. The product category section lists products subdivided by therapeutic classes, such as analgesics, laxatives, oxytocics, and antibiotics. The product information section contains reprints of the package inserts for the major products of manufacturers.
DIF: Cognitive Level: Comprehension REF: p. 4 OBJ: 3
NAT: NCLEX Client Needs Category: Physiological Integrity
TOP: Nursing Process Step: Planning CON: Safety | Patient Education | Clinical Judgment
5.Which online drug reference makes available to healthcare providers and the public a standard, comprehensive, up-to-date look up and downloadable resource about medicines?
| a. |
American Drug Index |
| b. |
American Hospital Formulary |
| c. |
DailyMed |
| d. |
Physicians’ Desk Reference (PDR) |
ANS: C
DailyMed makes available to healthcare providers and the public a standard, comprehensive, up-to-date look up and downloadable resource about medicines. The American Drug Index is not appropriate for patient use. The American Hospital Formulary is not appropriate for patient use. The PDR is not appropriate for patient use.
DIF: Cognitive Level: Knowledge REF: p. 3 | p. 5 OBJ: 4
NAT: NCLEX Client Needs Category: Physiological Integrity
TOP: Nursing Process Step: Implementation
CON: Safety | Patient Education | Clinical Judgment
6.Which legislation authorizes the FDA to determine the safety of a drug before its marketing?
| a. |
Federal Food, Drug, and Cosmetic Act (1938) |
| b. |
Durham Humphrey Amendment (1952) |
| c. |
Controlled Substances Act (1970) |
| d. |
Kefauver Harris Drug Amendment (1962) |
ANS: A
The Federal Food, Drug, and Cosmetic Act of 1938 authorized the FDA to determine the safety of all drugs before marketing. Later amendments and acts helped tighten FDA control and ensure drug safety. The Durham Humphrey Amendment defines the kinds of drugs that cannot be used safely without medical supervision and restricts their sale to prescription by a licensed practitioner. The Controlled Substances Act addresses only controlled substances and their categorization. The Kefauver Harris Drug Amendment ensures drug efficacy and greater drug safety. Drug manufacturers are required to prove to the FDA the effectiveness of their products before marketing them.
DIF: Cognitive Level: Knowledge REF: p. 5 OBJ: 6
NAT: NCLEX Client Needs Category: Physiological Integrity
TOP: Nursing Process Step: Assessment
CON: Safety | Patient Education | Evidence | Health Care Law
7.Meperidine (Demerol) is a narcotic with a high potential for physical and psychological dependency. Under which classification does this drug fall?
ANS: B
Meperidine (Demerol) is a Schedule II drug; it has a high potential for abuse and may lead to severe psychological and physical dependence. Schedule I drugs have high potential for abuse and no recognized medical use. Schedule III drugs have some potential for abuse. Use may lead to low to moderate physical dependence or high psychological dependence. Schedule IV drugs have low potential for abuse. Use may lead to limited physical or psychological dependence.
DIF: Cognitive Level: Comprehension REF: p. 5 OBJ: 2
NAT: NCLEX Client Needs Category: Safe, Effective Care Environment
TOP: Nursing Process Step: Assessment CON: Patient Education | Addiction | Pain
8:What would the FDA do to expedite drug development and approval for an outbreak of smallpox, for which there is no known treatment?
| a. |
List smallpox as a health orphan disease. |
| b. |
Omit the preclinical research phase. |
| c. |
Extend the clinical research phase. |
| d. |
Fast track the investigational drug. |
ANS: D | Chapter 01: Using Evidence in Practice
Perry et al.: Clinical Nursing Skills & Techniques, 9th Edition
MULTIPLE CHOICE
- 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)
- 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)
- When a PICOT question is developed, the letter that corresponds with the usual standard of care is:
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)
- 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)
- 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)
- 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)
- 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)
- 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)
- 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
- 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 | Test Bank for Maternal Child Nursing Care 6th Edition Perry
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Chapter 01: 21st Century Maternity Nursing
Perry: Maternal Child Nursing Care, 6th Edition
MULTIPLE CHOICE
1. When providing care for a pregnant woman, the nurse should be aware that one of the most
frequently reported maternal medical risk factors is:
a. diabetes mellitus.
b. mitral valve prolapse (MVP).
c. chronic hypertension.
d. anemia.
ANS: A
The most frequently reported maternal medical risk factors are diabetes and hypertension
associated with pregnancy. Both of these conditions are associated with maternal obesity.
There are no studies that indicate MVP is among the most frequently reported maternal risk
factors. Hypertension associated with pregnancy, not chronic hypertension, is one of the most
frequently reported maternal medical risk factors. Although anemia is a concern in pregnancy,
it is not one of the most frequently reported maternal medical risk factors in pregnancy.
PTS: 1 DIF: Cognitive Level: Knowledge
OBJ: Nursing Process: Assessment MSC: Client Needs: Physiologic Integrity
2. To ensure optimal outcomes for the patient, the contemporary maternity nurse must
incorporate both teamwork and communication with clinicians into her care delivery. The
SBAR technique of communication is an easy-to-remember mechanism for communication.
Which of the following correctly defines this acronym?
a. Situation, baseline assessment, response
b. Situation, background, assessment, recommendation
c. Subjective background, assessment, recommendation
d. Situation, background, anticipated recommendation
ANS: B
The situation, background, assessment, recommendation (SBAR) technique provides a
specific framework for communication among health care providers. Failure to communicate
is one of the major reasons for errors in health care. The SBAR technique has the potential to
serve as a means to reduce errors.
PTS: 1 DIF: Cognitive Level: Comprehension
OBJ: Nursing Process: Assessment, Planning
MSC: Client Needs: Safe and Effective Care Environment
3. The role of the professional nurse caring for childbearing families has evolved to emphasize:
a. providing care to patients directly at the bedside.
b. primarily hospital care of maternity patients.
c. practice using an evidence-based approach.
d. planning patient care to cover longer hospital stays.
ANS: C
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Professional nurses are part of the team of health care providers who collaboratively care for
patients throughout the childbearing cycle. Providing care to patients directly at the bedside is
one of the nurse’s tasks; however, it does not encompass the concept of the evolved
professional nurse. Throughout the prenatal period, nurses care for women in clinics and
physician’s offices and teach classes to help families prepare for childbirth. Nurses also care
for childbearing families in birthing centers and in the home. Nurses have been critically
important in developing strategies to improve the well-being of women and their infants and
have led the efforts to implement clinical practice guidelines using an evidence-based
approach. Maternity patients have experienced a decreased, rather than an increased, length of
stay over the past two decades.
PTS: 1 DIF: Cognitive Level: Comprehension
OBJ: Nursing Process: Implementation
MSC: Client Needs: Safe and Effective Care Environment
4. A 23-year-old African-American woman is pregnant with her first child. Based on the
statistics for infant mortality, which plan is most important for the nurse to implement?
a. Perform a nutrition assessment.
b. Refer the woman to a social worker.
c. Advise the woman to see an obstetrician, not a midwife.
d. Explain to the woman the importance of keeping her prenatal care appointments.
ANS: D
Consistent prenatal care is the best method of preventing or controlling risk factors associated
with infant mortality. Nutritional status is an important modifiable risk factor, but a nutrition
assessment is not the most important action a nurse should take in this situation. The patient
may need assistance from a social worker at some time during her pregnancy, but a referral to
a social worker is not the most important aspect the nurse should address at this time. If the
woman has identifiable high risk problems, her health care may need to be provided by a
physician. However, it cannot be assumed that all African-American women have high risk
issues. In addition, advising the woman to see an obstetrician is not the most important aspect
on which the nurse should focus at this time, and it is not appropriate for a nurse to advise or
manage the type of care a patient is to receive.
PTS: 1 DIF: Cognitive Level: Application OBJ: Nursing Process: Planning
MSC: Client Needs: Health Promotion and Maintenance
5. During a prenatal intake interview, the nurse is in the process of obtaining an initial
assessment of a 21-year-old Hispanic patient with limited English proficiency. It is important
for the nurse to:
a. use maternity jargon in order for the patient to become familiar with these terms.
b. speak quickly and efficiently to expedite the visit.
c. provide the patient with handouts.
d. assess whether the patient understands the discussion.
ANS: D
Nurses contribute to health literacy by using simple, common words; avoiding jargon; and
evaluating whether the patient understands the discussion. Speaking slowly and clearly and
focusing on what is important increase understanding. Most patient education materials are
written at too high a level for the average adult and may not be useful for a patient with
limited English proficiency.
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PTS: 1 DIF: Cognitive Level: Application OBJ: Nursing Process: Evaluation
MSC: Client Needs: Health Promotion and Maintenance
6. When managing health care for pregnant women at a prenatal clinic, the nurse should
recognize that the most significant barrier to access to care is the pregnant woman’s:
a. age.
b. minority status.
c. educational level.
d. inability to pay.
ANS: D
The most significant barrier to health care access is the inability to pay for services; this is
compounded by the fact that many physicians refuse to care for women who cannot pay.
Although adolescent pregnant patients statistically receive less prenatal care, age is not the
most significant barrier. Significant disparities in morbidity and mortality rates exist for
minority women; however, minority status is not the most significant barrier to access of care.
Disparities in educational level are associated with morbidity and mortality rates; however,
educational level is not the most significant barrier to access of care.
PTS: 1 DIF: Cognitive Level: Knowledge
OBJ: Nursing Process: Assessment
MSC: Client Needs: Safe and Effective Care Environment
7. When the nurse is unsure about how to perform a patient care procedure, the best action
would be to:
a. ask another nurse.
b. discuss the procedure with the patient’s physician.
c. look up the procedure in a nursing textbook.
d. consult the agency’s procedure manual and follow the guidelines for the
procedure.
ANS: D
It is always best to follow the agency’s policies and procedures manual when seeking
information on correct patient procedures. These policies should reflect the current standards
of care and state guidelines. Each nurse is responsible for her own practice. Relying on
another nurse may not always be safe practice. Each nurse is obligated to follow the standards
of care for safe patient care delivery. Physicians are responsible for their own patient care
activity. Nurses may follow safe orders from physicians, but they are also responsible for the
activities that they as nurses are to carry out. Information provided in a nursing textbook is
basic information for general knowledge. Furthermore, the information in a textbook may not
reflect the current standard of care or individual state or hospital policies.
PTS: 1 DIF: Cognitive Level: Application
OBJ: Nursing Process: Implementation MSC: Client Needs: Physiologic Integrity
8. From the nurse’s perspective, what measure should be the focus of the health care system to
reduce the rate of infant mortality further?
a. Implementing programs to ensure women’s early participation in ongoing prenatal
care.
b. Increasing the length of stay in a hospital after vaginal birth from 2 to 3 days.
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c. Expanding the number of neonatal intensive care units (NICUs).
d. Mandating that all pregnant women receive care from an obstetrician.
ANS: A
Early prenatal care allows for early diagnosis and appropriate interventions to reduce the rate
of infant mortality. An increased length of stay has been shown to foster improved self-care
and parental education. However, it does not prevent the incidence of leading causes of infant
mortality rates, such as low birth weight. Early prevention and diagnosis reduce the rate of
infant mortality. NICUs offer care to high risk infants after they are born. Expanding the
number of NICUs would offer better access for high risk care, but this factor is not the
primary focus for further reduction of infant mortality rates. A mandate that all pregnant
women receive obstetric care would be nearly impossible to enforce. Furthermore, certified
nurse-midwives (CNMs) have demonstrated reliable, safe care for pregnant women.
PTS: 1 DIF: Cognitive Level: Comprehension
OBJ: Nursing Process: Implementation MSC: Client Needs: Health Promotion and Maintenance
9. Alternative and complementary therapies:
a. replace conventional Western modalities of treatment.
b. are used by only a small number of American adults.
c. recognize the value of patients’ input into their health care.
d. focus primarily on the disease an individual is experiencing.
ANS: C
Many popular alternative healing modalities offer human-centered care based on philosophies
that recognize the value of the patient’s input and honor the individual’s beliefs, values, and
desires. Alternative and complementary therapies are part of an integrative approach to health
care. An increasing number of American adults are seeking alternative and complementary
health care options. Alternative healing modalities offer a holistic approach to health, focusing
on the whole person, not just the disease.
PTS: 1 DIF: Cognitive Level: Comprehension OBJ: Nursing Process: Planning
MSC: Client Needs: Physiologic Integrity
10. A 38-year-old Hispanic woman delivered a 9-pound, 6-ounce girl vaginally after being in
labor for 43 hours. The baby died 3 days later from sepsis. On what grounds would the
woman potentially have a legitimate legal case for negligence?
a. She is Hispanic.
b. She delivered a girl.
c. The standards of care were not met.
d. She refused fetal monitoring.
ANS: C
Not meeting the standards of care is a legitimate factor for a case of negligence. The patient’s
race is not a factor for a case of negligence. The infant’s gender is not a factor for a case of
negligence. Although fetal monitoring is the standard of care, the patient has the right to
refuse treatment. This refusal is not a case for negligence; however, informed consent should
be properly obtained, and the patient should sign an against medical advice form for refusal of
any treatment that is within the standard of care.
PTS: 1 DIF: Cognitive Level: Comprehension OBJ: Nursing Process: Planning
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MSC: Client Needs: Health Promotion and Maintenance
11. A newly graduated nurse is attempting to understand the reason for increasing health care
spending in the United States. Her research finds that these costs are much higher compared
with other developed countries as a result of:
a. a higher rate of obesity among pregnant women.
b. limited access to technology.
c. increased usage of health care services along with lower prices.
d. homogeneity of the population.
ANS: A
Health care is one of the fastest growing sectors of the U.S. economy. Currently, 17.5% of the
gross domestic product is spent on health care. Higher spending in the United States compared
with 12 other industrialized countries is related to higher prices and readily accessible
technology along with greater obesity rates among women. More than one third of women in
the United States are obese. Of the U.S. population, 16% is uninsured and has limited access
to health care. Maternal morbidity and mortality are directly related to racial disparities.
PTS: 1 DIF: Cognitive Level: Analysis OBJ: Nursing Process: Planning
MSC: Client Needs: Safe and Effective Care Environment
12. The term used to describe legal and professional responsibility for practice for maternity
nurses is:
a. collegiality.
b. ethics.
c. evaluation.
d. accountability.
ANS: D
Accountability refers to legal and professional responsibility for practice. Collegiality refers to
a working relationship with one’s colleagues. Ethics refers to a code to guide practice.
Evaluation refers to examination of the effectiveness of interventions in relation to expected
outcomes.
PTS: 1 DIF: Cognitive Level: Understanding OBJ: Nursing Process: Evaluation
MSC: Client Needs: Health Promotion and Maintenance
13. Through the use of social media technology, nurses can link with other nurses who may share
similar interests, insights about practice, and advocate for patients. The most concerning
pitfall for nurses using this technology is:
a. violation of patient privacy and confidentiality.
b. institutions and colleagues may be cast in an unfavorable light.
c. unintended negative consequences for using social media.
d. lack of institutional policy governing online contact.
ANS: A
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The most significant pitfall for nurses using this technology is the violation of patient privacy
and confidentiality. Furthermore, institutions and colleagues can be cast in unfavorable lights
with negative consequences for those posting information. Nursing students have been
expelled from school and nurses have been fired or reprimanded by their Board of Nursing for
injudicious posts. The American Nurses Association has published six principles for social
networking and nurses. All institutions should have policies guiding the use of social media,
and nurses should be familiar with these guidelines.
PTS: 1 DIF: Cognitive Level: Analysis
OBJ: Nursing Process: Implementation
MSC: Client Needs: Safe and Effective Care Environment
14. An important development that affects maternity nursing is integrative health care, which:
a. seeks to provide the same health care for all racial and ethnic groups.
b. blends complementary and alternative therapies with conventional Western
treatment.
c. focuses on the disease or condition rather than the background of the patient.
d. has been mandated by Congress.
ANS: B
Integrative health care tries to mix the old with the new at the discretion of the patient and
health care providers. Integrative health care is a blending of new and traditional practices.
Integrative health care focuses on the whole person, not just the disease or condition. U.S. law
supports complementary and alternative therapies but does not mandate them.
PTS: 1 DIF: Cognitive Level: Understanding
OBJ: Nursing Process: Implementation MSC: Client Needs: Health Promotion and Maintenance
15. The nurse caring for a pregnant patient should be aware that the U.S. birth rate shows which
trend?
a. Births to unmarried women are more likely to have less favorable outcomes.
b. Birth rates for women 40 to 44 years old are beginning to decline.
c. Cigarette smoking among pregnant women continues to increase.
d. The rates of maternal death owing to racial disparity are elevated in the United
States.
ANS: A
Low-birth-weight infants and preterm birth are more likely because of the large number of
teenagers in the unmarried group. Birth rates for women in their early 40s continue to
increase. Fewer pregnant women smoke. In the United States, there is significant racial
disparity in the rates of maternal death.
PTS: 1 DIF: Cognitive Level: Comprehension
OBJ: Nursing Process: Assessment
MSC: Client Needs: Safe and Effective Care Environment
16. Maternity nursing care that is based on knowledge gained through research and clinical
trials is:
a. derived from the Nursing Intervention Classification.
b. known as evidence-based practice.
c. at odds with the Cochrane School of traditional nursing.
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d. an outgrowth of telemedicine.
ANS: B
Evidence-based practice is based on knowledge gained from research and clinical trials. The
Nursing Intervention Classification is a method of standardizing language and categorizing
care. Dr. Cochrane systematically reviewed research trials and is part of the evidence-based
practice movement. Telemedicine uses communication technologies to support health care.
PTS: 1 DIF: Cognitive Level: Comprehension
OBJ: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity
17. The level of practice a reasonably prudent nurse provides is called:
a. the standard of care.
b. risk management.
c. a sentinel event.
d. failure to rescue.
ANS: A
Guidelines for standards of care are published by various professional nursing organizations.
Risk management identifies risks and establishes preventive practices, but it does not define
the standard of care. Sentinel events are unexpected negative occurrences. They do not
establish the standard of care. Failure to rescue is an evaluative process for nursing, but it does
not define the standard of care.
PTS: 1 DIF: Cognitive Level: Comprehension OBJ: Nursing Process: Diagnosis
MSC: Client Needs: Safe and Effective Care Environment
18. While obtaining a detailed history from a woman who has recently emigrated from Somalia,
the nurse realizes that the patient has undergone female genital mutilation (FGM). The nurse’s
best response to this patient is:
a. “this is a very abnormal practice and rarely seen in the United States.”
b. “do you know who performed this so that it can be reported to the authorities?”
c. “we will be able to restore your circumcision fully after delivery.”
d. “the extent of your circumcision will affect the potential for complications.”
ANS: D
“The extent of your circumcision will affect the potential for complications” is the most
appropriate response. The patient may experience pain, bleeding, scarring, or infection and
may require surgery before childbirth. With the growing number of immigrants from countries
where FGM is practiced, nurses will increasingly encounter women who have undergone the
procedure. Although this practice is not prevalent in the United States, it is very common in
many African and Middle Eastern countries for religious reasons. Responding with, “This is a
very abnormal practice and rarely seen in the United States” is culturally insensitive. The
infibulation may have occurred during infancy or childhood. The patient will have little to no
recollection of the event. She would have considered this to be a normal milestone during her
growth and development. The International Council of Nurses has spoken out against this
procedure as harmful to a woman’s health.
PTS: 1 DIF: Cognitive Level: Application OBJ: Nursing Process: Planning
MSC: Client Needs: Safe and Effective Care Environment
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19. To ensure patient safety, the practicing nurse must have knowledge of the current Joint
Commission’s “Do Not Use” list of abbreviations. Which of the following is acceptable for
use?
a. q.o.d. or Q.O.D.
b. MSO4 or MgSO4
c. International Unit
d. Lack of a leading zero
ANS: C
The abbreviations “i.u.” and “I.U.” are no longer acceptable because they could be misread as
“I.V.” or the number “10.” The abbreviation “q.o.d. or Q.O.D.” should be written out as
“every other day.” The period after the “Q” could be mistaken for an “I”; the “o” could also
be mistaken for an “i.” With MSO4 or MgSO4, it is too easy to confuse one medication for
another. These medications are used for very different purposes and could put a patient at risk
for an adverse outcome. They should be written as morphine sulfate and magnesium sulfate.
The decimal point should never be missed before a number to avoid confusion (i.e., 0.4 rather
than .4).
PTS: 1 DIF: Cognitive Level: Application
OBJ: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity
20. Healthy People 2020 has established national health priorities that focus on a number of
maternal-child health indicators. Nurses are assuming greater roles in assessing family health
and providing care across the perinatal continuum. Therefore, it is important for the nurse to
be aware that significant progress has been made in:
a. the reduction of fetal deaths and use of prenatal care.
b. low birth weight and preterm birth.
c. elimination of health disparities based on race.
d. infant mortality and the prevention of birth defects.
ANS: A
Trends in maternal child health indicate that progress has been made in relation to reduced
infant and fetal deaths and increased prenatal care. Notable gaps remain in the rates of low
birth weight and preterm births. According to the March of Dimes, persistent disparities still
exist between African-Americans and non-Hispanic Caucasians. Many of these negative
outcomes are preventable through access to prenatal care and the use of preventive health
practices. This demonstrates the need for comprehensive community-based care for all
mothers, infants, and families.
PTS: 1 DIF: Cognitive Level: Knowledge
OBJ: Nursing Process: Implementation
MSC: Client Needs: Safe and Effective Care Environment
MULTIPLE RESPONSE
1. Which interventions would help alleviate the problems associated with access to health care
for maternity patients? (Select all that apply.)
a. Provide transportation to prenatal visits.
b. Provide child care so that a pregnant woman may keep prenatal visits.
c. Mandate that physicians make house calls.
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d. Provide low-cost or no-cost health care insurance.
e. Provide job training.
ANS: A, B, D
Lack of transportation to visits, lack of child care, and lack of affordable health insurance are
prohibitive factors associated with lack of prenatal care. House calls are not a cost-effective
approach to health care. Although job training may result in employment and income, the
likelihood of significant changes during the time frame of the pregnancy is remote.
PTS: 1 DIF: Cognitive Level: Implementation OBJ: Nursing Process: Planning
MSC: Client Needs: Health Promotion and Maintenance
MATCHING
Medical errors are a leading cause of death in the United States. The National Quality Forum
has recommended numerous safe practices that nursing can promote to reduce errors. Match
each safe practice with the correct statement.
a. Ask the patient to “teach back.”
b. Comply with CDC guidelines.
c. Ensure that information is documented in a timely manner.
d. Promote interventions that will reduce patient risk.
e. Reduce exposure to radiation.
1. Hand hygiene
2. Informed consent
3. Culture measurement, feedback, and intervention
4. Pediatric imaging
5. Patient care information
1. ANS: B PTS: 1 DIF: Cognitive Level: Application
OBJ: Nursing Process: Implementation
MSC: Client Needs: Safe and Effective Care Environment
NOT: The National Quality Forum updated its publication Safe Practices for Better Healthcare in
2010, outlining 24 safe practices that should be used in all health care settings to reduce the risk of
harm from the environment of care, processes, and systems. These are only a few of the recommended
practices; however, nurses should be familiar with these guidelines.
2. ANS: A PTS: 1 DIF: Cognitive Level: Application
OBJ: Nursing Process: Implementation
MSC: Client Needs: Safe and Effective Care Environment
NOT: The National Quality Forum updated its publication Safe Practices for Better Healthcare in
2010, outlining 24 safe practices that should be used in all health care settings to reduce the risk of
harm from the environment of care, processes, and systems. These are only a few of the recommended
practices; however, nurses should be familiar with these guidelines.
3. ANS: D PTS: 1 DIF: Cognitive Level: Application
OBJ: Nursing Process: Implementation
MSC: Client Needs: Safe and Effective Care Environment
NOT: The National Quality Forum updated its publication Safe Practices for Better Healthcare in
2010, outlining 24 safe practices that should be used in all health care settings to reduce the risk of
harm from the environment of care, processes, and systems. These are only a few of the recommended
practices; however, nurses should be familiar with these guidelines.
4. ANS: E PTS: 1 DIF: Cognitive Level: Application
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OBJ: Nursing Process: Implementation
MSC: Client Needs: Safe and Effective Care Environment
NOT: The National Quality Forum updated its publication Safe Practices for Better Healthcare in
2010, outlining 24 safe practices that should be used in all health care settings to reduce the risk of
harm from the environment of care, processes, and systems. These are only a few of the recommended
practices; however, nurses should be familiar with these guidelines.
5. ANS: C PTS: 1 DIF: Cognitive Level: Application
OBJ: Nursing Process: Implementation
MSC: Client Needs: Safe and Effective Care Environment
NOT: The National Quality Forum updated its publication Safe Practices for Better Healthcare in
2010, outlining 24 safe practices that should be used in all health care settings to reduce the risk of
harm from the environment of care, processes, and systems. These are only a few of the recommended
practices; however, nurses should be familiar with these guidelines.
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| Chapter 01: Foundations of Maternity, Women’s Health, and Child Health Nursing
MULTIPLE CHOICE
- 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
- 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
- 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
- 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
- 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
- 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
- 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
- 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
- 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
- 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
- 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
- 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 Public Health Science and Nursing Practice Caring For Populations by Savage
Chapter 10: Mental Health
MULTIPLE RESPONSE
1.According to Healthy People 2020, which of the following are characteristics of mental health?
Select all that apply.
| A. |
Engaging in productive activities |
| B. |
Having fulfilling relationships |
| C. |
Experiencing alterations in thinking |
| D. |
Adapting to change |
| E. |
Coping with challenges |
ANS: A, B, D, E
Objective: 3. Define the difference between behavioral, biological, environmental, and socioeconomic risk factors related to mental health disorders.
pp. 225-226
Heading: Introduction
Integrated Processes: N/A
Client Need: Psychosocial Integrity
Cognitive Level: Knowledge [Remembering]
Concept: Promoting Health
Difficulty: Moderate
|
Feedback |
| 1. |
Mental health is a state of successful performance of mental function, including engagement in productive activities. |
| 2. |
Mental health is a state of successful performance of mental function, including being able to form fulfilling relationships with other people. |
| 3. |
This is incorrect; it is an example of a mental disorder. Mental disorders are health conditions that are characterized by alterations in thinking, mood, or behavior that are associated with distress or impaired functioning. |
| 4. |
Mental health is a state of successful performance of mental function, including the ability to adapt to change. |
| 5. |
Mental health is a state of successful performance of mental function, including the ability to cope with challenges. |
PTS:1CON:Promoting Health
MULTIPLE CHOICE
2.In 2010, approximately how many people in the United States reported experiencing mental disorders in the previous year?
| A. |
15% |
| B. |
50% |
| C. |
30% |
| D. |
25% |
ANS: D
Objective: 1. Define the burden of disease related to mental disorders using current epidemiological frameworks.
pp. 226-227
Heading: Epidemiology of Mental Disorders
Integrated Processes: N/A
Client Need: Psychosocial Integrity
Cognitive Level: Comprehension [Understanding]
Concept: Promoting Health
Difficulty: Moderate
|
Feedback |
| A |
This is incorrect. In the United States in 2010 an estimated 25% of adults reported having mental disorders in the previous year. |
| B |
This is incorrect. In the United States in 2010 an estimated 25% of adults reported having mental disorders in the previous year. |
| C |
This is incorrect. In the United States in 2010 an estimated 25% of adults reported having mental disorders in the previous year. |
| D |
In the United States in 2010 an estimated 25% of adults reported having mental disorders in the previous year. |
PTS:1CON:Promoting Health
3.A student nurse is studying stress and mental health. The student nurse learns that ____ is based on an individual’s ability to access protective factors that exist at different levels in order to withstand chronic stress or recover from traumatic life events.
| A. |
Intervention |
| B. |
Support |
| C. |
Resilience |
| D. |
Therapy |
ANS: C
Objective: 3. Define the difference between behavioral, biological, environmental, and socioeconomic risk factors related to mental health disorders.
pp. 229-231
Heading: Protective Factors: Building Resilience
Integrated Processes: Teaching/Learning
Client Need: Psychosocial Integrity
Cognitive Level: Application [Applying]
Concept: Trauma; Stress; Promoting Health; Nursing Roles
Difficulty: Moderate
|
Feedback |
| A |
This is incorrect. Resilience is based on an individual’s ability to access protective factors that exist at different levels in order to withstand chronic stress or recover from traumatic life events. Preventive and treatment interventions are useful tools to build on an individual’s natural resilience to promote positive outcomes. |
| B |
This is incorrect. Resilience is based on an individual’s ability to access protective factors that exist at different levels in order to withstand chronic stress or recover from traumatic life events. Support from family, friends, and community is an important part of strengthening an individual’s resilience. |
| C |
Resilience is based on an individual’s ability to access protective factors that exist at different levels in order to withstand chronic stress or recover from traumatic life events. |
| D |
This is incorrect. Resilience is based on an individual’s ability to access protective factors that exist at different levels in order to withstand chronic stress or recover from traumatic life events. Therapy is an important part of an overall treatment plan, in conjunction with intervention, support, and an individual’s capacity for resilience. |
PTS: 1 CON: Trauma | Stress | Promoting Health | Nursing Roles
4.____ addresses specific subgroups at highest risk for development of a mental disorder or those that are showing early signs of a mental disorder.
| A. |
Indicated prevention |
| B. |
Selective prevention |
| C. |
Universal prevention |
| D. |
Both 1 and 2 |
ANS: A
Objective: 4. Apply current evidence-based population level interventions to the prevention of mental disorders and the promotion of optimal mental health for communities and populations.
pp. 232-233
Heading: Prevention of Mental Disorders and Promotion of Mental Health > Institute of Medicine Model of Prevention
Integrated Processes: Nursing Process
Client Need: Psychosocial Integrity
Cognitive Level: Comprehension [Understanding]
Concept: Promoting Health
Difficulty: Moderate
|
Feedback |
| A |
Indicated prevention addresses specific subgroups at highest risk for development of a mental disorder or those that are showing early signs of a mental disorder. The purpose of indicated techniques is to delay or reduce the severity of a mental disorder. |
| B |
Selective prevention includes interventions provided to specific subgroups that are known to be at high risk for mental disorders owing to biological, psychological, social, or environmental factors but that have not yet been diagnosed with mental disorders. High-risk subgroups include but are not limited to those with a family history of mental disorders, history of adverse childhood events, or victims of violence. |
| C |
Universal prevention refers to prevention interventions provided to the entire population, not just those who may be at risk. The interventions include but are not limited to public service announcements provided to the public at large through billboards, media messages (print and electronic), or general health education programs. |
| D |
Indicated prevention addresses specific subgroups at highest risk for development of a mental disorder or those that are showing early signs of a mental disorder. The purpose of indicated techniques is to delay or reduce the severity of a mental disorder. Selective prevention includes interventions provided to specific subgroups that are known to be at high risk for mental disorders owing to biological, psychological, social, or environmental factors but that have not yet been diagnosed with mental disorders. High-risk subgroups include but are not limited to those with a family history of mental disorders, history of adverse childhood events, or victims of violence. |
PTS:1CON:Promoting Health
5.The public health nurse (PHN) recognizes that which of the following are used as screening tools for depression?
| A. |
Patient Health Questionnaire 2 |
| B. |
Center for Epidemiological Studies Depression Scale (CESD-10) |
| C. |
Brief Symptom Checklist-18 of the My Mood Monitor (M-3) |
| D. |
Both 1 and 2 |
ANS: D
Objective: 5. Describe systems approaches to the promotion of mental health and the prevention and treatment of mental health disorders.
p. 232
Heading: Prevention of Mental Disorders and Promotion of Mental Health > Measure of Mental Health: Health-Related Quality of Life
Integrated Processes: Nursing Process
Client Need: Psychosocial Integrity
Cognitive Level: Application [Applying]
Concept: Promoting Health; Mood; Assessment
Difficulty: Moderate
|
Feedback |
| A |
Tools to screen for depression include the Patient Health Questionnaire 2 and the CESD-10. |
| B |
Tools to screen for depression include the Patient Health Questionnaire 2 and the CESD-10. |
| C |
This is incorrect. Tools to screen for depression include the Patient Health Questionnaire 2 and the CESD-10. Screening tools for anxiety disorders include the Brief Symptom Checklist-18 of the My Mood Monitor (M-3). |
| D |
Tools to screen for depression include the Patient Health Questionnaire 2 and the CESD-10. |
PTS:1CON:Promoting Health | Mood | Assessment
6.During a course on mental disorders, a PHN learns that the term serious mental illness (SMI) refers to diagnosable mental disorders that may disrupt a person’s ability to function and may qualify that person for support services. The PHN also notes that the mental disorders that can lead to SMI include:
| A. |
Mild depression |
| B. |
Panic disorder |
| C. |
Schizophrenia |
| D. |
Both 2 and 3 |
ANS: D
Objective: 1. Define the burden of disease related to mental disorders using current epidemiological frameworks.
pp. 225-226
Heading: Introduction
Integrated Processes: Teaching/Learning
Client Need: Psychosocial Integrity
Cognitive Level: Application [Applying]
Concept: Cognition; Mood; Stress; Promoting Health; Nursing Roles
Difficulty: Moderate
|
Feedback |
| A |
This is incorrect. Major depression, however, is one of the mental disorders that can lead to SMI. |
| B |
Both panic disorder and schizophrenia, among other mental disorders, can lead to SMI. |
| C |
Both schizophrenia and panic disorder, among other mental disorders, can lead to SMI. |
| D |
The mental disorders that can lead to SMI include major depression, panic disorder, schizophrenia, bipolar disorder, obsessive compulsive disorder (OCD), post-traumatic stress disorder (PTSD), and borderline personality disorder. |
PTS: 1 CON: Cognition | Mood | Stress | Promoting Health | Nursing Roles
7.While studying the prevalence of mental health disorders worldwide, a PHN learns about the World Mental Health Survey, which is used to determine estimates of human capital costs and prevalence of mental disorders in a wide range of countries. The survey was developed by
| A. |
The Centers for Disease Control and Prevention (CDC) |
| B. |
The World Health Organization (WHO) |
| C. |
The Institute of Medicine (IOM) |
| D. |
The World Health Assembly |
ANS: B
Objective: 1. Define the burden of disease related to mental disorders using current epidemiological frameworks.
p. 227
Heading: Epidemiology of Mental Disorders > Surveillance of Mental Health Disorders
Integrated Processes: Teaching/Learning
Client Need: Psychosocial Integrity
Cognitive Level: Application [Applying]
Concept: Promoting Health; Nursing Roles
Difficulty: Moderate
|
Feedback |
| A |
This is incorrect. WHO developed the World Mental Health Survey to estimate human capital costs and mental disorders prevalence on a global scale. The CDC conducts many types of surveys on the prevalence of mental disorders but the organization did not develop the World Mental Health Survey. |
| B |
The WHO developed the World Mental Health Survey to estimate human capital costs and mental disorders prevalence on a global scale. |
| C |
This is incorrect. WHO developed the World Mental Health Survey to estimate human capital costs and mental disorders prevalence on a global scale. The IOM is involved in screening for mental health disorders and addresses the need for appropriate behavioral health treatment in its report, Improving the Quality of Health Care for Mental and Substance-Use Conditions: Quality Chasm Series. |
| D |
This is incorrect. WHO developed the World Mental Health Survey to estimate human capital costs and mental disorders prevalence on a global scale. The World Health Assembly issued a resolution on mental health that aims to reduce the global burden of mental disorders and improve overall mental health worldwide. |
PTS: 1 CON: Promoting Health | Nursing Roles
8.Which ethnic group has the highest 12-month prevalence of a mental disorder?
| A. |
Hispanics |
| B. |
African Americans |
| C. |
Asian Americans |
| D. |
Non-Hispanic whites |
ANS: D
Objective: 1. Define the burden of disease related to mental disorders using current epidemiological frameworks.
pp. 227-228
Heading: Epidemiology of Mental Disorders > Prevalence of Mental Health Disorders
Integrated Processes: N/A
Client Need: Psychosocial Integrity
Cognitive Level: Knowledge [Remembering]
Concept: Promoting Health
Difficulty: Moderate
|
Feedback |
| A |
This is incorrect. Non-Hispanic whites have the highest 12-month prevalence rate for mental disorders at 21% compared with 16% for Hispanics. |
| B |
This is incorrect. Non-Hispanic whites have the highest 12-month prevalence rate for mental disorders at 21% compared with 15% for African Americans. |
| C |
This is incorrect. Non-Hispanic whites have the highest 12-month prevalence rate for mental disorders at 21% compared with 9% for Asian Americans. |
| D |
Non-Hispanic whites have the highest 12-month prevalence rate for mental disorders at 21%. |
PTS:1CON:Promoting Health
9.A PHN learns in a behavioral health class that the relationship between physiology and mental health plays an important role in mental disorders. Which of the following physiological factors may contribute to the development of mental disorders?
| A. |
Conditions that affect brain chemistry, such as medication side effects or toxins |
| B. |
Physical trauma |
| C. |
1 and 2 |
| D. |
Unstable family life |
ANS: C
Objective: 3. Define the difference between behavioral, biological, environmental, and socioeconomic risk factors related to mental health disorders.
pp. 228-229
Heading: Behavioral, Biological, Environmental, and Socioeconomic Risk Factors > Individual Level Risk Factors for Mental Disorders
Integrated Processes: Teaching/Learning
Client Need: Psychosocial Integrity
Cognitive Level: Application [Application]
Concept: Cognition; Trauma; Promoting Health
Difficulty: Moderate
|
Feedback |
| A |
Both conditions that affect brain chemistry and physical trauma are the physiological factors that may contribute to the development of mental disorders. |
| B |
Both physical trauma and conditions that affect brain chemistry are physiological factors that may contribute to the development of mental disorders. |
| C |
Conditions that affect brain chemistry and physical trauma are two of the physiological factors that may contribute to the development of mental disorders. |
| D |
This is incorrect. Conditions that affect brain chemistry and physical trauma are two of the physiological factors that may contribute to the development of mental disorders. An unstable family life is not a physiological factor, although it may also contribute to the development of mental disorders. |
PTS:1CON:Cognition | Trauma | Promoting Health
10.Which of the following community environment factors play a role in the development of mental disorders?
| A. |
Living in high crime areas |
| B. |
Poverty |
| C. |
Both 1 and 2 |
| D. |
Family instability |
ANS: C
Objective: 3. Define the difference between behavioral, biological, environmental, and socioeconomic risk factors related to mental health disorders.
p. 229
Heading: Behavioral, Biological, Environmental, and Socioeconomic Risk Factors > Community-Level Risk Factors for Mental Disorders
Integrated Processes: N/A
Client Need: Psychosocial Integrity
Cognitive Level: Comprehension [Understanding]
Concept: Promoting Health
Difficulty: Easy
|
Feedback |
| A |
Living in high crime areas is a factor, along with poverty. |
| B |
Both poverty and living in high crime areas play a role in the development of mental disorders. |
| C |
Both poverty and living in high crime areas play a role in the development of mental disorders. |
| D |
This is incorrect. Although family instability often contributes to the development of mental disorders, it is not considered a community environment factor. |
PTS:1CON:Promoting Health
11.____ is a combination of personal attributes and societal stereotypes related to human characteristics viewed as unacceptable.
| A. |
Indicated prevention |
| B. |
Stigma |
| C. |
Risk factors |
| D. |
Transinstitutionalization |
ANS: B
Objective: 3. Define the difference between behavioral, biological, environmental, and socioeconomic risk factors related to mental health disorders.
pp. 231-232
Heading: Culture, Stigma, and Mental Health Disorders
Integrated Processes: N/A
Client Need: Psychosocial Integrity
Cognitive Level: Comprehension [Understanding]
Concept: Promoting Health
Difficulty: Moderate
|
Feedback |
| A |
This is incorrect. Stigma is a combination of personal attributes and societal stereotypes related to human characteristics viewed as unacceptable. Indicated prevention addresses specific subgroups at highest risk for development of a mental disorder or those that are showing early signs of a mental disorder. |
| B |
Stigma is a combination of personal attributes and societal stereotypes related to human characteristics viewed as unacceptable. |
| C |
This is incorrect. Stigma is a combination of personal attributes and societal stereotypes related to human characteristics viewed as unacceptable. Risk factors increase an individual’s chance of developing a mental disorder. |
| D |
This is incorrect. Stigma is a combination of personal attributes and societal stereotypes related to human characteristics viewed as unacceptable. Transinstitutionalization refers to the growing number of mentally ill persons who are homeless, in jail, in shelters, or in other facilities instead of being home or in a hospital. |
PTS:1CON:Promoting Health
12.A nurse interested in working with persons with mental disorders who live in poverty understands that the most effective treatment involves multiple sectors of society, such as government agencies, grass roots groups, nonprofits, and businesses, working in tandem. This interrelationship is called:
| A. |
Indicated prevention |
| B. |
Intersectoral strategies |
| C. |
Health-Related Quality of Life |
| D. |
Institute of Medicine Model of Prevention |
ANS: B
Objective: 4. Apply current evidence-based population level interventions to the prevention of mental disorders and the promotion of optimal mental health for communities and populations.
p. 233
Heading: Prevention of Mental Disorders and Promotion of Mental Health > Promotion of Mental Health and Policy
Integrated Processes: Nursing Process
Client Need: Psychosocial Integrity
Cognitive Level: Application [Applying]
Concept: Promoting Health; Collaboration
Difficulty: Moderate
|
Feedback |
| A |
This is incorrect. Intersectoral strategies engage more than one sector of society with a shared interest such as government agencies, grass roots citizens groups, nonprofits, and businesses. Indicated prevention addresses specific subgroups at highest risk for development of a mental disorder or those that are showing early signs of a mental disorder. |
| B |
Intersectoral strategies engage more than one sector of society with a shared interest such as government agencies, grass roots citizens groups, nonprofits, and businesses. |
| C |
This is incorrect. Intersectoral strategies engage more than one sector of society with a shared interest such as government agencies, grass roots citizens groups, nonprofits, and businesses. Health-Related Quality of Life is the self-perceived impact of physical and emotional health on overall quality of life. |
| D |
This is incorrect. Intersectoral strategies engage more than one sector of society with a shared interest such as government agencies, grass roots citizens groups, nonprofits, and businesses. The Institute of Medicine Model of Prevention is a framework for mental disorders that clearly separates prevention into three categories with specific interventions at each level. |
PTS: 1 CON: Promoting Health | Collaboration
13.A recent graduate nurse working in an urban labor and delivery unit had a patient who experienced a difficult labor. The mother, suffering from postpartum depression (PPD), committed suicide a year after giving birth. Although the nurse knew the basics about PPD, the nurse immediately studied the condition in depth and learned that PPD:
| A. |
Can be triggered by a massive hormone drop following delivery |
| B. |
Can intensify to cause delusions |
| C. |
Occurs soon after delivery |
| D. |
All of the above |
ANS: D
Objective: 4. Apply current evidence-based population level interventions to the prevention of mental disorders and the promotion of optimal mental health for communities and populations.
pp. 233-235
Heading: Prevention of Mental Disorders and Promotion of Mental Health > Secondary Prevention: Screening for Mental Disorders
Integrated Processes: Nursing Process
Client Need: Psychosocial Integrity
Cognitive Level: Application [Applying]
Concept: Pregnancy; Mood; Violence; Promoting Health; Nursing Roles
Difficulty: Moderate
|
Feedback |
| A |
PPD can be triggered by a massive post-delivery hormone drop, intensify enough to cause delusions, and occur soon after delivery. |
| B |
PPD can be triggered by a massive post-delivery hormone drop, intensify enough to cause delusions, and occur soon after delivery. |
| C |
PPD can be triggered by a massive post-delivery hormone drop, intensify enough to cause delusions, and occur soon after delivery. |
| D |
PPD can be triggered by a massive post-delivery hormone drop, intensify enough to cause delusions, and occur soon after delivery. |
PTS: 1 CON: Pregnancy | Mood | Violence | Promoting Health | Nursing Roles
14.A nurse working in labor and delivery requested permission from the nurse manager to conduct a quality improvement project to screen patients that might be susceptible to PPD. After completing the project, which of the following screening guidelines did the unit incorporate?
| A. |
All patients will be screened for PPD when they are admitted to the labor and delivery unit. |
| B. |
Patients at high risk are referred to the attending obstetrician. |
| C. |
Before being discharged, all new mothers will complete a questionnaire specific to PPD symptoms. |
| D. |
All of the above |
ANS: D
Objective: Apply current evidence-based population level interventions to the prevention of mental disorders and the promotion of optimal mental health for communities and populations.
pp. 233-235
Heading: Prevention of Mental Disorders and Promotion of Mental Health > Secondary Prevention: Screening for Mental Disorders
Integrated Processes: Nursing Process
Client Need: Psychosocial Integrity
Cognitive Level: Application [Applying]
Concept: Pregnancy; Mood; Promoting Health; Assessment; Quality Improvement
Difficulty: Moderate
|
Feedback |
| A |
This is incorrect. Screening, high-risk referrals to the attending obstetrician and completion of a PPD symptom questionnaire were all incorporated. |
| B |
This is incorrect. Screening, high-risk referrals to the attending obstetrician and completion of a PPD symptom questionnaire were all incorporated. |
| C |
This is incorrect. Screening, high-risk referrals to the attending obstetrician and completion of a PPD symptom questionnaire were all incorporated. |
| D |
Screening, high-risk referrals to the attending obstetrician and completion of a PPD symptom questionnaire were all incorporated. |
PTS:1
CON: Pregnancy | Mood | Promoting Health | Assessment | Quality Improvement
15.A PHN treats a patient who may be depressed. To verify suspicions, the PHN checks ____, the definitive clinical guide for diagnosing mental disorders and providing consistency and accuracy in the screening for mental disorders.
| A. |
The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) |
| B. |
The Center for Epidemiological Studies Depression Scale (CESD-10) |
| C. |
Patient Health Questionnaire 2 |
| D. |
Brief System Checklist-18 of the My Mood Monitor |
ANS: A |
