Chapter 7 Womens Care: Social Issues My Nursing Test Banks

Olds Maternal-Newborn Nursing and Womens Health, 10e (Davidson)

Chapter 7 Womens Care: Social Issues

1) When discussing the feminization of poverty, the nurse educator will inform the students of what fact?

1. The out-of-wedlock birth rate is above 40%.

2. In 2012, 25% of the households headed by single mothers lived in poverty.

3. Poverty is not directly linked to level of education attained.

4. Women work fewer hours for more pay than men do.

Answer: 1

Explanation: 1. The reality is that many children will spend at least a portion of their lives in single-parent families.

Page Ref: 113

Cognitive Level: Understanding

Client Need/Sub: Safe and Effective Care Environment: Management of 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 Essentials Competencies: V. 8. Discuss the implications of healthcare policy on issues of access, equity, affordability, and social justice in healthcare delivery. | 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: Planning

Learning Outcome: 1 Define the phrase feminization of poverty.

MNL LO: 6.1.4 Recognize social issues affecting women in todays society.

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2) The nurse is on a panel at a conference discussing poverty and health care for those living below the poverty level. Which statements should the nurse include?

Note: Credit will be given only if all correct and no incorrect choices are selected.

Select all that apply.

1. The poverty level is defined as a family of four living on less than $23,550 per year.

2. Two-thirds of Americans living in poverty are women and children.

3. The majority of single-parent families are headed by women.

4. The greatest number of people living under the poverty level are the elderly.

5. Parental race does not affect the level of poverty.

Answer: 1, 2, 3

Explanation: 1. Increasing numbers of U.S. women and their children are attempting to live on $23,550 or less, which is the current income that defines the poverty level for a family of four.

2. Currently, two-thirds of Americans living in poverty are women and children.

3. The majority of single parent-families are headed by women, and these families are four times more likely to live in poverty than families with two parents.

Page Ref: 113

Cognitive Level: Understanding

Client Need/Sub: Safe and Effective Care Environment: Management of Care

Standards: QSEN Competencies: I. C. 13. Acknowledge the tension that may exist between patient rights and the organization responsibility for professional, ethical care. | AACN Essentials Competencies: V. 8. Discuss the implications of healthcare policy on issues of access, equity, affordability, and social justice in healthcare delivery. | NLN Competencies: Context and Environment: Appreciate the influence of systems on healthcare outcomes. | Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 3 Discuss povertys effect on womens health care.

MNL LO: 6.1.4 Recognize social issues affecting women in todays society.

3) There have been a number of historical trends that have contributed to this existing wage gap, including which of the following?

1. There was a perception that men were the sole breadwinners.

2. Women who were competitive in the work environment were viewed positively.

3. Women in past generations generally were not limited to certain occupations.

4. Increase in societal importance of womens intellectual traits.

Answer: 1

Explanation: 1. Historically, there was a perception that men were the sole breadwinners, thus higher salaries for men were justified to support a family.

Page Ref: 115

Cognitive Level: Understanding

Client Need/Sub: Safe and Effective Care Environment: Management of Care

Standards: QSEN Competencies: I. C. 13. Acknowledge the tension that may exist between patient rights and the organizational responsibility for professional, ethical care. | AACN Essentials Competencies: V. 8. Discuss the implications of healthcare policy on issues of access, equity, affordability, and social justice in healthcare delivery. | NLN Competencies: Context and Environment:

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Appreciate the influence of systems of health care outcomes. | Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 2 Identify factors that contribute to the wage gap between women and men.

MNL LO: 6.1.4 Recognize social issues affecting women in todays society.

4) In a community clinic, a number of women working low-paying jobs come in for health care in the evening. The nurse knows that which of the following is true about the womens working situations?

Note: Credit will be given only if all correct and no incorrect choices are selected.

Select all that apply.

1. They have no health insurance.

2. They have pink collar jobs.

3. They earn less pay than do their male counterparts.

4. They will be receiving a pension upon retirement.

5. They have no problem securing child care.

Answer: 1, 2, 3

Explanation: 1. Lack of health insurance continues to be a major problem for the poor.

2. About one-third of women work in a cluster of pink collar occupations, which tend to be poorly paid when compared with male-dominated positions requiring comparable levels of responsibility, skill, and education.

3. Women are paid less than men for comparable work in virtually all occupations.

Page Ref: 113, 114

Cognitive Level: Applying

Client Need/Sub: Safe and Effective Care Environment: Management of Care

Standards: QSEN Competencies: I. C. 13. Acknowledge the tensions that may exist between patient rights and the organizational responsibility for professional, ethical care. | AACN Essentials Competencies: V. 8. Discuss the implications of healthcare policy on issues of access, equity, affordability, and social justice in healthcare delivery. | NLN Competencies: Context and Environment: Appreciate the influence of systems of health care outcomes. | Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 3 Discuss povertys effect on womens health care.

MNL LO: 6.1.4 Recognize social issues affecting women in todays society.

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5) The nurse is planning a community educational presentation for people living below the poverty level. The nurse knows that which of the following is the largest population in this socioeconomic category?

1. Adults in communal living situations

2. Young married couples under the age of 20

3. Single women with children

4. Single adults

Answer: 3

Explanation: 3. Of households headed by single mothers, 40% live in poverty.

Page Ref: 113

Cognitive Level: Understanding

Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

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 Essentials Competencies: V. 8. Discuss the implications of healthcare policy on issues of access, equity, affordability, and social justice in healthcare delivery. | NLN Competencies: Context and Environment: Appreciate the influences of systems on health care outcomes. | Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 1 Define the phrase feminization of poverty.

MNL LO: 6.1.4 Recognize social issues affecting women in todays society.

6) The community clinic nurse manager is working on a long-term budget. The manager understands that in the next few years, Medicaid is expected to pay for fewer births. This is, in part, because of which of the following?

1. The U.S. economy is becoming stronger.

2. More women are able to pay for private insurance.

3. New public policies are providing other forms of payment.

4. Rules for Medicaid have been changed.

Answer: 4

Explanation: 4. Women receiving Temporary Assistance for Needy Families (TANF) do not automatically receive Medicaid services when they become pregnant.

Page Ref: 114

Cognitive Level: Understanding

Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: QSEN Competencies: I. C. 13. Acknowledge the tension that may exist between patient rights, and the organizational responsibility for professional, ethical care. | AACN Essentials Competencies: V. 3. Compare the benefits and limitations of the major forms of reimbursement on the delivery of health care services. | NLN Competencies: Context and Environment: Appreciate the influence of systems on health care outcomes. | Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 3 Discuss povertys effect on womens health care.

MNL LO: 6.1.4 Recognize social issues affecting women in todays society.

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7) The nurse working at a homeless shelter is studying case statistics. Of the total homeless population served at the shelter, which group would the nurses statistics likely uncover as the fastest-growing group?

1. Unemployed women

2. Families with children

3. The mentally ill

4. The elderly

Answer: 2

Explanation: 2. In 2012, the number of homeless individuals fell slightly, by 0.4%, with the exception of homeless families.

Page Ref: 114

Cognitive Level: Understanding

Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: QSEN Competencies: II. B. 6. Participate in structuring the work environment to facilitate integration of new evidence into standards of practice. | AACN Essentials Competencies: V. 6. Explore the impact of socio-cultural, economic, legal, and political factors influencing healthcare delivery and practice. | 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: 3 Discuss povertys effect on womens health care.

MNL LO: 6.1.4 Recognize social issues affecting women in todays society.

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8) The nurse is working in an obstetrical clinic in an urban setting. The nurse knows that which certain facts affect the health care of this group of women?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Select all that apply.

1. Women who receive adequate prenatal care are less likely to develop preterm labor.

2. Women who do not receive prenatal care are more likely to have low-birth-weight babies.

3. A lack of prenatal care is a risk for infant morbidity and mortality.

4. Decreases in health insurance coverage have led to declines in preventive health care.

5. Women who do not receive prenatal care are more likely to have high-birth-weight babies.

Answer: 1, 2, 3, 4

Explanation: 1. Women who receive adequate prenatal care are less likely to develop severe complications, such as preterm labor.

2. Women who do not receive prenatal care are 3 times more likely to have low-birth-weight babies.

3. Lack of prenatal care is a risk for infant morbidity and mortality.

4. Decreases in health insurance coverage have led to declines in preventive health care.

Page Ref: 115

Cognitive Level: Understanding

Client Need/Sub: Safe and Effective Care Environment: Safety and Infection Control

Standards: QSEN Competencies: III. B. 6. Participate in structuring the work environment to facilitate integration of new evidence into standards of practice. | AACN Essentials Competencies: V. 6. Explore the impact of socio-cultural, economic, legal, and political factors influencing healthcare delivery and practice. | 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: Implementation

Learning Outcome: 3 Discuss povertys effect on womens health care.

MNL LO: 6.1.4 Recognize social issues affecting women in todays society.

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9) The nurse working with a client who is seeking a family and medical leave knows that the employee must meet which eligibility requirement of the Family and Medical Leave Act (FMLA) of 1993?

1. Work at least 40 hours per week

2. Have been employed for at least 1 month

3. Work for a company with fewer than 50 employees

4. Be allowed parental leave for childbirth or adoption

Answer: 4

Explanation: 4. The Family and Medical Leave Act mandates parental leave for childbirth or adoption but applies only to companies with 50 or more employees.

Page Ref: 116

Cognitive Level: Understanding

Client Need/Sub: Safe and Effective Care Environment: Management of Care

Standards: QSEN Competencies: I. A. 6. Describe strategies to empower patients or families in all aspects of the health care process. | AACN Essentials Competencies: V. 4. Examine legislative and regulatory processes relevant to the provision of healthcare. | NLN Competencies: Context and Environment: Health care economic policy; reimbursement structures; accreditation standards; staffing models and productivity; supply chain models. | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 4 Describe the impact of the Family and Medical Leave Act (FMLA) of 1993 on maternity and paternity leave.

MNL LO: 6.1.4 Recognize social issues affecting women in todays society.

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10) A woman who works full-time approaches her employer after suddenly discovering that she and her husband will be receiving a child for adoption. The woman knows that she is entitled to certain rights as a result of the Family and Medical Leave Act (FMLA) of 1993. The nurse knows that which criteria of the act apply to this client?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Select all that apply.

1. An employee is entitled to return to the former position or one considered comparable.

2. The employee is covered because she works more than 25 hours per week.

3. The employee is covered by this act because 25 employees work at the company.

4. The act is part of a larger national paid maternity leave program.

5. The employees medical coverage must continue during the leave.

Answer: 1, 2, 5

Explanation: 1. Job security to return to the employees former position or one considered comparable is part of FLMA.

2. Employees must work at least 25 hours per week to be eligible.

5. Continued health insurance benefits are part of the protections and benefits to both men and women provided by FLMA.

Page Ref: 115, 116

Cognitive Level: Understanding

Client Need/Sub: Safe and Effective Care Environment: Management of Care

Standards: QSEN Competencies: I. A. 6. Describe strategies to empower patients or families in all aspects of the health care process. | AACN Essentials Competencies: V. 4. Examine legislative and regulatory processes relevant to the provision of health care. | NLN Competencies: Context and Environment: Health care economic policy; reimbursement structures; accreditation standards; staffing models and productivity; supply chain models. | Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 4 Describe the impact of the Family and Medical Leave Act (FMLA) of 1993 on maternity and paternity leave.

MNL LO: 6.1.4 Recognize social issues affecting women in todays society.

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11) The nurse manager is discussing the Family and Medical Leave Act with the staff. What correct statement does the nurse make about the act?

1. The act covers men as well as women, and they are allowed to take 12 weeks of unpaid leave and continue with their medical coverage.

2. Men can have 6 weeks under the act, where women can have 2.

3. Paid maternity and paternity leave does not occur in other countries.

4. The United States is the one country that has a paid maternity leave program.

Answer: 1

Explanation: 1. This is true. Men and women are covered under the act for up to 12 weeks of unpaid leave.

Page Ref: 115

Cognitive Level: Understanding

Client Need/Sub: Safe and Effective Care Environment: Management of Care

Standards: QSEN Competencies: I. A. 6. Describe strategies to empower patients or families in all aspects of the health care process. | AACN Essentials Competencies: V. 4. Examine legislative and regulatory processes relevant to the provision of health care. | NLN Competencies: Context and Environment: Health care economic policy; reimbursement structures; accreditation standards; staffing models and productivity; supply chain models. | Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 4 Describe the impact of the Family and Medical Leave Act (FMLA) of 1993 on maternity and paternity leave.

MNL LO: 6.1.4 Recognize social issues affecting women in todays society.

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12) The pregnant client employed at a factory asks the nurse whether exposure to chemicals can cause harm to her fetus. The nurse should advise that exposure to which substance can lead to neurological damage?

1. Lead

2. Latex

3. Formaldehyde

4. Benzene

Answer: 1

Explanation: 1. Women exposed to lead during pregnancy are at risk for spontaneous abortion, prematurity, low birth weight, intrauterine growth restriction, and brain, kidney, and nervous system dysfunction.

Page Ref: 118

Cognitive Level: Understanding

Client Need/Sub: Health Promotion and Maintenance: Ante/Intra/Postpartum and Newborn Care

Standards: QSEN Competencies: I. A. 1. Elicit patient values, preferences and expressed needs as part of clinical interview, implementation of care plan and evaluation of care. | AACN Essentials Competencies: VII. 2. Conduct a health history, including environmental exposure and a family history that recognizes genetic risks, to identify current and future health problems. | 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: 5 Identify environmental hazards that may be present in the workplace or home of a woman of childbearing age.

MNL LO: 6.1.4 Recognize social issues affecting women in todays society.

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13) A new nurse is teaching a class to expectant parents about environmental hazards at home. Which statement, if made by an expectant parent, would indicate the need for further teaching?

1. Air pollution is an environmental hazard caused by the release of toxins into the air.

2. Indoor air pollution poses the more serious threat to womens health.

3. Radon, a naturally occurring radioactive gas, is the leading cause of lung cancer, which kills more women than any other type of cancer, including breast.

4. Asthma is worsened by most forms of indoor air pollution.

Answer: 3

Explanation: 3. Radon is the second-leading cause of lung cancer. Smoking is the first.

Page Ref: 118

Cognitive Level: Understanding

Client Need/Sub: Safe and Effective Care Environment: Safety and Infection Control

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 Essentials Competencies: IX. 7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care. | NLN Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 5 Identify environmental hazards that may be present in the workplace or home of a woman of childbearing age.

MNL LO: 6.1.4 Recognize social issues affecting women in todays society.

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14) Pesticide exposure can be linked to a variety of adverse health outcomes, including which of the following?

Note: Credit will be given only if all correct and no incorrect choices are selected.

Select all that apply.

1. Increased risk of cancer

2. Endocrine abnormalities

3. Liver damage

4. Birth defects

5. Cardiovascular diseases

Answer: 1, 2, 3, 4

Explanation: 1. Pesticide exposure can be linked to a variety of adverse health outcomes, including an increased risk of cancer.

2. Pesticide exposure can be linked to a variety of adverse health outcomes, including endocrine abnormalities.

3. Pesticide exposure can be linked to a variety of adverse health outcomes, including liver damage.

4. Pesticide exposure can be linked to a variety of adverse health outcomes, including birth defects.

Page Ref: 119

Cognitive Level: Understanding

Client Need/Sub: Health Promotion and Maintenance: Ante/Intra/Postpartum and Newborn Care

Standards: QSEN Competencies: I. C. 10. Value active partnership with patients or designated surrogates in planning, implementation, and evaluation of care. | AACN Essentials Competencies: VII. 2. Conduct a health history, including environmental exposure and family history that recognizes genetic risks, to identify current and future health problems. | 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: Planning

Learning Outcome: 5 Identify environmental hazards that may be present in the workplace or home of a woman of childbearing age.

MNL LO: 6.1.4 Recognize social issues affecting women in todays society.

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15) Which of the following federal departments actively investigates and prosecutes individuals who cross state lines to avoid paying child support, and now intercepts delinquent parents income tax refunds?

1. U.S. Department of Health and Human Services

2. U.S. Department of Labor

3. U.S. Department of Justice

4. U.S. Equal Employment Opportunity Commission,

Answer: 3

Explanation: 3. The U.S. Department of Justice actively investigates and prosecutes individuals who cross state lines to avoid paying child support, and now intercepts delinquent parents income tax refunds.

Page Ref: 113

Cognitive Level: Remembering

Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: QSEN Competencies: I. A. 4. Examine how the safety, quality, and cost effectiveness of health care can be improved through the active involvement of patients and families. | AACN Essentials Competencies: V. 1. Demonstrate basic knowledge of healthcare policy, finance, and regulatory environments; including local, state, national, and global healthcare trends. | NLN Competencies: Context and Environment: Health care economic policy; reimbursement structures; accreditation standards; staffing models and productivity; supply chain models. | Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 1 Define the phrase feminization of poverty.

MNL LO: 6.1.4 Recognize social issues affecting women in todays society.

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16) The nurse is leading a discussion among nursing students about differences in living conditions between men and women. Which statement, if made by the nursing student, would correctly depict the susceptibility of older women?

1. Older women tend to have more educational preparation than older men.

2. Women typically earn less than men and often work in jobs without pension benefits or only limited benefits.

3. Intermittent employment is less common in women, increasing their Social Security and retirement benefits.

4. Women generally have fewer family caregiving responsibilities than men.

Answer: 2

Explanation: 2. This is true. Many older women rely on Social Security payments as their primary source of income and often dont receive private pensions due to having had fewer years in the workforce.

Page Ref: 113

Cognitive Level: Applying

Client Need/Sub: Safe and Effective Care Environment: Management of Care

Standards: QSEN Competencies: I. C. 13. Acknowledge the tension that may exist between patient rights and the organizational responsibility for professional, ethical care. | AACN Essentials Competencies: V. 6. Explore the impact of socio-cultural, economic, legal, and political factors influencing healthcare delivery and practice. | 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: Implementation

Learning Outcome: 6 Specify the factors that contribute to older womens economic vulnerability.

MNL LO: 6.1.4 Recognize social issues affecting women in todays society.

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17) The nurse manager is preparing an educational in-service for staff nurses about elder abuse. The nurse manager develops a hypothetical situation: A wheelchair-bound client who lives with her daughter has experienced hunger because she cannot reach the cupboards to make lunch. Which category of elder abuse does this example describe?

1. Psychologic abuse

2. Physical abuse

3. Neglect

4. Financial abuse

Answer: 3

Explanation: 3. Neglect is a failure on the part of a caregiver, or any person having custody of an elder, to provide reasonable care, which is the degree of care that a reasonable person would provide.

Page Ref: 120

Cognitive Level: Understanding

Client Need/Sub: Health Promotion and Maintenance: Aging Process

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 Essentials Competencies: IX. 7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care. | NLN Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 7 Identify four different categories of elder abuse.

MNL LO: 6.1.4 Recognize social issues affecting women in todays society.

18) Psychologic elder abuse includes, but is not limited to, which of the following?

Note: Credit will be given only if all correct and no incorrect choices are selected.

Select all that apply.

1. Verbal assaults

2. Humiliation

3. Desertion

4. Intimidation

5. Failure to provide reasonable care

Answer: 1, 2, 4

Explanation: 1. Psychologic abuse includes verbal assaults.

2. Psychologic abuse includes humiliation.

4. Psychologic abuse includes intimidation.

Page Ref: 120

Cognitive Level: Understanding

Client Need/Sub: Safe and Effective Care Environment: Management of Care

Standards: QSEN Competencies: V. B. 2. Demonstrate effective use of strategies to reduce risk of harm to self or others. | AACN Essentials Competencies: IX. 12. Create a safe environment that results in high quality patient outcomes. | NLN Competencies: Quality and Safety: Communicate potential risk factors and actual errors. | Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 7 Identify four different categories of elder abuse.

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MNL LO: 6.1.4 Recognize social issues affecting women in todays society.

19) A public health nurse, along with a student, is visiting the home of an elderly woman who is widowed and lives alone. Her 40-year-old son is her caregiver, and the public health nurses visit about once a week to follow up on her high blood pressure, recent surgery for a hip fracture, and diabetes. The nurse and student find the home dirty, sink full of dirty dishes, and the client in clothes that are extremely soiled. She cannot reach her walker to get up, and she has been incontinent. The nurse recognizes this as which type of abuse?

1. Neglect

2. Abandonment

3. Physical abuse

4. Financial abuse

Answer: 1

Explanation: 1. The abuse described is called neglect. Assistance and personal hygiene have not been provided.

Page Ref: 120

Cognitive Level: Understanding

Client Need/Sub: Safe and Effective Care Environment: Safety and Infection Control

Standards: QSEN Competencies: V. B. 6. Demonstrate effective use of strategies to reduce risk of harm to self or others. | AACN Essentials Competencies: IX. 12. Create a safe environment that results in high quality patient outcomes. | NLN Competencies: Quality and Safety: Communicate potential risk factors and actual errors. | Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 7 Identify four different categories of elder abuse.

MNL LO: 6.1.4 Recognize social issues affecting women in todays society.

20) The community health nurse manager is reviewing the charts of female elderly clients. Which issue are these clients most likely to experience?

1. Adequate financial resources to purchase medications

2. Senior services that provide transportation to healthcare appointments

3. Multiple medications prescribed by different physicians

4. Medicare that covers healthcare costs so no out-of-pocket expenses occur

Answer: 3

Explanation: 3. Polypharmacy, which means multiple medicines, is a common problem in the elderly population. Elderly women (as well as elderly men) often have multiple healthcare providers with different specialties who provide pharmacologic intervention.

Page Ref: 121

Cognitive Level: Understanding

Client Need/Sub: Health Promotion and Maintenance: Aging Process

Standards: QSEN Competencies: V. B. 6. Demonstrate effective use of strategies to reduce risk of harm to self or others. | AACN Essentials Competencies: IX. 12. Create a safe environment that results in high quality patient outcomes. | NLN Competencies: Quality and Safety: Communicate potential risk factors and actual errors. | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 8 Discuss the implications of aging on womens health and health care.

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MNL LO: 6.1.4 Recognize social issues affecting women in todays society.

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21) The nurse recognizes that what are the most common disabilities in women?

1. Asthma and headaches

2. Arthritis or rheumatism

3. Adverse kidney and nervous system functioning

4. Cardiovascular diseases

Answer: 2

Explanation: 2. The most common disabilities in women are arthritis or rheumatism and the incidence of disability increases with age.

Page Ref: 121

Cognitive Level: Understanding

Client Need/Sub: Health Promotion and Maintenance: Aging Process

Standards: QSEN Competencies: V. B. 6. Demonstrate effective use of strategies to reduce risk of harm to self or others. | AACN Essentials Competencies: IX. 12. Create a safe environment that results in high quality patient outcomes. | NLN Competencies: Quality and Safety: Communicate potential risk factors and actual errors. | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 10 Discuss ways in which a womans disability may affect her health care.

MNL LO: 6.1.4 Recognize social issues affecting women in todays society.

22) A home care nurse is looking over the charts of four elderly female clients. The nurse knows that which client has the highest risk for developing diabetes and heart disease?

1. A woman who is 55 and is white

2. A woman who is 60 and from a middle class background

3. All women over 55

4. A woman over 65 who is African American

Answer: 4

Explanation: 4. Minority and low-income women 65 years old and older are more likely than white, higher income women to have serious health problems.

Page Ref: 120

Cognitive Level: Applying

Client Need/Sub: Safe and Effective Care Environment: Management of Care

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 Essentials Competencies: IX. 5. Deliver compassionate, patient-centered, evidence-based care that respects patient and family preferences. | 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: Implementation

Learning Outcome: 8 Discuss the implications of aging on womens health and health care.

MNL LO: 6.1.4 Recognize social issues affecting women in todays society.

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23) The nurse in a community clinic recognizes that older women face various barriers to obtaining health care. Which of the following are barriers that must be overcome?

Note: Credit will only be given if all correct and no incorrect choices are selected.

Select all that apply.

1. Transportation difficulties

2. Lack of private health care coverage

3. Excessive medical costs not covered by Medicare

4. Adequate research on chronic conditions

5. The Family and Medical Leave Act

Answer: 1, 2, 3

Explanation: 1. Older women can face multiple barriers when obtaining healthcare services, and difficulty with transportation is one of them.

2. Older women can face multiple barriers when obtaining healthcare services, and lack of private health coverage is one of them.

3. Older women can face multiple barriers when obtaining health-care services, and excessive medical costs not covered by Medicare is one of them.

Page Ref: 121

Cognitive Level: Understanding

Client Need/Sub: Safe and Effective Care Environment: Management of Care

Standards: QSEN Competencies: I. B. 8. Remove barriers to presence of families and other designated surrogates based on patient preferences. | AACN Essentials Competencies: IX. 5. Deliver compassionate, patient-centered, evidence-based care that respects patient and family preferences. | 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: 8 Discuss the implications of aging on womens health and health care.

MNL LO: 6.1.4 Recognize social issues affecting women in todays society.

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24) The nurse is caring for a 20-year-old labor client who is autistic. This client will not talk with the nurse, she wants her mother right at her side, and she obviously does not understand what is happening. Which term best describes the disability of this client?

1. Developmental

2. Learning

3. Neurological

4. Sensory

Answer: 1

Explanation: 1. Autism is classified as a developmental disability that manifests before 22 years of age and creates limitations in three or more areas.

Page Ref: 121

Cognitive Level: Understanding

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 Essentials Competencies: I. A. 2. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches. | NLN Competencies: Personal and Professional Development: Identify problems. | Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 9 Summarize the five main types of disability.

MNL LO: 6.1.4 Recognize social issues affecting women in todays society.

25) The nurse is caring for a new mother who is intellectually disabled. She has chosen to keep her baby, and will live with her parents, who both work full-time. Public health nurses are going to be following this client and her baby closely. What is the main thing the nurse will have to remember when caring for this client?

1. This client will need to have a babysitter at all times.

2. This client is not going to be able to keep this baby, due to her disability.

3. The father of the baby needs to move in with the family to assist with care.

4. The nurse and the clients family will have to give clear, concise, easy-to-understand directions multiple times.

Answer: 4

Explanation: 4. When working with clients with intellectual disabilities, it is important for the nurse to provide modified teaching materials and delivery to meet varying learning needs.

Page Ref: 122

Cognitive Level: Applying

Client Need/Sub: Safe and Effective Care Environment: Management of Care

Standards: QSEN Competencies: I. C. 1. Value seeing health care situations through patients eyes. | AACN Essentials Competencies: IX. 5. Deliver compassionate, patient centered, evidence-based care that respects patient and family preferences. | 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: Evaluation

Learning Outcome: 9 Summarize the five main types of disability.

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MNL LO: 6.1.4 Recognize social issues affecting women in todays society.

26) The nurse is teaching a group of parents of school-aged girls with intellectual disabilities. The nurse tells the parents which of the following?

1. The girls need education about STIs, contraception, and routine gynecological checkups.

2. The girls would be better off if they had permanent sterilization.

3. The girls will probably not be sexually active.

4. The girls are not able to understand about contraception and sex.

Answer: 1

Explanation: 1. In contemporary society, the need for sexual health education is imperative because some girls and women with intellectual disabilities may face unplanned pregnancies.

Page Ref: 122

Cognitive Level: Applying

Client Need/Sub: Safe and Effective Care Environment: Management of 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 Essentials Competencies: IX. 7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care. | NLN Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 9 Summarize the five main types of disability.

MNL LO: 6.1.4 Recognize social issues affecting women in todays society.

27) The nurse is assessing a woman with a paralyzed arm who has lost her health insurance due to unemployment. The nurse recognizes that women with disabilities face which barriers to employment?

Note: Credit will be given only if all correct and no incorrect choices are selected.

Select all that apply.

1. No access to transportation

2. Lack of education and training

3. Lack of wheelchair access

4. Lack of wide door openings into buildings

5. Lack of readily available ramps

Answer: 1, 2

Explanation: 1. People with disabilities might not have access to transportation.

2. Lack of education and training is a common factor related to unemployment among women with disabilities.

Page Ref: 122

Cognitive Level: Applying

Client Need/Sub: Safe and Effective Care Environment: Management of Care

Standards: QSEN Competencies: I. B. 8. Remove barriers to presence of families and other designated surrogates based on patient preferences. | AACN Essentials Competencies: IX. 5. Deliver compassionate, patient-centered, evidence-based care that respects patient and family preferences. | NLN Competencies: Relationship-Centered Care: Appreciate the patient as a whole person, with his or

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her own life story and ideas about the meaning of health or illness. | Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 10 Discuss ways in which a womans disability may affect her health care.

MNL LO: 6.1.4 Recognize social issues affecting women in todays society.

28) The nurse making home visits to a number of adult women with disabilities monitors the clients closely out of awareness of which of the following?

1. Healthcare services for women who are disabled are more than adequate.

2. They receive more preventive care than do women without disabilities.

3. These women seldom have sexual relations.

4. They receive less preventive care and have greater yearly health expenditures than do women without disabilities.

Answer: 4

Explanation: 4. Women who are disabled receive less preventive care than women without disabilities but have 2.5 times the yearly health expenditures of women without disabilities.

Page Ref: 123

Cognitive Level: Applying

Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: QSEN Competencies: I. B. 8. Remove barriers to presence of families and other designated surrogates based on patient preferences. | AACN Essentials Competencies: IX. 5. Deliver compassionate, patient-centered, evidence-based care that respects patient and family preferences. | 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: 10 Discuss ways in which a womans disability may affect her health care.

MNL LO: 6.1.4 Recognize social issues affecting women in todays society.

29) The nurse is caring for a client who is a lesbian. What should the well-educated nurse be aware of for this client?

1. She is at lesser risk for sexually transmitted diseases and cervical cancer than a heterosexual woman would be.

2. She is less likely to experience domestic violence than a heterosexual woman would be, and does not need to be asked about it.

3. She is at greater risk for breast cancer than a heterosexual woman would be.

4. She does not need to have a Pap smear as frequently as a heterosexual woman would.

Answer: 3

Explanation: 3. Lesbians are at a greater risk for breast cancer, especially if they have never given birth.

Page Ref: 125

Cognitive Level: Understanding

Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: QSEN Competencies: I. B. 3. Provide patient-centered care with sensitivity and respect for the diversity of human experience. | AACN Essentials Competencies: IX. 5. Deliver compassionate, patient-centered, evidence-based care that respects patient and family preferences. | NLN Com

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petencies: 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: 11 Explain the implications of homophobia for lesbian and bisexual womens health care.

MNL LO: 6.1.4 Recognize social issues affecting women in todays society.

30) The lesbian woman who is pregnant by in vitro fertilization from an unknown donor comes to the obstetric clinic in her seventh month with her partner. When asked by the nurse why she has waited so long to come in, the client remarks, Oh, you know why. What does the nurse suspect?

1. The client is experiencing a fear of discrimination on the part of providers.

2. The client is without insurance, and is afraid she will be turned away.

3. The client is in good health, and did not need to come in any sooner.

4. The client is independent in her health care, and opted for self-care until now.

Answer: 1

Explanation: 1. The woman most likely has a fear of discrimination due to her sexual orientation. Womens health services in particular have not shown acceptance of lesbian, bisexual, or transgender status.

Page Ref: 125

Cognitive Level: Analyzing

Client Need/Sub: Health Promotion and Maintenance: Ante/Intra/Postpartum and Newborn Care

Standards: QSEN Competencies: I. B. 3. Provide patient-centered care with sensitivity and respect for the diversity of human experience. | AACN Essentials Competencies: IX. 5. Deliver compassionate, patient-centered, evidence-based care that respects patient and family preferences. | 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: 12 Identify types of discrimination commonly faced by lesbian and bisexual women.

MNL LO: 6.1.4 Recognize social issues affecting women in todays society.

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31) The nurse at a womens clinic is reviewing a new client health information questionnaire. Which question does she find to be insulting and discriminatory toward lesbian client?

1. Who should be contacted in case of emergency?

2. What method of birth control do you use?

3. How often do you drink alcohol?

4. Do you feel safe in your relationship?

Answer: 2

Explanation: 2. The assumption that all women are in need of contraception for birth control is often cited as a reason that lesbian women may conceal their sexual orientation.

Page Ref: 125

Cognitive Level: Applying

Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

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 Essentials Competencies: IX. 1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches. | 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: 12 Identify types of discrimination commonly faced by lesbian and bisexual women.

MNL LO: 6.1.4 Recognize social issues affecting women in todays society.

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32) Lesbian and bisexual women are greater risk for health and social disparities, including which of the following?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Select all that apply.

1. Increased suicide risk

2. Increased risk of homelessness

3. Lack of screening for female-related cancers

4. Lack of screening for lung cancers

5. Increased divorce rates

Answer: 1, 2, 3

Explanation: 1. Healthy People 2020 recognizes that health disparities continue to exist for lesbian, gay, bisexual, and transgendered individuals, which includes increased suicide risk.

2. Healthy People 2020 recognizes that health disparities continue to exist for lesbian, gay, bisexual, and transgendered individuals, which includes increased risk of homelessness.

3. Healthy People 2020 recognizes that health disparities continue to exist for lesbian, gay, bisexual, and transgendered individuals, which includes lack of screening for female-related cancers.

Page Ref: 125

Cognitive Level: Understanding

Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: QSEN Competencies: I. B. 3. Provide patient-centered care with sensitivity and respect for the diversity of human experience. | AACN Essentials Competencies: IX. 5. Deliver compassionate, patient-centered, evidence-based care that respects patient and family preferences. | 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: Evaluation

Learning Outcome: 12 Identify types of discrimination commonly faced by lesbian and bisexual women.

MNL LO: 6.1.4 Recognize social issues affecting women in todays society.

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33) A lesbian woman tells her nurse that she has begun to work for a new company. The womans biggest fear is that her new employer will find out about her sexual orientation. Why is this woman afraid of this discovery?

1. The Employment Non-Discrimination Act was passed into law.

2. It is still legal in many states to fire a lesbian on the basis of sexual orientation.

3. Fortune 500 companies have not enacted antidiscrimination workplace regulations for sexual orientation.

4. No state prohibits discrimination based on gender identity.

Answer: 2

Explanation: 2. Employment discrimination is the most frequent complaint the American Civil Liberties Union (ACLU) receives from gay and lesbian individuals.

Page Ref: 123

Cognitive Level: Applying

Client Need/Sub: Safe and Effective Care Environment: Management of Care

Standards: QSEN Competencies: I. C. 7. Recognize personally held attitudes about working with patients from different ethnic, cultural, and social backgrounds. | AACN Essentials Competencies: IX. 4. Communicate effectively with all members of the healthcare team, including the patient and the patients support network. | 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: 12 Identify types of discrimination commonly faced by lesbian and bisexual women.

MNL LO: 6.1.4 Recognize social issues affecting women in todays society.

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Copyright 2016 Pearson Education, Inc.

34) The nurse is working with a group of recent immigrants from a country in which female genital mutilation (FGM) is practiced. In order to be effective in teaching about gynecologic care in the U.S., the nurse must keep which issues in mind?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Select all that apply.

1. Women might undergo FGM willingly to support the status quo of society.

2. Women might undergo the procedure to be considered for marriage.

3. Women who immigrate to other countries feel a sense pride once the procedure has been performed.

4. Women might undergo the procedure to be gain greater sexual pleasure.

5. Women might undergo the procedure to lose their virginity.

Answer: 1, 2

Explanation: 1. The ritual is performed by various ethnic groups for a variety of reasons including perceived improved social acceptance.

2. The ritual is performed by various ethnic groups for a variety of reasons including marriageability.

Page Ref: 125

Cognitive Level: Applying

Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

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 Essentials Competencies: IX. 1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches. | 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: 13 Discuss the cultural implications of female genital mutilation.

MNL LO: 6.1.4 Recognize social issues affecting women in todays society.

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35) The culturally competent nurse recognizes that female genital mutilation (FMG) can include which health implications?

Note: Credit will be given only if all correct and no incorrect choices are selected.

Select all that apply.

1. Hemorrhage

2. Infertility

3. Urinary tract infections

4. Increased sexual pleasure

5. Easier childbirth

Answer: 1, 2, 3

Explanation: 1. FGM can cause a variety of health problems, including bleeding.

2. FGM can cause a variety of health problems, including infertility.

3. FGM can cause a variety of health problems, including urinary tract infections.

Page Ref: 125

Cognitive Level: Understanding

Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: QSEN Competencies: I. B. 3. Provide patient-centered care with sensitivity and respect for the diversity of human experience. | AACN Essentials Competencies: IX. 5. Deliver compassionate, patient-centered, evidence-based care that respects patient and family preferences. | 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: 13 Discuss the cultural implications of female genital mutilation.

MNL LO: 6.1.4 Recognize social issues affecting women in todays society.

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