COMPLETE TEST BANK___
FAMILY PRACTICE GUIDELINES 6TH EDITION
BY JILL C. CASH MSN APN FNP-BC (EDITOR)
6TH EDITION
,TABLE OF CONTENTS
CHAPTER 1. HEALTH MAINTENANCE GUIDELINES MULTIPLE CHOICE.....................................................3
CHAPTER 2. PUBLIC HEALTH GUIDELINES..............................................................................................18
CHAPTER 3. PAIN MANAGEMENT GUIDELINES......................................................................................47
CHAPTER 4. DERMATOLOGY GUIDELINES..............................................................................................58
CHAPTER 5. EYE GUIDELINES.................................................................................................................67
CHAPTER 6. EAR GUIDELINES.................................................................................................................80
CHAPTER 7. NASAL GUIDELINES.............................................................................................................94
CHAPTER 8. THROAT AND MOUTH GUIDELINES.................................................................................100
CHAPTER 9. RESPIRATORY GUIDELINES..............................................................................................115
CHAPTER 10. CARDIOVASCULAR GUIDELINES......................................................................................140
CHAPTER 11. GASTROINTESTINAL GUIDELINES...................................................................................213
CHAPTER 12. GENITOURINARY GUIDELINES........................................................................................227
CHAPTER 13. OBSTETRICS GUIDELINES................................................................................................241
CHAPTER 14. GYNECOLOGIC GUIDELINES...........................................................................................260
CHAPTER 15. SEXUALLY TRANSMITTED INFECTIONS GUIDELINES......................................................293
CHAPTER 16. INFECTIOUS DISEASE GUIDELINES..................................................................................316
CHAPTER 17. SYSTEMIC DISORDERS GUIDELINES MULTIPLE CHOICE..................................................341
CHAPTER 18. MUSCULOSKELETAL GUIDELINES MULTIPLE CHOICE.....................................................387
CHAPTER 19. NEUROLOGIC GUIDELINES..............................................................................................413
CHAPTER 20. ENDOCRINE GUIDELINES................................................................................................435
CHAPTER 21. RHEUMATOLOGICAL GUIDELINES..................................................................................441
CHAPTER 22. PSYCHIATRIC GUIDELINES..............................................................................................457
CHAPTER 23. ASSESSMENT GUIDE FOR SPORT PARTICIPATION..........................................................490
,CHAPTER 1. HEALTH MAINTENANCE GUIDELINES MULTIPLE CHOICE
QUESTION 1
THE NURSE IS PREPARING TO TEACH A PATIENT OF THE ASIAN CULTURE TO PERFORM POSTOPERATIVE
DRESSING CHANGES AT HOME AFTER DISCHARGE. WHICH STATEMENT MADE BY THE NURSE INDICATES
CULTURAL COMPETENCE?
A. TELL ME HOW YOU FEEL ABOUT YOUR SURGERY.
B. ASIAN PEOPLE ARE SMART, SO THIS SHOULD BE EASY FOR YOU TO UNDERSTAND.
C. AMERICAN SURGEONS ARE HIGHLY QUALIFIED; I’M SURE YOU WILL HEAL QUICKLY.
D. WILL YOU TELL ME ABOUT ANY TRADITIONAL HEALING PRACTICES THAT YOU WOULD LIKE TO USE?
ANSWER:>D. WILL YOU TELL ME ABOUT ANY TRADITIONAL HEALING PRACTICES THAT YOU WOULD
LIKE TO USE?
RATIONALE: CULTURAL COMPETENCE INVOLVES RESPECTING AND INTEGRATING THE PATIENT’S
CULTURAL BELIEFS AND PRACTICES INTO CARE. OPTION D DEMONSTRATES THIS BY ASKING ABOUT
TRADITIONAL HEALING PRACTICES. OPTION A IS EMPATHETIC BUT DOES NOT ADDRESS CULTURAL
COMPETENCE. OPTIONS B AND C ARE CULTURALLY INSENSITIVE AND MAKE ASSUMPTIONS BASED ON
STEREOTYPES.
QUESTION 2
AN UNCONSCIOUS VICTIM OF A HOUSE FIRE IS BROUGHT TO THE EMERGENCY DEPARTMENT BY THE
PARAMEDICS. TIED TO THE RIGHT WRIST IS AN EMBLEM THAT APPEARS TO BE A RELIGIOUS TALISMAN.
WHICH ACTION SHOULD THE NURSE TAKE?
A. TAPE IT IN PLACE.
B. DO NOTHING WITH IT.
C. REMOVE IT AND LOCK IT UP FOR SAFEKEEPING.
D. PLACE IT IN A CLOTHING BAG WITH THE REST OF THE PATIENT’S BELONGINGS.
ANSWER:>A. TAPE IT IN PLACE.
,RATIONALE: RELIGIOUS OR CULTURAL ITEMS SHOULD BE RESPECTED AND LEFT IN PLACE UNLESS
THEY INTERFERE WITH CARE. TAPING IT IN PLACE ENSURES IT REMAINS WITH THE PATIENT WHILE
ALLOWING FOR NECESSARY MEDICAL INTERVENTIONS. OPTIONS B, C, AND D DO NOT RESPECT THE
PATIENT’S CULTURAL OR RELIGIOUS BELIEFS.
QUESTION 3
A 43-YEAR-OLD PATIENT OF ARAB DESCENT IS ADMITTED TO THE HOSPITAL. TO COMPLY WITH THE
STATE LAWS OF THE ORGANIZATION, THE NURSE OFFERS THE PATIENT A PAPANICOLAOU SMEAR,
WHICH SHE REFUSES. WHICH ACTION SHOULD THE NURSE TAKE FIRST?
A. NOTIFY THE PHYSICIAN.
B. REPORT THE REFUSAL TO THE SUPERVISOR.
C. EXPLAIN THE RATIONALE FOR AND BENEFITS OF THE TEST.
D. TELL HER IT IS STATE LAW AND THAT SHE DOES NOT HAVE A CHOICE.
ANSWER:>C. EXPLAIN THE RATIONALE FOR AND BENEFITS OF THE TEST.
RATIONALE: THE NURSE SHOULD FIRST EDUCATE THE PATIENT ABOUT THE IMPORTANCE OF THE
TEST WHILE RESPECTING HER AUTONOMY. OPTIONS A AND B ARE UNNECESSARY UNLESS THE PATIENT
CONTINUES TO REFUSE AFTER EDUCATION. OPTION D IS COERCIVE AND VIOLATES THE PATIENT’S RIGHT
TO REFUSE CARE.
QUESTION 4
A PATIENT WHO IS A JEHOVAH’S WITNESS HAS SEVERE GASTROINTESTINAL BLEEDING AND A
DANGEROUSLY LOW HEMOGLOBIN LEVEL. THE PATIENT IS FULLY ALERT AND COMPETENT AND REFUSES
TO ACCEPT THE BLOOD TRANSFUSION ORDERED BY THE PHYSICIAN. WHICH ACTION BY THE NURSE IS
MOST APPROPRIATE?
A. OBTAIN A COURT ORDER TO GIVE THE BLOOD.
B. ADMINISTER THE BLOOD WHILE THE PATIENT IS SLEEPING.
C. HAVE THE PATIENT’S SPOUSE SIGN THE CONSENT TO HAVE THE BLOOD ADMINISTERED.
D. ENSURE THE PATIENT UNDERSTANDS POSSIBLE CONSEQUENCES AND THEN RESPECT THE PATIENT’S
WISHES.
,ANSWER:>D. ENSURE THE PATIENT UNDERSTANDS POSSIBLE CONSEQUENCES AND THEN RESPECT
THE PATIENT’S WISHES.
RATIONALE: COMPETENT PATIENTS HAVE THE RIGHT TO REFUSE TREATMENT, EVEN IF IT IS LIFE-
SAVING. THE NURSE MUST ENSURE THE PATIENT UNDERSTANDS THE RISKS AND THEN RESPECT THEIR
DECISION. OPTIONS A, B, AND C VIOLATE THE PATIENT’S AUTONOMY AND LEGAL RIGHTS.
QUESTION 5
A PATIENT OF MEXICAN DESCENT SEES A CURANDERO FOR ASTHMA; THE CURANDERO HAS PRESCRIBED
A SPECIAL TEA TO BE TAKEN FOUR TIMES A DAY TO OPEN THE AIRWAYS. HOW SHOULD THE NURSE
RESPOND TO THIS SITUATION?
A. ENCOURAGE THE PATIENT TO CONTINUE DRINKING THE TEA.
B. ENCOURAGE THE PATIENT TO DRINK ONLY ONE CUP OF THE TEA EACH DAY.
C. ASK THE PATIENT TO BRING IN THE TEA PACKAGE AND HAVE THE PHARMACIST CHECK THE
INGREDIENTS.
D. ADVISE THE PATIENT TO STOP DRINKING THE TEA BECAUSE OF POTENTIAL INTERACTIONS WITH
OTHER MEDICATIONS.
ANSWER:>C. ASK THE PATIENT TO BRING IN THE TEA PACKAGE AND HAVE THE PHARMACIST CHECK
THE INGREDIENTS.
RATIONALE: THE NURSE SHOULD RESPECT THE PATIENT’S CULTURAL PRACTICES WHILE ENSURING
SAFETY. HAVING THE PHARMACIST CHECK THE TEA FOR POTENTIAL INTERACTIONS IS THE BEST
APPROACH. OPTIONS A AND B DO NOT ADDRESS SAFETY CONCERNS, AND OPTION D DISMISSES THE
PATIENT’S CULTURAL BELIEFS WITHOUT INVESTIGATION.
QUESTION 6
THE NURSE IS CARING FOR A YOUNG ADULT MALE PATIENT WHO REFUSES PERSONAL CARE FROM A
FEMALE NURSING ASSISTANT. WHICH APPROACH BY THE NURSE IS BEST?
A. ENCOURAGE THE PATIENT’S FAMILY TO TALK WITH HIM ABOUT HIS CARE.
B. HAVE A REGISTERED NURSE (RN) HELP WITH HIS PERSONAL CARE.
, C. ASSIGN A MALE ASSISTANT TO HELP WITH HIS PERSONAL CARE IF ONE IS AVAILABLE.
D. EXPLAIN TO HIM THAT MALES AND FEMALES TAKE CARE OF BOTH GENDERS IN THIS HOSPITAL.
ANSWER:>C. ASSIGN A MALE ASSISTANT TO HELP WITH HIS PERSONAL CARE IF ONE IS AVAILABLE.
RATIONALE: RESPECTING THE PATIENT’S CULTURAL OR PERSONAL PREFERENCES IS ESSENTIAL.
ASSIGNING A MALE ASSISTANT DEMONSTRATES CULTURAL SENSITIVITY. OPTIONS A, B, AND D DO NOT
ADDRESS THE PATIENT’S PREFERENCE.
QUESTION 7
THE NURSE IS PROVIDING MEDICATION INSTRUCTIONS TO A 45-YEAR-OLD PATIENT WHO DOES NOT
MAINTAIN EYE CONTACT. WHAT SHOULD THIS PATIENT’S BEHAVIOR INDICATE TO THE NURSE?
A. THE PATIENT IS NOT INTERESTED.
B. THE NURSE THREATENS THE PATIENT’S EGO.
C. THE NURSE IS IN A HIERARCHICAL POSITION.
D. THE PATIENT DOES NOT INTEND TO FOLLOW THE INSTRUCTIONS.
ANSWER:>C. THE NURSE IS IN A HIERARCHICAL POSITION.
RATIONALE: IN SOME CULTURES, AVOIDING EYE CONTACT IS A SIGN OF RESPECT, ESPECIALLY WHEN
SPEAKING TO SOMEONE IN A POSITION OF AUTHORITY. OPTIONS A, B, AND D MISINTERPRET THE
BEHAVIOR AS DISINTEREST OR DEFIANCE.
QUESTION 8
THE NURSE IS CARING FOR A PATIENT OF SPANISH DESCENT WHO IS EXPERIENCING PAIN, BUT DOES
NOT SPEAK ENGLISH. AN INTERPRETER IS LOCATED TO HELP WITH THE ASSESSMENT. WHAT SHOULD
THE NURSE DO TO FACILITATE COMMUNICATION WITH THIS PATIENT?
A. USE HAND SIGNALS TO DETERMINE THE CAUSE OF THE PAIN.
B. ENSURE THE INTERPRETER IS NOT LEFT ALONE WITH THE PATIENT.
C. MAINTAIN EYE CONTACT WITH THE PATIENT AND THE INTERPRETER.
FAMILY PRACTICE GUIDELINES 6TH EDITION
BY JILL C. CASH MSN APN FNP-BC (EDITOR)
6TH EDITION
,TABLE OF CONTENTS
CHAPTER 1. HEALTH MAINTENANCE GUIDELINES MULTIPLE CHOICE.....................................................3
CHAPTER 2. PUBLIC HEALTH GUIDELINES..............................................................................................18
CHAPTER 3. PAIN MANAGEMENT GUIDELINES......................................................................................47
CHAPTER 4. DERMATOLOGY GUIDELINES..............................................................................................58
CHAPTER 5. EYE GUIDELINES.................................................................................................................67
CHAPTER 6. EAR GUIDELINES.................................................................................................................80
CHAPTER 7. NASAL GUIDELINES.............................................................................................................94
CHAPTER 8. THROAT AND MOUTH GUIDELINES.................................................................................100
CHAPTER 9. RESPIRATORY GUIDELINES..............................................................................................115
CHAPTER 10. CARDIOVASCULAR GUIDELINES......................................................................................140
CHAPTER 11. GASTROINTESTINAL GUIDELINES...................................................................................213
CHAPTER 12. GENITOURINARY GUIDELINES........................................................................................227
CHAPTER 13. OBSTETRICS GUIDELINES................................................................................................241
CHAPTER 14. GYNECOLOGIC GUIDELINES...........................................................................................260
CHAPTER 15. SEXUALLY TRANSMITTED INFECTIONS GUIDELINES......................................................293
CHAPTER 16. INFECTIOUS DISEASE GUIDELINES..................................................................................316
CHAPTER 17. SYSTEMIC DISORDERS GUIDELINES MULTIPLE CHOICE..................................................341
CHAPTER 18. MUSCULOSKELETAL GUIDELINES MULTIPLE CHOICE.....................................................387
CHAPTER 19. NEUROLOGIC GUIDELINES..............................................................................................413
CHAPTER 20. ENDOCRINE GUIDELINES................................................................................................435
CHAPTER 21. RHEUMATOLOGICAL GUIDELINES..................................................................................441
CHAPTER 22. PSYCHIATRIC GUIDELINES..............................................................................................457
CHAPTER 23. ASSESSMENT GUIDE FOR SPORT PARTICIPATION..........................................................490
,CHAPTER 1. HEALTH MAINTENANCE GUIDELINES MULTIPLE CHOICE
QUESTION 1
THE NURSE IS PREPARING TO TEACH A PATIENT OF THE ASIAN CULTURE TO PERFORM POSTOPERATIVE
DRESSING CHANGES AT HOME AFTER DISCHARGE. WHICH STATEMENT MADE BY THE NURSE INDICATES
CULTURAL COMPETENCE?
A. TELL ME HOW YOU FEEL ABOUT YOUR SURGERY.
B. ASIAN PEOPLE ARE SMART, SO THIS SHOULD BE EASY FOR YOU TO UNDERSTAND.
C. AMERICAN SURGEONS ARE HIGHLY QUALIFIED; I’M SURE YOU WILL HEAL QUICKLY.
D. WILL YOU TELL ME ABOUT ANY TRADITIONAL HEALING PRACTICES THAT YOU WOULD LIKE TO USE?
ANSWER:>D. WILL YOU TELL ME ABOUT ANY TRADITIONAL HEALING PRACTICES THAT YOU WOULD
LIKE TO USE?
RATIONALE: CULTURAL COMPETENCE INVOLVES RESPECTING AND INTEGRATING THE PATIENT’S
CULTURAL BELIEFS AND PRACTICES INTO CARE. OPTION D DEMONSTRATES THIS BY ASKING ABOUT
TRADITIONAL HEALING PRACTICES. OPTION A IS EMPATHETIC BUT DOES NOT ADDRESS CULTURAL
COMPETENCE. OPTIONS B AND C ARE CULTURALLY INSENSITIVE AND MAKE ASSUMPTIONS BASED ON
STEREOTYPES.
QUESTION 2
AN UNCONSCIOUS VICTIM OF A HOUSE FIRE IS BROUGHT TO THE EMERGENCY DEPARTMENT BY THE
PARAMEDICS. TIED TO THE RIGHT WRIST IS AN EMBLEM THAT APPEARS TO BE A RELIGIOUS TALISMAN.
WHICH ACTION SHOULD THE NURSE TAKE?
A. TAPE IT IN PLACE.
B. DO NOTHING WITH IT.
C. REMOVE IT AND LOCK IT UP FOR SAFEKEEPING.
D. PLACE IT IN A CLOTHING BAG WITH THE REST OF THE PATIENT’S BELONGINGS.
ANSWER:>A. TAPE IT IN PLACE.
,RATIONALE: RELIGIOUS OR CULTURAL ITEMS SHOULD BE RESPECTED AND LEFT IN PLACE UNLESS
THEY INTERFERE WITH CARE. TAPING IT IN PLACE ENSURES IT REMAINS WITH THE PATIENT WHILE
ALLOWING FOR NECESSARY MEDICAL INTERVENTIONS. OPTIONS B, C, AND D DO NOT RESPECT THE
PATIENT’S CULTURAL OR RELIGIOUS BELIEFS.
QUESTION 3
A 43-YEAR-OLD PATIENT OF ARAB DESCENT IS ADMITTED TO THE HOSPITAL. TO COMPLY WITH THE
STATE LAWS OF THE ORGANIZATION, THE NURSE OFFERS THE PATIENT A PAPANICOLAOU SMEAR,
WHICH SHE REFUSES. WHICH ACTION SHOULD THE NURSE TAKE FIRST?
A. NOTIFY THE PHYSICIAN.
B. REPORT THE REFUSAL TO THE SUPERVISOR.
C. EXPLAIN THE RATIONALE FOR AND BENEFITS OF THE TEST.
D. TELL HER IT IS STATE LAW AND THAT SHE DOES NOT HAVE A CHOICE.
ANSWER:>C. EXPLAIN THE RATIONALE FOR AND BENEFITS OF THE TEST.
RATIONALE: THE NURSE SHOULD FIRST EDUCATE THE PATIENT ABOUT THE IMPORTANCE OF THE
TEST WHILE RESPECTING HER AUTONOMY. OPTIONS A AND B ARE UNNECESSARY UNLESS THE PATIENT
CONTINUES TO REFUSE AFTER EDUCATION. OPTION D IS COERCIVE AND VIOLATES THE PATIENT’S RIGHT
TO REFUSE CARE.
QUESTION 4
A PATIENT WHO IS A JEHOVAH’S WITNESS HAS SEVERE GASTROINTESTINAL BLEEDING AND A
DANGEROUSLY LOW HEMOGLOBIN LEVEL. THE PATIENT IS FULLY ALERT AND COMPETENT AND REFUSES
TO ACCEPT THE BLOOD TRANSFUSION ORDERED BY THE PHYSICIAN. WHICH ACTION BY THE NURSE IS
MOST APPROPRIATE?
A. OBTAIN A COURT ORDER TO GIVE THE BLOOD.
B. ADMINISTER THE BLOOD WHILE THE PATIENT IS SLEEPING.
C. HAVE THE PATIENT’S SPOUSE SIGN THE CONSENT TO HAVE THE BLOOD ADMINISTERED.
D. ENSURE THE PATIENT UNDERSTANDS POSSIBLE CONSEQUENCES AND THEN RESPECT THE PATIENT’S
WISHES.
,ANSWER:>D. ENSURE THE PATIENT UNDERSTANDS POSSIBLE CONSEQUENCES AND THEN RESPECT
THE PATIENT’S WISHES.
RATIONALE: COMPETENT PATIENTS HAVE THE RIGHT TO REFUSE TREATMENT, EVEN IF IT IS LIFE-
SAVING. THE NURSE MUST ENSURE THE PATIENT UNDERSTANDS THE RISKS AND THEN RESPECT THEIR
DECISION. OPTIONS A, B, AND C VIOLATE THE PATIENT’S AUTONOMY AND LEGAL RIGHTS.
QUESTION 5
A PATIENT OF MEXICAN DESCENT SEES A CURANDERO FOR ASTHMA; THE CURANDERO HAS PRESCRIBED
A SPECIAL TEA TO BE TAKEN FOUR TIMES A DAY TO OPEN THE AIRWAYS. HOW SHOULD THE NURSE
RESPOND TO THIS SITUATION?
A. ENCOURAGE THE PATIENT TO CONTINUE DRINKING THE TEA.
B. ENCOURAGE THE PATIENT TO DRINK ONLY ONE CUP OF THE TEA EACH DAY.
C. ASK THE PATIENT TO BRING IN THE TEA PACKAGE AND HAVE THE PHARMACIST CHECK THE
INGREDIENTS.
D. ADVISE THE PATIENT TO STOP DRINKING THE TEA BECAUSE OF POTENTIAL INTERACTIONS WITH
OTHER MEDICATIONS.
ANSWER:>C. ASK THE PATIENT TO BRING IN THE TEA PACKAGE AND HAVE THE PHARMACIST CHECK
THE INGREDIENTS.
RATIONALE: THE NURSE SHOULD RESPECT THE PATIENT’S CULTURAL PRACTICES WHILE ENSURING
SAFETY. HAVING THE PHARMACIST CHECK THE TEA FOR POTENTIAL INTERACTIONS IS THE BEST
APPROACH. OPTIONS A AND B DO NOT ADDRESS SAFETY CONCERNS, AND OPTION D DISMISSES THE
PATIENT’S CULTURAL BELIEFS WITHOUT INVESTIGATION.
QUESTION 6
THE NURSE IS CARING FOR A YOUNG ADULT MALE PATIENT WHO REFUSES PERSONAL CARE FROM A
FEMALE NURSING ASSISTANT. WHICH APPROACH BY THE NURSE IS BEST?
A. ENCOURAGE THE PATIENT’S FAMILY TO TALK WITH HIM ABOUT HIS CARE.
B. HAVE A REGISTERED NURSE (RN) HELP WITH HIS PERSONAL CARE.
, C. ASSIGN A MALE ASSISTANT TO HELP WITH HIS PERSONAL CARE IF ONE IS AVAILABLE.
D. EXPLAIN TO HIM THAT MALES AND FEMALES TAKE CARE OF BOTH GENDERS IN THIS HOSPITAL.
ANSWER:>C. ASSIGN A MALE ASSISTANT TO HELP WITH HIS PERSONAL CARE IF ONE IS AVAILABLE.
RATIONALE: RESPECTING THE PATIENT’S CULTURAL OR PERSONAL PREFERENCES IS ESSENTIAL.
ASSIGNING A MALE ASSISTANT DEMONSTRATES CULTURAL SENSITIVITY. OPTIONS A, B, AND D DO NOT
ADDRESS THE PATIENT’S PREFERENCE.
QUESTION 7
THE NURSE IS PROVIDING MEDICATION INSTRUCTIONS TO A 45-YEAR-OLD PATIENT WHO DOES NOT
MAINTAIN EYE CONTACT. WHAT SHOULD THIS PATIENT’S BEHAVIOR INDICATE TO THE NURSE?
A. THE PATIENT IS NOT INTERESTED.
B. THE NURSE THREATENS THE PATIENT’S EGO.
C. THE NURSE IS IN A HIERARCHICAL POSITION.
D. THE PATIENT DOES NOT INTEND TO FOLLOW THE INSTRUCTIONS.
ANSWER:>C. THE NURSE IS IN A HIERARCHICAL POSITION.
RATIONALE: IN SOME CULTURES, AVOIDING EYE CONTACT IS A SIGN OF RESPECT, ESPECIALLY WHEN
SPEAKING TO SOMEONE IN A POSITION OF AUTHORITY. OPTIONS A, B, AND D MISINTERPRET THE
BEHAVIOR AS DISINTEREST OR DEFIANCE.
QUESTION 8
THE NURSE IS CARING FOR A PATIENT OF SPANISH DESCENT WHO IS EXPERIENCING PAIN, BUT DOES
NOT SPEAK ENGLISH. AN INTERPRETER IS LOCATED TO HELP WITH THE ASSESSMENT. WHAT SHOULD
THE NURSE DO TO FACILITATE COMMUNICATION WITH THIS PATIENT?
A. USE HAND SIGNALS TO DETERMINE THE CAUSE OF THE PAIN.
B. ENSURE THE INTERPRETER IS NOT LEFT ALONE WITH THE PATIENT.
C. MAINTAIN EYE CONTACT WITH THE PATIENT AND THE INTERPRETER.
