Chapter 1: Traditional and Community Nursing Care for Women, Families, and
Children
G
MULTIPLE CHOICE
1. The clinic nurse understands the new description of nursing art/aesthetics as the way that
nurses and patients help each other through a circular process. What is the event that begins
Nthis process?
A. A health threat
B. Experiencing new possibilities for health
S I C. Hope and understanding for the future
D. Relationship building
ANS: A
R Nursing aesthetics consists of the low-tech, high-touch caring in a nurse–patient encounter.
This transformative process begins with a health threat. The event that begins the process is
not experiencing new possibilities for health, hope and understanding for the future, or
relationship building. U
Cognitive Level: Knowledge/Remembering
Content Area: Pediatrics/Maternity
Patient Needs: Safe and Effective Care Environment: Management of Care
Integrated Process: Caring
Difficulty: Moderate L N
PTS: 1
2. A nurse manager in a community clinic is concerned because the local refugee population
A
does not seek health care routinely. What action by the nurse would be most helpful?
A. Assess clinic staff and procedures for evidence of ethnocentrism.
B. Put up flyers advertising the clinic’s services in local retailers.
C
C. Reward preventative health patients with coupons for needed items.
D. Try to meet with community leaders to work on the problem.
ANS: A
I
Ethnocentrism is the view that the beliefs, values, and behaviors of one culture are superior to
D
those of other cultures. Ethnocentrism is dangerous in health care because it is blind to the
possibilities of other solutions and viewpoints and alienates people in need of health care. The
nurse manager would be wise to assess the clinic’s staff and procedures for ethnocentrism.
E
Meeting with a community leader is always a good idea to learn the viewpoints of the
community, but unless ethnocentric behaviors change, it is unlikely that the refugee
community will increase its use of the clinic. Flyers and incentives may also be helpful in
some cases, but not as helpful as reducing the barriers imposed by ethnocentrism.
Cognitive Level: Application/Applying
Content Area: Pediatrics/Maternity
Patient Needs: Health Promotion and Maintenance
Integrated Process: Caring
Difficulty: Moderate
, PTS: 1
3. The nursing faculty explains to students that ethnopluralism is an important force shaping
G health care today. What concept is most important in understanding this trend?
A. The decreased need for cultural competency
B. The growth in one ethnic group in a single area
C. The increased impact of diverse cultures on health care
N
D. The percentage increase of the non-Caucasian population
ANS: C
Ethnopluralism means diverse cultures. As the population of different ethnic
I
S (non-Euro-Caucasian) groups grows, their impact on health care will increase exponentially.
Ethnopluralism is not just the growth of one ethnic group in one location. It is also more than
just the percentage change in the non-Euro-Caucasian population, although that is part of the
R phenomenon. As ethnopluralism continues to impact health care, providers will need to be
more, not less, culturally competent.
Cognitive Level: Knowledge/Remembering
U
Content Area: Pediatrics/Maternity
Patient Needs: Psychosocial Integrity
Integrated Process: Teaching/Learning
Difficulty: Moderate N
PTS: 1 L
4. A nursing faculty member is explaining recent shifts in nursing practice. What change has
been important in applying the nursing process?
A. A change to a spiral or circular process
B. A focus on more independent nursing actions
C. A return to the nurse-as-expert model of care
A
D. An emphasis on attaining a disease-free state C
ANS: A
The nursing process has recently changed from a linear one to a spiral or circular process in
which the patient/family is motivated toward promotion, maintenance, and restoration of
I
health. The focus has not changed to include more independent actions, a return to the
D
nurse-as-expert model, or an emphasis on attaining a disease-free state of being.
Cognitive Level: Comprehension/Understanding E
Content Area: Pediatrics/Maternity
Patient Needs: Health Promotion and Maintenance
Integrated Process: Teaching/Learning
Difficulty: Easy
PTS: 1
5. A nurse is working in an urban clinic with a diverse population. What action by the nurse is
most important?
A. Determine patients’ definitions of health and desired outcomes of health care.
B. Explain policies such as appointment cancellations to ensure compliance.
, C. Learn to speak one or two common languages of the patients in the clinic.
D. Read about different folk remedies common among the populations seen.
ANS: A
G Divergent populations enter the health-care system with differing beliefs about health care and
wellness and differing expectations for the outcomes of such experiences. Understanding
these expectations will help the nurse plan care that has a better chance of meeting these
expectations. Learning languages and becoming familiar with folk remedies is helpful as well,
N
but these two solutions are very limited in scope and a nurse cannot hope to become proficient
in all the languages/behaviors of every population seen, leaving some patients with a lessened
experience. Explaining policies is important too, but simply telling someone the rules does not
S I
take his or her cultural norms into account and may not be successful.
Cognitive Level: Application/Applying
Content Area: Pediatrics/Maternity
R Patient Needs: Psychosocial Integrity
Integrated Process: Nursing Process: Assessment
Difficulty: Moderate
PTS: 1
U
6. A nurse is working with a minority group that has a high incidence of cardiovascular disease,
including hypertension and stroke. When participating in a community health fair with this
N
group, what action by the nurse will be most effective?
A. Educate the participants about weight loss and a low-sodium, low-fat diet.
B. Explain the genetic basis for the high incidence of cardiovascular disease in the
group.
L
C. Help participants make lifestyle changes that are culturally congruent.
D. Present statistics on the mortality and morbidity of cardiovascular disease.
ANS: C
A
The ever-increasing culturally diverse population interacting with the health-care system
C
brings its own beliefs, values, and health-related practices that impact health and well-being.
In order to help people make healthy lifestyle changes, the changes must be culturally
congruent and acceptable. Forcing an incongruent practice makes it highly unlikely to
succeed. Education is important, but it must be done in a culturally congruent way.
I
Pathophysiology and statistical knowledge, by itself, is not likely to be beneficial.
D
Cognitive Level: Application/Applying
Content Area: Pediatrics/Maternity E
Patient Needs: Psychosocial Integrity
Integrated Process: Teaching/Learning
Difficulty: Difficult
PTS: 1
7. What does the practicing nurse understand to be the most important influence on
interdependent, assertive nursing practice today?
A. Higher education of registered nurses
B. Improved working conditions and salaries
C. Increased numbers of female physicians
, D. Use of the nursing process for patient care
ANS: D
Nurses were passive, deferential, and compliant to the knowledge and orders of mostly male
G physicians until the late 20th century. The nursing process changed that. The nursing process
is a framework for systematic problem solving and implementation of both independent and
dependent nursing actions. The nursing process allows nurses to make decisions regarding
patient care based on critical thinking and clinical judgment. The other options listed were not
N
vital in creating a nursing practice that is interdependent and assertive.
Cognitive Level: Analysis/Analyzing
I
Content Area: Pediatrics/Maternity
Patient Needs: Safe and Effective Care Environment: Management of Care
S Integrated Process: Nursing Process
Difficulty: Difficult
R PTS: 1
8. A child who has been hospitalized for a long time is preparing to go home, where care will be
U
continued. Which action by the nurse is most beneficial to assist the family in this transition?
A. Advise the family to call the local visiting nurses association for home visits.
B. Call the child’s school to inquire about requirements for returning to school.
C. Consult a social worker to help evaluate insurance coverage and transportation.
N
D. Give the family brochures for the local support group for chronically ill children.
ANS: C
Preparing a family for home-based care, or other community-based care, involves ensuring
L
that the family is able to provide the care needed by the child at home or in another setting.
This can include discussing specialized equipment in the home, health insurance coverage,
A
transportation, and/or returning to school. If the family needs or desires visiting nurses, the
nursing staff or social worker at the hospital should arrange this for the family. Calling the
school to get information about the child’s return to school yields helpful information, but
C
may not be needed yet, and is too limited in scope to be the best answer. Simply giving
parents brochures for support groups may or may not be helpful; the parents may not be
literate or may not understand the benefit without discussion.
I
Cognitive Level: Analysis/Analyzing D
Content Area: Pediatrics/Maternity
Patient Needs: Health Promotion and Maintenance
Integrated Process: Communication and Documentation E
Difficulty: Difficult
PTS: 1
9. A nurse manager wants to make the pediatric clinic a more family-centered health-care
setting. Which of the following actions by the nursing staff would best meet this goal?
A. Encourage family members to be present in the exam room and to ask questions.
B. Incorporate the use of a community health map for all new patients in the clinic.
C. Recognize family members as experts on their child and incorporate them in
decision making.
D. Use evidence-based practice to develop policies and procedures used in the clinic.
Children
G
MULTIPLE CHOICE
1. The clinic nurse understands the new description of nursing art/aesthetics as the way that
nurses and patients help each other through a circular process. What is the event that begins
Nthis process?
A. A health threat
B. Experiencing new possibilities for health
S I C. Hope and understanding for the future
D. Relationship building
ANS: A
R Nursing aesthetics consists of the low-tech, high-touch caring in a nurse–patient encounter.
This transformative process begins with a health threat. The event that begins the process is
not experiencing new possibilities for health, hope and understanding for the future, or
relationship building. U
Cognitive Level: Knowledge/Remembering
Content Area: Pediatrics/Maternity
Patient Needs: Safe and Effective Care Environment: Management of Care
Integrated Process: Caring
Difficulty: Moderate L N
PTS: 1
2. A nurse manager in a community clinic is concerned because the local refugee population
A
does not seek health care routinely. What action by the nurse would be most helpful?
A. Assess clinic staff and procedures for evidence of ethnocentrism.
B. Put up flyers advertising the clinic’s services in local retailers.
C
C. Reward preventative health patients with coupons for needed items.
D. Try to meet with community leaders to work on the problem.
ANS: A
I
Ethnocentrism is the view that the beliefs, values, and behaviors of one culture are superior to
D
those of other cultures. Ethnocentrism is dangerous in health care because it is blind to the
possibilities of other solutions and viewpoints and alienates people in need of health care. The
nurse manager would be wise to assess the clinic’s staff and procedures for ethnocentrism.
E
Meeting with a community leader is always a good idea to learn the viewpoints of the
community, but unless ethnocentric behaviors change, it is unlikely that the refugee
community will increase its use of the clinic. Flyers and incentives may also be helpful in
some cases, but not as helpful as reducing the barriers imposed by ethnocentrism.
Cognitive Level: Application/Applying
Content Area: Pediatrics/Maternity
Patient Needs: Health Promotion and Maintenance
Integrated Process: Caring
Difficulty: Moderate
, PTS: 1
3. The nursing faculty explains to students that ethnopluralism is an important force shaping
G health care today. What concept is most important in understanding this trend?
A. The decreased need for cultural competency
B. The growth in one ethnic group in a single area
C. The increased impact of diverse cultures on health care
N
D. The percentage increase of the non-Caucasian population
ANS: C
Ethnopluralism means diverse cultures. As the population of different ethnic
I
S (non-Euro-Caucasian) groups grows, their impact on health care will increase exponentially.
Ethnopluralism is not just the growth of one ethnic group in one location. It is also more than
just the percentage change in the non-Euro-Caucasian population, although that is part of the
R phenomenon. As ethnopluralism continues to impact health care, providers will need to be
more, not less, culturally competent.
Cognitive Level: Knowledge/Remembering
U
Content Area: Pediatrics/Maternity
Patient Needs: Psychosocial Integrity
Integrated Process: Teaching/Learning
Difficulty: Moderate N
PTS: 1 L
4. A nursing faculty member is explaining recent shifts in nursing practice. What change has
been important in applying the nursing process?
A. A change to a spiral or circular process
B. A focus on more independent nursing actions
C. A return to the nurse-as-expert model of care
A
D. An emphasis on attaining a disease-free state C
ANS: A
The nursing process has recently changed from a linear one to a spiral or circular process in
which the patient/family is motivated toward promotion, maintenance, and restoration of
I
health. The focus has not changed to include more independent actions, a return to the
D
nurse-as-expert model, or an emphasis on attaining a disease-free state of being.
Cognitive Level: Comprehension/Understanding E
Content Area: Pediatrics/Maternity
Patient Needs: Health Promotion and Maintenance
Integrated Process: Teaching/Learning
Difficulty: Easy
PTS: 1
5. A nurse is working in an urban clinic with a diverse population. What action by the nurse is
most important?
A. Determine patients’ definitions of health and desired outcomes of health care.
B. Explain policies such as appointment cancellations to ensure compliance.
, C. Learn to speak one or two common languages of the patients in the clinic.
D. Read about different folk remedies common among the populations seen.
ANS: A
G Divergent populations enter the health-care system with differing beliefs about health care and
wellness and differing expectations for the outcomes of such experiences. Understanding
these expectations will help the nurse plan care that has a better chance of meeting these
expectations. Learning languages and becoming familiar with folk remedies is helpful as well,
N
but these two solutions are very limited in scope and a nurse cannot hope to become proficient
in all the languages/behaviors of every population seen, leaving some patients with a lessened
experience. Explaining policies is important too, but simply telling someone the rules does not
S I
take his or her cultural norms into account and may not be successful.
Cognitive Level: Application/Applying
Content Area: Pediatrics/Maternity
R Patient Needs: Psychosocial Integrity
Integrated Process: Nursing Process: Assessment
Difficulty: Moderate
PTS: 1
U
6. A nurse is working with a minority group that has a high incidence of cardiovascular disease,
including hypertension and stroke. When participating in a community health fair with this
N
group, what action by the nurse will be most effective?
A. Educate the participants about weight loss and a low-sodium, low-fat diet.
B. Explain the genetic basis for the high incidence of cardiovascular disease in the
group.
L
C. Help participants make lifestyle changes that are culturally congruent.
D. Present statistics on the mortality and morbidity of cardiovascular disease.
ANS: C
A
The ever-increasing culturally diverse population interacting with the health-care system
C
brings its own beliefs, values, and health-related practices that impact health and well-being.
In order to help people make healthy lifestyle changes, the changes must be culturally
congruent and acceptable. Forcing an incongruent practice makes it highly unlikely to
succeed. Education is important, but it must be done in a culturally congruent way.
I
Pathophysiology and statistical knowledge, by itself, is not likely to be beneficial.
D
Cognitive Level: Application/Applying
Content Area: Pediatrics/Maternity E
Patient Needs: Psychosocial Integrity
Integrated Process: Teaching/Learning
Difficulty: Difficult
PTS: 1
7. What does the practicing nurse understand to be the most important influence on
interdependent, assertive nursing practice today?
A. Higher education of registered nurses
B. Improved working conditions and salaries
C. Increased numbers of female physicians
, D. Use of the nursing process for patient care
ANS: D
Nurses were passive, deferential, and compliant to the knowledge and orders of mostly male
G physicians until the late 20th century. The nursing process changed that. The nursing process
is a framework for systematic problem solving and implementation of both independent and
dependent nursing actions. The nursing process allows nurses to make decisions regarding
patient care based on critical thinking and clinical judgment. The other options listed were not
N
vital in creating a nursing practice that is interdependent and assertive.
Cognitive Level: Analysis/Analyzing
I
Content Area: Pediatrics/Maternity
Patient Needs: Safe and Effective Care Environment: Management of Care
S Integrated Process: Nursing Process
Difficulty: Difficult
R PTS: 1
8. A child who has been hospitalized for a long time is preparing to go home, where care will be
U
continued. Which action by the nurse is most beneficial to assist the family in this transition?
A. Advise the family to call the local visiting nurses association for home visits.
B. Call the child’s school to inquire about requirements for returning to school.
C. Consult a social worker to help evaluate insurance coverage and transportation.
N
D. Give the family brochures for the local support group for chronically ill children.
ANS: C
Preparing a family for home-based care, or other community-based care, involves ensuring
L
that the family is able to provide the care needed by the child at home or in another setting.
This can include discussing specialized equipment in the home, health insurance coverage,
A
transportation, and/or returning to school. If the family needs or desires visiting nurses, the
nursing staff or social worker at the hospital should arrange this for the family. Calling the
school to get information about the child’s return to school yields helpful information, but
C
may not be needed yet, and is too limited in scope to be the best answer. Simply giving
parents brochures for support groups may or may not be helpful; the parents may not be
literate or may not understand the benefit without discussion.
I
Cognitive Level: Analysis/Analyzing D
Content Area: Pediatrics/Maternity
Patient Needs: Health Promotion and Maintenance
Integrated Process: Communication and Documentation E
Difficulty: Difficult
PTS: 1
9. A nurse manager wants to make the pediatric clinic a more family-centered health-care
setting. Which of the following actions by the nursing staff would best meet this goal?
A. Encourage family members to be present in the exam room and to ask questions.
B. Incorporate the use of a community health map for all new patients in the clinic.
C. Recognize family members as experts on their child and incorporate them in
decision making.
D. Use evidence-based practice to develop policies and procedures used in the clinic.
