Introductory Maternity & Pediatric Nursing 2nd edition Klossner, Hatfield Test Bank

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  • Published: 2009
  • ISBN-10: 0781785588
  • ISBN-13: 978-0781785587

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Introductory Maternity and Pediatric Nursing 2nd edition Klossner, Hatfield Test Bank

Chapter 2

Client Needs:  B

Cognitive Level:  Analysis

Integrated Process:  Teaching & learning

Objective:  5

Page and Header:  29, The Family as a Social Unit

1.You are answering questions from parents who are concerned about the differences in language development skills among their three children, aged 7, 4, and 3. In discussing the differences among the children, you explain that
A)Firstborn children are slower to develop language skills than their siblings
B)Second-born children are slower to develop language skills than their siblings
C)Boys raised with older sisters are slower to develop language skills than their siblings
D)Girls raised with older brothers are slower to develop language skills than their siblings
Ans:C
Feedback:
Birth order has an impact on the development of children. First-born children command a great deal of attention and tend to be higher achievers than siblings; thus language skills develop sooner in older children. With second and subsequent children, parents tend to be more relaxed and permissive. These children are likely to be more relaxed and are slower to develop language skills. They often identify more with peers than with parents.
Client Needs:  B

Cognitive Level:  Knowledge

Integrated Process:  Teaching & learning

Objective:  9

Page and Header:  31, Health Care Shift: From Hospital to Community

2.As part of your role as a school nurse, you are conducting a drug education program in a fourth-grade class. This is an example of nursing in
A)Primary prevention
B)Secondary prevention
C)Tertiary prevention
D)Home health care
Ans:A
Feedback:
Primary prevention is promotion of heath positive activities and includes teaching regarding safety, diet, rest, exercise, and disease prevention. Secondary prevention focuses on health screening activities that aid in early diagnosis and encourage prompt treatment. Tertiary prevention focuses on rehabilitation and instruction on ways to prevent further injury or illness.  Home health care refers to practices done in the home by the patient.
Client Needs:  B

Cognitive Level:  Application

Integrated Process:  Teaching & learning

Objective:  9

Page and Header:  31, Health Care Shift: From Hospital to Community

3.You are a nurse focused only on tertiary prevention. Which of the following most likely describes your actions in your current role?
A)Caring for new mothers in a maternity clinic
B)Identifying a child with pediculosis in an elementary school
C)Taking case histories in an orthopedic clinic
D)Providing care for an elderly patient in a home-care setting
Ans:C
Feedback:
Orthopedic patients are typically recovering from injury or are in need of rehabilitation. Tertiary prevention focus is on rehabilitation activities and would be the focus of a nurse in an orthopedic clinic, aligning with the needs of the patients in the clinic.
Client Needs:  A-1

Cognitive Level:  Comprehension

Integrated Process:  Caring

Objective:  10

Page and Header:  33, Health Care Shift: From Hospital to Community

4.You are counseling a pregnant woman as to the best option for delivering her baby. She is 25 years old, has one other child, and is in a low-risk pregnancy. You advise her that the best option for delivery is
A)A home setting
B)A birthing center
C)A hospital
D)There is no evidence of any superiority among settings
Ans:D
Feedback:
When a women is low-risk and has no known medical needs, delivery location is the choice of the mother. Home births attended with certified nurse midwives are less likely to have complications and require interventions. Birthing centers are an option for an alternative birth setting, and hospitals are required delivery locations for women with potential needs or complications.
Client Needs:  B

Cognitive Level:  Comprehension

Integrated Process:  Caring

Objective:  13

Page and Header:  37, Health Care Shift: From Hospital to Community

5.Working in a clinic, you are following up on the doctor’s recommendation that your patient consult a nutritionist. By giving a list of referrals to this patient, you are fulfilling part of your role of
A)Client advocacy
B)Community-based nursing
C)Primary care
D)Secondary prevention
Ans:A
Feedback:
Client advocacy is speaking or acting on behalf of clients to help them gain greater independence and to make the health care delivery system more responsive and relevant to their needs. Community-based nursing focuses on prevention and is directed toward persons and families within a community. Primary care is the direct action of the physician.  Secondary prevention involves health screening activities that aid in early diagnosis and encourage prompt treatment before long-term negative effects occur.
Client Needs:  D-1

Cognitive Level:  comprehension

Integrated Process:  Caring

Objective:  14

Page and Header:  37, Health Care Shift: From Hospital to Community

6.You are a community-based nurse and your new patient is a physically challenged 9-year-old girl in a family of four. As part of your client advocacy for this child, you might
A)Take a case history for each member of the family
B)Make telephone calls to establish eligibility for special equipment needed to transport the child to school
C)Take the patient’s blood pressure
D)Document the patient’s progress in physical therapy
Ans:B
Feedback:
Client advocacy is acting on behalf of the patient. Making calls to arrange for special equipment is one role of the nurse who is acting on behalf of the patient.  A case history would be taken at the initial visit to the treatment center by the attending nurse.  During that first visit, blood pressure would be measured as well, not in the follow up with the community-based nurse.  The patient’s progress in physical therapy is to be noted by the therapist or PT assistant.
Client Needs:  B

Cognitive Level:  Application

Integrated Process:  Teaching & learning

Objective:  12

Page and Header:  37, Health Care Shift: From Hospital to Community

7.You are preparing an hour-long prenatal seminar for a group of 27 teenage mothers. Which type of information will you gather to help ensure the success of your program?
A)Medical histories of each of the participants
B)Age, education levels, and language barriers of each of the participants
C)Names of each of the participants
D)Incomes of each of the participants
Ans:B
Feedback:
When teaching a group of patients, the group leader should seek demographic information to help develop an appropriate teaching plan for all participants in the group.  This is an impersonal group, and taking the medical histories or learning their names or incomes is not appropriate.
Client Needs:  B

Cognitive Level:  Knowledge

Integrated Process:  Teaching & learning

Objective:  1

Page and Header:  26, The Family as a Social Unit

8.You are counseling new parents on the best ways to help their newborn develop its senses. You advise them to
A)Make sure the infant receives nutritional supplements
B)Wait until the child is 12 months old before reading to him
C)Provide minimal distraction in the nursery
D)Buy brightly colored toys
Ans:D
Feedback:
Children, from an early age, need stimulation and interaction to develop the five senses optimally. Many parents buy brightly colored toys to facilitate stimulation.  You should encourage proper nutrition through diet rather than supplementation.  Stimulation and interaction such as reading should begin immediately.
Client Needs:  B

Cognitive Level:  Comprehension

Integrated Process:  Teaching & learning

Objective:  14

Page and Header:  31, Health Care Shift: From Hospital to Community

9.As a community-based nurse, your primary focus is
A)Wellness
B)Cost containment
C)Rehabilitation
D)Emergency care
Ans:A
Feedback:
The community-based nurse is in a unique position of health promotion for the community. Wellness is health promotion and aligns with the holistic practice of the community-based nurse.  Cost, rehabilitation, and emergency care are the responsibility of direct care facilities.
Client Needs:  B

Cognitive Level:  Comprehension

Integrated Process:  Caring

Objective:  2

Page and Header:  30, The Family as a Social Unit

10.You are an elementary school nurse, and your patient is a 7-year-old boy whose family has recently immigrated. His teacher has brought him down because he refuses to eat any lunch. You should
A)Do nothing; the child will eat when he is hungry
B)Call the child’s parents to make sure nothing is wrong at home
C)Develop an understanding of the child’s culture and how that may affect eating habits
D)Refer the child to a guidance counselor
Ans:C
Feedback:
Culture influences the family’s health beliefs. A newly immigrated family may have attitudes toward food which are culturally founded. The nurse should seek to clarify the cultural food influences of the family and the needs of this child.  Waiting until the child is hungry may make matters worse, as he is probably already hungry.  Involving the parents at this stage may also make matters worse by adding pressure to the child.  The guidance counselor is an inappropriate step for a 7-year-old child.
Client Needs:  B

Cognitive Level:  Knowledge

Integrated Process:  Caring

Objective:  3

Page and Header:  27, The Family as a Social Unit

11.The Cho family are recent immigrants to the United States. They live with their Aunt Sue and her parents. This is an example of which family form?
A)Extended
B)Nuclear
C)Communal
D)Blended
Ans:A
Feedback:
The extended family is a nuclear family with other family members in the same house. The nuclear family is composed of a man, a woman, and their children (either biological or adopted), who share a common household.  Members of a communal family share responsibility for homemaking and child rearing; all children are the collective responsibility of adult members. In a blended family, both partners in the marriage bring children from a previous marriage into the household.
Client Needs:  B

Cognitive Level:  Knowledge

Integrated Process:  Caring

Objective:  3

Page and Header:  28, The Family as a Social Unit

12.Sally is seen in the family planning clinic. She has two children. She is marrying a man who has three children, and they have decided not to have any children now. This is an example of a/n
A)Blended family
B)Nuclear family
C)Extended family
D)Communal family
Ans:A
Feedback:
The stepfamily or blended family consists of a custodial parent, children, and a new spouse. The nuclear family is composed of a man, a woman, and their children (either biological or adopted), who share a common household.  Members of a communal family share responsibility for homemaking and child rearing; all children are the collective responsibility of adult members. An extended family consists of one or more nuclear families plus other relatives, often crossing generations to include grandparents, aunts, uncles, and cousins.
Client Needs:  B

Cognitive Level:  Comprehension

Integrated Process:  Caring

Objective:  3

Page and Header:  27, The Family as a Social Unit

13.A family was recently enlarged to include a mother and father, a 6-year-old boy, and a new baby sister. What type of family does this represent?
A)Cohabitation
B)Adoptive
C)Nuclear
D)Extended
Ans:C
Feedback:
A nuclear family is defined as consisting of parents and children. An extended family consists of one or more nuclear families plus other relatives, often crossing generations to include grandparents, aunts, uncles, and cousins. In the cohabitation family, couples live together but are not married. The children in this family may be children of earlier unions, or they may be a result of this union. The parents, child, and siblings in the adoptive family all have challenges that differ from other family structures.
Client Needs:  B

Cognitive Level:  Application

Integrated Process:  Caring

Objective:  3

Page and Header:  27, The Family as a Social Unit

14.Which of the following may occur in nuclear families at a greater level than in some other types of families?
A)Financial difficulties.
B)Problems with allocation of resources.
C)Formation of a poor parent-child relationship.
D)Lack of support people in a crisis.
Ans:D
Feedback:
People in a nuclear family may all be so involved in a crisis that there is no objective support person.  Financial difficulties, resource allocation problems, and poor relationships may be formed in any family situation.
Client Needs:  B

Cognitive Level:  Application

Integrated Process:  Nursing process

Objective:  3

Page and Header:  28, The Family as a Social Unit

15.Which of the following may be a strength of the single-parent type of family?
A)Financial security
B)Readily available support in a crisis
C)Development of a special parent-child relationship
D)Child wishing for no other siblings
Ans:C
Feedback:
Because there is no competition for time from a spouse, single-parent

families can promote special parent-child relationships.  Financial security, support in a crisis, and the desire for no siblings can occur in any family situation.

Client Needs:  A-1

Cognitive Level:  Comprehension

Integrated Process:  Caring

Objective:  2

Page and Header:  30, The Family as a Social Unit

16.The nurse is caring for a childbearing family of a different cultural background. In order to provide culturally appropriate and competent care, the nurse should execute which nursing action?
A)Use your personal cultural experiences with the family
B)Use a standard nursing care plan for the family
C)Expect the family to adopt the cultural beliefs of that facility
D)Ask the family for input into their care based on their cultural beliefs
Ans:D
Feedback:
Cultural beliefs vary; care should be based on the individual beliefs of each family. The imposition of personal, institutional, or others beliefs should never be done to a patient.
Client Needs:  B

Cognitive Level:  Application

Integrated Process:  Nursing Care

Objective:  10

Page and Header:  34, Health Care Shift: From Hospital to Community

17.A nurse is reading about care of patients in the home. The role of the nurse in home care is
A)Limited due to the lack of increase in home care costs
B)Based only on the request of the patient
C)Provider of direct patient care after receipt of health care provider orders
D)As a visitor only, not to provide direct care in the home
Ans:C
Feedback:
Nurses are providers of home health care and follow the orders of the health care provider. Cost should not be an issue for the nurse. Patient requests can be listened to, but not at the detriment of care. The job of the nurse is direct care of the patient, the nurse is not a visitor in the home.
Client Needs:  B

Cognitive Level:  Application

Integrated Process:  Caring

Objective:  3

Page and Header:  26, The Family as a Social Unit

18.To assess the sociocultural aspects of the family of an adolescent in an ambulatory clinic, about which of the following would you ask?
A)His mother’s occupation
B)His mother’s attitude toward citizenship
C)The adolescent’s education level
D)His family structure
Ans:D
Feedback:
Family structure is a characteristic strongly influenced by culture. The mother’s occupation and citizenship do not affect the treatment of the adolescent patient. The patient’s education also should not be a factor in treatment.
Client Needs:  B

Cognitive Level:  Application

Integrated Process:  Caring

Objective:  3

Page and Header:  26, The Family as a Social Unit

19.An adolescent believes that people from the Bronx are stupid. What does this type of belief represent?
A)Group analysis
B)Definitive analysis
C)Ethnocentrism
D)Stereotyping
Ans:D
Feedback:
Stereotyping is viewing people and things from preconceived notions.  Group and definitive analysis are scientific measures. Ethnocentrism describes a tendency to judge other cultures by the standards of one’s own culture.
Client Needs:  B

Cognitive Level:  Analysis

Integrated Process:  Caring

Objective:  1

Page and Header:  26, The Family as a Social Unit

20.An adolescent tells you that it is taboo in his family to use credit cards. You would interpret this to mean which of the following?
A)His parents do not use credit cards
B)His parents probably have few credit cards
C)The family is wealthy
D)The adolescent is too young to apply for a credit card
Ans:A
Feedback:
A cultural taboo refers to an action that is disapproved. Nothing other than the fact that it is forbidden can be inferred from a taboo.
Client Needs:  B

Cognitive Level:  Application

Integrated Process:  Caring

Objective:  2

Page and Header:  30, The Family as a Social Unit

21.A boy tells you that his family celebrates the Fourth of July by eating out at a local restaurant. He tells you this is a better way to celebrate the holiday than having a picnic like his neighbors. This statement represents which of the following?
A)Ethnocentrism
B)Stereotyping
C)A taboo
D)Cultural assimilation
Ans:A
Feedback:
Ethnocentrism is a belief that one’s own culture or customs are superior to others.  A stereotype is often used with a negative connotation when referring to an oversimplified, exaggerated, or demeaning assumption that a particular individual possesses the characteristics associated with the class due to his or her membership in it. A taboo is forbidden. Assimilation is the fusion of a person into a culture.
Client Needs:  B

Cognitive Level:  Analysis

Integrated Process:  Caring

Objective:  5

Page and Header:  30, The Family as a Social Unit

22.During a hospital admission an 8-year-old of Polish heritage tells you he is angry because so many people have asked him how to pronounce his name. Which of the following would be your best response?
A)“Polish names are hard to pronounce.”
B)“No one ever says my name correctly either.”
C)“I will mark in your nursing care plan how to say it correctly.”
D)“I’ll never use your name. Then, I can’t say it wrong.”
Ans:C
Feedback:
Respect for other cultures begins with personal respect. Stating that it is hard to pronounce or that no one says your name correctly dismisses the patient’s feelings. Not using the patients name is disrespectful.
Client Needs:  B

Cognitive Level:  Application

Integrated Process:  Caring

Objective:  5

Page and Header:  27, The Family as a Social Unit

23.A girl comes from a large family that you analyze as being extended. In planning hospital care for her, which factor would be most important for you consider?
A)Restricting visitors to reduce the noise level.
B)Organizing nursing care at times other than visiting hours.
C)Asking the hospital’s visitor program to call on her to prevent loneliness.
D)Spending increased time with her yourself to prevent loneliness.
Ans:B
Feedback:
Because extended families have many members, support people in time of an illness are usually available. Restricting visitors will leave her without support and will be detrimental to her treatment. Asking the staff to visit will reduce her privacy. You as a practitioner cannot become personally involved.
Client Needs:  B

Cognitive Level:  Application

Integrated Process:  Caring

Objective:  2

Page and Header:  27, The Family as a Social Unit

24.You view a boy from a large extended family as poor because his father is unemployed. Considering his family structure, which way might he view you as “poor”?
A)You are planning to be a nurse.
B)You own only one student nurse’s uniform.
C)You are unmarried and live alone.
D)You stated you value honesty.
Ans:C
Feedback:
Part of the richness of an extended family is the availability of support people in times of family stress.  Planning to be a nurse would not be a factor. They would not know that you only own one uniform. Your views on honesty are unrelated to your financial status.
Client Needs:  B

Cognitive Level:  Application

Integrated Process:  Caring

Objective:  10

Page and Header:  30, The Family as a Social Unit

25.You see a 3-year-old girl in an ambulatory clinic because she has a bad cold. Her mother tells you the girl’s problem was caused by her being affected by “mal ojo.” Which of the following would be the best action?
A)Tell her mother this is not a legitimate illness
B)Teach her mother that colds are caused by viruses
C)Ask her mother what symptoms her daughter is experiencing
D)Explain there is nothing to do for illnesses caused by evil spirits
Ans:C
Feedback:
Respecting cultural values is important for effective nurse-patient relationships, and can be accomplished without insulting the mother. Telling her that the illness is not legitimate will establish an adversarial relationship. It would insult the mother if you tried to teach her what she believes she knows. Religious views of good and evil in relation to a disease are not to enter the conversation.
Client Needs:  A-1

Cognitive Level:  Application

Integrated Process:  Teaching & learning

Objective:  2

Page and Header:  33, Health Care Shift: From Hospital to Community

26.When a woman is admitted to the labor and delivery unit, her husband says he is going to work and asks you to call when the baby is born. Your best response to this husband would be to
A)Ask him if he knows that he can stay with his wife during labor
B)Tell him that all fathers now stay with their wives during labor
C)Tell him he is missing out on the opportunity of a lifetime by leaving
D)Insist he stay with his wife during labor because she will need his support
Ans:A
Feedback:
Respect for cultural values is important for developing effective nurse-patient relationships; and informing, rather than enforcing what you believe to be correct, is the best way to handle the situation.
Client Needs:  A-1

Cognitive Level:  Application

Integrated Process:  Caring

Objective:  5

Page and Header:  30, The Family as a Social Unit

27.A woman in labor has brought a butcher knife with her and insists on putting it under her hospital mattress to “cut the labor pain.” Your best response to this practice would be to do which of the following?
A)Teach her to use chest breathing with contractions.
B)Educate her about the cause of labor pain.
C)Tell her that she cannot keep the knife because it is a lethal weapon.
D)Allow her to keep the knife under her mattress during labor.
Ans:D
Feedback:
Respect for cultural values is important for developing effective nurse-patient relationships, and allowing her to believe what she wishes is appropriate. Any attempt to educate her or restrict her actions would worsen the situation.
Client Needs:  B

Cognitive Level:  Application

Integrated Process:  Caring

Objective:  5

Page and Header:  30, The Family as a Social Unit

28.When caring for a woman in her sixth month of pregnancy, she reports her plans to nurse for at least two to three years like the rest of the women in her family. Based upon your knowledge you:
A)Advise her to be careful who she discusses this with as many will consider that a type of reportable child abuse
B)Document her report but do nothing as this is a cultural belief that should be respected
C)Encourage her to start the baby on formula after the first year as recommended by many physicians
D)Discuss how painful this will be once the baby has teeth
Ans:B
Feedback:
Culturally specific decisions should be respected and incorporated into the plan of care.  Options other than following the mother’s wishes (insomuch as these wishes do not put the child in danger), are inconsequential and may be viewed as intrusive and inappropriate.
Client Needs:  A-1

Cognitive Level:  Knowledge

Integrated Process:  Caring

Objective:  1

Page and Header:  30, The Family as a Social Unit

29.While caring for a pregnancy woman of Middle Eastern descent a nurse attempts to mold the patient’s choices to fit what she calls the “American Way.” When questioned she reports it is best and easier to plan and deliver care this way. Based upon your knowledge you recognize this as:
A)Cultural destructiveness
B)Cultural blindness
C)Cultural awareness
D)Cultural sensitivity
Ans:A
Feedback:
Attempts to modify the culture and beliefs of others is a form of cultural destructiveness. .  Cultural blindness is an unknowing ignorance. Nurses should strive for full cultural understanding and awareness. Cultural sensitivity is the demonstration of awareness.
Client Needs:  B-2

Cognitive Level:  Application

Integrated Process:  Teaching & Learning

Objective:  10

Page and Header:  30, The Family as a Social Unit

30.A woman seven weeks pregnant is admitted with vaginal bleeding. She reports she should have never raised her arms above her with this pregnancy. Based upon your knowledge, how do you respond?
A)“I agree—keeping your arms down will reduce your risk factors”
B)Explain to the patient that this an unfounded myth
C)Ignore her comment
D)Recognize her cultural beliefs and explain in a non-judgmental manner the potential causes of miscarriage
Ans:D
Feedback:
Lying to the patient inappropriate. Explaining that it is a mythdoes not handle the manner in an informative and sensitive manner. Ignoring her does nothing to help the patient.

Introductory Maternity and Pediatric Nursing 2nd edition Klossner, Hatfield Test Bank

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