Maternal-Child Nursing Care, 2nd Edition

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