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Test Bank for Wongs Essentials of Pediatric Nursing 10th Edition by Hockenberry

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Hockenberry: Wong’s Essentials of Pediatric Nursing, 10th Edition

Chapter 02: Family, Social, Cultural, and Religious Influences on Child Health Promotion

MULTIPLE CHOICE

1. A nurse is selecting a family theory to assess a patient’s family dynamics. Which family theory best describes a series of tasks for the family throughout its life span?

a. Interactional theory
b. Developmental systems theory
c. Structural-functional theory
d. Duvall’s developmental theory

ANS: D

Duvall’s developmental theory describes eight developmental tasks of the family throughout its life span. Interactional theory and structural-functional theory are not family theories. Developmental systems theory is an outgrowth of Duvall’s theory. The family is described as a small group, a semiclosed system of personalities that interact with the larger cultural system. Changes do not occur in one part of the family without changes in others.

DIF:Cognitive Level: UnderstandREF:p. 17

TOP:Integrated Process: Nursing Process: Assessment

MSC:Area of Client Needs: Health Promotion and Maintenance

2.Which family theory explains how families react to stressful events and suggests factors that promote adaptation to these events?

a. Interactional theory
b. Developmental systems theory
c. Family stress theory
d. Duvall’s developmental theory

ANS: C

Family stress theory explains the reaction of families to stressful events. In addition, the theory helps suggest factors that promote adaptation to the stress. Stressors, both positive and negative, are cumulative and affect the family. Adaptation requires a change in family structure or interaction. Interactional theory is not a family theory. Interactions are the basis of general systems theory. Developmental systems theory is an outgrowth of Duvall’s theory. The family is described as a small group, a semiclosed system of personalities that interact with the larger cultural system. Changes do not occur in one part of the family without changes in others. Duvall’s developmental theory describes eight developmental tasks of the family throughout its life span.

DIF:Cognitive Level: UnderstandREF:p. 16

TOP:Integrated Process: Nursing Process: Assessment

MSC:Area of Client Needs: Health Promotion and Maintenance

3.Which is the term for a family in which the paternal grandmother, the parents, and two minor children live together?

a. Blended
b. Nuclear
c. Binuclear
d. Extended

ANS: D

An extended family contains at least one parent, one or more children, and one or more members (related or unrelated) other than a parent or sibling. A blended family contains at least one stepparent, step-sibling, or half-sibling. The nuclear family consists of two parents and their children. No other relatives or nonrelatives are present in the household. In binuclear families, parents continue the parenting role while terminating the spousal unit. For example, when joint custody is assigned by the court, each parent has equal rights and responsibilities for the minor child or children.

DIF:Cognitive Level: RememberREF:p. 18

TOP:Integrated Process: Nursing Process: Planning

MSC:Area of Client Needs: Health Promotion and Maintenance

4.A nurse is assessing a family’s structure. Which describes a family in which a mother, her children, and a stepfather live together?

a. Blended
b. Nuclear
c. Binuclear
d. Extended

ANS: A

A blended family contains at least one stepparent, step-sibling, or half-sibling. The nuclear family consists of two parents and their children. No other relatives or nonrelatives are present in the household. In binuclear families, parents continue the parenting role while terminating the spousal unit. For example, when joint custody is assigned by the court, each parent has equal rights and responsibilities for the minor child or children. An extended family contains at least one parent, one or more children, and one or more members (related or unrelated) other than a parent or sibling.

DIF:Cognitive Level: UnderstandREF:p. 18

TOP:Integrated Process: Nursing Process: Assessment

MSC:Area of Client Needs: Health Promotion and Maintenance

5.Parents of a firstborn child are asking whether it is normal for their child to be extremely competitive. The nurse should respond to the parents that studies about the ordinal position of children suggest that firstborn children tend to:

a. be praised less often.
b. be more achievement oriented.
c. be more popular with the peer group.
d. identify with peer group more than parents.

ANS: B

Firstborn children, like only children, tend to be more achievement oriented. Being praised less often, being more popular with the peer group, and identifying with peer groups more than parents are characteristics of later-born children.

DIF:Cognitive Level: ApplyREF:p. 29

TOP:Integrated Process: Nursing Process: Implementation

MSC:Area of Client Needs: Health Promotion and Maintenance

6.The nurse is teaching a group of new parents about the experience of role transition. Which statement by a parent would indicate a correct understanding of the teaching?

a. “My marital relationship can have a positive or negative effect on the role transition.”
b. “If an infant has special care needs, the parents’ sense of confidence in their new role is strengthened.”
c. “Young parents can adjust to the new role easier than older parents.”
d. “A parent’s previous experience with children makes the role transition more difficult.”

ANS: A

If parents are supportive of each other, they can serve as positive influences on establishing satisfying parental roles. When marital tensions alter caregiving routines and interfere with the enjoyment of the infant, then the marital relationship has a negative effect. Infants with special care needs can be a significant source of added stress. Older parents are usually more able to cope with the greater financial responsibilities, changes in sleeping habits, and reduced time for each other and other children. Parents who have previous experience with parenting appear more relaxed, have less conflict in disciplinary relationships, and are more aware of normal growth and development.

DIF:Cognitive Level: UnderstandREF:p. 17

TOP:Integrated Process: Nursing Process: Evaluation

MSC:Area of Client Needs: Health Promotion and Maintenance

7.When assessing a family, the nurse determines that the parents exert little or no control over their children. What is this style of parenting called?

a. Permissive
b. Dictatorial
c. Democratic
d. Authoritarian

ANS: A

Permissive parents avoid imposing their own standards of conduct and allow their children to regulate their own activity as much as possible. The parents exert little or no control over their children’s actions. Dictatorial or authoritarian parents attempt to control their children’s behavior and attitudes through unquestioned mandates. They establish rules and regulations or standards of conduct that they expect to be followed rigidly and unquestioningly. Democratic parents combine permissive and dictatorial styles. They direct their children’s behavior and attitudes by emphasizing the reasons for rules and negatively reinforcing deviations. They respect the child’s individual nature.

DIF:Cognitive Level: RememberREF:p. 20

TOP:Integrated Process: Nursing Process: Diagnosis

MSC:Area of Client Needs: Health Promotion and Maintenance

8.When discussing discipline with the mother of a 4-year-old child, the nurse should include which instruction?

a. Children as young as 4 years old rarely need to be punished.
b. Parental control should be consistent.
c. Withdrawal of love and approval is effective at this age.
d. One should expect rules to be followed rigidly and unquestioningly.

ANS: B

For effective discipline, parents must be consistent and must follow through with agreed-on actions. Realistic goals should be set for this age group. Parents should structure the environment to prevent unnecessary difficulties. Requests for behavior change should be phrased in a positive manner to provide direction for the child. Withdrawal of love and approval is never appropriate or effective. Discipline strategies should be appropriate to the child’s age, temperament, and severity of the misbehavior. Following rules rigidly and unquestioningly is beyond the developmental capabilities of a 4-year-old.

DIF:Cognitive Level: ApplyREF:p. 20

TOP:Integrated Process: Teaching/Learning

MSC:Area of Client Needs: Health Promotion and Maintenance

9.Which is most characteristic of the physical punishment of children, such as spanking?

a. Psychological impact is usually minimal.
b. Children rarely become accustomed to spanking.
c. Children’s development of reasoning increases.
d. Misbehavior is likely to occur when parents are not present.

ANS: D

Through the use of physical punishment, children learn what they should not do. When parents are not around, it is more likely that children will misbehave because they have not learned to behave well for their own sake, but rather out of fear of punishment. Spanking can cause severe physical and psychological injury and interfere with effective parent-child interaction. Children do become accustomed to spanking, requiring more severe corporal punishment each time. The use of corporal punishment may interfere with the child’s development of moral reasoning.

DIF:Cognitive Level: UnderstandREF:p. 20

TOP:Integrated Process: Teaching/Learning

MSC:Area of Client Needs: Health Promotion and Maintenance

10.A 3-year-old girl was adopted immediately after birth. The parents have just asked the nurse how they should tell the child that she is adopted. Which guidelines concerning adoption should the nurse use in planning a response?

a. Telling the child is an important aspect of their parental responsibilities.
b. The best time to tell the child is between ages 7 and 10 years.
c. It is not necessary to tell the child who was adopted so young.
d. It is best to wait until the child asks about it.

ANS: A

It is important for the parents not to withhold information about the adoption from the child. It is an essential component of the child’s identity. There is no recommended best time to tell children. It is believed that children should be told young enough so they do not remember a time when they did not know. It should be done before the children enter school to keep third parties from telling the children before the parents have had the opportunity.

DIF:Cognitive Level: UnderstandREF:p. 22

TOP:Integrated Process: Teaching/Learning

MSC:Area of Client Needs: Health Promotion and Maintenance

11.A parent of a school-age child is going through a divorce. The parent tells the school nurse the child has not been doing well in school and sometimes has trouble sleeping. The nurse should recognize this as which implication?

a. Indication of maladjustment
b. Common reaction to divorce
c. Lack of adequate parenting
d. Unusual response that indicates need for referral

ANS: B

Parental divorce affects school-age children in many ways. In addition to difficulties in school, they often have profound sadness, depression, fear, insecurity, frequent crying, loss of appetite, and sleep disorders. This is not an indication of maladjustment, suggestive of lack of adequate parenting, or an unusual response that indicates need for referral in school-age children after parental divorce.

DIF:Cognitive Level: ApplyREF:p. 24

TOP:Integrated Process: Teaching/Learning

MSC: Area of Client Needs: Psychosocial Integrity

12.A mother brings 6-month-old Eric to the clinic for a well-baby checkup. She comments, “I want to go back to work, but I don’t want Eric to suffer because I’ll have less time with him.” The nurse’s most appropriate answer would be which statement?

a. “I’m sure he’ll be fine if you get a good babysitter.”
b. “You will need to stay home until Eric starts school.”
c. “You should go back to work so Eric will get used to being with others.”
d. “Let’s talk about the child care options that will be best for Eric.”

ANS: D

Let’s talk about the child care options that will be best for Eric is an open-ended statement that will assist the mother in exploring her concerns about what is best for both her and Eric. I’m sure he’ll be fine if you get a good babysitterYou will need to stay home until Eric starts school, and You should go back to work so Eric will get used to being with others are directive statements. They do not address the effect of her working on Eric.

DIF:Cognitive Level: ApplyREF:p. 27

TOP:Integrated Process: Communication and Documentation

MSC: Area of Client Needs: Psychosocial Integrity

13.Which term best describes a group of people who share a set of values, beliefs, practices, social relationships, law, politics, economics, and norms of behavior?

a. Race
b. Culture
c. Ethnicity
d. Social group

ANS: B

Culture is a pattern of assumptions, beliefs, and practices that unconsciously frames or guides the outlook and decisions of a group of people. A culture is composed of individuals who share a set of values, beliefs, and practices that serve as a frame of reference for individual perceptions and judgments. Race is defined as a division of humankind possessing traits that are transmissible by descent and are sufficient to characterize it as a distinct human type. Ethnicity is an affiliation of a set of persons who share a unique cultural, social, and linguistic heritage. A social group consists of systems of roles carried out in groups. Examples of primary social groups include the family and peer groups.

DIF:Cognitive Level: RememberREF:p. 29

TOP:Integrated Process: Nursing Process: Assessment

MSC: Area of Client Needs: Psychosocial Integrity

14.Which term best describes the emotional attitude that one’s own ethnic group is superior to others?

a. Culture
b. Ethnicity
c. Superiority
d. Ethnocentrism

ANS: D

Ethnocentrism is the belief that one’s way of living and behaving is the best way. This includes the emotional attitude that the values, beliefs, and perceptions of one’s ethnic group are superior to those of others. Culture is a pattern of assumptions, beliefs, and practices that unconsciously frames or guides the outlook and decisions of a group of people. A culture is composed of individuals who share a set of values, beliefs, and practices that serves as a frame of reference for individual perception and judgments. Ethnicity is an affiliation of a set of persons who share a unique cultural, social, and linguistic heritage. Superiority is the state or quality of being superior; it does not include ethnicity.

DIF:Cognitive Level: UnderstandREF:p. 30

TOP:Integrated Process: Nursing Process: Assessment

MSC: Area of Client Needs: Psychosocial Integrity

MULTIPLE RESPONSE

1.Dunst, Trivette, and Deal identified the qualities of strong families that help them function effectively. Which qualities are included? (Select all that apply.)

a. Ability to stay connected without spending time together
b. Clear set of family values, rules, and beliefs
c. Adoption of one coping strategy that always promotes positive functioning in dealing with life events
d. Sense of commitment toward growth of individual family members as opposed to that of the family unit
e. Ability to engage in problem-solving activities
f. Sense of balance between the use of internal and external family resources

ANS: B, E, F

A clear set of family rules, values, and beliefs that establishes expectations about acceptable and desired behavior is one of the qualities of strong families that help them function effectively. Strong families also are able to engage in problem-solving activities and to find a balance between internal and external forces. Strong families have a sense of congruence among family members regarding the value and importance of assigning time and energy to meet needs. Strong families also use varied coping strategies. The sense of commitment is toward the growth and well-being of individual family members, as well as the family unit.

DIF:Cognitive Level: UnderstandREF:p. 19

TOP:Integrated Process: Nursing Process: Diagnosis

MSC:Area of Client Needs: Health Promotion and Maintenance

2.A nurse is conducting a teaching session on the use of time-out as a discipline measure to parents of toddlers. Which are correct strategies the nurse should include in the teaching session? (Select all that apply.)

a. Time-out as a discipline measure cannot be used when in a public place.
b. A rule for the length of time-out is 1 minute per year.
c. When the child misbehaves, one warning should be given.
d. The area for time-out can be in the family room where the child can see the television.
e. When the child is quiet for the specified time, he or she can leave the room.

ANS: B, C, E

A rule for the length of time-out is 1 minute per year of age; use a kitchen timer with an audible bell to record the time rather than a watch. When the child misbehaves, one warning should be given. When the child is quiet for the duration of the time, he or she can then leave the room. Time-out can be used in public places and the parents should be consistent on the use of time-out. Implement time-out in a public place by selecting a suitable area or explain to children that time-out will be spent immediately on returning home. The time-out should not be spent in an area from which the child can view the television. Select an area for time-out that is safe, convenient, and unstimulating but where the child can be monitored, such as the bathroom, hallway, or laundry room.

DIF:Cognitive Level: ApplyREF:p. 21

TOP:Integrated Process: Teaching/Learning

MSC:Area of Client Needs: Health Promotion and Maintenance

3.Divorced parents of a preschool child are asking whether their child will display any feelings or behaviors related to the effect of the divorce. The nurse is correct when explaining that the parents should be prepared for which types of behaviors? (Select all that apply.)

a. Displaying fears of abandonment
b. Verbalizing that he or she “is the reason for the divorce”
c. Displaying fear regarding the future
d. Ability to disengage from the divorce proceedings
e. Engaging in fantasy to understand the divorce

ANS: A, B, E

A child 3 to 5 years of age (preschool) may display fears of abandonment, verbalize feelings that he or she is the reason for the divorce, and engage in fantasy to understand the divorce. He or she would not be displaying fear regarding the future until school age, and the ability to disengage from the divorce proceedings would be characteristic of an adolescent.

DIF:Cognitive Level: ApplyREF:p. 24

TOP:Integrated Process: Nursing Process: Implementation

MSC: Area of Client Needs: Teaching and Learning

COMPLETION

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DescriptionBy: Hockenberry Edition: 10th Edition Format: Downloadable ZIP Fille Resource Type: Test bank Duration: Unlimited downloads Delivery: Instant DownloadBy: Sole Edition: 7th 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 DownloadBy: Davidson Edition: 6th Edition Format: Downloadable ZIP Fille Resource Type: Test bank Duration: Unlimited downloads Delivery: Instant DownloadEdition: 1st Edition Format: Downloadable ZIP Fille Resource Type: Test bank Duration: Unlimited downloads Delivery: Instant DownloadBy: Savage Format: Downloadable ZIP Fille Resource Type: Test bank Duration: Unlimited downloads Delivery: Instant Download
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Hockenberry: Wong’s Essentials of Pediatric Nursing, 10th Edition

Chapter 02: Family, Social, Cultural, and Religious Influences on Child Health Promotion MULTIPLE CHOICE 1. A nurse is selecting a family theory to assess a patient’s family dynamics. Which family theory best describes a series of tasks for the family throughout its life span?
a. Interactional theory
b. Developmental systems theory
c. Structural-functional theory
d. Duvall’s developmental theory
ANS: D Duvall’s developmental theory describes eight developmental tasks of the family throughout its life span. Interactional theory and structural-functional theory are not family theories. Developmental systems theory is an outgrowth of Duvall’s theory. The family is described as a small group, a semiclosed system of personalities that interact with the larger cultural system. Changes do not occur in one part of the family without changes in others. DIF:Cognitive Level: UnderstandREF:p. 17 TOP:Integrated Process: Nursing Process: Assessment MSC:Area of Client Needs: Health Promotion and Maintenance 2.Which family theory explains how families react to stressful events and suggests factors that promote adaptation to these events?
a. Interactional theory
b. Developmental systems theory
c. Family stress theory
d. Duvall’s developmental theory
ANS: C Family stress theory explains the reaction of families to stressful events. In addition, the theory helps suggest factors that promote adaptation to the stress. Stressors, both positive and negative, are cumulative and affect the family. Adaptation requires a change in family structure or interaction. Interactional theory is not a family theory. Interactions are the basis of general systems theory. Developmental systems theory is an outgrowth of Duvall’s theory. The family is described as a small group, a semiclosed system of personalities that interact with the larger cultural system. Changes do not occur in one part of the family without changes in others. Duvall’s developmental theory describes eight developmental tasks of the family throughout its life span. DIF:Cognitive Level: UnderstandREF:p. 16 TOP:Integrated Process: Nursing Process: Assessment MSC:Area of Client Needs: Health Promotion and Maintenance 3.Which is the term for a family in which the paternal grandmother, the parents, and two minor children live together?
a. Blended
b. Nuclear
c. Binuclear
d. Extended
ANS: D An extended family contains at least one parent, one or more children, and one or more members (related or unrelated) other than a parent or sibling. A blended family contains at least one stepparent, step-sibling, or half-sibling. The nuclear family consists of two parents and their children. No other relatives or nonrelatives are present in the household. In binuclear families, parents continue the parenting role while terminating the spousal unit. For example, when joint custody is assigned by the court, each parent has equal rights and responsibilities for the minor child or children. DIF:Cognitive Level: RememberREF:p. 18 TOP:Integrated Process: Nursing Process: Planning MSC:Area of Client Needs: Health Promotion and Maintenance 4.A nurse is assessing a family’s structure. Which describes a family in which a mother, her children, and a stepfather live together?
a. Blended
b. Nuclear
c. Binuclear
d. Extended
ANS: A A blended family contains at least one stepparent, step-sibling, or half-sibling. The nuclear family consists of two parents and their children. No other relatives or nonrelatives are present in the household. In binuclear families, parents continue the parenting role while terminating the spousal unit. For example, when joint custody is assigned by the court, each parent has equal rights and responsibilities for the minor child or children. An extended family contains at least one parent, one or more children, and one or more members (related or unrelated) other than a parent or sibling. DIF:Cognitive Level: UnderstandREF:p. 18 TOP:Integrated Process: Nursing Process: Assessment MSC:Area of Client Needs: Health Promotion and Maintenance 5.Parents of a firstborn child are asking whether it is normal for their child to be extremely competitive. The nurse should respond to the parents that studies about the ordinal position of children suggest that firstborn children tend to:
a. be praised less often.
b. be more achievement oriented.
c. be more popular with the peer group.
d. identify with peer group more than parents.
ANS: B Firstborn children, like only children, tend to be more achievement oriented. Being praised less often, being more popular with the peer group, and identifying with peer groups more than parents are characteristics of later-born children. DIF:Cognitive Level: ApplyREF:p. 29 TOP:Integrated Process: Nursing Process: Implementation MSC:Area of Client Needs: Health Promotion and Maintenance 6.The nurse is teaching a group of new parents about the experience of role transition. Which statement by a parent would indicate a correct understanding of the teaching?
a. “My marital relationship can have a positive or negative effect on the role transition.”
b. “If an infant has special care needs, the parents’ sense of confidence in their new role is strengthened.”
c. “Young parents can adjust to the new role easier than older parents.”
d. “A parent’s previous experience with children makes the role transition more difficult.”
ANS: A If parents are supportive of each other, they can serve as positive influences on establishing satisfying parental roles. When marital tensions alter caregiving routines and interfere with the enjoyment of the infant, then the marital relationship has a negative effect. Infants with special care needs can be a significant source of added stress. Older parents are usually more able to cope with the greater financial responsibilities, changes in sleeping habits, and reduced time for each other and other children. Parents who have previous experience with parenting appear more relaxed, have less conflict in disciplinary relationships, and are more aware of normal growth and development. DIF:Cognitive Level: UnderstandREF:p. 17 TOP:Integrated Process: Nursing Process: Evaluation MSC:Area of Client Needs: Health Promotion and Maintenance 7.When assessing a family, the nurse determines that the parents exert little or no control over their children. What is this style of parenting called?
a. Permissive
b. Dictatorial
c. Democratic
d. Authoritarian
ANS: A Permissive parents avoid imposing their own standards of conduct and allow their children to regulate their own activity as much as possible. The parents exert little or no control over their children’s actions. Dictatorial or authoritarian parents attempt to control their children’s behavior and attitudes through unquestioned mandates. They establish rules and regulations or standards of conduct that they expect to be followed rigidly and unquestioningly. Democratic parents combine permissive and dictatorial styles. They direct their children’s behavior and attitudes by emphasizing the reasons for rules and negatively reinforcing deviations. They respect the child’s individual nature. DIF:Cognitive Level: RememberREF:p. 20 TOP:Integrated Process: Nursing Process: Diagnosis MSC:Area of Client Needs: Health Promotion and Maintenance 8.When discussing discipline with the mother of a 4-year-old child, the nurse should include which instruction?
a. Children as young as 4 years old rarely need to be punished.
b. Parental control should be consistent.
c. Withdrawal of love and approval is effective at this age.
d. One should expect rules to be followed rigidly and unquestioningly.
ANS: B For effective discipline, parents must be consistent and must follow through with agreed-on actions. Realistic goals should be set for this age group. Parents should structure the environment to prevent unnecessary difficulties. Requests for behavior change should be phrased in a positive manner to provide direction for the child. Withdrawal of love and approval is never appropriate or effective. Discipline strategies should be appropriate to the child’s age, temperament, and severity of the misbehavior. Following rules rigidly and unquestioningly is beyond the developmental capabilities of a 4-year-old. DIF:Cognitive Level: ApplyREF:p. 20 TOP:Integrated Process: Teaching/Learning MSC:Area of Client Needs: Health Promotion and Maintenance 9.Which is most characteristic of the physical punishment of children, such as spanking?
a. Psychological impact is usually minimal.
b. Children rarely become accustomed to spanking.
c. Children’s development of reasoning increases.
d. Misbehavior is likely to occur when parents are not present.
ANS: D Through the use of physical punishment, children learn what they should not do. When parents are not around, it is more likely that children will misbehave because they have not learned to behave well for their own sake, but rather out of fear of punishment. Spanking can cause severe physical and psychological injury and interfere with effective parent-child interaction. Children do become accustomed to spanking, requiring more severe corporal punishment each time. The use of corporal punishment may interfere with the child’s development of moral reasoning. DIF:Cognitive Level: UnderstandREF:p. 20 TOP:Integrated Process: Teaching/Learning MSC:Area of Client Needs: Health Promotion and Maintenance 10.A 3-year-old girl was adopted immediately after birth. The parents have just asked the nurse how they should tell the child that she is adopted. Which guidelines concerning adoption should the nurse use in planning a response?
a. Telling the child is an important aspect of their parental responsibilities.
b. The best time to tell the child is between ages 7 and 10 years.
c. It is not necessary to tell the child who was adopted so young.
d. It is best to wait until the child asks about it.
ANS: A It is important for the parents not to withhold information about the adoption from the child. It is an essential component of the child’s identity. There is no recommended best time to tell children. It is believed that children should be told young enough so they do not remember a time when they did not know. It should be done before the children enter school to keep third parties from telling the children before the parents have had the opportunity. DIF:Cognitive Level: UnderstandREF:p. 22 TOP:Integrated Process: Teaching/Learning MSC:Area of Client Needs: Health Promotion and Maintenance 11.A parent of a school-age child is going through a divorce. The parent tells the school nurse the child has not been doing well in school and sometimes has trouble sleeping. The nurse should recognize this as which implication?
a. Indication of maladjustment
b. Common reaction to divorce
c. Lack of adequate parenting
d. Unusual response that indicates need for referral
ANS: B Parental divorce affects school-age children in many ways. In addition to difficulties in school, they often have profound sadness, depression, fear, insecurity, frequent crying, loss of appetite, and sleep disorders. This is not an indication of maladjustment, suggestive of lack of adequate parenting, or an unusual response that indicates need for referral in school-age children after parental divorce. DIF:Cognitive Level: ApplyREF:p. 24 TOP:Integrated Process: Teaching/Learning MSC: Area of Client Needs: Psychosocial Integrity 12.A mother brings 6-month-old Eric to the clinic for a well-baby checkup. She comments, “I want to go back to work, but I don’t want Eric to suffer because I’ll have less time with him.” The nurse’s most appropriate answer would be which statement?
a. “I’m sure he’ll be fine if you get a good babysitter.”
b. “You will need to stay home until Eric starts school.”
c. “You should go back to work so Eric will get used to being with others.”
d. “Let’s talk about the child care options that will be best for Eric.”
ANS: D Let’s talk about the child care options that will be best for Eric is an open-ended statement that will assist the mother in exploring her concerns about what is best for both her and Eric. I’m sure he’ll be fine if you get a good babysitterYou will need to stay home until Eric starts school, and You should go back to work so Eric will get used to being with others are directive statements. They do not address the effect of her working on Eric. DIF:Cognitive Level: ApplyREF:p. 27 TOP:Integrated Process: Communication and Documentation MSC: Area of Client Needs: Psychosocial Integrity 13.Which term best describes a group of people who share a set of values, beliefs, practices, social relationships, law, politics, economics, and norms of behavior?
a. Race
b. Culture
c. Ethnicity
d. Social group
ANS: B Culture is a pattern of assumptions, beliefs, and practices that unconsciously frames or guides the outlook and decisions of a group of people. A culture is composed of individuals who share a set of values, beliefs, and practices that serve as a frame of reference for individual perceptions and judgments. Race is defined as a division of humankind possessing traits that are transmissible by descent and are sufficient to characterize it as a distinct human type. Ethnicity is an affiliation of a set of persons who share a unique cultural, social, and linguistic heritage. A social group consists of systems of roles carried out in groups. Examples of primary social groups include the family and peer groups. DIF:Cognitive Level: RememberREF:p. 29 TOP:Integrated Process: Nursing Process: Assessment MSC: Area of Client Needs: Psychosocial Integrity 14.Which term best describes the emotional attitude that one’s own ethnic group is superior to others?
a. Culture
b. Ethnicity
c. Superiority
d. Ethnocentrism
ANS: D Ethnocentrism is the belief that one’s way of living and behaving is the best way. This includes the emotional attitude that the values, beliefs, and perceptions of one’s ethnic group are superior to those of others. Culture is a pattern of assumptions, beliefs, and practices that unconsciously frames or guides the outlook and decisions of a group of people. A culture is composed of individuals who share a set of values, beliefs, and practices that serves as a frame of reference for individual perception and judgments. Ethnicity is an affiliation of a set of persons who share a unique cultural, social, and linguistic heritage. Superiority is the state or quality of being superior; it does not include ethnicity. DIF:Cognitive Level: UnderstandREF:p. 30 TOP:Integrated Process: Nursing Process: Assessment MSC: Area of Client Needs: Psychosocial Integrity MULTIPLE RESPONSE 1.Dunst, Trivette, and Deal identified the qualities of strong families that help them function effectively. Which qualities are included? (Select all that apply.)
a. Ability to stay connected without spending time together
b. Clear set of family values, rules, and beliefs
c. Adoption of one coping strategy that always promotes positive functioning in dealing with life events
d. Sense of commitment toward growth of individual family members as opposed to that of the family unit
e. Ability to engage in problem-solving activities
f. Sense of balance between the use of internal and external family resources
ANS: B, E, F A clear set of family rules, values, and beliefs that establishes expectations about acceptable and desired behavior is one of the qualities of strong families that help them function effectively. Strong families also are able to engage in problem-solving activities and to find a balance between internal and external forces. Strong families have a sense of congruence among family members regarding the value and importance of assigning time and energy to meet needs. Strong families also use varied coping strategies. The sense of commitment is toward the growth and well-being of individual family members, as well as the family unit. DIF:Cognitive Level: UnderstandREF:p. 19 TOP:Integrated Process: Nursing Process: Diagnosis MSC:Area of Client Needs: Health Promotion and Maintenance 2.A nurse is conducting a teaching session on the use of time-out as a discipline measure to parents of toddlers. Which are correct strategies the nurse should include in the teaching session? (Select all that apply.)
a. Time-out as a discipline measure cannot be used when in a public place.
b. A rule for the length of time-out is 1 minute per year.
c. When the child misbehaves, one warning should be given.
d. The area for time-out can be in the family room where the child can see the television.
e. When the child is quiet for the specified time, he or she can leave the room.
ANS: B, C, E A rule for the length of time-out is 1 minute per year of age; use a kitchen timer with an audible bell to record the time rather than a watch. When the child misbehaves, one warning should be given. When the child is quiet for the duration of the time, he or she can then leave the room. Time-out can be used in public places and the parents should be consistent on the use of time-out. Implement time-out in a public place by selecting a suitable area or explain to children that time-out will be spent immediately on returning home. The time-out should not be spent in an area from which the child can view the television. Select an area for time-out that is safe, convenient, and unstimulating but where the child can be monitored, such as the bathroom, hallway, or laundry room. DIF:Cognitive Level: ApplyREF:p. 21 TOP:Integrated Process: Teaching/Learning MSC:Area of Client Needs: Health Promotion and Maintenance 3.Divorced parents of a preschool child are asking whether their child will display any feelings or behaviors related to the effect of the divorce. The nurse is correct when explaining that the parents should be prepared for which types of behaviors? (Select all that apply.)
a. Displaying fears of abandonment
b. Verbalizing that he or she “is the reason for the divorce”
c. Displaying fear regarding the future
d. Ability to disengage from the divorce proceedings
e. Engaging in fantasy to understand the divorce
ANS: A, B, E A child 3 to 5 years of age (preschool) may display fears of abandonment, verbalize feelings that he or she is the reason for the divorce, and engage in fantasy to understand the divorce. He or she would not be displaying fear regarding the future until school age, and the ability to disengage from the divorce proceedings would be characteristic of an adolescent. DIF:Cognitive Level: ApplyREF:p. 24 TOP:Integrated Process: Nursing Process: Implementation MSC: Area of Client Needs: Teaching and Learning COMPLETION

Test Bank for Introduction to Critical Care Nursing 7th Edition by Sole

Chapter 05: Comfort and Sedation

Sole: Introduction to Critical Care Nursing, 7th Edition

MULTIPLE CHOICE 1.Nociceptors differ from other nerve receptors in the body in that they:
a. adapt very little to continual pain response.
b. inhibit the infiltration of neutrophils and eosinophils.
c. play no role in the inflammatory response.
d. transmit only the thermal stimuli.
ANS: A Nociceptors are stimulated by mechanical, chemical, or thermal stimuli. Nociceptors differ from other nerve receptors in the body in that they adapt very little to the pain response. The body continues to experience pain until the stimulus is discontinued or therapy is initiated. This is a protective mechanism so that the body tissues being damaged will be removed from harm. Nociceptors usually initiate inflammatory responses near injured capillaries. As such, the response promotes infiltration of injured tissues with neutrophils and eosinophils. DIF: Cognitive Level: Remember/Knowledge REF: p. 54 OBJ:Discuss the physiology of pain and anxiety. TOP:Nursing Process Step: Assessment MSC: NCLEX Client Needs Category: Physiological Integrity 2.A postsurgical patient is on a ventilator in the critical care unit. The patient has been tolerating the ventilator well and has not required any sedation. On assessment, the nurse notes the patient is tachycardic and hypertensive with an increased respiratory rate of 28 breaths/min. The patient has been suctioned recently via the endotracheal tube, and the airway is clear. The patient responds appropriately to the nurse’s commands. The nurse should:
a. assess the patient’s level of pain.
b. decrease the ventilator rate.
c. provide sedation as ordered.
d. suction the patient again.
ANS: A Pulse, respirations, and blood pressure frequently result from activation of the sympathetic nervous system by the pain stimulus. Because the patient is postoperative, the patient should be assessed for the presence of pain and need for pain medication. Decreasing the ventilator rate will not help in this situation. Providing sedation may calm the patient but will not solve the problem if the physiological changes are from pain. The patient has just been suctioned and the airway is clear. There is no need to suction again. DIF: Cognitive Level: Analyze/Analysis REF: p. 55 OBJ: Describe the positive and negative effects of pain and anxiety in critically ill patients. TOP:Nursing Process Step: Assessment MSC: NCLEX Client Needs Category: Physiological Integrity 3.The assessment of pain and anxiety is a continuous process. When critically ill patients exhibit signs of anxiety, the nurse’s first priority is to
a. administer antianxiety medications as ordered.
b. administer pain medication as ordered.
c. identify and treat the underlying cause.
d. reassess the patient hourly to determine whether symptoms resolve on their own.
ANS: C When patients exhibit signs of anxiety or agitation, the first priority is to identify and treat the underlying cause, which could be hypoxemia, hypoglycemia, hypotension, pain, or withdrawal from alcohol and drugs. Treatment is not initiated until assessment is completed. Medication may not be needed if the underlying cause can be resolved. DIF: Cognitive Level: Apply/Application REF: p. 70 | Table 5-11 OBJ: Describe methods and tools for assessing pain and anxiety in the critically ill patient. TOP:Nursing Process Step: Assessment MSC: NCLEX Client Needs Category: Physiological Integrity 4.Both the electroencephalogram (EEG) monitor and the Bispectral Index Score (BIS) or Patient State Index (PSI) analyzer monitors are used to assess patient sedation levels in critically ill patients. The BIS and PSI monitors are simpler to use because they
a. can be used only on heavily sedated patients.
b. can be used only on pediatric patients.
c. provide raw EEG data and a numeric value.
d. require only five leads.
ANS: C The BIS and PSI have very simple steps for application, and results are displayed as raw EEG data and the numeric value. A single electrode is placed across the patient’s forehead and is attached to a monitor. These monitors can be used in both children and adults and in patients with varying levels of sedation. DIF: Cognitive Level: Understand/Comprehension REF: p. 60 OBJ: Describe methods and tools for assessing pain and anxiety in the critically ill patient. TOP:Nursing Process Step: Assessment MSC: NCLEX Client Needs Category: Physiological Integrity 5.The nurse is caring for a patient who requires administration of a neuromuscular blocking agent to facilitate ventilation with nontraditional modes. The nurse understands that neuromuscular blocking agents provide:
a. antianxiety effects.
b. complete analgesia.
c. high levels of sedation.
d. no sedation or analgesia.
ANS: D Neuromuscular blocking (NMB) agents do not possess any sedative or analgesic properties. Patients who receive NMBs must also receive sedatives and pain medication. DIF: Cognitive Level: Remember/Knowledge REF: p. 72 OBJ: Discuss assessment and management challenges in subsets of critically ill patients. TOP:Nursing Process Step: Implementation MSC: NCLEX Client Needs Category: Physiological Integrity 6.The patient is receiving neuromuscular blockade. Which nursing assessment indicates a target level of paralysis?
a. Glasgow Coma Scale score of 3
b. Train-of-four yields two twitches
c. Bispectral index of 60
d. CAM-ICU positive
ANS: B A train-of-four response of two twitches (out of four) using a peripheral nerve stimulator indicates adequate paralysis. The Glasgow Coma Scale does not assess paralysis; it is an indicator of consciousness. The bispectral index provides an assessment of sedation. The CAM-ICU is a tool to assess delirium. DIF: Cognitive Level: Remember/Knowledge REF: p. 73 OBJ: Discuss assessment and management challenges in subsets of critically ill patients. TOP:Nursing Process Step: Assessment MSC: NCLEX Client Needs Category: Physiological Integrity 7.The nurse is concerned that the patient will pull out the endotracheal tube. As part of the nursing management, the nurse obtains an order for
a. arm binders or splints.
b. a higher dosage of lorazepam.
c. propofol.
d. soft wrist restraints.
ANS: D The priority in caring for agitated patients is safety. The least restrictive methods of keeping the patient safe are appropriate. If possible, the tube or device causing irritation should be removed, but if that is not possible, the nurse must prevent the patient from pulling it out. Restraints are associated with an increased incidence of agitation and delirium. Therefore, restraints should not be used unless as a last resort for combative patients. The least amount of sedation is also recommended; therefore, neither increasing the dosage of lorazepam nor adding propofol is indicated and would be likely to prolong mechanical ventilation. DIF: Cognitive Level: Apply/Application REF: p. 61 OBJ:Identify nonpharmacological and pharmacological strategies to promote comfort and reduce anxiety.TOP:Nursing Process Step: Planning MSC: NCLEX Client Needs Category: Safe and Effective Care Environment 8.The primary mode of action for neuromuscular blocking agents used in the management of some ventilated patients is
a. analgesia.
b. anticonvulsant therapy.
c. paralysis.
d. sedation.
ANS: C These agents cause respiratory muscle paralysis. They do not provide analgesia or sedation. They do not have anticonvulsant properties. DIF: Cognitive Level: Remember/Knowledge REF: p. 72 OBJ: Discuss assessment and management challenges in subsets of critically ill patients. TOP:Nursing Process Step: Implementation MSC: NCLEX Client Needs Category: Physiological Integrity 9.The most important nursing intervention for patients who receive neuromuscular blocking agents is to
a. administer sedatives in conjunction with the neuromuscular blocking agents.
b. assess neurological status every 30 minutes.
c. avoid interaction with the patient, because he or she won’t be able to hear.
d. restrain the patient to avoid self-extubation.
ANS: A Neuromuscular blocking agents cause paralysis only; they do not cause sedation. Therefore, concomitant administration of sedatives is essential. Neurological status is monitored according to unit protocol. Nurses should communicate with all critically ill patients, regardless of their status. If the patient is paralyzed, restraining devices may not be needed. DIF: Cognitive Level: Apply/Application REF: p. 72 OBJ: Discuss assessment and management challenges in subsets of critically ill patients. TOP:Nursing Process Step: Implementation MSC: NCLEX Client Needs Category: Physiological Integrity 10.The best way to monitor agitation and effectiveness of treating it in the critically ill patient is to use a/the:
a. Confusion Assessment Method (CAM-ICU).
b. FACES assessment tool.
c. Glasgow Coma Scale.
d. Richmond Agitation Sedation Scale.
ANS: D Various sedation scales are available to assist the nurse in monitoring the level of sedation and assessing response to treatment. The Richmond Agitation Sedation Scale is a commonly used tool that has been validated. The CAM-ICU assesses for delirium. The FACES scale assesses pain. The Glasgow Coma Scale assesses neurological status. DIF: Cognitive Level: Remember/Knowledge REF: p. 59 | Table 5-5 OBJ: Describe methods and tools for assessing pain and anxiety in the critically ill patient. TOP:Nursing Process Step: Assessment MSC: NCLEX Client Needs Category: Physiological Integrity 11.The nurse is caring for a patient receiving intravenous ibuprofen for pain management. The nurse recognizes which laboratory assessment to be a possible side effect of the ibuprofen?
a. Creatinine: 3.1 mg/dL
b. Platelet count 350,000 billion/L
c. White blood count 13, 550 mm3
d. ALT 25 U/L
ANS: A Ibuprofen can result in renal insufficiency, which may be noted in an elevated serum creatinine level. Thrombocytopenia (low platelet count) is another possible side effect. This platelet count is elevated. An elevated white blood count indicates infection. Although ibuprofen is cleared primarily by the kidneys, it is also important to assess liver function, which would show elevated liver enzymes, not low values such as shown here. DIF: Cognitive Level: Analyze/Analysis REF: p. 71 OBJ:Identify nonpharmacological and pharmacological strategies to promote comfort and reduce anxiety.TOP:Nursing Process Step: Evaluation MSC: NCLEX Client Needs Category: Physiological Integrity 12.The nurse is assessing pain levels in a critically ill patient using the Behavioral Pain Scale. The nurse recognizes __________ as indicating the greatest level of pain.
a. brow lowering
b. eyelid closing
c. grimacing
d. relaxed facial expression
ANS: C The Behavioral Pain Scale issues the most points, indicating the greatest amount of pain, to assessment of facial grimacing. DIF: Cognitive Level: Understand/Comprehension REF: p. 58 | Table 5-3 OBJ: Describe methods and tools for assessing pain and anxiety in the critically ill patient. TOP:Nursing Process Step: Assessment MSC: NCLEX Client Needs Category: Physiological Integrity 13.The nurse wishes to assess the quality of a patient’s pain. Which of the following questions is appropriate to obtain this assessment if the patient is able to give a verbal response?
a. “Is the pain constant or intermittent?”
b. “Is the pain sharp, dull, or crushing?”
c. “What makes the pain better? Worse?”
d. “When did the pain start?”
ANS: B If the patient can describe the pain, the nurse can assess quality, such as sharp, dull, or crushing. The other responses relate to continuous or intermittent presence, what provides relief, and duration. DIF: Cognitive Level: Understand/Comprehension REF: p. 56 OBJ: Describe methods and tools for assessing pain and anxiety in the critically ill patient. TOP:Nursing Process Step: Assessment MSC: NCLEX Client Needs Category: Physiological Integrity 14.The nurse is assessing the patient’s pain using the Critical Care Pain Observation Tool. Which of the following assessments would indicate the greatest likelihood of pain and need for nursing intervention?
a. Absence of vocal sounds
b. Fighting the ventilator
c. Moving legs in bed
d. Relaxed muscles in upper extremities
ANS: B Fighting the ventilator is rated with the greatest number of points for compliance with the ventilator, and could indicate pain or anxiety. Absence of vocal sounds (e.g., no crying) and relaxed muscles do not indicate pain and are not given a point value. The patient may be moving the legs as a method of range of motion, not necessarily in response to pain. The patient needs to be assessed for restlessness if the movement is excessive. DIF: Cognitive Level: Apply/Application REF: p. 59 | Table 5-4 OBJ: Describe methods and tools for assessing pain and anxiety in the critically ill patient. TOP:Nursing Process Step: Assessment MSC: NCLEX Client Needs Category: Physiological Integrity 15.The nurse is caring for four patients on the progressive care unit. Which patient is at greatest risk for developing delirium?
a. 36-year-old recovering from a motor vehicle crash; being treated with an evidence-based alcohol withdrawal protocol.
b. 54-year-old postoperative aortic aneurysm resection with a 40 pack-year history of smoking
c. 86-year-old from nursing home with dementia, postoperative from colon resection, still being mechanically ventilated
d. 95-year-old with community-acquired pneumonia; family has brought in eyeglasses and hearing aid
ANS: C From this list, the 86-year-old postoperative nursing home resident is at greatest risk due to advanced age, cognitive impairment, and some degree of respiratory failure. The 96-year-old has been provided eyeglasses and a hearing aid, which will decrease the risk of delirium. Smoking is a possible risk for delirium. The 36-year-old is receiving medications as part of an alcohol withdrawal protocol, which should decrease the risk for delirium. DIF: Cognitive Level: Analyze/Analysis REF: p. 61 | Table 5-8 OBJ: Describe methods and tools for assessing pain and anxiety in the critically ill patient. TOP:Nursing Process Step: Assessment MSC: NCLEX Client Needs Category: Physiological Integrity 16.The nurse is caring for a patient with hyperactive delirium. The nurse focuses interventions toward keeping the patient:
a. comfortable.
b. nourished.
c. safe.
d. sedated.
ANS: C The greatest priority in managing delirium is to keep the patient safe. Sedation may contribute to the development of delirium. Comfort and nutrition are important, but they are not priorities. DIF: Cognitive Level: Understand/Comprehension REF: p. 61 OBJ: Identify nonpharmacological and pharmacological strategies to promote comfort, reduce anxiety, and prevent delirium. TOP: Nursing Process Step: Implementation MSC: NCLEX Client Needs Category: Safe and Effective Care Environment 17.The nurse is caring for a critically ill trauma patient who is expected to be hospitalized for an extended period. Which of the following nursing interventions would improve the patient’s well-being and reduce anxiety the most?
a. Arrange for the patient’s dog to be brought into the unit (per protocol).
b. Provide aromatherapy with scents such as lavender that are known to help anxiety.
c. Secure the harpist to come and play soothing music for an hour every afternoon.
d. Wheel the patient out near the unit aquarium to observe the tropical fish.
ANS: A Nonpharmacological approaches are helpful in reducing stress and anxiety, and each of these activities has the potential for improving the patient’s well-being. The patient is likely to benefit most from the presence of his or her own dog rather than the other activities, however; if unit protocol does not allow the patient’s own dog, the nurse should investigate the use of therapy animals or the other options. DIF: Cognitive Level: Apply/Application REF: p. 64 OBJ: Identify nonpharmacological and pharmacological strategies to promote comfort, reduce anxiety, and prevent delirium. TOP: Nursing Process Step: Intervention MSC: NCLEX Client Needs Category: Psychological Integrity 18.The nurse recognizes that which patient is likely to benefit most from patient-controlled analgesia (PCA)?
a. Patient with a C4 fracture and quadriplegia
b. Patient with a femur fracture and closed head injury
c. Postoperative patient who had elective bariatric surgery
d. Postoperative cardiac surgery patient with mild dementia
ANS: C The patient undergoing bariatric surgery (an elective procedure) is the best candidate for PCA as this patient should be awake, cognitively intact, and will have the acute pain related to the surgical procedure. The quadriplegic would be unable to operate the PCA pump. The cardiac surgery patient with mild dementia may not understand how to operate the pump. Likewise, the patient with the closed head injury may not be cognitively intact. DIF: Cognitive Level: Analyze/Analysis REF: p. 71 | Box 5-6 OBJ: Identify nonpharmacological and pharmacological strategies to promote comfort, reduce anxiety, and prevent delirium. TOP: Nursing Process Step: Intervention MSC: NCLEX Client Needs Category: Physiological Integrity 19.The nurse is caring for a patient receiving a benzodiazepine intermittently. The nurse understands that the best way to administer such drugs is to:
a. administer around the clock, rather than as needed, to ensure constant sedation.
b. administer the medications through the feeding tube to prevent complications.
c. give the highest allowable dose for the greatest effect.
d. titrate to a predefined endpoint using a standard sedation scale.
ANS: D The best approach for administering benzodiazepines (and all sedatives) is to administer and titrate to a desired endpoint using a standard sedation scale. Administering around the clock as well as giving the highest allowable dose without basing it on an assessment target may result in excessive sedation. For greatest effect, most benzodiazepines are given intravenously. DIF: Cognitive Level: Apply/Application REF: p. 72 OBJ: Identify nonpharmacological and pharmacological strategies to promote comfort, reduce anxiety, and prevent delirium. TOP: Nursing Process Step: Intervention MSC: NCLEX Client Needs Category: Physiological Integrity 20.The nurse is concerned about the risk of alcohol withdrawal syndrome in a postoperative patient. Which statement by the nurse indicates understanding of management of this patient?
a. “Alcohol withdrawal is common; we see it all of the time in the trauma unit.”
b. “There is no way to assess for alcohol withdrawal.”
c. “This patient will require less pain medication.”
d. “We have initiated the alcohol withdrawal protocol.”
ANS: D The most important treatment of alcohol withdrawal syndrome is prevention. Many units have protocols that are initiated early to prevent the syndrome. Alcohol withdrawal syndrome is common; however, this statement does not indicate knowledge of management. The patient experiencing alcohol withdrawal may exhibit a variety of symptoms, such as disorientation, agitation, and tachycardia. Patients with substance abuse require increased dosages of pain medications. DIF: Cognitive Level: Understand/Comprehension REF: p. 74 OBJ: Identify nonpharmacological and pharmacological strategies to promote comfort, reduce anxiety, and prevent delirium. TOP: Nursing Process Step: Intervention MSC: NCLEX Client Needs Category: Physiological Integrity MULTIPLE RESPONSE 1.Nonpharmacological approaches to pain and/or anxiety that may best meet the needs of critically ill patients include: (Select all that apply.)
a. anaerobic exercise.
b. art therapy.
c. guided imagery.
d. music therapy.
e. animal therapy.
ANS: C, D, E Guided imagery is a powerful technique for controlling pain and anxiety, especially that associated with painful procedures. Similar to guided imagery, a music therapy program offers patients a diversionary technique for pain and anxiety relief. Likewise animal therapy has many benefits for the critically ill patient. Anaerobic exercise is not a nonpharmacological approach for managing pain and anxiety. Most critically ill patients are not able to participate in art therapy. DIF: Cognitive Level: Remember/Knowledge REF: pp. 62-64 OBJ:Identify nonpharmacological and pharmacological strategies to promote comfort and reduce anxiety.TOP:Nursing Process Step: Implementation MSC: NCLEX Client Needs Category: Physiological Integrity 2.Which of the following statements regarding pain and anxiety are true? (Select all that apply.)
a. Anxiety is a state marked by apprehension, agitation, autonomic arousal, and/or fearful withdrawal.
b. Critically ill patients often experience anxiety, but they rarely experience pain.
c. Pain and anxiety are often interrelated and may be difficult to differentiate because their physiological and behavioral manifestations are similar.
d. Pain is defined by each patient; it is whatever the person experiencing the pain says it is.
e. While anxiety is unpleasant, it does not contribute to mortality or morbidity of the critically ill patient.
ANS: A, C, D Pain is defined by each patient, anxiety is associated with marked apprehension, and pain and anxiety are often interrelated. Critically ill patients commonly have both pain and anxiety. Anxiety does increase both morbidity and mortality in critically ill patients, especially those with cardiovascular disease. DIF: Cognitive Level: Understand/Comprehension REF: p. 53 OBJ: Define pain and anxiety. TOP: Nursing Process Step: Planning MSC: NCLEX Client Needs Category: Physiological Integrity 3.Which of the following factors predispose the critically ill patient to pain and anxiety? (Select all that apply.)
a. Inability to communicate
b. Invasive procedures
c. Monitoring devices
d. Nursing care
e. Preexisting conditions
ANS: A, B, C, D, E All of these factors predispose the patient to pain or anxiety. DIF: Cognitive Level: Remember/Knowledge REF: pp. 53-54 OBJ: Identify factors that place the critically ill patient at risk for developing pain and anxiety. TOP:Nursing Process Step: Assessment MSC: NCLEX Client Needs Category: Physiological Integrity 4.Choose the items that are common to both pain and anxiety. (Select all that apply.)
a. Cyclical exacerbation of one another
b. Require good nursing assessment for proper treatment
c. Response only to real phenomena
d. Subjective in nature
e. Perception may be influenced by prior experience
ANS: A, B, D, E Both pain and anxiety are subjective in nature. One can exacerbate the other in a vicious cycle that often requires good nursing assessment to manage the precipitating problem and break the cycle. Anxiety is a response to a real or perceived fear. Pain is a response to real or “phantom” phenomenon but always involves transmission of nerve impulses. Both relate to the patient’s perceptions of pain and fear. Previous experiences of both pain and/or anxiety can influence the patient’s perception of both. Anxiety is a response to real or perceived fear, and pain is a response to a real or “phantom” phenomenon. DIF: Cognitive Level: Understand/Comprehension REF: pp. 53-54 OBJ: Identify factors that place the critically ill patient at risk for developing pain and anxiety. TOP:Nursing Process Step: Assessment MSC: NCLEX Client Needs Category: Physiological Integrity 5.Anxiety differs from pain in that: (Select all that apply.)
a. it is confined to neurological processes in the brain.
b. it is linked to reward and punishment centers in the limbic system.
c. it is subjective.
d. there is no actual tissue injury.
e. it can be increased by noise and light.
ANS: A, B, D, E Unlike pain, anxiety is linked to the reward and punishment centers in the limbic system of the brain. It is totally neurological and does not involve tissue injury. Like pain, it is a subjective phenomenon. Noise, light, and other stimuli can increase the intensity of anxiety. Both anxiety and pain are subjective in nature. DIF: Cognitive Level: Understand/Comprehension REF: pp. 53-55 OBJ:Discuss the physiology of pain and anxiety. TOP: Nursing Process Step: Assessment 6.Factors in the critical care unit that may predispose the client to increased pain and anxiety include: (Select all that apply.)
a. an endotracheal tube.
b. frequent vital signs.
c. monitor alarms.
d. room temperature.
e. hostile environment.
ANS: A, B, C, D, E Anxiety is likely to result from loss of control, the inability to communicate, continuous noise and lighting, excessive stimulation (including repeated vital sign measurements), lack of mobility, and uncomfortable room temperatures. Increased anxiety levels often lead to increased pain perception. Environments that are perceived as hostile also contribute. DIF: Cognitive Level: Understand/Comprehension REF: pp. 53-54 OBJ: Identify factors that place the critically ill patient at risk for developing pain and anxiety. TOP:Nursing Process Step: Assessment MSC: NCLEX Client Needs Category: Physiological Integrity 7.In the healthy individual, pain and anxiety: (Select all that apply.)
a. activate the sympathetic nervous system (SNS).
b. decrease stress levels.
c. help remove one from harm.
d. increase performance levels.
e. limit sympathetic nervous system activity.
ANS: A, C, D In the healthy person, pain and anxiety are adaptive mechanisms used to increase performance levels or to remove one from potential harm. The “fight or flight” response occurs in response to pain and/or anxiety and involves the activation of the sympathetic nervous system. Pain and anxiety, however, can induce significant stress. The SNS is activated, not limited, by pain and/or anxiety. DIF: Cognitive Level: Remember/Knowledge REF: p. 55 OBJ: Describe the positive and negative effects of pain and anxiety in critically ill patients. TOP:Nursing Process Step: Assessment MSC: NCLEX Client Needs Category: Physiological Integrity 8.The nurse is caring for a patient who is intubated and on a ventilator following extensive abdominal surgery. Although the patient is responsive, the nurse is not able to read the patient’s lips as the patient attempts to mouth the words. Which of the following assessment tools would be the most appropriate for the nurse to use when assessing the patient’s pain level? (Select all that apply.)
a. The FACES scale
b. Pain Intensity Scale
c. The PQRST method
d. The Visual Analogue Scale
e. The CAM tool
ANS: A, D

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

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.  

Medical-Surgical Nursing: Making Connections to Practice 1st edition Hoffman, Sullivan Test Bank

 

Chapter 1: Foundations for Medical-Surgical Nursing

Multiple Choice Identify the choice that best completes the statement or answers the question.

____ 1. The medical-surgical nurse identifies a clinical practice issue and wants to determine if there is sufficient evidence to support a change in practice. Which type of study provides the strongest evidence to support a practice change? 1) Randomized control study 2) Quasi-experimental study 3) Case-control study 4) Cohort study

____ 2. The medical-surgical unit recently implemented a patient-centered care model. Which action implemented by the nurse supports this model? 1) Evaluating care 2) Assessing needs 3) Diagnosing problems 4) Providing compassion

____ 3. Which action should the nurse implement when providing patient care in order to support The Joint Commission’s (TJC) National Patient Safety Goals (NPSG)? 1) Silencing a cardiorespiratory monitor 2) Identifying each patient using one source 3) Determining patient safety issues upon admission 4) Decreasing the amount of pain medication administered

____ 4. Which interprofessional role does the nurse often assume when providing patient care in an acute care setting? 1) Social worker 2) Client advocate 3) Care coordinator 4) Massage therapist

____ 5. The medical-surgical nurse wants to determine if a policy change is needed for an identified clinical problem. Which is the first action the nurse should implement? 1) Developing a question 2) Disseminating the findings 3) Conducting a review of the literature 4) Evaluating outcomes of practice change

____ 6. The nurse is evaluating the level of evidence found during a recent review of the literature. Which evidence carries the lowest level of support for a practice change? 1) Level IV 2) Level V 3) Level VI 4) Level VII

____ 7. The nurse is reviewing evidence from a quasi-experimental research study. Which level of evidence should the nurse identify for this research study? 1) Level ITestBankWorld.org 2) Level II 3) Level III 4) Level IV

____ 8. Which level of evidence should the nurse identify when reviewing evidence from a single descriptive research study? 1) Level IV 2) Level V 3) Level VI 4) Level VII

____ 9. Which statement should the nurse make when communicating the “S” in the SBAR approach for effective communication? 1) “The patient presented to the emergency department at 0200 with lower left abdominal pain.” 2) “The patient rated the pain upon admission as a 9 on a 10-point numeric scale.” 3) “The patient has no significant issues in the medical history.” 4) “The patient was given a prescribed opioid analgesic at 0300.” ____ 10. The staff nurse is communicating with the change nurse about the change of status of the patient. The nurse would begin her communication with which statement if correctly using the SBAR format? 1) “The patient’s heartrate is 110.” 2) “I think this patient needs to be transferred to the critical care unit.” 3) “The patient is a 68-year-old male patient admitted last night.” 4) “The patient is complaining of chest pain.” ____ 11. Which nursing action exemplifies the Quality and Safety Education for Nursing (QSEN) competency of safety? 1) Advocating for a patient who is experiencing pain 2) Considering the patient’s culture when planning care 3) Evaluating patient learning style prior to implementing discharge instructions 4) Assessing the right drug prior to administering a prescribed patient medication ____ 12. Which type of nursing is the root of all other nursing practice areas? 1) Pediatric nursing 2) Geriatric nursing 3) Medical-surgical nursing 4) Mental health-psychiatric nursing ____ 13. Which did the Nursing Executive Center of The Advisory Board identify as an academic-practice gap for new graduate nurses? 1) Patient advocacy 2) Patient education 3) Disease pathophysiology 4) Therapeutic communication ____ 14. Which statement regarding the use of the nursing process in clinical practice is accurate? 1) “The nursing process is closely related to clinical decision-making.” 2) “The nursing process is used by all members of the interprofessional team to plan care.” 3) “The nursing process has 4 basic steps: assessment, planning, implementation, evaluation.” 4) “The nursing process is being replaced by the implementation of evidence-based practice.”TestBankWorld.org ____ 15. Which is the basis of nursing care practices and protocols? 1) Assessment 2) Evaluation 3) Diagnosis 4) Research ____ 16. Which is a common theme regarding patient dissatisfaction related to care provided in the hospital setting? 1) Space in hospital rooms 2) Medications received to treat pain 3) Time spent with the health-care team 4) Poor quality food received from dietary ____ 17. The nurse manager is preparing a medical-surgical unit for The Joint Commission (TJC) visit With the nurse manager presenting staff education focusing on TJC benchmarks, which of the following topics would be most appropriate? 1) Implementation of evidence-based practice 2) Implementation of patient-centered care 3) Implementation of medical asepsis practices 4) Implementation of interprofessional care ____ 18. Which aspect of patient-centered care should the nurse manager evaluate prior to The Joint Commission site visit for accreditation? 1) Visitation rights 2) Education level of staff 3) Fall prevention protocol 4) Infection control practices ____ 19. The medical-surgical nurse is providing patient care. Which circumstance would necessitate the nurse verifying the patient’s identification using at least two sources? 1) Prior to delivering a meal tray 2) Prior to passive range of motion 3) Prior to medication administration 4) Prior to documenting in the medical record ____ 20. The nurse is providing care to several patients on a medical-surgical unit. Which situation would necessitate the nurse to use SBAR during the hand-off process? 1) Wound care 2) Discharge to home 3) Transfer to radiology 4) Medication education Multiple Response Identify one or more choices that best complete the statement or answer the question. ____ 21. The staff nurse is teaching a group of student nurses the situations that necessitate hand-off communication. Which student responses indicate the need for further education related to this procedure? Select all that apply. 1) “A hand-off is required prior to administering a medication.” 2) “A hand-off is required during change of shift.” 3) “A hand-off is required for a patient is transferred to the surgical suite.”TestBankWorld.org 4) “A hand-off is required whenever the nurse receives a new patient assignment.” 5) “A hand-off is required prior to family visitation.” ____ 22. Which actions by the nurse enhance patient safety during medication administration? Select all that apply. 1) Answering the call bell while transporting medications for a different patient 2) Identifying the patient using two sources prior to administering the medication 3) Holding a medication if the patient’s diagnosis does not support its use 4) Administering the medication two hours after the scheduled time 5) Having another nurse verify the prescribed dose of insulin the patient is to receive ____ 23. The medical-surgical nurse assumes care for a patient who is receiving continuous cardiopulmonary monitoring. Which actions by the nurse enhance safety for this patient? Select all that apply. 1) Silencing the alarm during family visitation 2) Assessing the alarm parameters at the start of the shift 3) Responding to the alarm in a timely fashion 4) Decreasing the alarm volume to enhance restful sleep 5) Adjusting alarm parameters based on specified practitioner prescription ____ 24. The nurse is planning an interprofessional care conference for a patient who is approaching discharge from the hospital. Which members of the interprofessional team should the nurse invite to attend? Select all that apply. 1) Physician 2) Pharmacist 3) Unit secretary 4) Social worker 5) Home care aide ____ 25. The nurse manager wants to designate a member of the nursing team as the care coordinator for a patient who will require significant care during the hospitalization. Which skills should this nurse possess in order to assume this role? Select all that apply. 1) Effective clinical reasoning 2) Effective communication skills 3) Effective infection control procedures 4) Effective documentation 5) Effective intravenous skillsTestBankWorld.org Chapter 1: Foundations for Medical-Surgical Nursing Answer Section MULTIPLE CHOICE 1. ANS: 1 Chapter number and title: 1, Foundations for Medical Surgical Practice Chapter learning objective: Discussing the incorporation of evidence-based practices into medical-surgical nursing Chapter page reference: 003-004 Heading: Evidence-Based Nursing Care Integrated Processes: Nursing Process: Planning Client Need: Safe and Effective Care Environment/Management of Care Cognitive level: Comprehension [Understanding] Concept: Evidence-Based Practice Difficulty: Easy Feedback 1 Systematic reviews of randomized control studies (Level I) are the highest level of evidence because they include data from selected studies that randomly assigned participants to control and experimental groups. The lower the numerical rating of the level of evidence indicates the highest level of evidence; therefore, this type of study provides the strongest evidence to support a practice change. 2 Quasi-experimental studies are considered Level III; therefore, this study does not provide the strongest evidence to support a practice change. 3 Case-control studies are considered Level IV; therefore, this study does not provide the strongest evidence to support a practice change. 4 Cohort studies are considered Level IV; therefore, this study does not provide the strongest evidence to support a practice change. PTS: 1 CON: Evidence-Based Practice 2. ANS: 4 Chapter number and title: 1, Foundations of Medical-Surgical Practice Chapter learning objective: Explaining the importance of patient-centered care in the management of medical-surgical patients Chapter page reference: 004-005 Heading: Patient-Centered Care in the Medical-Surgical Setting Integrated Processes: Caring Client Need: Psychosocial Integrity Cognitive level: Application [Applying] Concept: Nursing Roles Difficulty: Moderate Feedback 1 Evaluation is a step in the nursing process; however, this is not an action that supports the patient-centered care model. 2 Assessment is a step in the nursing process; however, this is not an action that supports the patient-centered care model.TestBankWorld.org 3 Diagnosis is a step in the nursing process; however, this is not an action that supports the patient-centered care model. 4 Compassion is a competency closely associated with patient-centered care; therefore, this action supports the patient-centered model of care. PTS: 1 CON: Nursing Roles 3. ANS: 3 Chapter number and title: 1, Foundations of Medical-Surgical Nursing Practice Chapter learning objective: Discussing implications to medical-surgical nurses of Quality and Safety Education for Nurses (QSEN) competencies Chapter page reference: 005-006 Heading: Patient Safety Outcomes Integrated Processes: Nursing Process: Implementation Client Need: Safe and Effective Care Environment/Management of Care Cognitive level: Application [Applying] Concept: Safety Difficulty: Moderate Feedback 1 Safely using alarms is a NPSG identified by TJC. Silencing a cardiorespiratory monitor is not nursing action that supports this NPSG. 2 Patient identification using two separate resources is a NPSG identified by TJC. Identifying a patient using only one source does not support this NPSG. 3 Identification of patient safety risks is a NPSG identified by the TJC. Determining patient safety issues upon admission supports this NPSG. 4 Safe use of medication is a NPSG identified by the TJC. Decreasing the amount of pain medication administered does not support this NPSG. PTS: 1 CON: Safety 4. ANS: 3 Chapter number and title: 1, Foundations of Medical-Surgical Nursing Practice Chapter learning objective: Describing the role and competencies of medical-surgical nursing Chapter page reference: 006-007 Heading: Interprofessional Collaboration and Communication Integrated Processes: Nursing Process: Implementation Client Need: Safe and Effective Care Environment/Management of Care Cognitive level: Comprehension [Understanding] Concept: Nursing Roles Difficulty: Easy Feedback 1 The nurse does not often assume the interprofessional role of social worker when providing patient care in an acute care setting. 2 The nurse does not often assume the interprofessional role of client advocate role when providing patient care in an acute care setting. 3 The nurse often assumes the interprofessional role of care coordinator when providing patient care in an acute care setting. 4 The nurse does not often assume the interprofessional role of massage therapist when providing patient care in an acute care setting.TestBankWorld.org PTS: 1 CON: Nursing Roles 5. ANS: 1 Chapter number and title: 1, Foundations of Medical-Surgical Practice Chapter learning objective: Discussing the incorporation of evidence-based practices into medical-surgical nursing Chapter page reference: 003 Heading: Box 1.3 Steps of Evidence-Based Practice Integrated Processes: Nursing Process: Implementation Client Need: Safe and Effective Care Environment/Management of Care Cognitive level: Analysis [Analyzing] Concept: Evidence-Based Practice Difficulty: Difficult Feedback 1 The first step of evidence-based practice is to develop a question based on the clinical issue. 2 The last step of evidence-based practice is to disseminate findings. 3 The second step of evidence-based practice is to conduct a review of the literature, or current evidence, available. 4 The fifth step of evidence-based practice is to evaluate the outcomes associated with the practice change. PTS: 1 CON: Evidence-Based Practice 6. ANS: 4 Chapter number and title: 1, Foundations of Medical-Surgical Nursing Practice Chapter learning objective: Discussing the incorporation of evidence-based practices into medical-surgical nursing Chapter page reference: 004 Heading: Box 1.4 Evaluating Levels of Evidence Integrated Processes: Nursing Process: Planning Client Need: Safe and Effective Care Environment/Management of Care Cognitive level: Comprehension [Understanding] Concept: Evidence-Based Practice Difficulty: Easy Feedback 1 The lower the numeric value of the evidence the greater the support for a change in practice. Level IV evidence does not carry the lowest level of support for a practice change. 2 The lower the numeric value of the evidence the greater the support for a change in practice. Level V evidence does not carry the lowest level of support for a practice change. 3 The lower the numeric value of the evidence the greater the support for a change in practice. Level VI evidence does not carry the lowest level of support for a practice change. 4 The lower the numeric value of the evidence the greater the support for a change in practice. Level VII evidence carries the lowest level of support for a practice change.

Test Bank for Public Health Science and Nursing Practice Caring For Populations by Savage

Chapter 10: Mental Health MULTIPLE RESPONSE 1.According to Healthy People 2020, which of the following are characteristics of mental health? Select all that apply.
A. Engaging in productive activities
B. Having fulfilling relationships
C. Experiencing alterations in thinking
D. Adapting to change
E. Coping with challenges
ANS: A, B, D, E Objective: 3. Define the difference between behavioral, biological, environmental, and socioeconomic risk factors related to mental health disorders. pp. 225-226 Heading: Introduction Integrated Processes: N/A Client Need: Psychosocial Integrity Cognitive Level: Knowledge [Remembering] Concept: Promoting Health Difficulty: Moderate
Feedback
1. Mental health is a state of successful performance of mental function, including engagement in productive activities.
2. Mental health is a state of successful performance of mental function, including being able to form fulfilling relationships with other people.
3. This is incorrect; it is an example of a mental disorder. Mental disorders are health conditions that are characterized by alterations in thinking, mood, or behavior that are associated with distress or impaired functioning.
4. Mental health is a state of successful performance of mental function, including the ability to adapt to change.
5. Mental health is a state of successful performance of mental function, including the ability to cope with challenges.
PTS:1CON:Promoting Health MULTIPLE CHOICE 2.In 2010, approximately how many people in the United States reported experiencing mental disorders in the previous year?
A. 15%
B. 50%
C. 30%
D. 25%
ANS: D Objective: 1. Define the burden of disease related to mental disorders using current epidemiological frameworks. pp. 226-227 Heading: Epidemiology of Mental Disorders Integrated Processes: N/A Client Need: Psychosocial Integrity Cognitive Level: Comprehension [Understanding] Concept: Promoting Health Difficulty: Moderate
Feedback
A This is incorrect. In the United States in 2010 an estimated 25% of adults reported having mental disorders in the previous year.
B This is incorrect. In the United States in 2010 an estimated 25% of adults reported having mental disorders in the previous year.
C This is incorrect. In the United States in 2010 an estimated 25% of adults reported having mental disorders in the previous year.
D In the United States in 2010 an estimated 25% of adults reported having mental disorders in the previous year.
PTS:1CON:Promoting Health 3.A student nurse is studying stress and mental health. The student nurse learns that ____ is based on an individual’s ability to access protective factors that exist at different levels in order to withstand chronic stress or recover from traumatic life events.
A. Intervention
B. Support
C. Resilience
D. Therapy
ANS: C Objective: 3. Define the difference between behavioral, biological, environmental, and socioeconomic risk factors related to mental health disorders. pp. 229-231 Heading: Protective Factors: Building Resilience Integrated Processes: Teaching/Learning Client Need: Psychosocial Integrity Cognitive Level: Application [Applying] Concept: Trauma; Stress; Promoting Health; Nursing Roles Difficulty: Moderate
Feedback
A This is incorrect. Resilience is based on an individual’s ability to access protective factors that exist at different levels in order to withstand chronic stress or recover from traumatic life events. Preventive and treatment interventions are useful tools to build on an individual’s natural resilience to promote positive outcomes.
B This is incorrect. Resilience is based on an individual’s ability to access protective factors that exist at different levels in order to withstand chronic stress or recover from traumatic life events. Support from family, friends, and community is an important part of strengthening an individual’s resilience.
C Resilience is based on an individual’s ability to access protective factors that exist at different levels in order to withstand chronic stress or recover from traumatic life events.
D This is incorrect. Resilience is based on an individual’s ability to access protective factors that exist at different levels in order to withstand chronic stress or recover from traumatic life events. Therapy is an important part of an overall treatment plan, in conjunction with intervention, support, and an individual’s capacity for resilience.
PTS: 1 CON: Trauma | Stress | Promoting Health | Nursing Roles 4.____ addresses specific subgroups at highest risk for development of a mental disorder or those that are showing early signs of a mental disorder.
A. Indicated prevention
B. Selective prevention
C. Universal prevention
D. Both 1 and 2
ANS: A Objective: 4. Apply current evidence-based population level interventions to the prevention of mental disorders and the promotion of optimal mental health for communities and populations. pp. 232-233 Heading: Prevention of Mental Disorders and Promotion of Mental Health > Institute of Medicine Model of Prevention Integrated Processes: Nursing Process Client Need: Psychosocial Integrity Cognitive Level: Comprehension [Understanding] Concept: Promoting Health Difficulty: Moderate
Feedback
A Indicated prevention addresses specific subgroups at highest risk for development of a mental disorder or those that are showing early signs of a mental disorder. The purpose of indicated techniques is to delay or reduce the severity of a mental disorder.
B Selective prevention includes interventions provided to specific subgroups that are known to be at high risk for mental disorders owing to biological, psychological, social, or environmental factors but that have not yet been diagnosed with mental disorders. High-risk subgroups include but are not limited to those with a family history of mental disorders, history of adverse childhood events, or victims of violence.
C Universal prevention refers to prevention interventions provided to the entire population, not just those who may be at risk. The interventions include but are not limited to public service announcements provided to the public at large through billboards, media messages (print and electronic), or general health education programs.
D Indicated prevention addresses specific subgroups at highest risk for development of a mental disorder or those that are showing early signs of a mental disorder. The purpose of indicated techniques is to delay or reduce the severity of a mental disorder. Selective prevention includes interventions provided to specific subgroups that are known to be at high risk for mental disorders owing to biological, psychological, social, or environmental factors but that have not yet been diagnosed with mental disorders. High-risk subgroups include but are not limited to those with a family history of mental disorders, history of adverse childhood events, or victims of violence.
PTS:1CON:Promoting Health 5.The public health nurse (PHN) recognizes that which of the following are used as screening tools for depression?
A. Patient Health Questionnaire 2
B. Center for Epidemiological Studies Depression Scale (CESD-10)
C. Brief Symptom Checklist-18 of the My Mood Monitor (M-3)
D. Both 1 and 2
ANS: D Objective: 5. Describe systems approaches to the promotion of mental health and the prevention and treatment of mental health disorders. p. 232 Heading: Prevention of Mental Disorders and Promotion of Mental Health > Measure of Mental Health: Health-Related Quality of Life Integrated Processes: Nursing Process Client Need: Psychosocial Integrity Cognitive Level: Application [Applying] Concept: Promoting Health; Mood; Assessment Difficulty: Moderate
Feedback
A Tools to screen for depression include the Patient Health Questionnaire 2 and the CESD-10.
B Tools to screen for depression include the Patient Health Questionnaire 2 and the CESD-10.
C This is incorrect. Tools to screen for depression include the Patient Health Questionnaire 2 and the CESD-10. Screening tools for anxiety disorders include the Brief Symptom Checklist-18 of the My Mood Monitor (M-3).
D Tools to screen for depression include the Patient Health Questionnaire 2 and the CESD-10.
PTS:1CON:Promoting Health | Mood | Assessment 6.During a course on mental disorders, a PHN learns that the term serious mental illness (SMI) refers to diagnosable mental disorders that may disrupt a person’s ability to function and may qualify that person for support services. The PHN also notes that the mental disorders that can lead to SMI include:
A. Mild depression
B. Panic disorder
C. Schizophrenia
D. Both 2 and 3
ANS: D Objective: 1. Define the burden of disease related to mental disorders using current epidemiological frameworks. pp. 225-226 Heading: Introduction Integrated Processes: Teaching/Learning Client Need: Psychosocial Integrity Cognitive Level: Application [Applying] Concept: Cognition; Mood; Stress; Promoting Health; Nursing Roles Difficulty: Moderate
Feedback
A This is incorrect. Major depression, however, is one of the mental disorders that can lead to SMI.
B Both panic disorder and schizophrenia, among other mental disorders, can lead to SMI.
C Both schizophrenia and panic disorder, among other mental disorders, can lead to SMI.
D The mental disorders that can lead to SMI include major depression, panic disorder, schizophrenia, bipolar disorder, obsessive compulsive disorder (OCD), post-traumatic stress disorder (PTSD), and borderline personality disorder.
PTS: 1 CON: Cognition | Mood | Stress | Promoting Health | Nursing Roles 7.While studying the prevalence of mental health disorders worldwide, a PHN learns about the World Mental Health Survey, which is used to determine estimates of human capital costs and prevalence of mental disorders in a wide range of countries. The survey was developed by
A. The Centers for Disease Control and Prevention (CDC)
B. The World Health Organization (WHO)
C. The Institute of Medicine (IOM)
D. The World Health Assembly
ANS: B Objective: 1. Define the burden of disease related to mental disorders using current epidemiological frameworks. p. 227 Heading: Epidemiology of Mental Disorders > Surveillance of Mental Health Disorders Integrated Processes: Teaching/Learning Client Need: Psychosocial Integrity Cognitive Level: Application [Applying] Concept: Promoting Health; Nursing Roles Difficulty: Moderate
Feedback
A This is incorrect. WHO developed the World Mental Health Survey to estimate human capital costs and mental disorders prevalence on a global scale. The CDC conducts many types of surveys on the prevalence of mental disorders but the organization did not develop the World Mental Health Survey.
B The WHO developed the World Mental Health Survey to estimate human capital costs and mental disorders prevalence on a global scale.
C This is incorrect. WHO developed the World Mental Health Survey to estimate human capital costs and mental disorders prevalence on a global scale. The IOM is involved in screening for mental health disorders and addresses the need for appropriate behavioral health treatment in its report, Improving the Quality of Health Care for Mental and Substance-Use Conditions: Quality Chasm Series.
D This is incorrect. WHO developed the World Mental Health Survey to estimate human capital costs and mental disorders prevalence on a global scale. The World Health Assembly issued a resolution on mental health that aims to reduce the global burden of mental disorders and improve overall mental health worldwide.
PTS: 1 CON: Promoting Health | Nursing Roles 8.Which ethnic group has the highest 12-month prevalence of a mental disorder?
A. Hispanics
B. African Americans
C. Asian Americans
D. Non-Hispanic whites
ANS: D Objective: 1. Define the burden of disease related to mental disorders using current epidemiological frameworks. pp. 227-228 Heading: Epidemiology of Mental Disorders > Prevalence of Mental Health Disorders Integrated Processes: N/A Client Need: Psychosocial Integrity Cognitive Level: Knowledge [Remembering] Concept: Promoting Health Difficulty: Moderate
Feedback
A This is incorrect. Non-Hispanic whites have the highest 12-month prevalence rate for mental disorders at 21% compared with 16% for Hispanics.
B This is incorrect. Non-Hispanic whites have the highest 12-month prevalence rate for mental disorders at 21% compared with 15% for African Americans.
C This is incorrect. Non-Hispanic whites have the highest 12-month prevalence rate for mental disorders at 21% compared with 9% for Asian Americans.
D Non-Hispanic whites have the highest 12-month prevalence rate for mental disorders at 21%.
PTS:1CON:Promoting Health 9.A PHN learns in a behavioral health class that the relationship between physiology and mental health plays an important role in mental disorders. Which of the following physiological factors may contribute to the development of mental disorders?
A. Conditions that affect brain chemistry, such as medication side effects or toxins
B. Physical trauma
C. 1 and 2
D. Unstable family life
ANS: C Objective: 3. Define the difference between behavioral, biological, environmental, and socioeconomic risk factors related to mental health disorders. pp. 228-229 Heading: Behavioral, Biological, Environmental, and Socioeconomic Risk Factors > Individual Level Risk Factors for Mental Disorders Integrated Processes: Teaching/Learning Client Need: Psychosocial Integrity Cognitive Level: Application [Application] Concept: Cognition; Trauma; Promoting Health Difficulty: Moderate
Feedback
A Both conditions that affect brain chemistry and physical trauma are the physiological factors that may contribute to the development of mental disorders.
B Both physical trauma and conditions that affect brain chemistry are physiological factors that may contribute to the development of mental disorders.
C Conditions that affect brain chemistry and physical trauma are two of the physiological factors that may contribute to the development of mental disorders.
D This is incorrect. Conditions that affect brain chemistry and physical trauma are two of the physiological factors that may contribute to the development of mental disorders. An unstable family life is not a physiological factor, although it may also contribute to the development of mental disorders.
PTS:1CON:Cognition | Trauma | Promoting Health 10.Which of the following community environment factors play a role in the development of mental disorders?
A. Living in high crime areas
B. Poverty
C. Both 1 and 2
D. Family instability
ANS: C Objective: 3. Define the difference between behavioral, biological, environmental, and socioeconomic risk factors related to mental health disorders. p. 229 Heading: Behavioral, Biological, Environmental, and Socioeconomic Risk Factors > Community-Level Risk Factors for Mental Disorders Integrated Processes: N/A Client Need: Psychosocial Integrity Cognitive Level: Comprehension [Understanding] Concept: Promoting Health Difficulty: Easy
Feedback
A Living in high crime areas is a factor, along with poverty.
B Both poverty and living in high crime areas play a role in the development of mental disorders.
C Both poverty and living in high crime areas play a role in the development of mental disorders.
D This is incorrect. Although family instability often contributes to the development of mental disorders, it is not considered a community environment factor.
PTS:1CON:Promoting Health 11.____ is a combination of personal attributes and societal stereotypes related to human characteristics viewed as unacceptable.
A. Indicated prevention
B. Stigma
C. Risk factors
D. Transinstitutionalization
ANS: B Objective: 3. Define the difference between behavioral, biological, environmental, and socioeconomic risk factors related to mental health disorders. pp. 231-232 Heading: Culture, Stigma, and Mental Health Disorders Integrated Processes: N/A Client Need: Psychosocial Integrity Cognitive Level: Comprehension [Understanding] Concept: Promoting Health Difficulty: Moderate
Feedback
A This is incorrect. Stigma is a combination of personal attributes and societal stereotypes related to human characteristics viewed as unacceptable. Indicated prevention addresses specific subgroups at highest risk for development of a mental disorder or those that are showing early signs of a mental disorder.
B Stigma is a combination of personal attributes and societal stereotypes related to human characteristics viewed as unacceptable.
C This is incorrect. Stigma is a combination of personal attributes and societal stereotypes related to human characteristics viewed as unacceptable. Risk factors increase an individual’s chance of developing a mental disorder.
D This is incorrect. Stigma is a combination of personal attributes and societal stereotypes related to human characteristics viewed as unacceptable. Transinstitutionalization refers to the growing number of mentally ill persons who are homeless, in jail, in shelters, or in other facilities instead of being home or in a hospital.
PTS:1CON:Promoting Health 12.A nurse interested in working with persons with mental disorders who live in poverty understands that the most effective treatment involves multiple sectors of society, such as government agencies, grass roots groups, nonprofits, and businesses, working in tandem. This interrelationship is called:
A. Indicated prevention
B. Intersectoral strategies
C. Health-Related Quality of Life
D. Institute of Medicine Model of Prevention
ANS: B Objective: 4. Apply current evidence-based population level interventions to the prevention of mental disorders and the promotion of optimal mental health for communities and populations. p. 233 Heading: Prevention of Mental Disorders and Promotion of Mental Health > Promotion of Mental Health and Policy Integrated Processes: Nursing Process Client Need: Psychosocial Integrity Cognitive Level: Application [Applying] Concept: Promoting Health; Collaboration Difficulty: Moderate
Feedback
A This is incorrect. Intersectoral strategies engage more than one sector of society with a shared interest such as government agencies, grass roots citizens groups, nonprofits, and businesses. Indicated prevention addresses specific subgroups at highest risk for development of a mental disorder or those that are showing early signs of a mental disorder.
B Intersectoral strategies engage more than one sector of society with a shared interest such as government agencies, grass roots citizens groups, nonprofits, and businesses.
C This is incorrect. Intersectoral strategies engage more than one sector of society with a shared interest such as government agencies, grass roots citizens groups, nonprofits, and businesses. Health-Related Quality of Life is the self-perceived impact of physical and emotional health on overall quality of life.
D This is incorrect. Intersectoral strategies engage more than one sector of society with a shared interest such as government agencies, grass roots citizens groups, nonprofits, and businesses. The Institute of Medicine Model of Prevention is a framework for mental disorders that clearly separates prevention into three categories with specific interventions at each level.
PTS: 1 CON: Promoting Health | Collaboration 13.A recent graduate nurse working in an urban labor and delivery unit had a patient who experienced a difficult labor. The mother, suffering from postpartum depression (PPD), committed suicide a year after giving birth. Although the nurse knew the basics about PPD, the nurse immediately studied the condition in depth and learned that PPD:
A. Can be triggered by a massive hormone drop following delivery
B. Can intensify to cause delusions
C. Occurs soon after delivery
D. All of the above
ANS: D Objective: 4. Apply current evidence-based population level interventions to the prevention of mental disorders and the promotion of optimal mental health for communities and populations. pp. 233-235 Heading: Prevention of Mental Disorders and Promotion of Mental Health > Secondary Prevention: Screening for Mental Disorders Integrated Processes: Nursing Process Client Need: Psychosocial Integrity Cognitive Level: Application [Applying] Concept: Pregnancy; Mood; Violence; Promoting Health; Nursing Roles Difficulty: Moderate
Feedback
A PPD can be triggered by a massive post-delivery hormone drop, intensify enough to cause delusions, and occur soon after delivery.
B PPD can be triggered by a massive post-delivery hormone drop, intensify enough to cause delusions, and occur soon after delivery.
C PPD can be triggered by a massive post-delivery hormone drop, intensify enough to cause delusions, and occur soon after delivery.
D PPD can be triggered by a massive post-delivery hormone drop, intensify enough to cause delusions, and occur soon after delivery.
PTS: 1 CON: Pregnancy | Mood | Violence | Promoting Health | Nursing Roles 14.A nurse working in labor and delivery requested permission from the nurse manager to conduct a quality improvement project to screen patients that might be susceptible to PPD. After completing the project, which of the following screening guidelines did the unit incorporate?
A. All patients will be screened for PPD when they are admitted to the labor and delivery unit.
B. Patients at high risk are referred to the attending obstetrician.
C. Before being discharged, all new mothers will complete a questionnaire specific to PPD symptoms.
D. All of the above
ANS: D Objective: Apply current evidence-based population level interventions to the prevention of mental disorders and the promotion of optimal mental health for communities and populations. pp. 233-235 Heading: Prevention of Mental Disorders and Promotion of Mental Health > Secondary Prevention: Screening for Mental Disorders Integrated Processes: Nursing Process Client Need: Psychosocial Integrity Cognitive Level: Application [Applying] Concept: Pregnancy; Mood; Promoting Health; Assessment; Quality Improvement Difficulty: Moderate
Feedback
A This is incorrect. Screening, high-risk referrals to the attending obstetrician and completion of a PPD symptom questionnaire were all incorporated.
B This is incorrect. Screening, high-risk referrals to the attending obstetrician and completion of a PPD symptom questionnaire were all incorporated.
C This is incorrect. Screening, high-risk referrals to the attending obstetrician and completion of a PPD symptom questionnaire were all incorporated.
D Screening, high-risk referrals to the attending obstetrician and completion of a PPD symptom questionnaire were all incorporated.
PTS:1 CON: Pregnancy | Mood | Promoting Health | Assessment | Quality Improvement 15.A PHN treats a patient who may be depressed. To verify suspicions, the PHN checks ____, the definitive clinical guide for diagnosing mental disorders and providing consistency and accuracy in the screening for mental disorders.
A. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5)
B. The Center for Epidemiological Studies Depression Scale (CESD-10)
C. Patient Health Questionnaire 2
D. Brief System Checklist-18 of the My Mood Monitor
ANS: A
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