Chapter 1: The Past, Present, and Future(FREE) My Nursing Test Banks

Chapter 1: The Past, Present, and Future

Elsevier items and derived items 2007 by Saunders, an imprint of Elsevier Inc.

MULTIPLE CHOICE

1. The certified nurse-midwife (CNM) clarifies to the pregnant patient that the CNMs scope of practice includes:

a.

Practice independent from medical supervision

b.

Comprehensive prenatal care

c.

Attendance at all deliveries

d.

Simple surgical techniques

ANS: B

The CMN provides comprehensive prenatal and postnatal care and attends uncomplicated deliveries and assures a back-up physician in case of unforeseen problems.

DIF: Cognitive Level: Comprehension REF: Text Reference: 7

OBJ: Objective: 2 TOP: Topic: Advance Practice Nursing Roles

KEY: Nursing Process Step: Implementation

MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease

2. The medical pioneer who discovered the relationship between the incidence of puerperal fever and unwashed hands was:

a.

Karl Cred

b.

Ignaz Semmelweis

c.

Louis Pasteur

d.

Joseph Lister

ANS: B

Ignaz Semmelweis deduced that puerperal fever was septic, contagious, and transmitted by the unwashed hands of physicians and medical students.

DIF: Cognitive Level: Knowledge REF: Text Reference: 2

OBJ: Objective: 7 TOP: Topic: The Past

KEY: Nursing Process Step: N/A

MSC: NCLEX: Safe, Effective Care Environment: Safety and Infection Control

3. A pregnant woman who has recently immigrated to the United States comments to the nurse, I am afraid of childbirth. It is so dangerous. I am afraid I will die. A nursing response reflecting cultural sensitivity would be:

a.

Maternal mortality in the United States is extremely low.

b.

Anesthesia is available to relieve pain during labor and childbirth.

c.

Tell me why you are afraid of childbirth.

d.

Your condition will be monitored during labor and delivery.

ANS: C

Asking the patient about her concerns helps promote understanding and individualizes patient care.

DIF: Cognitive Level: Application REF: Text Reference: 7

OBJ: Objective: 5 TOP: Topic: Cross-Cultural Care

KEY: Nursing Process Step: Implementation

MSC: NCLEX: Psychosocial Integrity: Psychological Adaptation

4. An urban area has been reported to have a high perinatal mortality rate. The nurse explains that this statistic refers to:

a.

Maternal and infant deaths per 100,000 live births per year

b.

Deaths of fetuses weighing more than 500 g per 10,000 births per year

c.

Deaths of infants up to 1 year of age per 1,000 live births per year

d.

Fetal and neonatal deaths per 1,000 live births per year

ANS: D

The perinatal mortality rate includes both fetal and neonatal deaths per 1,000 live births per year.

DIF: Cognitive Level: Comprehension REF: Text Reference: 9

OBJ: Objective: 13 TOP: Topic: The Present-Child Care

KEY: Nursing Process Step: Implementation

MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care

5. Current maternity practices focus on:

a.

Hospital births for the majority of women

b.

The traditional family unit

c.

Teaching the proper attitudes toward childbearing

d.

A quality family experience for each patient

ANS: D

Current maternity practice focuses on a high-quality family experience.

DIF: Cognitive Level: Comprehension REF: Text Reference: 6

OBJ: Objective: 2 TOP: Topic: The Present-Maternity Care

KEY: Nursing Process Step: N/A

MSC: NCLEX: Health Promotion and Maintenance

6. The nurse explains that the individual who advocated the establishment of the Childrens Bureau was:

a.

Lillian Wald

b.

Florence Nightingale

c.

Florence Kelly

d.

Clara Barton

ANS: A

Lillian Wald is credited with suggesting the establishment of a federal Childrens Bureau.

DIF: Cognitive Level: Knowledge REF: Text Reference: 3

OBJ: Objective: 7 TOP: Topic: The Past

KEY: Nursing Process Step: Implementation

MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

7. As a result of research done in the 1930s by the Childrens Bureau:

a.

Children with heart problems are now cared for by pediatric cardiologists

b.

The Child Abuse and Prevention Act was passed

c.

Hot lunch programs were established in many schools

d.

Childrens asylums were founded

ANS: C

School hot lunch programs were developed as a result of research by the Childrens Bureau on the effects of economic depression on children.

DIF: Cognitive Level: Knowledge REF: Text Reference: 3

OBJ: Objective: 7 TOP: Topic: The Past

KEY: Nursing Process Step: N/A

MSC: NCLEX: Health Promotion and Maintenance: Coordinated Care

8. The government program that was implemented to increase the educational exposure of preschool children is:

a.

WIC program

b.

Title XIX of the Medicaid program

c.

The Childrens Charter

d.

Head Start

ANS: D

Head Start programs were established to increase educational exposure of preschool children.

DIF: Cognitive Level: Knowledge REF: Text Reference: 3

OBJ: Objective: 9 TOP: Topic: Government Influences in Maternity and Pediatric Care

KEY: Nursing Process Step: N/A

MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

9. The nurse explains that guidelines that define multidisciplinary patient care in terms of expected outcome and timeframe are known as:

a.

Clinical pathways

b.

Nursing outcome criteria

c.

Standards of care

d.

Nursing care plan

ANS: A

Clinical pathways, also known as critical pathways or care maps, are collaborative guidelines that define patient care across disciplines. Expected progress within a specified time line is identified.

DIF: Cognitive Level: Knowledge REF: Text Reference: 6

OBJ: Objective: 14 TOP: Topic: Health Care Delivery Systems

KEY: Nursing Process Step: N/A

MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care

10. A nursing student has reviewed a hospitalized childs chart, interviewed her mother, and performed a physical assessment. The next step in developing a nursing care plan for this child is to:

a.

Identify measurable outcomes with a time line

b.

Identify specific nursing implementations for the child

c.

Determine appropriate nursing diagnoses

d.

State nursing actions related to the childs medical diagnosis

ANS: C

The nurse uses assessment data to select appropriate nursing diagnoses from the NANDA list. Outcomes and Implementations are then developed to address the relevant nursing diagnoses.

DIF: Cognitive Level: Application REF: Text Reference: 15

OBJ: Objective: 6 TOP: Topic: Nursing Process

KEY: Nursing Process Step: Nursing Diagnosis

MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care

11. A nursing student on an obstetrical rotation questions the floor nurse where the LVN/LPN scope of practice is defined. The nurse directs the student to contact the:

a.

American Nurses Association

b.

State Board of Nursing

c.

Joint Commission on Accreditation of Healthcare Organizations

d.

Association of Womens Obstetric and Neonatal Nurses

ANS: B

The scope of practice of the LVN/LPN is published by the State Board of Nursing.

DIF: Cognitive Level: Application REF: Text Reference: 16

OBJ: Objective: 11 TOP: Topic: Critical Thinking

KEY: Nursing Process Step: Implementation

MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care

12. The delivery room nurse remarks that in 1884 Karl Cred recommended that:

a.

All women should be delivered in a hospital setting

b.

Chemical means should be used to combat infection

c.

Podalic version be done on all fetuses

d.

Silver nitrate be placed in the eyes of newborns

ANS: D

In 1884 Karl Cred recommended the use of 2% silver nitrate to be placed in the eyes of newborns to reduce the incidence of blindness. The practice is still current, but uses 1% silver nitrate.

DIF: Cognitive Level: Comprehension REF: Text Reference: 2

OBJ: Objective: 7 TOP: Topic: Use of Silver Nitrate

KEY: Nursing Process Step: N/A

MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease

13. White House Conferences on Children and Youth are held every _____ years.

a.

2

b.

3

c.

5

d.

10

ANS: D

White House Conferences are held every 10 years.

DIF: Cognitive Level: Knowledge REF: Text Reference: 5

OBJ: Objective: 9 TOP: Topic: White House Conferences

KEY: Nursing Process Step: N/A

MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease.

14. The nurse takes into consideration in designing the nursing care plan for a vaginally delivered postpartum patient that the patient will be hospitalized a minimum of ____ hours.

a.

24

b.

48

c.

36

d.

72

ANS: B

Postpartum patients who deliver vaginally stay in the hospital for an average of 48 hours, patients who have had a cesarean delivery usually stay 4 days.

DIF: Cognitive Level: Application REF: Text Reference: 6

OBJ: Objective: 12

TOP: Topic: Hospital Terms for Postpartum Patients

KEY: Nursing Process Step: Planning

MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease

15. The nurse explains that the clinical pathway or critical pathway improves quality of care by:

a.

Listing diagnosis specific implementations

b.

Outlining expected progress with stated time lines

c.

Prioritizing effective nursing diagnoses

d.

Describing common complications

ANS: B

Critical pathways outline expected progress with stated time lines. Any deviation from those time lines is called a variance.

DIF: Cognitive Level: Comprehension REF: Text Reference: 6

OBJ: Objective: 14 TOP: Topic: Critical Pathway

KEY: Nursing Process Step: Implementation

MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care

16. When the patient asks the nurse to explain what is meant by gene therapy, the nurses best response would be that gene therapy:

a.

Can replace missing genes

b.

Evaluates parents genes

c.

Can change the sex of the fetus

d.

Supports the regeneration of defective genes

ANS: A

Gene Therapy can replace missing or defective genes.

DIF: Cognitive Level: Analysis REF: Text Reference: 10

OBJ: Objective: 2 TOP: Topic: Gene Therapy

KEY: Nursing Process Step: Implementation

MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease

17. The nurse clarifies to a patient that diagnosis related groups (DRGs) are designed to contain medical care costs by:

a.

Determining payment based on diagnosis

b.

Requiring two medical opinions to confirm a diagnosis

c.

Organizing HMOs

d.

Defining a person who will require hospitalization

ANS: A

DRGs determine the amount of payment and length of hospital stay based on the diagnosis.

DIF: Cognitive Level: Comprehension REF: Text Reference: 11

OBJ: Objective: 12 TOP: Topic: DRGs

KEY: Nursing Process Step: Implementation

MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care

18. An example of an NIC is:

a.

Patient will ambulate in the hall independently for 10 minutes three times a day.

b.

The nurse will report temperature elevations to the charge nurse.

c.

The nurse will offer extra liquids at all meals.

d.

Patient will express pain relief after massage.

ANS: C

NICs (Nursing Implementations Classifications) are guides to nursing actions.

DIF: Cognitive Level: Application REF: Text Reference: 15

OBJ: Objective: 15 TOP: Topic: NICs

KEY: Nursing Process Step: N/A

MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care

19. The nurse clarifies to the patient that computer charting supports accurate and comprehensive documentation by requiring:

a.

A uniform style of chart

b.

Certain responses before allowing the user to progress

c.

Documentation reflective of the Nursing Care Plan

d.

A daily audit by the charge nurse

ANS: B

Comprehensive charting by computer is ensured by requiring specific input in designated categories before the user can progress through the system.

DIF: Cognitive Level: Application REF: Text Reference: 16

OBJ: Objective: 2 TOP: Topic: Computer Charting

KEY: Nursing Process Step: Implementation

MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care

MULTIPLE RESPONSE

1. The nurse clarifies that family-centered care focuses on:

Select all that apply.

a.

Family integrity

b.

Family as caregivers

c.

Family as decision makers

d.

Empowerment of the family

e.

Cultural values of the family

ANS: A, B, C, D, E

Family-centered care empowers the family to exercise its own integrity to give care and make medical decisions that are culturally consistent.

DIF: Cognitive Level: Analysis REF: Text Reference: 2

OBJ: Objective: 2 TOP: Topic: Family Centered Care

KEY: Nursing Process Step: Implementation

MSC: NCLEX: Health Promotion and Maintenance: Coordinated Care

2. The nurse explains that the developments in the early 20th century that focused on hospitalization for childbirth were:

Select all that apply.

a.

Use of specialized obstetrical instruments

b.

Use of anesthesia

c.

Physicians closer relationships with hospitals

d.

Focus on family-centered care

e.

Insurance coverage

ANS: A, B, C

In the early 1900s the development of specialized obstetrical instruments, better modes of anesthesia, and the physicians reliance on hospital services were instrumental in bringing childbirth to the hospital rather than at home.

DIF: Cognitive Level: Analysis REF: Text Reference: 2

OBJ: Objective: 2 TOP: Topic: Hospitalization for Childbirth

KEY: Nursing Process Step: Implementation

MSC: NCLEX: Safe, Effective Care Environment: Safety and Infection Control

3. The nurse points out that some non-family-centered policies of hospital in the 1960s were:

Select all that apply.

a.

Waiting room for fathers

b.

Sedation of mother during labor

c.

Delay of reunion of mother and baby

d.

Stringent visiting hours

e.

Restrictions of visitations by minor children

ANS: A, B, C, D, E

Hospital policies in the 1960s provided a separate waiting room for fathers while the mother went through labor in a sedated state. The reunion of mother and baby was delayed for several hours due to the sedation. Visiting hours were rigid and disallowed the visitation of minor children.

DIF: Cognitive Level: Comprehension REF: Text Reference: 3

OBJ: Objective: 2 TOP: Topic: Non-Family-Centered Practices

KEY: Nursing Process Step: Implementation

MSC: NCLEX: Safe, Effective Care Environment: Safety and Infection Control

COMPLETION

1. The nurse who is very conscientious about handwashing is following the concepts set out by ____________________ and ____________________.

ANS: Lister and Pasteur

DIF: Cognitive Level: Application REF: Text Reference: 2

OBJ: Objective: 7 TOP: Topic: Handwashing

KEY: Nursing Process Step: Implementation

MSC: NCLEX: Health Promotion and Maintenance: Safety and Infection Control

NOT: Rationale: Both Lister and Pasteur set out that handwashing could reduce incidence of infection by cross-contamination.

2. The first White House Conference on Children and Youth was called by ______________________________.

ANS: Theodore Roosevelt

DIF: Cognitive Level: Knowledge REF: Text Reference: 5

OBJ: Objective: 7 TOP: Topic: White House Conferences

KEY: Nursing Process Step: N/A

MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease

NOT: Rationale: Theodore Roosevelt called the first White House Conference in 1909.

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