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Test Bank for Medical-Surgical Nursing, 9th Edition, Donna D. Ignatavicius, Linda Workman, Cherie Rebar,

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Test Bank for Medical-Surgical Nursing, 9th Edition, Donna D. Ignatavicius, Linda Workman, Cherie Rebar,

Table of Contents

Chapter 01: Overview of Professional Nursing Concepts for Medical-Surgical Nursing
Chapter 02: Overview of Health Concepts for Medical-Surgical Nursing
Chapter 03: Common Health Problems of Older Adults
Chapter 04: Assessment and Care of Patients with Pain
Chapter 05: Genetic Concepts for Medical-Surgical Nursing
Chapter 06: Rehabilitation Concepts for Chronic and Disabling Health Problems
Chapter 07: End-of-Life Care
Chapter 08: Concepts of Emergency and Trauma Nursing
Chapter 09: Care of Patients with Common Environmental Emergencies
Chapter 10: Concepts of Emergency and Disaster Preparedness
Chapter 11: Assessment and Care of Patients with Fluid and Electrolyte Imbalances
Chapter 12: Assessment and Care of Patients with Acid-Base Imbalances
Chapter 13: Infusion Therapy
Chapter 14: Care of Preoperative Patients
Chapter 15: Care of Intraoperative Patients
Chapter 16: Care of Postoperative Patients
Chapter 17: Inflammation and Immunity
Chapter 18: Care of Patients with Arthritis and Other Connective Tissue Diseases
Chapter 19: Care of Patients with HIV Disease
Chapter 20: Care of Patients with Hypersensitivity (Allergy) and Autoimmunity
Chapter 21: Cancer Development
Chapter 22: Care of Patients with Cancer
Chapter 23: Care of Patients with Infection
Chapter 24: Assessment of the Skin, Hair, and Nails
Chapter 25: Care of Patients with Skin Problems
Chapter 26: Care of Patients with Burns
Chapter 27: Assessment of the Respiratory System
Chapter 28: Care of Patients Requiring Oxygen Therapy or Tracheostomy
Chapter 29: Care of Patients with Noninfectious Upper Respiratory Problems
Chapter 30: Care of Patients with Noninfectious Lower Respiratory Problems
Chapter 31: Care of Patients with Infectious Respiratory Problems
Chapter 32: Care of Critically Ill Patients with Respiratory Problems
Chapter 33: Assessment of the Cardiovascular System
Chapter 34: Care of Patients with Dysrhythmias
Chapter 35: Care of Patients with Cardiac Problems
Chapter 36: Care of Patients with Vascular Problems
Chapter 37: Care of Patients with Shock
Chapter 38: Care of Patients with Acute Coronary Syndromes
Chapter 39: Assessment of the Hematologic System
Chapter 40: Care of Patients with Hematologic Problems
Chapter 41: Assessment of the Nervous System
Chapter 42: Care of Patients with Problems of the CNS: The Brain
Chapter 43: Care of Patients with Problems of the CNS: The Spinal Cord
Chapter 44: Care of Patients with Problems of the Peripheral Nervous System
Chapter 45: Care of Critically Ill Patients with Neurologic Problems
Chapter 46: Assessment of the Eye and Vision
Chapter 47: Care of Patients with Eye and Vision Problems
Chapter 48: Assessment and Care of Patients with Ear and Hearing Problems
Chapter 49: Assessment of the Musculoskeletal System
Chapter 50: Care of Patients with Musculoskeletal Problems
Chapter 51: Care of Patients with Musculoskeletal Trauma
Chapter 52: Assessment of the Gastrointestinal System
Chapter 53: Care of Patients with Oral Cavity Problems
Chapter 54: Care of Patients with Esophageal Problems
Chapter 55: Care of Patients with Stomach Disorders
Chapter 56: Care of Patients with Noninflammatory Intestinal Disorders
Chapter 57: Care of Patients with Inflammatory Intestinal Disorders
Chapter 58: Care of Patients with Liver Problems
Chapter 59: Care of Patients with Problems of the Biliary System and Pancreas
Chapter 60: Care of Patients with Malnutrition: Undernutrition and Obesity
Chapter 61: Assessment of the Endocrine System
Chapter 62: Care of Patients with Pituitary and Adrenal Gland Problems
Chapter 63: Care of Patients with Problems of the Thyroid and Parathyroid Glands
Chapter 64: Care of Patients with Diabetes Mellitus
Chapter 65: Assessment of the Renal/Urinary System
Chapter 66: Care of Patients with Urinary Problems
Chapter 67: Care of Patients with Kidney Disorders
Chapter 68: Care of Patients with Acute Kidney Injury and Chronic Kidney Disease
Chapter 69: Assessment of the Reproductive System
Chapter 70: Care of Patients with Breast Disorders
Chapter 71: Care of Patients with Gynecologic Problems
Chapter 72: Care of Patients with Male Reproductive Problems
Chapter 73: Care of Transgender Patients
Chapter 74: Care of Patients with Sexually Transmitted Diseases

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DescriptionEdition: 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 DownloadBy: McKinney Edition: 5th Edition Format: Downloadable ZIP Fille Resource Type: Test bank Duration: Unlimited downloads Delivery: Instant DownloadBy: Savage Format: Downloadable ZIP Fille Resource Type: Test bank Duration: Unlimited downloads Delivery: Instant DownloadBy: Townsend Edition: 8th Edition Format: Downloadable ZIP Fille Resource Type: Test bank Duration: Unlimited downloads Delivery: Instant Download
Content

Test Bank for Medical-Surgical Nursing, 9th Edition, Donna D. Ignatavicius, Linda Workman, Cherie Rebar,

Table of Contents

Chapter 01: Overview of Professional Nursing Concepts for Medical-Surgical Nursing Chapter 02: Overview of Health Concepts for Medical-Surgical Nursing Chapter 03: Common Health Problems of Older Adults Chapter 04: Assessment and Care of Patients with Pain Chapter 05: Genetic Concepts for Medical-Surgical Nursing Chapter 06: Rehabilitation Concepts for Chronic and Disabling Health Problems Chapter 07: End-of-Life Care Chapter 08: Concepts of Emergency and Trauma Nursing Chapter 09: Care of Patients with Common Environmental Emergencies Chapter 10: Concepts of Emergency and Disaster Preparedness Chapter 11: Assessment and Care of Patients with Fluid and Electrolyte Imbalances Chapter 12: Assessment and Care of Patients with Acid-Base Imbalances Chapter 13: Infusion Therapy Chapter 14: Care of Preoperative Patients Chapter 15: Care of Intraoperative Patients Chapter 16: Care of Postoperative Patients Chapter 17: Inflammation and Immunity Chapter 18: Care of Patients with Arthritis and Other Connective Tissue Diseases Chapter 19: Care of Patients with HIV Disease Chapter 20: Care of Patients with Hypersensitivity (Allergy) and Autoimmunity Chapter 21: Cancer Development Chapter 22: Care of Patients with Cancer Chapter 23: Care of Patients with Infection Chapter 24: Assessment of the Skin, Hair, and Nails Chapter 25: Care of Patients with Skin Problems Chapter 26: Care of Patients with Burns Chapter 27: Assessment of the Respiratory System Chapter 28: Care of Patients Requiring Oxygen Therapy or Tracheostomy Chapter 29: Care of Patients with Noninfectious Upper Respiratory Problems Chapter 30: Care of Patients with Noninfectious Lower Respiratory Problems Chapter 31: Care of Patients with Infectious Respiratory Problems Chapter 32: Care of Critically Ill Patients with Respiratory Problems Chapter 33: Assessment of the Cardiovascular System Chapter 34: Care of Patients with Dysrhythmias Chapter 35: Care of Patients with Cardiac Problems Chapter 36: Care of Patients with Vascular Problems Chapter 37: Care of Patients with Shock Chapter 38: Care of Patients with Acute Coronary Syndromes Chapter 39: Assessment of the Hematologic System Chapter 40: Care of Patients with Hematologic Problems Chapter 41: Assessment of the Nervous System Chapter 42: Care of Patients with Problems of the CNS: The Brain Chapter 43: Care of Patients with Problems of the CNS: The Spinal Cord Chapter 44: Care of Patients with Problems of the Peripheral Nervous System Chapter 45: Care of Critically Ill Patients with Neurologic Problems Chapter 46: Assessment of the Eye and Vision Chapter 47: Care of Patients with Eye and Vision Problems Chapter 48: Assessment and Care of Patients with Ear and Hearing Problems Chapter 49: Assessment of the Musculoskeletal System Chapter 50: Care of Patients with Musculoskeletal Problems Chapter 51: Care of Patients with Musculoskeletal Trauma Chapter 52: Assessment of the Gastrointestinal System Chapter 53: Care of Patients with Oral Cavity Problems Chapter 54: Care of Patients with Esophageal Problems Chapter 55: Care of Patients with Stomach Disorders Chapter 56: Care of Patients with Noninflammatory Intestinal Disorders Chapter 57: Care of Patients with Inflammatory Intestinal Disorders Chapter 58: Care of Patients with Liver Problems Chapter 59: Care of Patients with Problems of the Biliary System and Pancreas Chapter 60: Care of Patients with Malnutrition: Undernutrition and Obesity Chapter 61: Assessment of the Endocrine System Chapter 62: Care of Patients with Pituitary and Adrenal Gland Problems Chapter 63: Care of Patients with Problems of the Thyroid and Parathyroid Glands Chapter 64: Care of Patients with Diabetes Mellitus Chapter 65: Assessment of the Renal/Urinary System Chapter 66: Care of Patients with Urinary Problems Chapter 67: Care of Patients with Kidney Disorders Chapter 68: Care of Patients with Acute Kidney Injury and Chronic Kidney Disease Chapter 69: Assessment of the Reproductive System Chapter 70: Care of Patients with Breast Disorders Chapter 71: Care of Patients with Gynecologic Problems Chapter 72: Care of Patients with Male Reproductive Problems Chapter 73: Care of Transgender Patients Chapter 74: Care of Patients with Sexually Transmitted Diseases

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
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 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
AThis is incorrect. In the United States in 2010 an estimated 25% of adults reported having mental disorders in the previous year.
BThis is incorrect. In the United States in 2010 an estimated 25% of adults reported having mental disorders in the previous year.
CThis is incorrect. In the United States in 2010 an estimated 25% of adults reported having mental disorders in the previous year.
DIn 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
AThis 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.
BThis 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.
CResilience 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.
DThis 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
AIndicated 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.
BSelective 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.
CUniversal 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.
DIndicated 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
ATools to screen for depression include the Patient Health Questionnaire 2 and the CESD-10.
BTools to screen for depression include the Patient Health Questionnaire 2 and the CESD-10.
CThis 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).
DTools 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
AThis is incorrect. Major depression, however, is one of the mental disorders that can lead to SMI.
BBoth panic disorder and schizophrenia, among other mental disorders, can lead to SMI.
CBoth schizophrenia and panic disorder, among other mental disorders, can lead to SMI.
DThe 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
AThis 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.
BThe WHO developed the World Mental Health Survey to estimate human capital costs and mental disorders prevalence on a global scale.
CThis 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.
DThis 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
AThis is incorrect. Non-Hispanic whites have the highest 12-month prevalence rate for mental disorders at 21% compared with 16% for Hispanics.
BThis is incorrect. Non-Hispanic whites have the highest 12-month prevalence rate for mental disorders at 21% compared with 15% for African Americans.
CThis is incorrect. Non-Hispanic whites have the highest 12-month prevalence rate for mental disorders at 21% compared with 9% for Asian Americans.
DNon-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
ABoth conditions that affect brain chemistry and physical trauma are the physiological factors that may contribute to the development of mental disorders.
BBoth physical trauma and conditions that affect brain chemistry are physiological factors that may contribute to the development of mental disorders.
CConditions that affect brain chemistry and physical trauma are two of the physiological factors that may contribute to the development of mental disorders.
DThis 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
ALiving in high crime areas is a factor, along with poverty.
BBoth poverty and living in high crime areas play a role in the development of mental disorders.
CBoth poverty and living in high crime areas play a role in the development of mental disorders.
DThis 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
AThis 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.
BStigma is a combination of personal attributes and societal stereotypes related to human characteristics viewed as unacceptable.
CThis 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.
DThis 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
AThis 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.
BIntersectoral strategies engage more than one sector of society with a shared interest such as government agencies, grass roots citizens groups, nonprofits, and businesses.
CThis 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.
DThis 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
APPD can be triggered by a massive post-delivery hormone drop, intensify enough to cause delusions, and occur soon after delivery.
BPPD can be triggered by a massive post-delivery hormone drop, intensify enough to cause delusions, and occur soon after delivery.
CPPD can be triggered by a massive post-delivery hormone drop, intensify enough to cause delusions, and occur soon after delivery.
DPPD 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
AThis is incorrect. Screening, high-risk referrals to the attending obstetrician and completion of a PPD symptom questionnaire were all incorporated.
BThis is incorrect. Screening, high-risk referrals to the attending obstetrician and completion of a PPD symptom questionnaire were all incorporated.
CThis is incorrect. Screening, high-risk referrals to the attending obstetrician and completion of a PPD symptom questionnaire were all incorporated.
DScreening, 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
Chapter 1. The Concept of Stress Adaptation

Test Bank for Psychiatric Mental Health Nursing 8th Edition by Townsend

Multiple Choice
  1. A client has experienced the death of a close family member and at the same time becomes unemployed. This situation has resulted in a 6-month score of 110 on the Recent Life Changes Questionnaire. How should the nurse evaluate this client data?
  2. The client is experiencing severe distress and is at risk for physical and psychological illness.
  3. A score of 110 on the Miller and Rahe Recent Life Changes Questionnaire indicates no significant threat of stress-related illness.
  4. Susceptibility to stress-related physical or psychological illness cannot be estimated without knowledge of coping resources and available supports.
  5. The client may view these losses as challenges and perceive them as opportunities.
ANS: C The Recent Life Changes Questionnaire is an expanded version of the Schedule of Recent Experiences and the Rahe-Holmes Social Readjustment Rating Scale. A 6-month score of 300 or more, or a year-score total of 500 or more, indicates high stress in a client’s life. However, positive coping mechanisms and strong social support can limit susceptibility to stress-related illnesses. KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Evaluation | Client Need: Psychosocial Integrity
  1. A physically and emotionally healthy client has just been fired. During a routine office visit he states to a nurse: “Perhaps this was the best thing to happen. Maybe I’ll look into pursuing an art degree.” How should the nurse characterize the client’s appraisal of the job loss stressor?
  2. Irrelevant
  3. Harm/loss
  4. Threatening
  5. Challenging
ANS: D The client perceives the situation of job loss as a challenge and an opportunity for growth. KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Assessment | Client Need: Psychosocial Integrity
  1. Which client statement should alert a nurse that a client may be responding maladaptively to stress?
  2. “I’ve found that avoiding contact with others helps me cope.”
  3. “I really enjoy journaling; it’s my private time.”
  4. “I signed up for a yoga class this week.”
  5. “I made an appointment to meet with a therapist.”
ANS: A Reliance on social isolation as a coping mechanism is a maladaptive method to relieve stress. It can prevent learning appropriate coping skills and can prevent access to needed support systems.  KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Evaluation | Client Need: Psychosocial Integrity
  1. A nursing student finds that she comes down with a sinus infection toward the end of every semester. When this occurs, which stage of stress is the student most likely experiencing?
  2. Alarm reaction stage
  3. Stage of resistance
  4. Stage of exhaustion
  5. Fight-or-flight stage
ANS: C At the stage of exhaustion, the student’s exposure to stress has been prolonged and adaptive energy has been depleted. Diseases of adaptation occur more frequently in this stage. KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Assessment | Client Need: Psychosocial Integrity
  1. A school nurse is assessing a female high school student who is overly concerned about her appearance. The client’s mother states, “That’s not something to be stressed about!” Which is the most appropriate nursing response?
  2. “Teenagers! They don’t know a thing about real stress.”
  3. “Stress occurs only when there is a loss.”
  4. “When you are in poor physical condition, you can’t experience psychological well-being.”
  5. “Stress can be psychological. A threat to self-esteem may result in high stress levels.”
ANS: D Stress can be physical or psychological in nature. A perceived threat to self-esteem can be as stressful as a physiological change. KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Implementation | Client Need: Psychosocial Integrity
  1. A bright student confides in the school nurse about conflicts related to attending college or working to add needed financial support to the family. Which coping strategy is most appropriate for the nurse to recommend to the student at this time?
  2. Meditation
  3. Problem-solving training
  4. Relaxation
  5. Journaling
ANS: B The student must assess his or her situation and determine the best course of action. Problem-solving training, by providing structure and objectivity, can assist in decision making. KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Implementation | Client Need: Psychosocial Integrity
  1. An unemployed college graduate is experiencing severe anxiety over not finding a teaching position and has difficulty with independent problem-solving. During a routine physical examination, the graduate confides in the clinic nurse. Which is the most appropriate nursing intervention?
  2. Encourage the student to use the alternative coping mechanism of relaxation exercises.
  3. Complete the problem-solving process for the client.
  4. Work through the problem-solving process with the client.
  5. Encourage the client to keep a journal.
ANS: C During times of high anxiety and stress, clients will need more assistance in problem-solving and decision making. KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Implementation | Client Need: Psychosocial Integrity
  1. A school nurse is assessing a distraught female high school student who is overly concerned because her parents can’t afford horseback riding lessons. How should the nurse interpret the student’s reaction to her perceived problem?
  2. The problem is endangering her well-being.
  3. The problem is personally relevant to her.
  4. The problem is based on immaturity.
  5. The problem is exceeding her capacity to cope.
ANS: B Psychological stressors to self-esteem and self-image are related to how the individual perceives the situation or event. Self-image is of particular importance to adolescents, who feel entitled to have all the advantages that other adolescents experience. KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Evaluation | Client Need: Psychosocial Integrity
  1. Meditation has been shown to be an effective stress management technique. When meditation is effective, what should a nurse expect to assess?
  2. An achieved state of relaxation
  3. An achieved insight into one’s feelings
  4. A demonstration of appropriate role behaviors
  5. An enhanced ability to problem-solve
ANS: A Meditation produces relaxation by creating a special state of consciousness through focused concentration. KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Evaluation | Client Need: Psychosocial Integrity
  1. A distraught, single, first-time mother cries and asks a nurse, “How can I go to work if I can’t afford childcare?” What is the nurse’s initial action in assisting the client with the problem-solving process?
  2. Determine the risks and benefits for each alternative.
  3. Formulate goals for resolution of the problem.
  4. Evaluate the outcome of the implemented alternative.
  5. Assess the facts of the situation.
ANS: D Before any other steps can be taken, accurate information about the situation must be gathered and assessed. KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Implementation | Client Need: Psychosocial Integrity
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