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Test Bank Foundations of Maternal-Newborn and Women’s Health Nursing 7th Edition

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Test Bank Foundations of Maternal-Newborn and Women’s Health Nursing 7th Edition

Chapter 01: Maternity and Women’s Health Care Today
Foundations of Maternal-Newborn & Women’s Health Nursing, 7th Edition

MULTIPLE CHOICE
1. A nurse educator is teaching a group of nursing students about the history of family-centered
maternity care. Which statement should the nurse include in the teaching session?
a. The Sheppard-Towner Act of 1921 promoted family-centered care.
b. Changes in the pharmacologic management of labor prompted family-centered care.
c. Demands by physicians for family involvement in childbirth increased the practice
of family-centered care.
d. Parental requests that infants be allowed to remain with them rather than in a
nursery initiated the practice of family-centered care.
ANS: D
As research began to identify the benefits of early, extended parent-infant contact, parents began to insist that the infant remain with them. This gradually developed into the practice of
rooming-in and finally to family-centered maternity care. The Sheppard-Towner Act provided
funds for state-managed programs for mothers and children but did not promote
family-centered care. The changes in pharmacologic management of labor were not a factor in
family-centered maternity care. Family-centered care was a request by parents, not physicians.
DIF: Cognitive Level: Application OBJ: Nursing Process Step: Planning
MSC: Patient Needs: Health Promotion and Maintenance

2. Expectant parents ask a prenatal nurse educator, “Which setting for childbirth limits the amount of parent-infant interaction?” Which answer should the nurse provide for these parents in order to assist them in choosing an appropriate birth setting?
a. Birth center
b. Homebirth
c. Traditional hospital birth
d. Labor, birth, and recovery room
ANS: C
In the traditional hospital setting, the mother may see the infant for only short feeding periods,
and the infant is cared for in a separate nursery. Birth centers are set up to allow an increase in parent-infant contact. Home births allow the greatest amount of parent-infant contact. The labor, birth, recovery, and postpartum room setting allows for increased parent-infant contact.
DIF: Cognitive Level: Understanding OBJ: Nursing Process Step: Planning
MSC: Patient Needs: Health Promotion and Maintenance

3. Which statement best describes the advantage of a labor, birth, recovery, and postpartum
(LDRP) room?
a. The family is in a familiar environment.
b. They are less expensive than traditional hospital rooms.
c. The infant is removed to the nursery to allow the mother to rest.
d. The woman’s support system is encouraged to stay until discharge.
ANS: D
NURSINGTB.COM
Foundations of Maternal-Newborn and Women’s Health Nursing 7th Edition Murray Test BankNU
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Sleeping equipment is provided in a private room. A hospital setting is never a familiar
environment to new parents. An LDRP room is not less expensive than a traditional hospital
room. The baby remains with the mother at all times and is not removed to the nursery for
routine care or testing. The father or other designated members of the mother’s support system
are encouraged to stay at all times.
DIF: Cognitive Level: Understanding OBJ: Nursing Process Step: Assessment
MSC: Patient Needs: Health Promotion and Maintenance

4. Which nursing intervention is an independent function of the professional nurse?
a. Administering oral analgesics
b. Requesting diagnostic studies
c. Teaching the patient perineal care
d. Providing wound care to a surgical incision
ANS: C
Nurses are now responsible for various independent functions, including teaching, counseling,
and intervening in nonmedical problems. Interventions initiated by the physician and carried
out by the nurse are called dependent functions. Administrating oral analgesics is a dependent
function; it is initiated by a physician and carried out by a nurse. Requesting diagnostic
studies is a dependent function. Providing wound care is a dependent function; however, the
physician prescribes the type of wound care through direct orders or protocol.
DIF: Cognitive Level: Understanding OBJ: Nursing Process Step: Assessment
MSC: Patient Needs: Safe and Effective Care Environment

5. Which response by the nurse is the most therapeutic when the patient states, “I’m so afraid to
have a cesarean birth”?
a. “Everything will be OK.”
b. “Don’t worry about it. It will be over soon.”
c. “What concerns you most about a cesarean birth?”
d. “The physician will be in later and you can talk to him.”
ANS: C
The response, “What concerns you most about a cesarean birth” focuses on what the patient is
saying and asks for clarification, which is the most therapeutic response. The response,
“Everything will be ok” is belittling the patient’s feelings. The response, “Don’t worry about
it. It will be over soon” will indicate that the patient’s feelings are not important. The
response, “The physician will be in later and you can talk to him” does not allow the patient to
verbalize her feelings when she wishes to do that.
DIF: Cognitive Level: Application OBJ: Nursing Process Step: Implementation
MSC: Patient Needs: Psychosocial Integrity

6. In which step of the nursing process does the nurse determine the appropriate interventions for
the identified nursing diagnosis?
a. Planning
b. Evaluation
c. Assessment
d. Intervention
ANS: A
NURSINGTB.COM
Foundations of Maternal-Newborn and Women’s Health Nursing 7th Edition Murray Test BankNU
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The third step in the nursing process involves planning care for problems that were identified
during assessment. The evaluation phase is determining whether the goals have been met.
During the assessment phase, data are collected. The intervention phase is when the plan of
care is carried out.
DIF: Cognitive Level: Understanding OBJ: Nursing Process Step: Planning
MSC: Patient Needs: Safe and Effective Care Environment

7. Which goal is most appropriate for the collaborative problem of wound infection?
a. The patient will not exhibit further signs of infection.
b. Maintain the patient’s fluid intake at 1000 mL/8 hour.
c. The patient will have a temperature of 98.6F within 2 days.
d. Monitor the patient to detect therapeutic response to antibiotic therapy.
ANS: D
In a collaborative problem, the goal should be nurse-oriented and reflect the nursing
interventions of monitoring or observing. Monitoring for complications such as further signs
of infection is an independent nursing role. Intake and output is an independent nursing role.
Monitoring a patient’s temperature is an independent nursing role.
DIF: Cognitive Level: Application OBJ: Nursing Process Step: Planning
MSC: Patient Needs: Safe and Effective Care Environment

8. Which nursing intervention is written correctly?
a. Force fluids as necessary.
b. Observe interaction with the infant.
c. Encourage turning, coughing, and deep breathing.
d. Assist to ambulate for 10 minutes at 8 AM, 2 PM, and 6 PM.
ANS: D
Interventions might not be carried out if they are not detailed and specific. “Force fluids” is
not specific; it does not state how much or how often. Encouraging the patient to turn, cough,
and breathe deeply is not detailed or specific. Observing interaction with the infant does not
state how often this procedure should be done. Assisting the patient to ambulate for 10
minutes within a certain timeframe is specific.
DIF: Cognitive Level: Application OBJ: Nursing Process Step: Planning
MSC: Patient Needs: Safe and Effective Care Environment

9. The patient makes the statement: “I’m afraid to take the baby home tomorrow.” Which
response by the nurse would be the most therapeutic?
a. “You’re afraid to take the baby home?”
b. “Don’t you have a mother who can come and help?”
c. “You should read the literature I gave you before you leave.”
d. “I was scared when I took my first baby home, but everything worked out.”
ANS: A
NURSINGTB.COM
Foundations of Maternal-Newborn and Women’s Health Nursing 7th Edition Murray Test BankNU
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This response uses reflection to show concern and open communication. The other choices are
blocks to communication. Asking if the patient has a mother who can come and assist blocks
further communication with the patient. Telling the patient to read the literature before leaving
does not allow the patient to express her feelings further. Sharing your own birth experience is
inappropriate.
DIF: Cognitive Level: Application OBJ: Nursing Process Step: Implementation
MSC: Patient Needs: Psychosocial Integrity
10. The nurse is writing an expected outcome for the nursing diagnosis—acute pain related to
tissue trauma, secondary to vaginal birth, as evidenced by patient stating pain of 8 on a scale
of 10. Which expected outcome is correctly stated for this problem?
a. Patient will state that pain is a 2 on a scale of 10.
b. Patient will have a reduction in pain after administration of the prescribed
analgesic.
c. Patient will state an absence of pain 1 hour after administration of the prescribed
analgesic.
d. Patient will state that pain is a 2 on a scale of 10, 1 hour after the administration of
the prescribed analgesic.
ANS: D
The outcome should be patient-centered, measurable, realistic, and attainable and within a
specified timeframe. Patient stating that her pain is now 2 on a scale of 10 lacks a timeframe.
Patient having a reduction in pain after administration of the prescribed analgesic lacks a
measurement. Patient stating an absence of pain 1 hour after the administration of prescribed
analgesic is unrealistic.
DIF: Cognitive Level: Application OBJ: Nursing Process Step: Planning
MSC: Patient Needs: Physiologic Integrity
11. Which nursing diagnosis should the nurse identify as a priority for a patient in active labor?
a. Risk for anxiety related to upcoming birth
b. Risk for imbalanced nutrition related to NPO status
c. Risk for altered family processes related to new addition to the family
d. Risk for injury (maternal) related to altered sensations and positional or physical
changes
ANS: D
The nurse should determine which problem needs immediate attention. Risk for injury is the
problem that has the priority at this time because it is a safety problem. Risk for anxiety,
imbalanced nutrition, and altered family processes are not the priorities at this time.
DIF: Cognitive Level: Application OBJ: Nursing Process Step: Implementation
MSC: Patient Needs: Safe and Effective Care Environment

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Test Bank Foundations of Maternal-Newborn and Women’s Health Nursing 7th Edition

Chapter 01: Maternity and Women’s Health Care Today Foundations of Maternal-Newborn & Women’s Health Nursing, 7th Edition MULTIPLE CHOICE 1. A nurse educator is teaching a group of nursing students about the history of family-centered maternity care. Which statement should the nurse include in the teaching session? a. The Sheppard-Towner Act of 1921 promoted family-centered care. b. Changes in the pharmacologic management of labor prompted family-centered care. c. Demands by physicians for family involvement in childbirth increased the practice of family-centered care. d. Parental requests that infants be allowed to remain with them rather than in a nursery initiated the practice of family-centered care. ANS: D As research began to identify the benefits of early, extended parent-infant contact, parents began to insist that the infant remain with them. This gradually developed into the practice of rooming-in and finally to family-centered maternity care. The Sheppard-Towner Act provided funds for state-managed programs for mothers and children but did not promote family-centered care. The changes in pharmacologic management of labor were not a factor in family-centered maternity care. Family-centered care was a request by parents, not physicians. DIF: Cognitive Level: Application OBJ: Nursing Process Step: Planning MSC: Patient Needs: Health Promotion and Maintenance 2. Expectant parents ask a prenatal nurse educator, “Which setting for childbirth limits the amount of parent-infant interaction?” Which answer should the nurse provide for these parents in order to assist them in choosing an appropriate birth setting? a. Birth center b. Homebirth c. Traditional hospital birth d. Labor, birth, and recovery room ANS: C In the traditional hospital setting, the mother may see the infant for only short feeding periods, and the infant is cared for in a separate nursery. Birth centers are set up to allow an increase in parent-infant contact. Home births allow the greatest amount of parent-infant contact. The labor, birth, recovery, and postpartum room setting allows for increased parent-infant contact. DIF: Cognitive Level: Understanding OBJ: Nursing Process Step: Planning MSC: Patient Needs: Health Promotion and Maintenance 3. Which statement best describes the advantage of a labor, birth, recovery, and postpartum (LDRP) room? a. The family is in a familiar environment. b. They are less expensive than traditional hospital rooms. c. The infant is removed to the nursery to allow the mother to rest. d. The woman’s support system is encouraged to stay until discharge. ANS: D NURSINGTB.COM Foundations of Maternal-Newborn and Women's Health Nursing 7th Edition Murray Test BankNU RS IN GT B.CO M Sleeping equipment is provided in a private room. A hospital setting is never a familiar environment to new parents. An LDRP room is not less expensive than a traditional hospital room. The baby remains with the mother at all times and is not removed to the nursery for routine care or testing. The father or other designated members of the mother’s support system are encouraged to stay at all times. DIF: Cognitive Level: Understanding OBJ: Nursing Process Step: Assessment MSC: Patient Needs: Health Promotion and Maintenance 4. Which nursing intervention is an independent function of the professional nurse? a. Administering oral analgesics b. Requesting diagnostic studies c. Teaching the patient perineal care d. Providing wound care to a surgical incision ANS: C Nurses are now responsible for various independent functions, including teaching, counseling, and intervening in nonmedical problems. Interventions initiated by the physician and carried out by the nurse are called dependent functions. Administrating oral analgesics is a dependent function; it is initiated by a physician and carried out by a nurse. Requesting diagnostic studies is a dependent function. Providing wound care is a dependent function; however, the physician prescribes the type of wound care through direct orders or protocol. DIF: Cognitive Level: Understanding OBJ: Nursing Process Step: Assessment MSC: Patient Needs: Safe and Effective Care Environment 5. Which response by the nurse is the most therapeutic when the patient states, “I’m so afraid to have a cesarean birth”? a. “Everything will be OK.” b. “Don’t worry about it. It will be over soon.” c. “What concerns you most about a cesarean birth?” d. “The physician will be in later and you can talk to him.” ANS: C The response, “What concerns you most about a cesarean birth” focuses on what the patient is saying and asks for clarification, which is the most therapeutic response. The response, “Everything will be ok” is belittling the patient’s feelings. The response, “Don’t worry about it. It will be over soon” will indicate that the patient’s feelings are not important. The response, “The physician will be in later and you can talk to him” does not allow the patient to verbalize her feelings when she wishes to do that. DIF: Cognitive Level: Application OBJ: Nursing Process Step: Implementation MSC: Patient Needs: Psychosocial Integrity 6. In which step of the nursing process does the nurse determine the appropriate interventions for the identified nursing diagnosis? a. Planning b. Evaluation c. Assessment d. Intervention ANS: A NURSINGTB.COM Foundations of Maternal-Newborn and Women's Health Nursing 7th Edition Murray Test BankNU RS IN GT B.CO M The third step in the nursing process involves planning care for problems that were identified during assessment. The evaluation phase is determining whether the goals have been met. During the assessment phase, data are collected. The intervention phase is when the plan of care is carried out. DIF: Cognitive Level: Understanding OBJ: Nursing Process Step: Planning MSC: Patient Needs: Safe and Effective Care Environment 7. Which goal is most appropriate for the collaborative problem of wound infection? a. The patient will not exhibit further signs of infection. b. Maintain the patient’s fluid intake at 1000 mL/8 hour. c. The patient will have a temperature of 98.6F within 2 days. d. Monitor the patient to detect therapeutic response to antibiotic therapy. ANS: D In a collaborative problem, the goal should be nurse-oriented and reflect the nursing interventions of monitoring or observing. Monitoring for complications such as further signs of infection is an independent nursing role. Intake and output is an independent nursing role. Monitoring a patient’s temperature is an independent nursing role. DIF: Cognitive Level: Application OBJ: Nursing Process Step: Planning MSC: Patient Needs: Safe and Effective Care Environment 8. Which nursing intervention is written correctly? a. Force fluids as necessary. b. Observe interaction with the infant. c. Encourage turning, coughing, and deep breathing. d. Assist to ambulate for 10 minutes at 8 AM, 2 PM, and 6 PM. ANS: D Interventions might not be carried out if they are not detailed and specific. “Force fluids” is not specific; it does not state how much or how often. Encouraging the patient to turn, cough, and breathe deeply is not detailed or specific. Observing interaction with the infant does not state how often this procedure should be done. Assisting the patient to ambulate for 10 minutes within a certain timeframe is specific. DIF: Cognitive Level: Application OBJ: Nursing Process Step: Planning MSC: Patient Needs: Safe and Effective Care Environment 9. The patient makes the statement: “I’m afraid to take the baby home tomorrow.” Which response by the nurse would be the most therapeutic? a. “You’re afraid to take the baby home?” b. “Don’t you have a mother who can come and help?” c. “You should read the literature I gave you before you leave.” d. “I was scared when I took my first baby home, but everything worked out.” ANS: A NURSINGTB.COM Foundations of Maternal-Newborn and Women's Health Nursing 7th Edition Murray Test BankNU RS IN GT B.CO M This response uses reflection to show concern and open communication. The other choices are blocks to communication. Asking if the patient has a mother who can come and assist blocks further communication with the patient. Telling the patient to read the literature before leaving does not allow the patient to express her feelings further. Sharing your own birth experience is inappropriate. DIF: Cognitive Level: Application OBJ: Nursing Process Step: Implementation MSC: Patient Needs: Psychosocial Integrity 10. The nurse is writing an expected outcome for the nursing diagnosis—acute pain related to tissue trauma, secondary to vaginal birth, as evidenced by patient stating pain of 8 on a scale of 10. Which expected outcome is correctly stated for this problem? a. Patient will state that pain is a 2 on a scale of 10. b. Patient will have a reduction in pain after administration of the prescribed analgesic. c. Patient will state an absence of pain 1 hour after administration of the prescribed analgesic. d. Patient will state that pain is a 2 on a scale of 10, 1 hour after the administration of the prescribed analgesic. ANS: D The outcome should be patient-centered, measurable, realistic, and attainable and within a specified timeframe. Patient stating that her pain is now 2 on a scale of 10 lacks a timeframe. Patient having a reduction in pain after administration of the prescribed analgesic lacks a measurement. Patient stating an absence of pain 1 hour after the administration of prescribed analgesic is unrealistic. DIF: Cognitive Level: Application OBJ: Nursing Process Step: Planning MSC: Patient Needs: Physiologic Integrity 11. Which nursing diagnosis should the nurse identify as a priority for a patient in active labor? a. Risk for anxiety related to upcoming birth b. Risk for imbalanced nutrition related to NPO status c. Risk for altered family processes related to new addition to the family d. Risk for injury (maternal) related to altered sensations and positional or physical changes ANS: D The nurse should determine which problem needs immediate attention. Risk for injury is the problem that has the priority at this time because it is a safety problem. Risk for anxiety, imbalanced nutrition, and altered family processes are not the priorities at this time. DIF: Cognitive Level: Application OBJ: Nursing Process Step: Implementation MSC: Patient Needs: Safe and Effective Care Environment

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 Fundamentals of Nursing Care 2nd Edition by Burton

Chapter 1 Multiple Choice Identify the choice that best completes the statement or answers the question. ____    1.   A nurse is educating a nursing student about nursing history. The nurse explains that throughout ancient history, nursing care was provided by family members and
1. Nurses.
2. Physicians.
3. Male priests.
4. Female priests.
____    2.   A nurse is teaching a student about the history of nursing. The nurse informs the student that in 1836, the first school of nursing was established in Kaiserworth, Germany, by
1. Jean Watson.
2. Clara Barton.
3. Theodor Fliedner.
4. Florence Nightingale.
____    3.   A nurse teaches a student nurse that in 1897, the Nurses Associated Alumnae of the United States was formed in an effort to
1. Set standards and rules in nursing education.
2. Keep nurses aware of the newest medical information.
3. Oversee training to protect patients from incompetent nurses.
4. Keep nurses updated on the newest information about nursing education.
____    4.   The purpose of the National League for Nursing is to
1. Set standards and rules in nursing education.
2. Keep nurses aware of the newest medical information.
3. Oversee training to protect patients from incompetent nurses.
4. Keep nurses updated on the newest information about nursing education.
____    5.   All states required practical nurses to be licensed in the year
1. 1940.
2. 1945.
3. 1950.
4. 1955.
____    6.   The title licensed practical nurse (LPN) is used in all states except California and
1. Texas.
2. Maine.
3. Alaska.
4. Arizona.
____    7.   The National Council Licensure Examination for Practical Nursing (NCLEX-PN) is
1. Taken in order to practice as a nurse.
2. Given as an entrance examination for nursing school.
3. Individualized based on where an examinee resides.
4. Taken in order to practice as a certified nursing assistant (CNA).
____    8.   A nurse recruiter is seeking a graduate nurse who has been educated more extensively on management and leadership. The graduate nurse who most likely fits this description is the
1. Diploma nurse.
2. Associate degree nurse (ADN).
3. Licensed practical/vocational nurse (LPN/LVN).
4. Baccalaureate degree nurse (BSN).
____    9.   Which statement about the Nurse Practice Act is accurate?
1. The Nurse Practice Act clarifies who can supervise a physician.
2. The Nurse Practice Act is the law that governs the actions of nurses.
3. The Nurse Practice Act is determined by the National League of Nursing.
4. The Nurse Practice Act specifies the tasks of the unlicensed assistive personnel.
____   10.   A nurse educates a nursing student about the Nurse Practice Act. The nursing student demonstrates understanding when he or she states:
1. “The Nurse Practice Act is the same in every state.”
2. “The Nurse Practice Act does not specify who can supervise a nurse.”
3. “The Nurse Practice Act is determined by the American Nurses Association.”
4. “The Nurse Practice Act establishes the scope of practice for each level of nurse.”
____   11.   While caring for a patient, a nurse performs a nursing action that is not within his or her scope of practice. The nurse has violated the
1. Ethics Committee.
2. Nurse Practice Act.
3. State Department of Health.
4. National League for Nursing Education.
____   12.   The Nurse Practice Act is enforced by the
1. State Board of Nursing.
2. County Health Department.
3. State Department of Health.
4. National League for Nursing.
____   13.   A nurse is caring for a resident in a long-term setting. The nurse best demonstrates a caring approach when
1. Performing all activities of daily living for the resident.
2. Asking the resident’s spouse to bring a family picture for the resident’s room.
3. Answering the resident’s questions quickly without allowing time for clarification.
4. Encouraging the resident’s spouse to decide which activities the resident should do.
____   14.   A nurse is caring for multiple patients on a medical unit. The nurse can best practice the art of nursing with an emphasis on caring by
1. Providing identical care to each patient.
2. Individualizing care provided to each patient.
3. Viewing the patients in terms of a cellular disorder.
4. Viewing the patients as seriously ill and needing a cure.
____   15.   A nurse is educating a student nurse about the responsibilities of a student nurse. The nurse recognizes that additional teaching is needed when the student nurse states:
1. “I will check laboratory results for my patients often.”
2. “I am responsible for noting abnormal assessment findings.”
3. “I will frequently check the patient’s chart for diagnostic test results.”
4. “It is not within my scope of practice to notify someone of abnormal findings.”
____   16.   A nursing instructor teaches a student nurse about the importance of joining a professional organization. The nursing instructor recognizes that further instruction is necessary when the student nurse states,
1. “Professional organizations allow me to have a collective voice.”
2. “Professional organizations limit my ability to influence laws and policies.”
3. “Professional behavior is demonstrated by joining a professional organization.”
4. “By joining a professional organization, I will have opportunities for leadership.”
 

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

Chapter 01- Introduction to Psychiatric-Mental Health Nursing

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

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

Test Bank for Fundamentals of Nursing 3rd Edition by Wilkinson

Chapter 1. Evolution of Nursing Thought & Action MULTIPLE CHOICE
  1. Which of the following is an example of an illness prevention activity?
a. Encouraging the use of a food diary
b. Joining a cancer support group
c. Administering immunization for HPV
d. Teaching a diabetic patient about his diet
ANS:  C Administering immunization for HPV is an example of illness prevention. Although cancer is a disease, it is assumed that a person joining a support group would already have the disease; therefore, it would be treatment and not disease prevention. Illness prevention activities focus on avoiding a specific disease. A food diary is a health promotion activity. Teaching a diabetic patient about diet is a treatment for diabetes; the patient already has diabetes, so the teaching cannot prevent diabetes. Difficulty: Moderate Client Need: Health Promotion and Maintenance Cognitive Level: Application Page 15 PTS:   1
  1. Which organization can require nurses to take continuing education courses as a condition of licensure renewal?
a. American Nurses Association
b. National League for Nursing
c. Sigma Theta Tau
d. State Board of Nursing
ANS:  D Continuing education is a professional strategy designed to ensure that nurses remain current in their clinical knowledge. Many states require nurses to engage in a certain number of continuing-education requirements to renew their license. The knowledge gained in the nursing curriculum is sufficient for nursing school graduates to obtain their initial license. Requirements for renewal of a nurse’s license can be found in the state’s nurse practice act (state board of nursing). Difficulty: Difficult Cognitive Level: Analysis Client Need: Health Promotion and Maintenance Cognitive Level: Application Page 11 PTS:   1
  1. An experienced seasoned nurse uses her knowledge of patient medical conditions and intuition to identify patient problems. She is often the resource for other nurses on the unit. What stage of proficiency has this nurse achieved?
a. Novice
b. Advanced beginner
c. Competent
d. Expert
ANS:  D The nurse who has reached the expert stage of proficiency has a deep understanding of the clinical situation based on knowledge and experience. The nurse often senses a potential problem in the absence of classic signs and symptoms. The novice nurse is inexperienced and relies on rules and processes. The advanced beginner focuses on aspects of a situation and is unable to see the comprehensive perspective. A nurse functioning at the competent level is able to prioritize to meet the patient needs but does not fully grasp the total situation. Difficulty: Moderate Cognitive Level: Comprehension Pages 11-12 PTS:   1
  1. Which of the following best explains the importance of standards of practice?
a. Nurses and other healthcare providers have the same standards of practice.
b. Standard of practice only apply to nurses who work in hospital settings.
c. Standards of practice identify the knowledge, skills, and attitudes nurses need to provide safe care.
d. Standards of practice differ among registered nurses because the roles are different based on the population they serve.
ANS:  C Standards of practice are authoritative statements of the duties that all registered nurses, regardless of role, population, or specialty, are expected to perform competently. Standards are derived from several sources, including professional organizations and healthcare facilities’ policies and procedures. Difficulty: Moderate Cognitive Level: Application Pages 12-13 PTS:   1
  1. What is the primary goal of the National League for Nursing?
a. Advocate for the needs of registered nurses to promote patient safety
b. Establish and maintain standards for nursing education
c. Support global health policies and improve health worldwide
d. Foster nursing scholarship, leadership, and service to improve health worldwide
ANS:  B The National League for Nursing (NLN) was founded to establish and maintain a universal standard of nursing education. The NLN focuses on faculty development in nursing education programs and is the voice for nursing education. Difficulty: Moderate Cognitive Level: Application Page 14   PTS:   1
  1. A patient who requires long-term rehabilitation needs which type of care?
a. Primary care
b. Secondary care
c. Tertiary care
d. Preventive care
ANS:  C Tertiary care is required for individuals who need long-term care or for those who are dying. Difficulty: Easy Cognitive Level: Knowledge Page 18 PTS:   1
  1. An elderly patient is covered under Medicare. She is scheduled for discharge and tells the nursing student that several therapists will come to her home to help her regain functional abilities. The patient then asks, “Why can’t I just stay in the hospital and receive this type of care?” What is the nursing student’s best response?
a. “You should be able to stay in the hospital. I will ask the nurse to call your doctor.”
b. “Once you have reached your reimbursable length of stay and your condition is stable, it is more cost effective to provide you with home healthcare.”
c. “Medicare is a type of managed care, which mean that you are only allowed to stay in the hospital for a certain number of days before being discharged, regardless of your condition.”
d. “You should be glad to be in your own home. You will recover in no time.”
ANS:  B Home healthcare services are provided to patients who still require skilled care but are discharged from the hospital because the reimbursable length-of-stay has expired. The patient is stable and can receive provider services at home. It would be incorrect and misleading to tell the patient she “should be able to stay in the hospital.” It would be incorrect to tell the patient she is allowed only “a certain number of days before being discharged,” because the patient’s condition is a factor in determining whether the patient can be discharged from the hospital. Telling the patient that she should be glad to be going home is a form of closed communication and does not address her question. Difficulty: Moderate
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