Content | Test Bank for Neonatal and Pediatric Respiratory Care , (4th Edition)
CONTENTS
SECTION 1: FETAL DEVELOPMENT, ASSESSMENT, AND DELIVERY
1. Fetal Lung Development
2. Fetal Gas Exchange and Circulation
3. Antenatal Assessment and High-Risk Delivery
SECTION 2: ASSESSMENT AND MONITORING OF THE NEONATAL AND PEDIATRIC PATIENT
4. Exam and Assessment of the Neonatal and Pediatric Patient
5. Pulmonary Function Testing and Bedside Pulmonary Mechanics
6. Radiographic Assessment
7. Bronchoscopy
8. Invasive Blood Gas Analysis and Monitoring
9. Non-Invasive Monitoring in Neonatal and Pediatric Care
SECTION 3: THERAPEUTIC PROCEDURES FOR TREATMENT OF NEONATAL AND PEDIATRIC DISORDERS
10. Oxygen Administration
11. Aerosols and Administration of Medication
12. Airway Clearance Techniques and Lung Volume Expansion
13. Airway Management
14. Surfactant Replacement
15. Non-Invasive Mechanical Ventilation and Continuous Positive Pressure of the Neonate
16. Non-Invasive Mechanical Ventilation of the Child
17. Mechanical Ventilation of the Neonatal and Pediatric Patient
18. Administration of Gas Mixtures
19. Extracorporeal Life Support
20. Pharmacology
21. Thoracic Organ Transplantation
22. Neonatal Complications and Pulmonary Disorders
SECTION 4: NEONATAL AND PEDIATRIC DISORDERS: PRESENTATION, DIAGNOSIS, AND TREATMENT
23. Congenital and Surgical Disorders that Affect Respiratory Care
24. Congenital Cardiac Defects
25. Sudden Infant Death Syndrome and Sleep Disorders
26. Pediatric Airway Disorders and Pulmonary Infections
27. Asthma
28. Cystic Fibrosis
29. Acute Respiratory Distress Syndrome
30. Shock, Sepsis, and Anaphylaxis
31. Pediatric Trauma
32. Disorders of the Pleura
33. Neurological and Neuromuscular Disorders
SECTION 5: NEONATAL AND PEDIATRIC TRANSIENT AND AMBULATORY CARE
34. Transport of Infants and Children
35. Home Care
36. Quality and Safety NEW! | 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 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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| Test Bank For Essentials of Psychiatric Mental Health Nursing 8th Morgan
Chapter 1: Mental Health and Mental Illness
Multiple Choice
Identify the choice that best completes the statement or answers the question.
____ 1. A nurse is assessing a client who experiences occasional feelings of sadness because of the recent
death of a beloved pet. The client’s appetite, sleep patterns, and daily routine have not changed.
How would the nurse interpret the client’s behaviors?
1. The client’s behaviors demonstrate mental illness in the form of depression.
2. The client’s behaviors are inappropriate, which indicates the presence of mental
illness.
3. The client’s behaviors are not congruent with cultural norms.
4. The client’s behaviors demonstrate no functional impairment, indicating no mental
illness.
____ 2. At which point would the nurse determine that a client is at risk for developing a mental illness?
1. When thoughts, feelings, and behaviors are not reflective of the DSM-5 criteria.
2. When maladaptive responses to stress are coupled with interference in daily
functioning.
3. When a client communicates significant distress.
4. When a client uses defense mechanisms as ego protection.
____ 3. A client has been given a diagnosis of human immunodeficiency virus (HIV). Which statement
made by the client does the nurse recognize as the bargaining stage of grief?
1. “I hate my partner for giving me this disease I will die from!”
2. “If I don’t do intravenous (IV) drugs anymore, God won’t let me die.”
3. “I am going to support groups and learn more about the disease.”
4. “Can you please re-draw the test results, I think they may be wrong?”
____ 4. A nurse notes that a client is extremely withdrawn, delusional, and emotionally exhausted. The
nurse assesses the client’s anxiety as which level?
1. Mild anxiety
2. Moderate anxiety
3. Severe anxiety
4. Panic anxiety
____ 5. A psychiatric nurse intern states, “This client’s use of defense mechanisms should be eliminated.”
Which is a correct evaluation of this nurse’s statement?
1. Defense mechanisms can be appropriate responses to stress and need not be
eliminated.
2. Defense mechanisms are a maladaptive attempt of the ego to manage anxiety and
should always be eliminated.
3. Defense mechanisms, used by individuals with weak ego integrity, should be
discouraged and not completely eliminated.
4. Defense mechanisms cause disintegration of the ego and should be fostered and
encouraged.
ESSENTIALS OF PSYCHIATRIC MENTAL HEALTH NURSING 8TH MORGAN TEST BANK
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____ 6. During an intake assessment, a nurse asks both physiological and psychosocial questions. The
client angrily responds, “I’m here for my heart, not my head problems.” Which is the nurse’s best
response?
1. “It is just a routine part of our assessment. All clients are asked these same
questions.”
2. “Why are you concerned about these types of questions?”
3. “Psychological factors, like excessive stress, have been found to affect medical
conditions.”
4. “We can skip these questions, if you like. It isn’t imperative that we complete this
section.”
____ 7. A client who is being treated for chronic kidney disease complains to the health-care provider that
he does not like the food available to him while hospitalized. The health-care provider insists that
the client strictly adhere to the diet plan. What action can be expected is the client uses the defense
mechanism of displacement?
1. The client assertively confronts the health-care provider.
2. The client insists on being discharged and goes for a long, brisk walk.
3. The client snaps at the nurse and criticizes the nursing care provided.
4. The client hides his anger by explaining the logical reasoning for the diet to his
spouse.
____ 8. A fourth-grade boy teases and makes jokes about a cute girl in his class. A nurse would recognize
this behavior as indicative of which defense mechanism?
1. Displacement
2. Projection
3. Reaction formation
4. Sublimation
____ 9. Which nursing statement regarding the concept of psychosis is most accurate?
1. Individuals experiencing psychoses are aware that their behaviors are maladaptive.
2. Individuals experiencing psychoses experience little distress.
3. Individuals experiencing psychoses are aware of experiencing psychological
problems.
4. Individuals experiencing psychoses are based in reality.
____ 10. When under stress, a client routinely uses alcohol to excess. When the client’s husband finds her
drunk, the husband yells at the client about her chronic alcohol abuse. Which action alerts the
nurse to the client’s use of the defense mechanism of denial?
1. The client hides liquor bottles in a closet.
2. The client yells at her son for slouching in his chair.
3. The client burns dinner on purpose.
4. The client says to the spouse, “I don’t drink too much!”
____ 11. Devastated by a divorce from an abusive husband, a wife completes grief counseling. Which
statement by the wife would indicate to a nurse that the client is in the acceptance stage of grief?
1. “If only we could have tried again, things might have worked out.”
2. “I am so mad that the children and I had to put up with him as long as we did.”
3. “Yes, it was a difficult relationship, but I think I have learned from the
ESSENTIALS OF PSYCHIATRIC MENTAL HEALTH NURSING 8TH MORGAN TEST BANK
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experience.”
4. “I have a difficult time getting out of bed most days.”
____ 12. According to Maslow’s hierarchy of needs, which client action would demonstrate the highest
achievement in terms of mental health?
1. Maintaining a long-term, faithful, intimate relationship
2. Achieving a sense of self-confidence
3. Possessing a feeling of self-fulfillment and realizing full potential
4. Developing a sense of purpose and the ability to direct activities
____ 13. According to Maslow’s hierarchy of needs, which situation on an inpatient psychiatric unit would
require priority intervention by a nurse?
1. A client rudely complaining about limited visiting hours
2. A client exhibiting aggressive behavior toward another client
3. A client stating that no one cares
4. A client verbalizing feelings of failure
Multiple Response
Identify one or more choices that best complete the statement or answer the question.
____ 14. Which describes a defense mechanism an individual may use to relieve anxiety in a stressful
situation? (Select all that apply.)
1. Homework
2. Smoking
3. Itching
4. Nail biting
5. Sleeping
____ 15. The nurse is reviewing the DSM-5 definition of a mental health disorder and notes the definition
includes a disturbance in which areas? (Select all that apply.)
1. Cognition
2. Physical
3. Emotional regulation
4. Behavior
5. Developmental
Completion
Complete each statement.
16. _______________________ is a diffuse apprehension that is vague in nature and is associated
with feelings of uncertainty and helplessness.
17. _______________________ is a subjective state of emotional, physical, and social responses to
the loss of a valued entity.
Other
ESSENTIALS OF PSYCHIATRIC MENTAL HEALTH NURSING 8TH MORGAN TEST BANK
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18. Place in order the Kübler Ross stages of grief from 1-5. (Enter the number of each step in the
proper sequence, using comma and space format, such as: 1, 2, 3, 4.)
1. Bargaining
2. Denial
3. Acceptance
4. Depression
5. Anger |
Chapter 01: Community Health Nursing
Stanhope: Community Health Nursing in Canada, 3rd Canadian Edition
MULTIPLE CHOICE
1. Which of the following best describes community health nursing?
a. |
Giving care with a focus on the aggregate’s needs |
b. |
Giving care with a focus on the group’s needs |
c. |
Focusing on the health care of individual clients in the community |
d. |
Working with an approach of unique client care |
ANS: C
By definition, community health nursing is the health care of individual clients in the community.
DIF: Cognitive Level: Knowledge/Remember REF: p. 3
OBJ: 1.6
TOP: Client Need: Safe and Effective Care Environment - Management of Care
2. Which of the following best describes primary health care?
a. |
A comprehensive way to address issues of social justice |
b. |
Giving the care to manage acute or chronic conditions |
c. |
Giving direct care to ill individuals within their family setting |
d. |
Having the goal of health promotion and disease prevention |
ANS: A
By definition, primary health care is comprehensive and addresses issues of social justice and equity. Social justice in the context of health refers to ensuring fairness and equality in health services so that vulnerable individuals in society have easy access to health care.
DIF: Cognitive Level: Knowledge/Remember REF: p. 10
OBJ: 1.4 TOP: Client Need: Health Promotion and Maintenance
3. The health of which of the following is the primary focus of public health nurses (PHNs)?
a. |
Families |
b. |
Groups |
c. |
Individuals |
d. |
Populations |
ANS: D
PHNs use knowledge of nursing, social sciences, and public health sciences for the promotion and protection of health and for the prevention of disease among populations.
DIF: Cognitive Level: Knowledge/Remember REF: p. 13, Table 1-4 | p. 20
OBJ: 1.5 TOP: Client Need: Health Promotion and Maintenance
4. Which change is the primary explanation for life expectancy increasing so notably since the early 1900s?
a. |
An increase in findings from medical laboratory research |
b. |
Incredible advances in surgical techniques and procedures |
c. |
Improved sanitation and other public health activities |
d. |
Increased use of antibiotics to fight infections |
ANS: C
Improvement in control of infectious diseases through immunizations, sanitation, and other public health activities led to the increase in life expectancy since the early 1900s.
DIF: Cognitive Level: Knowledge/Remember REF: pp. 12-13
OBJ: 1.5 TOP: Client Need: Health Promotion and Maintenance
5. Which community health nursing practice area receives funding from the private sector?
a. |
Telenurses |
b. |
Corrections nurses |
c. |
Nurse entrepreneurs |
d. |
Street or outreach nurses |
ANS: C
The nurse entrepreneur receives private funding, whereas all of the other community health nurse (CHN) roles are with provincially or federally funded positions.
DIF: Cognitive Level: Knowledge/Remember REF: p. 22, Table 1-4 Examples
OBJ: 1.6
TOP: Client Need: Safe and Effective Care Environment - Management of Care
6. A PHN strives to prevent disease and disability, often in partnership with other community groups. Which statement is an appropriate summary of the PHN’s role?
a. |
The PHN asks the political leaders what interventions should be chosen. |
b. |
The PHN assesses the community and decides on appropriate interventions. |
c. |
The PHN uses data from the main health care institutions in the community to determine needed health services. |
d. |
The PHN works with community members to carry out public health functions. |
ANS: D
It is crucial that the PHN work with members of the community to carry out core public health functions.
DIF: Cognitive Level: Application/Apply REF: p. 13, How To box
OBJ: 1.5 TOP: Client Need: Health Promotion and Maintenance
7. Which of the following is used as a measurement of population health?
a. |
Health status indicators |
b. |
The levels of prevention |
c. |
The number of memberships at the local fitness centre |
d. |
Reported provincial alcohol and tobacco sales in any given month |
ANS: A
Population health refers to the health outcomes of a population as measured by determinants of health and health outcomes.
DIF: Cognitive Level: Knowledge/Remember REF: p. 16
OBJ: 1.2 TOP: Client Need: Health Promotion and Maintenance
8. A registered nurse (RN), has just been employed as a CHN. Which question would be most relevant to her practice as she begins her position?
a. |
“Which community groups are at greatest risk for problems?” |
b. |
“Which patients should I see first as I begin my day?” |
c. |
“With which physicians will I be collaborating most closely?” |
d. |
“Who is the nursing assistant to whom I can refer patients?” |
ANS: A
CHNs apply the nursing process to the entire community; asking which groups are at greatest risk reflects a community-oriented perspective. The other possible responses focus on particular individuals.
DIF: Cognitive Level: Application/Apply REF: p. 15
OBJ: 1.6 TOP: Client Need: Health Promotion and Maintenance
9. The CHN working with women at the senior citizens’ centre reminds them that the only way the centre will be able to afford a driver and a van service for those who cannot drive themselves is to continue to write letters to their local city council representatives, requesting funding for such a service. What is the CHN doing?
a. |
Ensuring that the women do not expect the CHN herself to do anything about their problem |
b. |
Demonstrating that she understands the women’s concerns and needs |
c. |
Expressing empathy, support, and concern |
d. |
Helping the women engage in political action locally |
ANS: D
CHNs have an imperative to work with the members of the community to carry out public health functions such as political action.
DIF: Cognitive Level: Application/Apply REF: p. 13, How To box
OBJ: 1.5 | 1.6
TOP: Client Need: Safe and Effective Care Environment - Management of Care
10. Which activity is an example of the “advocate” role of the CHN?
a. |
Organizing home care support for a newly discharged older adult client |
b. |
Acting as a member of a community action group for provision of accessible transit choices |
c. |
Doing prenatal assessments |
d. |
Facilitating a self-help group for smoking cessation |
ANS: B
An advocate provides a voice to client concerns when acting as a member of a community action group for provision of accessible transit choices.
DIF: Cognitive Level: Application/Apply REF: p. 19, Table 1-3
OBJ: 1.6
TOP: Client Need: Safe and Effective Care Environment - Management of Care
11. In which scenario is the PHN most comprehensively fulfilling collaborative practice responsibilities?
a. |
The PHN meets with several groups about community recreation issues. |
b. |
The PHN spends the day attending meetings at various health agencies. |
c. |
The PHN talks to several people about their particular health concerns. |
d. |
The PHN watches television, including a telecast of a city council meeting on the local cable station. |
ANS: B
Any of these might represent a PHN communicating, cooperating, or collaborating with community residents or groups about health concerns. However, the PHN who spends the day attending meetings at various health agencies is most comprehensively fulfilling requirements effectively, since health is broader than recreation, individual concerns are not as important as aggregate priorities, and watching television is only one-way communication.
DIF: Cognitive Level: Synthesis/Synthesize REF: pp. 15-16
OBJ: 1.5
TOP: Client Need: Safe and Effective Care Environment - Management of Care
12. A CHN often has to make resource allocation decisions. In such cases, which approach will most help the CHN to arrive at the decision?
a. |
Choosing a moral or ethical principle |
b. |
Choosing the cheapest, most economical approach |
c. |
Choosing the most rational outcome |
d. |
Choosing the needs of the aggregate, rather than the needs of a few individuals |
ANS: D
Although all of the answers represent components of the CHN’s decision-making process, the predominant needs of the population outweigh the expressed needs of one person or a few people.
DIF: Cognitive Level: Application/Apply REF: pp. 7-8
OBJ: 1.3
TOP: Client Need: Safe and Effective Care Environment - Management of Care
13. Which situation most closely represents the focus of public health nursing?
a. |
Assessing the services and effectiveness of the school health clinic |
b. |
Caring for patients after their outpatient surgeries |
c. |
Giving care to schoolchildren at the school clinic and to the children’s families |
d. |
Treating paediatric patients at an outpatient clinic |
ANS: A
A public health or population-focused approach would consider the entire group of children receiving care, to see if services are effective in achieving the goal of improving the health of the school population.
DIF: Cognitive Level: Application/Apply REF: p. 13, How To box
OBJ: 1.5 TOP: Client Need: Health Promotion and Maintenance
14. Which public health service best represents primary prevention?
a. |
Developing a health education program about the dangers of smoking |
b. |
Providing a diabetes clinic for adults in low-income neighbourhoods |
c. |
Providing an influenza vaccination program in a community retirement village |
d. |
Teaching school-aged children about the positive effects of exercise |
ANS: C
Although all the services listed are appropriate and valuable, providing influenza vaccines to healthy adults represents the primary level of health prevention.
DIF: Cognitive Level: Application/Apply REF: p. 14
OBJ: 1.5 TOP: Client Need: Health Promotion and Maintenance
15. What term is used interchangeably with the term subpopulations?
a. |
Groups |
b. |
Aggregates |
c. |
Clients |
d. |
Communities |
ANS: B
Generally, subpopulations are referred to as aggregates within the larger community population.
DIF: Cognitive Level: Knowledge/Remember REF: p. 16
OBJ: 1.2 TOP: Client Need: Health Promotion and Maintenance
| 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 ............................ |