Maternal-Child Nursing 5th Edition Test Bank

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Chapter 01: Foundations of Maternity, Women’s Health, and Child Health NursingMcKinney: Evolve Resources for Maternal-Child Nursing, 5th EditionMULTIPLE CHOICE1.Which factor significantly contributed to the shift from home births to hospital births in theearly 20th century?a.Puerperal sepsis was identified as a risk factor in labor and delivery.b.Forceps were developed to facilitate difficult births.c.The importance of early parental-infant contact was identified.d.Technologic developments became available to physicians.ANS:DTechnologic developments were available to physicians, not lay midwives. So in-hospitalbirths increased in order to take advantage of these advancements. Puerperal sepsis has been aknown problem for generations. In the late 19th century, Semmelweis discovered how it couldbe prevented with improved hygienic practices. The development of forceps is an example ofa technology advance made in the early 20th century but is not the only reason birthplacesmoved. Unlike home births, early hospital births hindered bonding between parents and theirinfants.PTS:1DIF:Cognitive Level: Knowledge/RememberingREF:p. 1OBJ:Integrated Process: Teaching-LearningMSC:Client Needs: Safe and Effective Care Environment2.Family-centered maternity care developed in response toa.demands by physicians for family involvement in childbirth.b.the Sheppard-Towner Act of 1921.c.parental requests that infants be allowed to remain with them rather than in anursery.d.changes in pharmacologic management of labor.ANS:CAs research began to identify the benefits of early extended parent-infant contact, parentsbegan to insist that the infant remain with them. This gradually developed into the practice ofrooming-in and finally to family-centered maternity care. Family-centered care was a requestby parents, not physicians. The Sheppard-Towner Act of 1921 provided funds forstate-managed programs for mothers and children. The changes in pharmacologicmanagement of labor were not a factor in family-centered maternity care.PTS:1DIF:Cognitive Level: Knowledge/RememberingREF:p. 2OBJ:Integrated Process: Teaching-LearningMSC:Client Needs: Psychosocial Integrity3.Which setting for childbirth allows the least amount of parent-infant contact?a.Labor/delivery/recovery/postpartum roomb.Birth centerc.Traditional hospital birthd.Home birth

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ANS:CIn the traditional hospital setting, the mother may see the infant for only short feeding periods,and the infant is cared for in a separate nursery. The labor/delivery/recovery/postpartum roomsetting allows increased parent-infant contact. Birth centers are set up to allow an increase inparent-infant contact. Home births allow an increase in parent-infant contact.PTS:1DIF:Cognitive Level: Knowledge/RememberingREF:p. 2OBJ:Nursing Process: PlanningMSC:Client Needs: Health Promotion and Maintenance4.As a result of changes in health care delivery and funding, a current trend seen in the pediatricsetting isa.increased hospitalization of children.b.decreased number of children living in poverty.c.an increase in ambulatory care.d.decreased use of managed care.ANS:COne effect of managed care has been that pediatric health care delivery has shifteddramatically from the acute care setting to the ambulatory setting in order to provide morecost-efficient care. The number of hospital beds being used has decreased as more care isgiven in outpatient settings and in the home. The number of children living in poverty hasincreased over the past decade. One of the biggest changes in health care has been the growthof managed care.PTS:1DIF:Cognitive Level: Knowledge/RememberingREF:p. 5OBJ:Nursing Process: PlanningMSC:Client Needs: Safe and Effective Care Environment5.The Women, Infants, and Children (WIC) program providesa.well-child examinations for infants and children living at the poverty level.b.immunizations for high-risk infants and children.c.screening for infants with developmental disorders.d.supplemental food supplies to low-income pregnant or breastfeeding women.ANS:DWIC is a federal program that provides supplemental food supplies to low-income womenwho are pregnant or breastfeeding and to their children until age 5 years. Medicaid’s Earlyand Periodic Screening, Diagnosis, and Treatment Program provides for well-childexaminations and for treatment of any medical problems diagnosed during such checkups.Children in the WIC program are often referred for immunizations, but that is not the primaryfocus of the program. Public Law 99-457 is part of the Individuals with Disabilities EducationAct that provides financial incentives to states to establish comprehensive early interventionservices for infants and toddlers with, or at risk for, developmental disabilities.PTS:1DIF:Cognitive Level: ComprehensionREF:p. 8OBJ:Integrated Process: Teaching-LearningMSC:Client Needs: Health Promotion and Maintenance6.In most states, adolescents who are not emancipated minors must have the permission of theirparents before

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a.treatment for drug abuse.b.treatment for sexually transmitted diseases (STDs).c.accessing birth control.d.surgery.ANS:DMinors are not considered capable of giving informed consent, so a surgical procedure wouldrequire consent of the parent or guardian. Exceptions exist for obtaining treatment for drugabuse or STDs or for getting birth control in most states.PTS:1DIF:Cognitive Level: Knowledge/RememberingREF:p. 17OBJ:Nursing Process: PlanningMSC:Client Needs: Safe and Effective Care Environment7.The maternity nurse should have a clear understanding of the correct use of a clinicalpathway. One characteristic of clinical pathways is that theya.are developed and implemented by nurses.b.are used primarily in the pediatric setting.c.set specific time lines for sequencing interventions.d.are part of the nursing process.ANS:CClinical pathways are standardized, interdisciplinary plans of care devised for patients with aparticular health problem. They are used to identify patient outcomes, specify time lines toachieve those outcomes, direct appropriate interventions and sequencing of interventions,include interventions from a variety of disciplines, promote collaboration, and involve acomprehensive approach to care. They are developed by multiple health care professionalsand reflect interdisciplinary care. They can be used in multiple settings and for patientsthroughout the life span. They are not part of the nursing process but can be used inconjunction with the nursing process to provide care to patients.PTS:1DIF:Cognitive Level: Knowledge/RememberingREF:p. 7OBJ:Nursing Process: PlanningMSC:Client Needs: Safe and Effective Care Environment8.The fastest growing group of homeless people isa.men and women preparing for retirement.b.migrant workers.c.single women and their children.d.intravenous (IV) substance abusers.ANS:CPregnancy and birth, especially for a teenager, are important contributing factors for becominghomeless. People preparing for retirement, migrant workers, and IV substance abusers are notamong the fastest growing groups of homeless people.PTS:1DIF:Cognitive Level: Knowledge/RememberingREF:p. 14OBJ:Nursing Process: AssessmentMSC:Client Needs: Physiologic Integrity9.A nurse wishes to work to reduce infant mortality in the United States. Which activity wouldthis nurse most likely participate in?

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a.Creating pamphlets in several different languages using an interpreter.b.Assisting women to enroll in Medicaid by their third trimester.c.Volunteering to provide prenatal care at community centers.d.Working as an intake counselor at a women’s shelter.ANS:CPrenatal care is vital to reducing infant mortality and medical costs. This nurse would mostlikely participate in community service providing prenatal care outreach activities incommunity centers, particularly in low-income areas. Pamphlets in other languages, enrollingin Medicaid, and working at a women’s shelter all might impact infant mortality, but thegreatest effect would be from assisting women to get consistent prenatal care.PTS:1DIF:Cognitive Level: Application/ApplyingREF:p. 14OBJ:Nursing Process: ImplementationMSC:Client Needs: Health Promotion and Maintenance10.The intrapartum woman sees no need for a routine admission fetal monitoring strip. If shecontinues to refuse, what is the first action the nurse should take?a.Consult the family of the woman.b.Notify the provider of the situation.c.Document the woman’s refusal in the nurse’s notes.d.Make a referral to the hospital ethics committee.ANS:BPatients must be allowed to make choices voluntarily without undue influence or coercionfrom others. The physician, especially if unaware of the patient’s decision, should be notifiedimmediately. Both professionals can work to ensure the mother understands the rationale forthe action and the possible consequences of refusal. The woman herself is the decision maker,unless incapacitated. Documentation should occur but is not the first action. This situationdoes not rise to the level of an ethical issue so there is no reason to call the ethics committee.PTS:1DIF:Cognitive Level: Application/ApplyingREF:p. 18OBJ:Nursing Process: ImplementationMSC:Client Needs: Safe and Effective Care Environment11.Which statement is true regarding the “quality assurance” or “incident” report?a.The report assures the legal department that no problem exists.b.Reports are a permanent part of the patient’s chart.c.The nurse’s notes should contain, “Incident report filed, and copy placed in chart.”d.This report is a form of documentation of an event that may result in legal action.ANS:DAn incident report is used when something occurs that might result in legal action, such as apatient fall or medication error. It warns the legal department that there may be a problem in aparticular patient’s care. Incident reports are not part of the patient’s chart; thus the nurses’notes should not contain any reference to them.PTS:1DIF:Cognitive Level: Knowledge/RememberingREF:p. 18OBJ:Integrated Process: Communication and DocumentationMSC:Client Needs: Safe and Effective Care Environment12.Elective abortion is considered an ethical issue because

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a.abortion law is unclear about a woman’s constitutional rights.b.the Supreme Court ruled that life begins at conception.c.a conflict exists between the rights of the woman and the rights of the fetus.d.it requires third-party consent.ANS:CElective abortion is an ethical dilemma because two opposing courses of action are available.The belief that induced abortion is a private choice is in conflict with the belief that electivepregnancy termination is taking a life. Abortion laws are clear concerning a woman’sconstitutional rights. The Supreme Court has not ruled on when life begins. Abortion does notrequire third-party consent.PTS:1DIF:Cognitive Level: Knowledge/RememberingREF:p. 11OBJ:Integrated Process: Teaching-LearningMSC:Client Needs: Safe and Effective Care Environment13.Which woman would be most likely to seek prenatal care?a.A 15-year-old who tells her friends, “I don’t believe I’m pregnant.”b.A 20-year-old who is in her first pregnancy and has access to a free prenatal clinic.c.A 28-year-old who is in her second pregnancy and abuses drugs and alcohol.d.A 30-year-old who is in her fifth pregnancy and delivered her last infant at home.ANS:BThe patient who acknowledges the pregnancy early, has access to health care, and has noreason to avoid health care is most likely to seek prenatal care. Being in denial about thepregnancy increases the risk of not seeking care. This patient is also 15, and other socialfactors may discourage her from seeking care as well. Women who abuse substances are lesslikely to receive prenatal care. Some women see pregnancy and delivery as a naturaloccurrence and do not seek health care.PTS:1DIF:Cognitive Level: Comprehension/UnderstandingREF:p. 14OBJ:Nursing Process: AssessmentMSC:Client Needs: Health Promotion and Maintenance14.A woman who delivered her baby 6 hours ago complains of headache and dizziness. Thenurse administers an analgesic but does not perform any assessments. The woman then has atonic-clonic seizure, falls out of bed, and fractures her femur. How would the actions of thenurse be interpreted in relation to standards of care?a.Negligent: the nurse failed to assess the woman for possible complicationsb.Negligent: because the nurse medicated the womanc.Not negligent: the woman had signed a waiver concerning the use of side railsd.Not negligent: the woman did not inform the nurse of her symptoms as soon asthey occurredANS:AThere are four elementsto malpractice, which is negligence in the performance ofprofessional duties: duty, breach of duty, damage, and proximate cause. The nurse wasnegligent because she or he did not perform any assessments, which is the first step of thenursing process and is a standard of care. By not assessing the patient, the nurse did not meetestablished standards of care, and thus is guilty of professional negligence, or malpractice.PTS:1DIF:Cognitive Level: Knowledge/Remembering

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REF:p. 16OBJ:Nursing Process: EvaluationMSC:Client Needs: Safe and Effective Care Environment15.Which patient situation fails to meet the first requirement of informed consent?a.The patient does not understand the physician’s explanations.b.The physician gives the patient only a partial list of possible side effects andcomplications.c.The patient is confused and disoriented.d.The patient signs a consent form because her husband tells her to.ANS:CThe first requirement of informed consent is that the patient must be competent to makedecisions about health care. Full disclosure of information is an important element of theconsent, but first the patient has to be competent to sign. Understanding is an importantelement of the consent, but first the patient has to be competent to sign. Voluntary consent isan important element of the consent, but first the patient has to be competent to sign.PTS:1DIF:Cognitive Level: Knowledge/RememberingREF:p. 17OBJ:Nursing Process: AssessmentMSC:Client Needs: Safe and Effective Care Environment16.Which situation reflects a potential ethical dilemma for the nurse?a.A nurse administers analgesics to a patient with cancer as often as the provider’sorder allows.b.A neonatal nurse provides nourishment and care to a newborn who has a defectthat is incompatible with life.c.A labor nurse, whose religion opposes abortion, is asked to assist with an electiveabortion.d.A postpartum nurse provides information about adoption to a new mother whofeels she cannot adequately care for her infant.ANS:CA dilemma exists in this situation because the nurse is being asked to assist with a procedurethat she or he believes is morally wrong. The other situations do not contain elements ofconflict for the nurse.PTS:1DIF:Cognitive Level: Comprehension/UnderstandingREF:p. 11OBJ:Nursing Process: AssessmentMSC:Client Needs: Safe and Effective Care Environment17.When planning a parenting class, the nurse should explain that the leading cause of death inchildren 1 to 4 years of age in the United States isa.premature birth.b.congenital anomalies.c.accidental death.d.respiratory tract illness.ANS:CAlthough the rates have dropped, unintentional injury (accidents) are still the leading cause ofdeath for children aged 1 to 19. The other options contribute to morbidity and mortality inchildren but are not the leading cause.

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PTS:1DIF:Cognitive Level: Knowledge/RememberingREF:p. 10 | Table 1.3OBJ:Integrated Process: Teaching-LearningMSC:Client Needs: Safe and Effective Care Environment18.A nurse is floated to a different unit. The nurse does not know how to perform a treatment thathas been prescribed for one of his or her assigned patients. What should the nurse’s firstaction be?a.Delay the treatment until another nurse can do it.b.Make the child’s parents aware of the situation.c.Inform the nursing supervisor of the problem.d.Arrange to have the child transferred to another unit.ANS:CNurses who work outside their usual areas of expertise must assess their own skills and avoidperforming tasks or taking on responsibilities in areas in which they are not competent. Thisnurse should inform the supervisor of the situation. The nurse could endanger the child bydelaying the intervention until another nurse is available. Telling the child’s parents wouldmost likely increase their anxiety and will not resolve the difficulty. Transfer to another unitdelays needed treatment and would create unnecessary disruption for the child and family.PTS:1DIF:Cognitive Level: Application/ApplyingREF:p. 19OBJ:Nursing Process: ImplementationMSC:Client Needs: Safe and Effective Care Environment19.The mother of a 5-year-old female inpatient on the pediatric unit asks the nurse if she couldprovide information regarding the recommended amount of television viewing time for herdaughter. The nurse responds that the appropriate amount of time a child should be watchingtelevision isa.1 to 2 hours per day.b.2 to 3 hours per day.c.3 to 4 hours per day.d.4 hours or more.ANS:AThe American Academy of Pediatrics (2013) encourages parents to monitor their children’smedia exposure and limit their children’s screen time (TV, computer, video games) to nomore than 1 to 2 hours per day. The other options all contain more screen time than isrecommended.PTS:1DIF:Cognitive Level: Comprehension/UnderstandingREF:p. 15OBJ:Integrated Process: Teaching-LearningMSC:Client Needs: Health Promotion and Maintenance20.Family-centered care (FCC) describes safe, quality care that recognizes and adapts to both thephysical and psychosocial needs of the family. Which nursing practice coincides with theprinciples of FCC?a.The newborn is returned to the nursery at night so that the mother can receiveadequate rest before discharge.b.The father is encouraged to go home after the baby is delivered.c.All patients are routinely placed on the fetal monitor.d.The nurse’s assignment includes both mom and baby and increases the nurse’s

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responsibility for education.ANS:DFamily-centered care increases the responsibilities of nurses. In addition to the physical careprovided, nurses assume a major role in teaching, counseling, and supporting families. Theother options do not provide family-centered care because they increase family separation oruse technology routinely, which may not be needed.PTS:1DIF:Cognitive Level: Comprehension/UnderstandingREF:p. 2OBJ:Integrated Process: CaringMSC:Client Needs: Health Promotion and Maintenance21.Which statement related to nursing care of the child at home is most correct?a.The technology-dependent infant can safely be cared for at home.b.Home care increases readmissions to the hospital for a child with chronicconditions.c.There is increased stress for the family when a sick child is being cared for athome.d.The family of the child with a chronic condition is likely to be separated from theirsupport system if the child is cared for at home.ANS:AGreater numbers of technology-dependent infants and children are now cared for at home. Thenumbers include those needing ventilator assistance, total parenteral nutrition, IV medications,apnea monitoring, and other device-assisted nursing care. Optimal home care can reduce therate of readmission to the hospital for children with chronic conditions. Consumers oftenprefer home care because of the decreased stress on the family when the patient is able toremain at home. When the child is cared for at home the family is less likely to be separatedfrom their support system because of the need for hospitalization.PTS:1DIF:Cognitive Level: Comprehension/UnderstandingREF:p. 7OBJ:Nursing Process: PlanningMSC:Client Needs: Safe and Effective Care Environment22.Maternity nursing care that is based on knowledge gained through research is known asa.nurse-sensitive indicators.b.evidence-based practice.c.case management.d.outcomes management.ANS:BEvidence-based practice is based on knowledge gained from research and clinical trials.Nurse-sensitive indicators are patient care outcomes particularly dependent on the quality andquantity of nursing care provided. Case management is a practice model that uses a systematicapproach to identify specific patients, determine eligibility for care, and arrange access toservices. The determination to lower health care costs while maintaining the quality of carehas led to a clinical practice model known as outcomes management.PTS:1DIF:Cognitive Level: Comprehension/UnderstandingREF:p. 6OBJ:Integrated Process: Teaching-LearningMSC:Client Needs: Safe and Effective Care Environment

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23.The level of practice a reasonably prudent nurse provides is calleda.the standard of care.b.risk management.c.a sentinel event.d.failure to rescue.ANS:AGuidelines for standards of care are published by various professional nursing organizations.The standard of care for neonatal nurses is set by the Association of Women’s Health,Obstetric, and Neonatal Nurses (AWHONN). The Society of Pediatric Nurses is the primaryspecialty organization that sets standards for the pediatric nurse. Risk management identifiesrisks and establishes preventive practices, but it does not define the standard of care. Sentinelevents and failure to rescue can be caused by not practicing up to standards of care, but theydo not define it.PTS:1DIF:Cognitive Level: Knowledge/RememberingREF:p. 16OBJ:Nursing Process: ImplementationMSC:Client Needs: Safe and Effective Care EnvironmentMULTIPLE RESPONSE1.When counseling the newly pregnant woman regarding the option of using a free-standingbirth center for care, the nurse should be aware that this type of care setting includes whichadvantages? (Select all that apply.)a.Less expensive than acute-care hospitalsb.Access to follow-up care for 6 weeks postpartumc.Equipped for obstetric emergenciesd.Safe, home-like births in a familiar settinge.Staffing by lay midwivesANS:A, B, DWomen who are at low risk and desire a safe, home-like birth are very satisfied with this typeof care setting. The new mother may return to the birth center for postpartum follow-up care,breastfeeding assistance, and family planning information for 6 weeks postpartum. Becausebirth centers do not incorporate advanced technologies into their services, costs aresignificantly less than those for a hospital setting. The major disadvantage of this care settingis that these facilities are not equipped to handle obstetric emergencies. Should unforeseendifficulties occur, the woman must be transported by ambulance to the nearest hospital. Birthcenters are usually staffed by certified nurse-midwives (CNMs); however, in some states laymidwives may provide this service.PTS:1DIF:Cognitive Level: Comprehension/UnderstandingREF:p. 3OBJ:Integrated Process: Teaching-LearningMSC:Client Needs: Safe and Effective Care Environment2.A school nurse is working with unlicensed assistive personnel (UAPs). What aspects ofdelegation should the nurse incorporate into his or her practice in this setting?a.The registered nurse is always responsible for assessment.b.Uncomplicated medication administration can be performed by the UAP.c.The nurse does not need to supervise UAPs in this setting.

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d.The nurse must work within school district policies when delegating.e.Understanding the complexity of the child’s needs is a consideration whendelegating.ANS:A, B, D, EDelegation to UAPs is very common in all health care settings, including schools. Whendelegating to a UAP in the school setting, factors for the nurse to consider include that the RNis always responsible for assessment, supervision is necessary, the complexity of the child’sneeds must be considered, and policies must be followed. Medication administration by theUAP may be allowed.PTS:1DIF:Cognitive Level: Knowledge/RememberingREF:p. 19OBJ:Nursing Process: ImplementationMSC:Client Needs: Safe and Effective Care Environment3.A student nurse has been studyingHealthy People 2020.What information about thisinitiative does the student understand? (Select all that apply.)a.It is a new agenda for health care and research priorities.b.None of the priorities in this document pertains to pregnant women or children.c.Objectives are aimed at keeping people healthy with a good quality of life.d.Ensuring that 77.9% of women receive prenatal care in the first trimester is onegoal.e.Increasing to 100% the proportion of people with health insurance.ANS:C, D, ETheHealthy People 2020initiative is an update of previous versions and is the nation’sblueprint for health care and research priorities. Many of its objectives pertain to pregnantwomen and children. The objectives include improving health and quality of life, ensuringthat 77.9% of pregnant women receive prenatal care in the first trimester, and increasing thenumber of people with health insurance to 100%.PTS:1DIF:Cognitive Level: Knowledge/RememberingREF:p. 5OBJ:Integrated Process: Teaching-LearningMSC:Client Needs: Health Promotion and Maintenance

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Chapter 02: The Nurse’s Role in Maternity, Women’s Health, and Pediatric NursingMcKinney: Evolve Resources for Maternal-Child Nursing, 5th EditionMULTIPLE CHOICE1.Which principle of teaching should the nurse use to ensure learning in a family situation?a.Motivate the family with praise and positive reinforcement.b.Present complex subject material first, while the family is alert and ready to learn.c.Families should be taught using medical jargon so they will be able to understandthe technical language used by physicians.d.Learning is best accomplished using the lecture format.ANS:APraise and positive reinforcement are particularly important when a family is trying to mastera frustrating task, such as breastfeeding. Learning is enhanced when the teaching is structuredto present the simple tasks before the complex material. Even though a family may understandEnglish fairly well, they may not understand the medical terminology or slang terms. A livelydiscussion stimulates more learning than a straight lecture, which tends to inhibit questions.PTS:1DIF:Cognitive Level: Knowledge/RememberingREF:p. 25OBJ:Nursing Process: PlanningMSC:Client Needs: Health Promotion and Maintenance2.When addressing the questions of a newly pregnant woman, the nurse can explain that thecertified nurse-midwife is qualified to performa.regional anesthesia.b.cesarean deliveries.c.vaginal deliveries.d.internal versions.ANS:CThe nurse-midwife is qualified to deliver infants vaginally in uncomplicated pregnancies. Theother procedures must be performed by a physician or other medical provider.PTS:1DIF:Cognitive Level: Knowledge/RememberingREF:p. 26OBJ:Integrated Process: Teaching-LearningMSC:Client Needs: Safe and Effective Care Environment3.Which nursing intervention is an independent (nurse-driven) function of the nurse?a.Administering oral analgesicsb.Teaching the woman perineal carec.Requesting diagnostic studiesd.Providing wound care to a surgical incisionANS:B

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Nurses are responsible for various independent functions, including teaching, counseling, andintervening in nonmedical problems. Interventions initiated by the physician and carried outby the nurse are called dependent functions. Administering oral analgesics is a dependentfunction; it is initiated by a physician or other provider and carried out by the nurse.Requesting diagnostic studies is a dependent function. Providing wound care is a dependentfunction; it is usually initiated by the physician or other provider through direct orders orprotocol.PTS:1DIF:Cognitive Level: Comprehension/UnderstandingREF:Box 2.3OBJ:Integrated Process: Teaching-LearningMSC:Client Needs: Health Promotion and Maintenance4.Which response by the nurse to the woman’s statement, “I’m afraid to have a cesarean birth,”would be the most therapeutic?a.“What concerns you most about a cesarean birth?”b.“Everything will be OK.”c.“Don’t worry about it. It will be over soon.”d.“The doctor will be in later, and you can talk to him.”ANS:AFocusing on what the woman is saying and asking for clarification are the most therapeuticresponses. Stating that “everything will be ok” or “don’t worry about it” belittles the woman’sfeelings and might be providing false hope. Telling the patient to talk to the doctor does notallow the woman to verbalize her feelings when she desires.PTS:1DIF:Cognitive Level: Application/ApplyingREF:Box 2.2OBJ:Integrated Process: Communication and DocumentationMSC:Client Needs: Psychosocial Integrity5.To evaluate the woman’s learning about performing infant care, the nurse shoulda.demonstrate infant care procedures.b.allow the woman to verbalize the procedure.c.observe the woman as she performs the procedure.d.routinely assess the infant for cleanliness.ANS:CThe woman’s ability to perform the procedure correctly under the nurse’s supervision is thebest method of evaluation. Demonstration is an excellent teaching method but not anevaluation method. During verbalization of the procedure, the nurse may not pick up ontechniques that are incorrect. It is not the best tool for evaluation. Observing the infant forcleanliness does not ensure the proper procedure is carried out. The nurse may miss seeingunsafe techniques being used.PTS:1DIF:Cognitive Level: Evaluation/EvaluatingREF:p. 31OBJ:Nursing Process: EvaluationMSC:Client Needs: Health Promotion and Maintenance6.What situation is most conducive to learning?a.A teacher who speaks very little Spanish is teaching a class of Latino students.b.A class is composed of students of various ages and educational backgrounds.c.An auditorium is being used as a classroom for 300 students.

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d.An Asian nurse provides nutritional information to a group of pregnant Asianwomen.ANS:DTeaching is a vital function of the professional nurse. A patient’s language and cultureinfluence the learning process; thus a situation that is most conducive to learning is one inwhich the teacher has knowledge and understanding of the patient’s language and culturalbeliefs. The ability to understand the language in which teaching is done determines howmuch the patient learns. Patients for whom English is not their primary language may notunderstand idioms, nuances, slang terms, informal usage of words, or medical words. Theteacher should be fluent in the language of the student. Developmental levels and educationallevels influence how a person learns best. In order for the teacher to best present information,the class should be composed of the same levels. A large class is not conducive to learning. Itdoes not allow for questions, and the teacher is not able to see the nonverbal cues from thestudents to ensure understanding.PTS:1DIF:Cognitive Level: Application/ApplyingREF:p. 25OBJ:Nursing Process: PlanningMSC:Client Needs: Psychosocial Integrity7.What is the primary role of practicing nurses in the research process?a.Designing research studiesb.Collecting data for other researchersc.Identifying researchable problemsd.Seeking funding to support research studiesANS:CNursing generates and answers its own questions based on evidence within its unique subjectarea. Nurses of all educational levels are in a position to find researchable questions based onproblems seen in their practice area. Designing research studies is generally left to nurses withadvanced degrees. Collecting data may be part of a nurse’s daily activity, but not all nurseswill have this opportunity. Seeking funding goes along with designing and implementingresearch studies.PTS:1DIF:Cognitive Level: Comprehension/UnderstandingREF:p. 25OBJ:Integrated Process: Teaching-LearningMSC:Client Needs: Safe and Effective Care Environment8.The step of the nursing process in which the nurse determines the appropriate interventionsfor the identified nursing diagnosis is calleda.assessment.b.planning.c.intervention.d.evaluation.ANS:BThe third step in the nursing process involves planning care for problems that were identifiedduring assessment. The first step of the nursing process is assessment, during which data arecollected. The intervention phase is when the plan of care is carried out. The evaluation phaseis determining whether the goals have been met.PTS:1DIF:Cognitive Level: Knowledge/Remembering

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REF:pp. 30-31OBJ:Nursing Process: PlanningMSC:Client Needs: Safe and Effective Care Environment9.Which goal is most appropriate for demonstrating effective parenting?a.The parents will demonstrate correct bathing by discharge.b.The mother will make an appointment with the lactation specialist prior todischarge.c.The parents will place the baby in the proper position for sleeping and napping by2300 on postpartum day 1.d.The parents will demonstrate effective parenting by discharge.ANS:DOutcomes and goals are not the same. Goals are broad and not measurable and so must belinked to more measurable outcome criteria. Demonstrating effective parenting is one suchgoal. The other options are measurable outcome indicators that help determine if the goal hasbeen met.PTS:1DIF:Cognitive Level: Evaluation/EvaluatingREF:p. 31OBJ:Nursing Process: PlanningMSC:Client Needs: Safe and Effective Care Environment10.Which nursing intervention is correctly written?a.Encourage turning, coughing, and deep breathing.b.Force fluids as necessary.c.Assist to ambulate for 10 minutes at 8 AM, 2 PM, and 6 PM.d.Observe interaction with infant.ANS:CThis intervention is the most specific and details what should be done, for how long, andwhen. The other interventions are too vague.PTS:1DIF:Cognitive Level: Comprehension/UnderstandingREF:p. 31OBJ:Nursing Process: PlanningMSC:Client Needs: Safe and Effective Care Environment11.What part of the nursing process includes the collection of data on vital signs, allergies, sleeppatterns, and feeding behaviors?a.Assessmentb.Planningc.Interventiond.EvaluationANS:AAssessment includes gathering baseline data. Planning is based on baseline data and physicalassessment. Implementation is the initiation and completion of nursing interventions.Evaluation is the last step in the nursing process and involves determining whether the goalswere met.PTS:1DIF:Cognitive Level: Knowledge/RememberingREF:p. 29OBJ:Nursing Process: AssessmentMSC:Client Needs: Safe and Effective Care Environment

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12.The nurse who coordinates and manages a patient’s care with other members of the healthcare team is functioning in which role?a.Teacherb.Collaboratorc.Researcherd.AdvocateANS:BThe nurse collaborates with other members of the health care team, often coordinating andmanaging the patient’s care. Care is improved by this interdisciplinary approach as nurseswork together with dietitians, social workers, physicians, and others. Education is an essentialrole of today’s nurse. The nurse functions as a teacher during prenatal care, during maternitycare, and when teaching parents of children regarding normal growth and development.Nurses contribute to their profession’s knowledge base by systematically investigatingtheoretic for practice issues and nursing. A nursing advocate is one who speaks on behalf ofanother. As the health professional who is closest to the patient, the nurse is in an idealposition to humanize care and to intercede on the patient’s behalf.PTS:1DIF:Cognitive Level: Knowledge/RememberingREF:p. 25OBJ:Nursing Process: PlanningMSC:Client Needs: Safe and Effective Care Environment13.Which statement about alternative and complementary therapies is true?a.Replace conventional Western modalities of treatmentb.Are used by only a small number of American adultsc.Allow for more patient autonomy but also may carry risksd.Focus primarily on the disease an individual is experiencingANS:CBeing able to choose alternative and complementary health products and practicesdoes allowfor patient autonomy, but the major concern is risk as patients may not disclose their use orsubstances may interact with other medications the patient is taking. Alternative andcomplementary therapies are part of an integrative approach to health care for most people,although some may choose only these types of therapies. An increasing number of Americanadults are seeking alternative and complementary health care options. Alternative healingmodalities offer a holistic approach to health, focusing on the whole person and not just thedisease.PTS:1DIF:Cognitive Level: Comprehension/UnderstandingREF:p. 31OBJ:Integrated Process: Culture and SpiritualityMSC:Client Needs: Physiologic Integrity14.Which step in the nursing process identifies the basis or cause of the patient’s problem?a.Interventionb.Expected outcomec.Nursing diagnosisd.EvaluationANS:C

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