Test Bank For Maternal-Newborn Nursing & Women's Health Across the Lifespan, 12th edition Michele C. by welldoneassistant

B) A registered nurse who is a circulating nurse at surgical deliveries (cesarean sections) is a professional nurse who has graduated from an accredited program in nursing and completed the licensure examination. C) A clinical nurse specialist working as a staff nurse on a family-centered care unit might have the qualifications for an advanced practice nursing staff member but is not working in that capacity. D) A clinical nurse specialist with whom other nurses consult for expertise in caring for high-risk infants is working in an advanced practice nursing role. This nurse has specialized knowledge and competence in a specific clinical area, and is master's prepared. Page Ref: 5 Cognitive Level: Understanding Client/Need Sub: Safe and Effective Care Environment: Management of Care Standards: QSEN Competencies: II. A. 2. Describe scopes of practice and roles of healthcare team members. | AACN Domains and Competencies: 6.2 Perform effectively in different team roles, using principles and values of team dynamics. | NLN Competencies: Teamwork: Scope of practice, roles, and responsibilities of healthcare team members, including overlaps. | Nursing/Integrated Concepts: Nursing Process: Assessment. Learning Outcome: 1.2 Compare the nursing roles available to the maternal-newborn nurse. MNL LO: Recognize contemporary issues related to care of the childbearing family. 5) A nursing student investigating potential career goals is strongly considering becoming a nurse practitioner (NP). Which focus should the nurse identify as being major for the NP? A) Leadership B) Physical and psychosocial clinical assessment C) Independent care of the high-risk pregnant client D) Tertiary prevention Answer: B Explanation: A) Leadership might be a quality of the NP, but it is not the major focus. B) Physical and psychosocial clinical assessment is the major focus of the NP. C) NPs cannot provide independent care of the high-risk pregnant client, but must work under a healthcare provider's supervision. D) The NP cannot do tertiary prevention as a major focus. Page Ref: 5 Cognitive Level: Understanding Client/Need Sub: Safe and Effective Care Environment: Management of Care Standards: QSEN Competencies: II. A. 2. Describe scopes of practice and roles of healthcare team members. | AACN Domains and Competencies: 6.2 Perform effectively in different team roles, using principles and values of team dynamics. | NLN Competencies: Teamwork: Scope of practice, roles, and responsibilities of healthcare team members, including overlaps. | Nursing/Integrated Concepts: Nursing Process: Assessment. Learning Outcome: 1.2 Compare the nursing roles available to the maternal-newborn nurse. MNL LO: Recognize contemporary issues related to care of the childbearing family.

6) The nurse manager is consulting with a certified nurse-midwife about a client. Which statement explains the role of the CNM? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A) Be prepared to manage independently the care of women at low risk for complications during pregnancy and birth. B) Give primary care to high-risk clients who are in hospital settings. C) Give primary care to healthy newborns. D) Obtain a healthcare provider consultation for any technical procedures at delivery. E) Be educated in two disciplines of nursing. Answer: A, C, E Explanation: A) A CNM is prepared to manage independently the care of women at low risk for complications during pregnancy and birth and the care of healthy newborns. B) CNMs cannot give primary care for high-risk clients who are in hospital settings. The healthcare provider provides the primary care. C) A CNM is prepared to manage independently the care of women at low risk for complications during pregnancy and birth and the care of healthy newborns. D) The CNM does not need to obtain a healthcare provider consultation for any technical procedures at delivery. E) The CNM is educated in the disciplines of nursing and midwifery. Page Ref: 3 Cognitive Level: Understanding Client/Need Sub: Safe and Effective Care Environment: Management of Care Standards: QSEN Competencies: II. A. 2. Describe scopes of practice and roles of healthcare team members. | AACN Domains and Competencies: 6.2 Perform effectively in different team roles, using principles and values of team dynamics. | NLN Competencies: Teamwork: Scope of practice, roles, and responsibilities of healthcare team members, including overlaps. | Nursing/Integrated Concepts: Nursing Process: Assessment. Learning Outcome: 1.2 Compare the nursing roles available to the maternal-newborn nurse. MNL LO: Recognize contemporary issues related to care of the childbearing family. 7) The registered nurse who has completed a master's degree program and passed a national certification exam has clinic appointments with clients who are pregnant or seeking well-client care. In which role is this nurse practicing? A) Professional nurse B) Certified registered nurse (RNC) C) Clinical nurse specialist D) Nurse practitioner Answer: D Explanation: A) A professional nurse is one who has completed an accredited basic educational program and has passed the NCLEX-RN® exam. B) A certified registered nurse (RNC) has shown expertise in the field and has taken a national certification exam. C) A clinical nurse specialist has completed a master's degree program, has specialized knowledge 4 Copyright © 2024 Pearson Education, Inc.

and competence in a specific clinical area, and often is employed in hospitals on specialized units. D) A nurse practitioner has completed either a master's or doctoral degree in nursing and passed a certification exam, and functions as an advanced practice nurse. Ambulatory care settings and the community are common sites for nurse practitioners to provide client care. Page Ref: 5 Cognitive Level: Remembering Client/Need Sub: Health Promotion and Maintenance Standards: QSEN Competencies: II. A. 2. Describe scopes of practice and roles of healthcare team members. | AACN Domains and Competencies: 6.2 Perform effectively in different team roles, using principles and values of team dynamics. | NLN Competencies: Teamwork: Scope of practice, roles, and responsibilities of healthcare team members, including overlaps. | Nursing/Integrated Concepts: Nursing Process: Assessment. Learning Outcome: 1.2 Compare the nursing roles available to the maternal-newborn nurse. MNL LO: Recognize contemporary issues related to care of the childbearing family. 8) The parent of a child being admitted to the hospital asks about family-centered care. Which response should the nurse make to the parent? A) The mother is the principal caregiver in each family. B) The child's primary care provider is the key person in ensuring that the health of a child is maintained. C) The family serves as the constant influence and continuing support in the child's life. D) The father is the leader in each home; thus, all communications should include him. Answer: C Explanation: A) Culturally competent care recognizes that both matriarchal and patriarchal households exist. B) The physician is not present during the day-to-day routines in a child's life. C) Family-centered care is characterized by an emphasis on the family and family involvement throughout the pregnancy, birth, and postpartum period. D) Culturally competent care recognizes that both matriarchal and patriarchal households exist. Page Ref: 2 Cognitive Level: Understanding Client/Need Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I. B. 3. Provide patient-centered care with sensitivity and respect for the diversity of human experience. | AACN Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Relationship-Centered Care: Promote and accept the patient's emotions; accept and respond to distress in the patient and self; facilitate hope, trust and, faith. | Nursing/Integrated Concepts: Nursing Process: Implementation. Learning Outcome: 1.4 Identify specific factors that contribute to a family's value system. MNL LO: Recognize contemporary issues related to care of the childbearing family.

9) The nurse is reviewing the latest information on federal healthcare reform. Which benefit should the nurse identify from this reform? A) Assessment of the details of the family's income and expenditures B) Case management to limit costly, unnecessary duplication of services C) Nurses will be needed to help control costs D) Education of the family about the need for keeping regular well-child visit appointments Answer: C Explanation: A) Financial assessment is more commonly the function of a social worker. The social worker is part of the interdisciplinary team working with clients, and this professional's expertise is helping clients get into the appropriate programs. B) The case management activity mentioned will not provide a source of funding. C) As access to healthcare and the need to control costs increase, so will the need for, and use of, nurses in many roles–especially in advanced practice. D) The education of the family will not provide a source of funding. Page Ref: 4 Cognitive Level: Understanding Client/Need Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I. A. 4. Examine how the safety, quality, and cost-effectiveness of healthcare can be improved through the active involvement of patients and families. | AACN Domains and Competencies: 6.3 Use knowledge of nursing and other professions to address healthcare needs. | NLN Competencies: Context and Environment: Read and interpret data; apply health promotion/disease prevention strategies; apply health policy; conduct population-based transcultural health assessments and interventions. | Nursing/Integrated Concepts: Nursing Process: Assessment. Learning Outcome: 1.2 Compare the nursing roles available to the maternal-newborn nurse. MNL LO: Recognize contemporary issues related to care of the childbearing family. 10) A pregnant client is receiving care in a clinic being provided by registered nurses and a certified nurse-midwife. In which way should this level of prenatal care be categorized? A) Secondary care B) Tertiary care C) Community care D) Unnecessarily costly care Answer: C Explanation: A) Secondary care is specialized care; an example is checking the hemoglobin A1C of a diabetic client at an endocrine clinic. B) Tertiary care is very specialized, and includes trauma units and neonatal intensive care units. C) Prenatal care is primary care. Community care is often provided at clinics in neighborhoods to facilitate clients' access to primary care, including prenatal care and prevention of illness. D) Community care decreases costs while improving client outcomes, and is not unnecessarily expensive. Page Ref: 6 Cognitive Level: Understanding Client/Need Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I. A. 1. Integrate understanding of multiple dimensions of patient-centered care. | AACN Domains and Competencies: 2.9 Provide care coordination. | NLN 6 Copyright © 2024 Pearson Education, Inc.

Competencies: Context and Environment: Environmental health; health promotion/disease prevention (e.g. transmission of disease, disease patterns, epidemiological principles); chronic disease management; healthcare systems; transcultural approaches to health; family dynamics. | Nursing/Integrated Concepts: Nursing Process: Implementation. Learning Outcome: 1.3 Describe the use of community-based nursing care in meeting the needs of childbearing families. MNL LO: Recognize contemporary issues related to care of the childbearing family.

11) The parent of an elementary school student is unable to provide permission for the child to have testing for tuberculosis because the grandmother is not available for 2 weeks. Which cultural element is contributing to the dilemma that faces the nurse? A) Permissible physical contact with strangers B) Beliefs about the concepts of health and illness C) Religion and social beliefs D) Presence and influence of the extended family Answer: D Explanation: A) The situation the nurse faces is not being caused by permissible contact with strangers. B) The situation the nurse faces is not caused by beliefs about the concepts of health and illness. C) The situation the nurse faces is not caused by religion and social beliefs. D) The presence and influence of the extended family contribute to the situation the nurse faces. In many cultures, a family elder is the primary decision-maker when it comes to healthcare. In this case, the parent cannot grant permission to the nurse until the parent consults the grandmother. Page Ref: 4 Cognitive Level: Analyzing Client/Need Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I. A. 2. Describe how diverse cultural, ethnic, and social backgrounds function as sources of patient, family, and community values. | AACN Domains and Competencies: 5.2 Contribute to a culture of patient safety. | NLN Competencies: Context and Environment: Analyze ethical challenges presented by ambiguous and uncertain clinical situations; self-assess one's own tolerance for ambiguity and uncertainty; accept the possibility of multiple "right" answers (rather than one right answer thinking) in patient care and other professional situations. | Nursing/Integrated Concepts: Nursing Process: Assessment. Learning Outcome: 1.4 Identify specific factors that contribute to a family's value system. MNL LO: Recognize contemporary issues related to care of the childbearing family. 12) A maternity client is in need of surgery. Which healthcare member is legally responsible for obtaining informed consent for an invasive procedure? A) The nurse B) The physician C) The unit secretary D) The social worker Answer: B Explanation: A) It is not the nurse's legal responsibility to obtain informed consent. B) Informed consent is a legal concept designed to allow clients to make intelligent decisions regarding their own healthcare. Informed consent means that a client, or a legally designated 7 Copyright © 2024 Pearson Education, Inc.

decision-maker, has granted permission for a specific treatment or procedure based on full information about that specific treatment or procedure as it relates to that client under the specific circumstances of the permission. The individual who is ultimately responsible for the treatment or procedure should provide the information necessary to obtain informed consent. In most instances, this is a physician. C) Unit secretaries are not responsible for obtaining informed consent. D) It is not within a social worker's scope of practice to obtain informed consent. Page Ref: 8 Cognitive Level: Remembering Client/Need Sub: Safe and Effective Care Environment: Management of Care Standards: QSEN Competencies: I. B. 12. Facilitate informed patient consent for care. | AACN Domains and Competencies: 5.2 Contribute to a culture of patient safety. | NLN Competencies: Context and Environment: Code of ethics (e.g. American Nurses Association 2005; International Council of Nurses, 2006); regulatory and professional standards (ANA Social Policy Statement [ANA, 2003]; HIPAA [Health Insurance Portability and Accountability Act]); ethical decision-making modes; scope of practice considerations; principles of informed consent, confidentiality, patient self-determination. | Nursing/Integrated Concepts: Nursing Process: Planning. Learning Outcome: 1.5 Delineate significant legal and ethical issues that influence the practice of nursing for childbearing families. MNL LO: Recognize contemporary issues related to care of the childbearing family. 13) The nurse tells family members the sex of a newborn baby without first consulting the parents. Which client right did the nurse violate? A) Privacy B) Negligence C) Malpractice D) Ethics Answer: A Explanation: A) Informing other family members of the child's sex without the parents' consent violates the parents' right to privacy. The right to privacy is the right of a person to keep his person and property free from public scrutiny (or even from other family members). B) Negligence is a punishable legal offense, and is more serious. C) Malpractice is a punishable legal offense, and is more serious. D) No breach of ethics has been committed in this situation. Page Ref: 8 Cognitive Level: Understanding Client/Need Sub: Safe and Effective Care Environment: Management of Care Standards: QSEN Competencies: I. B. 13. Assess own level of communication skill in encounters with patient and families. | AACN Domains and Competencies: 9.4 Comply with relevant laws, policies, and regulations. | NLN Competencies: Context and Environment: Code of ethics (e.g. American Nurses Association 2005; International Council of Nurses, 2006); regulatory and professional standards (ANA Social Policy Statement [ANA, 2003]; HIPAA [Health Insurance Portability and Accountability Act]); ethical decision-making modes; scope of practice considerations; principles of informed consent, confidentiality, patient self-determination. | Nursing/Integrated Concepts: Nursing Process: Assessment. Learning Outcome: 1.5 Delineate significant legal and ethical issues that influence the practice of 8 Copyright © 2024 Pearson Education, Inc.

nursing for childbearing families. MNL LO: Recognize contemporary issues related to care of the childbearing family. 14) The nursing instructor is reviewing the 1973 Supreme Court decision in Roe v. Wade about abortion. Which information should the instructor share regarding the current legislation about this decision? A) Abortion is illegal. B) Abortion can occur before the period of viability. C) Abortion is permitted for therapeutic research. D) The decision for abortions is to be made by the individual states. Answer: D Explanation: A) Abortion is not illegal. B) The latest decision does not support abortions being performed legally until the period of viability. C) Abortion cannot be used for the sole purpose of providing tissue for therapeutic research. D) With the 2022 Dobbs v. Jackson Supreme Court decision, Roe v. Wade was overturned, with authority to determine legality of abortion at any stage of pregnancy returned to the states. Page Ref: 9 Cognitive Level: Understanding Client/Need Sub: Safe and Effective Care Environment: Management of Care Standards: QSEN Competencies: I. B. 3. Provide patient-centered care with sensitivity and respect for the diversity of human experience. | AACN Domains and Competencies: 9.1 Demonstrate an ethical comportment in one's practice reflective of nursing's mission to society. | NLN Competencies: Context and Environment: Code of ethics (e.g. American Nurses Association 2005; International Council of Nurses, 2006); regulatory and professional standards (ANA Social Policy Statement [ANA, 2003]; HIPAA [Health Insurance Portability and Accountability Act]); ethical decision-making modes; scope of practice considerations; principles of informed consent, confidentiality, patient self-determination. | Nursing/Integrated Concepts: Nursing Process: Implementation. Learning Outcome: 1.5 Delineate significant legal and ethical issues that influence the practice of nursing for childbearing families. MNL LO: Recognize contemporary issues related to care of the childbearing family. 15) The nurse is questioning if a labor and delivery nurse acted appropriately when a client experienced a complication during labor. Which action should the nurse take to determine if the labor nurse acted appropriately? A) Call the nurse manager of the labor and delivery unit and ask what the nurse should have done. B) Ask the departmental chair of the obstetrical physicians what the best nursing action would have been. C) Examine other charts to find cases of the same complication, and determine how it was handled in those situations. D) Look in the policy and procedure book, and examine the practice guidelines published by a professional nursing organization. Answer: D Explanation: A) The nurse should find the standards, and not rely on another person to determine appropriateness of care. B) Physician care and nursing care are very different; physicians might not be up to date on 9 Copyright © 2024 Pearson Education, Inc.

nursing standards of care or nursing policies and procedures. C) What nursing action was undertaken in a different situation might not be based on the policies and procedures or other standards of care. The quality improvement nurse will obtain the most accurate information by examining the policies, procedures, and standards of care. D) Agency policies, procedures, and protocols contain guidelines for nursing action in specific situations. Professional organizations such as the Association of Women's Health, Obstetrical, and Neonatal Nurses (AWHONN) also publish standards of practice that should guide nursing care. Page Ref: 7 Cognitive Level: Applying Client/Need Sub: Safe and Effective Care Environment: Management of Care Standards: QSEN Competencies: IV. A. 4. Explain the importance of variation and measurement in assessing quality of care. | AACN Domains and Competencies: 5.2 Contribute to a culture of patient safety. | NLN Competencies: Knowledge and Science: Retrieve research findings and other sources of information; critique research to judge its value and usefulness; evaluate the strength of evidence for application of research findings to clinical practice. | Nursing/Integrated Concepts: Nursing Process: Implementation. Learning Outcome: 1.5 Delineate significant legal and ethical issues that influence the practice of nursing for childbearing families. MNL LO: Recognize contemporary issues related to care of the childbearing family. 16) The nurse is reviewing care of clients in a family-centered care unit. Which situation should be reported to the supervisor? A) A 2-day-old infant has breastfed every 2-3 hours and voided four times. B) An infant was placed in the wrong crib after examination by the physician. C) The client who delivered by cesarean birth yesterday received oral narcotics. D) A primiparous client who delivered today is requesting discharge within 24 hours. Answer: B Explanation: A) Breastfeeding every 2 hours and voiding four times is within normal limits for a 2-day-old infant. There is no negligence in this situation. B) Placing an infant in the wrong crib is a major violation of safety. This should be reported to the supervisor. C) Receiving oral narcotics at this point in the client's stay is within normal limits. There is no negligence in this situation. D) If the client is feeling well and able to care for her infant, it is normal to be discharged at this time. The mother and baby both must be within normal limits to be discharged. Page Ref: 7 Cognitive Level: Analyzing Client/Need Sub: Safe and Effective Care Environment: Safety and Infection Control Standards: QSEN Competencies: V. B. 1. Demonstrate effective use of strategies to reduce risk of harm to self or others. | AACN Domains and Competencies: 5.2 Contribute to a culture of patient safety. | NLN Competencies: Quality and Safety: Communicate effectively with different individuals (team members, other care providers, patients, families, etc.) so as to minimize risks associated with handoffs among providers and across transitions in care. | Nursing/Integrated Concepts: Nursing Process: Assessment. Learning Outcome: 1.5 Delineate significant legal and ethical issues that influence the practice of nursing for childbearing families. MNL LO: Recognize contemporary issues related to care of the childbearing family. 10 Copyright © 2024 Pearson Education, Inc.

17) The nurse manager is planning a presentation on ethical issues in caring for childbearing families. Which example should the nurse manager include to illustrate maternal-fetal conflict? A) A client lives in a state where abortion is permitted for a fetus diagnosed with a genetic anomaly. B) A 39-year-old nulliparous client undergoes therapeutic insemination. C) A family of a child with leukemia requests cord-blood banking at a sibling's birth. D) A cesarean delivery of a breech fetus is court-ordered after the client refuses. Answer: D Explanation: A) Abortion is a different type of ethical situation and is determined by the individual states. B) Achieving pregnancy through the use of therapeutic insemination is a form of reproductive assistance and is not considered a maternal-fetal conflict. C) Cord-blood banking is a different type of ethical situation. D) Maternal-fetal conflict is a special ethical situation where the rights of the fetus and the rights of the mother are considered separately. Forced cesarean birth, coercion of mothers who practice high-risk behaviors, and, perhaps most controversial, mandating experimental in utero therapy or surgery in an attempt to correct a specific birth defect are interventions that infringe on the mother's autonomy. Page Ref: 9 Cognitive Level: Applying Client/Need Sub: Safe and Effective Care Environment: Management of Care Standards: QSEN Competencies: I. B. 9. Assess level of patient's decisional conflict and provide access to resources. | AACN Domains and Competencies: 9.1 Demonstrate an ethical comportment in one's practice reflective of nursing's mission to society. | NLN Competencies: Context and Environment: Show respect for others' values; appreciate diversity; be civil during relationships and work; value community empowerment and social justice; work to improve social conditions affecting health; adopt inclusive language. | Nursing/Integrated Concepts: Nursing Process: Planning. Learning Outcome: 1.5 Delineate significant legal and ethical issues that influence the practice of nursing for childbearing families. MNL LO: Recognize contemporary issues related to care of the childbearing family. 18) The nurse is reviewing the latest client safety goals. For which reason are these goals evaluated and updated regularly? A) Clinical practice guidelines B) Scope of practice C) Accreditation D) Standards of care Answer: C Explanation: A) Clinical practice guidelines are adopted within a healthcare setting to reduce variation in care management, to limit costs of care, and to evaluate the effectiveness of care. B) State nurse practice acts protect the public by broadly defining the legal scope of practice within which every nurse must function and by excluding untrained or unlicensed individuals from practicing nursing. C) The Joint Commission, a nongovernmental agency that audits the operation of hospitals and healthcare facilities, has identified patient safety as an important responsibility of healthcare providers and provides an annual list of specific patient safety goals. 11 Copyright © 2024 Pearson Education, Inc.

D) Standards of care establish minimum criteria for competent, proficient delivery of nursing care. Page Ref: 7 Cognitive Level: Understanding Client/Need Sub: Safe and Effective Care Environment: Safety and Infection Control Standards: QSEN Competencies: V. A. 7. Discuss potential and actual impact of national patient safety resources, initiatives, and regulations. | AACN Domains and Competencies: 5.2 Contribute to a culture of patient safety. | NLN Competencies: Quality and Safety: Value and encourage nurses' involvement in the design, selection, implementation, and evaluation of information technologies to support patient care (e.g. as recommended by QSEN). | Nursing/Integrated Concepts: Nursing Process: Planning. Learning Outcome: 1.5 Delineate significant legal and ethical issues that influence the practice of nursing for childbearing families. MNL LO: Recognize contemporary issues related to care of the childbearing family. 19) A fetus has been diagnosed with myelomeningocele. Which surgery would be performed to correct this condition? A) Tubal ligation B) Intrauterine fetal surgery C) Cesarean section D) Sterilization Answer: B Explanation: A) Tubal ligation is not an intrauterine fetal surgery. B) Intrauterine fetal surgery, which is generally considered experimental, is a therapy for anatomic lesions that can be corrected surgically and are incompatible with life if not treated. Examples include surgery for myelomeningocele and some congenital cardiac defects. C) A cesarean birth is not considered an intrauterine fetal surgery. D) Sterilization surgery does not involve the fetus. Page Ref: 10 Cognitive Level: Remembering Client/Need Sub: Physiological Integrity: Physiological Adaptation Standards: QSEN Competencies: II. B. 8. Integrate the contributions of others who play a role in helping the patient/family achieve health goals. | AACN Domains and Competencies: 1.1 Demonstrate an understanding of the discipline of nursing's distinct perspective and where shared perspectives exist with other disciplines. | NLN Competencies: Teamwork: Function competently within one's own scope of practice as leader or member of the healthcare team and manage delegation effectively. | Nursing/Integrated Concepts: Nursing Process: Planning. Learning Outcome: 1.5 Delineate significant legal and ethical issues that influence the practice of nursing for childbearing families. MNL LO: Recognize contemporary issues related to care of the childbearing family. 20) The nurse is providing guidance to a group of parents of children in the infant-to-under 1 year of age group. Which reason should the nurse explain is a leading cause of death in this age group? A) Cancer B) Pneumonia C) Heart disease D) Unintentional injury Answer: D Explanation: 12 Copyright © 2024 Pearson Education, Inc.

A) Cancer is not a leading cause of death in this age group. B) Pneumonia is not a leading cause of death in this age group. C) Heart disease is not a leading cause of death in this age group. D) Unintentional injury is one of five leading causes of death in this age group. Page Ref: 13 Cognitive Level: Applying Client/Need Sub: Safe and Effective Care Environment: Safety and Infection Control Standards: QSEN Competencies: V. A. 1. Examine human factors and other basic safety design principles as well as commonly used unsafe practices (such as workarounds and dangerous abbreviations). | AACN Domains and Competencies: 5.2 Contribute to a culture of patient safety. | NLN Competencies: Quality and Safety: Communicate potential risk factors and actual errors. | Nursing/Integrated Concepts: Nursing Process: Implementation. Learning Outcome: 1.7 Identify statistical data relevant to maternal-newborn nursing practice. MNL LO: Recognize contemporary issues related to care of the childbearing family. 21) The nurse is preparing a report on the number of births by three service providers at the facility (certified nurse-midwives, family practitioners, and obstetricians). Which type of data is the nurse using? A) Inferential statistics B) Descriptive statistics C) Evidence-based practice D) Secondary use of data Answer: B Explanation: A) Inferential statistics allow the investigator to conclude from data to either support or refute causation. B) Descriptive statistics concisely describe phenomena such as births by providers. C) Evidence-based practice is the use of research conclusions to improve nursing care. D) Secondary use of data is analyzing data in a different way than was originally undertaken, or looking at different variables from a data set. Page Ref: 11 Cognitive Level: Understanding Client/Need Sub: Safe and Effective Care Environment: Management of Care Standards: QSEN Competencies: III. A. 2. Describe EBP to include the components of research evidence, clinical expertise and patient/family values. | AACN Domains and Competencies: 1.1 Demonstrate an understanding of the discipline of nursing's distinct perspective and where shared perspectives exist with other disciplines. | NLN Competencies: Knowledge and Science: Retrieve research findings and other sources of information; critique research to judge its value and usefulness; evaluate the strength of evidence for application of research findings to clinical practice. | Nursing/Integrated Concepts: Nursing Process: Planning. Learning Outcome: 1.7 Identify statistical data relevant to maternal-newborn nursing practice. MNL LO: Recognize contemporary issues related to care of the childbearing family. 22) The nurse is explaining the difference between descriptive statistics and inferential statistics to a group of student nurses. Which example should the nurse use to illustrate descriptive statistics? A) A positive correlation between breastfeeding and infant weight gain B) The infant mortality rate in the state of Oklahoma C) A causal relationship between the number of sexual partners and sexually transmitted infections D) The total number of spontaneous abortions in drug-abusing women as compared with 13 Copyright © 2024 Pearson Education, Inc.

non-drug-abusing women Answer: B Explanation: A) A positive correlation between two or more variables is an inferential statistic. B) The infant mortality rate in the state of Oklahoma is a descriptive statistic, because it describes or summarizes a set of data. C) A causal relationship between the number of sexual partners and sexually transmitted infections is an inferential statistic. D) The total number of spontaneous abortions in drug-abusing women is an inferential statistic. Page Ref: 12 Cognitive Level: Understanding Client/Need Sub: Health Promotion and Maintenance Standards: QSEN Competencies: III. A. 2. Describe EBP to include the components of research evidence, clinical expertise, and patient/family values. | AACN Domains and Competencies: 1.2 Apply theory and research‐based knowledge from nursing, the arts, humanities, and other sciences. | NLN Competencies: Knowledge and Science: Retrieve research findings and other sources of information; critique research to judge its value and usefulness; evaluate the strength of evidence for application of research findings to clinical practice. | Nursing/Integrated Concepts: Nursing Process: Implementation. Learning Outcome: 1.7 Identify statistical data relevant to maternal-newborn nursing practice. MNL LO: Recognize contemporary issues related to care of the childbearing family. 23) The nurse manager is examining the descriptive statistics of increasing teen pregnancy rates in the community. Which inferential statistical research question would the nurse manager find most useful in investigating the reasons for increased frequency of teen pregnancy? A) What providers do pregnant teens see for prenatal care? B) What are the ages of the parents of pregnant teens in the community? C) Do pregnant teens drink caffeinated beverages? D) What do pregnant teens do for recreation? Answer: A Explanation: A) Understanding which providers pregnant teens are most likely to seek out for prenatal care can lead to further investigation on why prenatal care with that provider is more acceptable to teens, which in turn can lead to greater understanding of the issue of teen pregnancy. B) A question about the age of parents of pregnant teens might prove useful in seeking causes of teen pregnancy, but it is not the most useful question in understanding the increased frequency of teen pregnancy. C) Whether pregnant teens drink caffeinated beverages gives no further insight into the issues of teen pregnancy. D) Understanding the recreational activities of pregnant teens would not lead to an understanding of the issues surrounding increasing teen pregnancy rates. Page Ref: 12 Cognitive Level: Analyzing Client/Need Sub: Health Promotion and Maintenance Standards: QSEN Competencies: III. A. 2. Describe EBP to include the components of research evidence, clinical expertise, and patient/family values. | AACN Domains and Competencies: 1.2 Apply theory and research‐based knowledge from nursing, the arts, humanities, and other sciences. | NLN Competencies: Knowledge and Science: Retrieve research findings and other 14 Copyright © 2024 Pearson Education, Inc.

sources of information; critique research to judge its value and usefulness; evaluate the strength of evidence for application of research findings to clinical practice. | Nursing/Integrated Concepts: Nursing Process: Implementation. Learning Outcome: 1.7 Identify statistical data relevant to maternal-newborn nursing practice. MNL LO: Recognize contemporary issues related to care of the childbearing family. 24) The nurse is reviewing the Quality and Safety Education for Nurses (QSEN) project. Which competency is in this project? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A) Client-centered care B) Teamwork and collaboration C) Evidence-based practice D) Family planning E) Injury and violence prevention Answer: A, B, C Explanation: A) The Quality and Safety Education for Nurses (QSEN) project is designed "to meet the challenge of preparing future nurses who will have the knowledge, skills, and attitudes (KSAs) necessary to continuously improve the quality and safety of the healthcare systems within which they work," which includes client-centered care. B) The Quality and Safety Education for Nurses (QSEN) project, is designed "to meet the challenge of preparing future nurses who will have the knowledge, skills, and attitudes (KSAs) necessary to continuously improve the quality and safety of the healthcare systems within which they work," which includes teamwork and collaboration. C) The Quality and Safety Education for Nurses (QSEN) project, is designed "to meet the challenge of preparing future nurses who will have the knowledge, skills, and attitudes (KSAs) necessary to continuously improve the quality and safety of the healthcare systems within which they work," which includes evidence-based practice. D) Healthy People 2020 focuses on family planning. E) Healthy People 2020 focuses on injury and violence prevention. Page Ref: 7 Cognitive Level: Understanding Client/Need Sub: Safe and Effective Care Environment: Management of Care Standards: QSEN Competencies: V. B. 8. Use national patient safety resources for own professional development and to focus attention on safety in care settings. | AACN Domains and Competencies: 5.1 Apply quality improvement principles in care delivery. | NLN Competencies: Quality and Safety: Value and encourage nurses' involvement in the design, selection, implementation, and evaluation of information technologies to support patient care (e.g., as recommended by QSEN). | Nursing/Integrated Concepts: Nursing Process: Assessment. Learning Outcome: 1.5 Delineate significant legal and ethical issues that influence the practice of nursing for childbearing families. MNL LO: Recognize contemporary issues related to care of the childbearing family.

25) The nurse is serving on a panel to evaluate the hospital staff's reliance on evidence-based practice in the decision-making processes. Which practice characterizes the basic competencies related to evidence-based practice? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A) Recognizing which clinical practices are supported by good evidence B) Recognizing and including clinical practice supported by intuitive evidence C) Using data in clinical work to evaluate outcomes of care D) Including quality-improvement measures in clinical practice E) Appraising and integrating scientific bases into practice Answer: A, C, E Explanation: A) Recognizing which clinical practices are supported by sound evidence is a basic competency related to evidence-based practice. B) Including clinical practice supported by intuitive evidence is not a basic competency related to evidence-based practice. C) Using data in clinical work to evaluate outcomes of care is one of the basic competencies related to evidence-based practice. D) Including quality-improvement measures is a form of evidence that can be useful in making clinical practice decisions, but it is not a basic competency related to evidence-based practice. E) Appraising and integrating scientific bases into practice is one of the characteristics of the basic competencies related to evidence-based practice. Page Ref: 11-12 Cognitive Level: Understanding Client/Need Sub: Safe and Effective Care Environment: Management of Care Standards: QSEN Competencies: III. A. 2. Describe EBP to include the components of research evidence, clinical expertise and patient/family values. | AACN Domains and Competencies: 4.2 Integrate best evidence into nursing practice. | NLN Competencies: Knowledge and Science: Translate research into practice in order to promote quality and improve practices. | Nursing/Integrated Concepts: Nursing Process: Assessment. Learning Outcome: 1.8 Explore the impact of evidence-based practice in improving the quality of nursing care for childbearing families. MNL LO: Recognize contemporary issues related to care of the childbearing family. 26) The nurse is reviewing a nursing research publication. For which reason is nursing research vital to the profession? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A) Expand the science of nursing. B) Foster evidence-based practice. C) Improve client care. D) Visually depict nursing management. E) Plan and organize care. Answer: A, B, C 16 Copyright © 2024 Pearson Education, Inc.

Explanation: A) Research is vital to expanding the science of nursing. B) Research is vital to fostering evidence-based practice. C) Research is vital to improving client care. D) The nursing process is research-based, but is not a part of the clinical pathway. Visually depicting nursing management is part of concept mapping, not nursing research. E) Organizing patient care is an aspect of the nursing process. Planning and organizing care are part of nursing care plans, not nursing research. Page Ref: 12 Cognitive Level: Understanding Client/Need Sub: Safe and Effective Care Environment: Management of Care Standards: QSEN Competencies: III. A. 7. Discriminate between valid and invalid reasons for modifying evidence-based clinical practice based on clinical expertise or patient/family preferences. | AACN Domains and Competencies: 4.1 Advance the scholarship of nursing. | NLN Competencies: Knowledge and Science: Retrieve research findings and other sources of information; critique research to judge its value and usefulness; evaluate the strength of evidence for application of research findings to clinical practice. | Nursing/Integrated Concepts: Nursing Process: Assessment. Learning Outcome: 1.8 Explore the impact of evidence-based practice in improving the quality of nursing care for childbearing families. MNL LO: Recognize contemporary issues related to care of the childbearing family. 27) A group of nurses are meeting as identified in the image below. Which behavior are the nurses demonstrating during this meeting?

A) Privacy B) Advocacy C) Collaboration D) Informed consent Answer: C Explanation: A) The right to privacy is the right of a person to keep his or her person and property free from 17 Copyright © 2024 Pearson Education, Inc.

public scrutiny. B) Advocacy is ensuring a patient receives necessary and required support. C) Collaborative practice is a comprehensive model of healthcare that uses a multidisciplinary team of health professionals to provide cost-effective, high-quality care. In a successful team, each individual has autonomy but functions within a clearly defined scope of practice. In such a collaborative approach, no single profession "owns the patient." D) Informed consent is a legal concept designed to allow patients to make intelligent decisions regarding their own healthcare. Page Ref: 7 Cognitive Level: Analyzing Client/Need Sub: Safe and Effective Care Environment: Management of Care Standards: QSEN Competencies: II. B. 9. Communicate with team members, adapting own style of communicating to needs of the team and situation. | AACN Domains and Competencies: 6.4 Work with other professions to maintain a climate of mutual learning, respect, and shared values. | NLN Competencies: Relationship-Centered Care; Practice; Share responsibility responsibly; collaborate and work cooperatively with others. | Nursing/Integrated Concepts: Assessment; Communication and Documentation. Learning Outcome: 1.3 Describe the use of community-based nursing care in meeting the needs of childbearing families. MNL LO: Recognize contemporary issues related to care of the childbearing family. 28) The nurse is reviewing the Quality and Safety Education for Nurses (QSEN) competencies while preparing an in-service program to address safety in the neonatal intensive care unit. In which order should the nurse present these competencies? 1. Safety 2. Informatics 3. Client-centered care 4. Quality improvement 5. Evidence-based practice 6. Teamwork and collaboration Answer: 3, 6, 5, 4, 1, 2 Explanation: The Quality and Safety Education for Nurses (QSEN) project is designed "to meet the challenge of preparing future nurses who will have the knowledge, skills and attitudes (KSAs) necessary to continuously improve the quality and safety of the healthcare systems within which they work." The project focuses on competencies in six areas: 1. Client-centered care; 2. Teamwork and collaboration; 3. Evidence-based practice; 4. Quality improvement; 5. Safety; and 6. Informatics. Page Ref: 7 Cognitive Level: Applying Client/Need Sub: Safe and Effective Care Environment: Safety and Infection Control Standards: QSEN Competencies: I. A. 1. Integrate understanding of multiple dimensions of patient-centered care. | AACN Domains and Competencies: 5.1 Apply quality improvement principles in care delivery. | NLN Competencies: Quality and Safety; Ethical Comportment; Commit to a generative safety culture. | Nursing/Integrated Concepts: Implementation; Teaching/Learning. Learning Outcome: 1.5 Delineate significant legal and ethical issues that influence the practice of nursing for childbearing families. 18 Copyright © 2024 Pearson Education, Inc.

MNL LO: Recognize contemporary issues related to care of the childbearing family. 29) The nurse is ensuring that a patient has provided informed consent before agreeing to an amniocentesis. In which order should the nurse validate that informed consent was provided by the patient? 1. Information provides risk and benefits 2. Information provided clearly and concisely 3. Information included treatment alternatives 4. Information explaining the right to refuse treatment 5. Information reviews consequences if no treatment provided Answer: 2, 1, 3, 5, 4 Explanation: Several elements must be addressed to ensure that the patient has given informed consent. The information must be clearly and concisely presented in a manner understandable to the patient and must include risks and benefits, the probability of success, and significant treatment alternatives. The patient also needs to be told the consequences of receiving no treatment or procedure. Finally, the patient must be told of the right to refuse a specific treatment or procedure. Each patient should be told that refusing the specified treatment or procedure does not result in the withdrawal of all support or care. Page Ref: 8 Cognitive Level: Applying Client/Need Sub: Safe and Effective Care Environment: Management of Care Standards: QSEN Competencies: I. B. 12. Facilitate informed patient consent for care. | AACN Domains and Competencies: 5.2 Contribute to a culture of patient safety. | NLN Competencies: Context and Environment; Knowledge; principles of informed consent, confidentiality, patient self-determination. | Nursing/Integrated Concepts: Evaluation; Nursing Process. Learning Outcome: 1.5 Delineate significant legal and ethical issues that influence the practice of nursing for childbearing families. MNL LO: Recognize contemporary issues related to care of the childbearing family. 30) The nurse is preparing a presentation for new labor and delivery nurses. Which country should the nurse identify that has the lowest infant mortality rate? Table 1-2 Live Birth Rates and Infant Mortality Rates for Selected Countries COUNTRY Afghanistan Argentina Australia Cambodia Canada China Egypt Germany Ghana India Iraq Japan Mexico

Russia 10 4 United Kingdom 10 4 United States 11 5 * Based on 2020 estimates. 2022). Washington, DC: Central Intelligence Agency. g/indicator/SP.DYN.IMRT.IN A) Japan B) Australia C) Germany D) United Kingdom Answer: A Explanation: A) Japan has an infant mortality rate of 2 which is the lowest rate for all the countries listed. B) Australia has an infant mortality rate of 3. C) Germany has an infant mortality rate of 3. D) United Kingdom has an infant mortality rate of 4. Page Ref: 13 Cognitive Level: Applying Client/Need Sub: Safe and Effective Care Environment: Management of Care Standards: QSEN Competencies: I. A. 1. Integrate understanding of multiple dimensions of patient-centered care. | AACN Domains and Competencies: 1.2 Apply theory and research‐based knowledge from nursing, the arts, humanities, and other sciences. | NLN Competencies: Relationship-Centered Care; Knowledge; The role of family, culture, and community in a person's development. | Nursing/Integrated Concepts: Implementation; Teaching/Learning. Learning Outcome: 1.6 Evaluate the potential impact of selected special situations in contemporary maternity care. MNL LO: Recognize contemporary issues related to care of the childbearing family. 31) The manager of a family-centered care area is preparing information to share with nursing staff regarding the leading causes of infant death in the United States. In which order, from most to least frequent, should the manager provide this information? 1. SIDS 2. Low birth weight 3. Unintentional injuries 4. Maternal complications 5. Congenital malformation Answer: 5, 2, 1, 3, 4 Explanation: The five leading causes of deaths of infants in the United States, from highest to lowest in frequency, are congenital malformations, low birth weight, SIDS, unintentional injury, and maternal complications. Page Ref: 13 Cognitive Level: Applying Client/Need Sub: Safe and Effective Care Environment: Management of Care Standards: QSEN Competencies: I. A. 1. Integrate understanding of multiple dimensions of patient-centered care. | AACN Domains and Competencies: 5.2 Contribute to a culture of patient safety. | NLN Competencies: Relationship-Centered Care; Knowledge; The role of family, culture, 20 Copyright © 2024 Pearson Education, Inc.

and community in a person's development. | Nursing/Integrated Concepts: Implementation; Teaching/Learning. Learning Outcome: 1.6 Evaluate the potential impact of selected special situations in contemporary maternity care. MNL LO: Recognize contemporary issues related to care of the childbearing family.

Old's Maternal-Newborn Nursing and Women's Health, 12e (Davidson) Chapter 2 Families, Cultures, and Complementary Therapies 1) The nurse is caring for a family who immigrated to the United States several years ago. Which parent statement indicates the family has acculturated? A) "The children are much less well-behaved than they used to be." B) "Our diet now includes hamburgers and French fries." C) "We celebrate the same holidays that we used to at home." D) "When the children leave the house, I worry about them." Answer: B Explanation: A) Concern about behavior of the children is nearly universal, and is not an indicator of a family's acculturation. B) Acculturation refers to the process of modifying one's culture to fit within the new or dominant culture. Acculturation frequently occurs when people leave their country of origin and immigrate to a new country. Often acculturation is associated with improved health status and health behaviors, especially if the immigration is associated with improved socioeconomic status, which leads to better nutrition and access to healthcare. C) The holidays that are celebrated might not change as a part of acculturation. D) Concern about the children leaving the home is universal, and is not an indicator of a family's acculturation. Page Ref: 21 Cognitive Level: Analyzing Client/Need Sub: Psychosocial Integrity Standards: QSEN Competencies: I. B. 3. Provide patient-centered care with sensitivity and respect for the diversity of human experience. | AACN Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Relationship-Centered Care: Appreciate the patient as a whole person, with his or her own life story and ideas about the meaning of health or illness. | Nursing/Integrated Concepts: Nursing Process: Assessment. Learning Outcome: 2.2 Examine how cultural values, beliefs, and practices can influence childbearing and childrearing. MNL LO: Demonstrate ability to incorporate culturally competent care for patients and families.

2) The nurse is preparing a teaching tool about family structures. In which way should the nurse describe a nuclear family? A) An unmarried woman who chooses to conceive or adopt without a life partner. B) Children live in a household with both biologic parents and no other relatives or persons. C) A couple shares household and childrearing responsibilities with parents, siblings, or other relatives. D) The head of the household is widowed, divorced, abandoned, separated, or most often, the mother remains unmarried. Answer: B Explanation: A) The single mother by choice family represents a family composed of an unmarried woman who chooses to conceive or adopt without a life partner. B) In the nuclear family, children live in a household with both biologic parents and no other relatives or persons. C) In an extended family, a couple shares household and childrearing responsibilities with parents, siblings, or other relatives. D) In the single-parent family, the head of the household is widowed, divorced, abandoned, separated, or most often, the mother remains unmarried. Page Ref: 18 Cognitive Level: Applying Client/Need Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I. A. 2. Describe how diverse cultural, ethnic, and social backgrounds function as sources of patient, family, and community values. | AACN Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Relationship-Centered Care: The role of family, culture, and community in a person's development. | Nursing/Integrated Concepts: Nursing Process: Implementation. Learning Outcome: 2.1 Compare the characteristics of different types of families. MNL LO: Demonstrate ability to incorporate culturally competent care for patients and families.

3) The nurse is caring for a child who lives between two homes and is exposed to coparenting with parental joint custody. In which way should the nurse document the family structure of this child? A) Blended or reconstituted nuclear family B) Extended kin network family C) Binuclear family D) Extended family Answer: C Explanation: A) The blended or reconstituted nuclear family includes two parents with biologic children from a previous marriage or relationship who marry or cohabitate. B) An extended kin network family is a specific form of an extended family in which two nuclear families of primary or unmarried kin live in proximity to each other. C) A binuclear family is a post-divorce family in which the biologic children are members of two nuclear households, with parenting by both the father and the mother. D) In an extended family, a couple shares household and childrearing responsibilities with parents, siblings, or other relatives. Page Ref: 18 Cognitive Level: Applying Client/Need Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I. A. 2. Describe how diverse cultural, ethnic, and social backgrounds function as sources of patient, family, and community values. | AACN Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Relationship-Centered Care: The role of family, culture, and community in a person's development. | Nursing/Integrated Concepts: Nursing Process: Implementation. Learning Outcome: 2.1 Compare the characteristics of different types of families. MNL LO: Demonstrate ability to incorporate culturally competent care for patients and families.

4) The nurse is caring for a pregnant client who recently immigrated from another country. Which assessment finding indicates to the nurse that the client is experiencing culture shock? A) Appears anxious B) Asks many questions C) Reports visiting a shaman D) Lives with extended family members Answer: A Explanation: A) The experience when attempting to adapt to a culture different from the primary culture can cause culture shock. Evidence of culture shock includes discomfort, powerlessness, anxiety, and disorientation. B) Asking questions is not a characteristic of culture shock. C) Visiting a shaman is a healthcare practitioner and not a characteristic of culture shock. D) Living with extended family members helps identify the client's family structure. Page Ref: 24 Cognitive Level: Analyzing Client/Need Sub: Psychosocial Integrity Standards: QSEN Competencies: I. A. 2. Describe how diverse cultural, ethnic, and social backgrounds function as sources of patient, family, and community values. | AACN Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Relationship-Centered Care: The role of family, culture, and community in a person's development. | Nursing/Integrated Concepts: Nursing Process: Assessment. Learning Outcome: 2.1 Compare the characteristics of different types of families. MNL LO: Demonstrate ability to incorporate culturally competent care for patients and families.

5) A 7-year-old client states "Grandpa, Mommy, Daddy, and my brother live at my house." Which type of family should the nurse document for this client? A) Binuclear B) Extended C) Gay or lesbian D) Traditional Answer: B Explanation: A) A binuclear family includes divorced parents with joint custody of their biologic children, who alternate spending varying amounts of time in the home of each parent. B) An extended family consists of a couple who share the house with their parents, siblings, or other relatives. C) A gay or lesbian family is composed of two same-sex domestic partners; they might not have children. D) The traditional nuclear family consists of a husband provider, a wife who stays home, and the biologic children of this union. Page Ref: 18 Cognitive Level: Applying Client/Need Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I. A. 2. Describe how diverse cultural, ethnic, and social backgrounds function as sources of patient, family, and community values. | AACN Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Relationship-Centered Care: The role of family, culture, and community in a person's development. | Nursing/Integrated Concepts: Nursing Process: Implementation. Learning Outcome: 2.1 Compare the characteristics of different types of families. MNL LO: Demonstrate ability to incorporate culturally competent care for patients and families.

6) The nurse is assessing a family with a father and mother who both work. In which way should the nurse document this family structure? A) A traditional nuclear family B) A dual-career/dual-earner family C) An extended family D) An extended kin family Answer: B Explanation: A) The traditional nuclear family is defined as a husband provider, a wife who stays home, and children. B) A dual-career/dual-earner family is characterized by both parents working, either by choice or necessity. C) An extended family is defined as a couple who share household and childrearing responsibilities with parents, siblings, or other relatives. D) An extended kin family is a specific form of an extended family in which two nuclear families of primary or unmarried kin live in close proximity to each other. Page Ref: 18 Cognitive Level: Applying Client/Need Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I. A. 2. Describe how diverse cultural, ethnic, and social backgrounds function as sources of patient, family, and community values. | AACN Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Relationship-Centered Care: The role of family, culture, and community in a person's development. | Nursing/Integrated Concepts: Nursing Process: Implementation. Learning Outcome: 2.1 Compare the characteristics of different types of families. MNL LO: Demonstrate ability to incorporate culturally competent care for patients and families.

7) The nurse is asked why family structure is important during an assessment. Which response should the nurse make? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A) Family structure can influence finances. B) Some families choose to conceive or adopt without a life partner. C) The nurse can anticipate which problems a client will experience based on the type of family the client has. D) Understanding if the client's family is nuclear or blended will help the nurse teach the client the appropriate information. E) The values of the family will be predictable if the nurse knows what type of family the client is a part of. Answer: A, B Explanation: A) Single-parent families often face difficulties because the sole parent may lack social and emotional support, need assistance with childrearing issues, and face financial strain. B) In the single mother by choice family, the mother is typically older, college-educated, and financially stable and has contemplated pregnancy significantly prior to conceiving. C) Family structure is not used to anticipate problems, an assessment should be completed for the client and family as individuals without making assumptions. D) Teaching is based on client and family needs and not according to family structure. E) A family assessment is not used to predict client and family values. Page Ref: 18 Cognitive Level: Applying Client/Need Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I. B. 3. Provide patient-centered care with sensitivity and respect for the diversity of human experience. | AACN Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Relationship-Centered Care: Promote and accept the patient's emotions; accept and respond to distress in patient and self; facilitate hope, trust, and faith. | Nursing/Integrated Concepts: Nursing Process: Assessment. Learning Outcome: 2.1 Compare the characteristics of different types of families. MNL LO: Demonstrate ability to incorporate culturally competent care for patients and families.

8) The nurse is reviewing home care visits made. Which group of people should be considered as a family? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A) Married heterosexual couple without children B) Gay couple with two adopted children C) Unmarried heterosexual couple with two biological children" D) Lesbian couple not living together that have no children E) Married heterosexual couple with three children, living with grandparents Answer: A, B, C, E Explanation: A) A couple without children is still a family. B) Gay families are those in which two or more people who share a same-sex orientation live together, and may or may not have children. C) A family may be formed without a legal marriage. D) A couple not living together and without children together are considered dating and not yet a family. E) Extended family members, including parents or grandparents, will often live with their adult children or grandchildren, creating intergenerational families. Page Ref: 18 Cognitive Level: Analyzing Client/Need Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I. C. 5. Recognize personally held attitudes about working with patients from different ethnic, cultural and social backgrounds. | AACN Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Relationship-Centered Care: Demonstrate self-awareness, self-care, self-growth, be open and nonjudgmental. | Nursing/Integrated Concepts: Nursing Process: Assessment. Learning Outcome: 2.1 Compare the characteristics of different types of families. MNL LO: Demonstrate ability to incorporate culturally competent care for patients and families.

9) A family is identified as being an extended kin family. Which finding the nurse assess to make this determination? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A) A sharing of a social support network B) Each family establishes their own sources of goods and services C) Elderly parents share housing D) Children are members of two nuclear families E) A sharing of goods and services Answer: A, E Explanation: A) Extended kin family networks share a social support network. B) Extended kin family networks share goods and services, rather than establishing their own sources of goods and services. C) Elderly parents sharing a household is a feature of the extended family system. D) Children being members of two nuclear families applies to the binuclear family. E) Extended kin family networks share goods and services. Page Ref: 18 Cognitive Level: Analyzing Client/Need Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I. B. 1. Elicit patient values, preferences and expressed needs as part of clinical interview, implementation of care plan and evaluation of care. | AACN Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Relationship-Centered Care: Demonstrate self-awareness, self-care, self-growth; be open and nonjudgmental. | Nursing/Integrated Concepts: Nursing Process: Assessment. Learning Outcome: 2.1 Compare the characteristics of different types of families. MNL LO: Demonstrate ability to incorporate culturally competent care for patients and families.

10) The nurse is caring for a client who has yet to learn to communicate in English. Which action should the nurse take to communicate with this client? A) Contact an interpreter B) Ask the client's adult child to interpret for the client C) Ask the healthcare provider to provide information about the client D) Use nonverbal communication techniques to communicate with the client Answer: A Explanation: A) To ensure effective care, it is essential for clients to be able to communicate with nurses and other healthcare providers. This becomes an issue when the client does not speak the language of the health professionals. In such cases, it is best if the healthcare facility provides interpreters. B) It is recommended that children never be used to interpret in healthcare situations due to the confidentiality needs of both parent and child. C) The healthcare provider might not be able to communicate with the client either. This is not the best approach to take. D) Nonverbal communication is not an appropriate technique to communicate with the client. Page Ref: 24 Cognitive Level: Applying Client/Need Sub: Psychosocial Integrity Standards: QSEN Competencies: I. B. 2. Describe how diverse cultural, ethnic, and social backgrounds function as sources of patient, family, and community values. | AACN Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Relationship-Centered Care: The role of family, culture, and community in a person's development. | Nursing/Integrated Concepts: Nursing Process: Implementation. Learning Outcome: 2.4 Discuss the use of a cultural assessment tool as a means of providing culturally sensitive care. MNL LO: Demonstrate ability to incorporate culturally competent care for patients and families.

11) The nurse is caring for a client from a non-English speaking culture who is in labor. Which healthcare professional should the nurse consult to assist the client with transportation and financial concerns? A) Social worker B) Nurse manager C) Anesthesiologist D) Primary healthcare provider Answer: A Explanation: A) A social worker would be appropriate to assist the client with issues such as transportation and financial concerns. B) The nurse manager would not be able to assist with transportation and financial concerns. C) The anesthesiologist would focus on pain control and not be able to assist with transportation and financial concerns. D) The primary healthcare provider would not be appropriate to assist with transportation and financial concerns. Page Ref: 26 Cognitive Level: Applying Client/Need Sub: Safe and Effective Care Environment: Management of Care Standards: QSEN Competencies: I. A. 2. Describe how diverse cultural, ethnic, and social backgrounds function as sources of patient, family, and community values. | AACN Domains and Competencies: 2.6 Demonstrate accountability for care delivery. | NLN Competencies: Relationship-Centered Care: The role of family, culture, and community in a person's development. | Nursing/Integrated Concepts: Nursing Process: Implementation. Learning Outcome: 2.1 Compare the characteristics of different types of families. MNL LO: Demonstrate ability to incorporate culturally competent care for patients and families.

12) A client reports seeing a healer who provided medicines that would cause an illness. Which complementary therapy should the nurse realize the client was using? A) Naturopathy B) Homeopathy C) Mind-based therapy D) Traditional Chinese medicine Answer: B Explanation: A) Naturopathy is a form of medicine that utilizes the healing forces of nature and is commonly referred to as natural medicine. It is more precisely defined as a healing system that combines safe and effective traditional means of preventing and treating human disease with the most current advances in modern medicine. B) Homeopathy is a healing approach in which a person is treated with small doses of medicines that would cause illness when given to someone who is healthy. C) Mind-based therapies include biofeedback, hypnosis, visualization, and guided imagery. D) Traditional Chinese medicine seeks to ensure the balance of energy. Page Ref: 28 Cognitive Level: Understanding Client/Need Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I. A. 2. Describe how diverse cultural, ethnic, and social backgrounds function as sources of patient, family, and community values. | AACN Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Relationship-Centered Care: The role of family, culture, and community in a person's development. | Nursing/Integrated Concepts: Nursing Process: Assessment. Learning Outcome: 2.6 Examine the benefits and risks of complementary health approaches. MNL LO: Demonstrate ability to incorporate culturally competent care for patients and families.

13) The nurse is planning a community education program on the role of complementary and alternative therapies during pregnancy. Which statement about alternative and complementary therapies should the nurse include? A) "They bring about cures for illnesses and diseases." B) "They are invasive but effective for achieving health." C) "They emphasize prevention and wellness." D) "They prevent pregnancy complications." Answer: C Explanation: A) These therapies emphasize prevention and wellness, aiming for holistic health rather than cure or treatment. B) Most alternative and complimentary therapies are noninvasive. The only ones that are invasive are acupuncture, herbs, and foods. C) Complementary and alternative therapies have many benefits during pregnancy. They emphasize prevention and wellness, aiming for holistic health rather than cure or treatment. D) No method of treatment can prevent all pregnancy complications. Page Ref: 28 Cognitive Level: Applying Client/Need Sub: Health Promotion and Maintenance Standards: QSEN Competencies: II. A. 2. Describe scopes of practice and roles of healthcare team members. | AACN Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Teamwork: Contribution of other individuals and groups in helping patient/family achieve health goals. | Nursing/Integrated Concepts: Nursing Process: Implementation; Teaching/Learning. Learning Outcome: 2.7 Implement complementary therapies appropriate for the nurse to use with childbearing and childrearing families. MNL LO: Demonstrate ability to incorporate culturally competent care for patients and families.

14) The nurse is preparing to assess the development of a family new to the clinic. For which reason should the nurse complete this assessment? A) Obtain a comprehensive medical history of family members. B) Determine to which clinic the client should be referred. C) Predict how a family will likely change with the addition of children. D) Understand the physical, function, support, sociocultural, environment and needs. Answer: D Explanation: A) The medical history is one area that is explored using a family assessment tool, but it is not the primary use of the family assessment. B) Although referrals might take place as a result of the family assessment findings, this is not the primary purpose of the assessment. C) Family development models help predict how a family will likely change with the addition of children. D) Understanding the structure, functioning, support system, sociocultural background, environment, and needs is the purpose of the family assessment. Page Ref: 20 Cognitive Level: Understanding Client/Need Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | AACN Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Quality and Safety: Carefully maintain and use electronic and/or written health records. | Nursing/Integrated Concepts: Nursing Process: Assessment. Learning Outcome: 2.4 Discuss the use of a cultural assessment tool as a means of providing culturally sensitive care. MNL LO: Demonstrate ability to incorporate culturally competent care for patients and families.

15) The nurse is preparing to assess a family. Which information should the nurse expect to collect? A) How long the family has lived at its current address B) What other health insurance the family has had in the past C) How the family communicates D) What eye color the family desires in its unborn child Answer: C Explanation: A) The length of time at a residence is not included in the family assessment tool. B) Past health insurance coverage is not included in the family assessment tool. C) Basic information in the family assessment includes communication patterns, including language barriers. D) Desired eye color of a child is not included in the family assessment tool. Page Ref: 20 Cognitive Level: Applying Client/Need Sub: Health Promotion and Maintenance Standards: QSEN Competencies: VI. A. 2. Identify essential information that must be available in a common database to support patient care. | AACN Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Quality and Safety: Carefully maintain and use electronic and/or written health records. | Nursing/Integrated Concepts: Nursing Process: Assessment. Learning Outcome: 2.1 Compare the characteristics of different types of families. MNL LO: Demonstrate ability to incorporate culturally competent care for patients and families.

16) The nurse is assessing a new family in the community. Which information should the nurse collect? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A) Family type, structure, roles, and values B) Disabilities in any family member C) Religious affiliations and practices related to childbearing D) Acculturation to traditional lifestyles E) Ability to include a new spouse in the family unit Answer: A, B, C Explanation: A) Family type, structure, roles and values are assessed when completing a family assessment. B) Disabilities in any family member are collected during the family assessment. C) Religious affiliations and practices related to childbearing are assessed during the family assessment. D) Acculturation to traditional lifestyles is assessed during the family assessment. E) The ability to include a new spouse in the family unit is not a part of the family assessment. Page Ref: 20 Cognitive Level: Applying Client/Need Sub: Health Promotion and Maintenance Standards: QSEN Competencies: VI. B. 1. Seek education about how information is managed in care settings before providing care. | AACN Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Quality and Safety: Carefully maintain and use electronic and/or written health records. | Nursing/Integrated Concepts: Nursing Process: Assessment. Learning Outcome: 2.1 Compare the characteristics of different types of families. MNL LO: Demonstrate ability to incorporate culturally competent care for patients and families.

17) The nurse is assessing a client who reports seeing an acupuncturist on a weekly basis to treat back pain. In which way should the nurse categorize this information? A) A risky practice without evidence of efficacy B) A folk remedy C) A complementary therapy D) An alternative therapy Answer: C Explanation: A) Acupuncture has been used in traditional Chinese medicine for over 3000 years. Good evidence is available on the efficacy of acupuncture for treatment of chronic pain. B) A folk remedy is a practice of a cultural group that either has no evidence to support efficacy or has been found not to have an effect. C) Acupuncture is a therapy that is used in conjunction with conventional medical treatment, and therefore is an example of a complementary therapy. D) Acupuncture is not categorized as an alternative therapy, because it is used in conjunction with conventional medical treatment. Page Ref: 28 Cognitive Level: Applying Client/Need Sub: Physiological Integrity: Basic Care and Comfort Standards: QSEN Competencies: II. A. 2. Describe scope of practice and roles of healthcare team members. | AACN Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Teamwork: Contribution of other individuals and groups in helping patient/family achieve health goals. | Nursing/Integrated Concepts: Nursing Process: Assessment. Learning Outcome: 2.7 Implement complementary therapies appropriate for the nurse to use with childbearing and childrearing families. MNL LO: Demonstrate ability to incorporate culturally competent care for patients and families.

18) The nurse cares for immigrants in an inner-city setting. Which benefit should the nurse identify with the acculturation of immigrants? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A) Improved socioeconomic status B) Use of preventive care services C) Better nutrition D) Increase in substance abuse over time E) More physician visits due to language barriers Answer: A, B, C Explanation: A) Improvement of socioeconomic status is a benefit of acculturation in the United States. B) Acculturation of immigrants increases the likelihood that the family members will use preventive health services. C) Improved socioeconomic status leads to better nutrition and access to healthcare. D) There is no evidence that substance use increases over time because of acculturation. E) Language barriers with physicians tend to decrease the use of healthcare services. Page Ref: 21 Cognitive Level: Applying Client/Need Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I. B. 3. Provide patient-centered care with sensitivity and respect for the diversity of human experience. | AACN Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Relationship-Centered Care: Appreciate the patient as a whole person, with his or her own life story and ideas about the meaning of health or illness. | Nursing/Integrated Concepts: Nursing Process: Assessment. Learning Outcome: 2.2 Examine how cultural values, beliefs, and practices can influence childbearing and childrearing. MNL LO: Demonstrate ability to incorporate culturally competent care for patients and families.

19) A postpartum client who immigrated to the United States several years ago asks for something to eat because food tastes so much better in this country. Which cultural concept should the nurse recognize the client is demonstrating? A) Acculturation B) Ethnocentrism C) Enculturation D) Stereotyping Answer: A Explanation: A) The client is demonstrating acculturation because of an adaptation to a new cultural norm in terms of food choices. B) Ethnocentrism refers to a social identity that is associated with shared behaviors and patterns. C) Enculturation occurs when culture is learned and passed on from generation to generation, and often happens when a group is isolated. D) Stereotyping is the assumption that all members of a group have the same characteristics. Page Ref: 21 Cognitive Level: Applying Client/Need Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I. B. 3. Provide patient-centered care with sensitivity and respect for the diversity of human experience. | AACN Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Relationship-Centered Care: Appreciate the patient as a whole person, with his or her own life story and ideas about the meaning of health or illness. | Nursing/Integrated Concepts: Nursing Process: Assessment. Learning Outcome: 2.2 Examine how cultural values, beliefs, and practices can influence childbearing and childrearing. MNL LO: Demonstrate ability to incorporate culturally competent care for patients and families.

20) The nurse is teaching a community education class on complementary and alternative therapies. Which treatment should the nurse explain that is used to increase the invisible flow of energy in the body that maintains health and ensures physiologic functioning? A) Meridians B) Chi C) Yin D) Yang Answer: B Explanation: A) Meridians are the 14 pathways along which energy flows, connecting all parts of the body. B) Chi is the energy that flows through the body along meridians, or pathways, to maintain health. C) Yin and yang are opposites. Yin is the female force: passive, cool, wet, and close to the earth. D) Yin and yang are opposites. Yang is the masculine force: aggressive, hot, dry, and celestial. Page Ref: 28 Cognitive Level: Applying Client/Need Sub: Physiological Integrity: Basic Care and Comfort Standards: QSEN Competencies: I. A. 2. Describe how diverse cultural, ethnic, and social backgrounds function as sources of patient, family, and community values. | AACN Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Relationship-Centered Care: The role of family, culture, and community in a person's development. | Nursing/Integrated Concepts: Nursing Process: Implementation; Teaching/Learning. Learning Outcome: 2.6 Examine the benefits and risks of complementary health approaches. MNL LO: Demonstrate ability to incorporate culturally competent care for patients and families.

21) The nurse is completing an assessment of a family. In which way should the nurse recognize that culture influences childrearing and childbearing? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A) Beliefs about the importance of children B) Beliefs and attitudes about pregnancy C) Norms regarding infant feeding D) Acculturation is important in rearing children E) Time orientation to the future is very important Answer: A, B, C Explanation: A) Culture influences beliefs about the importance of children. B) Culture influences attitudes about pregnancy and the right vs. the obligation of women to bear children. C) Culture influences infant feeding norms and practices. D) Acculturation is not important in rearing children. E) Time orientation is a cultural difference and can emphasize the past, present, or future. It does not influence childbearing and childrearing. Page Ref: 23 Cognitive Level: Applying Client/Need Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I. C. 1. Value seeing healthcare situations "through patients' eyes." | AACN Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Relationship-Centered Care: Affirm and value diversity. | Nursing/Integrated Concepts: Nursing Process: Assessment. Learning Outcome: 2.2 Examine how cultural values, beliefs, and practices can influence childbearing and childrearing. MNL LO: Demonstrate ability to incorporate culturally competent care for patients and families.

22) A client reports using concentration to focus on antibodies to heal a health condition. Which approach should the nurse realize the client is describing? A) Guided imagery B) Qigong C) Biofeedback D) Homeopathy Answer: A Explanation: A) Guided imagery is a state of intense, focused concentration used to create compelling mental images and is useful in imagining a desired effect. B) Qigong involves the use of breathing, meditation, self-massage, and movement. C) Biofeedback is learning to control physiologic responses to stimuli or thoughts. D) Homeopathy is not a mind-body therapy, but uses the concept of like curing like. Page Ref: 29 Cognitive Level: Analyzing Client/Need Sub: Physiological Integrity: Physiological Adaptation Standards: QSEN Competencies: I. A. 6. Describe strategies to empower patients or families in all aspects of the healthcare process. | AACN Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Relationship-Centered Care: Respect the patient's dignity, uniqueness, integrity, and self-determination and his or her own power and self-healing process. | Nursing/Integrated Concepts: Nursing Process: Assessment. Learning Outcome: 2.6 Examine the benefits and risks of complementary health approaches. MNL LO: Demonstrate ability to incorporate culturally competent care for patients and families.

23) The nurse is assessing a client from a foreign culture experiencing a health condition. Which question should the nurse ask during the assessment? A) "What other treatments have you used for your abdominal pain?" B) "In what country you were born?" C) "When you talk to family members, how close do you stand?" D) "How would you describe your role within your family?" Answer: A Explanation: A) Knowing what other treatments the client has used for pain is most important because some traditional or folk remedies include the use of herbs, which can have medication interactions. B) Although information about the country of birth is helpful, it is not a physiological issue. Asking other questions is a higher priority. C) Although understanding the client's perception of appropriate personal space is helpful, it is not a physiological issue. Asking other questions is a higher priority. D) Although understanding the client's family roles is helpful, it is not a physiological issue. Asking other questions is a higher priority. Page Ref: 22 Cognitive Level: Applying Client/Need Sub: Psychosocial Integrity Standards: QSEN Competencies: I. B. 1. Elicit patient values, preferences, and expressed needs as part of clinical interview, implementation of care plan and evaluation of care. | AACN Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Assessment. Learning Outcome: 2.4 Discuss the use of a cultural assessment tool as a means of providing culturally sensitive care. MNL LO: Demonstrate ability to incorporate culturally competent care for patients and families.

24) The nurse is preparing a seminar for staff who work in a facility with residents of various racial, ethnic, cultural, and religious backgrounds. Which statement should the nurse include in the presentation? A) "Our clients come from a broad range of backgrounds, but we have a good interpreter service." B) "Many of our clients come from backgrounds different from your own, but it doesn't cause problems for the nurses." C) "Because most of the doctors are bilingual, we don't have to deal with the differences in cultural backgrounds of our clients." D) "Understanding the common values and health practices of our diverse clients will facilitate better care and health outcomes." Answer: D Explanation: A) The role of a foreign language interpreter is to facilitate communication. B) Racial, ethnic, cultural, and religious backgrounds of clients have significant implications for how the clients perceive health, illness, and healthcare. It is important for nurses to understand the backgrounds of the client population that attends that facility. C) It is the responsibility of the nurse to become familiar with the backgrounds of the client population. D) Cultural norms influence a client's beliefs about health practices which facilitate better care and health outcomes. Page Ref: 31 Cognitive Level: Applying Client/Need Sub: Psychosocial Integrity Standards: QSEN Competencies: I. B. 1. Elicit patient values, preferences, and expressed needs as part of clinical interview, implementation of care plan and evaluation of care. | AACN Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Planning; Teaching/Learning. Learning Outcome: 2.4 Discuss the use of a cultural assessment tool as a means of providing culturally sensitive care. MNL LO: Demonstrate ability to incorporate culturally competent care for patients and families.

25) The nurse is preparing teaching about ethnocentrism for staff who care for clients from various cultural backgrounds. For which reason should the nurse include information to avoid believing personal values and beliefs are the best or the only acceptable ones? A) It implies newcomers to the United States should adopt the norms and values of the country. B) It can create barriers to communication through misunderstanding. C) It leads to an expectation that all clients will exhibit pain the same way. D) It improves the quality of care provided to culturally diverse client bases. Answer: B Explanation: A) Although acculturation involves adoption of some of the majority culture's practices and beliefs, each cultural group will continue to hold and express its own set of values and beliefs. B) When the nurse assumes that a client has the same values and beliefs as the nurse, misunderstanding will frequently occur, which in turn can negatively impact nurse-client communication. Ethnocentrism is the conviction that the values and beliefs of one's own cultural group are the best or only acceptable ones. C) Expression of pain is one area that varies greatly from one culture to another. D) The belief that one's own values and beliefs are the best will not improve the quality of care provided to culturally diverse client bases. Page Ref: 24 Cognitive Level: Understanding Client/Need Sub: Psychosocial Integrity Standards: QSEN Competencies: I. C. 1. Value seeing healthcare situations "through patients' eyes." | AACN Domains and Competencies: 2.5 Develop a plan of care. | NLN Competencies: Relationship-Centered Care: Appreciate the patient as a whole person, with his or her own life story and ideas about the meaning of health or illness. | Nursing/Integrated Concepts: Nursing Process: Planning. Learning Outcome: 2.4 Discuss the use of a cultural assessment tool as a means of providing culturally sensitive care. MNL LO: Demonstrate ability to incorporate culturally competent care for patients and families.

26) The client reports using an alternative therapy that involves the manipulation of soft tissues that reduces stress, diminishes pain, and increases circulation. Which therapy has this client most likely received? A) Guided imagery B) Homeopathy C) Massage therapy D) Reflexology Answer: C Explanation: A) Guided imagery involves picturing a desired outcome. B) Homeopathy uses the concept of like curing like. C) Massage therapy involves the manipulation of soft tissues. D) Reflexology is the application of pressure to designated points or reflexes on the client's feet, hands, or ears using the thumb and fingers. Page Ref: 29 Cognitive Level: Understanding Client/Need Sub: Physiological Integrity: Basic Care and Comfort Standards: QSEN Competencies: I. B. 2. Communicate patient values, preferences, and expressed needs to other members of the healthcare team. | AACN Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Relationship-Centered Care: Appreciate the patient as a whole person, with his or her own life story and ideas about the meaning of health or illness. | Nursing/Integrated Concepts: Nursing Process: Assessment. Learning Outcome: 2.6 Examine the benefits and risks of complementary health approaches. MNL LO: Demonstrate ability to incorporate culturally competent care for patients and families.

27) The nurse is working in a clinic where clients from several cultures receive care. Which action should the nurse take to achieve the goal of personal cultural competence? A) Enhance cultural skills. B) Gain cultural awareness. C) Seek cultural encounters. D) Acquire cultural knowledge. Answer: B Explanation: A) Ways to enhance cultural skill include learning a prevalent language and learning how to recognize health-manifesting skin color variations in different races. B) One begins to gain cultural competence by gaining cultural awareness or by gaining an effective and cognitive self-awareness of personal worldview biases, and beliefs. C) During daily interactions with clients from diverse backgrounds, these cultural encounters allow the nurse to appreciate the uniqueness of individuals from varying backgrounds. D) Acquiring cultural knowledge includes studying information about the beliefs, biological variations, and favored treatments of specific cultural groups. Page Ref: 26 Cognitive Level: Applying Client/Need Sub: Psychosocial Integrity Standards: QSEN Competencies: I. B. 1. Elicit patient values, preferences, and expressed needs as part of clinical interview, implementation of care plan and evaluation of care. | AACN Domains and Competencies: 2.5 Develop a plan of care. | NLN Competencies: Relationship-Centered Care: Communicate information effectively: listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Planning. Learning Outcome: 2.3 Analyze the importance of cultural competency in providing nursing care. MNL LO: Demonstrate ability to incorporate culturally competent care for patients and families.

28) The nurse is preparing teaching about birthing options. Which action should the nurse take when the participants are from different cultures in the class? A) Understands that the families have the same values as the nurse B) Teaches the families how childbearing takes place in the United States C) Insists that the clients answer questions instead of their partners D) Incorporates the specific beliefs of the cultural groups that are attending the class Answer: D Explanation: A) Assuming that the families have the same values as the nurse is ethnocentrism. B) Although it is important to explain healthcare during pregnancy and childbearing, this is not the top priority. C) The partners asking questions might be a cultural norm, and insisting that the client answer could decrease the family's trust in the healthcare system. D) Providing culturally competent care involves recognizing the importance of the childbearing family's value system, acknowledging that differences occur among people, and respecting and responding to ethnic diversity in a way that leads to mutually desirable outcomes. Page Ref: 31 Cognitive Level: Applying Client/Need Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I. B. 3. Provide patient-centered care with sensitivity and respect for the diversity of human experience. | AACN Domains and Competencies: 2.5 Develop a plan of care. | NLN Competencies: Relationship-Centered Care: Communicate information effectively: listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Planning; Teaching/Learning. Learning Outcome: 2.3 Analyze the importance of cultural competency in providing nursing care. MNL LO: Demonstrate ability to incorporate culturally competent care for patients and families.

29) The nurse is caring for a client who is new to a community clinic. Which question should the nurse include when completing the cultural assessment? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A) What genetic and other biological differences affect caregiving? B) Which family member must be consulted for decisions about care? C) What type of healthcare provider is the most appropriate? D) Does the client have beliefs or traditions that might impact the care plan? E) Are communications patterns established? Answer: B, C, D Explanation: A) Genetic and biological differences are health concerns, such as hypertension that the nurse must keep in mind, but the nurse would not ask about genetic and biological differences during a cultural assessment. B) It is important that the nurse recognize cultural differences in regard to which family member must be consulted for decisions about care. C) Some cultures do not allow a person of the opposite sex to touch the client. Cultural sensitivity will recognize and allow for this. D) The nurse must be aware of traditions and beliefs that might impact the care plan. E) Communication patterns will have been established. The nurse must be able to communicate with the client, using the patterns of communication the client uses. Page Ref: 27 Cognitive Level: Applying Client/Need Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I. B. 1. Elicit patient values, preferences, and expressed needs as part of clinical interview, implementation of care plan and evaluation of care. | AACN Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Assessment. Learning Outcome: 2.4 Discuss the use of a cultural assessment tool as a means of providing culturally sensitive care. MNL LO: Demonstrate ability to incorporate culturally competent care for patients and families.

30) The nurse is working with a client whose religious beliefs differ from those of the general population. Which action should the nurse take to meet the client's spiritual needs? A) Ask how important the client's religious and spiritual beliefs are when making decisions about healthcare. B) Show respect while allowing time and privacy for religious rituals. C) Ask for the client's opinion on what caused the illness. D) Identify healthcare practices forbidden by religious or spiritual beliefs. Answer: B Explanation: A) Considering the impact of religious and spiritual beliefs might be part of the spiritual assessment process but is not an intervention. B) Whenever possible, the nurse should attempt to accommodate religious rituals and practices requested by the family. C) Asking what caused the client's illness is not an intervention, and does nothing to meet the spiritual needs specific to the family. D) Identifying what health practices might be forbidden by the family's beliefs might be part of the spiritual assessment process, but is not an intervention. Page Ref: 23 Cognitive Level: Applying Client/Need Sub: Psychosocial Integrity Standards: QSEN Competencies: I. C. 2. Respect and encourage individual expression of patient values, preferences, and expressed need. | AACN Domains and Competencies: 2.6 Demonstrate accountability for care delivery. | NLN Competencies: Relationship-Centered Care: Appreciate the patient as a whole person with his or her own life story and ideas about the meaning of health or illness. | Nursing/Integrated Concepts: Nursing Process: Implementation. Learning Outcome: 2.5 Identify key considerations in providing spiritually sensitive care. MNL LO: Demonstrate ability to incorporate culturally competent care for patients and families.

31) A client in labor asks to see a spiritual advisor because in the past, a family member died during labor. Which response should the nurse make? A) "Nothing is going to happen to you. We'll take very good care of you during your birth." B) "Would you like to have an epidural so that you won't feel the pain of the contractions?" C) "The spiritual advisor won't be able to prevent complications, and might get in the way of your providers." D) "Would you like me to contact someone from your spiritual community or our hospital chaplain to come see you?" Answer: D Explanation: A) Avoid statements of reassurance, as there are no guarantees of outcome during healthcare. Using such statements shuts down effective communication because the client's concern is downplayed. B) The client's expressed concern is not about pain; it is a fear of death and a desire to see a spiritual advisor. The nurse should address the client's concern directly. C) Although this statement is true, it is not therapeutic. It downplays the client's concerns, and will shut down effective communication. The nurse should address the concerns the client expresses. D) Providing spiritually sensitive care involves determining the current spiritual and religious beliefs and practices that will affect the mother and baby and accommodating these practices where possible. Page Ref: 23 Cognitive Level: Applying Client/Need Sub: Psychosocial Integrity Standards: QSEN Competencies: I. C. 2. Respect and encourage individual expression of patient values, preferences, and expressed need. | AACN Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Relationship-Centered Care: Appreciate the patient as a whole person with his or her own life story and ideas about the meaning of health or illness. | Nursing/Integrated Concepts: Nursing Process: Implementation. Learning Outcome: 2.5 Identify key considerations in providing spiritually sensitive care. MNL LO: Demonstrate ability to incorporate culturally competent care for patients and families.

32) The client reports relief from headaches when the temples are rubbed on each side of the head. Which approach should the nurse identify the client is using? A) Acupressure B) Acupuncture C) Reflexology D) Hydrotherapy Answer: A Explanation: A) Acupressure uses pressure from the fingers and thumbs to stimulate pressure points to relieve symptoms. B) Acupuncture uses 6-12 very fine stainless steel needles to stimulate specific points, depending on the client's medical assessment and condition. C) Reflexology is a form of massage that involves the application of pressure to designated points or reflexes on the client's feet, hands, or ears using the thumb and fingers. D) Hydrotherapy is therapy that makes use of hot or cold moisture in any form. Page Ref: 28 Cognitive Level: Analyzing Client/Need Sub: Physiological Integrity: Basic Care and Comfort Standards: QSEN Competencies: I. A. 2. Describe strategies to empower patients or families in all aspects of the healthcare process. | AACN Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Relationship-Centered Care: Appreciate the patient as a whole person, with his or her own life story and ideas about the meaning of health and illness. | Nursing/Integrated Concepts: Nursing Process: Assessment. Learning Outcome: 2.6 Examine the benefits and risks of complementary health approaches. MNL LO: Demonstrate ability to incorporate culturally competent care for patients and families.

33) A pregnant client experiencing nausea asks if there is anything that can be done without taking medication or herbal remedies. Which recommendation should the nurse make to the client? A) Massage B) Music therapy C) Therapeutic touch D) Acupressure wristband Answer: D Explanation: A) Massage is used to reduce stress and tension. B) Music therapy is used to reduce stress and enhance relaxation. C) Therapeutic touch is an approach used to promote well-being and healing. D) Acupressure wristbands have been used for the treatment of nausea. Page Ref: 31 Cognitive Level: Applying Client/Need Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I. A. 2. Describe how diverse cultural, ethnic, and social backgrounds function as sources of patient, family, and community values. | AACN Domains and Competencies: 2.6 Demonstrate accountability for care delivery. | NLN Competencies: Relationship-Centered Care; Knowledge; The role of family, culture, and community in a person's development. | Nursing/Integrated Concepts: Implementation. Learning Outcome: 2.1 Compare the characteristics of different types of families. MNL LO: Demonstrate ability to incorporate culturally competent care for patients and families.

34) The nurse is visiting a family whose grandparents are helping the adult parents with child-rearing activities. For which type of family should the nurse plan care? A) Nuclear B) Blended C) Binuclear D) Extended Answer: D Explanation: A) In the nuclear family, children live in a household with both biologic parents and no other relatives or persons. B) The blended family includes two parents with biologic children from a previous marriage or relationship who marry or cohabitate. C) A binuclear family is a post-divorce family in which the biologic children are members of two nuclear households, with parenting by both the father and the mother. D) In an extended family, a couple shares household and childrearing responsibilities with parents, siblings, or other relatives. Families may reside together to share housing expenses and child care. In many cases, a child may be residing with a grandparent and one parent because of issues associated with unemployment, parental separation, parental death, or parental substance abuse. Grandparents may raise children due to the inability of parents to care for their own children. Page Ref: 18 Cognitive Level: Applying Client/Need Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I. A. 2. Describe how diverse cultural, ethnic, and social backgrounds function as sources of patient, family, and community values. | AACN Domains and Competencies: 2.5 Develop a plan of care. | NLN Competencies: Relationship-Centered Care; Knowledge; The role of family, culture, and community in a person's development. | Nursing/Integrated Concepts: Planning. Learning Outcome: 2.1 Compare the characteristics of different types of families. MNL LO: Demonstrate ability to incorporate culturally competent care for patients and families.

35) A pregnant client from a culture that treats hot and cold conditions with food is experiencing a severe lower backache. According to the table shown here, which food should the nurse provide to help this client? Table 2-1 Hot and Cold Conditions and Foods Cold Food Used to Treat Hot Food Used to Treat Hot Condition Hot Condition Cold Condition Cold Condition Diarrhea Barley water Cancer Beef Fever Chicken Earaches Cheese Constipation Dairy products Headaches Eggs Infection Raisins Musculoskeletal Grains (other than barley) conditions Kidney problems Fish Pneumonia Liquor Liver conditions Cucumber Menstrual cramps Pork Sore throats Fresh fruits Malaria Onions Stomach ulcers Fresh vegetables Arthritis Spicy foods Goat meat Rhinitis Chocolate Colic Warm water and honey SOURCES: Purnell & Fenkl, 2019; Andrews, Boyle, & Collins, 2019; Lincoln & Dodge, 2016. A) Green salad B) Glass of milk C) String cheese D) Sliced orange Answer: C Explanation: A) Salad is a cold food and would not be appropriate to treat a cold condition. B) Milk is a cold food and would not be appropriate to treat a cold condition. C) A backache is a cold musculoskeletal condition and should be treated with a hot food such as string cheese. D) An orange is a cold food and would not be appropriate to treat a cold condition. Page Ref: 22 Cognitive Level: Applying Client/Need Sub: Psychosocial Integrity Standards: QSEN Competencies: I. A. 2. Describe how diverse cultural, ethnic, and social backgrounds function as sources of patient, family, and community values. | AACN Domains and Competencies: 2.6 Demonstrate accountability for care delivery. | NLN Competencies: Relationship-Centered Care; Knowledge; The role of family, culture, and community in a person's development. | Nursing/Integrated Concepts: Implementation. Learning Outcome: 2.4 Discuss the use of a cultural assessment tool as a means of providing culturally sensitive care. MNL LO: Demonstrate ability to incorporate culturally competent care for patients and families.

36) A pregnant client is attending a class to learn the movements identified in the following photo. For which reason should the client learn these movements?

A) Stimulate the flow of chi B) Stimulate pressure points C) Mind control over the body D) Correct spinal misalignment Answer: A Explanation: A) The patient is practicing Qi gong, which is designed to stimulate the flow of chi. B) Acupressure uses pressure from the fingers and thumbs to stimulate pressure points. C) Biofeedback is a method used to help individuals learn to control their physiologic responses based on the concept that the mind controls the body. D) Chiropractic is based on concepts of manipulation to address health problems that are thought to be the result of abnormal nerve transmissions (subluxation) caused by misalignment of the spine. Page Ref: 29 Cognitive Level: Understanding Client/Need Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I. A. 2. Describe how diverse cultural, ethnic, and social backgrounds function as sources of patient, family, and community values. | AACN Domains and Competencies: 2.5 Develop a plan of care. | NLN Competencies: Relationship-Centered Care; Knowledge; The role of family, culture, and community in a person's development. | Nursing/Integrated Concepts: Planning. Learning Outcome: 2.6 Examine the benefits and risks of complementary health approaches. MNL LO: Demonstrate ability to incorporate culturally competent care for patients and families. 37) During a home visit the nurse observes a new mother performing the following action. In 57 Copyright © 2024 Pearson Education, Inc.

which way should the nurse document the mother's action?

A) Massage B) Acupressure C) Biofeedback D) Moxibustion Answer: A Explanation: A) Infant massage is also growing in popularity in the United States, and many parents have learned to massage their infants and young children. B) Acupressure uses pressure from the fingers and thumbs to stimulate pressure points. C) Biofeedback is a method used to help individuals learn to control their physiologic responses based on the concept that the mind controls the body. D) Moxibustion involves the application of heat from a small piece of burning herb called moxa (Artemisia vulgaris). Page Ref: 30 Cognitive Level: Applying Client/Need Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I. A. 2. Describe how diverse cultural, ethnic, and social backgrounds function as sources of patient, family, and community values. | AACN Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Relationship-Centered Care; Knowledge; The role of family, culture, and community in a person's development. | Nursing/Integrated Concepts: Assessment; Communication and Documentation. Learning Outcome: 2.7 Implement complementary therapies appropriate for the nurse to use with childbearing and childrearing families. MNL LO: Demonstrate ability to incorporate culturally competent care for patients and families. Old's Maternal-Newborn Nursing and Women's Health, 12e (Davidson) Chapter 3 Health Promotion 1) The clinic nurse is returning phone calls. Which call should the nurse return first? A) The call from a 22-year-old reporting that she has menstrual cramps and vomiting every month B) The call from a 17-year-old asking whether there is a problem with using one tampon for a whole day 58 Copyright © 2024 Pearson Education, Inc.

20) The nurse at the prenatal clinic has four calls to return. Which call should the nurse return first? A) Client at 32 weeks, reports headache and blurred vision. B) Client at 18 weeks, reports no fetal movement in this pregnancy. C) Client at 16 weeks, reports increased urinary frequency. D) Client at 40 weeks, reports sudden gush of fluid and contractions. Answer: A Explanation: A) Headache and blurred vision are signs of preeclampsia, which is potentially life-threatening for both the client and fetus. This client has top priority. B) Fetal movement should be felt by 19-20 weeks. The lack of fetal movement prior to 20 weeks is considered normal. This client is a lower priority. C) Increased urinary frequency is common during pregnancy as the increased size of the uterus puts pressure on the urinary bladder. D) A full-term client who is experiencing contractions and a sudden gush of fluid is in labor. Although laboring clients should be in contact with their provider for advice on when to go to the hospital, labor at full term is an expected finding. This client is a lower priority. Page Ref: 238 Cognitive Level: Analyzing Client/Need Sub: Health Promotion and Maintenance Standards: QSEN Competencies: V. B. 4. Communicate observations or concerns related to hazards and errors to patients. | AACN Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Quality and Safety: Communicate potential risk factors and errors. | Nursing/Integrated Concepts: Nursing Process: Assessment. Learning Outcome: 11.3 Identify risk factors for adverse perinatal outcomes. MNL LO: Demonstrate ability to perform assessment and interpret data for a patient during the antepartum period.

21) The nurse is caring for a pregnant client. At which time of gestation should the client be scheduled for screening for gestational diabetes mellitus (GDM)? A) 36 and 40 weeks B) Before 20 weeks C) 24 and 28 weeks D) 30 and 34 weeks Answer: C Explanation: A) Screening for gestational diabetes mellitus (GDM) is not completed between 36 and 40 weeks' gestation. B) Screening for gestational diabetes mellitus (GDM) is not completed before 20 weeks' gestation. C) Screening for gestational diabetes mellitus (GDM) is typically completed between 24 and 28 weeks' gestation. D) Screening for gestational diabetes mellitus (GDM) is not completed between 30 and 34 weeks' gestation. Page Ref: 236 Cognitive Level: Applying Client/Need Sub: Physiological Integrity: Reduction of Risk Potential Standards: QSEN Competencies: V. B. 4. Communicate observations or concerns related to hazards and errors to patients, families, and the healthcare team. | AACN Domains and Competencies: 2.5 Develop a plan of care. | NLN Competencies: Quality and Safety: Communicate potential risk factors and actual errors. | Nursing/Integrated Concepts: Planning. Learning Outcome: 11.7 Summarize the results of the major screening tests used during the prenatal period in the assessment of the prenatal patient. MNL LO: Demonstrate ability to perform assessment and interpret data for a patient during the antepartum period. 22) A pregnant client's first day of the last menstrual period was 6/14. At which time should the client anticipate delivery? Answer: 3/21 Explanation: To determine estimated date of birth, subtract 3 months and add 7 days from the first day of the patient's last menstrual period. For this patient, this would be 6 - 3 or 3 and 14 + 7 or 21. The estimated date of birth would be 3/21. Page Ref: 232 Cognitive Level: Applying Client/Need Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I. A. 1. Integrate understanding of multiple dimensions of patient-centered care. | AACN Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Context and Environment: Practice; conduct population-based transcultural health assessments and interventions. | Nursing/Integrated Concepts: Assessment. Learning Outcome: 11.5 Calculate the estimated date of birth using the common methods. MNL LO: Demonstrate ability to perform assessment and interpret data for a patient during the antepartum period.

23) The nurse is measuring the fundal height of a client who is at 28 weeks' gestation using the following method. Which finding should the nurse identify as expected?

A) 22 cm B) 24 cm C) 28 cm D) 30 cm Answer: C Explanation: A) Fundal height of 22 cm could indicate restricted fetal growth. B) Fundal height of 24 cm could indicate restricted fetal growth. C) Fundal height in centimeters correlates well with weeks of gestation between 22 weeks and 34 weeks. At 28 weeks' gestation, fundal height is probably about 28 cm. D) A fundal height of 30 cm may indicate the presence of twins, hydramnios, or a large for gestational age (LGA) fetus. Page Ref: 233 Cognitive Level: Analyzing Client/Need Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I. A. 1. Integrate understanding of multiple dimensions of patient-centered care. | AACN Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Context and Environment: Practice; conduct population-based transcultural health assessments and interventions. | Nursing/Integrated Concepts: Assessment. Learning Outcome: 11.4 Predict the normal physiologic changes one would expect to find when performing a physical assessment on a pregnant woman. MNL LO: Demonstrate ability to perform assessment and interpret data for a patient during the antepartum period.

24) The nurse is explaining pelvic measurements to a client who is 20 weeks pregnant. On the diagram, which measurement should the nurse identify as being the smallest for the fetus to pass during delivery?

A) A B) B C) C D) D Answer: B Explanation: A) The conjugate vera is not the smallest area for the fetus to pass during delivery. B) The obstetric conjugate is the smallest and the most important anteroposterior diameter through which the fetus must pass. C) The diagonal conjugate is not the smallest area for the fetus to pass during delivery. D) Plane of least pelvic dimension is not an important measurement for delivery. Page Ref: 234 Cognitive Level: Applying Client/Need Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I. A. 1. Integrate understanding of multiple dimensions of patient-centered care. | AACN Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Context and Environment: Practice; conduct population-based transcultural health assessments and interventions. | Nursing/Integrated Concepts: Implementation; Teaching/Learning. Learning Outcome: 11.6 Describe the essential measurements that can be determined by clinical pelvimetry. MNL LO: Demonstrate ability to perform assessment and interpret data for a patient during the antepartum period.

25) A pregnant client is having measurements of the pelvis. Which approach should the examiner use to determine the client's estimated length of the pubic ramus? A)

Answer: B Explanation: A) Choice A is an estimation of the subpubic angle. B) Choice B is an estimation of the length of the pubic ramus. C) Choice C is an estimation of the depth and inclination of the pubis. D) Choice D is an estimation of the contour of the subpubic angle. Page Ref: 237 Cognitive Level: Applying Client/Need Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I. A. 1. Integrate understanding of multiple dimensions of patient-centered care. | AACN Domains and Competencies: 2.6 Demonstrate accountability for care delivery. | NLN Competencies: Context and Environment; Practice; conduct population-based transcultural health assessments and interventions. | Nursing/Integrated Concepts: Implementation. Learning Outcome: 11.6 Describe the essential measurements that can be determined by clinical pelvimetry. MNL LO: Demonstrate ability to perform assessment and interpret data for a patient during the antepartum period.

26) During the examination of a client who is pregnant 24 weeks, the healthcare provider performs the maneuver in the diagram below. Which measurement should the nurse expect is being done on this client?

A) Subpubic angle B) Transverse diameter C) Anteroposterior sagittal diameter D) Height and angle of the symphysis pubis Answer: B Explanation: A) The subpubic angle is estimated by palpating the bony structure externally with two fingers placed side by side at the border of the symphysis. B) The transverse diameter of the outlet is measured by placing the fist between the ischial tuberosities. C) The anteroposterior sagittal diameter is the most significant diameter of the outlet because it is the shortest diameter through which the infant must pass. The examiner uses two fingers to determine the contour of the pubic arch. This provides information on the width of the angle at which these bones come together. D) The height and inclination of the symphysis pubis are measured, and the contour of the pubic arch is estimated. Excessively long or angulated bone structure shortens the diameter of the obstetric conjugate. Height can be determined by placing the index finger of the gloved hand up to the superior border of the symphysis. Page Ref: 236 Cognitive Level: Analyzing Client/Need Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I. A. 1. Integrate understanding of multiple dimensions of patient-centered care. | AACN Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Context and Environment: Practice; conduct population-based transcultural health assessments and interventions. | Nursing/Integrated Concepts: Assessment. Learning Outcome: 11.6 Describe the essential measurements that can be determined by clinical pelvimetry. MNL LO: Demonstrate ability to perform assessment and interpret data for a patient during the antepartum period.

27) The nurse is collecting information during an initial prenatal visit. Which question is appropriate when assessing the current pregnancy? A) "What was the date of your last menstrual period?" B) "How many times have you been pregnant?" C) "What were your children's birth weights?" D) "How many living children do you have?" Answer: A Explanation: A) The nurse would ask the client for the date of the last menstrual period when assessing the current pregnancy as part of the client profile. B) The nurse would ask the client how many pregnancies when assessing past pregnancies as part of the client profile. C) The nurse would assess the birth weights of the client's children when assessing past pregnancies as part of the client profile. D) The nurse would ask the client how many living children were delivered when assessing past pregnancies as part of the client profile. Page Ref: 217 Cognitive Level: Applying Client/Need Sub: Health Promotion and Maintenance Standards: QSEN Competencies: III. B. 3. Base individualized care plan on client values, clinical expertise and evidence. | AACN Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Context and Environment: Practice; apply health promotion/disease prevention strategies; apply health policy. | Nursing/Integrated Concepts: Assessment. Learning Outcome: 11.1 Summarize the essential components of a prenatal history. MNL LO: Demonstrate ability to perform assessment and interpret data for a patient during the antepartum period.

28) An obese pregnant client is having a routine prenatal visit. Which assessment should the nurse make a priority? A) Complete blood count (CBC) B) Basic metabolic panel (BMP) C) Blood pressure D) Fetal heart rate Answer: C Explanation: A) While it is important to monitor the client's CBC to assess for anemia, this is not the priority assessment for this client. B) The BMP is not commonly monitored during pregnancy. A blood glucose level may be monitored, as the client's weight increases the risk for gestational diabetes mellitus. C) The blood pressure would be monitored closely at each prenatal visit due to the client's weight. Obese clients have a greater risk for gestational hypertension. This is the priority assessment for this client. D) While it is important to monitor the fetal heart rate during every prenatal visit, this is not the priority for this client. Page Ref: 224 Cognitive Level: Analyzing Client/Need Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I. B. 3. Provide client-centered care with sensitivity and respect for the diversity of human experience. | AACN Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies; apply health policy. | Nursing/Integrated Concepts: Assessment. Learning Outcome: 11.9 Relate the components of the subsequent prenatal history and assessment to the progress of pregnancy and the nursing care of the prenatal client. MNL LO: Demonstrate ability to perform assessment and interpret data for a patient during the antepartum period.

29) A pregnant client is diagnosed with a urinary tract infection (UTI). About which condition should the nurse instruct the client? A) Gestational hypertension B) Gestational diabetes mellitus C) Preterm labor D) Anemia Answer: C Explanation: A) A diagnosis of a UTI during pregnancy does not increase the risk for gestational hypertension. B) A diagnosis of a UTI during pregnancy does not increase the risk for gestational diabetes mellitus. C) The nurse would provide teaching to the client regarding signs and symptoms associated with preterm labor, as the diagnosis of a UTI increases the risk for developing this complication of pregnancy. D) A diagnosis of a UTI during pregnancy does not increase the risk for anemia. Page Ref: 223 Cognitive Level: Applying Client/Need Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I. B. 3. Provide client-centered care with sensitivity and respect for the diversity of human experience. | AACN Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Context and Environment: Practice: apply health promotion/disease prevention strategies; apply health policy. | Nursing/Integrated Concepts: Implementation; Teaching/Learning. Learning Outcome: 11.9 Relate the components of the subsequent prenatal history and assessment to the progress of pregnancy and the nursing care of the prenatal client. MNL LO: Demonstrate ability to perform assessment and interpret data for a patient during the antepartum period.

30) The nurse is preparing to assess a pregnant client's fundal height during a routine prenatal visit. Which action should the nurse take? A) Telling the client not to eat or drink for one hour after the procedure B) Asking the client to empty the bladder prior to the procedure C) Obtaining informed consent for the procedure D) Assessing blood pressure after the procedure Answer: B Explanation: A) It is not necessary for the client to abstain from eating or drinking for one hour after the procedure. B) The client should empty the bladder prior to assessing fundal height. A full bladder may impact the accuracy of the measurement. C) Informed consent is not needed, as assessing fundal height is not an invasive procedure. D) There is no reason to assess the client's blood pressure after measuring fundal height. Page Ref: 233 Cognitive Level: Applying Client/Need Sub: Health Promotion and Maintenance Standards: QSEN Competencies: III. B. 3. Base individualized care plan on client values, clinical expertise and evidence. | AACN Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Context and Environment: Practice; apply health promotion/disease prevention strategies; apply health policy. | Nursing/Integrated Concepts: Assessment. Learning Outcome: 11.6 Describe the essential measurements that can be determined by clinical pelvimetry. MNL LO: Demonstrate ability to perform assessment and interpret data for a patient during the antepartum period.

31) A client who is pregnant for the first time is being instructed on quickening. Which statement should indicate to the nurse that additional teaching is required? A) "It will feel like butterflies in my stomach." B) "It might feel like I have gas." C) "It should occur during the second trimester of my pregnancy." D) "It is an indication that I am experiencing preterm labor." Answer: D Explanation: A) Quickening is often described as if there are butterflies in the stomach. This statement indicates appropriate understanding of the information presented. B) Quickening is often mistaken for gas. This statement indicates appropriate understanding of the information presented. C) Quickening often occurs during the second trimester of pregnancy, between 16 and 22 weeks' gestation. This statement indicates appropriate understanding of the information presented. D) Quickening is not an indication of preterm labor, but an expected finding during pregnancy. This statement indicates the need for further education. Page Ref: 233 Cognitive Level: Analyzing Client/Need Sub: Health Promotion and Maintenance Standards: QSEN Competencies: III. B. 3. Base individualized care plan on client values, clinical expertise and evidence. | AACN Domains and Competencies: 2.7 Evaluate outcomes of care. | NLN Competencies: Context and Environment: Practice; apply health promotion/disease prevention strategies; apply health policy. | Nursing/Integrated Concepts: Evaluation; Teaching/Learning. Learning Outcome: 11.4 Predict the normal physiologic changes one would expect to find when performing a physical assessment on a pregnant woman. MNL LO: Demonstrate ability to perform assessment and interpret data for a patient during the antepartum period.

32) A pregnant client is being instructed on the clinical manifestations associated with preterm labor. Which statement should indicate to the nurse the need for further education? A) "Menstrual-like cramps are a sign of preterm labor." B) "A dull low backache is a sign of preterm labor." C) "Diarrhea is a sign of preterm labor." D) "Vomiting is a sign of preterm labor." Answer: D Explanation: A) Painful menstrual-like cramps are a sign of preterm labor. This statement indicates appropriate understanding of the information presented. B) A dull low backache is a sign of preterm labor. This statement indicates appropriate understanding of the information presented. C) Diarrhea is a sign of preterm labor. This statement indicates appropriate understanding of the information presented. D) Vomiting is not a clinical manifestation associated with preterm labor. This statement indicates the need for further education. Page Ref: 238 Cognitive Level: Analyzing Client/Need Sub: Health Promotion and Maintenance Standards: QSEN Competencies: III. B. 3. Base individualized care plan on client values, clinical expertise and evidence. | AACN Domains and Competencies: 2.7 Evaluate outcomes of care. | NLN Competencies: Context and Environment: Practice; apply health promotion/disease prevention strategies; apply health policy. | Nursing/Integrated Concepts: Evaluation; Teaching/Learning. Learning Outcome: 11.8 Relate the danger signs of pregnancy to their possible causes. MNL LO: Demonstrate ability to perform assessment and interpret data for a patient during the antepartum period.

33) The nurse is conducting an initial prenatal assessment with a pregnant client. Which screening should the nurse anticipate for this client? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A) Complete blood count (CBC) B) Glucose tolerance test (GTT) C) ABO and Rh typing D) HIV screening E) Urinalysis Answer: A, C, D, E Explanation: A) A CBC is drawn during the initial prenatal visit. B) A GTT is not done until the second trimester of the pregnancy. C) ABO and Rh typing are drawn during the initial prenatal visit. D) An HIV screening is drawn during the initial prenatal visit. E) A urinalysis is conducted during the initial prenatal visit and for every subsequent prenatal visit. Page Ref: 236 Cognitive Level: Applying Client/Need Sub: Physiological Integrity: Reduction of Risk Potential Standards: QSEN Competencies: III. B. 3. Base individualized care plan on client values, clinical expertise and evidence. | AACN Domains and Competencies: 2.5 Develop a plan of care. | NLN Competencies: Context and Environment: Practice; apply health promotion/disease prevention strategies; apply health policy. | Nursing/Integrated Concepts: Planning. Learning Outcome: 11.7 Summarize the results of the major screening tests used during the prenatal period in the assessment of the prenatal patient. MNL LO: Demonstrate ability to perform assessment and interpret data for a patient during the antepartum period.

34) A pregnant client has chronic hypertension. Which laboratory test should the nurse expect to be assessed in this client? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A) Serum creatine B) Electrolytes C) Uric acid D) Liver enzymes E) Sedimentation rate Answer: A, B, C, D Explanation: A) A client with known chronic hypertension should have an evaluation of serum creatine. B) A client with known chronic hypertension should have an evaluation of electrolytes. C) A client with known chronic hypertension should have an evaluation of uric acid. D) A client with known chronic hypertension should have an evaluation of liver enzymes. E) A client with known chronic hypertension does not need to have an evaluation of sedimentation rate. Page Ref: 237 Cognitive Level: Applying Client/Need Sub: Physiological Integrity: Reduction of Risk Potential Standards: QSEN Competencies: III. B. 3. Base individualized care plan on client values, clinical expertise and evidence. | AACN Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Context and Environment: Practice; apply health promotion/disease prevention strategies; apply health policy. | Nursing/Integrated Concepts: Assessment. Learning Outcome: 11.7 Summarize the results of the major screening tests used during the prenatal period in the assessment of the prenatal patient. MNL LO: Demonstrate ability to perform assessment and interpret data for a patient during the antepartum period.

35) The nurse is teaching a pregnant client about the symptoms of preeclampsia. Which clinical manifestation should the nurse include in the teaching session? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A) Dizziness B) Blurred vision C) Abdominal pain D) Vaginal bleeding E) Severe headache Answer: A, B, E Explanation: A) Dizziness is a clinical manifestation associated with preeclampsia. B) Blurred vision is a clinical manifestation associated with preeclampsia. C) Abdominal pain is a clinical manifestation of premature labor or abruptio placentae, not preeclampsia. D) Vaginal bleeding is a clinical manifestation of abruptio placentae or placenta previa, not preeclampsia. E) Severe headache is a clinical manifestation associated with preeclampsia. Page Ref: 238 Cognitive Level: Applying Client/Need Sub: Health Promotion and Maintenance Standards: QSEN Competencies: III. B. 3. Base individualized care plan on client values, clinical expertise and evidence. | AACN Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Context and Environment: Practice; apply health promotion/disease prevention strategies; apply health policy. | Nursing/Integrated Concepts: Implementation; Teaching/Learning. Learning Outcome: 11.8 Relate the danger signs of pregnancy to their possible causes. MNL LO: Demonstrate ability to perform assessment and interpret data for a patient during the antepartum period. Old's Maternal-Newborn Nursing and Women's Health, 12e (Davidson) Chapter 12 The Expectant Family: Needs and Care 1) The partner of a pregnant client arrives for a prenatal visit. Which question should the nurse ask to assess the partner's adaptation to the pregnancy? A) "What kind of work do you do?" B) "What furniture have you gotten for the baby?" C) "How moody has your wife been lately?" D) "How are you feeling about becoming a father?" Answer: D Explanation: A) What kind of work the partner does is not an indicator of adaptation to the pregnancy. B) What furniture has been obtained is not an indicator of the partner's adaptation to the pregnancy. C) The partner's perceptions of the client's moodiness are not an indicator of the partner's adaptation to the pregnancy. 350 Copyright © 2024 Pearson Education, Inc.

D) A partner's adaptation to pregnancy includes feelings about impending fatherhood. Page Ref: 249 Cognitive Level: Applying Client/Need Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I. B. 1. Elicit patient values, preferences, and expressed needs as part of clinical interview, implementation of care plan, and evaluation of care. | AACN Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Assessment. Learning Outcome: 12.2 Identify actions the nurse can take to help maintain the well-being of the expectant father or partner and siblings during a family's pregnancy. MNL LO: Demonstrate use of the nursing process in the care of the expectant family.

2) The nurse is preparing a class for expectant fathers. Which information should the nurse include? A) Siblings adjust readily to the new baby. B) Sexual activity is safe for normal pregnancy. C) The expectant mother decides the feeding method. D) Fathers are expected to be involved in labor and birth. Answer: B Explanation: A) Siblings often have difficulty adapting to the arrival of a new baby. Parents who are unprepared for the older child's feelings of anger, jealousy, and rejection may respond inappropriately in their confusion and surprise. B) In a healthy pregnancy, there is no medical reason to limit sexual activity. C) Often, the father wants input in deciding on the feeding method. D) In some cultures, the father is not present at birth. The nurse should recognize the importance of birth practices that are part of a family's tradition and honor these practices when possible. Page Ref: 270 Cognitive Level: Applying Client/Need Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | AACN Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Implementation; Teaching/Learning. Learning Outcome: 12.2 Identify actions the nurse can take to help maintain the well-being of the expectant father or partner and siblings during a family's pregnancy. MNL LO: Demonstrate use of the nursing process in the care of the expectant family.

3) The nurse is preparing information for prenatal classes. Which evidence-based information should the nurse include in these classes? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A) Breastfeeding B) Pain relief C) Obstetric complications and procedures D) Toddler care E) Antepartum adjustment Answer: A, B, C Explanation: A) The prenatal period should expose prospective parents to up-to-date, evidence-based information about breastfeeding. B) The prenatal period should expose prospective parents to up-to-date, evidence-based information about pain relief. C) The prenatal period should expose prospective parents to up-to-date, evidence-based information about obstetric complications and procedures. D) The prenatal period should expose prospective parents to up-to-date, evidence-based information about normal newborn care. E) The prenatal period should expose prospective parents to up-to-date, evidence-based information about postpartum adjustment. Page Ref: 256 Cognitive Level: Applying Client/Need Sub: Health Promotion and Maintenance: Ante/Intra/Postpartum and Newborn Care Standards: QSEN Competencies: I. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | AACN Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Implementation; Teaching/Learning. Learning Outcome: 12.4 Identify information that expectant parents may need to assist them in making the best decisions possible about issues related to pregnancy, labor, and birth. MNL LO: Demonstrate use of the nursing process in the care of the expectant family.

4) A client of native American descent is 36 weeks pregnant and meets with a traditional healer as well as a physician. In which way should the nurse interpret this information? A) Client is seeking spiritual direction. B) Client does not trust the physician. C) Client will not adapt well to mothering. D) Client is experiencing complications of pregnancy. Answer: A Explanation: A) Navajo Native American clients are aware of the mind-soul connection, and might try to follow certain practices to have a healthy pregnancy and birth. Practices could include focus on peace and positive thoughts as well as certain types of prayers and ceremonies. A traditional healer may assist them. B) Seeing a traditional healer does not indicate mistrust of the provider. C) Seeking a spiritual healer does not indicate the client's lack of parenting ability. D) Seeking a spiritual healer does not indicate any type of pathology or complications. Page Ref: 251 Cognitive Level: Analyzing Client/Need Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I. C. 1. Value seeing healthcare situations "through patients' eyes." | AACN Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Relationship-Centered Care: Appreciate the patient as a whole person with his or her own life story and ideas about the meaning of health or illness. | Nursing/Integrated Concepts: Assessment. Learning Outcome: 12.3 Examine the significance of cultural considerations in managing nursing care during pregnancy. MNL LO: Demonstrate use of the nursing process in the care of the expectant family.

5) A client of Asian descent is 12 weeks pregnant and reports using ginseng and bamboo leaves to help reduce anxiety. In which way should the nurse respond to the client? A) Advise to give up the bamboo leaves but to continue taking ginseng. B) Advise to discuss all herbal remedies with the provider. C) State that the provider thinks the remedies have no scientific foundation. D) Assess where the remedies are obtained and investigate the source. Answer: B Explanation: A) The nurse should find out what medications and home remedies the client is using, and counsel the client regarding overall effects. B) The nurse should advise the client to discuss all medications (including herbal supplements) with the healthcare provider. C) It is not appropriate to tell the client that the provider thinks the remedies have no scientific foundation. D) It is outside the nurse's scope to assess the source of the herbs. Page Ref: 250 Cognitive Level: Applying Client/Need Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | AACN Domains and Competencies: 2.6 Demonstrate accountability for care delivery. | NLN Competencies: Relationship-Centered Care: Appreciate the patient as a whole person with his or her own life story and ideas about the meaning of health or illness. | Nursing/Integrated Concepts: Implementation. Learning Outcome: 12.3 Examine the significance of cultural considerations in managing nursing care during pregnancy. MNL LO: Demonstrate use of the nursing process in the care of the expectant family.

6) A pregnant client is concerned about developing hemorrhoids as other family members developed them during pregnancy. Which response should the nurse make? A) "It is not unusual for hemorrhoids to develop during pregnancy." B) "Most clients don't have any problem until after they've delivered." C) "If family members developed hemorrhoids, you will get them, too." D) "If you get hemorrhoids, you probably will need surgery to get rid of them." Answer: A Explanation: A) Many pregnant clients will develop hemorrhoids. Hemorrhoids are varicosities of the veins in the lower end of the rectum and anus. During pregnancy, the gravid uterus presses on the veins and interferes with venous circulation. As the pregnancy progresses, the straining that accompanies constipation can contribute to the development of hemorrhoids. B) It is not true that most clients have no hemorrhoids until after the birth. C) A family history does not automatically mean that a client will develop the condition. D) Hemorrhoids that occur in pregnancy or at birth usually become asymptomatic after the early postpartum period. Page Ref: 259 Cognitive Level: Applying Client/Need Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I. B. 10. Engage the patient or designated surrogates in active partnership that promotes health, safety and well-being, and self-care management. | AACN Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Implementation. Learning Outcome: 12.6 Identify the common discomforts of pregnancy and their causes. MNL LO: Demonstrate use of the nursing process in the care of the expectant family.

7) The nurse reviews health promotion information with a pregnant client. Which statement should indicate to the nurse that teaching was effective? A) "I lie down after eating to relieve heartburn." B) "I try to limit my fluid intake to 3 or 4 glasses each day." C) "I elevate my legs while sitting at my desk." D) "I am avoiding exercise to stay well rested." Answer: C Explanation: A) Heartburn is gastroesophageal reflux, and will be exacerbated by lying down. B) At least 8-10 glasses of fluids should be consumed each day to maintain the increased blood volume of pregnancy. C) Elevating the legs can help decrease lower leg edema. D) Regular mild to moderate exercise has many benefits for pregnant women. Page Ref: 262 Cognitive Level: Analyzing Client/Need Sub: Health Promotion and Maintenance: Ante/Intra/Postpartum and Newborn Care Standards: QSEN Competencies: I. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | AACN Domains and Competencies: 2.7 Evaluate outcomes of care. | NLN Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Evaluation; Teaching/Learning. Learning Outcome: 12.7 Summarize appropriate measures to alleviate the common discomforts of pregnancy. MNL LO: Demonstrate use of the nursing process in the care of the expectant family.

8) The nurse is teaching a class for clients in the first trimester of pregnancy. For which statement should the nurse intervene? A) "When my nausea is bad, I will drink some ginger tea." B) "The fatigue I am experiencing will improve in the second trimester." C) "It is normal for my vaginal discharge to be green." D) "I will urinate less often during the middle of my pregnancy." Answer: C Explanation: A) Ginger helps nausea, and is safe for use during pregnancy. B) First-trimester fatigue is common; fatigue usually improves during the second trimester. C) Increased whitish vaginal discharge, called leukorrhea, is common in pregnancy. Green discharge is not a normal finding, and indicates a vaginal infection. D) Urinary frequency, a common discomfort of pregnancy, occurs early in pregnancy and again during the third trimester because of the pressure of the enlarging uterus on the bladder. Page Ref: 261 Cognitive Level: Analyzing Client/Need Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | AACN Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Assessment. Learning Outcome: 12.1 Describe the significance of using the nursing process to promote health in the pregnant patient and family during pregnancy. MNL LO: Demonstrate use of the nursing process in the care of the expectant family.

9) The nurse is caring for a pregnant client of African heritage in the first trimester. Which client action should the nurse identify as a cultural practice? A) Use of herbs like dandelion during pregnancy to increase lactation B) Drinking ginseng tea for faintness C) Eating clay to supply dietary minerals D) Consulting a spiritual advisor to ensure a healthy pregnancy and birth Answer: C Explanation: A) Use of dandelion is a practice of Native American Indians. B) Asian clients who are pregnant often drink ginseng tea. C) Clients of African descent may be guided by their extended family into common practices such as geophagia, the ingestion of dirt or clay, which is believed to alleviate mineral deficiencies. D) Consulting a spiritual advisor is common among Navajo and many other Native American cultures. Page Ref: 251 Cognitive Level: Analyzing Client/Need Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I. C. 4. Seek learning opportunities with patients who represent all aspects of human diversity. | AACN Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Relationship-Centered Care: Appreciate the patient as a whole person with his or her own life story and ideas about the meaning of health or illness. | Nursing/Integrated Concepts: Assessment. Learning Outcome: 12.3 Examine the significance of cultural considerations in managing nursing care during pregnancy. MNL LO: Demonstrate use of the nursing process in the care of the expectant family.

10) A pregnant client is experiencing back pain. Which remedy should the nurse review with the client? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A) Pelvic tilt B) Water aerobics C) Sit-ups D) Proper body mechanics E) Dorsiflex the feet Answer: A, D Explanation: A) The pelvic tilt can help restore proper body alignment and relieve back pain. B) Exercise is an effective treatment for lower back pain. Exercise in water seems to provide benefits while being physically comfortable for expectant mothers. C) Sit-ups require back-lying. Because of the pressure of the enlarging uterus on the vena cava, the client should not lie flat on the back after about the fourth month. D) The use of proper posture and good body mechanics throughout pregnancy is important. E) Dorsiflexing the feet does not reduce backache associated with pregnancy. Page Ref: 263 Cognitive Level: Applying Client/Need Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | AACN Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Relationship-Centered Care: Appreciate the patient as a whole person, with his or her own life story and ideas about the meaning of health or illness. | Nursing/Integrated Concepts: Implementation; Teaching/Learning. Learning Outcome: 12.7 Summarize appropriate measures to alleviate the common discomforts of pregnancy. MNL LO: Demonstrate use of the nursing process in the care of the expectant family.

11) A client in the third trimester of pregnancy reports frequent leg cramps. Which strategy should the nurse suggest? A) Point the toes of the affected leg B) Increase intake of protein-rich foods C) Limit activity for several days D) Flex the foot to stretch the calf Answer: D Explanation: A) Leg cramps are exacerbated by pointing the toes. B) Leg cramps often result from an imbalance in the calcium-phosphorus ratio, not from a lack of protein-rich foods. C) Leg cramps are not caused by excess activity. D) Dorsiflexion of the feet helps to stretch the affected muscle. Page Ref: 264 Cognitive Level: Applying Client/Need Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I. B. 7. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | AACN Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Implementation; Teaching/Learning. Learning Outcome: 12.7 Summarize appropriate measures to alleviate the common discomforts of pregnancy. MNL LO: Demonstrate use of the nursing process in the care of the expectant family.

12) The nurse is contacted by four pregnant clients. Which client should the nurse return first? A) Client at 7 weeks' gestation reporting nasal stuffiness B) Client at 38 weeks' gestation experiencing rectal itching and hemorrhoids C) Client at 15 weeks' gestation with nausea and vomiting and a 15-pound weight loss D) Client at 32 weeks' gestation treating constipation with prune juice Answer: C Explanation: A) Nasal stuffiness is common in the first trimester as a result of increased estrogen. B) Hemorrhoids are common during pregnancy and often cause itching. C) Nausea and vomiting symptoms generally decrease by the 16th week of pregnancy. If they do not, hyperemesis gravidarum, which occurs in 0.3 to 2% of pregnancies, must be considered. Hyperemesis symptoms include weight loss. D) Constipation during the third trimester is a common finding. Increased fluid and fiber from food sources are most effective in relieving constipation. Page Ref: 260 Cognitive Level: Analyzing Client/Need Sub: Health Promotion and Maintenance Standards: QSEN Competencies: V. B. 4. Communicate observations or concerns related to hazards and errors to patients, families, and the healthcare team. | AACN Domains and Competencies: 2.3 Integrate assessment skills in practice. | NLN Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Assessment. Learning Outcome: 12.6 Identify the common discomforts of pregnancy and their causes. MNL LO: Demonstrate use of the nursing process in the care of the expectant family.

13) A client in the second trimester wants to begin an exercise program to decrease fatigue. Which response should the nurse make? A) "Fatigue should resolve in the second trimester, but walking daily might help." B) "Avoid a strenuous exercise regimen. Drink coffee to combat fatigue." C) "Avoid an exercise regimen due to your pregnancy. Try to nap daily." D) "Fatigue will increase as pregnancy progresses, but running daily might help." Answer: A Explanation: A) Even mild to moderate exercise is beneficial during pregnancy. Regular exercise-at least 30 minutes of moderate exercise daily or at least most days of the week-is preferred. B) Nurses should advise clients of common sources of caffeine, including coffee, tea, colas, and chocolate and suggest they limit their caffeine intake to about 200 mg/day. C) Mild to moderate exercise is beneficial during pregnancy. Scheduling activities to allow for napping is helpful. D) Jogging or running is acceptable for clients already conditioned to these activities, as long as they avoid exercising at maximum effort and overheating. Page Ref: 268 Cognitive Level: Applying Client/Need Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | AACN Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Implementation. Learning Outcome: 12.8 Delineate self-care actions a pregnant patient and family can take to maintain and promote well-being during each trimester of pregnancy. MNL LO: Demonstrate use of the nursing process in the care of the expectant family.

14) A pregnant client is concerned about breast size and wants to find a good bra. Which response should the nurse make? A) "Avoid cotton fabrics and get an underwire bra; they fit everyone best." B) "Just buy a bra one cup size bigger than usual, and it will fit." C) "Look for wide straps and cups big enough for all of your breast tissue." D) "There isn't much you can do for comfort. Try not wearing a bra at all." Answer: C Explanation: A) Cotton is comfortable during pregnancy when perspiration increases, because it does not retain heat and moisture. B) The client should be fitted for a well-fitting, supportive bra of an appropriate size. C) The client should be instructed to get a bra that fits with straps that are wide and do not stretch, and a cup that holds all breast tissue comfortably. D) One can obtain a bra that fits and is comfortable. It is not necessary to be uncomfortable. Page Ref: 265 Cognitive Level: Applying Client/Need Sub: Health Promotion and Maintenance Standards: QSEN Competencies: I. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | AACN Domains and Competencies: 2.2 Communicate effectively with individuals. | NLN Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Implementation. Learning Outcome: 12.7 Summarize appropriate measures to alleviate the common discomforts of pregnancy. MNL LO: Demonstrate use of the nursing process in the care of the expectant family.