Maternal & Child Health Nursing: Care of the Childbearing & Childrearing Family 8th Edition Test Bank

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Page 11.For which reasons would a nurse review infant mortality statistics in the United States?(Select all that apply.)A)Measures the quality of pregnancy careB)Reviews information on overall nutritionC)Compares health with those of other statesD)Determines infant health and available careE)Provides an index of the country's general healthAns:A, B, D, EFeedback:Infant mortality statistics provide an index of a country's general health, measures thequality of pregnancy care, provides information on overall nutrition, and determinesinfant health and available care. Infant mortality statistics compares the health withthose of other countries and not with those of other states.2. The nurse is providing care in an organization that supports the maternal and child carecontinuum. Which type of patient care area is an example of this approach?A)Primary careB)Team nursingC)Case managementD)Family-centered careAns: DFeedback:Keeping the family at the center of care is important because the level of a family'sfunctioning is important to the health status of its members. A healthy family establishesan environment conducive to growth and health-promoting behaviors to sustain familymembers during crises. A family-centered approach enables nurses to better understandindividuals and their effect on others and, in turn, to provide more holistic care. Primarynursing, team nursing, and case management do not necessary take into considerationthe maternal and child care continuum.

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Page 23.Which actions should the nurse perform when supporting the goals of maternal andchild health care? (Select all that apply.)A)Advocates protecting the rights of the mother and fetusB)Teaches family members interventions to improve healthC)Adheres to principles that focus on the needs of the motherD)Encourages maternal hospitalization to regain strength and staminaE)Assesses family members for strengths and specific needs or challengesAns:A, B, EFeedback:Actions that the nurse should perform when supporting the goals of maternal and childhealth care include advocating the rights for the mother and fetus, teaching healthpromotion interventions, and assessing the family for strengths and specific needs orchallenges. Adhering to principles that focus on the needs of the mother andencouraging maternal hospitalization to regain strength and stamina are not actions thatsupport the goals of maternal and child health care.4. The nurse is reviewing the 2020 National Health Goals and notes that which is a focusof these goals?A)Health promotion and disease preventionB)Early diagnosis of chronic health problemsC)Effective use of medication to treat diseaseD)Reduce the cost of health care and medicationsAns: AFeedback:The 2020 National Health Goals are intended to help citizens more easily understand theimportance of health promotion and disease prevention and to encourage wideparticipation in improving health in the next decade. These goals do not focus on theearly diagnosis of chronic problems, use of medications to treat disease, or reduce thecost of health care and medications.

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Page 35.The nurse has noticed a change in the type of care needed to support maternal and childhealth issues. What does the nurse realize as reasons for the changes in care? (Select allthat apply.)A)Smaller familiesB)Less domestic violenceC)More employed mothersD)Stable home environmentsE)More single-parent familiesAns:A, C, EFeedback:Nursing care for maternal and child is changing because families are smaller, moremothers are employed out of the home, and there are more single-parent families. Thereis an increase in domestic violence, and families are less stable and more mobile, whichinfluences homelessness.6. During an assessment, the nurse asks a patient from a non-English-speaking culturewhich types of home remedies and herbs the patient uses for health care. What is thepurpose of asking the patient this question?A)Analyze for herb–drug interactionsB)Understand the patient's philosophy of alternative health careC)Determine the types of medications the patient will need to be prescribedD)Explain to the physician the patient's preference for nontraditional medicineapproachesAns: AFeedback:Assessing what alternative measures are being used is important because the action ofan herb can interfere with prescribed medications. Assessing the use of herbal remediesis not done to understand the patient's philosophy of alternative health care, determinethe types of medications the patient will need to be prescribed, or explain the patient'spreferences for nontraditional medicine approaches to the physician.

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Page 47.The nurse notes that statistics on maternal mortality had improved but are againbecoming elevated. What does the nurse realize as a reason for this change in maternalmortality rates?A)Earlier prenatal careB)Gestational hypertensionC)Increased vaginal deliveriesD)Treatment for chronic diseasesAns:BFeedback:This increasing rate in maternal mortality is associated with more cesarean births, moregestational hypertension related to preexisting hypertensive disorders, and lack of healthinsurance for many Americans. This increase is not because of earlier prenatal care,increased vaginal deliveries, or treatment for chronic diseases.8. A new mother asks the nurse if all of the new baby's injections can be given in one visitbecause the mother is losing income from missing work because of the office visits.What does this new mother's issue indicate to the nurse?A)The mother needs to find an alternative employer.B)The mother's income is more important that the baby's health.C)Missing work does not support the baby's health maintenance visits.D)The federal government needs to do more to support well-baby visits.Ans: CFeedback:An area that needs additional research is finding effective stimuli to encourage womento bring children for health maintenance visits. The mother losing income because ofmissing work for well-baby visits will deter health maintenance visits for the baby goingforward. This mother's issue does not indicate that the mother needs to find another job,that the mother's income is more important that the baby's health, or that the federalgovernment needs to do more to support well-baby visits.

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Page 59.The nurse works in a maternal and child care area that supports health promotion.Which activities will the nurse perform to support this philosophy of health care?(Select all that apply.)A)Planning careB)Patient teachingC)Family counselingD)New mother advocacyE)Identifying nursing diagnosesAns:B, C, DFeedback:Extensive changes in the scope of maternal and child health nursing have occurred ashealth promotion has become a greater priority in care. The nursing activities for healthpromotion include teaching, counseling, and advocacy. Planning care and identifyingnursing diagnoses are a part of the nursing process and not specific to health promotion.10. During a care conference, a nurse provides everyone with a copy of the latest researchon improving the success of breastfeeding for first-time mothers. Which Quality &Safety Education for Nurses competency does this nurse's action support?A)Quality improvementB)Patient-centered careC)Evidence-based practiceD)Teamwork and collaborationAns: CFeedback:Providing research material supports the Quality & Safety Education for Nursescompetency of evidence-based practice because the nurse is integrating the best currentevidence with clinical expertise and patient/family preferences and values for deliveryof optimal health care. Providing research evidence does not support the Quality &Safety Education for Nurses competencies of quality improvement, patient-centeredcare, or teamwork and collaboration.

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Page 611.The nurse is caring for a mother who has just given birth to twins of 28 weeks gestation,each weighing 2 kg. What is the health risk for the mother and the twins?A)Child mortalityB)Neonatal deathC)Infant mortalityD)Maternal mortalityAns:BFeedback:Neonatal death reflects the quality of care available to women during pregnancy andchildbirth and the quality of care available to infants during the first month of life. Theleading causes of death during this time are prematurity with associated low birthweight. Child mortality is the number of people who die during childhood years. Infantmortality is the number of infants who die before the age of 1 year. Maternal mortalityis the number of women who die from activities related to childbirth.12. The nurse is planning an educational session for community members to address theissue of school-age child mortality. Which topic should the nurse identify as the highestpriority for this population?A)CancerB)AssaultC)SuicideD)AccidentsAns: DFeedback:For the school-age child between the ages of 5 and 14 years, the number one cause ofmortality is from unintentional injuries or accidents. Other top five causes for childmortality include cancer, assault, and suicide.13. While providing care to a child, the nurse informs the parents about the treatment plansand helps the parents make decisions about the child's care needs. What do this nurse'sactions support?A)AutonomyB)EmpowermentC)AccountabilityD)Informed consentAns: BFeedback:Nurses promote empowerment of parents and children by respecting their views andconcerns, regarding parents as important participants in their own or their child's health,keeping them informed, and helping and supporting them to make decisions about care.The nurse's actions are not being done to support autonomy, accountability, or informedconsent.

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Page 714.The nurse has been hired to provide care to patients on a maternal and child unit. Whatwill the nurse use to as a guide to legally provide care to this patient population?A)Code of ethicsB)Nursing researchC)Standards of practiceD)Evidence-based guidelinesAns:CFeedback:Understanding standards of care can help nurses practice within appropriate legalparameters. The Code of Ethics will help with ethical situations. Nursing research andevidence-based guidelines will help with providing care that is based upon bestpractices.15. The nurse is providing care to a new mother and infant according to the Quality &Safety Education for Nurses competency approach. Which action should the nurseperform to demonstrate the skill for the competency of safety?A)Assess the mother for preferences based on personal values.B)Ensure the mother and newborn have intact identification bands.C)Introduce all members of the care team to the mother and family.D)Document patient care using computerized spreadsheets and forms.Ans: BFeedback:Action to demonstrate the skill of the competency of safety is to ensure that the motherand newborn have intact identification bands. Assessing the mother for preferencesbased on personal values is the skill associated with patient-centered care. Introducingall members of the care team to the mother and family is the skill associated withteamwork and collaboration. Documenting patient care using computerized spreadsheetsand forms is the skill associated with quality improvement.

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Page 11.A school-age child, a member of a family with a mother, father, and toddler, ishospitalized. The father is employed outside of the home, and the mother stays at homewith the other child. The mother is challenged with supporting both children at this time.What should the nurse suggest to the mother?A)Place the toddler in day care.B)Suggest the father take time off to help.C)Ask extended family members to help out during this time.D)Visit with the patient after the father comes home from work.Ans:CFeedback:In a time of crisis, the nuclear family is challenged because there are few familymembers to share the burden or look at a problem objectively. The nurse should suggestthat the family locate and reach out to support people in their extended family during acrisis. Placing the toddler in day care and suggesting the father take time off to helpmight negatively impact the family's financial situation and would be inappropriate forthe nurse to suggest these options. The option of visiting the school-age child after thefather comes home from work may not support the child adequately during thehospitalization.2. A preadolescent patient, a member of a single-parent family, has abdominal pain and thehealth care provider suspects that an appendectomy might need to be performed. Thepatient's father is asking for a second opinion, whereas the mother tells the nurse to dowhatever needs to be done to help the patient. What does the nurse need to assess beforemoving forward with planning care for this patient?A)Permission to miss schoolB)Identify the custodial parentC)The type of health insuranceD)Plans for help upon dischargeAns: BFeedback:The nurse needs to identify who is the custodial parent. This is especially importantwhen consent forms for care need to be signed. Once this information is obtained, thenurse needs to clearly document it in the patient's medical record. Permission to missschool, health insurance, and needs after discharge do not necessarily need to beassessed prior to planning care for the patient.

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Page 23.During a family assessment, the nurse learns that the male parent smokes. What shouldthe nurse do with this information to support the 2020 National Health Goals?A)Document the information in the medical record.B)Explain that smoking can cause long-term health problems.C)Ask if the male parent has made any efforts towards smoking cessation.D)Suggest that smoking be done away from other family members because of healthconcerns.Ans:CFeedback:One of the 2020 National Health Goals is to increase the percentage of adult smokersaged 18 years and older attempting to stop smoking from 48.3% to 80%. To support thisgoal, the nurse should ask the parent if any efforts toward smoking cessation have beentaken. The nurse needs to do more than just document the information. Explaining thatsmoking can cause long-term health problems may not be an effective strategy toencourage the parent to stop smoking. Suggesting that smoking be done away fromother family members is assuming that the parent is smoking with the family memberspresent.4. During a family assessment, it is identified that the mother is unemployed but stays athome to prepare meals, monitor medication doses, and comfort the children withemotional issues. The father works outside of the home and pays the bills. Which termsshould the nurse use to document the role of the father in this family? (Select all thatapply.)A)ProviderB)NurturerC)Culture bearerD)Health managerE)Financial managerAns: A, EFeedback:The provider is considered the person who brings home the money, which would be thefather because he works outside of the home. The person who pays the bills isconsidered the financial manager. The nurturer would be the one who makes the mealsor the mother in this situation. The health manager is also the mother because she is theperson who monitors medication doses. There is no evidence to support that either themother or father function in the role as culture bearer.

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Page 35.The nurse is completing an assessment of a family with a preschool-age child. Whichareas should the nurse focus when instructing the parents on tasks needed during thisstage of family development? (Select all that apply.)A)Prevention of accidental injuriesB)Importance of child's socializationC)Promoting health through immunizationsD)Socialization through sporting eventsE)Need for dental care and health assessmentsAns:A, BFeedback:In the stage of family development with a preschool-age child, the parent's tasks are toprevent accidental injuries and begin the child's socialization. Socialization throughsporting events, promoting health through immunizations, and the need for dental careand health assessments are family responsibilities for the family with a school-age child.6. The nurse is caring for a school-age child whose mother works two jobs, father is awayfrom the home during the week truck driving, and older brother has a part-time afterschool job. The child will be hospitalized for several weeks for chemotherapytreatments. Which nursing diagnosis should the nurse identify as being appropriate forthis family?A)Impaired parentingB)Parental role conflictC)Health-seeking behaviorsD)Readiness for enhanced family copingAns: BFeedback:The diagnosis parental role conflict would address the parents' work responsibilities andschedules and the relationship of work to the child's extended hospitalization. There isno evidence to suggest that there is impaired parenting, health-seeking behaviors, orreadiness for enhanced family coping.

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Page 47.The nurse is evaluating outcomes about a family's ability to care for an adolescent childthat is recovering from a spinal cord injury. Which statements indicate that this family istransitioning in a healthy manner?A)The patient states the injuries“messed up”the rest of his life.B)The mother states the need to have a break at least once per week.C)The patient states fewer episodes of nausea with changing position.D)The father states the child's accident has brought the family closer together.E)The mother states the ability to provide care for the child is becoming easier.Ans:D, EFeedback:The statements that indicate that the family is able to care for an adolescent child that isrecovering from a spinal cord injury include the father's statement about the familybeing brought closer together and the mother's statement about the care being easier toprovide. The patient's two statements do not address the family's ability to care for thepatient. The mother's statement about needing a break does not measure if the family isable to care for the adolescent patient.8. The nurse is planning outcomes of care for a family whose infant was born with a birthdefect. Which outcome statement would be the most appropriate for this family?A)The parents will seek information regarding the birth defect.B)The parents will limit involvement with extended family members.C)The mother will return to work after 6 weeks as planned before the delivery.D)The father will learn to care for the infant so that the mother can return to work.Ans: AFeedback:The family has a new member that has a birth defect. The outcome statement that wouldbe most appropriate for the family would be for the parents to seek out informationabout the birth defect. The parents limiting involvement with extended family membersmay indicate that the family will be isolated. The father learning to care for the infant sothat the mother can return to work does not take into consideration if the father isemployed. The mother planning to return to work after 6 weeks as planned before thedelivery does not take into consideration the newborn's health care needs.

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Page 59.The nurse is visiting a family with a toddler and school-age child. Which teachingshould the nurse provide to the parents that would be appropriate for both children?A)Increased freedomB)Actions to ensure safetyC)Encourage independent thinkingD)Importance of school experiencesAns:BFeedback:The teaching that would support both of the children's needs would be to focus onactions to ensure safety. Increased freedom would be appropriate for the adolescent.Encourage independent thinking would be appropriate for the young adult. Importanceof school experiences would be appropriate for the school-age child but not for thetoddler.10. A recently separated mother is overwhelmed with caring for three children under theage of 5 years. The oldest child has been recently diagnosed with muscular dystrophy.Which health care providers should the nurse consult to help the mother? (Select all thatapply.)A)DieticianB)PhysicianC)PharmacistD)Social workerE)Physical therapistAns: D, EFeedback:The mother is recently separated and is raising three children independently. The olderchild is diagnosed with a chronic illness. The nurse should consult a social worker tohelp identify resources that the mother and family need. The nurse should consult with aphysical therapist to help the oldest child attain or maintain the maximum level ofphysical functioning. A dietician, physician, and pharmacist will not necessarily be ofassistance to the family at this time.

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Page 611.A family of dual-parent employment with two school-age children has moved into acommunity. During the home visit, the nurse overhears the children talking aboutsomething on the Internet being more interesting than school work. What type ofinformation would be beneficial for the nurse to share with the parents at this time?A)School clubs that meet on the weekendsB)Community activities planned specifically for after schoolC)Names of the Internet providers that service the communityD)Local businesses seeking workers for part-time employmentAns:BFeedback:The children of a dual-parent employment family might spend significant amounts oftime on the Internet. The parents may not be aware of what Internet sites the childrenare frequenting. To reduce the amount of time spent alone on the Internet, the nurseshould provide the parents with information about community activities plannedspecifically for after school. This could reduce the amount of time the children spend inthe Internet while waiting for parents to return home from work. School clubs that meeton weekends will not help with the children spending time on the Internet during theweek. Providing the names of Internet service providers does not address the issue.Local businesses seeking workers for part-time employment is inappropriate because thechildren are of school age.12. The nurse is visiting a family new to a community. The mother has a disability, and theadolescent child is being treated for anorexia. What will the nurse do first whenassessing this family?A)Construct an ecomap.B)Complete a genogram.C)Assess the home for safety.D)Discuss the daughter's anorexia.Ans: AFeedback:An ecomap documents the“fit”of a family into their community by diagramming thefamily and community relationships. Because this family is new to the community, thiswould be the best thing for the nurse to do first. A mark of families who are new to acommunity is they have few community contacts because they have not formed these asyet. A family with few connecting lines between its members and the community mayneed increased nursing contact and support to remain a well family. A genogram is adiagram that details family structure and provides information about the family's healthhistory and the roles of various family members across several generations. This mightbe appropriate for the nurse to complete at a later time. Assessing the home for safetyand discussing the daughter's anorexia could also be done at a later time.

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Page 713.The nurse has been working with a family on actions that strengthen loyalty between allmembers. Which healthy family behavior has been the focus of the nurse'sinterventions?A)Division of laborB)Physical maintenanceC)Socialization of family membersD)Maintenance of motivation and moraleAns:DFeedback:In maintenance of motivation and morale, healthy families have pride in their familyand allow them to support each other during a crisis. Assessing for loyalty is one way tomeasure this behavior. Division of labor focuses on family members dividing theworkload among family members and adjusting workloads as necessary. Physicalmaintenance focuses on food, shelter, clothing, and health care. Socialization of familymembers focuses on every family member feeling as a part of the family and interactingwith people outside of the family.14. The nurse determines that a small nuclear family has achieved the family task ofdivision of labor. What did the nurse assess in this family to come to this conclusion?A)Parents take the children out to meet the new neighbors.B)Parents and children attend religious services every week.C)Older children finish homework before watching television.D)Mother cares for children while father works outside of the home.Ans: DFeedback:The task of division of labor is when the workload is divided evenly between familymembers. Parents taking children to meet the neighbors fulfill the task of familymember socialization. The family attending religious services every week fulfills thetask of member placement in society. Older children finishing homework beforewatching television fulfills the task of maintenance of order.

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Page 815.An extended family is experiencing a crisis. Excessive work demands have caused theprimary parents to work longer hours, but the grandmother who usually watches thechildren after school is recovering from hip replacement surgery. What can the nursesuggest to help this family through this period of time?A)One parent reduces work hours.B)Children go to the grandmother's house after school.C)Identify another extended family member to assist while the grandmotherrecovers.D)Recommend the children learn independence and stay at home alone until a parentarrives.Ans:CFeedback:A positive aspect of the extended family is the availability of many people for child careand support. The family needs to call on this strength and ask another family member tohelp with the child support until the grandmother recovers. One negative aspect of theextended family is reduced resources because of fewer wage earners. This is not thecase because both primary parents are working. Asking for one parent to reduce workhours would be a negative suggestion. Having the children go to the grandmother'shome after school would negatively impact the grandmother's healing and is aninappropriate suggestion to make at this time. Recommending the children learnindependence and stay at home alone could be a safety issue and would be aninappropriate suggestion at this time.

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Page 11.Which question should the nurse ask when assessing the sociocultural aspects of apatient's family?A)CitizenshipB)OccupationC)Education levelD)Family structureAns:DFeedback:Family structure is a lifestyle area that is culturally determined. Citizenship, occupation,and education level are influenced by culture but on an individual basis.2. The nurse suspects that an adolescent patient from the inner city stereotypes otherpeople. Which statement did the patient make that caused the nurse to come to thisconclusion?A)“Kids who study are just nerds.”B)“All people who live in the suburbs drive big cars.”C)“City people are smarter than those who live in the suburbs.”D)“I stay away from people who live downtown because they look funny.”Ans: BFeedback:Stereotyping is expecting a person to act in a characteristic way without regard to his orher individual traits. Ethnocentrism is the belief one's own culture is superior to allothers as exemplified by the statement,“City people are smarter than those who live inthe suburbs.”Discrimination is treating people differently based on their physical orcultural traits, or by performing an act. The statements that exemplify discrimination are“kids who study are just nerds”and“I stay away from people who live downtownbecause they look funny.”3. A young patient tells the nurse that it is taboo to date before the age of 18 years. Howshould the nurse interpret this patient's statement?A)Everyone dates before the age of 18 years.B)Dating before the age of 18 years is not permitted.C)Dating before the age of 18 years can be done with permission.D)Dating before the age of 18 years is permitted in large groups only.Ans: BFeedback:A taboo is an action that is not acceptable to a culture. Dating before the age of 18 yearsbeing taboo means that it is not permitted to be done. This does not mean that everyonedates before the age of 18 years or that dating is done with permission or in large groupsonly.

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Page 24.Which nursing action supports a 2020 National Health Goal that addresses culturaldiversity?A)Focusing on actions to enhance disease preventionB)Reviewing actions to prevent accidents in the home environmentC)Discussing breastfeeding with a pregnant patient who is HispanicD)Analyzing the patient's compliance with health promotion activitiesAns:CFeedback:One 2020 National Health Goal for cultural diversity is to increase the proportion ofmothers who breastfeed their babies in the early postpartum period from a baseline of43.5% to a target of 60.6%. Actions to enhance disease prevention, prevent accidents,and comply with health promotion activities do not support the 2020 National HealthGoals for cultural diversity.5. The nurse is preparing to assess a pregnant patient who is a member of anon-English-speaking culture. Which areas should the nurse assess to address culturaldiversity?(Select all that apply.)A)PainB)TimeC)TouchD)EnvironmentE)CommunicationAns: A, B, C, EFeedback:When conducting an assessment, areas to include that address cultural diversity includepain, time, touch, and communication. Environment is a global term that may or maynot be appropriate to for an assessment on cultural diversity.6. The nurse is beginning an assessment with a pregnant patient from anon-English-speaking culture. The interpreter is having difficulty understanding whatthe patient is trying to say and the patient is becoming frustrated. Which nursingdiagnosis would be the most appropriate for this situation?A)FearB)AnxietyC)PowerlessnessD)Impaired verbal communicationAns: DFeedback:For this patient, impaired verbal communication is because of the frustration that isoccurring between the patient, interpreter, and the nurse. There is no evidence to supportthe diagnoses of fear, anxiety, or powerlessness with this patient.

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Page 37.A pregnant patient from nondominant culture arrives for a prenatal examination isescorted to an examination room. When asked to remove clothing and wear anexamination gown, the patient hesitates. What should the nurse do to ensure culturalsensitivity in preparation for the examination?A)Leave the room.B)Stay in the room.C)Assist with clothing removal.D)Stand the distance of business space from the patient.Ans:AFeedback:The patient may be from a culture that values modesty. Because the patient hesitated toremove clothing while the nurse was in attendance, the nurse should leave the room topermit the patient to change into the examination gown. Staying in the room, assistingwith clothing removal, or standing at the business distance from the patient does notrespect the patient's modesty.8. The nurse teaches a pregnant patient from a nondominant culture that the health careprovider wants the patient to rest for several hours every afternoon. Which patientstatement indicates that teaching has been effective?A)“I need to go to sleep a few hours earlier every night.”B)“I can stay in bed for a few more hours every morning.”C)“I can lie down before lunch and then again right after dinner.”D)“I need to lie down after lunch and not get up until it's time to prepare dinner.”Ans: DFeedback:The nurse is evaluating the patient's comprehension of teaching regarding obtaining restfor several hours every afternoon. The statement about lying down after lunch and notgetting up until time to prepare dinner indicates the patient understands the teaching.The other statements indicate that additional teaching is necessary because going tosleep earlier each evening, lying in bed longer each morning, and resting before lunchand after dinner do not demonstrate understanding of the health care provider'sinstructions.

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Page 49.The husband of a patient in active labor asks the nurse to phone him when the baby isdelivered because he needs to go to work. Which nursing response respects thehusband's culture?A)Ask 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:AFeedback:When implementing care, the nurse needs to avoid forcing cultural values onto others.The nurse needs to appreciate that such values are ingrained and usually very difficult tochange. The nurse also does not know the cultural value of work and should not assumethat the patient's delivery is more important that work in that family's culture. Theresponses that“tell”or“insist”that the husband stay to support the patient do notrespect the family's culture.10. A pregnant patient from a nondominant culture arrives 2 hours late for a scheduledsonogram. What does this patient's behavior indicate to the nurse?A)The patient is confused.B)The patient does not wear a wrist watch.C)Time orientation may be different for the patient's culture.D)The patient's culture may focus on the past and not the future.Ans: CFeedback:The patient who is from a culture that has a different time orientation than the dominantculture will have difficulty adhering to time expectations. The patient not arriving forthe diagnostic test at the scheduled time does not mean that the patient is confused. It isinconsequential if the patient does or does not wear a wrist watch. There is no enoughinformation to determine if the patient is from a culture that focuses on the past and notthe future.

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Page 511.A pregnant patient from a nondominant culture explains that milk and dairy productscannot be consumed for 2 months during the pregnancy because of the need to fast forher religion. Which response should the nurse make after learning this information?A)“I'm sure that you don't need to follow this while you are pregnant.”B)“Avoiding milk and dairy products for 2 months will harm the fetus.”C)“There are other food sources where you can obtain the nutrients that are in milk.”D)“You must have a great deal of will power to avoid milk and dairy products for 2months.”Ans:CFeedback:The patient is explaining a religious practice that influences the patient's culture. Thenurse needs to support this practice by offering other food sources for the patient toconsume which can provide the same or similar nutrients as the foods that are beingabstained. Stating that religious practices do not need to be followed while pregnant isnot taking the patient's cultural needs into consideration. Stating that avoiding milk anddairy products will harm the fetus is an inappropriate scare tactic to persuade the patientto follow the nurse's cultural expectations. Stating that the patient has will power has novalue and should not be made by the nurse.12. The nurse is visiting a patient from a nondominant culture that was recently dischargedfrom the hospital for complications of pregnancy. Which outcome of care would beappropriate for this patient?A)The patient will return to normal activities of daily living.B)The patient will understand signs of the complication developing again.C)The patient will consult with cultural healers to ensure the complication does notoccur again.D)The patient will follow medical advice and keep all scheduled appointments forcontinued care.Ans: BFeedback:Because the patient is from a nondominant culture, the best outcome of care would befor the patient to understand the signs of the complication developing again so thatmedical treatment can be obtained as soon as possible. An outcome that the patient willreturn to normal activities of daily living may not be appropriate because of thecomplication. The patient may consult with cultural healers about the complication, butit is unclear if the complication can be treated by them. Expecting the patient to followmedical advice and keep all scheduled appointments does not necessarily take thepatient's cultural needs into consideration.

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Page 613.During an assessment, a pregnant patient tells the nurse that“white foods”are notconsumed in the patient's culture. What should the nurse do first after learning thisinformation?A)Ask the patient to define“white foods.”B)Document that“white foods”are not eaten.C)Explain that“white foods”have nutrients needed for pregnancy.D)Discuss reasons why“white foods”are avoided in the patient's culture.Ans:AFeedback:The patient is from a culture that avoids eating“white foods.”The first thing that thenurse should do is assess what“white foods”are. From this information, the nurse couldthen determine appropriate diet teaching for the patient. The nurse needs to do morethan document that“white foods”are avoided. The nurse needs to know what“whitefoods”are before explaining their nutritional value. Discussing why“white foods”areavoided demonstrates cultural insensitivity.14. A patient from a nondominant culture is in the second stage of labor and is notdemonstrating any manifestations of pain. What should the nurse do to support thispatient?A)Offer to provide the patient with a back rubB)Measure the pain level with a pain rating scaleC)Discuss pain control measures with the physicianD)Nothing until the patient asks for pain medicationAns: BFeedback:The patient may be from a culture where it is inappropriate to respond to pain. Thenurse needs to objectively assess the patient's level of pain before implementingnonpharmacologic or pharmacologic pain management measures. Offering to provide aback rub may or may not be desired by the patient. Discussing pain control measureswith the physician may be premature. Doing nothing unless the patient asks for painmedication is inappropriate, considering the patient is in the second stage of labor.

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Page 715.A pregnant patient from a nondominant culture wants to deliver the baby“the Americanway”with epidural pain management. How should the nurse describe this patient'sstatement about childbirth?A)Attempting assimilationB)Combating ethnocentrismC)Expression of acculturationD)Stereotyping American behaviorAns:AFeedback:Assimilation occurs when people from a nondominant culture adopt the values of thedominant culture. The patient believes that epidural pain management is the Americanway of childbirth. Ethnocentrism is the belief one's own culture is superior to all others.The patient is not demonstrating ethnocentrism. Acculturation is losing ethnic traditionsbecause of disuse. There is no enough information to determine if the patient ispracticing acculturation. Stereotyping is expecting a person to act in a characteristic waywithout regard to individual traits. The patient's desire to deliver the baby the Americanway is not stereotyping.

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Page 11.Which observation indicates to the nurse that a family is not functioning in a healthyway?A)The family pays cash for health care.B)The father comforts his crying daughter.C)The mother states,“This family couldn't function without me.”D)The father does not share his concerns so his wife will not worry about them.Ans:DFeedback:Health family functioning includes communication with each other and identifying andsharing feelings about the home situation. The family paying cash for health care doesnot support a family that is not functioning in a healthy way. The father comforting hiscrying daughter demonstrates healthy family functioning. The mother who believes thefamily could not function without could be a statement of frustration or evidence thatthe family needs her to maintain healthy functioning.2. During a home visit, the nurse determines that a family is functioning in a healthymanner. Which behavior did the nurse observe to make this determination?A)A mother is angry that the father never helps with housework.B)A brother is so jealous of his new sister that he hides her clothes.C)A father wishes the family was able to spend more time together.D)A mother states she has grown up since giving birth to her children.Ans: DFeedback:A family that is supportive of all family members and provides an environmentconducive to each member's continued growth and development is more likely to beable to manage home care. The mother's statement about growing up after giving birthdemonstrates growth. The mother that is angry because of no help with housework isdemonstrating unrealistic expectations of family members. A brother that hides clothesis not successfully dealing with the stresses within the family. The father wishing thefamily had more time together might be overwhelmed with the home situation.

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Page 23.A pregnant patient experiencing exacerbation of asthma is prescribed home care. Thenurse is planning to assess the patient's community for resources. On which areas willthe nurse focus this assessment? (Select all that apply.)A)ReligionB)Age spanC)Health careD)RecreationE)EnvironmentAns:C, EFeedback:For a patient with asthma, the community areas that the nurse should assess includeenvironment and access to health care. The environment could exacerbate the patient'ssymptoms and health care could influence the patient's ability to obtain help ifnecessary. Religion, age span, and recreation will not necessarily impact themaintenance of the patient's asthma.4. The nurse is completing the health histories for twin toddlers. Which statement shouldthe nurse make to the mother that focuses on the 2020 National Health Goals?A)Discuss adequate dental care.B)Explain the need for the toddlers to have socialization with other children.C)Remind the mother that the toddlers need regularly scheduled vaccinations.D)Stress the importance of home safety and prevention of accidental poisoning.Ans: CFeedback:The 2020 National Health Goal applicable to this situation is to reduce or eliminatevaccine-preventable diseases such as measles, pertussis, and varicella. Dental care,socialization, and home safety are not 2020 National Health Goals.5. A preschooler, receiving home oxygen therapy, is excited about an upcoming birthday.Which statement by the patient's mother indicates that additional teaching on the safetyof home oxygen therapy is needed for the occasion?A)“I'll be careful that no guest smokes.”B)“I'll be certain he doesn't get too tired.”C)“His brother can help him open presents.”D)“I'm baking a cake and we'll have candles.”Ans: DFeedback:During the home visit, the nurse should have instructed the mother on home safety withoxygen therapy. This includes knowing not to light candles near oxygen for a birthday.The statement about no guests smoking indicates that teaching has been effective. Thestatements about fatigue and having help with presents do not evaluate the effectivenessof teaching on home oxygen safety.

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Page 36.During a home care visit, the nurse learns that a pregnant adolescent is concerned aboutbeing lonely at home. What should the nurse suggest to help with this problem?A)The family could buy her a television set.B)Her father could purchase her a cell phone.C)The family might install an intercom system.D)The family could have dinner together in the same room.Ans:DFeedback:To combat the feelings of loneliness and support the family structure, the family canplan to have one meal a day together, such as dinner, in the same room. A cell phone,intercom system, or television set may or may not help the adolescent with feelings ofloneliness.7. The nurse is assessing a patient for potential home care. Which patient statementindicates that the patient will be able to take a medication that is prescribed for threetimes a day?A)“I can take the three pills together at one time.”B)“I will take one pill before breakfast, before lunch, and before dinner.”C)“I can take one pill when I have symptoms and save the others for later.”D)“I will take the pill when I get up in the morning and before I go to bed.”Ans: BFeedback:The nurse is assessing if a patient is able to properly take a medication that is prescribedthree doses per day. The statement that the patient will take one dose before breakfast,lunch, and dinner is evidence that the patient will be able to safely take the medication.Taking three pills together, taking a pill with symptoms, and taking a pill in the morningand at night indicates that the patient will not be able to adhere to the prescribedmedication schedule.8. A parent caring for an ill child at home states that at first it was difficult but now hasadjusted to the situation. Which would be the most appropriate nursing diagnosis for thisfamily?A)Hopelessness related to prolonged home careB)Health-seeking behaviors related to home careC)Readiness for enhanced coping related to home careD)Compromised coping related to difficulty of home careAns: CFeedback:Home care of a child can place a heavy burden on a family as the stress of beingresponsible for an ill child's daily health status can have a negative impact on a parent'sself-esteem. The statement that the mother has adjusted to the situation indicatesreadiness for enhanced coping. The mother is not demonstrating hopelessness,health-seeking behaviors, or compromised coping.

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Page 49. The nurse is explaining to a school-age child the need to soak the hands twice a day tohelp with an infection. Which teaching should the nurse provide that would beappropriate for the patient's cognitive level?A)“You should soak both hands to get them clean.”B)“You need to stay in bed while your hand soaks.”C)“Would you like to sit in the chair or stay in bed to soak your hand?”D)“I know your favorite show is on right now, but we need to soak your hand now.”Ans: CFeedback:Before anyone can be cared for at home, teaching will be required so the familyunderstands the illness and principles of care. Because the patient is a school-age child,the nurse should provide choices so that the patient has a sense of control over thesituation. Soaking both hands may or may not be medically necessary. Telling thepatient to stay in bed or soaking the hands now does not provide the patient with a senseof control and may lead to resistance or nonadherence to medical treatment.10. A patient who is at 30 weeks gestation is prescribed bed rest and home care. Whichskills should the nurse anticipate providing when making the home care visits with thepatient? (Select all that apply.)A)Health teachingB)Monitoring vital signsC)Bathing and washing hairD)Monitoring fetal heart rateE)Administering medicationAns: A, B, D, EFeedback:Nursing care is considered skilled home nursing care if it includes primary health careprovider–prescribed procedures such as dressing changes, administration of medication,health teaching, or observation of a woman status through monitoring vital signs or fetalheart rate. Bathing and washing hair is not considered skilled nursing care.

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Page 511.The nurse is preparing to obtain a health history from a patient with preeclampsia who isat home. In which area should the nurse conduct the assessment?A)Bedroom, where it is quiet and privateB)Kitchen, so other family members can participateC)Porch, so the nurse does not have to enter the homeD)Living room, so as to not interrupt television viewingAns:AFeedback:The nurse should provide privacy and confidentiality when obtaining the health historyand performing a physical examination. The nurse should identify a private locationsuch as the bedroom. The kitchen, porch, and living room are not private areas for thisassessment.12. The nurse instructs a patient who is at 28 weeks gestation on the correct use of the fetalheart monitor at home. Which observation indicates that teaching has been effective?A)The device is sitting on the kitchen table.B)The patient cannot locate the device during a routine home visit.C)The patient has two rhythm strips to share with the nurse during the home visit.D)The patient has a log with the date, time, and number of fetal heart beats counted.Ans: DFeedback:Fetal heart rate monitoring can be taught to the patient including how to record thefindings. The patient that has a log with the date, time, and number of fetal heart beatscounted indicates that teaching has been effective. Fetal heart monitoring should beconducted in the reclining position and the device should not be on the kitchen table.The patient who is unable to locate the device is not performing the assessment asinstructed. The patient who has two rhythm strips to share with the nurse may or maynot be performing the assessment as instructed.

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Page 613.The nurse instructs a pregnant patient who is at home on bed rest to drink at least eightglasses of fluid each day. What would be the best method to encourage the patient todrink this amount?A)Get up every hour and get a drink from the refrigerator.B)Keep a pitcher of fluid readily available on a bedside table.C)Drink cool liquids and avoid hot liquids because they increase thirst.D)Drink the eight glasses before the spouse leaves for work in the morning.Ans:BFeedback:All women during pregnancy should drink six to eight full glasses of fluid a day toobtain adequate fluid for effective kidney function and placental exchange. The patienton bed rest should have a supply of fluid close to the bed such as a water pitcher so thiscan be done easily. Getting up every hour does not support bed rest. Drinking eightglasses of fluid before the spouse leaves for work does not ensure adequate hydrationduring the day. The temperature of the liquids is inconsequential. Hot liquids do notnecessarily increase thirst.14. The nurse is preparing to make a home visit to admit a new patient to services. Whichactions should the nurse take to ensure personal safety? (Select all that apply.)A)Keeping the car doors unlockedB)Keeping the gas tank of the car fullC)Parking the car in a well-lighted areaD)Using a map to avoid getting lost in a strange neighborhoodE)Informing the agency of the estimated arrival time and expected returnAns: B, C, D, EFeedback:Safety tips for making home care visits include keeping the gas tank full, park in awell-lighted area, using a map to avoid getting lost, and informing the agency of theestimated arrival time and expected return. The nurse should keep the car doors lockedfor safety.

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Page 715.During a home visit, the nurse begins teaching on medication safety in the home. Whatshould the nurse include in these instructions? (Select all that apply.)A)Never take medication in front of children.B)Use a reminder sheet and cross off when a medication has been taken.C)Drink a full glass of water with pills to ensure they reach the stomach.D)Keep all medication in a safe place above the height for a child to reach.E)Place medication doses in empty candy or mint containers to reduce waste.Ans:A, B, C, DFeedback:Instructions for medication safety in the home should include never taking medication infront of children, using a reminder sheet to keep track of medication doses, drinking afull glass of water with medication doses, and keeping all medication in a safe placeabove the height for a child to reach. Medications should not be placed in empty candyor mint containers because children might think that these items are candy and mightaccidentally ingest someone else's prescribed medication. This could lead to anaccidental poisoning in the home.

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Page 11.After an examination, a pregnant patient is diagnosed with a cystocele. How should thenurse explain this finding to the patient?A)A fold of peritoneum behind the uterusB)Pouching of the bladder into the vaginal wallC)A part of the rectum is pushing into the vaginal wall.D)Folds of peritoneum that cover the uterus front and backAns:BFeedback:Pouching of the bladder into the vaginal wall is a cystocele. A fold of peritoneumbehind the uterus is posterior ligament. A part of the rectum pushing into the vaginalwall is a rectocele. Folds of peritoneum that cover the uterus front and back are thebroad ligaments.2. A pregnant patient is concerned about a sharp pain that is felt in the lower abdomenwhen making a quick move. What action should the nurse take to help this patient?A)Assess when the patient's last bowel movement occurred.B)Explain that the sharp pain is tension on a uterine ligament.C)Notify the physician because of manifestations of appendicitis.D)Instruct that the pain is a pulled muscle and a heating pad will help.Ans: BFeedback:If a pregnant woman moves quickly, she may pull one of the round or broad ligamentscausing a quick, sharp pain of frightening intensity in one of the lower abdominalquadrants. This pain is not associated with bowel function. Pain of this type calls forconscientious assessment or it can be mistaken for labor or appendicitis pain. This painis not because of a pulled muscle and application of heat is not indicated.3. After an assessment, a pregnant patient asks the nurse questions about her changinguterus and body. Which nursing diagnosis would be appropriate for the patient at thistime?A)Anxiety related to being pregnantB)Ineffective coping related to being pregnantC)Health-seeking behaviors related to reproductive functioningD)Disturbance in body image related to body changes with pregnancyAns: CFeedback:The patient is asking questions related to reproductive functioning which indicateshealth-seeking behaviors. The patient's questions do not indicate that the patient isexperiencing anxiety, ineffective coping, or a disturbance in body image.

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