Gynecologic Health Care- With an Introduction to Prenatal and Postpartum Care 4th EditionTest Bank 2023 Update

Gynecologic Health Care- With an Introduction to Prenatal and Postpartum Care 4th EditionTest Bank 2023 Update Chapter 1 A Feminist Perspective of Women's Health & Chapter 2 Racism and Health Disparities MULTIPLE-CHOICE QUESTIONS Select the one correct answer to each of the following questions. • Which of the following best defines the term “gender” as used in this text? • A person’s sex • A person’s sex as defined by society • A societal response to a person’s self-representation as a man or woman • A person’s biological presentation as defined by himself or herself • Which factor bears most on women’s health care today? • The complexity of women’s health • Women’s status and position in society • Population growth • The economy • Why is acknowledging the oppression of women more difficult within Western societies? • The multiplicity of minority groups complicates the issue. • The availability of health care makes acknowledgment more difficult. • The diversity of the news media clouds the issue. • Affluence and increased opportunities mask oppression. • Which of the following most accurately defines “oppression” as used in the text? • Not having a choice • Not having a voice • An act of tyranny • A feeling of being burdened • In what way does a model of care based on a feminist perspective contrast sharplywith a biomedical model? • It provides a forum for the exploration of gender issues. • It seeks equal distribution of power within the healthcare interaction. • It emphasizes women’s rights. • It opens new avenues for women’s health care. • Gender is rooted in and shaped by . • society, biology • self-representation, societal expectations • biology, environment and experience • biology, hormones • Women’s health risks, treatments, and approaches are not always based in science and biology because • they are often based on outdated treatments and approaches. • they are determined by social expectations and gender assumptions. • they often rely on alternative treatments and approaches. • scientific research often fails to take women into consideration. • Reproductive rights were added to the World Health Organization’s human rights framework in the last ? • 5 years • 10 years • 20 years • 40 years • “Safe Motherhood” was added to the human rights framework in order to • address maternal morbidity and mortality on a global level • meet a legal obligation • correct an injustice • correct an oversight • What is a chief failing of the biomedical model in regards to women’s health care? • Its reliance on studies comprised exclusively of males • Its consideration of women as central the model • Its emphasis on science and medicine • Its limited definition of “health” as “the absence of disease” • The social model of health places the focus of health on • the community. • the individual. • environmental conditions. • scientific research. • Which question below supports the strategy: “Identify women’s agency in themidst of social constraint and the biomedical paradigm.”? • “Are ‘all women’ the same?” • “Why do you care about the issue?” • “Are women really victims or are they acting with agency?” • “Who has a choice within the context of health?” • What had been a significant problem in medical research well into the 1990s? • The focus on randomized clinical trials over epidemiological investigations • The lack of representation of women in research trials • The lack of research related to gynecology • The focus on randomized clinical trials over observational research • Gender differences in heart disease can be found in • diagnosis. • treatment. • identification of symptoms. • all of the above. • What opportunities are created by applying feminist strategies to gynecologic health? • Better insight into research methods related to gynecology • Better access to the populations affected by gynecologic health • Better understandings from a wellness-oriented, women-centered framework • Better understandings of the social construction of gender ANSWER KEY MULTIPLE-CHOICE QUESTIONS • c • b • d • a • b • c • b • c • a • d • a • c • b • d • c CHAPTER 2 Women's Growth and Development Across the Life Span MULTIPLE-CHOICE QUESTIONS Select the one correct answer to each of the following questions. • How does Erick Erikson’s grand theory of human development differ for females? • It recognizes achieving autonomy as a primary focus. • It assumes only men desire autonomy. • It assumes female dependence on another in order to achieve a sense of self. • It assumes females desire dependence on others. • What is true about human development theories published before the 1970s? • They are based on interviews conducted only with men. • They assume androcentric models can be applied correctly to women. • They frame women’s development as flawed in comparison to the standard. • All of the above. • What is the intention of the newer feminist models of development? • To offer a new model within the traditional biomedical focus. • To offer alternatives to the constrained and previously misapplied models. • To replace male generalist models with female generalist models. • To present a contrast to privileged, white male-based models. • What is a key limitation of prevailing developmental models for women? • Gender differences assumed to be biologically determined are more often socially constructed. • They present conflicting and misapplied models. • Gender differences are assumed to be socially prescribed. • Similarities between male and female are emphasized over differences. • What event in female development marks the beginning of a tension betweenbiologic changes and the social context? • Turning 18 years old • The onset of menses • The accumulation of adipose tissue with the onset of puberty • Pregnancy • How many stages does the Tanner scale use to stage sexual maturity? • 3 stages • 5 stages • 6 stages • 8 stages • What is the median age for the onset of menstruation for adolescent girls in theUnited States? a. 9.8 b. 10.8 c. 12.8 d. 13.8 • What factor limits an individual’s ability to function productively as an adult? • Failure to take into account social and cultural norms • The inability to move through the world with credibility and respect • Poverty • Failure to negotiate the developmental tasks of adolescence successfully • The type of thinking that influences the risk-taking behaviors of adolescence • involves the use of symbols, advanced reasoning and expanded possibilities. • works proactively to achieve autonomy. • encourages experimentation and foresight. • is rooted in the immediate and concrete. • What narrow term is often used to refer to the period of Early Adulthood? • Productive years • Reproductive years • Young Adulthood • Adolescence • Why have women’s changing roles come at a cost to their health? • Increases in caregiving expectations compromise health • Balancing competing demands increases stress • Less attention is being placed on health care • Men’s roles have not changed in relation to the change in women’s roles • How do Franz and White (1985) expand Erikson’s theory of development? • By proposing a two-pathway process that includes both individuationand capacity for attachment • By refining Erikson’s single pathway to include capacity for attachment • By expanding issues around career and lifestyle • By expanding issues around identity • What factors affect the mood changes many women in midlife suffer? • Deficiencies of estrogen • Psychological transitions • Cultural beliefs and expectations • All of the above • What is the primary reason many older women live in poverty and have health problems? • They outnumber older men. • They have outlived their support systems. • Their cognitive abilities decline. • They must contend with ageism and sexism. ANSWER KEY MULTIPLE-CHOICE QUESTIONS • c • d • b • a • c • b • c • d • a • b • b • a • d • b Chapter 3 Women's Growth and Development Across the Life Span MULTIPLE-CHOICE QUESTIONS Select the one correct answer to each of the following questions. • According to Wuest (1994), the major goal of feminist research is • to change the design and evaluation of research. • to liberate women from societal expectations. • to emancipate the world from systemic bias based on gender and class. • to expand notions of gender beyond stereotypes. • What concern prompted the initiation of the modern EBP movement in health care? • That clinicians often failed to evaluate the effectiveness of their own care • That expert opinion was valued over scientific evidence • That scientific evidence was valued over expert opinion • That patients were demanding more evidence to support care decisions • Quine’s (1952) concept of a web of interconnecting beliefs and knowledge supports • the inferiority of quantitative research. • a multiple-method approach to examining phenomena. • the superiority of qualitative research. • the difficulties of establishing best practices. • Why are multiple approaches needed to identify best clinical practices? • To reflect the multiple variables within clinical settings • To offer alternatives to poorly functioning practices • To address the complexity of the human condition • To ensure that no single approach dominates • What is the third part of the clinical decision-making triad that includes clinical experience and patient preference? • An investigation of treatment pathways • A consultation with clinical management • An evaluation of current clinical research • Establishing research methodology • How many classifications are used by the U.S. Preventative Service Task Force to gauge the strength of recommendations for using research evidence in clinicalpractice? • 3 • 5 • 6 • 8 • What are the corresponding clinical terms for Type I and Type II errors in quantitative research? • “false positive” and “false negative” • “negativity” and “positivity” • “bias I” and “bias II” • “evidence flaw” and “process flaw” • What key factor shapes the methodology of qualitative research? • A person’s view of the world • The ability to establish control over variables • The ability to establish cause and effect • A well-conducted meta-analysis • What is a difference between quantitative and qualitative research? • One follows strict protocols while the other does not. • One deduces the reason why something happens and the other induces why it happens. • One places greater emphasizes on the expansion of knowledge. • All of the above. • What field of study informs qualitative research? • Anthropology • Ecological psychology • Sociolinguistics • All of the above • Which research question most closely exemplifies a qualitative approach? • Why do some women experience postpartum depression? • How does physical exercise affect menopause? • How does Kegel exercise affect a woman’s perinatal outcomes? • Does a specific method of contraception cause weight gain? • What is a recognized limitation of EBP? • Emphasis on the routinization of practice • Over-reliance on RCT-derived results • The challenge of staying abreast of current research • All of the above • What is the purpose of the Stetler (2001) model of research utilization? • To weigh the risks and benefits of EBP • To supply methods for critiquing evidence • To encourage a synthesis of all research methods • To help move best evidence into the clinical practice setting • One common barrier to using EBP in clinical settings is the lack of confidence in critiquing research studies. The second is • the lack of time to find studies. • the lack of willing colleagues. • the lack of support from management. • the lack of protocol in using EBP. • What is the single most important action a clinician can take to advance EBP in the clinical setting? • Employ quantitative research methods • Employ qualitative research methods • Question everything • Consult with management ANSWER KEY MULTIPLE-CHOICE QUESTIONS • c • a • b • c • c • b • a • a • b • d • a • d • d • a • c Chapter 4 Using Evidence to Support Quality Clinical Practice MULTIPLE CHOICE 1. In evaluating the level of a pregnant womans risk of having a low-birth-weight (LBW) infant, which factor is the most important for the nurse to consider? a. African-American race b. Cigarette smoking c. Poor nutritional status d. Limited maternal education ANS: A For African-American births, the incidence of LBW infants is twice that of Caucasian births. Race is a nonmodifiable risk factor. Cigarette smoking is an important factor in potential infant mortality rates, but it is not the most important. Additionally, smoking is a modifiable risk factor. Poor nutrition is an important factor in potential infant mortality rates, but it is not the most important. Additionally, nutritional status is a modifiable risk factor. Maternal education is an important factor in potential infant mortality rates, but it is not the most important. Additionally, maternal education is a modifiable risk factor. 2. 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 When problems are identified, research can be properly conducted. Research of health care issues leads to evidence-based practice guidelines. Designing research studies is only one factor of the research process. Data collection is another factor of research. Financial support is necessary to conduct research, but it is not the primary role of the nurse in the research process. 3. A 23-year-old African-American woman is pregnant with her first child. Based on the statistics for infant mortality, which plan is most important for the nurse to implement? a. Perform a nutrition assessment. b. Refer the woman to a social worker. c. Advise the woman to see an obstetrician, not a midwife. d. Explain to the woman the importance of keeping her prenatal care appointments. ANS: D Consistent prenatal care is the best method of preventing or controlling risk factors associated with infant mortality. Nutritional status is an important modifiable risk factor, but it is not the most important action a nurse should take in this situation. The client may need assistance from a social worker at some time during her pregnancy, but a referral to a social worker is not the most important aspect the nurse should address at this time. If the woman has identifiable high-risk problems, then her health care may need to be provided by a physician. However, it cannot be assumed that all African-American women have high-risk issues. In addition, advising the woman to see an obstetrician is not the most important aspect on which the nurse should focus at this time, and it is not appropriate for a nurse to advise or manage the type of care a client is to receive. 4. During a prenatal intake interview, the nurse is in the process of obtaining an initial assessment of a 21-year-old Hispanic client with limited English proficiency. Which action is the most important for the nurse to perform? a. Use maternity jargon to enable the client to become familiar with these terms. b. Speak quickly and efficiently to expedite the visit. c. Provide the client with handouts. d. Assess whether the client understands the discussion. ANS: D Nurses contribute to health literacy by using simple, common words, avoiding jargon, and evaluating whether the client understands the discussion. Speaking slowly and clearly and focusing on what is important will increase understanding. Most client education materials are written at a level too high for the average adult and may not be useful for a client with limited English proficiency. 5. The nurses working at a newly established birthing center have begun to compare their performance in providing maternal-newborn care against clinical standards. This comparison process is most commonly known as what? a. Best practices network b. Clinical benchmarking c. Outcomes-oriented practice d. Evidencebased practice ANS: C Outcomes-oriented practice measures the effectiveness of the interventions and quality of care against benchmarks or standards. The term best practice refers to a program or service that has been recognized for its excellence. Clinical benchmarking is a process used to compare ones own performance against the performance of the best in an area of service. The term evidence-based practice refers to the provision of care based on evidence gained through research and clinical trials. 6. Which statement best exemplifies contemporary maternity nursing? a. Use of midwives for all vaginal deliveries b. Family-centered care c. Free-standing birth clinics d. Physician-driven care ANS: B Contemporary maternity nursing focuses on the familys needs and desires. Fathers, partners, grandparents, and siblings may be present for the birth and participate in activities such as cutting the babys umbilical cord. Both midwives and physicians perform vaginal deliveries. Free-standing clinics are an example of alternative birth options. Contemporary maternity nursing is driven by the relationship between nurses and their clients. 7. A 38-year-old Hispanic woman vaginally delivered a 9-pound, 6-ounce baby girl after being in labor for 43 hours. The baby died 3 days later from sepsis. On what grounds could the woman have a legitimate legal case for negligence? a. Inexperienced maternity nurse was assigned to care for the client. b. Client was past her due date by 3 days. c. Standard of care was not met. d. Client refused electronic fetal monitoring. ANS: C Not meeting the standard of care is a legitimate factor for a case of negligence. An inexperienced maternity nurse would need to display competency before being assigned to care for clients on his or her own. This client may have been past her due date; however, a term pregnancy often goes beyond 40 weeks of gestation. Although fetal monitoring is the standard of care, the client has the right to refuse treatment. This refusal is not a case for negligence, but informed consent should be properly obtained, and the client should have signed an against medical advice form when refusing any treatment that is within the standard of care. 8. When the nurse is unsure how to perform a client care procedure that is high risk and low volume, his or her best action in this situation would be what? a. Ask another nurse. b. Discuss the procedure with the clients physician. c. Look up the procedure in a nursing textbook. d. Consult the agency procedure manual, and follow the guidelines for the procedure. ANS: D Following the agencys policies and procedures manual is always best when seeking information on correct client procedures. These policies should reflect the current standards of care and the individual states guidelines. Each nurse is responsible for his or her own practice. Relying on another nurse may not always be a safe practice. Each nurse is obligated to follow the standards of care for safe client care delivery. Physicians are responsible for their own client care activity. Nurses may follow safe orders from physicians, but they are also responsible for the activities that they, as nurses, are to carry out. Information provided in a nursing textbook is basic information for general knowledge. Furthermore, the information in a textbook may not reflect the current standard of care or the individual state or hospital policies. 9. The National Quality Forum has issued a list of never events specifically pertaining to maternal and child health. These include all of the following except: a. infant discharged to the wrong person. b. kernicterus associated with the failure to identify and treat hyperbilirubinemia. c. artificial insemination with the wrong donor sperm or egg. d. foreign object retained after surgery. ANS: D Although a foreign object retained after surgery is a never event, it does not specifically pertain to obstetric clients. A client undergoing any type of surgery may be at risk for this event. An infant discharged to the wrong person specifically pertains to postpartum care. Death or serious disability as a result of kernicterus pertains to newborn assessment and care. Artificial insemination affects families seeking care for infertility. 10. A nurse caring for a pregnant client should be aware that the U.S. birth rate shows what trend? a.Births to unmarried women are more likely to have less favorable outcomes. b. Birth rates for women 40 to 44 years of age are declining. c. Cigarette smoking among pregnant women continues to increase. d. Rates of pregnancy and abortion among teenagers are lower in the United States than in any other industrialized country. ANS: A LBW infants and preterm births are more likely because of the large number of teenagers in the unmarried group. Birth rates for women in their early 40s continue to increase. Fewer pregnant women smoke. Teen pregnancy and abortion rates are higher in the United States than in any other industrial country. 11. A recently graduated nurse is attempting to understand the reason for increasing health care spending in the United States. Which information gathered from her research best explains the rationale for these higher costs compared with other developed countries? a. Higher rate of obesity among pregnant women b. Limited access to technology c. Increased use of health care services along with lower prices d. Homogeneity of the population ANS: A Health care is one of the fastest growing sectors of the U.S. economy. Currently, 17.4% of the gross domestic product is spent on health care. Higher spending in the United States, as compared with 12 other industrialized countries, is related to higher prices and readily accessible technology along with greater obesity rates among women. More than one third of women in the United States are obese. In the population in the United States, 16% are uninsured and have limited access to health care. Maternal morbidity and mortality are directly related to racial disparities. 12. Which statement best describes maternity nursing care that is based on knowledge gained through research and clinical trials? a. Maternity nursing care is derived from the Nursing Intervention Classification. b. Maternity nursing care is known as evidence-based practice. c. Maternity nursing care is at odds with the Cochrane School of traditional nursing. d. Maternity nursing care is an outgrowth of telemedicine. ANS: B Evidence-based practice is based on knowledge gained from research and clinical trials. The Nursing Intervention Classification is a method of standardizing language and categorizing care. Dr. Cochrane systematically reviewed research trials and is part of the evidence-based practice movement. Telemedicine uses communication technologies to support health care. 13. What is the minimum level of practice that a reasonably prudent nurse is expected to provide? a. Standard of care b. Risk management c. Sentinel event d. Failure to rescue ANS: A Guidelines for standards of care are published by various professional nursing organizations. Risk management identifies risks and establishes preventive practices, but it does not define the standard of care. Sentinel events are unexpected negative occurrences. They do not establish the standard of care. Failure to rescue is an evaluative process for nursing, but it does not define the standard of care. 14. Through the use of social media technology, nurses can link with other nurses who may share similar interests, insights about practice, and advocate for clients. Which factor is the most concerning pitfall for nurses using this technology? a. Violation of client privacy and confidentiality b. Institutions and colleagues who may be cast in an unfavorable light c. Unintended negative consequences for using social media d. Lack of institutional policy governing online contact ANS: A The most significant pitfall for nurses using this technology is the violation of client privacy and confidentiality. Furthermore, institutions and colleagues can be cast in an unfavorable light with negative consequences for those posting information. Nursing students have been expelled from school and nurses have been fired or reprimanded by their Board of Nursing for injudicious posts. The American Nurses Association has published six principles for social networking and the nurse. All institutions should have policies guiding the use of social media, and the nurse should be familiar with these guidelines. 15. During a prenatal intake interview, the client informs the nurse that she would prefer a midwife to provide both her care during pregnancy and deliver her infant. Which information is most appropriate for the nurse to share with this client? a. Midwifery care is only available to clients who are uninsured because their services are less expensive than an obstetrician. b. She will receive fewer interventions during the birth process. c. She should be aware that midwives are not certified. d. Her delivery can take place only at home or in a birth center. ANS: B This client will be able to participate actively in all decisions related to the birth process and is likely to receive fewer interventions during the birth process. Midwifery services are available to all low-risk pregnant women, regardless of the type of insurance they have. Midwifery care in all developed countries is strictly regulated by a governing body to ensure that core competencies are met. In the United States, this body is the American College of Nurse-Midwives (ACNM). Midwives can provide care and delivery at home, in freestanding birth centers, and in community and teaching hospitals. CONTINUES...