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 |
Sample Questions
Chapter 04: Genetic Issues
Urden: Critical Care Nursing, 8th Edition
MULTIPLE CHOICE
- What is a genetic variant that exists in greater than 1% of the population termed?
a. |
Genetic mutation |
b. |
Genetic polymorphism |
c. |
Genetic deletion |
d. |
Tandem repeat |
ANS: B
When a genetic variant occurs frequently and is present in 1% or more of the population, it is described as a genetic polymorphism. The term genetic mutation refers to a change in the DNA genetic sequence that can be inherited that occurs in less than 1% of the population. Genetic material in the chromosome can also be deleted and new information from another chromosome can be inserted or can be a tandem repeat (multiple repeats of the same sequence).
PTS: 1 DIF: Cognitive Level: Remembering REF: p. 43
OBJ: Nursing Process Step: General TOP: Genetics in Critical Care
MSC: NCLEX: Health Promotion and Maintenance
- Which type of genetic disorder occurs when there is an interaction between genetic and environmental factors such as that which occurs with type 2 diabetes?
a. |
Chromosome |
b. |
Mitochondrial |
c. |
Multifactorial disorders |
d. |
Allele dysfunction |
ANS: C
In multifactorial disorders there is an interaction between vulnerable genes and the environment. Cardiovascular atherosclerotic diseases and type 2 diabetes are examples of multifactorial disorders that result from an interaction of genetic and environmental factors.
PTS: 1 DIF: Cognitive Level: Understanding REF: p. 46
OBJ: Nursing Process Step: General TOP: Genetics in Critical Care
MSC: NCLEX: Health Promotion and Maintenance
- Prader-Willi syndrome (PWS) is a rare genetic disorder in which genes on chromosome 15 (q11.2-13) are deleted. What type of disorder is PWS?
a. |
Chromosome disorder |
b. |
Mitochondrial disorder |
c. |
Complex gene disorder |
d. |
Multifactorial disorder |
ANS: A
Prader-Willi syndrome (PWS) is a chromosome disorder as a result of several missing genes on chromosome 15. In chromosome disorders, the entire chromosome or very large segments of the chromosome are damaged, missing, duplicated, or otherwise altered.
PTS: 1 DIF: Cognitive Level: Applying REF: p. 45
OBJ: Nursing Process Step: General TOP: Genetics in Critical Care
MSC: NCLEX: Health Promotion and Maintenance
- A family pedigree is used to determine whether a disease has a genetic component. What does a proband indicate in a family pedigree?
a. |
The disease being mother related or father related |
b. |
The first person in the family who was diagnosed with the disorder |
c. |
Who in the family is the xy band |
d. |
The disease genotype including locus |
ANS: B
For nurses, it is important to ask questions that elucidate which family members are affected versus those who are unaffected and then to identify the individuals who may carry the gene in question but who do not have symptoms (carriers). The proband is the name given to the first person diagnosed in the family pedigree. Homozygous versus heterozygous determines if the disorder is carried by a gene from one or both parents. The xy band determines if the disorder is carried through the sex genes. A disease locus is the genetic address of the disorder.
PTS: 1 DIF: Cognitive Level: Remembering REF: p. 46
OBJ: Nursing Process Step: General TOP: Genetics in Critical Care
MSC: NCLEX: Health Promotion and Maintenance
- Philadelphia translocation is a specific chromosomal abnormality that occurs from a reciprocal translocation between chromosomes 9 and 22, where parts of these two chromosomes switch places. This abnormality is associated with which disease?
a. |
Hemophilia A |
b. |
Chronic myelogenous leukemia |
c. |
Obesity |
d. |
Marfan syndrome |
ANS: B
Philadelphia chromosome or Philadelphia translocation is a specific chromosomal abnormality associated with chronic myelogenous leukemia. It occurs from a reciprocal translocation between chromosomes 9 and 22, where parts of these two chromosomes switch places. Hemophilia A is a sex-linked inheritance. Obesity is being studied with the FTO gene on chromosome 16. Marfan syndrome is classified as a single-gene disorder.
PTS: 1 DIF: Cognitive Level: Remembering REF: p. 42
OBJ: Nursing Process Step: General TOP: Genetics in Critical Care
MSC: NCLEX: Health Promotion and Maintenance
- What was the goal of the Human Genome Project?
a. |
Identifying haplotype tags |
b. |
Exposing untaggable SNPs and recombination hot spots |
c. |
Producing a catalog of human genome variation |
d. |
Mapping all the human genes |
ANS: D
The Human Genome Project was a huge international collaborative project that began in 1990 with the goal of making a map of all the human genes (the genome). The final genome sequence was published in 2003. The HapMap project was to identify haplotype tags. The Genome-Wide Association Studies was used to expose untaggable SNPs and recombination hot spots. The 1000 Genomes project was used to map all the human genes.
PTS: 1 DIF: Cognitive Level: Remembering REF: p. 49
OBJ: Nursing Process Step: General TOP: Genetics in Critical Care
MSC: NCLEX: Health Promotion and Maintenance
- The patient is placed under general anesthesia for a carotid endarterectomy. During the surgery, the patient develops muscle contracture with skeletal muscle rigidity, acidosis, and elevated temperature. What is a possible cause for malignant hyperthermia?
a. |
Polymorphism in RYR1 at chromosome 19q13.1 |
b. |
Variant in the VKOR1 gene |
c. |
Variant in the cytochrome P450 enzyme CYP2C9 gene |
d. |
Halothane overdose |
ANS: A
Individuals with polymorphisms in the ryanodine receptor gene (RYR1) at chromosome 19q13.1 are at risk of a rare pharmacogenetic condition known as malignant hyperthermia. In affected individuals, exposure to inhalation anesthetics and depolarizing muscle relaxants during general anesthesia induces life-threatening muscle contracture with skeletal muscle rigidity, acidosis, and elevated temperature. Warfarin is being researched as a variant in the VKOR1 gene and in the cytochrome P450 enzyme CYP2C9 gene.
PTS: 1 DIF: Cognitive Level: Evaluating REF: p. 53|Box 4-3
OBJ: Nursing Process Step: Diagnosis TOP: Genetics in Critical Care
MSC: NCLEX: Health Promotion and Maintenance
- What is the study of heredity particularly as it relates to the transfer heritable physical characteristics called?
a. |
Chromatids |
b. |
Karyotype |
c. |
Genetics |
d. |
Histones |
ANS: C
Genetics refers to the study of heredity, particularly as it relates to the ability of individual genes to transfer heritable physical characteristics. Each somatic chromosome, also called an autosome, is made of two strands, called chromatids, which are joined near the center. A karyotype is the arrangement of human chromosomes from largest to smallest. A specialized class of proteins called histones organizes the double-stranded DNA into what looks like a tightly coiled telephone cord.
PTS: 1 DIF: Cognitive Level: Remembering REF: p. 54
OBJ: Nursing Process Step: General TOP: Genetics in Critical Care
MSC: NCLEX: Health Promotion and Maintenance
- Each chromosome consists of an unbroken strand of DNA inside the nucleus of the cell. What is the arrangement of human chromosomes termed?
a. |
Chromatids |
b. |
Karyotype |
c. |
Genomics |
d. |
Histones |
ANS: B
A karyotype is the arrangement of human chromosomes from largest to smallest. Each somatic chromosome, also called an autosome, is made of two strands, called chromatids, which are joined near the center. Genomics refers to the study of all of the genetic material within cells and encompasses the environmental interaction and impact on biologic and physical characteristics. A specialized class of proteins called histones organizes the double-stranded DNA into what looks like a tightly coiled telephone cord.
PTS: 1 DIF: Cognitive Level: Remembering REF: p. 39
OBJ: Nursing Process Step: General TOP: Genetics in Critical Care
MSC: NCLEX: Health Promotion and Maintenance
- What is the study of all the genetic material within the cell and its impact on biologic and physical characteristics called?
a. |
Chromatids |
b. |
Karyotype |
c. |
Genomics |
d. |
Histones |
ANS: C
Genomics refers to the study of all of the genetic material within cells and encompasses the environmental interaction and impact on biologic and physical characteristics. Each somatic chromosome, also called an autosome, is made of two strands, called chromatids, which are joined near the center. A karyotype is the arrangement of human chromosomes from largest to smallest. A specialized class of proteins called histones organizes the double-stranded DNA into what looks like a tightly coiled telephone cord.
PTS: 1 DIF: Cognitive Level: Remembering REF: p. 39
OBJ: Nursing Process Step: General TOP: Genetics in Critical Care
MSC: NCLEX: Health Promotion and Maintenance
- A specialized class of proteins that organizes the double-stranded DNA into what looks like a tightly coiled telephone cord is known which of the following?
a. |
Chromatids |
b. |
Karyotype |
c. |
Genomics |
d. |
Histones |
ANS: D
A specialized class of proteins called histones organizes the double-stranded DNA into what looks like a tightly coiled telephone cord. Genomics refers to the study of all of the genetic material within cells and encompasses the environmental interaction and impact on biologic and physical characteristics. Each somatic chromosome, also called an autosome, is made of two strands, called chromatids, which are joined near the center. A karyotype is the arrangement of human chromosomes from largest to smallest.
PTS: 1 DIF: Cognitive Level: Remembering REF: p. 39
OBJ: Nursing Process Step: General TOP: Genetics in Critical Care
MSC: NCLEX: Health Promotion and Maintenance
- To achieve a consistent distance across the width of the DNA strand, the nucleotide base guanine (G) can only be paired with what other genetic material?
a. |
Adenine (A) |
b. |
Thymine (T) |
c. |
Cytosine (C) |
d. |
Sex chromosome X |
ANS: C
Four nucleotide bases—adenine (A), thymine (T), guanine (G), and cytosine (C)—comprise the “letters” in the genetic DNA “alphabet.” The bases in the double helix are paired T with A and G with C. The nucleotide bases are designed so that only G can pair with C and only T can pair with A to achieve a consistent distance across the width of the DNA strand. The TA and GC combinations are known as base pairs.
PTS: 1 DIF: Cognitive Level: Evaluating REF: p. 40
OBJ: Nursing Process Step: Diagnosis TOP: Genetics in Critical Care
MSC: NCLEX: Health Promotion and Maintenance
- Why are monozygotic twins separated at birth used to study the effects of genetics versus environment?
a. |
They share an identical genome. |
b. |
They have different sex chromosomes. |
c. |
They have mirror chromosomes. |
d. |
They have identical health issues. |
ANS: A
Studies of identical twins offer a unique opportunity to investigate the association of genetics, environment, and health. Identical twins are monozygotic and share an identical genome. Monozygotic twins are the same sex. Studies occur much less frequently today because tremendous efforts are made to keep siblings together when they are adopted. Genetics can be stable in a study group, but the environment and health issues are dynamic even in a controlled study group.
PTS: 1 DIF: Cognitive Level: Remembering REF: p. 48
OBJ: Nursing Process Step: General TOP: Genetics in Critical Care
MSC: NCLEX: Health Promotion and Maintenance
- The process that is used to make polypeptide chains that constitute proteins can be written as:
a. |
RNA ® DNA ® protein. |
b. |
DNA ® RNA ® protein. |
c. |
Protein ® RNA ® DNA. |
d. |
Protein ® DNA ® RNA. |
ANS: B
The nucleotides A, T, C, and G can be thought of as “letters” of a genetic alphabet that are combined into three-letter “words” that are transcribed (written) by the intermediary of ribonucleic acid (RNA). The RNA translates the three-letter words into the amino acids used to make the polypeptide chains that constitute proteins. This process may be written as DNA ® RNA ® protein.
PTS: 1 DIF: Cognitive Level: Remembering REF: p. 41
OBJ: Nursing Process Step: Diagnosis TOP: Genetics in Critical Care
MSC: NCLEX: Health Promotion and Maintenance
- What are the studies called that are done on large, extended families who have several family members affected with a rare disease?
a. |
Genetic association |
b. |
Genetic epidemiology |
c. |
Kinships |
d. |
Phenotypes |
ANS: C
In genetic epidemiologic research of a rare disease, it can be a challenge to find enough people to study. One method is to work with large, extended families, known as kinships, which have several family members affected with the disease. Genetic association studies are usually conducted in large, unrelated groups based on demonstration of a phenotype (disease trait or symptoms) and associated genotype. Genetic epidemiology represents the fusion of epidemiologic studies and genetic and genomic research methods. Phenotypes are different at different stages of a disease and are influenced by medications, environmental factors, and gene–gene interaction.
PTS: 1 DIF: Cognitive Level: Remembering REF: p. 48
OBJ: Nursing Process Step: Diagnosis TOP: Genetics in Critical Care
MSC: NCLEX: Health Promotion and Maintenance
- What is an example of direct-to-consumer genomic testing?
a. |
Genetic testing through amniocentesis |
b. |
Paternity testing from buccal swabs of the child and father |
c. |
Biopsy of a lump for cancer |
d. |
Drug testing using hair follicles |
ANS: B
An example of direct-to-consumer testing is paternity testing from buccal swabs of the child and father. Genetic testing can be done through biopsies and amniocentesis, but they are performed in a facility by a medical professional. Drug testing and genomic testing are two different tests and are unrelated.
PTS: 1 DIF: Cognitive Level: Evaluating REF: p. 53
OBJ: Nursing Process Step: Diagnosis TOP: Genetics in Critical Care
MSC: NCLEX: Health Promotion and Maintenance
- What was the Genetic Information Nondiscrimination Act (GINA) of 2008 designed to prevent from happening?
a. |
Abuse of genetic information in employment and health insurance decisions |
b. |
Genetic counselors from reporting results to the health insurance companies |
c. |
Mandatory genetics testing of all individuals with certain diseases |
d. |
Information sharing between biobanks that are studying the same genetic disorders |
ANS: A
The Genetic Information Nondiscrimination Act (GINA) of 2008 is an essential piece of legislation designed to prevent abuse of genetic information in employment and health insurance decisions in the United States. One of the paramount concerns in the genomic era is to protect the privacy of individuals’ unique genetic information. Many countries have established biobanks as repositories of genetic material, and many tissue samples are stored in medical center tissue banks. Some people who may be at risk for a disorder disease will not be tested because they fear that a positive result may affect their employability. GINA also mandates that genetic information about an individual and his or her family has the same protections as health information.
PTS: 1 DIF: Cognitive Level: Remembering REF: p. 53
OBJ: Nursing Process Step: Diagnosis TOP: Genetics in Critical Care
MSC: NCLEX: Health Promotion and Maintenance
MULTIPLE RESPONSE
- Which patients would be candidates for genetic testing for long QT syndrome (LQTS)? (Select all that apply.)
a. |
Patients with prolonged QT interval during a cardiac and genetic work-up |
b. |
Family history of positive genotype and negative phenotype |
c. |
Patients diagnosed with torsades de pointes |
d. |
Family history of sudden cardiac death |
e. |
Family history of bleeding disorders |
f. |
Family history of obesity |
ANS: A, B, C, D | LeMone & Burke's Medical-Surgical Nursing, 7e (Bauldoff/Gubrud/Carno)
Chapter 1 Medical-Surgical Nursing in the 21st Century
1) A patient is instructed on the role of diet, exercise, and medication to control type 2 diabetes mellitus. Which core competency for healthcare professionals is the nurse implementing?
- Quality improvement
- Evidence-based practice
- Patient-centered care
- Teamwork and collaboration
Answer: 3
Explanation: 1. Identifying safety hazards and measuring quality is an example of the core competency quality improvement.
- Using best research when providing patient care is an example of the core competency evidence-based practice.
- Patient teaching is an example of the competency patient-centered care.
- The core competency teamwork and collaboration involves collaboration between disciplines to provide continuous and reliable care.
Page Ref: 5
Cognitive Level: Applying
Client Need & Sub: Safe and Effective Care Environment: Management of Care
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care | NLN Competencies: Relationship-Centered Care; Practice-Know-How; Communicate information effectively; listen openly and cooperatively | Nursing/Integrated Concepts: Nursing Process: Implementation/Teaching/Learning
Learning Outcome: 1.1 Describe the core competencies for healthcare professionals: Patient-centered care, interprofessional teams, evidence-based practice, quality improvement, safety, and health information technology.
MNL Learning Outcome: 1. Demonstrate use of the core competencies for healthcare professionals in nursing practice.
2) The nurse is planning to utilize the core competency use informatics when providing patient care. Which action should the nurse perform when using this core competency?
- Change the sharps container in a patient's room.
- Document the effectiveness of pain medication for a patient.
- Discuss the effectiveness of bedside physical therapy with the therapist.
- Search through a database of articles to find current research on wound care.
Answer: 4
Explanation: 1. Changing the sharps container is an example of quality improvement.
- Documenting the effectiveness of pain medication for a patient is an example of patient-centered care.
- Discussing the effectiveness of bedside physical therapy with the therapist is an example of teamwork and collaboration.
- Searching through a database of articles to find current research on wound care is an example of use informatics.
Page Ref: 5
Cognitive Level: Applying
Client Need & Sub: Safe and Effective Care Environment: Management of Care
Standards: QSEN Competencies: VI.B.2. Apply technology and information management tools to support safe processes of care | AACN Essentials Competencies: IV.1. Demonstrate skills in using patient care technologies, information systems, and communication devices that support safe nursing practice | NLN Competencies: Knowledge and Science: Practice-Know-How: Retrieve research findings and other sources of information | Nursing/Integrated Concepts: | Test Bank for Pharmacology and the Nursing Process 9th Edition
Contents
Chapter 01: The Nursing Process and Drug Therapy................................................................................. 4
Chapter 02: Pharmacologic Principles...................................................................................................... 8
Chapter 03: Lifespan Considerations...................................................................................................... 14
Chapter 04: Cultural, Legal, and Ethical Considerations.......................................................................... 20
Chapter 05: Medication Errors: Preventing and Responding .................................................................. 26
Chapter 06: Patient Education and Drug Therapy................................................................................... 29
Chapter 07: Over-the-Counter Drugs and Herbal and Dietary Supplements ........................................... 34
Chapter 08: Gene Therapy and Pharmacogenomics............................................................................... 38
Chapter 09: Photo Atlas of Drug Administration .................................................................................... 41
Chapter 10: Analgesic Drugs.................................................................................................................. 50
Chapter 11: General and Local Anesthetics............................................................................................ 57
Chapter 12: Central Nervous System Depressants and Muscle Relaxants............................................... 61
Chapter 13: Central Nervous System Stimulants and Related Drugs....................................................... 66
Chapter 14: Antiepileptic Drugs............................................................................................................. 70
Chapter 15: Antiparkinson Drugs.............................................................................................................76
Chapter 16: Psychotherapeutic Drugs.................................................................................................... 81
Chapter 17: Substance Use Disorder...................................................................................................... 88
Chapter 18: Adrenergic Drugs................................................................................................................ 93
Chapter 19: Adrenergic-Blocking Drugs.................................................................................................. 98
Chapter 20: Cholinergic Drugs ............................................................................................................. 103
Chapter 21: Cholinergic-Blocking Drugs............................................................................................... 108
Chapter 22: Antihypertensive Drugs.................................................................................................... 113
Chapter 23: Antianginal Drugs............................................................................................................. 119
Chapter 24: Heart Failure Drugs........................................................................................................... 125
Chapter 25: Antidysrhythmic Drugs..................................................................................................... 131
Chapter 26: Coagulation Modifier Drugs.............................................................................................. 137
Chapter 27: Antilipemic Drugs............................................................................................................. 143
Chapter 28: Diuretic Drugs................................................................................................................... 148
Chapter 29: Fluids and Electrolytes...................................................................................................... 154
Chapter 30: Pituitary Drugs.................................................................................................................. 160
Chapter 31: Thyroid and Antithyroid Drugs.......................................................................................... 163
Chapter 32: Antidiabetic Drugs............................................................................................................ 168
Chapter 33: Adrenal Drugs................................................................................................................... 177
Chapter 34: Women’s Health Drugs..................................................................................................... 181
Chapter 35: Men’s Health Drugs.......................................................................................................... 188
Chapter 36: Antihistamines, Decongestants, Antitussives, and Expectorants ....................................... 193
Chapter 37: Respiratory Drugs............................................................................................................. 198
Chapter 38: Antibiotics Part 1.............................................................................................................. 204
Chapter 39: Antibiotics Part 2.............................................................................................................. 211
Chapter 40: Antiviral Drugs.................................................................................................................. 216
Chapter 41: Antitubercular Drugs ........................................................................................................ 221
Chapter 42: Antifungal Drugs............................................................................................................... 226
Chapter 43: Antimalarial, Antiprotozoal, and Anthelmintic Drugs ........................................................ 231
Chapter 44: Anti-inflammatory and Antigout Drugs............................................................................. 236
Chapter 45: Antineoplastic Drugs Part 1: Cancer Overview and Cell Cycle–Specific Drugs..................... 242
Chapter 46: Antineoplastic Drugs Part 2: Cell Cycle–Nonspecific Drugs and Miscellaneous Drugs......... 248
Chapter 47: Biologic Response–Modifying and Antirheumatic Drugs ................................................... 253
Chapter 48: Immunosuppressant Drugs............................................................................................... 258
Chapter 49: Immunizing Drugs............................................................................................................. 263
Chapter 50: Acid-Controlling Drugs...................................................................................................... 268
Chapter 51: Bowel Disorder Drugs....................................................................................................... 274
Chapter 52: Antiemetic and Antinausea Drugs..................................................................................... 281
Chapter 53: Vitamins and Minerals...................................................................................................... 286
Chapter 54: Anemia Drugs................................................................................................................... 292
Chapter 55: Nutritional Supplements................................................................................................... 299
Chapter 56: Dermatologic Drugs.......................................................................................................... 304
Chapter 57: Ophthalmic Drugs............................................................................................................. 310
Chapter 58: Otic Drugs ............................ | 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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