Test Bank Davidson London Ladewig Olds’ Maternal Newborn Nursing and Women’s Health Across the Lifespan 10th Edition

Test Bank Davidson London Ladewig Olds’ Maternal Newborn Nursing and Women’s Health Across the Lifespan 10th Edition Table of Contents Chapter 1 .................................................................................................................................................................. 2 Chapter 2 ................................................................................................................................................................ 14 Chapter 3 ................................................................................................................................................................ 29 Chapter 4 ................................................................................................................................................................ 41 Chapter 5 ................................................................................................................................................................ 52 Chapter 6 ................................................................................................................................................................ 63 Chapter 7 ................................................................................................................................................................ 73 Chapter 8 ................................................................................................................................................................ 84 Chapter 9 ................................................................................................................................................................ 96 Chapter 10 ............................................................................................................................................................ 108 Chapter 11 ............................................................................................................................................................ 120 Chapter 12 ............................................................................................................................................................ 131 Chapter 13 ............................................................................................................................................................ 141 Chapter 14 ............................................................................................................................................................ 151 Chapter 15 ............................................................................................................................................................ 163 Chapter 16 ............................................................................................................................................................ 174 Chapter 17 ............................................................................................................................................................ 184 Chapter 18 ............................................................................................................................................................ 194 Chapter 19 ............................................................................................................................................................ 204 Chapter 20 ............................................................................................................................................................ 215 Chapter 21 ............................................................................................................................................................ 225 Chapter 22 ............................................................................................................................................................ 233 Chapter 23 ............................................................................................................................................................ 243 Chapter 24 ............................................................................................................................................................ 255 Chapter 25 ............................................................................................................................................................ 267 Chapter 26 ............................................................................................................................................................ 279 Chapter 27 ............................................................................................................................................................ 292 Chapter 28 ............................................................................................................................................................ 306 Chapter 29 ............................................................................................................................................................ 320 Chapter 30 ............................................................................................................................................................ 333 Chapter 31 ............................................................................................................................................................ 347 Chapter 32 ............................................................................................................................................................ 360 Chapter 33 ............................................................................................................................................................ 372 Chapter 34 ............................................................................................................................................................ 383 Chapter 35 ............................................................................................................................................................ 395 Chapter 36 ............................................................................................................................................................ 407 Chapter 37 ............................................................................................................................................................ 418 1 | P a g eChapter 38 ............................................................................................................................................................ 430 Chapter 39 ............................................................................................................................................................ 443 Chapter 1 Question 1 Type: MCSA The nurse is speaking to students about changes in maternal–newborn care. One change is that self-care has gained wide acceptance with patients, the healthcare community, and third-party payers due to research findings that suggest that it: 1. Shortens newborn length of stay. 2. Decreases use of home health agencies. 3. Reduces healthcare costs. 4. Decreases the number of emergency department visits. Care delivered by nurse-midwives can be safe and effective and can represent a positive response to the healthcare provider shortage. Nurse midwives tend to use less technology, which often results in which of the following? 1. There is less trauma to the mother. 2. More childbirth education classes are available. 3. They are instrumental in providing change in the birth environment at work. 4. They advocate for more home healthcare agencies. Question 2 Type: MCMA In order to combat the impersonal nature of technology that sometimes interferes with family-focused care, the nurse should take which actions? Standard Text: Select all that apply. 1. Advocate within the community for natural childbirth. 2. Make childbirth education classes available. 3. Be instrumental in providing change in the birth environment at work. 4. Suggest that doulas not be allowed to interfere with the childbirth process. 5. Advocate for more home healthcare agencies. Question 3 Type: MCSA 2 | P a g eThe nurse is telling a new patient how technology used in maternal–newborn care has changed the way the nurse cares for her patients. An example of this is: 1. Elective inductions, requested cesareans, epidural anesthesia, and fetal monitoring. 2. Delivering at home with a nurse-midwife and doula. 3. Having the father present as the coach and cut the umbilical cord. 4. Breastfeeding of the new baby on the delivery table. The nurse is telling a new client how advanced technology has permitted the physician to do which of the following? 1. Treat the fetus and monitor fetal development. 2. Deliver at home with a nurse-midwife and doula. 3. Have the father present as the coach and cut the umbilical cord. 4. Breastfeed a new baby on the delivery table. Question 4 Type: MCSA A nurse is examining different nursing roles. Which example best illustrates an advanced practice nursing role? 1. A registered nurse who is the manager of a large obstetrical unit 2. A registered nurse who is the circulating nurse at surgical deliveries (cesarean sections) 3. A clinical nurse specialist working as a staff nurse on a mother-baby unit 4. A clinical nurse specialist with whom other nurses consult for her expertise in caring for high-risk infants Question 5 Type: MCSA A nursing student investigating potential career goals is strongly considering becoming a nurse practitioner (NP). The major focus of the NP is on: 1. Leadership. 2. Physical and psychosocial clinical assessment. 3. Independent care of the high-risk, pregnant patient. 4. Tertiary prevention. Question 6 Type: MCMA The nurse manager is consulting with a certified nurse–midwife about a patient. The role of the CNM is to: Standard Text: Select all that apply. 1. Be prepared to manage independently the care of women at low risk for complications during pregnancy 3 | P a g eand birth. 2. Give primary care for high-risk patients who are in hospital settings. 3. Give primary care for healthy newborns. 4. Obtain a physician consultation for any technical procedures at delivery. 5. Be educated in two disciplines of nursing. The nurse manager is consulting with a certified nurse-midwife about a client. What is the role of the CNM? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. Be prepared to manage independently the care of women at low risk for complications during pregnancy and birth. 2. Give primary care for high-risk clients who are in hospital settings. 3. Give primary care for healthy newborns. 4. Obtain a physician consultation for any technical procedures at delivery. 5. Be educated in two disciplines of nursing. Question 7 Type: MCSA The registered nurse who has completed a master's degree program and passed a national certification exam has clinic appointments with patients who are pregnant or seeking well-woman care. The role of this nurse would be considered: 1. Professional nurse. 2. Certified registered nurse (RNC). 3. Clinical nurse specialist. 4. Nurse practitioner. Question 8 Type: MCMA Several student nurses are discussing advanced practice, and know that the term advanced practice nurse includes nurses who are: Standard Text: Select all that apply. 1. Nurse practitioners. 2. Certified nurse-midwives. 3. Clinical nurse specialists. 4. Certified registered nurses. 4 | P a g e5. Professional nurses. Question 9 Type: MCSA While a child is being admitting to the hospital, the parent receives information about the pediatric unit's goals, including the statement that the unit practices family-centered care. The parent asks why that is important. The nurse responds that in the family-centered care paradigm, the: 1. Mother is the principal caregiver in each family. 2. Child's physician is the key person in ensuring the health of a child is maintained. 3. Family serves as the constant influence and continuing support in the child's life. 4. Father is the leader in each home; thus, all communications should include him. Question 10 Type: MCSA Despite the availability of Children's Health Insurance Programs (CHIPs), the nurse in a pediatric clinic knows that many eligible children are not enrolled. The nursing intervention that can best help eligible children become enrolled is: 1. Assessment of the details of the family's income and expenditures. 2. Case management to limit costly, unnecessary duplication of services. 3. Advocacy for the child by encouraging the family to investigate its CHIP eligibility. 4. Education of the family about the need for keeping regular well-child visit appointments. 10) The current emphasis on healthcare reform and the implementation of the Affordable Care Act has yielded what unexpected benefit? 1. Assessment of the details of the familys income and expenditures 2. Case management to limit costly, unnecessary duplication of services 3. Many healthcare providers and consumers are becoming more aware of the vitally important role nurses play in providing excellent care to clients and families 4. Education of the family about the need for keeping regular well-child visit appointments Question 11 Type: MCSA For prenatal care, the patient is attending a clinic held in a church basement. The patient's care is provided by registered nurses and a certified nurse-midwife. This type of prenatal care is an example of: 1. Secondary care. 5 | P a g e2. Tertiary care. 3. Community care. 4. Unnecessarily costly care. Question 12 Type: MCSA The nurse at an elementary school is performing TB screenings on all of the students. Permission slips were returned for all but the children of one family. When the nurse phones to obtain permission, the parent states in clearly understandable English that permission cannot be given because the grandmother is out of town for 2 more weeks. Which cultural element is contributing to the dilemma that faces the nurse? 1. Permissible physical contact with strangers 2. Beliefs about the concepts of health and illness 3. Religion and social beliefs 4. Presence and influence of the extended family Question 13 Type: MCMA The nurse working in a community clinic is aware that differences in beliefs between families and healthcare providers are common in which areas? Note: Credit will be given only if all correct and no incorrect choices are selected. Standard Text: Select all that apply. 1. Help-seeking behaviors 2. Pregnancy and childbirth practices 3. Causes of disease or illness 4. What defines a community 5. Educational level Question 14 Type: MCMA The maternal–child nurse stresses to the recently graduated nurse that primary care focuses on: Note: Credit will be given only if all correct and no incorrect choices are selected. Standard Text: Select all that apply. 6 | P a g e1. Health promotion. 2. Illness prevention. 3. Hospital care. 4. Skilled nursing care. 5. Curing disease. Question 15 Type: MCSA A maternity patient is in need of surgery. The healthcare member who is legally responsible for obtaining informed consent for an invasive procedure is: 1. The nurse. 2. The physician. 3. The unit secretary. 4. The social worker. Question 16 Type: MCSA A nurse who tells family members the sex of a newborn baby without first consulting the parents would have committed: 1. A breach of privacy. 2. Negligence. 3. Malpractice. 4. A breach of ethics. Question 17 Type: MCSA The nursing instructor explains to the class that according to the 1973 Supreme Court decision in Roe v. Wade, abortion is legal if induced: 1. Before the 30th week of pregnancy. 2. Before the period of viability. 3. To provide tissue for therapeutic research. 7 | P a g e4. Can be done any time if mother, doctor, and hospital all agree. Question 18 Type: MCSA The nurse reviewing charts for quality improvement notes that a patient experienced a complication during labor. The nurse is uncertain whether the labor nurse took the appropriate action during the situation. What is the best method for the nurse to take to determine what the appropriate action should have been? 1. Call the nurse manager of the labor and delivery unit and ask what the nurse should have done. 2. Ask the departmental chair of the obstetrical physicians what the best nursing action should have been. 3. Examine other charts to find cases of the same complication, and determine how it was handled in those situations. 4. Look in the policy and procedure book, and examine the practice guidelines published by a professional nursing organization. Question 19 Type: MCSA The nurse is reviewing care of patients on a mother–baby unit. Which situation should be reported to the supervisor? 1. A 2-day-old infant has breastfed every 3 hours and voided 4 times. 2. An infant was placed in the wrong crib after examination by the physician. 3. The patient who delivered by cesarean birth yesterday received oral narcotics. 4. A primiparous patient who delivered today is requesting discharge within 24 hours. Question 20 Type: MCSA The nurse manager is planning a presentation on ethical issues in caring for childbearing families. Which example should the nurse manager include to illustrate maternal–fetal conflict? 1. A patient chooses an abortion after her fetus is diagnosed with a genetic anomaly. 2. A 39-year-old nulliparous patient undergoes therapeutic insemination. 3. A family of a child with leukemia requests cord-blood banking at this birth. 4. A cesarean delivery of a breech fetus is court-ordered after the patient refuses. Question 21 8 | P a g eType: MCMA The maternal–newborn nurse reviewing charts recognizes that negligence occurs when there is: Note: Credit will be given only if all correct and no incorrect choices are selected. Standard Text: Select all that apply. 1. No notification to the physician of change in condition. 2. A failure to give an ordered medication. 3. An infant placed in the wrong crib. 4. Compliance with medication administration principles. 5. Compliance with the standards of care. Question 22 Type: MCMA The maternal–newborn nurse recognizes that cord-blood banking has ethical issues related to which of the following questions? Standard Text: Select all that apply. 1. Who owns the blood? 2. How is informed consent obtained? 3. How will confidentiality be maintained? 4. Will standards of care be met fairly? 5. What external agents force or restrict a therapy? 22) Client safety goals, which are evaluated and updated regularly, are requirements for what? 1. Clinical practice guidelines 2. Scope of practice 3. Accreditation 4. Standards of care Question 23 Type: MCMA The recently graduated nurse recognizes that standards provide information and guidelines for: Note: Credit will be given only if all correct and no incorrect choices are selected. Standard Text: Select all that apply. 9 | P a g e1. Nurses in their practice. 2. Devlopment of policies and protocols. 3. Developing basic nursing care. 4. Writing a state’s nurse practice act. 5. Who can and cannot consent to treatment. Question 24 Type: MCSA The nurse is reviewing the files of the expectant families scheduled to be seen in the clinic today. Which family might find cord-blood banking to be especially useful? 1. A family with a history of leukemia 2. A family with a history of infertility 3. A family that wishes to select the sex of a future child 4. A family that wishes to avoid a future intrauterine fetal surgery A fetus has been diagnosed with myelomeningocele. Which of the following surgeries would be performed to correct this condition? 1. Tubal ligation 2. Intrauterine fetal surgery 3. Cesarean section 4. Sterilization Question 25 Type: MCMA Therapeutic insemination has legal concerns for the donor of the sperm. To eliminate legal issues, the clinic nurse will have the donor: Note: Credit will be given only if all correct and no incorrect choices are selected. Standard Text: Select all that apply. 1. Sign a form waiving all parental rights. 2. Furnish accurate health information. 3. Agree to adopt the child. 4. Furnish a complete family tree. 5. Sign an agreement if married to the recipient. 10 | P a g eQuestion 26 Type: MCSA A nurse is providing guidance to a group of parents of children in the infant-to-preschool age group. After reviewing statistics on the most common cause of death in this age group, the nurse includes information about prevention of: 1. Cancer by reducing the use of pesticides in the home. 2. Accidental injury by reducing the risk of pool and traffic accidents. 3. Heart disease by incorporating heart-healthy foods into the child's diet. 4. Pneumonia by providing a diet high in vitamin C from fruits and vegetables. Question 27 Type: MCSA The nurse researcher will use descriptive statistics for a research project that has been assigned. A characteristic of descriptive statistics is that: 1. They can answer specific questions. 2. They can generate theories. 3. They allow the investigator to draw conclusions. 4. They are the starting point for the formation of a research question. Question 28 Type: MCMA The student nurse working for a nurse researcher recognizes that the researcher will use descriptive statistics to: Note: Credit will be given only if all correct and no incorrect choices are selected. Standard Text: Select all that apply. 1. Describe a set of data. 2. Summarize a set of data. 3. Report the facts. 4. Identify certain trends. 5. Allow conclusions to be drawn. 6. Use a small sample size. 11 | P a g eQuestion 29 Type: MCSA The nurse is preparing a report on the number of births by three service providers at the facility (certified nurse- midwives, family practitioners, and obstetricians). This is an example of: 1. Inferential statistics. 2. Descriptive statistics. 3. Evidence-based practice. 4. Secondary use of data. Question 30 Type: MCSA The nurse is explaining the difference between descriptive statistics and inferential statistics to a group of student nurses. To illustrate descriptive statistics, the nurses uses as an example: 1. A positive correlation between breastfeeding and infant weight gain. 2. The infant mortality rate in the state of Oklahoma. 3. A causal relationship between the number of sexual partners and sexually transmitted diseases. 4. The total number of spontaneous abortions in drug-abusing women as compared with non–drug- abusing women. Question 31 Type: MCSA The nurse manager is examining the descriptive statistics of increasing teen pregnancy rates in the community. Which inferential statistical research question would the nurse manager find most useful in investigating the reasons for increased frequency of teen pregnancy? 1. What providers do pregnant teens see for prenatal care? 2. What are the ages of the parents of pregnant teens in the community? 3. Do pregnant teens drink caffeinated beverages? 4. What do pregnant teens do for recreation? Question 32 Type: MCMA Based on research comparing home and hospital births, the nurse understands that questions remain to 12 | P a g ebe answered about outcomes, such as: Note: Credit will be given only if all correct and no incorrect choices are selected. Standard Text: Select all that apply. 1. Does nutrition affect home birth outcomes? 2. Does exercise affect home birth outcomes? 3. Do mortality and morbidity rates differ for home versus hospital births? 4. Do multiparous women have more problems than first-time mothers? 5. Do high-risk births cause fewer complications with a home birth? The Quality and Safety Education for Nurses (QSEN) project focused on competencies in which areas? Note: Credit will be given only if all correct and no incorrect choices are selected. Select all that apply. 1. Client-centered care 2. Teamwork and collaboration 3. Evidence-based practice 4. Family planning 5. Injury and violence prevention Question 33 Type: MCMA The nurse is serving on a panel to evaluate the hospital staff’s reliance on evidence-based practice in their decision-making processes. Which practices characterize the basic competencies related to evidence-based practice? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. Recognizing which clinical practices are supported by good evidence 2. Recognizing and including clinical practice supported by intuitive evidence 3. Using data in clinical work to evaluate outcomes of care 4. Including quality-improvement measures in clinical practice 5. Appraising and integrating scientific bases into practice Question 34 13 | P a g eType: MCMA As a clinician, the nurse must meet what basic competencies related to evidence-based practice? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. Recognize which clinical practices are supported by sound evidence. 2. Recognize that superiors, such as charge nurses, are the ones who know which clinical practices are supported by sound evidence. 3. Use data in clinical work to evaluate outcomes of care. 4. Integrate scientific basics into practice. 5. Will be able to identify which practices have no sound evidence to support their use. Question 35 Type: MCMA The nursing instructor is preparing clinical pathways to use in class because they provide: Note: Credit will be given only if all correct and no incorrect choices are selected. Standard Text: Select all that apply. 1. Essential nursing activities. 2 Basic guidelines for outcomes. 3. Information that allows the nurse to evaluate patient responses. 4. Examples of all steps of the nursing process. 5. For the organizing of patient care. Nursing research is vital to do which of the following? Note: Credit will be given only if all correct and no incorrect choices are selected. Select all that apply. 1. Expand the science of nursing. 2. Foster evidence-based practice. 3. Improve client care. 4. Visually depict nursing management. 5. Plan and organize care. Chapter 2 14 | P a g eQuestion 1 Type: MCSA A couple who came to the United States two years ago with their two children are seeing the nurse in the community clinic. The nurse knows their family is acculturating when the mother makes which statement? 1. "The children are much less well-behaved than they used to be." 2. "Our diet now includes hamburgers and French fries." 3. "We celebrate the same holidays that we used to at home." 4. "When the children leave the house, I worry about them." Question 2 Type: MCMA The nurse caring for several patients and their families knows that roles in each family are determined by: Note: Credit will be given only if all correct and no incorrect choices are selected. Standard Text: Select all that apply. 1. Age. 2. Stressors. 3. Demographic trends. 4. Definition of family. 5. Ethnocentrism. Which of the following best describes a nuclear family? 1. A family is composed of an unmarried woman who chooses to conceive or adopt without a life partner. 2. Children live in a household with both biologic parents and no other relatives or persons. 3. A couple shares household and childrearing responsibilities with parents, siblings, or other relatives. 4. The head of the household is widowed, divorced, abandoned, or separated or most often the mother remains unmarried. Question 3 Type: MCSA The nurse is caring for a family in the community with a 2-month-old infant who is breastfed. The father helps by changing diapers and dressing and bathing the baby. The mother will return to work when the baby is 3 months old, and a childcare provider has been arranged. Although the mother occasionally feels fatigued, the couple has resumed having sexual relations, although not as frequently as before the pregnancy. Which family model best describes this family? 15 | P a g e1. Model of the Childbearing Family 2. Model Incorporating the Unattached Young Adult 3. Model of the Nuclear Family 4. Model Incorporating Divorce and Remarriage What is the term for when children alternate between two homes, spending varying amounts of time with each parent in a situation called co-parenting and usually involving joint custody? 1. Blended or reconstituted nuclear family 2. Extended kin network family 3. Binuclear family 4. Extended family Question 4 Type: MCMA The nurse teaching a group of students about trends that have affected the contemporary family includes: Note: Credit will be given only if all correct and no incorrect choices are selected. Standard Text: Select all that apply. 1. An increase in the median age at the time of marriage. 2. A higher percentage of marriages ending in divorce. 3. A decline in childless families. 4. Traditional nuclear families remaining the norm. 5. An increased acceptance of single women having children. Duvalls eight stages in the family life cycle of a traditional nuclear family have been used as the foundation for contemporary models that describe the developmental processes and role expectations for different family types. Which of the following is an example of Stage IV of this family life cycle? 1. Families launching young adults (all children leave home) 2. Families with preschool-age children (oldest child is between 2.5 and 6 years of age) 3. Middle-aged parents (empty nest through retirement) 4. Families with schoolchildren (oldest child is between 6 and 13 years of age) Question 5 Type: MCSA A 7-year-old patient tells you that "Grandpa, Mommy, Daddy, and my brother live at my house." The nurse identifies this family type as: 16 | P a g e1. Binuclear. 2. Extended. 3. Gay or lesbian. 4. Traditional. Question 6 Type: MCSA A nurse is performing an assessment on a family with a father and mother who both work. What type of family does she record this family as being? 1. A traditional nuclear family 2. A dual-career/dual-earner family 3. An extended family 4. An extended kin family Question 7 Type: MCMA Why is it important for the nurse to understand the type of family that a client comes from? Select all that apply. Standard Text: Select all that apply. 1. Family structure can influence finances and the ability to purchase nutritious foods. 2. Many types of families exist, and it is important to address the persons who hold power within the family. 3. The nurse can anticipate which problems a client will experience based on the type of family the client has. 4. Understanding if the client's family is nuclear or blended will help the nurse teach the client the appropriate information. 5. The values of the family will be predictable if the nurse knows what type of family the client is a part of. Question 8 Type: MCMA The public health nurse is working with a student nurse. The student nurse asks which of the six groups of people they have seen today are considered to be families. The nurse responds: Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. “The married heterosexual couple without children." 17 | P a g e2. “The gay couple with two adopted children." 3. “The unmarried heterosexual couple with two biological children." 4. “The lesbian couple not living together that have no children." 5. “The married heterosexual couple with three children, living with grandparents." Question 9 Type: MCMA In assessing a new family coming to the clinic, the nurse determines they are an extended kin family. Extended kin network family characteristics include: Note: Credit will be given only if all correct and no incorrect choices are selected. Standard Text: Select all that apply. 1. A sharing of a social support network. 2. The sharing of goods and services. 3. Elderly parents share housing. 4. Children are members of two nuclear families. 5. Living in a Latino community. Question 10 Type: MCSA A nurse is comparing several different families' developmental stages, using Duvall’s eight-stage family life cycle. Which person serves as a marker for a family's developmental stage in this theory? 1. The youngest child 2. The mother 3. The oldest child 4. The father 10) The transcultural nursing theory was developed in 1961 by Dr. Madeleine Leininger. Its foundation is in which of the following? 1. The framework categorizes a familys progression over time 2. The family life cycle of a traditional nuclear family 3. Anthropology and nursing 4. Holistic health beliefs 18 | P a g eQuestion 11 Type: MCSA The nurse is preparing a community presentation on family development. Which statement should the nurse include? 1. The youngest child determines the family's current stage. 2. A family does not experience overlapping of stages. 3. Family development ends when the youngest child leaves home. 4. The stages describe the family's progression over time. Question 12 Type: MCMA In learning about Duvall’s life-cycle stages ascribed to traditional families, the nursing student recognizes that developmental tasks of each stage include: Note: Credit will be given only if all correct and no incorrect choices are selected. Standard Text: Select all that apply. 1. Adjusting to new roles as mother and father. 2. Working out authority and socialization roles with the school. 3. Becoming a single parent with custodial responsibilities. 4. Becoming a couple and dating. 5. Adjusting to the loss of a spouse. Question 13 Type: MCMA When working with families entering the childbearing years, the nurse knows that teaching will be needed regarding the challenges of: Note: Credit will be given only if all correct and no incorrect choices are selected. Standard Text: Select all that apply. 1. Meeting the emotional needs of a newborn. 2. Exploring the couple’s feelings about role transition. 3. Accessing resources in the community. 19 | P a g e4. Raising the infant in formal traditions of the grandparents. 5. Exploring ways of dealing with family conflict. The nurse is planning a community education program on the role of complementary and alternative therapies during pregnancy. Which statement about alternative and complementary therapies should the nurse include? 1. They bring about cures for illnesses and diseases. 2. They are invasive but effective for achieving health. 3. They emphasize prevention and wellness. 4. They prevent pregnancy complications. Question 14 Type: MCSA The nurse is preparing to assess the development of a family new to the clinic. The nurse understands that the primary use of a family assessment tool is to: 1. Obtain a comprehensive medical history of family members. 2. Determine to which clinic the client should be referred. 3. Predict how a family will likely change with the addition of children. 4. Understand the physical, emotional, and spiritual needs of members. Question 15 Type: MCSA The nurse in the community should use a family assessment tool to obtain what type of information? 1. How long the family has lived at its current address 2. What other health insurance the family has had in the past 3. How the family meets its nutritional needs and obtains food 4. What eye color the family desires in its unborn child Question 16 Type: MCMA In assessing a family, the community nurse uses a family assessment tool, which provides an organized framework to collect data concerning: Note: Credit will be given only if all correct and no incorrect choices are selected. Standard Text: Select all that apply. 1. Access to laundry, and grocery facilities. 20 | P a g e2. Access to health care. 3. Sharing of religious beliefs and values. 4. Acculturation to traditional lifestyles. 5. Ability to include a new spouse into the family unit. Question 17 Type: MCSA The pregnant patient reports to the nurse that she is eating dirt on a weekly basis and was told to do this by her grandmother to have a healthy pregnancy. How should the nurse respond? 1. "The soil might contain contaminants that could harm your baby." 2. "This practice is completely unhealthy and should be stopped." 3. "Your grandmother gave you bad advice. Stop at once." 4. "There is no problem with this practice. Feel free to continue." The nurse is assessing a client who reports seeing an acupuncturist on a weekly basis to treat back pain. The nurse understands that acupuncture is an example of what? 1. A risky practice without evidence of efficacy 2. A folk remedy 3. A complementary therapy 4. An alternative therapy Question 18 Type: MCSA The nurse is performing a cultural assessment using the Transcultural Assessment Model. What aspect of communication should the nurse keep in mind when planning the assessment? 1. Personal space does not vary from one culture to another. 2. Cultural groups living in the United States are future-oriented. 3. Nonverbal communication is consistent across cultures. 4. The use of silence can differ among different groups. In caring for pregnant clients, the nurse realizes that information on conventional, complementary, and alternative medicine is best obtained by which of the following means? 1. Obtained at the medical office if the physician feels it is appropriate 21 | P a g e2. Obtained from family and friends who have already experienced a situation 3. Readily obtainable on the Internet 4. Passed on by word of mouth Question 19 Type: MCMA In working with immigrants in an inner-city setting, the nurse recognizes that acculturation of immigrants often brings with it the benefit of: Note: Credit will be given only if all correct and no incorrect choices are selected. Standard Text: Select all that apply. 1. Improved socioeconomic status. 2. Use of preventive care services. 3. Increased job-related stressors. 4. Increase in substance abuse over time. 5. More physician visits due to language barriers. Question 20 Type: MCSA The nurse is caring for a postpartal patient of Hmong descent who immigrated to the United States 5 years ago. The patient asks for the regular hospital menu because American food tastes best. The nurse assesses this response to be related to which of the following cultural concepts? 1. Acculturation 2. Ethnocentrism 3. Enculturation 4. Stereotyping Question 21 Type: MCSA A home health nurse has set up a home visit with a Korean couple to follow up on their jaundiced 4-day-old baby, who was discharged home yesterday. Considering family power structure, what family members might the nurse expect to see in the home? 1. Just the parents 22 | P a g e2. The grandmother 3. The grandfather and parents 4. The godparents The nurse is teaching a community education class on complementary and alternative therapies. To assess learning, the nurse asks, In traditional Chinese medicine, what is the invisible flow of energy in the body that maintains health and ensures physiologic functioning? Which answer indicates that teaching was successful? 1. Meridians 2. Chi 3. Yin 4. Yang Question 22 Type: MCSA A laboring patient of Chinese descent has been very quiet during labor, and has made no noise during contractions during the past 4 hours. The nurse understands that this indicates that the client: 1. Believes pain should be endured and not expressed. 2. Is not in the active phase of labor yet. 3. Will not need pain medication during her hospitalization. 4. Has been abused by her husband, and is afraid to verbalize fear. The nurse is admitting a client in labor who states that she is a naturopath. The nurse understands that this client believes which of the following? 1. An initial worsening of symptoms after treatment means the correct remedy has been used. 2. There are five elements that take form in the body. 3. Her pregnancy is a kapha condition. 4. Naturopathy is a form of medicine that utilizes the healing forces of nature. Question 23 Type: MCSA A woman of Korean descent has just given birth to a son. Her partner wishes to give her sips of hot broth from a thermos he brought from home. The patient has refused the nurse’s offer of ice chips or other cold drinks. The nurse should: 1. Explain to the client that she can have the broth if she will also drink cold water or juice. 2. Encourage the partner to feed the client sips of broth and ask whether the patient would like you to bring her some warm water to drink as well. 3. Explain to the couple that food cannot be brought from home, but that the nurse will make hot broth for the client. 23 | P a g e4. Encourage the client to have the broth, but explain that it must be boiled first in the kitchen. The nurse is counseling a pregnant woman who intends to see a naturopathic physician. The nurse tells the woman that she can expect education on which of the following? Note: Credit will be given only if all correct and no incorrect choices are selected. Select all that apply. 1. Clinical nutrition 2. Botanical medicine 3. Lifestyle modification 4. Use of like to cure like 5. The role of yin and yang Question 24 Type: MCMA During the assessment phase of a family, the community nurse recognizes that culture influences childrearing and childbearing in the: Note: Credit will be given only if all correct and no incorrect choices are selected. Standard Text: Select all that apply. 1. Beliefs about the importance of children. 2. Beliefs and attitudes about pregnancy. 3. Norms regarding infant feeding. 4. Acculturation is important in rearing children. 5. Time orientation to the future is very important. Question 25 Type: MCMA The nurse will assess numerous health practices during patient pregnancies. Some practices include the: Note: Credit will be given only if all correct and no incorrect choices are selected. Standard Text: Select all that apply. 1. Prevalence of home remedies. 2. Importance of indigenous healers. 3. Influence of professional healthcare workers. 4. Addition of food to the formula at 2 weeks of age. 24 | P a g e5. Wife’s deferral to the spouse for decision making. 5) The nurse is teaching a class to the community on mind-based therapies. A class participant gives an example of a friend with leukemia who was taught by her complementary therapist to concentrate on making antibodies that will fight and kill the cancer cells in the bloodstream. How would the nurse identify this technique? 1. Guided imagery 2. Qigong 3. Biofeedback 4. Homeopathy Question 26 Type: MCSA During the assessment, the nurse notices that an African American baby has a darker, slightly bluish-hued patch about 5 cm 7 cm on the buttocks and lower back. What is the nurse's next action? 1. Call the Department of Social Services (DSS) to report this sign of abuse. 2. Confer with the physician about the possibility of a bleeding tendency. 3. Ask the mother about the cause of the bruise. 4. Chart the presence of a Mongolian spot. The nurse in a rural clinic is talking with some clients about biofeedback. The nurse explains to the clients that biofeedback is which of the following? 1. An alternative therapy 2. A state of great mental and physical relaxation in which one is susceptible to suggestion 3. A method used to help individuals learn to control their physiologic responses based on the concept that the mind controls the body 4. A complementary therapy in which one goes into a relaxed state and focuses on positive scenes Question 27 Type: MCSA The nurse is admitting a Mexican woman scheduled for a cholecystectomy. The nurse uses a cultural assessment tool during the admission. Which question would be most important for the nurse to ask? 1. "What other treatments have you used for your abdominal pain?" 2. "In what country were you were born?" 3. "When you talk to family members, how close do you stand?" 4. "How would you describe your role within your family?" 25 | P a g eQuestion 28 Type: MCSA The nurse works in a facility that cares for patients from a broad range of racial, ethnic, cultural, and religious backgrounds. Which statement should the nurse include in a presentation to recently hired nurses on the patient population of the facility? 1. "Our patients come from a broad range of backgrounds, but we have a good interpreter service." 2. "Many of our patients come from backgrounds different from your own, but it doesn't cause problems for the nurses." 3. "Because most of the doctors are bilingual, we don't have to deal with the differences in cultural backgrounds of our patients." 4. "Understanding the common values and health practices of our diverse patients will facilitate better care and health outcomes." Question 29 Type: MCSA The nurse manager in a hospital with a large immigrant population is planning an in-service. Aware of how ethnocentrism affects nursing care, the nurse manager includes the statement, "The belief that one's own values and beliefs are the only or the best values: 1. "Means that newcomers to the United States should adopt the norms and values of the country." 2. "Can create barriers to communication through misunderstanding." 3. "Leads to an expectation that all clients will exhibit pain the same way." 4. "Improves the quality of care provided to culturally diverse patient bases." Question 30 Type: MCSA The nurse is working with a woman newly enrolled in an English-as-a-second-language class. The nurse wants to teach the woman about the importance of hand washing before meals. The best way to assimilate the nurse's cultural values about hygienic nutrition is to: 1. Have the nurse model proper hand washing before examining the woman. 2. Provide written materials in English about hygiene and diet for the patient to take home. 3. Have the woman repeat her interpretation of the information that was taught. 4. Schedule a medical interpreter to accompany the patient to her next visit. 26 | P a g e30) The nurse in a rural clinic is talking with some clients about biofeedback. The nurse explains to the clients that biofeedback is which of the following? 1. An alternative therapy 2. A state of great mental and physical relaxation in which one is susceptible to suggestion 3. A method used to help individuals learn to control their physiologic responses based on the concept that the mind controls the body 4. A complementary therapy in which one goes into a relaxed state and focuses on positive scenes Question 31 Type: MCSA The charge nurse is reviewing the care plans written by the unit's staff nurses. The charge nurse recognizes that the nursing diagnosis most likely to be construed as culturally biased and possibly offensive is: 1. Fear related to separation from support system during hospitalization. 2. Spiritual Distress related to discrepancy between beliefs and prescribed treatment. 3. Interrupted Family Processes related to a shift in family roles secondary to demands of illness. 4. Noncompliance related to impaired verbal communication secondary to recent immigration from non–English- speaking area. The client in the first trimester of pregnancy tells the nurse she regularly sees a massage therapist to help with pain in her shoulders and neck. The nurse tells her that massage has which of the following added advantages? Note: Credit will be given only if all correct and no incorrect choices are selected. Select all that apply. 1. Increasing circulation 2. Reducing anxiety 3. Promoting a sense of well-being 4. Eliminating energy blockages 5. Allowing coordination of breathing and moving Question 32 Type: MCSA A nurse is working in a clinic where people from several cultures are seen. As a first step toward the goal of personal cultural competence, the nurse will: 1. Enhance cultural skills. 2. Gain cultural awareness. 3. Seek cultural encounters. 27 | P a g e4. Acquire cultural knowledge. Question 33 Type: MCSA When teaching a culturally diverse group of childbearing families about hospital birthing options, the culturally competent nurse: 1. Understands that the families have the same values as the nurse. 2. Teaches the families how childbearing takes place in the United States. 3. Insists that the clients answer questions instead of their husbands. 4. Incorporates the specific beliefs of the cultural groups that are attending the class. Question 34 Type: MCMA Which questions are appropriate for the nurse to ask during a cultural assessment of a patient new to the clinic? Note: Credit will be given only if all correct and no incorrect choices are selected. Standard Text: Select all that apply. 1. What genetic and other biological differences affect caregiving? 2. Which family member must be consulted for decisions about care? 3. What type of health provider is the most appropriate? 4. Does the patient have beliefs or traditions that might impact the care plan? 5. Are communications patterns established? Question 35 Type: MCSA The nurse is working with a patient whose religious beliefs differ from those of the general population. The best nursing intervention to use to meet the specific spiritual needs of this family is to: 1. Ask how important the patient’s religious and spiritual beliefs are when making decisions about health care. 2. Show respect while allowing time and privacy for religious rituals. 3. Ask for the patient’s opinion on what caused the illness. 4. Identify healthcare practices forbidden by religious or spiritual beliefs. 28 | P a g eQuestion 36 Type: MCSA The labor and delivery nurse is caring for a laboring patient who has asked for a priest to visit her during labor. The patient’s mother died during childbirth, and although there are no complications during her pregnancy, the patient is fearful of her own death during labor. What is the best response by the nurse? 1. "Nothing is going to happen to you. We'll take very good care of you during your birth." 2. "Would you like to have an epidural so that you won't feel the pain of the contractions?" 3. "The priest won't be able to prevent complications, and might get in the way of your providers." 4. "Would you like me to contact your parish or our hospital chaplain to come see you?" Question 37 Type: MCSA When planning care of childbearing families, the nurse encounters different spiritual and religious beliefs and practices. Which spiritual practice could impact the nurse's care of the childbearing family? 1. A strong belief in reincarnation, and thus refusal of an autopsy 2. The desire to light candles at home during a naming ceremony 3. Request by the family to speak to a Roman Catholic priest 4. Refusing consent for a blood transfusion by a Jehovah's Witness The client reports relief from headaches when she rubs the temples on each side of the head. The nurse understands that this is a form of which of the following? 1. Acupressure 2. Acupuncture 3. Reflexology 4. Hydrotherapy Chapter 3 Question 1 Type: MCSA The nurse is assessing a patient who reports seeing an acupuncturist on a weekly basis to treat back pain. The nurse understands that acupuncture is an example of: 1. A risky practice without evidence of efficacy. 2. A folk remedy. 3. A complementary therapy. 29 | P a g e4. An alternative therapy. Question 2 Type: MCSA In caring for pregnant patients, the nurse realizes that information on conventional, complementary, and alternative medicine is: 1. Obtained at the medical office if the physician feels it is appropriate. 2. Best obtained from family and friends who have already experienced a situation. 3. Readily obtainable on the Internet. 4. Best passed on by word of mouth. Question 3 Type: MCMA Based on an understanding of how patients learn about complementary and alternative therapies, the nurse realizes that which of the following patients are most likely to use complementary or alternative therapy? Standard Text: Select all that apply. 1. An elderly couple on a fixed income without a computer at home 2. A middle-aged woman who travels internationally for her job 3. An adolescent male who plays many sports through school 4. A young mother of preschoolers who uses the Internet daily 5. A middle-aged man who has never Question 4 Type: MCSA The nurse who is working with patients using complementary or alternative medicine is aware that the National Center for Complementary and Alternative Medicine is responsible for: 1. Ensuring the safety of complementary and alternative therapies. 2. Endorsing products for further approval by the FDA. 3. Testing new therapies and products. 4. Promoting research on complementary and alternative therapies and disseminating information to consumers. 30 | P a g eQuestion 5 Type: MCSA A nursing instructor is teaching a group of student nurses about the National Center for Complementary and Alternative Medicine (NCCAM). Which statement, if made by a nursing student, would indicate the need for further teaching? 1. “NCCAM is dedicated to exploring complementary and alternative healing practices in the context of rigorous science, training CAM researchers, and disseminating information to the public and professionals.” 2. “The NCCAM only distributes information to professional caregivers.” 3. “Recently, NCCAM recognized a new domain of integrative medicine.” 4. “Integrative medicine is an approach that combines mainstream medical therapies with complementary therapies for which there is some high-quality scientific evidence of safety and effectiveness.” Question 6 Type: MCSA The nurse is planning a community education program on the role of complementary and alternative therapies during pregnancy. Which statement should the nurse include? "Alternative and complementary therapies: 1. “Bring about cures for illnesses and diseases." 2. “Are invasive but effective for achieving health." 3. “Emphasize prevention and wellness." 4. “Prevent pregnancy complications." Question 7 Type: MCSA A nursing instructor has been teaching the clinical students the difference between complementary and alternative therapies. Which statement, if made by a student, would indicate that teaching has been successful? 1. “A complementary therapy may be defined as any procedure or product that is used instead of conventional treatment.” 2. “An alternative therapy is used in conjunction with conventional medicine.” 3. “Because alternative therapies are used in place of medically prescribed treatments, patients might be reluctant to discuss them with a conventional physician.” 4. “Integrative nursing combines mainstream medical therapies with alternative therapies.” 31 | P a g eQuestion 8 Type: MCSA The charge nurse is providing an in-service for the nurses on the obstetrical unit about complementary and alternative medicine as it relates to conventional medicine. Which statement from a nurse indicates an understanding of the topic? 1. “The therapies of conventional medicine treat symptoms and illness, whereas complementary and alternative medicine emphasizes wellness.” 2. “Conventional medicine only needs to be used in life-saving situations.” 3. “The goal of conventional therapy is to heal the patient’s spirit, mind, and body.” 4. “Complementary and alternative medicine is not concerned with nutrition and food preparation.” Question 9 Type: MCMA The patient who is in her third trimester of pregnancy asks the nurse whether hydrotherapy might help her. The nurse explains that hydrotherapy makes use of: Note: Credit will be given only if all correct and no incorrect choices are selected. Standard Text: Select all that apply. 1. Hot and cold compresses. 2. Different types of bathing. 3. Biofeedback. 4. Reflexology. 5. Therapeutic Touch. Question 10 Type: MCMA A pregnant patient tells the nurse that she takes part in complementary and alternative therapies to maintain wellness. Which situation that she describes would the nurse consider a risk? Note: Credit will be given only if all correct and no incorrect choices are selected. Standard Text: Select all that apply. 1. Getting a massage from a licensed massage therapist for back pain, prescribed by the primary caregiver 32 | P a g e2. Trying out a homeopathic medicine from a friend to reduce swelling in the legs 3. Getting a chiropractic treatment for lower back pain due to discomforts of pregnancy without telling the primary healthcare provider 4. Taking an herbal preparation suggested by a health food store worker for treatment of leg pain 5. Joining a group that practices tai chi weekly to help with physical fitness and movement Question 11 Type: MCSA A patient pregnant with her first child reports that her husband wants her to visit a homeopath for help with her nausea and vomiting. The patient asks what the nurse's opinion of homeopathy is. The best response by the nurse is: 1. "Homeopathy is unproven and potentially dangerous. Avoid using homeopathic remedies." 2. "The FDA has approved homeopathic remedies, and practitioners undergo education and certification." 3. "I can't give you advice about what alternatives to try. Go online and do some research to get information." 4. "Homeopathy is the same as herbal remedies. Some are safe during pregnancy and some are not." Question 12 Type: MCMA The nurse counseling a pregnant woman who expresses a desire to take herbal supplements explains that complementary therapies carry risks because of: Note: Credit will be given only if all correct and no incorrect choices are selected. Standard Text: Select all that apply. 1. Lack of regulation. 2. Inadequate training. 3. Lack of research. 4. Emphasis on wellness. 5. Noninvasive approach. Question 13 Type: MCSA The nurse is teaching a community education class on complementary and alternative therapies. To assess learning, the nurse asks, “In traditional Chinese medicine, what is the invisible flow of energy in the body that 33 | P a g emaintains health and ensures physiologic functioning?" Which answer indicates teaching was successful? 1. Meridians 2. Chi 3. Yin 4. Yang Question 14 Type: MCMA The patient reports to the nurse that she is utilizing ayurvedic medicine. Which statements would the nurse expect this patient to make? "Aryurvedic medicine: Note: Credit will be given only if all correct and no incorrect choices are selected. Standard Text: Select all that apply. 1. “Is knowledge of how to live a vital, healthful life." 2. “Combines heat and cold with spinal manipulation." 3. “Uses both traditional means and current modern medicine." 4. “Cures an illness with a like substance." 5. “Seeks balance to achieve harmony in my life." Question 15 Type: MCSA The nurse is admitting a patient in labor who states that she is a naturopath. The nurse understands that this patient believes: 1. An initial worsening of symptoms after treatment means the correct remedy has been used. 2. There are five elements that take form in the body. 3. She must nurture herself and be responsible for her own body. 4. That her pregnancy is a kapha condition. 5. She must nurture herself and be responsible for her own body. Question 16 Type: MCSA A Hindu patient being admitted to the hospital practices ayurveda. The nurse knows that which piece 34 | P a g eof information is true about this practice? 1. Ayurveda is a new system of Hindu medicine. 2. Ayurveda is the knowledge of how to live a vital, healthful life. 3. Ayurveda physicians believe that there are three elements: ether, wind, and fire. 4. The three tendencies, called doshas, are vata, pitta, and alpha. Question 17 Type: MCMA The nurse is counseling a pregnant woman who intends to see a naturopathic physician. The nurse tells the woman that she can expect education on: Note: Credit will be given only if all correct and no incorrect choices are selected. Standard Text: Select all that apply. 1. Clinical nutrition. 2. Botanical medicine. 3. Lifestyle modification. 4. Use of “like to cure like.” 5. The role of yin and yang. Question 18 Type: MCSA The nurse is teaching a class to the community on mind–body therapies. A class participant gives an example of a friend with leukemia who was taught by her complementary therapist to concentrate on making antibodies that will fight and kill the cancer cells in the bloodstream. The nurse would describe this technique as: 1. Guided imagery. 2. Qigong. 3. Biofeedback. 4. Homeopathy. Question 19 Type: MCSA The nurse in a rural clinic is talking with some patients about biofeedback. The nurse explains to the patients that biofeedback: 35 | P a g e1. Is an alternative therapy. 2. Is a state of great mental and physical relaxation in which one is susceptible to suggestion. 3. Is a method to learn control of physiological responses based on the concept that the mind controls the body. 4. Is a complementary therapy in which one goes into a relaxed state and focuses on positive scenes. Question 20 Type: MCSA The nurse is sitting with a patient in labor who practices meditation. The nurse understands from this that: 1. The patient is very religious, and is practicing her religion. 2. The patient tries to let all thoughts fade away and listen receptively in a state of not knowing. 3. The patient is in a state of intense, focused concentration used to create compelling mental images. 4. The patient relaxes and focuses on a positive or soothing scene. Question 21 Type: MCMA The patient in the third trimester tells the nurse that she has designed the baby’s room to take advantage of sense therapies. The nurse knows that complementary and alternative therapies affecting the senses include: Note: Credit will be given only if all correct and no incorrect choices are selected. Standard Text: Select all that apply. 1. Aromatherapy. 2. Color therapy. 3. Sound therapy. 4. Supplements. 5. Acupressure. Question 22 Type: MCSA The patient reports using an alternative therapy that involves the manipulation of soft tissues. This therapy has reduced the patient's stress, diminished pain, and increased circulation. This therapy is most likely: 1. Guided imagery. 36 | P a g e2. Homeopathy. 3. Massage therapy. 4. Reflexology. Question 23 Type: MCSA The patient asks why she should not use a sauna or sweat bath in the first trimester of pregnancy. The best explanation by the nurse is that saunas and sweat baths have been associated with fetal: 1. Craniofacial defects. 2. Neural tube defects. 3. Gastroschisis. 4. Patent ductus arteriosus. Question 24 Type: MCSA A woman has just been referred to a chiropractor for lower back pain by her primary physician. The physician’s nurse knows that which consideration is important in choosing an appropriate chiropractor? 1. Do not expect chiropractors to provide a written report to the primary physician. 2. Do not choose a chiropractor who considers a spinal manipulation a cure for anything that ails you. 3. Choose a chiropractor who orders frequent x-rays in order to determine treatment progression. 4. Do not expect chiropractors to provide you with a written treatment plan. Question 25 Type: MCSA The nurse is examining a patient in her third trimester of pregnancy. The patient’s weight gain has been within normal limits, she has no swelling of her feet, and she states that she feels great. She states that she has been doing yoga 5 days a week ever since she got pregnant. The nurse understands from this that: 1. The patient has continued her regular prepregnant exercise of walking 5 miles a day. 2. The patient has been doing hydrotherapy baths or using a hot tub. 3. The patient has been bicycling on the trails. 4. The patient has been doing a series of gentle stretches and postures coordinated with deep breathing. 37 | P a g eQuestion 26 Type: MCMA The patient in the first trimester of pregnancy tells the nurse she regularly sees a massage therapist to help with pain in her shoulders and neck. The nurse tells her that massage has the added advantage of: Note: Credit will be given only if all correct and no incorrect choices are selected. Standard Text: Select all that apply. 1. Improving immune function. 2. Reducing anxiety. 3. Promoting sleep. 4. Eliminating energy blockages. 5. Allowing coor