Foundations of Maternity, Women’s Health, and Child Health Nursing Test Bank By Mckinney

Chapter 1: Foundations of Maternity, Women’s Health, and Child Health Nursing Test Bank By Mckinney MULTIPLE CHOICE 1. Which factor significantly contributed to the shift from home births to hospital births in the early 20th century? a. Puerperal sepsis was identified as a risk factor in labor and delivery. b. Forceps were developed to facilitate difficult births. c. The importance of early parental-infant contact was identified. d. Technologic developments became available to physicians. ANS: D Feedback A Puerperal sepsis has been a known problem for generations. In the late 19th century, Semmelweis discovered how it could be prevented with improved hygienic practices. B The development of forceps to help physicians facilitate difficult births was a strong factor in the decrease of home births and increase of hospital births. Other important discoveries included chloroform, drugs to initiate labor, and the advancement of operative procedures such a cesarean birth. C Unlike home-births, early hospital births hindered bonding between parents and their infants. D Technological developments were available to physicians, not lay midwives. PTS: 1 DIF: Cognitive Level: Knowledge REF: p. 2 OBJ: Nursing Process: Assessment MSC: Client Needs: Safe and Effective Care Environment 2. Family-centered maternity care developed in response to: a. Demands by physicians for family involvement in childbirth b. The Sheppard-Towner Act of 1921 c. Parental requests that infants be allowed to remain with them rather than in a nursery d. Changes in pharmacologic management of labor ANS: C Feedback A Family-centered care was a request by parents, not physicians. B The Sheppard-Towner Act provided funds for state-managed programs for mothers and children. C 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. D The changes in pharmacologic management of labor were not a factor in family- centered maternity care. PTS: 1 DIF: Cognitive Level: Knowledge REF: p. 3 OBJ: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity 3. Which setting for childbirth allows the least amount of parent-infant contact? a. Labor/delivery/recovery/postpartum room b. Birth center c. Traditional hospital birth d. Home birth ANS: C Feedback A The labor/delivery/recovery/postpartum room setting allows increased parentinfant contact. B Birth centers are set up to allow an increase in parent-infant contact. 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. D Home births allow an increase in parent-infant contact. PTS: 1 DIF: Cognitive Level: Knowledge REF: p. 3 OBJ: Nursing Process: Planning MSC: Client Needs: Health Promotion and Maintenance 4. As a result of changes in health care delivery and funding, a current trend seen in the pediatric setting is: a. Increased hospitalization of children b. Decreased number of children living in poverty c. An increase in ambulatory care d. Decreased use of managed care ANS: C Feedback A Hospitalization for children has decreased. B Health care delivery has not altered the number of children living in poverty. C One effect of managed care has been that pediatric health care delivery has shifted dramatically from the acute care setting to the ambulatory setting. One of the biggest changes in health care has been the growth of managed care. The number of hospital beds being used has decreased as more care is given in outpatient settings and in the home. The number of children living in poverty has increased over the last decade. D Managed care has increased in order to control cost. PTS: 1 DIF: Cognitive Level: Knowledge REF: p. 6 OBJ: Nursing Process: Planning MSC: Client Needs: Safe and Effective Care Environment 5. The Women, Infants, and Children (WIC) program provides: a. Well-child examinations for infants and children living at the poverty level b. Immunizations for high-risk infants and children c. Screening for infants with developmental disorders d. Supplemental food supplies to low-income women who are pregnant or breastfeeding ANS: D Feedback A Medicaid’s Early and Periodic Screening, Diagnosis, and Treatment Program provides for well-child examinations and for treatment of any medical problems diagnosed during such checkups. B Children in the WIC program are often linked with immunizations, but that is not the primary focus of the program. C Public Law 99-457 provides financial incentives to states to establish comprehensive early intervention services for infants and toddlers with, or at risk for, developmental disabilities. D WIC is a federal program that provides supplemental food supplies to lowincome women who are pregnant or breastfeeding and to their children until age 5 years. PTS: 1 DIF: Cognitive Level: Comprehension REF: p. 2 | Tables 1-1, 1-9 OBJ: Nursing Process: Assessment MSC: Client Needs: Physiologic Integrity 6. In most states, adolescents who are not emancipated minors must have the permission of their parents before: a. Treatment for drug abuse b. Treatment for sexually transmitted diseases (STDs) c. Accessing birth control d. Surgery ANS: D Feedback A Most states allow minors to obtain treatment for drug or alcohol abuse without parental consent. B Most states allow minors to obtain treatment for STDs without parental consent. C In most states, minors are allowed access to birth control without parental consent. D If a minor receives surgery without proper informed consent, assault and battery charges against the care provider can result. This does not apply to an emancipated minor (a minor child who has the legal competency of an adult because of circumstances involving marriage, divorce, parenting of a child, living independently without parents, or enlistment in the armed services). PTS: 1 DIF: Cognitive Level: Application REF: p. 19 OBJ: Nursing Process: Planning MSC: Client Needs: Safe and Effective Care Environment 7. The maternity nurse should have a clear understanding of the correct use of a clinical pathway. One characteristic of clinical pathways is that they: a. Are developed and implemented by nurses b. Are used primarily in the pediatric setting c. Set specific time lines for sequencing interventions d. Are part of the nursing process ANS: C Feedback A Clinical pathways are developed by multiple health care professionals and reflect interdisciplinary interventions. B They are used in multiple settings and for patients throughout the life span. C Clinical pathways measure outcomes of patient care. Each pathway outlines specific time lines for sequencing interventions. D The steps of the nursing process are assessment, diagnosis, planning, intervention, and evaluation. PTS: 1 DIF: Cognitive Level: Application REF: p. 8 OBJ: Nursing Process: Planning MSC: Client Needs: Safe and Effective Care Environment 8. The fastest-growing group of homeless people is: a. Men and women preparing for retirement b. Migrant workers c. Single women and their children d. Intravenous (IV) substance abusers ANS: C Feedback A Most people contemplating retirement have made provisions. B Migrant workers may seek health care only when absolutely necessary; however, not all are homeless. C Pregnancy and birth, especially for a teenager, are important contributing factors for becoming homeless. D Not all substance abusers are homeless. PTS: 1 DIF: Cognitive Level: Knowledge REF: p. 16 OBJ: Nursing Process: Assessment MSC: Client Needs: Physiologic Integrity 9. The United States ranks 25th in infant mortality rates of the world. Which factor has a significant impact on decreasing the mortality rate of infants? a. Resolving all language and cultural differences b. Enrolling the pregnant woman in the Medicaid program by the 8th month of pregnancy c. Ensuring early and adequate prenatal care d. Providing more women’s shelters ANS: C Feedback A Language and cultural differences are not infant mortality issues but must be addressed to improve overall health care. B Medicaid provides health care for poor pregnant women, but the process may take weeks to take effect. The 8th month is too late to apply and receive benefits for this pregnancy. C Because preterm infants form the largest category of those needing expensive intensive care, early pregnancy intervention is essential for decreasing infant mortality rates. This is especially important for women in high-risk groups, such as racial minorities, teenagers, and those living in poverty. D The women in shelters have the same difficulties in obtaining health care as do other poor people, particularly lack of transportation and inconvenient hours of the clinics. PTS: 1 DIF: Cognitive Level: Comprehension REF: p. 11, 16 OBJ: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance 10. The intrapartum woman sees no need for an admission fetal monitoring strip. If she continues to refuse, what is the first action the nurse should take? a. Consult the family of the woman. b. Notify the physician. c. Document the woman’s refusal in the nurse’s notes. d. Make a referral to the hospital ethics committee. ANS: B Feedback A The patient must be allowed to make choices voluntarily without undue influence or coercion from others. B Patients must be allowed to make choices voluntarily without undue influence or coercion from others. The physician, especially if unaware of the patient’s decision, should be notified immediately. The nurse should notify the physician of the refusal of the agency’s protocol and document all aspects of the explanations given by the nurse, as well as any instructions from the physician. C Documentation is important, but it should not be the first action. D Fetal monitoring is not usually considered an ethical problem. PTS: 1 DIF: Cognitive Level: Application REF: p. 20 OBJ: Nursing Process: Implementation MSC: Client Needs: Safe and Effective Care Environment 11. Which statement is true regarding the “quality assurance” or “incident” report? a. The report assures the legal department that no problem exists. b. Reports are a permanent part of the patient’s chart. c. The nurse’s notes should contain, “Incident report filed, and copy placed in chart.” d. This report is a form of documentation of an event that may result in legal action. ANS: D Feedback A The report is a warning to the legal department to be prepared for a potential legal action. B Incident reports are not a part of the patient’s chart. C Incident reports are not mentioned in the nurse’s notes. D Documentation on the chart should include all factual information regarding the woman’s condition that would be recorded in any situation. Incident reports are not mentioned in the nurse’s notes. The nurse completes an incident report when something occurs that might result in a legal action against the clinic or hospital or is a variance from the standard of care. PTS: 1 DIF: Cognitive Level: Application REF: p. 21 OBJ: Nursing Process: Implementation MSC: Client Needs: Safe and Effective Care Environment 12. Elective abortion is considered an ethical issue because: a. Abortion law is unclear about a woman’s constitutional rights. b. The Supreme Court ruled that life begins at conception. c. A conflict exists between the rights of the woman and the rights of the fetus. d. It requires third-party consent. ANS: C Feedback A Abortion laws are clear concerning a woman’s constitutional rights. B The Supreme Court has not ruled on when life begins. C Elective abortion is an ethical dilemma because two opposing courses of action are available. The belief that induced abortion is a private choice is in conflict with the belief that elective pregnancy termination is taking a life. D Abortion does not require third-party consent. PTS: 1 DIF: Cognitive Level: Comprehension REF: p. 13 OBJ: Nursing Process: Assessment MSC: Client Needs: Safe and Effective Care Environment 13. Which woman would be most likely to seek prenatal care? a. A 15-year-old who tells her friends, “I don’t believe I’m pregnant.” b. A 20-year-old who is in her first pregnancy and has access to a free prenatal clinic c. A 28-year-old who is in her second pregnancy and abuses drugs and alcohol d. A 30-year-old who is in her fifth pregnancy and delivered her last infant at home with the help of her mother and sister ANS: B Feedback A Being in denial about the pregnancy will prevent her from seeking health care. B The patient who acknowledges the pregnancy early, has access to health care, and has no reason to avoid health care is most likely to seek prenatal care. C Substance abusers are less likely to seek health care. D Some women see pregnancy and delivery as a natural occurrence and do not seek health care. PTS: 1 DIF: Cognitive Level: Comprehension REF: p. 16 OBJ: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance 14. A woman who delivered her baby 6 hours ago complains of headache and dizziness. The nurse administers an analgesic but does not perform any assessments. The woman then has a grand mal seizure, falls out of bed, and fractures her femur. How would the actions of the nurse be interpreted in relation to standards of care? a. Negligent because the nurse failed to assess the woman for possible complications b. Negligent because the nurse medicated the woman c. Not negligent because the woman had signed a waiver concerning the use of side rails d. Not negligent because the woman did not inform the nurse of her symptoms as soon as they occurred ANS: A Feedback A By not assessing the woman, the nurse failed to meet the established standards of care. The first element of negligence relates to whether the nurse has a duty to provide care to the woman. The care that the nurse provides must meet the established standards of care. B By not first assessing the woman, the nurse does not meet the established standards of care. C The nurse could be found negligent. D The nurse is responsible for assessing the woman. PTS: 1 DIF: Cognitive Level: Application REF: p. 18 OBJ: Nursing Process: Evaluation MSC: Client Needs: Health Promotion and Maintenance 15. Which patient situation fails to meet the first requirement of informed consent? a. The patient does not understand the physician’s explanations. b. The physician gives the patient only a partial list of possible side effects and complications. c. The patient is confused and disoriented. d. The patient signs a consent form because her husband tells her to. ANS: C Feedback A Understanding is an important element of the consent, but first the patient has to be competent to sign. B Full disclosure of information is an important element of the consent, but first the patient has to be competent to sign. C The first requirement of informed consent is that the patient must be competent to make decisions about health care. D Voluntary consent is an important element of the consent, but first the patient has to be competent to sign. PTS: 1 DIF: Cognitive Level: Comprehension REF: p. 19 OBJ: Nursing Process: Assessment MSC: Client Needs: Safe and Effective Care Environment 16. Which situation reflects a potential ethical dilemma for the nurse? a. A nurse administers analgesics to a patient with cancer as often as the physician’s order allows. b. A neonatal nurse provides nourishment and care to a newborn who has a defect that is incompatible with life. c. A labor nurse, whose religion opposes abortion, is asked to assist with an elective abortion. d. A postpartum nurse provides information about adoption to a new mother who feels she cannot adequately care for her infant. ANS: C Feedback A There is no element of conflict for the nurse; therefore a dilemma does not exist. B There is no element of conflict for the nurse; therefore a dilemma does not exist. C A dilemma exists in this situation because the nurse is being asked to assist with a procedure that she or he believes is morally wrong. The other situations do not contain elements of conflict for the nurse. D There is no element of conflict for the nurse; therefore a dilemma does not exist. PTS: 1 DIF: Cognitive Level: Analysis REF: p. 12 OBJ: Nursing Process: Assessment MSC: Client Needs: Safe and Effective Care Environment 17. When planning a parenting class, the nurse should explain that the leading cause of death in children 1 to 4 years of age in the United States is: a. Premature birth b. Congenital anomalies c. Accidental death d. Respiratory tract illness ANS: C Feedback A Disorders of short gestation and unspecified low birth weight make up one of the leading causes of death in neonates. B One of the leading causes of infant death after the first month of life is congenital anomalies. C Accidents are the leading cause of death in children ages 1 to 19 years. D Respiratory tract illnesses are a major cause of morbidity in children. PTS: 1 DIF: Cognitive Level: Application REF: p. 11 OBJ: Nursing Process: Implementation MSC: Client Needs: Safe and Effective Care Environment 18. A nurse assigned to a child does not know how to perform a treatment that has been prescribed for the child. What should the nurse’s first action be? a. Delay the treatment until another nurse can do it. b. Make the child’s parents aware of the situation. c. Inform the nursing supervisor of the problem. d. Arrange to have the child transferred to another unit. ANS: C Feedback A The nurse could endanger the child by delaying the intervention until another nurse is available. B Telling the child’s parents would most likely increase their anxiety and will not resolve the difficulty. C If a nurse is not competent to perform a particular nursing task, the nurse must immediately communicate this fact to the nursing supervisor or physician. D Transfer to another unit delays needed treatment and would create unnecessary disruption for the child and family. PTS: 1 DIF: Cognitive Level: Application REF: p. 18 OBJ: Nursing Process: Implementation MSC: Client Needs: Safe and Effective Care Environment 19. The mother of a 5-year-old female inpatient on the pediatric unit asks the nurse if she could provide information regarding the recommended amount of television viewing time for her daughter. The nurse responds that the appropriate amount of time a child should be watching television is: a. 1-2 hours per day b. 2-3 hours per day c. 3-4 hours per day d. 4 hours or more ANS: A Feedback A The American Academy of Pediatrics (AAP, 2009) encourages all parents to monitor their children’s media exposure and limit screen time to no more than 1 to 2 hours per day. The AAP also recommends that parents remove televisions and computers from their children’s bedrooms and monitor programs that have sexual or violent content. B Two hours per day is the outer limit of media exposure according to the AAP. C Three to four hours per day is too much television per the AAP guidelines. In this situation, parents need to more carefully monitor the amount of television viewing time. D Watching television for 4 hours or more is an excessive amount of screen time per the AAP guidelines. In this situation, parents need to more carefully monitor the amount of television viewing time. PTS: 1 DIF: Cognitive Level: Knowledge REF: p. 17 OBJ: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance 20. Family-centered care (FCC) describes safe, quality care that recognizes and adapts to both the physical and psychosocial needs of the family. Which nursing practice coincides with the principles of FCC? a. The newborn is returned to the nursery at night so that the mother can receive adequate rest before discharge. b. The father is encouraged to go home after the baby is delivered. c. All patients are routinely placed on the fetal monitor. d. The nurse’s assignment includes both mom and baby and increases the nurse’s responsibility for education. ANS: D Feedback A In this model the infant usually stays with the mother in the labor/deliver/recovery (LDR) room throughout her hospital stay. B The father or other primary support person is encouraged to stay with the mother and infant, and many facilities provide beds so that they can remain through the night. C In this model the nurse uses selective technology rather than routine procedures. This includes electronic fetal monitoring and IV therapy. D Family-centered care increases the responsibilities of nurses. In addition to the physical care provided, nurses assume a major role in teaching, counseling, and supporting families. PTS: 1 DIF: Cognitive Level: Comprehension REF: p. 5 OBJ: Nursing Process: Implementation MSC: Client Needs: Safe and Effective Care Environment 21. Home nursing care has experienced dramatic growth since 1990. The nurse who works in this setting must function independently within established protocols. Which statement related to nursing care of the child at home is most correct? a. The technology-dependent infant can safely be cared for at home. b. Home care increases readmissions to the hospital for a child with chronic conditions. c. There is increased stress for the family when a sick child is being cared for at home. d. The family of the child with a chronic condition is likely to be separated from their support system if the child is cared for at home. ANS: A Feedback A Greater numbers of technology-dependent infants and children are now cared for at home. The numbers include those needing ventilator assistance, total parenteral nutrition, IV medications, apnea monitoring, and other device-assisted nursing care. B Optimal home care can reduce the rate of readmission to the hospital for children with chronic conditions. C Consumers often prefer home care because of the decreased stress on the family when the patient is able to remain at home. D When the child is cared for at home the family is less likely to be separated from their support system because of the need for hospitalization. PTS: 1 DIF: Cognitive Level: Comprehension REF: p. 8 OBJ: Nursing Process: Planning MSC: Client Needs: Safe and Effective Care Environment 22. Maternity nursing care that is based on knowledge gained through research and clinical trials is known as: a. Nurse sensitive indicators b. Evidence-based practice c. Case management d. Outcomes management ANS: B Feedback A Nurse sensitive indicators are patient care outcomes particularly dependent on the quality and quantity of nursing care provided. B Evidence-based practice is based on knowledge gained from research and clinical trials. C Case management is a practice model that uses a systematic approach to identify specific patients, determine eligibility for care, and arrange access to services. D The determination to lower health care costs while maintaining the quality of care has led to a clinical practice model known as outcomes management. PTS: 1 DIF: Cognitive Level: Comprehension REF: p. 7 OBJ: Nursing Process: Diagnosis MSC: Client Needs: Safe and Effective Care Environment 23. The level of practice a reasonably prudent nurse provides is called: a. The standard of care b. Risk management c. A sentinel event d. Failure to rescue ANS: A Feedback A Guidelines for standards of care are published by various professional nursing organizations. The standard of care for neonatal nurses is set by the Association of Women’s Health, Obstetric, and Neonatal Nurses (AWHONN). The Society of Pediatric Nurses is the primary specialty organization that sets standards for the pediatric nurse. B Risk management identifies risks and establishes preventive practices, but it does not define the standard of care. C Sentinel events are unexpected negative occurrences. They do not establish the standard of care. D Failure to rescue is an evaluative process for nursing, but it does not define the standard of care. PTS: 1 DIF: Cognitive Level: Knowledge REF: p. 18 OBJ: Nursing Process: Implementation MSC: Client Needs: Safe and Effective Care Environment MULTIPLE RESPONSE 1. Many communities now offer the availability of free-standing birth centers to provide care for low-risk women during pregnancy, birth, and postpartum. When counseling the newly pregnant woman regarding this option, the nurse should be aware that this type of care setting includes which advantages? Select all that apply. a. Less expensive than acute-care hospitals b. Access to follow-up care for 6 weeks postpartum c. Equipped for obstetric emergencies d. Safe, home-like births in a familiar setting e. Staffing by lay midwives ANS: A, B, D Feedback Correct Women who are at low risk and desire a safe, home-like birth are very satisfied with this type of care setting. The new mother may return to the birth center for postpartum follow-up care, breastfeeding assistance, and family planning information for 6 weeks postpartum. Because birth centers do not incorporate advanced technologies into their services, costs are significantly less than those for a hospital setting. Incorrect The major disadvantage of this care setting is that these facilities are not equipped to handle obstetric emergencies. Should unforeseen difficulties occur, the woman must be transported by ambulance to the nearest hospital. Birth centers are usually staffed by certified nurse-midwives (CNMs); however, in some states lay midwives may provide this service. PTS: 1 DIF: Cognitive Level: Comprehension REF: p. 4 OBJ: Nursing Process: Planning MSC: Client Needs: Safe and Effective Care Environment 2. In an effort to reduce prohibitive health care costs, many facilities have incorporated the use of unlicensed assistive personnel into their care delivery model. Nurses supervising these employees must be aware of what each such employee is competent to do within his or her scope of practice. Which tasks can be delegated with supervision? Select all that apply. a. Blood draws b. Medication administration c. Nursing assessment d. Housekeeping tasks e. Other diagnostic tests, such as electrocardiograms (ECGs or EKGs) ANS: A, B, D, E Feedback Correct With proper supervision and adequate instruction, unlicensed assistive personnel may perform all of these functions. In school settings, these personnel may be responsible for medication administration under the direction of the registered nurse (RN). Incorrect The nurse is always responsible for patient assessments and must make critical judgments to ensure patient safety. Use of the expert nurse to complete housekeeping or other mundane tasks is not a good use of human resources. For more information about the use of unlicensed personnel, refer to . PTS: 1 DIF: Cognitive Level: Application REF: p. 22 OBJ: Nursing Process: Implementation MSC: Client Needs: Safe and Effective Care Environment TRUE/FALSE 1. In late 2010, the US Department of Health and Human Services launched a comprehensive, nationwide health promotion and disease prevention program. This program is well known as Healthy People 2010. Is this statement true or false? ANS: F The program launched in late 2010 was Healthy People 2020. This was developed with input from widely diverse constituents. Healthy People 2020 expands on goals developed for Healthy People 2010. These include reducing health disparities and increasing access to health care. Two additional objectives are specifically directed to the health of children and adolescents. PTS: 1 DIF: Cognitive Level: Knowledge REF: p. 5 OBJ: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance Chapter 2: The Nurse’s Role in Maternity, Women’s Health, and Pediatric Nursing Test Bank MULTIPLE CHOICE 1. Which principle of teaching should the nurse use to ensure learning in a family situation? a. Motivate the family with praise and positive reinforcement. b. Present complex subject material first, while the family is alert and ready to learn. c. Families should be taught by using medical jargon so they will be able to understand the technical language used by physicians. d. Learning is best accomplished using the lecture format. ANS: A Feedback A Praise and positive reinforcement are particularly important when a family is trying to master a frustrating task, such as breastfeeding. B Learning is enhanced when the teaching is structured to present the simple tasks before the complex material. C Even though a family may understand English fairly well, they may not understand the medical terminology or slang terms. D A lively discussion stimulates more learning than a straight lecture, which tends to inhibit questions. PTS: 1 DIF: Cognitive Level: Application REF: p. 28 OBJ: Nursing Process: Planning MSC: Client Needs: Health Promotion and Maintenance 2. When addressing the questions of a newly pregnant woman, the nurse can explain that the certified nurse-midwife is qualified to perform: a. Regional anesthesia b. Cesarean deliveries c. Vaginal deliveries d. Internal versions ANS: C Feedback A Regional anesthesia must be performed by a physician. B Cesarean deliveries must be performed by a physician. C The nurse-midwife is qualified to deliver infants vaginally in uncomplicated pregnancies. D Internal versions must be performed by a physician. PTS: 1 DIF: Cognitive Level: Knowledge REF: p. 29 OBJ: Nursing Process: Assessment MSC: Client Needs: Safe and Effective Care Environment 3. Which nursing intervention is an independent function of the nurse? a. Administering oral analgesics b. Teaching the woman perineal care c. Requesting diagnostic studies d. Providing wound care to a surgical incision ANS: B Feedback A Administering oral analgesics is a dependent function; it is initiated by a physician and carried out by the nurse. B 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. C Requesting diagnostic studies is a dependent function. D Providing wound care is a dependent function; it is usually initiated by the physician through direct orders or protocol. PTS: 1 DIF: Cognitive Level: Comprehension REF: p. 27 OBJ: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance 4. Which response by the nurse to the woman’s statement, “I’m afraid to have a cesarean birth,” would be the most therapeutic? a. “What concerns you most about a cesarean birth?” b. “Everything will be OK.” c. “Don’t worry about it. It will be over soon.” d. “The doctor will be in later, and you can talk to him.” ANS: A Feedback A Focusing on what the woman is saying and asking for clarification is the most therapeutic response. B This response belittles the woman’s feelings. C This response will indicate that the woman’s feelings are not important. D This response does not allow the woman to verbalize her feelings when she desires. PTS: 1 DIF: Cognitive Level: Application REF: pp. 30-31 OBJ: Nursing Process: Implementation MSC: Client Needs: Psychosocial Integrity 5. To evaluate the woman’s learning about performing infant care, the nurse should: a. Demonstrate infant care procedures. b. Allow the woman to verbalize the procedure. c. Observe the woman as she performs the procedure. d. Routinely assess the infant for cleanliness. ANS: C Feedback A Demonstration is an excellent teaching method, but not an evaluation method. B During verbalization of the procedure, the nurse may not pick up on techniques that are incorrect. It is not the best tool for evaluation. C The woman’s ability to perform the procedure correctly under the nurse’s supervision is the best method of evaluation. D This will not ensure that the proper procedure is carried out. The nurse may miss seeing unsafe techniques being used. PTS: 1 DIF: Cognitive Level: Application REF: p. 35 OBJ: Nursing Process: Evaluation MSC: Client Needs: Health Promotion and Maintenance 6. What situation is most conducive to learning? a. A teacher who speaks very little Spanish is teaching a class of Latino students. b. A class is composed of students of various ages and educational backgrounds. c. An auditorium is being used as a classroom for 300 students. d. An Asian nurse provides nutritional information to a group of pregnant Asian women. ANS: D Feedback A The ability to understand the language in which teaching is done determines how much the patient learns. Patients for whom English is not their primary language may not understand idioms, nuances, slang terms, informal usage of words, or medical words. The teacher should be fluent in the language of the student. B Developmental levels and educational levels influence how a person learns best. In order for the teacher to best present information, it is best for the class to be of the same levels. C A large class is not conducive to learning. It does not allow for questions, and the teacher is not able to see the nonverbal cues from the students to ensure understanding. D A patient’s culture influences the learning process; thus a situation that is most conducive to learning is one in which the teacher has knowledge and understanding of the patient’s cultural beliefs. PTS: 1 DIF: Cognitive Level: Application REF: p. 28 OBJ: Nursing Process: Planning MSC: Client Needs: Psychosocial Integrity 7. What is the primary role of practicing nurses in the research process? a. Designing research studies b. Collecting data for other researchers c. Identifying researchable problems d. Seeking funding to support research studies ANS: C Feedback A Designing research studies is only one factor of the research process. B Data collection is one factor of research. C Nursing generates and answers its own questions based on evidence within its unique subject area. D Financial support is necessary to conduct research, but it is not the primary role of the nurse in the research process. PTS: 1 DIF: Cognitive Level: Comprehension REF: p. 29 OBJ: Nursing Process: Diagnosis and Evaluation MSC: Client Needs: Safe and Effective Care Environment 8. The step of the nursing process in which the nurse determines the appropriate interventions for the identified nursing diagnosis is called: a. Assessment b. Planning c. Intervention d. Evaluation ANS: B Feedback A During the assessment phase, data are collected. B The third step in the nursing process involves planning care for problems that were identified during assessment. C The intervention phase is when the plan of care is carried out. D The evaluation phase is determining whether the goals have been met. PTS: 1 DIF: Cognitive Level: Knowledge REF: p. 35 OBJ: Nursing Process: Planning MSC: Client Needs: Safe and Effective Care Environment 9. Which goal is most appropriate for the collaborative problem of wound infection? a. The patient will have a temperature of 98.6° F within 2 days. b. The patient’s fluid intake will be maintained at 1000 mL per 8 hours. c. The patient will not exhibit further signs of infection. d. The patient will be monitored to detect therapeutic response to antibiotic therapy. ANS: D Feedback A Monitoring a patient’s temperature is an independent nursing role. B Intake and output is an independent nursing role. C Monitoring for complications is an independent nursing role. D In a collaborative problem, the goal should be nurse oriented and reflect the nursing interventions of monitoring or observing. In collaborative problems, other team members are involved for other duties, such as prescribing antibiotics. PTS: 1 DIF: Cognitive Level: Comprehension REF: p. 28 OBJ: Nursing Process: Planning MSC: Client Needs: Safe and Effective Care Environment 10. Which nursing intervention is correctly written? a. Encourage turning, coughing, and deep breathing. b. Force fluids as necessary. c. Assist to ambulate for 10 minutes at 8 AM, 2 PM, and 6 PM. d. Observe interaction with infant. ANS: C Feedback A This intervention does not state how often this procedure should be done. B “Force fluids” is not specific; it does not state how much. C Interventions may not be carried out unless they are detailed and specific. D This intervention is not detailed and specific. PTS: 1 DIF: Cognitive Level: Comprehension REF: p. 35 OBJ: Nursing Process: Planning MSC: Client Needs: Safe and Effective Care Environment 11. What part of the nursing process includes the collection of data on vital signs, allergies, sleep patterns, and feeding behaviors? a. Assessment b. Planning c. Intervention d. Evaluation ANS: A Feedback A Assessment is the gathering of baseline data. B Planning is based on baseline data and physical assessment. C Implementation is the initiation and completion of nursing interventions. D Evaluation is the last step in the nursing process and involves determining whether the goals were met. PTS: 1 DIF: Cognitive Level: Comprehension REF: p. 33 OBJ: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance 12. The nurse who coordinates and manages a patient’s care with other members of the health care team is functioning in the role of: a. Teacher b. Collaborator c. Researcher d. Advocate ANS: B Feedback A Education is an essential role of today’s nurse. The nurse functions as a teacher during prenatal care, during maternity care, and when teaching parents of children regarding normal growth and development. B The nurse collaborates with other members of the health care team, often coordinating and managing the patient’s care. Care is improved by this interdisciplinary approach as nurses work together with dietitians, social workers, physicians, and others. C Nurses contribute to their profession’s knowledge base by systematically investigating theoretic for practice issues and nursing. D A nursing advocate is one who speaks on behalf of another. As the health professional who is closest to the patient, the nurse is in an ideal position to humanize care and to intercede on the patient’s behalf. PTS: 1 DIF: Cognitive Level: Comprehension REF: pp. 28-29 OBJ: Nursing Process: Planning MSC: Client Needs: Safe and Effective Care Environment 13. Alternative and complementary therapies: a. Replace conventional Western modalities of treatment b. Are used by only a small number of American adults c. Allow for more patient autonomy d. Focus primarily on the disease an individual is experiencing ANS: C Feedback A Alternative and complementary therapies are part of an integrative approach to health care. B An increasing number of American adults are seeking alternative and complementary health care options. C Many popular alternative healing modalities offer human-centered care based on philosophies that recognize the value of the patient’s input and honor the individual’s beliefs, values, and desires. D Alternative healing modalities offer a holistic approach to health, focusing on the whole person and not just the disease. PTS: 1 DIF: Cognitive Level: Comprehension REF: p. 36 OBJ: Nursing Process: Planning MSC: Client Needs: Physiologic Integrity 14. Which step in the nursing process identifies the basis or cause of the patient’s problem? a. Intervention b. Expected outcome c. Nursing diagnosis d. Evaluation ANS: C Feedback A Interventions are actions taken to meet the problem. B Expected outcome is a statement of the goal. C A nursing diagnosis states the problem and its cause (“related to”). D Evaluation determines whether the goal has been met. PTS: 1 DIF: Cognitive Level: Knowledge REF: p. 34 OBJ: Nursing Process: Planning MSC: Client Needs: Safe and Effective Care Environment MULTIPLE RESPONSE 1. Today’s nurse often assumes the role of teacher or educator. Patient teaching begins early in the childbirth process and continues throughout the postpartum period. Which strategies would be best to use for a nurse working with a teen mother? Select all that apply. a. Computer-based learning b. Videos c. Printed material d. Group discussion e. Models ANS: A, B, C, D, E Feedback Correct A number of factors influence learning at any age. One of the most significant considerations is developmental level. Teenage parents often have very different concerns and learn in a different way than older parents. Often grandparents are also involved in the rearing of these children and must be able to review and understand the material. There is a wealth of new information that may not have been available when they became parents. Incorrect All answers are correct. PTS: 1 DIF: Cognitive Level: Application REF: p. 28 OBJ: Nursing Process: Implementation MSC: Client Needs: Health Promotion and Maintenance 2. Optimal patient care relies on the nurse’s expertise and clinical judgment; however, critical thinking (a component of nursing judgment) underlies the nursing process. The nurse who uses critical thinking understands that the steps of critical thinking include (select all that apply) a. Therapeutic communication b. Examining biases c. Setting priorities d. Managing data e. Evaluating other factors ANS: B, D, E Feedback Correct The 5 steps of critical thinking include: recognizing assumptions, examining biases, analyzing the need for closure, managing data, and evaluating other factors. Incorrect Therapeutic communication is a skill that nurses must have to carry out the many roles expected with in the profession; however, it is not one of the steps of critical thinking. Setting priorities is part of the planning phase of the nursing process. PTS: 1 DIF: Cognitive Level: Application REF: p. 33 OBJ: Nursing Process: Planning and Implementation MSC: Client Needs: Safe and Effective Care Environment COMPLETION 1. Interventions, modalities, professions, theories, applications, or practices that are not currently part of the conventional medical system in North American culture are often referred to as and medicine. ANS: complementary, alternative For many people such therapies are not considered alternative, because they are mainstream in their culture. Others combine them with traditional medical practices, thereby using an integrative approach. A continued concern is patient safety. Some patients who use these techniques may delay necessary care, and others may take herbal or other remedies that might become toxic when used in combination with prescription drugs or when taken in excess. PTS: 1 DIF: Cognitive Level: Comprehension REF: p. 35 OBJ: Nursing Process: Assessment MSC: Client Needs: Physiologic Integrity Chapter 3: The Childbearing and Child-Rearing Family Test Bank MULTIPLE CHOICE 1. The formula used to guide time-out as a disciplinary method is a. 1 minute per each year of the child’s age b. To relate the length of the time-out to the severity of the behavior c. Never to use time-out for a child younger than 4 years d. To follow the time-out with a treat ANS: A Feedback A It is important to structure time-out in a time frame that allows the child to understand why he or she has been removed from the environment. B Relating time to a behavior is subjective and is inappropriate when the child is very young. C Time-out can be used with the toddler. D Negative behavior should not be reinforced with a positive action. PTS: 1 DIF: Cognitive Level: Knowledge REF: p. 50 OBJ: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance 2. The nurse observes that when an 8-year-old boy enters the playroom, he often causes disruption by taking toys from other children. The nurse’s best approach for this behavior is to a. Ban the child from the playroom. b. Explain to the children in the playroom that he is very ill and should be allowed to have the toys. c. Approach the child in his room and ask, “Would you like it if the other children took your toys from you?” d. Approach the child in his room and state, “I am concerned that you are taking the other children’s toys. It upsets them and me.” ANS: D Feedback A Banning the child from the playroom will not solve the problem. The problem is his behavior, not the place where he exhibits it. B Illness is not a reason for a child to be undisciplined. When the child recovers, the parents will have to deal with a child who is undisciplined and unruly. C Children should not be made to feel guilty and to have their self-esteem attacked. D By the nurse’s using “I” rather than the “you” message, the child can focus on the behavior. The child and the nurse can begin to explore why the behavior occurs. PTS: 1 DIF: Cognitive Level: Application REF: p. 50 OBJ: Nursing Process: Planning MSC: Client Needs: Health Promotion and Maintenance 3. Families who deal effectively with stress exhibit which behavior pattern? a. Focus on family problems b. Feel weakened by stress c. Expect that some stress is normal d. Feel guilty when stress exists ANS: C Feedback A Healthy families focus on family strengths rather than on the problems and know that stress is temporary and may be positive. B If families are dealing effectively with stress, then weakening of the family unit should not occur. C Healthy families recognize that some stress is normal in all families. D Because some stress is normal in all families, feeling guilty is not reasonable. Guilt only immobilizes the family and does not lead to resolution of the stress. PTS: 1 DIF: Cognitive Level: Comprehension REF: p. 42 OBJ: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity 4. Which family will most likely have the most difficulty coping with an ill child? a. A single-parent mother who has the support of her parents and siblings b. Parents who have just moved to the area and are living in an apartment while they look for a house c. The family of a child who has had multiple hospitalizations related to asthma and has adequate relationships with the nursing staff d. A family in which there is a young child and four older married children who live in the area ANS: B Feedback A Although only one parent is available, she has the support of her extended family, which will assist her in adjusting to the crisis. B Parents in a new environment will have increased stress related to their lack of a support system. They have no previous experiences in the setting from which to draw confidence. C Because this family has had positive experiences in the past, family members can draw from those experiences and feel confident about the setting. D This family has an extensive support system that will assist the parents in adjusting to the crisis. PTS: 1 DIF: Cognitive Level: Comprehension REF: p. 42 | Box 3-1 OBJ: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity 5. A nurse determines that a child consistently displays predictable behavior and is regular in performing daily habits. Which temperament is the child displaying? a. Easy b. Slow-to-warm-up c. Difficult d. Shy ANS: A Feedback A Children with an easy temperament are even tempered, predictable, and regular in their habits. They react positively to new stimuli. B The slow-to-warm-up temperament type prefers to be inactive and moody. C A high activity level and adapting slowly to new stimuli are characteristics of a difficult temperament. D Shyness is a personality type and not a characteristic of temperament. PTS: 1 DIF: Cognitive Level: Analysis REF: p. 49 OBJ: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity 6. The parent of a child who has had numerous hospitalizations asks the nurse for advice because her child has been having behavior problems at home and in school. In discussing effective discipline, what is an essential component? a. All children display some degree of acting out and this behavior is normal. b. The child is manipulative and should have firmer limits set on her behavior. c. Positive reinforcement and encouragement should be used to promote cooperation and the desired behaviors. d. Underlying reasons for rules should be given and the child should be allowed to decide which rules should be followed. ANS: C Feedback A Behavior problems should not be disregarded as normal. B It would be incorrect to assume the child is being manipulative and should have firmer limits set on her behaviors. C Using positive reinforcement and encouragement to promote cooperation and desired behaviors is one of the three essential components of effective discipline. D Providing the underlying reasons for rules and giving the child a choice concerning which rules to follow constitute a component of permissive parenting and are not considered an essential component of effective discipline. PTS: 1 DIF: Cognitive Level: Comprehension REF: p. 49 OBJ: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity 7. What characteristic would most likely be found in a Mexican-American family? a. Stoicism b. Close extended family c. Considering docile children weak d. Very interested in health-promoting lifestyles ANS: B Feedback A Although stoicism may be present in any family, Mexican-American families tend to be more expressive. B Most Mexican-American families are very close, and it is not unusual for children to be surrounded by parents, siblings, grandparents, and godparents. It is important to respect this cultural characteristic and to see it as a strength, not a weakness. C Considering docile children weak is a characteristic of Native Americans. D Although everyone tends now to embrace more health-promoting lifestyles, they are more prominent in Anglo-Americans. PTS: 1 DIF: Cognitive Level: Knowledge REF: p. 46 OBJ: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity 8. While reviewing the dietary-intake documentation of a 7-year-old Asian boy with a fractured femur, the nurse notes that he consistently refuses to eat the food on his tray. What assumption is most likely accurate? a. He is a picky eater. b. He needs less food because he is on bed rest. c. He may have culturally related food preferences. d. He is probably eating between meals and spoiling his appetite. ANS: C Feedback A Although the child may be a picky eater, the key point is that he is from a different culture. The foods he is being served may seem strange to him. B Nutrition plays an important role in healing. Although the energy the child expends has decreased while on bed rest, he has increased needs for good nutrition. C When cultural differences are noted, food preferences should always be obtained. A child will often refuse to eat unfamiliar foods. D Although the nurse should determine whether the child is eating food the family has brought from home, the more important point is to determine whether he has food preferences. PTS: 1 DIF: Cognitive Level: Analysis REF: p. 46 OBJ: Nursing Process: Evaluation MSC: Client Needs: Physiologic Integrity 9. A nurse is caring for a child with the religion of Christian Science. What intervention should the nurse include in the care plan for this child? a. Offer iced tea to the child who is experiencing deficient fluid volume. b. Inform the spiritual care department that the child has been admitted to the hospital. c. Allow parents to sign a form opting out of routine immunizations. d. Ask parents whether the child has been baptized. ANS: C Feedback A Coffee and tea are declined as a drink. B When a Christian Science believer is hospitalized, a parent or patient may request that a Christian Science practitioner be notified as opposed to the hospital-assigned clergy. C Christian Science believers seek exemption from immunizations but obey legal requirements. D Baptism is not a ceremony for the Christian Science religion. PTS: 1 DIF: Cognitive Level: Application REF: p. 44 | Table 3-1 OBJ: Nursing Process: Implementation MSC: Client Needs: Psychosocial Integrity 10. To resolve family conflict, it is necessary to have open communication, accurate perception of the problem, and a(n) a. Intact family structure b. Arbitrator c. Willingness to consider the view of others d. Balance in personality types ANS: C Feedback A The structure of a family may affect family dynamics, but it is still possible to resolve conflict without an intact family structure if all of the ingredients of conflict resolution are present. B Conflicts can be resolved without the assistance of an arbitrator. C Without the willingness of the members of a group to consider the views of others, conflict resolution cannot take place. D Most families have diverse personality types among their members. This diversity may make conflict resolution more difficult but should not impede it as long as the ingredients of conflict resolution are present. PTS: 1 DIF: Cognitive Level: Comprehension REF: p. 42 OBJ: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity 11. Which statement is true about the characteristics of a healthy family? a. The parents and children have rigid assignments for all the family tasks. b. Young families assume the total responsibility for the parenting tasks, refusing any assistance. c. The family is overwhelmed by the significant changes that occur as a result of childbirth. d. Adults agree on the majority of basic parenting principles. ANS: D Feedback A Healthy families remain flexible in their role assignments. B Members of a healthy family accept assistance without feeling guilty. C Healthy families can tolerate irregular sleep and meal schedules, which are common during the months after childbirth. D Adults in a healthy family communicate with each other so that minimal discord occurs in areas such as discipline and sleep schedules. PTS: 1 DIF: Cognitive Level: Knowledge REF: p. 41 OBJ: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity 12. A nurse observes that parents discuss rules with their children when the children do not agree with the rules. Which style of parenting is being displayed? a. Authoritarian b. Authoritative c. Permissive d. Disciplinarian ANS: B Feedback A A parent who expects children to follow rules without questioning is using an authoritarian parenting style. B A parent who discusses the rules with which children do not agree is using an authoritative parenting style. C A parent who does not consistently enforce rules and allows the child to decide whether he or she wishes to follow rules is using a permissive parenting style. D A disciplinarian style would be similar to the authoritarian style. PTS: 1 DIF: Cognitive Level: Analysis REF: p. 48 OBJ: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity 13. What should the nurse expect to be problematic for a family whose religious affiliation is Jehovah’s Witness? a. Immunizations b. Autopsy c. Organ donation d. Blood transfusion ANS: D Feedback A Christian Science believers may seek exemption from immunizations. B Believers in Islam are opposed to organ donation. C Jehovah’s Witness believers can make individual decisions about autopsy. D Jehovah’s Witness believers are opposed to blood transfusions. They may accept alternatives to transfusions, such as non-blood plasma expanders. PTS: 1 DIF: Cognitive Level: Comprehension REF: p. 44 | Table 3-1 OBJ: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity 14. A traditional family structure in which male and female partners and their children live as an independent unit is known as a(n) family. a. Extended b. Binuclear c. Nuclear d. Blended ANS: C Feedback A Extended families include other blood relatives in addition to the parents. B A binuclear family involves two households. C Approximately two thirds of U.S. households meet the definition of a nuclear family. This is also known as the traditional family. D A blended family is reconstructed after divorce and involves the merger of two families. PTS: 1 DIF: Cognitive Level: Knowledge REF: p. 39 OBJ: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity 15. A pictorial tool that can assist the nurse in assessing aspects of family life related to health care is the a. Genogram b. Ecomap c. Life cycle model d. Human development wheel ANS: B Feedback A A genogram (also known as a pedigree) is a diagram that depicts the relationships of family members over generations. B An ecomap is a pictorial representation of the family structures and their relationships with the external environment. C The life cycle model in no way illustrates a family genogram. This model focuses on stages that a person reaches throughout his or her life. D The human development wheel describes various stages of growth and development rather than a family’s relationships to each other. PTS: 1 DIF: Cognitive Level: Knowledge REF: p. 51 OBJ: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity 16. According to Friedman’s classifications, providing such physical necessities as food, clothing, and shelter is the family function. a. Economic b. Socialization c. Reproductive d. Health care ANS: D Feedback A The economic function provides resources but is not concerned with health care and other basic necessities. B The socialization function teaches the child cultural values. C The reproductive function is concerned with ensuring family continuity. D Physical necessities such as food, clothing, and shelter are considered part of health care. PTS: 1 DIF: Cognitive Level: Application REF: p. 51 OBJ: Nursing Process: Assessment MSC: Client Needs: Physiologic Integrity 17. In general, healthy families are able to adapt to changes within the family unit; however, some factors add to the usual stress experienced by any family. The nurse is in a unique position to assess the child for symptoms of neglect. Which high-risk family situation places the child at the greatest risk for being neglected? a. Marital conflict and divorce b. Adolescent parenting c. Substance abuse d. A child with special needs ANS: C Feedback A Although divorce is traumatic to children, research has shown that living in a home filled with conflict is also detrimental. In this situation conflict may arise and young children may be unable to verbalize their distress; however, the child is not likely to be neglected. B Teenage parenting often has a negative effect on the health and social outcomes of the entire family. Adolescent girls are at risk for a number of pregnancy complications, are unlikely to attain a high level of education, and are more likely to be poor. C Parents who abuse drugs or alcohol may neglect their children because obtaining and using the substance(s) may have a stronger pull on the parents than the care of their children. D When a child is born with a birth defect or has an illness that requires special care, the family is under additional stress. These families often suffer financial hardship as health insurance benefits quickly reach their maximum. PTS: 1 DIF: Cognitive Level: Analysis REF: pp. 41-42 OBJ: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance 18. More than 100 different ethno-cultural groups reside within the United States, and numerous traditional health beliefs are observed among these groups. Traditional beliefs related to the maintenance of health are likely to include a. Avoidance of natural events such as a solar eclipse b. Practicing silence, meditation, and prayer c. Protection of the soul by avoiding envy or jealousy d. Understanding that a hex, spell, or the evil eye may cause illness or injury ANS: B Feedback A Illness can be prevented by avoiding natural events such as a solar eclipse along with environmental factors such as bad air. B Mental and spiritual health is maintained by activities such as silence, meditation, and prayer. Many people view illness as punishment for breaking their religious code and adhere strictly to morals and religious practices to maintain health. C Phenomena such as accidental provocation of envy, jealousy, or hate of a friend or acquaintance may cause illness. D Agent such as hexes, spells, and the evil eye may strike a person (often a child) and causes injury, illness, or misfortunate. PTS: 1 DIF: Cognitive Level: Comprehension REF: p. 47 OBJ: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance MULTIPLE RESPONSE 1. The consequences technique will assist children to learn the direct result of their behavior. This technique can be used with children from toddler age to adolescence. If children learn to understand consequences, they are less likely to repeat the offending behavior. Consequences fall into which categories? Select all that apply. a. Corporal b. Natural c. Logical d. Unrelated e. Behavioral ANS: B, C, D Feedback Correct Natural consequences are those that occur spontaneously. For example, a child leaves a toy outside and it is lost. Logical consequences are those that are directly related to the misbehavior. If two children are fighting over a toy, the toy is removed and neither child has it. Unrelated consequences are purposely imposed; for example, the child is late for dinner so he or she is not allowed to watch television. Incorrect Corporal punishment is not part of this behavioral approach and usually takes the approach of spanking the child. Corporal punishment is highly controversial and is strongly discouraged by the American Academy of Pediatrics. Behavior modification is another disciplinary technique that rewards positive behavior and ignores negative behavior. PTS: 1 DIF: Cognitive Level: Comprehension REF: p. 50 OBJ: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity 2. The nurse is caring for a child from a Middle Eastern family. Which interventions should the nurse include in planning care? Select all that apply. a. Include the father in the decision making. b. Ask for a dietary consult to maintain religious dietary practices. c. Plan for a male nurse to care for a female patient. d. Ask the housekeeping staff to interpret if needed. e. Allow time for prayer. ANS: A, B, E Feedback Correct The man is typically the head of the household in Muslim families. So the father should be included in all decision making. Muslims do not eat pork and do not use alcohol. Many are vegetarians. The dietitian should be consulted for dietary preferences. Compulsory prayer is practiced several times throughout the day. The family should not be interrupted during prayer, and treatments should not be scheduled during this time. Incorrect Muslim women often prefer a female health care provider because of laws of modesty; therefore, the female patient should not be assigned a male nurse. A housekeeping staff member should not be asked to interpret. When interpreters are used, they should be of the same country and religion, if possible, because of regional differences and hostilities. PTS: 1 DIF: Cognitive Level: Application REF: pp. 45-46 | Table 3-1 OBJ: Nursing Process: Implementation MSC: Client Needs: Psychosocial Integrity COMPLETION 1. A family is one formed when single, divorced, or widowed parents bring children from a previous union into the new relationship. ANS: blended These families must overcome differences in parenting styles and values to form a cohesive blended family. Often they wish to have children with each other in the new relationship. Differing expectations of the children’s development and beliefs regarding discipline may lead to conflict. Older children often resent the introduction of a stepmother or stepfather. PTS: 1 DIF: Cognitive Level: Comprehension REF: p. 39 OBJ: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity 2. refers to the view that one’s own culture’s way of doing things is always the best. ANS: Ethnocentrism Rationale: Although the United States is a culturally diverse nation, the prevailing practice of health care is based on the beliefs held by members of the dominant culture, primarily Caucasians of European descent. Cultural relativism is the opposite of ethnocentrism. It refers to learning about and applying the standards of another’s culture. PTS: 1 DIF: Cognitive Level: Knowled