Ricci Chapter 2 - Test Bank - 4th Edition Questions And Answers

1. The nurse is providing care to a pregnant woman who speaks a different language from that of the nurse. When communicating with this client, the nurse demonstrates best practice by which action? A. speaking to the client in a loud voice at a slow pace B. standing close to the client while using a strong emphatic tone C. having a family member communicate the information to the client D. arranging for an interpreter to be present during any communication - ANS Answer: D Rationale: The nurse should arrange for an interpreter when communicating with a client who speaks another language. Speaking loudly, standing close to the client, and speaking emphatically would be of little benefit if the client does not understand the spoken language. Additionally, it can be interpreted as threatening to the client. Having a family member communicate the information to the client is inappropriate, violates client confidentiality (if the client has not given permission for that member to have the information), and does not ensure that the client will receive the correct information. 2. The nurse is caring for a 2-week-old newborn girl with a metabolic disorder. Which activity would deviate from the characteristics of family-centered care? A. softening unpleasant information or prognoses B. evaluating and changing the nursing plan of care C. collaborating with the child and family as equals D. showing respect for the family's beliefs and wishes - ANS Answer: A Rationale: Family-centered care requires that the nurse provide open and honest information to the child and family. It is inappropriate to soften unpleasant information or prognoses. Evaluating and changing the nursing plan of care to fit the needs of the child and family, collaborating with them as equals, and showing respect for their beliefs and wishes are guidelines for family-centered care. 3. The nurse is providing home care for a 6-year-old girl with multiple medical challenges. Which activity would be considered the tertiary level of prevention? A. arranging for a physical therapy session B. teaching parents to administer albuterol C. reminding parent to give a full course of antibiotics D. giving a DTaP vaccination at the proper interval - ANS Answer: A Rationale: The tertiary level of prevention involves restorative, rehabilitative, or quality of life care such as arranging for a physical therapy session. Teaching parents to administer albuterol and reminding a parent to give the full course of antibiotics as prescribed are part of the secondary level of prevention, which focuses on diagnosis and treatment of illness. Giving a DTaP vaccination at the proper interval is an example of the primary level of prevention, which centers on health promotion and illness prevention. 4. A pregnant client tells her nurse that she is interested in arranging a home birth. After educating the client on the advantages and disadvantages of a home birth, which statement would indicate that the client understood the information? A. "I like having the privacy, but it might be too expensive for me to set up in my home." B. "I want to have more control, but I am concerned if an emergency would arise." C. "It is safer because I will have a midwife." D. "The midwife is trained to resolve any emergency, and she can bring any pain meds." - ANS Answer: B Rationale: Home births have many advantages, such as having more control over the birth, being the least expensive option, creating a good relationship with a midwife, and having more flexibility in the comfort of your home. However, the limited availability of pain medication and danger to the mother and baby if an emergency arises are two of the main disadvantages. 5. A nurse is reading a journal article about the changes in health care delivery and funding that have occurred over the years. Which factor would the nurse expect to find as a current trend in maternal and child health care settings? A. increase in ambulatory care B. decrease in family poverty level C. increase in hospitalization of children D. decrease in managed care - ANS Answer: A Rationale: The health care system has moved from reactive treatment strategies in hospitals to a proactive approach in the community, resulting in an increased emphasis on health promotion and illness prevention in the community through the use of community-based settings such as ambulatory care. Poverty levels have not decreased, and the hospitalization of children has not increased. Case management also is a primary focus of care. 6. The nurse would recommend the use of which supplement as a primary prevention strategy to prevent neural tube defects in the future offspring of pregnant women? A. calcium B. folic acid C. vitamin C D. iron - ANS Answer: B Rationale: Prevention of neural tube defects in the offspring of pregnant women via the use of folic acid is an example of a primary prevention strategy. Calcium, vitamin C, and iron have no effect on the prevention of neural tube defects. 7. Which action would the nurse include in a primary prevention program in the community to help reduce the incidence of HIV infection? A. Provide treatment for clients who test positive for HIV. B. Monitor viral load counts periodically. C. Educate clients on how to practice safe sex. D. Offer testing for clients who practice unsafe sex. - ANS Answer: C Rationale: Primary prevention involves preventing disease before it occurs. Therefore, educating clients about safe sex practices would be an example of a primary prevention strategy. Providing treatment for clients who test positive for HIV, monitoring viral loads periodically, and offering testing for clients practicing unprotected sex are examples of secondary preventive strategies, which focus on early detection and treatment of adverse health conditions. 8. The nurse is preparing the discharge plan for a woman whose newborn requires ventilatory support at home. Which action by the nurse would be most appropriate to do when assuming the role of discharge planner? A. Confer with the client's parents. B. Teach new self-care skills to the client. C. Determine if there is a need for back-up power. D. Discuss coverage with the insurance company. - ANS Answer: C Rationale: The nurse should establish if there is a need for back-up power during discharge planning. Conferring with a woman's parents and dealing with insurance companies are case management activities. Teaching self-care skills are activities associated with the nurse as an educator. 9. A nurse working in the community is involved in providing primary prevention. Which intervention would be most appropriate to implement? A. teaching parents of toddlers about ways to prevent poisoning B. working with women who are victims of domestic violence C. working with clients at an HIV clinic to provide nutritional and CAM therapies D. teaching hypertensive clients to monitor blood pressure - ANS Answer: A Rationale: Primary prevention involves preventing a disease or condition before it occurs, such as teaching parents of toddlers about poisoning prevention. Working with women who are victims of domestic violence, clients at an HIV clinic, or hypertensive clients are all examples of tertiary prevention, which is designed to reduce or limit the progression of a disease or condition. 10. A nurse is preparing an in-service program for a group of newly hired nurses about trends in care for pregnant women. When describing events of the past decade, the nurse would state that the average length of stay in the hospital for vaginal births is: A. 24 to 48 hours or less. B. 72 to 96 hours or less. C. 48 to 72 hours or less. D. 96 to 120 hours or less. - ANS Answer: A Rationale: Hospital stays for vaginal births have averaged 24 to 48 hours or less during the past decade and 72 to 96 hours or less for cesarean births. 11. A nurse is teaching a local women's group about women's health care and changes that have occurred. When describing women's health care today, which statement would the nurse likely include? A. Women spend 50 cents of every dollar spent on health care. B. Women make almost 80% of all health care decisions. C. Women are still the minority in the United States. D. Men use more health services than women. - ANS Answer: B Rationale: Women make almost 80% of all health care decisions (those related to caregiver, mother, client); they represent the majority of the population; they spend 66 cents of every health care dollar; and they use more health services than men, with 7 of every 10 most frequently performed surgeries being specific to women. 1