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Test Bank for Olds Maternal Newborn Nursing and Womens Health Across the Lifespan 11th Edition by Davidson

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Old’s Maternal-Newborn Nursing and Women’s Health, 11e (Davidson/London/Ladewig)

 

Chapter 1 Contemporary Maternal-Newborn Nursing

 

  • The nurse is speaking to students about changes in maternal-newborn care. One change is that self-care has gained wide acceptance with clients and the healthcare community due to research findings that suggest that it has which effect?

 

  1. Shortens newborn length of stay
  2. Decreases use of home health agencies
  3. Decreases healthcare costs
  4. Decreases the number of emergency department visits

 

Answer:C

 

Explanation:

  1. Length of stay is often determined by third-party payer (insurance company) policies as well as the physiologic stability of the mother and newborn. Home healthcare agencies often are involved in client care to decrease hospital stay time.
  2. Home healthcare agencies often are involved in client care to decrease hospital stay time.
  3. Research indicates that self-care significantly decreases healthcare costs.
  4. Acute emergencies are addressed by emergency departments, and are not delayed by those practicing self-care.

 

Page Ref: 3

 

Cognitive Level:Understanding

Client Need/Sub:Health Promotion and Maintenance: Self-Care

Standards: QSEN Competencies: Ⅰ.A.2. Describe strategies to empower patients or families in all aspects of the healthcare process. | 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: Context and Environment: Health care economic policy; reimbursement structures; accreditation standards; staffing models and productivity; supply chain models | Nursing/Integrated Concepts: Nursing Process: Planning.

Learning Outcome:1 Discuss the impact of the self-care movement on contemporary childbirth.

MNL LO:Recognize contemporary issues related to care of the childbearing family.

 

 

  • Care delivered by nurse-midwives can be safe and effective and can represent a positive response to the healthcare provider shortage. Nurse-midwives tend to use less technology, which often results in which of the following?

 

  1. There is less trauma to the mother.
  2. More childbirth education classes are available.
  3. They are instrumental in providing change in the birth environment at work.
  4. They advocate for more home healthcare agencies.

 

Answer:A

 

Explanation:

  1. Nurse-midwife models of care can be one way to ensure that mothers receive excellent prenatal and intrapartum care.
  2. It is appropriate for nurse-midwives, in conjunction with doctors and hospitals, to provide childbirth classes for expectant families.
  3. By working with other staff members and doctors, the nurse-midwife is able to implement changes as needed within the birthing unit.
  4. Clients are increasingly going home sooner, so there needs to be more follow-up in the home.

 

Page Ref: 3

 

Cognitive Level:Understanding

Client Need/Sub:Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: QSEN Competencies: Ⅲ.A.6. Describe how the strength and relevance of available evidence influences the choice of interventions in provision of patient-centered care. | AACN Essentials Competencies: Ⅸ. 5. Deliver compassionate, patient-centered, evidence-based care that respects patient and family preferences. | NLN Competencies: Context and Environment: Read and interpret data; apply health promotion/disease prevention strategies; apply health policy; conduct population-based transcultural health assessments and interventions. | Nursing/Integrated Concepts: Nursing Process: Planning.

Learning Outcome:2 Compare the nursing roles available to the maternal-newborn nurse.

MNL LO:Recognize contemporary issues related to care of the childbearing family.

 

 

  • The nurse is telling a new client how advanced technology has permitted the physician to do which of the following?

 

  1. Treat the fetus and monitor fetal development.
  2. Deliver at home with a nurse-midwife and doula.
  3. Have the father act as the coach and cut the umbilical cord.
  4. Breastfeed a new baby on the delivery table.

 

Answer:A

 

Explanation:

  1. The fetus is increasingly viewed as a patient separate from the mother, although treatment of the fetus necessarily involves the mother.
  2. A nurse-midwife and a doula are not examples of technological care.
  3. Fathers being present during labor and coaching their partners represents nontechnological care during childbirth.
  4. Breastfeeding is not an example of technology impacting care.

 

Page Ref: 2—3

 

Cognitive Level:Understanding

Client Need/Sub:Safe and Effective Care Environment: Management of Care

Standards:QSEN Competencies: Ⅰ.B.10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | AACN Essentials Competencies: Ⅸ.5. Deliver compassionate, patient-centered, evidence-based care that respects patient and family preferences. | NLN Competencies: Teamwork: Scope of practice, roles, and responsibilities of health care team members, including overlaps. | Nursing/Integrated Concepts: Nursing Process: Implementation.

Learning Outcome:6 Evaluate the potential impact of some of the special situations in contemporary maternity care.

MNL LO:Recognize contemporary issues related to care of the childbearing family.

  • A nurse is examining different nursing roles. Which example best illustrates an advanced practice nursing role?

 

  1. A registered nurse who is the manager of a large obstetrical unit
  2. A registered nurse who is the circulating nurse during surgical deliveries (cesarean sections)
  3. A clinical nurse specialist working as a staff nurse on a mother-baby unit
  4. A clinical nurse specialist with whom other nurses consult for her expertise in caring for high-risk infants

Answer:D

Explanation:

  1. A registered nurse who is the manager of a large obstetrical unit is a professional nurse who has graduated from an accredited program in nursing and completed the licensure examination.
  2. A registered nurse who is a circulating nurse at surgical deliveries (cesarean sections) is a professional nurse who has graduated from an accredited program in nursing and completed the licensure examination.
  3. A clinical nurse specialist working as a staff nurse on a mother-baby unit might have the qualifications for an advanced practice nursing staff member but is not working in that capacity.
  4. A clinical nurse specialist with whom other nurses consult for expertise in caring for high-risk infants is working in an advanced practice nursing role. This nurse has specialized knowledge and competence in a specific clinical area, and is master’s prepared.

Page Ref: 5

Cognitive Level:Understanding

Client Need/Sub:Safe and Effective Care Environment: Management of Care

Standards:QSEN Competencies: Ⅱ.A.2. Describe scopes of practice and roles of healthcare team members. | AACN Essentials Competencies: Ⅵ. 6. Compare/contrast the roles and perspectives of the nursing profession with other care professionals on the healthcare team (i.e. scope of discipline, education, and licensure requirements). | NLN Competencies: Teamwork: Scope of practice, roles, and responsibilities of health care team members, including overlaps. | Nursing/Integrated Concepts: Nursing Process: Assessment.

Learning Outcome:2 Compare the nursing roles available to the maternal-newborn nurse.

MNL LO:Recognize contemporary issues related to care of the childbearing family.

 

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DescriptionBy: Davidson Edition: 6th Edition Format: Downloadable ZIP Fille Resource Type: Test bank Duration: Unlimited downloads Delivery: Instant DownloadEdition: 8th Edition Format: Downloadable ZIP Fille Resource Type: Test bank Duration: Unlimited downloads Delivery: Instant DownloadBy: Ackley Edition: 11th Edition Format: Downloadable ZIP Fille Resource Type: Solution manual Duration: Unlimited downloads Delivery: Instant DownloadBy: Bauldoff Edition: 7th Edition Format: Downloadable ZIP Fille Resource Type: Test bank Duration: Unlimited downloads Delivery: Instant DownloadEdition: 8th Edition Format: Downloadable ZIP Fille Resource Type: Test bank Duration: Unlimited downloads Delivery: Instant DownloadBy: Urden Edition: 8th Edition Format: Downloadable ZIP Fille Resource Type: Test bank Duration: Unlimited downloads Delivery: Instant Download
Content

Old’s Maternal-Newborn Nursing and Women’s Health, 11e (Davidson/London/Ladewig)

 

Chapter 1 Contemporary Maternal-Newborn Nursing

 
  • The nurse is speaking to students about changes in maternal-newborn care. One change is that self-care has gained wide acceptance with clients and the healthcare community due to research findings that suggest that it has which effect?
 
  1. Shortens newborn length of stay
  2. Decreases use of home health agencies
  3. Decreases healthcare costs
  4. Decreases the number of emergency department visits
  Answer:C   Explanation:
  1. Length of stay is often determined by third-party payer (insurance company) policies as well as the physiologic stability of the mother and newborn. Home healthcare agencies often are involved in client care to decrease hospital stay time.
  2. Home healthcare agencies often are involved in client care to decrease hospital stay time.
  3. Research indicates that self-care significantly decreases healthcare costs.
  4. Acute emergencies are addressed by emergency departments, and are not delayed by those practicing self-care.
  Page Ref: 3   Cognitive Level:Understanding Client Need/Sub:Health Promotion and Maintenance: Self-Care Standards: QSEN Competencies: Ⅰ.A.2. Describe strategies to empower patients or families in all aspects of the healthcare process. | 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: Context and Environment: Health care economic policy; reimbursement structures; accreditation standards; staffing models and productivity; supply chain models | Nursing/Integrated Concepts: Nursing Process: Planning. Learning Outcome:1 Discuss the impact of the self-care movement on contemporary childbirth. MNL LO:Recognize contemporary issues related to care of the childbearing family.    
  • Care delivered by nurse-midwives can be safe and effective and can represent a positive response to the healthcare provider shortage. Nurse-midwives tend to use less technology, which often results in which of the following?
 
  1. There is less trauma to the mother.
  2. More childbirth education classes are available.
  3. They are instrumental in providing change in the birth environment at work.
  4. They advocate for more home healthcare agencies.
  Answer:A   Explanation:
  1. Nurse-midwife models of care can be one way to ensure that mothers receive excellent prenatal and intrapartum care.
  2. It is appropriate for nurse-midwives, in conjunction with doctors and hospitals, to provide childbirth classes for expectant families.
  3. By working with other staff members and doctors, the nurse-midwife is able to implement changes as needed within the birthing unit.
  4. Clients are increasingly going home sooner, so there needs to be more follow-up in the home.
  Page Ref: 3   Cognitive Level:Understanding Client Need/Sub:Health Promotion and Maintenance: Health Promotion/Disease Prevention Standards: QSEN Competencies: Ⅲ.A.6. Describe how the strength and relevance of available evidence influences the choice of interventions in provision of patient-centered care. | AACN Essentials Competencies: Ⅸ. 5. Deliver compassionate, patient-centered, evidence-based care that respects patient and family preferences. | NLN Competencies: Context and Environment: Read and interpret data; apply health promotion/disease prevention strategies; apply health policy; conduct population-based transcultural health assessments and interventions. | Nursing/Integrated Concepts: Nursing Process: Planning. Learning Outcome:2 Compare the nursing roles available to the maternal-newborn nurse. MNL LO:Recognize contemporary issues related to care of the childbearing family.    
  • The nurse is telling a new client how advanced technology has permitted the physician to do which of the following?
 
  1. Treat the fetus and monitor fetal development.
  2. Deliver at home with a nurse-midwife and doula.
  3. Have the father act as the coach and cut the umbilical cord.
  4. Breastfeed a new baby on the delivery table.
  Answer:A   Explanation:
  1. The fetus is increasingly viewed as a patient separate from the mother, although treatment of the fetus necessarily involves the mother.
  2. A nurse-midwife and a doula are not examples of technological care.
  3. Fathers being present during labor and coaching their partners represents nontechnological care during childbirth.
  4. Breastfeeding is not an example of technology impacting care.
  Page Ref: 2—3   Cognitive Level:Understanding Client Need/Sub:Safe and Effective Care Environment: Management of Care Standards:QSEN Competencies: Ⅰ.B.10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | AACN Essentials Competencies: Ⅸ.5. Deliver compassionate, patient-centered, evidence-based care that respects patient and family preferences. | NLN Competencies: Teamwork: Scope of practice, roles, and responsibilities of health care team members, including overlaps. | Nursing/Integrated Concepts: Nursing Process: Implementation. Learning Outcome:6 Evaluate the potential impact of some of the special situations in contemporary maternity care. MNL LO:Recognize contemporary issues related to care of the childbearing family.
  • A nurse is examining different nursing roles. Which example best illustrates an advanced practice nursing role?
 
  1. A registered nurse who is the manager of a large obstetrical unit
  2. A registered nurse who is the circulating nurse during surgical deliveries (cesarean sections)
  3. A clinical nurse specialist working as a staff nurse on a mother-baby unit
  4. A clinical nurse specialist with whom other nurses consult for her expertise in caring for high-risk infants
Answer:D Explanation:
  1. A registered nurse who is the manager of a large obstetrical unit is a professional nurse who has graduated from an accredited program in nursing and completed the licensure examination.
  2. A registered nurse who is a circulating nurse at surgical deliveries (cesarean sections) is a professional nurse who has graduated from an accredited program in nursing and completed the licensure examination.
  3. A clinical nurse specialist working as a staff nurse on a mother-baby unit might have the qualifications for an advanced practice nursing staff member but is not working in that capacity.
  4. A clinical nurse specialist with whom other nurses consult for expertise in caring for high-risk infants is working in an advanced practice nursing role. This nurse has specialized knowledge and competence in a specific clinical area, and is master’s prepared.
Page Ref: 5 Cognitive Level:Understanding Client Need/Sub:Safe and Effective Care Environment: Management of Care Standards:QSEN Competencies: Ⅱ.A.2. Describe scopes of practice and roles of healthcare team members. | AACN Essentials Competencies: Ⅵ. 6. Compare/contrast the roles and perspectives of the nursing profession with other care professionals on the healthcare team (i.e. scope of discipline, education, and licensure requirements). | NLN Competencies: Teamwork: Scope of practice, roles, and responsibilities of health care team members, including overlaps. | Nursing/Integrated Concepts: Nursing Process: Assessment. Learning Outcome:2 Compare the nursing roles available to the maternal-newborn nurse. MNL LO:Recognize contemporary issues related to care of the childbearing family.  

Test Bank for Psychiatric Mental Health Nursing, 8th Edition Wanda Mohr

Chapter 01- Introduction to Psychiatric-Mental Health Nursing

  1. A nurse is giving a presentation about preventing mental illness to college freshmen. A student asks, “What does it mean to be mentally healthy?” Which of the following potential responses by the nurse is best?
  A)           “Mental health is difficult to define and depends on cultural norms.”   B)            “Mental health is marked by productivity, fulfilling relationships, and adaptability.”   C)            “Mental health is characterized by the absence of mental illness.”   D)           “Mental health is the performance of behavior that is accepted as normal.”  
  1. A 48-year-old independent, successful woman is recovering from a modified radical mastectomy. She states she was grateful that during the first few weeks after surgery her mother stayed with her and did “everything” for her. Which element of mental health does this reflect?
  A)           Reality orientation   B)            Mastery of the environment   C)            Self-governance   D)           Tolerance of the unknown  
  1. Why is the document Mental Health: A Report of the Surgeon General (1999) most significant?
  A)           Because it states clearly that there are effective treatments for mental illness   B)            Because it allocates research money to psychiatric facilities   C)            Because it sets new guidelines for use of restraints   D)           Because it establishes reimbursement guidelines for third-party payers  
  1. While a nurse is performing an admission assessment for a mental health client, the client states that all of his problems have been caused by his parents. The nurse knows that psychological factors that can influence mental health include which of the following?
 
A)           Neuroanatomy   B)            Emotional developmental level   C)            Values and beliefs   D)           Religion  
  1. What is the primary purpose of the five-axis system used in the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, text revision(DSM-IV-TR)?
  A)           To separate the various mental disorders into five related categories   B)            To give a comprehensive picture of client functioning   C)            To improve prognostic ability   D)           To provide a decision-making algorithm for pharmacologic treatment  
  1. One limitation of the DSM relates to diagnostic labels given to children. The most problematic issue caused by applying adult categories to children is which of the following?
  A)           It prevents the proper treatment of childhood disorders.   B)            The criteria for diagnosis of a disorder are flexible for an adult, but not for children.   C)            Categories are based on manifestations of adult disorders, not research in children.   D)           The DSM was written before childhood psychological conditions were recognized.  
  1. Which of the following represents a problem complicating the treatment of people with mental illness?
  A)           Insurers' reimbursement decisions   B)            Increased responsibility for care by state mental hospitals   C)            Overuse of the well-coordinated mental health care system   D)           Lack of effective treatments  
  1. Julie, a 47-year-old woman, missed 1 week of work when she was hospitalized with bipolar disorder. She was placed on medication and was able to return to work. When asked about her absence, Julie informed coworkers that she was suffering from influenza. What is the most likely reason Julie lied about her illness?
  A)           This is a sign that the medication is not effectively treating her illness.   B)            Fear of rejection, isolation, and discrimination based on her mental health diagnosis
 
C)            Due to workplace policies that encourage the firing of those with mental illnesses   D)           To avoid eliciting sympathy among her coworkers  
  1. A 22-year-old man with a history of a recent suicide attempt is being treated for depression. Prior to becoming depressed, the client attended a prestigious art school and enjoyed many social and leisure activities. Of the following long-term goals for this client, which is consistent with an overarching recovery goal for all clients with mental disorders?
  A)           The client will not injure himself.   B)            The client's symptoms will be reduced.   C)            The client will show interest in social and leisure activities.   D)           The client will resume pre-illness functioning.  
  1. Which of the following approaches to care best reflects cultural competence?
  A)           Always assign nurses of a specific ethnic background to clients with the same ethnic background.   B)            Learn the behaviors and values associated with people of specific ethnic backgrounds.   C)            Assess the culturally mediated beliefs of each client.   D)           Believe that people are more alike than they are different.       Chapter 02- Neuroscience-Biology and Behavior  
  1. The basic units of structure and function in the nervous system are called which of the following?
  A)            Glial cells   B)            Neurons   C)            Axons   D)            Dendrites  
  1. The structure and function of a neuron form the basis for the overall function of the nervous system. What are the components of a neuron?
  A)            A glial cell, nucleus, organelles, dendrites, and axons   B)            A glial cell, nucleus, dendrites, and synapses   C)            A cell body, nucleus, organelles, dendrites, and axons   D)            A cell body, nucleus, axon, and synapses  
  1. A patient has researched the role of neurotransmitters in her mental illness. What is the role of neurotransmitters?
 
A)            Excite the receptor cell located inside the synaptic cleft.   B)            Inhibit the receptor cell found inside of glial cells.   C)            Communicate information within the receptor cell.   D)            Communicate information from one cell or cell group to another.  
  1. Because neurotransmitters are responsible for immediately transmitting impulses between nerve cells, they are known as which of the following?
  A)            First messengers   B)            Second messengers   C)            Receptors   D)            Synapses  
  1. A nurse is caring for a patient who is addicted to alcohol and drugs and is discussing the pathway of the brain responsible for this behavior. The nurse should know that the pathway of the brain thought to be involved in pleasurable sensations and the euphoria resulting from use of drugs is called the:
  A)            Tuberinfundibular dopamine pathway   B)            Nigrostriatal dopamine pathway   C)            Mesocortical dopamine pathway   D)            Mesolimbic dopamine pathway  
  1. A client lives with acquired deficits in emotional control, memory, and learning. What part of this client's brain is most likely affected?
  A)            Basal ganglia   B)            Brainstem   C)            Limbic system   D)            Cerebellum  
  1. You are caring for a mental health client who has developed difficulty with balance and muscle tone after a car accident that involved a head injury. Based on this information, what area of the brain was most likely injured in the accident?
  A)            Diencephalon   B)            Brainstem   C)            Cerebellum   D)            Pons  
  1. A client who experiences dysfunction in the hypothalamus is most likely to have
  A)            Maintaining homeostasis   B)            Processing sensory input
 
C)            Secreting melatonin   D)            Integrating motor activities  
  1. Sensory deprivation in infancy and childhood has adversely affected a boy's brain development. Which characteristic of the brain was most directly involved in this process?
  A)            Neuroplasticity   B)            Reactive plasticity   C)            Adaptive plasticity   D)            Synaptic plasticity  
  1. Rather than being 100%, concordance rates for schizophrenia in monozygotic twins are only 50%. Which of the following statements best explains this phenomenon?
  A)            Genetic predisposition to disease is frequently overstated.   B)            One twin is inherently more vulnerable in every case.   C)            Environmental experiences affect gene expression.   D)            The genetic pathway responsible for vulnerability is unrelated to being a twin.       Chapter 03- Conceptual Frameworks and Theories  
  1. A psychiatric–mental health nurse is aware of the importance of theories in the development and delivery of care. Which of the following is the best definition of a theory?
  A)            A group of related concepts or ideas   B)            A person's or group's beliefs about how something happens or works   C)            A prediction about two or more concepts   D)            A researchable question related to health care  
  1. Which of the following explains why theories are important to psychiatric–mental health nursing?
  A)            Theories provide more treatment options for clients.   B)            Theories add professionalism to health care.   C)            Theories simplify treatment decisions for most clients.   D)            Theories lead to the expansion of knowledge.  
  1. A client has been told by a psychologist that memories in his unconscious are contributing to his depression. This reasoning implies that the psychologist ascribes to what theory?
  A)            Psychoanalytic theory   B)            Behavior theory   C)            Cognitive–behavioral theory
 
D)            The humanistic perspective  
  1. A client's current plan of care includes interventions that are rooted in the concepts of reinforcement. Which theory of human behavior is being prioritized during this client's care?
  A)            Humanistic theory   B)            Sociocultural theory   C)            Behavioral theory   D)            Psychoanalytic theory  
  1. A client and her therapist have been discussing the notion that her psychopathology results from the blocking or distortion of personal growth, excessive stress, and unfavorable social conditions. This discussion is congruent with what theory?
  A)            Humanistic theory   B)            Interpersonal theory   C)            Biophysiological theory   D)            Sociocultural theory  
  1. During marital counseling, a man complains that his wife often “bombards” him with problems as soon as he settles down at home after work, which results in a prolonged argument. The wife admits that she does this but states she feels neglected and that her husband does not take the family problems seriously. She doesn't want her marriage to turn out like her parents' marriage. The wife admits that she sometimes provokes an argument in order to gain her husband's attention. How would a behaviorist most likely explain the wife's actions?
  A)            She has repressed painful memories about her emotionally distant father and is working out her anger at the parent in the marital relationship.   B)            Her thoughts about her parents' unhappy marriage are a justification for her behavior.   C)            She has an underlying anxiety disorder.   D)            The long argument in which she and her husband participate positively reinforces her behavior.  
  1. An adult man recalls that he was teased as a child about his inability to participate in sports. He began to avoid situations in which others might evaluate his behavior. He seeks treatment now because he is an accomplished musician but cannot perform for an audience. According to behavioral theory, his behavior is an example of which of the following concepts?
  A)            Discrimination   B)            Modeling   C)            Generalization   D)            Shaping  
  1. The nurse is working with a client who admits to having low self-esteem. The care team has determined that cognitive restructuring will likely enhance the client's self-esteem. Which of the following best describes the goals of this intervention?
 
A)            Avoid negative self-talk   B)            Replace negative self-talk with positive statements   C)            Change distorted thinking and the subsequent behaviors   D)            Use adaptive defense mechanisms  
  1. A 55-year-old woman is being treated for narcissistic personality disorder. The therapist demonstrates caring and appropriate regard for the client. The therapist's behavior is an example of which concept of behavior theory?
  A)            Shaping   B)            Discrimination   C)            Modeling   D)            Conditioning  
  1. In a group therapy session, group members confront a 35-year-old woman about her abuse of prescription pain medications. The woman states that, because a physician has prescribed her medication, she is not a drug addict. The nurse identifies this as an example of which of the following defense mechanisms?
  A)            Regression   B)            Projection   C)            Denial   D)            Sublimation     Chapter 04- Evidence-Based Practice  
  1. The nurse demonstrates a commitment to the health, safety, and welfare of people by providing evidence-based practice. What does the term “evidence-based practice” mean?
  A)            Care that integrates research and clinical expertise with the client's characteristics, culture, and preferences   B)            Care that bases decision making on established clinical protocols   C)            Care based on prior outcomes from the nurse's practice   D)            Care based on outcomes and research conducted by the practitioner  
  1. Many pseudoscientific practitioners function openly and market themselves as mainstream
  “therapists.” Why does the public often respond favorably to unconventional therapies?   A)            Pseudoscientific therapies are frequently more effective than conventional therapies.   B)            Further advancements can be made in effective pseudoscientific treatments with continued practice.   C)            Malpractice is minimized because pseudoscientific treatments are not empirically supported.
 
D)            Some clients and families are disenchanted with the outcomes of professionally approved treatments.  
  1. Nursing is both an art and a science. Which statement best represents how evidence-based practice encompasses these two aspects of nursing?
  A)            The art of nursing has been replaced by evidence-based practice.   B)            Multiple theoretical perspectives no longer guide evidence-based nursing care.   C)            The art of nursing is demonstrated through carrying out the science of nursing in a skillful, knowledgeable, intelligent, and ethical manner.   D)            The artful side of nursing is of less value to positive patient outcomes than is the science of nursing.  
  1. Evidence-based practice is based on the scientific method and empirical evidence. Which of the following is a principle of empirical evidence?
  A)            Scientific observations are subjective inferences made by the knowledgeable nurse researcher.   B)            Empirical studies may be designed to report the physical and mental effects of subjective experiences.   C)            Empirical evidence is not appropriate in the field of mental health because cognitions and emotions are subjective and unpredictable.   D)            Empirical knowledge is verifiable only with valid and reliable measurement instruments.  
  1. The nurse is part of team conducting a research study that involves controlled observations. Controlled observations involve which of the following activities?
  A)            Putting information together to form a new understanding   B)            Watching something carefully and noting events   C)            Testing a hypothesis or prediction   D)            Determining whether data are reliable and supportive  
  1. Two patients with schizophrenia have consented to be involved in clinical trials to determine the efficacy of a new antipsychotic medication. The researcher administers the new drug to one subject and a sugar pill to another subject. The patient who received the sugar pill received a treatment that is considered which of the following?
  A)            Sham treatment   B)            Unethical treatment   C)            Placebo   D)            Supplemental therapy  
  1. A research team has been formed to study a new medication and its effects on depression. The researcher wants to use a design where neither the clients nor the research staff will know who is receiving the medication or the placebo. What type of study is this group conducting?
  A)            An empirical study   B)            An evidence-based study   C)            A case-control study
 
D)            A double-blind study  
  1. A researcher is determining whether data that were obtained in a psychiatric nursing study are reliable and whether the data support the study hypothesis. In what part of the scientific process is the researcher functioning?
  A)            Experimentation   B)            Analysis   C)            Synthesis   D)            Prediction  
  1. The nurse is working with a 42-year-old female patient who is mildly overweight. The patient expresses a desire to “tone up” before summer and is interested in trying an over-the-counter weight loss remedy. The nurse should perform health education related to what subject?
  A)            To be wary of any product that claims rapid or effortless results without exercise   B)            The relatively low risk of using natural remedies   C)            The small amount of active ingredient in most over-the-counter treatments   D)            To choose a product that reports data indicating a high degree of effectiveness  
  1. Many people get health care information from the Internet. Hence, evidence-based health care can be threatened by the proliferation of pseudoscientific information available to the public. Which measure is currently being taken to prevent the misinformation of the healthcare consumer?
  A)            Evidence-based knowledge is currently only disseminated in professional journals and publications.   B)            The Food and Drug Administration (FDA) has been denied the jurisdiction to prosecute unscrupulous internet marketers.   C)            Public education is being performed by the Federal Trade Commission (FTC) through a campaign called Operation Cure All.   D)            Websites publicizing misinformation on the Internet are being screened and blocked.       Chapter 05- Legal and Ethical Aspects  
  1. A psychiatric–mental health nurse has been consistently aware of the need to adhere to standards of practice during interactions with clients and their families. What is a standard of nursing practice?
  A)            The body of text in the state nurse practice act   B)            A document outlining minimum expectations for safe nursing practice   C)            Unwritten but traditional practices that constitute safe nursing care
 
D)            Part of the federal nurse practice act  
  1. Nursing students are reviewing the nurse practice act in the state where they reside. A state's nurse practice act has which of the following functions?
  A)            Makes recommendations for how nurses should practice   B)            Defines the scope and limit of nursing practice   C)            Defines specific situations that constitute malpractice   D)            Follows federal laws about nursing practice

Solution Manual for Nursing Diagnosis Handbook 11th Edition by Ackley

Ackley: Nursing Diagnosis Handbook, 11th Edition Table of Contents     41 cases  Lecture Notes

Problem-Based Learning/Critical Thinking

Case Study - Restless Leg Syndrome

Case Scenario Abdul Malek is a 21 year old college student. He attends the local state university and is a junior studying graphic design.  Three (3) weeks into his fall semester, Abdul’s professors notice that he is falling asleep in class and often looks restless. Abdul taps his foot and squirms around in his seat. Abdul, who is usually an excellent student, has failed his first test in his Graphic Design II course. His professor asks him to see his advisor because the fear is that Abdul has become chemically impaired. His advisor sends Abdul to the student health services and his case is reviewed by the nurse.  Nursing Assessment  Abdul is a well-developed 22 year old male with a BMI of 20. His vital signs are: blood pressure 104/78; temperature 98.4 degrees F.; heart rate – 64 BPM; respiratory rate – 16 per minute. A nutritional history confirms a well-balanced diet with the exclusion of pork products. Abdul had been working out every day at the University gym but reports that he is currently “too tired” to do so.  Abdul denies drug or alcohol use and this is confirmed by serum analysis. Abdul complains about sleeping poorly and feeling as if, “I am moving all night.” He states that he often wakes up his dorm mate and feels badly about that.  The nurse reclines Abdul on the examination table and checks his deep tendon reflexes (DTRs) which are all 2 . The nurse asks Abdul to relax and dims the lights while she consults with the primary care practitioner. While the nurse is out of the examination room Abdul dozes and when the nurse returns the nurse observes Abdul’s right leg jerking several times before she arouses him.
  1. ASSESS
  2. Identify significant symptoms by underlining them in the assessment.
  3. List those symptoms that indicate the client has a health problem (those you have underlined).
  • falling asleep in class
  • often looks restless
  • taps his foot
  • squirms around in his seat
  • failed his first test
  •  “too tired
  • complains about sleeping poorly
  • I am moving all night
  • often wakes up
  • dozes
  • right leg jerking several times
  1. Group the symptoms that are similar.
  • falling asleep in class
  • often looks restless
  • taps his foot
  • squirms around in his seat
  • failed his first test
  • complains about sleeping poorly
  • dozes
  •  “too tired
  • I am moving all night
  • often wakes up
  • right leg jerking several times

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?
  1. Quality improvement
  2. Evidence-based practice
  3. Patient-centered care
  4. Teamwork and collaboration
Answer:  3 Explanation:  1. Identifying safety hazards and measuring quality is an example of the core competency quality improvement.
  1. Using best research when providing patient care is an example of the core competency evidence-based practice.
  2. Patient teaching is an example of the competency patient-centered care.
  3. 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?

  1. Change the sharps container in a patient's room.
  2. Document the effectiveness of pain medication for a patient.
  3. Discuss the effectiveness of bedside physical therapy with the therapist.
  4. 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.
  1. Documenting the effectiveness of pain medication for a patient is an example of patient-centered care.
  2. Discussing the effectiveness of bedside physical therapy with the therapist is an example of teamwork and collaboration.
  3. 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 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 Copyright © 2020 F. A. Davis Company ____ 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 WWW.NURSINGTB.COMN U R S I N G T B . C O M Copyright © 2020 F. A. Davis Company 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 Copyright © 2020 F. A. Davis Company 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

Test Bank For Critical Care Nursing 8th Edition By Urden

Sample Questions 

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