Module 4 Text Review Question
Maria is a 6-year old child from Mexico. Maria's socialization into the Mexican culture is best described as: A: Assimilation B: Acculturation C: Biculturalism D: Enculturation
D
A nurse is preparing a presentation about basic nutrients for a group of high school athletes. She should explain that which of the following nutrients provides the body with most energy? A: Fat B: Protein C: Glycogen D: Carbohydrates
D: carbohydrates
Sequence the skills in the expected order of gross-motor development in an infant beginning with the earliest skill: 1. Move from prone to sitting unassisted 2. Sit down from standing position 3. Sit upright without support 4. Roll from abdomen to back 5. Can turn from side to back
5, 4, 3, 1, 2
Place the following in order of sequence for condom application and usage. 1. Gently squeeze air out from the tip of the condom; leave space at the tip. 2. Check the condom package for damage, expiration date, and protection from STIs. 3. After ejaculating, hold onto condom while pulling out. 4. Place on erect penis and unroll to the base of the penis.
2, 1, 4, 3
A 44-year-old male patient has just been told that his wife and child were killed in an auto accident while coming to visit him in the hospital. Which of the following statements are defining characteristics that support a nursing diagnosis of Spiritual Distress related to loss of family members? (Select all that apply.) 1. "I need to call my sister for support." 2. "I have nothing to live for now." 3. "Why would my God do this to me?" 4. "I need to pray for a miracle." 5. "I want to be more involved in my church."
2, 3
Which of the following best represents the dominant values in American society on individual autonomy and self-determination? A: Physician Orders B: Advanced Directives C: Durable Power of Attorney D: Court-Appointed Guardian
B
A nurse is caring for a client who weighs 80 kg (176 lb) and is 1.6 m (5 ft 3 in) tall. Calculate her body mass index (BMI) and determine whether this client's BMI indicates that she is of a healthy weight, overweight, or obese.
(weight(lb)/height(in)^2)x703 OR weight(kg)/height(cm)^2 31.25 A BMI greater than 30 is considered obese
The nurse is caring for a patient with pneumonia who has severe malnutrition. The nurse recognizes that, because of the nutritional status, the patient is at increased risk for: (Select all that apply.) 1. Heart disease. 2. Sepsis. 3. Pleural effusion. 4. Cardiac arrhythmias. 5. Diarrhea.
2. Sepsis. 3. Pleural effusion. 4. Cardiac arrhythmias.
An 8-year-old child is being admitted to the hospital from the emergency department with an injury from falling off her bicycle. Which of the following will most help her adjust to the hospital? 1. Explain hospital routines such as mealtimes to her. 2. Use terms such as "honey" and "dear" to show a caring attitude. 3. Explain when her parents can visit and why siblings cannot come to see her. 4. Since she is young, orient her parents to her room and hospital facility.
1
At a well-child examination, the mother comments that her toddler eats little at mealtime, will only sit briefly at the table, and wants snacks all the time. Which of the following should the nurse recommend? 1. Provide nutritious snacks. 2. Offer rewards for eating at mealtimes. 3. Avoid snacks so she is hungry at mealtime. 4. Explain to her firmly why eating at mealtime is important.
1
In an interview with a pregnant patient, the nurse discussed the three risk factors that have been cited as having a possible effect on prenatal development. They are: 1. Nutrition, stress, and mother's age. 2. Prematurity, stress, and mother's age. 3. Nutrition, mother's age, and fetal infections. 4. Fetal infections, prematurity, and placenta previa.
1
When nurses are communicating with adolescents, they should: 1. Be alert to clues to their emotional state. 2. Ask closed-ended questions to get straight answers. 3. Avoid looking for meaning behind adolescents' words or actions. 4. Avoid discussing sensitive issues such as sex and drugs.
1
Which statement made by a new graduate nurse about the teach-back technique requires intervention and further instruction by the nurse's preceptor? 1. "After teaching a patient how to use an inhaler, I need to use the Teach Back technique to test my patient's understanding." 2. "The Teach Back technique is an ongoing process of asking patients for feedback." 3. "Using Teach Back will help me identify explanations and communication strategies that my patients will most commonly understand." 4. "Using pictures, drawings, and models can enhance the effectiveness of the Teach Back technique."
1
How can a nurse work on developing cultural awareness? (Select all that apply.) 1. Reflect on his or her past learning about health, illness, race, gender, and sexual orientation 2. Develop greater self-knowledge about personal biases 3. Recognize consciously the multiple factors that influence his or her own world view 4. Engage in an in-depth self-examination of his or her own background 5. Learn as many facts as possible about an ethnic group
1, 2, 3, 4
Which of the following are considered social determinants of health? (Select all that apply.) 1. Lack of primary health care providers in a zip code 2. Poor-quality public school education that prevents a person from developing adequate reading skills 3. Lack of affordable health insurance 4. Employment opportunities that do not provide paid vacation or sick leave 5. The number of times a person exercises during a week 6. Neighborhood safety that prevents a person from walking around the block or socializing with neighbors outside of his or her home
1, 2, 3, 4, 6
Which of the following changes can help create a more inclusive environment for lesbian, gay, bisexual, and transgender (LGBT) patients? (Select all that apply.) 1. Explicitly including sexual orientation and gender identity into nondiscrimination policies 2. Displaying art that reflects LGBT community 3. Modifying health care forms to provide opportunities for gender identity and sexual orientation disclosure 4. Not asking patients about their gender identity and sexual orientation to avoid making them uncomfortable 5. Ensuring access to unisex or single-stall bathrooms
1, 2, 3, 5
A nurse is providing information on prevention of sudden infant death syndrome (SIDS) to the mother of a young infant. Which of the following statements indicates that the mother has a good understanding? (Select all that apply.) 1. "I won't use a pacifier to help my baby sleep." 2. "I'll be sure that my baby doesn't spend any time sleeping on her abdomen." 3. "I'll place my baby on her back for sleep." 4. "I'll be sure to keep my baby's room cool." 5. "I'll keep a crib bumper in the bed to prevent drafts."
2, 3, 4
The nurse is caring for a 50-year-old woman visiting the outpatient medicine clinic. The patient has had type 1 diabetes since age 13. She has numerous complications from her disease, including reduced vision, heart disease, and severe numbness and tingling of the extremities. Knowing that spirituality helps patients cope with their chronic illness, which of the following principles should the nurse apply in practice? (Select all that apply.) 1. Pay attention to the patient's spiritual identity throughout the course of her illness 2. Select interventions that you know scientifically support spiritual well-being 3. Listen to the patient's story each visit to the clinic and offer a compassionate presence 4. When the patient questions the reason for her long-time suffering, try to provide answers 5. Consult with a spiritual care advisor and have the advisor recommend useful interventions
1, 3
A patient is admitted through the emergency department (ED) after a serious car accident. The nurse assesses the patient and quickly learns that he speaks little English. Spanish is his primary language. The nurse speaks some Spanish. Which interventions would be appropriate at this time? (Select all that apply.) 1. The nurse requests a professional interpreter. 2. Since this is an emergent situation, the nurse will interpret and identify the patient's priority needs. 3. The nurse determines the interpreter's qualifications and makes sure that the interpreter can speak the patient's dialect. 4. The nurse uses short sentences to explain the treatments provided in the ED. 5. The nurse directs questions to the patient by looking at the patient instead of at the interpreter.
1, 3, 4, 5
Which of the following are examples of problems with the health care system that contribute to health disparities? (Select all that apply.) 1. A health care provider assumes that the patient missed two appointments because the patient does not care about his or her health and does not inquire about the reasons for missed visits. 2. The discharge nurse at a hospital uses Teach Back with a patient to ensure that she has communicated the discharge instructions clearly. 3. A community hospital lacks an adequate staff of social workers who are able to ensure patients' access to resources they need to take care of their health. 4. A hospital discharges a patient without ensuring that the patient has a primary care provider and has made a follow-up appointment. 5. A nurse uses a family member as an interpreter to explain the patient's medications. 6. The hospital conducts quality improvement without stratifying data by race, ethnicity, language, socioeconomic status, sexual orientation, and other axes of social group identities.
1, 3, 4, 5, 6
Select the three factors that are evident when a healing relationship develops between nurse and patient. 1. The nurse being able to realistically mobilize hope for the patient 2. The patient being able to share fears of loss with significant others 3. Finding an interpretation or understanding of the patient's illness that is acceptable to the patient 4. Understanding your own beliefs about spirituality 5. Helping the patient use spiritual resources that he or she chooses
1, 3, 5
A school nurse is counseling an obese 10-year-old child. Which factors would be important to consider when planning an intervention to support the child's health? (Select all that apply.) 1. Consider both the child and the family when addressing the issue. 2. Consider the use of medications to suppress the appetite. 3. First plan for weight loss through dieting and then add activity as tolerated. 4. Plan food intake to allow for growth. 5. Consider consulting a bariatric surgeon if other measures fail.
1, 4
The nurse is providing community education about how the sexual response changes with age. Which statement made by one of the adults indicates the need for further information? 1. "Health problems such as diabetes, chronic obstructive pulmonary disease, and hypertension have little effect on sexual functioning and desire." 2. "It usually takes longer for both sexes to reach an orgasm." 3. "Most of the normal changes in function are related to alteration in circulation and hormone levels." 4. "Many medications can interfere with sexual function."
1. "Health problems such as diabetes, chronic obstructive pulmonary disease, and hypertension have little effect on sexual functioning and desire."
The nurse is providing education on sexually transmitted infections (STIs) to a group of older adults. The nurse knows that further teaching is needed when the participants make which statements? (Select all that apply.) 1. "I don't need to use condoms since there is no risk for pregnancy." 2. "I should be screened for an STI each time I'm with a new partner." 3. "I know I'm not infected because I don't have discharge or sores." 4. "I was tested for STIs last year so I know I'm not infected." 5. "The infection rate in older adults is low because most are not sexually active."
1. "I don't need to use condoms since there is no risk for pregnancy." 3. "I know I'm not infected because I don't have discharge or sores." 4. "I was tested for STIs last year so I know I'm not infected." 5. "The infection rate in older adults is low because most are not sexually active."
An adolescent who is pregnant for the first time is at her initial prenatal visit. The women's health nurse practitioner (NP) informs her that she will be screening her for sexually transmitted infections (STIs). The patient replies, "I know I don't have an STI because I don't have any symptoms." How should the NP respond? (Select all that apply.) 1. "Untreated STIs can cause serious complications in pregnancy so we routinely screen pregnant women." 2. "Bacterial STIs don't usually cause symptoms, but you could have an asymptomatic viral STI." 3. "Chlamydia screening is recommended for all sexually active women up to age 25 even if asymptomatic." 4. "People between the ages of 15 and 24 have the highest incidence of STIs." 5. "There is no need to screen for infection since you aren't having any problems or symptoms."
1. "Untreated STIs can cause serious complications in pregnancy so we routinely screen pregnant women." 3. "Chlamydia screening is recommended for all sexually active women up to age 25 even if asymptomatic." 4. "People between the ages of 15 and 24 have the highest incidence of STIs."
The school nurse is counseling an adolescent male who is returning to school after attempting suicide. He denies substance abuse and has no history of treatment for depression. He says he has no friends or family who understand him. Critical thinking encourages the nurse to consider all possibilities, including which of the following? (Select all that apply.) 1. Adolescents often explore their sexual identity and expose themselves to complications such as sexually transmitted infections (STIs) or unplanned pregnancy. 2. Peer approval and acceptance are not important in this age-group. 3. Lesbian, gay, bisexual, and transgender (LGBT) youth often experience stress from identification with a sexual minority group. 4. Knowledge about normal changes associated with puberty and sexuality can decrease stress and anxiety. 5. Adolescence is a time of emotional stability and self-acceptance.
1. Adolescents often explore their sexual identity and expose themselves to complications such as sexually transmitted infections (STIs) or unplanned pregnancy. 3. Lesbian, gay, bisexual, and transgender (LGBT) youth often experience stress from identification with a sexual minority group. 4. Knowledge about normal changes associated with puberty and sexuality can decrease stress and anxiety.
Intimate partner violence (IPV) is linked to which of the following factors? (Select all that apply.) 1. Alcohol abuse 2. Marriage 3. Pregnancy 4. Unemployment 5. Drug use
1. Alcohol abuse 3. Pregnancy 4. Unemployment 5. Drug use
The nurse is teaching a program on healthy nutrition at the senior community center. Which points should be included in the program for older adults? (Select all that apply.) 1. Avoid grapefruit and grapefruit juice, which impair drug absorption. 2. Increase the amount of carbohydrates for energy. 3. Take a multivitamin that includes vitamin D for bone health. 4. Cheese and eggs are good sources of protein. 5. Limit fluids to decrease the risk of edema.
1. Avoid grapefruit and grapefruit juice, which impair drug absorption. 3. Take a multivitamin that includes vitamin D for bone health. 4. Cheese and eggs are good sources of protein.
The nurse is gathering a sexual health history on a patient being admitted to the hospital for surgery. Which question asked by the nurse demonstrates a nonjudgmental attitude? 1. Can you tell me your sexual orientation? 2. How do you and your wife feel about intimacy? 3. Do you have sex with men, women, or both? 4. Do you have sexual intercourse at your age?
1. Can you tell me your sexual orientation?
Health care agencies often have assessment tools to use in clarifying patient values and assess spirituality. Using the FICA assessment tool, match each letter of the acronym to the appropriate assessment questions below. a. Tell me if you have a higher power or authority that helps you act on your beliefs b. Describe which activities give you comfort spiritually? c. To whom do you go for support in times of difficulty? d. Your illness has kept you from attending church. Is that a problem for you?
1. F—Faith _a__ 2. I—Importance of spirituality _d__ 3. C—Community _c__ 4. A—Address spiritual needs _b__
4. A patient who is receiving parenteral nutrition (PN) through a central venous catheter (CVC) has an air embolus. What would the nurse do first? 1. Have the patient perform a Valsalva maneuver 2. Clamp the intravenous (IV) tubing to prevent more air from entering the line 3. Have the patient take a deep breath and hold it 4. Notify the health care provider immediately
1. Have the patient perform a Valsalva maneuver
Formation of positive health habits may prevent the development of chronic illness later in life. Which of the following are examples of positive health habits? (Select all that apply.) 1. Routine screening and diagnostic tests 2. Unprotected sexual activity 3. Regular exercise 4. Excess alcohol consumption 5. Consistent seat belt use
1. Routine screening and diagnostic tests 3. Regular exercise 5. Consistent seat belt use
Chronic illness (e.g., diabetes mellitus, hypertension, rheumatoid arthritis) may affect a person's roles and responsibilities during middle adulthood. When assessing the health-related knowledge base of both the middle-age patient with a chronic illness and his family, your assessment includes which of the following? (Select all that apply.) 1. The medical course of the illness 2. The prognosis for the patient 3. Socioeconomic status 4. Coping mechanisms of the patient and family 5. The need for community and social services
1. The medical course of the illness 2. The prognosis for the patient 4. Coping mechanisms of the patient and family 5. The need for community and social services
The nurse sees the nursing assistive personnel (NAP) perform the following intervention for a patient receiving continuous enteral feedings. Which action would require immediate attention? 1. Fastening tube to the gown with new tape 2. Placing patient supine while giving a bath 3. Hanging a new container of enteral feeding 4. Ambulating patient with enteral feedings still infusing
2. Placing patient supine while giving a bath
The nurse is educating the patient and his family about the parenteral nutrition. Which aspect related to this form of nutrition would be appropriate to include? (Select all that apply.) 1. The purpose of the fat emulsion in parenteral nutrition is to prevent a deficiency in essential fatty acids. 2. We can give you parenteral nutrition through your peripheral intravenous line to prevent further infection. 3. The fat emulsion will help control hyperglycemia during periods of stress. 4. The parenteral nutrition will help your wounds heal. 5. Since we just started the parenteral nutrition, we will only infuse it at 50% of your daily needs for the next 6 hours.
1. The purpose of the fat emulsion in parenteral nutrition is to prevent a deficiency in essential fatty acids. 3. The fat emulsion will help control hyperglycemia during periods of stress. 4. The parenteral nutrition will help your wounds heal.
A 45-year-old woman who is obese tells a nurse that she wants to lose weight. After conducting a thorough assessment, the nurse concludes that which of the following may be contributing factors to the woman's obesity? (Select all that apply.) 1. The woman works in an executive position that is very demanding. 2. The woman works out at the corporate gym at 5 AM two mornings per week. 3. The woman says that she has little time to prepare meals at home and eats out at least four nights a week. 4. The woman says that she tries to eat "low-cholesterol" foods to help lose weight. 5. The woman says that she vacations annually to reduce stress.
1. The woman works in an executive position that is very demanding. 3. The woman says that she has little time to prepare meals at home and eats out at least four nights a week. 4. The woman says that she tries to eat "low-cholesterol" foods to help lose weight.
Match the following definitions with the key terms related to intersectionality 1. Under inclusion 2. Social inequality 3. Social location a. Groups have unequal access to resources, services, and positions. b. A group has been overlooked in research and the design of interventions. c. One's place in society is based on membership in a social group that determines access to resources.
1: B 2: C 3: A
A nurse is caring for a patient with a seriously advanced infection who asks to have a spiritual care provider come who can offer Blessingway, a practice that attempts to remove ill health. This patient is likely a member of which religion or culture? 1. Hinduism 2. Navajo 3. Sikhism 4. Judaism
2
A patient has just learned she has been diagnosed with a malignant brain tumor. She is alone; her family will not be arriving from out of town for an hour. You have cared for her for only 2 hours but have a good relationship with her. What might be the most appropriate intervention for support of her spiritual well-being at this time? 1. Make a referral to a professional spiritual care advisor 2. Sit down and talk with the patient; have her discuss her feelings and listen attentively 3. Move the patient's bible from her bedside cabinet drawer to the top of the over-bed table 4. Ask the patient if she would like to learn more about the implications of having this type of tumor
2
In the United States, there has never been a president of Asian or Hispanic culture. This is an example of: 1. Social inequality 2. Marginalization 3. Under inclusion 4. Social location
2
You are caring for a 4-year-old child who is hospitalized for an infection. He tells you that he is sick because he was "bad." Which is the most correct interpretation of his comment? 1. Indicative of extreme stress 2. Representative of his cognitive development 3. Suggestive of excessive discipline at home 4. Indicative of his developing sense of inferiority
2
A nurse is preparing to teach an older adult who has chronic arthritis how to practice meditation. Which of the following strategies are appropriate? (Select all that apply.) 1. Encourage family members to participate in the exercise. 2. Have patient identify a quiet room in the home that has minimal interruptions. 3. Suggest use of a quiet fan running in the room. 4. Explain that it is best to meditate about 5 minutes 4 times a day. 5. Show the patient how to sit comfortably with the limitation of his arthritis and focus on a prayer.
2, 3, 5
When you care for a patient who does not speak English, it is necessary to call on a professional interpreter. Which of the following are proper principles for working with interpreters? (Select all that apply.) 1. Expect the interpreter to interpret your statements word-for-word so there is no misunderstanding by the patient. 2. If you feel an interpretation is not correct, stop and address the situation directly with the interpreter. 3. Pace a conversation so there is time for the patient's response to be interpreted. 4. Direct your questions to the interpreter. 5. Ask the patient for feedback and clarification at regular intervals.
2, 3, 5
A nurse is caring for a 78-year-old patient with chronic multiple sclerosis. The patient has severe fatigue, muscle weakness, severe muscle spasms, and difficulties with coordination and balance. Her disease will likely worsen. The nurse has gained the patient's trust and wants to assess her life satisfaction. Which of the following questions should the nurse ask? (Select all that apply.) 1. How often are you able to attend your synagogue? 2. What about your family makes you proudest? 3. What does your husband do for you at home? 4. Looking back, what is your greatest accomplishment? 5. How has your illness affected the way you live your life spiritually at home?
2, 4
The nurse is completing an admission history on a patient and says, "As a routine part of your medical history, it's important to include the sexual aspects of your life. Would it be alright if we discussed this?" This is an example of the nurse using the PLISSIT model to: 1. Place the patient in control of the situation. 2. Ask permission to discuss sexuality issues. 3. Provide the patent with limited information about sexual issues. 4. Ask the patient to provide sensitive information.
2. Ask permission to discuss sexuality issues.
A patient is receiving total parenteral nutrition (TPN). What is the primary intervention the nurse should follow to prevent a central line infection? 1. Institute isolation precautions 2. Clean the central line port through which the TPN is infusing with antiseptic 3. Change the TPN tubing every 24 hours 4. Monitor glucose levels to watch and assess for glucose intolerance
2. Clean the central line port through which the TPN is infusing with antiseptic
The nurse would delegate which of the following to nursing assistive personnel (NAP)? (Select all that apply.) 1. Repositioning and retaping a patient's nasogastric tube 2. Performing glucose monitoring every 6 hours on a patient 3. Documenting PO intake on a patient who is on a calorie count for 72 hours 4. Administering enteral feeding bolus after tube placement has been verified 5. Hanging a new bag of enteral feeding
2. Performing glucose monitoring every 6 hours on a patient 3. Documenting PO intake on a patient who is on a calorie count for 72 hours
The nurse reviews the health history of a 48-year-old man and notes that he was started on medications for elevated blood pressure and depression at his last annual physical. He tells the nurse that over the past 6 months he is having difficulty sustaining an erection. The nurse understands that: (Select all that apply.) 1. Nurses are not expected to discuss sexual issues with male patients and the physician should address this. 2. Sexual function can be affected negatively by some medications. 3. Sexually transmitted infections (STIs) can cause complications such as erectile dysfunction and screening should be done. 4. It is not unusual for men with health issues to experience erectile dysfunction. 5. Medications used to treat hypertension and depression seldom interfere with sexual function.
2. Sexual function can be affected negatively by some medications. 4. It is not unusual for men with health issues to experience erectile dysfunction.
Which patients are at high risk for nutritional deficits? (Select all that apply.) 1. The divorced computer programmer who eats precooked food from the local restaurant 2. The middle-age female with celiac disease who does not follow her gluten-free diet 3. The 45-year-old patient with type II diabetes who monitors her carbohydrate intake and exercises regularly 4. The 25-year-old patient with Crohn's disease who follows a strict diet but does not take vitamins or iron supplements 5. The 65-year-old patient with gallbladder disease whose electrolyte, albumin, and protein levels are normal
2. The middle-age female with celiac disease who does not follow her gluten-free diet 4. The 25-year-old patient with Crohn's disease who follows a strict diet but does not take vitamins or iron supplements
The nurse is gathering a history from a 72-year-old male patient being admitted to a nursing home. The patient requests a private room. The nurse understands that: 1. The patient cannot be sexually active since he is moving into a nursing home. 2. The patient may be requesting a private room to facilitate an intimate relationship with his partner. 3. There is no need to take a sexual history since most older adults are uncomfortable discussing intimate details of their lives. 4. Older adults in nursing homes usually do not participate in sexual activity.
2. The patient may be requesting a private room to facilitate an intimate relationship with his partner.
According to Healthy People 2020, certain ethnic groups in the United States are disproportionately affected by sexually transmitted infections (STIs) and human immunodeficiency virus (HIV). What are the likely causes of this issue? (Select all that apply.) 1. The large percentage of lesbian, gay, bisexual, or transgender individuals in the culture 2. Values and expectations about sexual behavior by the men or women in the culture 3. Religious beliefs and cultural attitudes toward the use of contraceptives 4. Educational background and knowledge of health risks associated with sexual behaviors 5. The higher incidence of sexual abuse in the affected ethnic groups
2. Values and expectations about sexual behavior by the men or women in the culture 3. Religious beliefs and cultural attitudes toward the use of contraceptives 4. Educational background and knowledge of health risks associated with sexual behaviors
A 53-year-old female being treated for breast cancer tells the nurse that she has no interest in sex since her surgery 2 months ago. The nurse is aware that: (Select all that apply.) 1. Sexual issues are expected in a woman this age. 2. Women experience sexual dysfunction more frequently than men. 3. Hypoactive sexual desire disorder (HSDD) occurs in women over 65 years of age. 4. It is not unusual for medical conditions such as cancer to contribute to HSDD. 5. Disturbances in self-concept affect sexual functioning.
2. Women experience sexual dysfunction more frequently than men. 4. It is not unusual for medical conditions such as cancer to contribute to HSDD. 5. Disturbances in self-concept affect sexual functioning.
With the exception of pregnant or lactating women, the young adult has usually completed physical growth by the age of: 1. 18. 2. 20. 3. 25. 4. 30.
20
A nurse begins a night shift, assuming care for a critically ill patient who was resuscitated earlier in the day from cardiac arrest. He survived and is physically stable, alert, oriented, and responding appropriately to the nurse's questions. Knowing that the patient experienced a period when his heart stopped beating, what would be the best approach for the nurse to use with him? 1. Have family come to visit and focus discussion about their gratitude that the patient survived 2. Change the subject when the patient begins talking about entering a dark tunnel when the doctors were resuscitating him 3. Sit and encourage the patient to share what he experienced during resuscitation 4. Provide the patient the opportunity to have passages from the bible read to him
3
A nurse has worked in a home health agency for a number of years. She goes to visit a patient who has diabetes and who lives in a public housing facility. This is the first time the nurse has cared for the patient. The patient has four other family members who live with her in the one-bedroom apartment. Which of the following, based on Campinha-Bacote's (2002) model of cultural competency, is an example of cultural awareness? 1. The nurse begins a discussion with the patient by asking, "Tell me about your family members who live with you?" 2. The nurse asks, "What do you believe is needed to make you feel better?" 3. The nurse silently reflects about how her biases regarding poverty can influence how she assesses the patient. 4. The nurse uses a therapeutic and caring approach to how she interacts with the patient.
3
A parent has brought her 6-month-old infant in for a well-child check. Which of her statements indicates a need for further teaching? 1. "I can start giving her whole milk at about 12 months." 2. "I can continue to breastfeed for another 6 months." 3. "I've started giving her plenty of fruit juice as a way to increase her vitamin intake." 4. "I can start giving her solid food now."
3
A patient states that he does not believe in a higher power but instead believes that people bring meaning to what they do. This patient most likely is an: 1. Academic. 2. Atheist. 3. Agnostic. 4. Anarchist.
3
A patient who is recovering from a bilateral amputation of the legs below the knee shows transcendence when she states: 1. "My pain medicine helps me feel better." 2. "I know I'll get better if I just keep trying." 3. "I see God's grace and become relaxed when I watch the sun set at night." 4. "I have had a great life and a good marriage. My husband has been so helpful in my healing."
3
During an encounter with an elderly patient, the nurse recognizes that a thorough cultural assessment is necessary because the patient has recently come to the United States from Russia and has never been hospitalized before. The nurse wants to discuss cultural similarities between herself and the patient. Which step of the LEARN mnemonic is this? 1. Listen 2. Explain 3. Acknowledge 4. Recommend treatment 5. Negotiate agreement
3
Evaluation of spiritual care is necessary to determine if a patient's level of spiritual health has changed following intervention. If the use of rituals was part of a nurse's care plan, which of the following questions is most appropriate to evaluate its efficacy? 1. Do you feel the need to forgive your wife over your loss? 2. What can I do to help you feel more at peace? 3. Were prayer or meditation helpful to you? 4. Should we plan on having your family try to visit you more often in the hospital?
3
Parents are concerned about their toddler's negativism. To avoid a negative response, which of the following is the best way for a nurse to demonstrate asking the toddler to eat his or her lunch? 1. Would you like to eat your lunch now? 2. When would you like to eat your lunch? 3. Would you like apple slices or applesauce with your sandwich? 4. Would you like to sit at the big table to eat?
3
You are caring for a hospitalized patient who is Muslim and has diabetes. Which of the following items do you need to remove from the meal tray when it is delivered to the patient? 1. Small container of vanilla ice cream 2. A dozen red grapes 3. Bacon and eggs 4. Garden salad with ranch dressing
3
You are working in an adolescent health center when a 15-year-old patient shares with you that she thinks she is pregnant and is worried that she may now have a sexually transmitted infection (STI). Her pregnancy test is negative. What is your next priority of care? 1. Contact her parents to alert them of her need for birth control. 2. Refer her to a primary health care provider to obtain a prescription for birth control. 3. Counsel her on safe sex practices. 4. Ask her to have her partner come to the clinic for sexually transmitted infection testing.
3
A student nurse is developing a plan of care for a 74-year-old-female patient who has spiritual distress over losing a spouse. As the nurse develops appropriate interventions, which characteristics of older adults should be considered? (Select all that apply.) 1. Older adults do not routinely use complementary medicine to cope with illness. 2. Older adults dislike discussing the afterlife and what might have happened to people who have passed on. 3. Older adults achieve spiritual resilience through frequent expressions of gratitude. 4. Have the patient determine if her husband left a legacy behind. 5. Offer the patient her choice of rituals or participation in exercise.
3, 4, 5
A 17-year-old girl asks for more information about birth control methods and says that she does not want her parents to know she is using birth control. The nurse informs the patient that the most effective option for her situation would be: 1. An effective long-term method such as a subdermal implant. 2. A hormonal method such as birth control pills or the transdermal patch. 3. A long-acting hormonal injection given every 12 weeks. 4. Abstinence during her most fertile time.
3. A long-acting hormonal injection given every 12 weeks.
A cardiac nurse who recently graduated from nursing school is providing discharge instructions to a patient who suffered a myocardial infarction (MI). The nurse knows that sexual issues are common after an MI but doesn't feel comfortable bringing up this topic. What is the best way for the nurse to handle this situation? (Select all that apply.) 1. Instruct the patient to discuss any sexual concerns with his or her partner after discharge 2. Avoid discussing the topic unless the patient brings it up 3. Ask a more experienced nurse to cover this with the patient and learn from the example. 4. Plan to attend conferences or training in the near future on how to discuss such issues 5. Encourage the patient to discuss any personal concerns with the cardiologist
3. Ask a more experienced nurse to cover this with the patient and learn from the example. 4. Plan to attend conferences or training in the near future on how to discuss such issues
The patient's blood glucose level is 330 mg/dL. What is the priority nursing intervention? 1. Recheck by performing another blood glucose test. 2. Call the primary health care provider. 3. Check the medical record to see if there is a medication order for abnormal glucose levels. 4. Monitor and recheck in 2 hours.
3. Check the medical record to see if there is a medication order for abnormal glucose levels.
A nurse is completing an assessment on a male patient, age 24. Following the assessment, the nurse notes that his physical and laboratory findings are within normal limits. Because of these findings, nursing interventions are directed toward activities related to: 1. Instructing him to return in 2 years. 2. Instructing him in secondary prevention. 3. Instructing him in health promotion activities. 4. Implementing primary prevention with vaccines.
3. Instructing him in health promotion activities.
A 16-year-old female tells the school nurse that she doesn't need the human papillomavirus (HPV) vaccine since her partner always uses condoms. The best response by the nurse to this statement is: 1. Latex condoms are the most effective way to eliminate the risk of HPV transmission. 2. Your parents may not want you to receive the HPV vaccine since it has been shown to increase sexual risk taking and sexual activity. 3. The HPV 9-valent vaccine is recommended for males and females and targets the specific viruses that cause cancer and genital warts. 4. You are past the recommended age to receive the vaccine.
3. The HPV 9-valent vaccine is recommended for males and females and targets the specific viruses that cause cancer and genital warts.
A new nurse is caring for a hospitalized obese patient who is homeless. This is the first time the patient has been admitted to the hospital, and the patient is scheduled for surgery. Which of the following is a universal skill that will help the nurse work effectively with this patient? 1. The nurse shifts her focus to understanding the patient by asking her, "Describe for me the course of your illness." 2. The nurse tells the patient, "Your choices of foods and unwillingness to exercise are adding to your health problems." 3. The nurse asks the patient, "Tell me about the main problems you have had with your health from not having a home." 4. The nurse explains, "Because you have obesity, it is important to know the effects it has on wound healing because of reduced tissue perfusion."
4
A nurse is preparing to perform a cultural assessment of a patient. Which of the following questions is an example of a contrast question? 1. Tell me about your ethnic background. 2. Have you had this problem in the past? 3. Where do other members of your family live? 4. How different is this problem from the one you had previously?
4
A student nurse is telling a faculty member that her patient talked about gaining spiritual comfort from being focused on her inner self, including her values and principles. The instructor explains that this is an example of: 1. Faith. 2. Community. 3. Interpersonal connection. 4. Self-transcendence.
4
The type of injury to which a child is most vulnerable at a specific age is most closely related to which of the following? 1. Provision of adult supervision 2. Educational level of the parent 3. Physical health of the child 4. Developmental level of the child
4
Which approach would be best for a nurse to use with a hospitalized toddler? 1. Always give several choices. 2. Set few limits to allow for open expression. 3. Use noninvasive methods when possible. 4. Establish a supportive relationship with the mother.
4
Which of the following statements is most descriptive of the psychosocial development of school-age children? 1. Boys and girls play equally with each other. 2. Peer influence is not yet an important factor to the child. 3. They like to play games with rigid rules. 4. Children frequently have "best friends."
4
A patient's gastric residual volume was 250 mL at 0800 and 350 mL at 0900. What is the appropriate nursing action? 1. Assess bowel sounds 2. Raise the head of the bed to at least 45 degrees 3. Position the patient on his or her right side to promote stomach emptying 4. Do not reinstall aspirate and hold the feeding until you talk to the primary care provider
4. Do not reinstall aspirate and hold the feeding until you talk to the primary care provider
Which statement made by a patient of a 2-month-old infant requires further education? 1. I'll continue to use formula for the baby until he is a least a year old. 2. I'll make sure that I purchase iron-fortified formula. 3. I'll start feeding the baby cereal at 4 months. 4. I'm going to alternate formula with whole milk starting next month.
4. I'm going to alternate formula with whole milk starting next month.
The nurse evaluates which laboratory values to assess a patient's potential for wound healing? 1. Fluid status 2. Potassium 3. Lipids 4. Nitrogen balance
4. Nitrogen balance
The nurse is caring for a patient with dysphagia and is feeding her a pureed chicken diet when she begins to choke. What is the priority nursing intervention? 1. Suction her mouth and throat 2. Turn her on their side 3. Put on oxygen at 2-L nasal cannula 4. Stop feeding her and place on NPO
4. Stop feeding her and place on NPO
A patient is receiving both parenteral (PN) and enteral nutrition (EN). When would the nurse collaborate with the health care provider and request discontinuing parenteral nutrition? 1. When 25% of the patient's nutritional needs are met by the tube feedings 2. When bowel sounds return 3. When central line has been in for 10 days 4. When 75% of the patient's nutritional needs are met by the tube feedings
4. When 75% of the patient's nutritional needs are met by the tube feedings
The nurse is inserting a small-bore nasoenteric tube before starting enteral feedings. Place the following steps in order to perform this procedure. 1. Place patient in high-Fowler's position. 2. Have patient flex head toward chest. 3. Assess patient's gag reflex. 4. Determine length of the tube to be inserted. 5. Obtain radiological confirmation of tube placement. 6. Check pH of gastric aspirate for verifying placement. 7. Identify patient with two identifiers.
7, 1, 3, 4, 2, 5, 6
The nurse at an outpatient clinic asks a patient who is Japanese American with newly diagnosed hypertension (HTN) if he is limiting his sodium intake as directed. The patient does not make eye contact with the nurse but nods his head. What should the nurse do NEXT? A: Ask the patient how much salt he is consuming each day B: Discuss the health implications of sodium and hypertension C: Remind the patient that many food such as soy sauce contain "hidden" sodium D: Suggest some low-sodium dietary alternatives
A
A nurse is a senior center is counseling a group of older adults about their nutritional needs and considerations. Which of the following information should the nurse include? (Select all that apply) A: Older adults are more prone to dehydration than younger adults are. B: Older adults need the same amount of vitamins and minerals as younger adults do. C: Many older men and women need calcium supplementation D: Older adults need more calories than they did when they were younger. E: Older adults should consume a diet low in carbohydrates.
A: Older adults are more prone to dehydration than younger adults are. B: Older adults need the same amount of vitamins and minerals as younger adults do. C: Many older men and women need calcium supplementation
A nurse enters the examination room of the emergency clinic and meets a 29-year-old patient who missed her last two follow-up appointments. The nurse notes from the medical record that the patient has high blood pressure that the doctor has been trying to help her manage. The patient just spoke with her doctor who left the room frustrated because the patient has not been taking her medication as prescribed. The patient confronts the nurse, saying, "I'm tired of being treated this way; no one cares. I need to find another doctor!" Using the C-LARA mnemonic, match the nurse's response to the correct letter of the mnemonic. a.The nurse acknowledges that it is absolutely reasonable for patients to expect that their health care providers care about their situations and that it is disappointing when they have experiences that make them feel like they do not. b. The nurse uses a relaxation technique before responding to the patient's concerns. Calm yourself. Take a deep breath. Check your pulse. c. The nurse says, "I want to help you. I can do that better if you tell me what's making it difficult for you to come to your appointments and take your medicine each day." d. The nurse maintains eye contact and allows the patient to discuss her perspective while remaining attentively quiet. e. The nurse explains, "One thing I want you to understand is that your blood pressure medicine will only work if you take the same amount each day. Your follow-up appointments are important so we can get this blood pressure under control. Let me get a social worker who can help you figure out these transportation issues or see if he can find a doctor closer to your house."
B: (Calm) D: (Listen) A: (Affirm) C: (Respond) E: (Add)
A nurse is caring for a client who is at high risk for aspiration. Which of the following actions should the nurse take? A: Give the client thin liquids B: Instruct the client to tuck her chin when swallowing C: Have the client use a straw D: Encourage client to lie down and rest after meals
B: instruct the client to tuck her chin when swallowing Rationale: tucking the chin when swallowing allows food to pass down the esophagus more easily
An example of a nurse imposing his/her own cultural beliefs on a client is evident in which of the following examples? A: Adaptation of the client's room to accommodate family members B: Seeking information on gender-congruent care for an Egyptian client. C: Administering less potent pain medication to an outpatient surgery client D: Encouraging family members to assist with the client's feeding and hygiene care.
C
The nurse recognizes that ethnicity differs from race in that ethnicity: A: Refers to subgroups within a race B: Is a unique factor within a cultural group C: Includes more than biological identification D: Is the set of conflicting values between races
C
A nurse is teaching the father of a 12-year-old boy about manifestations of puberty. The nurse should explain that which of the following physical changes occurs first? A: Appearance of downy hair on the upper lip B: Hair growth in the axillae C: Enlargement of the testes and scrotum D: Deepening of the voice
C: Enlargement of the testes and scrotum Rationale: using evidence-based practice, the first prepubescent change in boys is an increase in size of the testicles and scrotum, and growth of pubic hair.
A nurse is caring for a client who requires a low-residue diet. The nurse should expect to see which of the following on the client's meal tray? A: Cooked barley B: Pureed broccoli C: Vanilla custard D: Lentil soup
C: vanilla custard Rationale: A low-residue diet consists of foods that are low in fiber and easy to digest. Dairy products and eggs, such as custard and yogurt, are appropriate for a low-residue diet.
Sexually transmitted infections (STIs) continue to be a major health problem in young adults. Men ages 20 to 24 years have the highest rate of which STI? 1. Chlamydia 2. Syphilis 3. Gonorrhea 4. Herpes zoster
Chlamydia
A single young adult interacts with a group of close friends from college and work. They celebrate birthdays and holidays together. In addition, they help one another through many stressors. These individuals are viewed as: 1. Family. 2. Siblings. 3. Substitute parents. 4. Alternative family structure.
Family
A patient is laboring with her first baby, who is about to be delivered 2 weeks early. Her husband is in the military and might not get back in time, and both families are unable to be with her during labor. The doctor decides to call in which of the following people employed by the birthing area as a support person to be present during labor? 1. Nurse 2. Midwife 3. Geneticist 4. Lay doula
Lay doula, refers to lay women who are trained or experienced in providing postpartum care
Match each letter of the RESPECT mnemonic with a statement that describes the concept the letter represents. a. Ask about and try to understand barriers to care and adherence, and then offer resources to help the patient overcome them, involving family members if appropriate, and reassuring the patient that you are and will be available to help. b. Patients may have different reasons for not disclosing important information. Earn a patient's confidence through actions and attitude that demonstrate respect, compassion, and your interest in partnership. c. Work closely together with the patient by being flexible with regard to issues of control, negotiating roles when necessary, and stressing that you will be working together to mutually address medical problems. d. Provide explanations for the process and your action, checking often for understanding and using verbal clarification techniques such as Teach Back. e. Approach each encounter thinking about cultural competence and how you can demonstrate respect for the patient and his or her culture and beliefs. f. Approach the encounter with empathy, remembering that the patient has come to you for help. Seek out and understand the patient's rationale for his or her behaviors or illness, verbally acknowledging and legitimizing his or her feelings. g. Connect on a social level, seeking the patient's point of view; consciously attempt to suspend judgment; and avoid making assumptions.
Rapport: (G) Connect on a social level, seeking the patient's point of view; consciously attempt to suspend judgment; and avoid making assumptions. Empathy: (F) Approach the encounter with empathy, remembering that the patient has come to you for help. Seek out and understand the patient's rationale for his or her behaviors or illness, verbally acknowledging and legitimizing his or her feelings. Support: (A) Ask about and try to understand barriers to care and adherence, and then offer resources to help the patient overcome them, involving family members if appropriate, and reassuring the patient that you are and will be available to help. Partnership: (C) Work closely together with the patient by being flexible with regard to issues of control, negotiating roles when necessary, and stressing that you will be working together to mutually address medical problems. Explanations: (D) Provide explanations for the process and your action, checking often for understanding and using verbal clarification techniques such as Teach Back. Cultural Competence: (E) Approach each encounter thinking about cultural competence and how you can demonstrate respect for the patient and his or her culture and beliefs. Trust: (B) Patients may have different reasons for not disclosing important information. Earn a patient's confidence through actions and attitude that demonstrate respect, compassion, and your interest in partnership.
A 50-year-old male patient is seen in the clinic. He tells a nurse that he has recently lost his job and his wife of 26 years has asked for a divorce. He has a flat affect. Family history reveals that his father committed suicide at the age of 53. The nurse assesses for the following: 1. Cardiovascular disease 2. Depression 3. Sexually transmitted infection 4. Iron deficiency anemia
depression
A 50-year-old woman has elevated serum cholesterol levels that increase her risk for cardiovascular disease. One method to control this risk factor is to identify current diet trends and describe dietary changes to reduce the risk. This nursing activity is a form of: 1. Referral. 2. Counseling. 3. Health education. 4. Stress-management techniques.
health education
When determining the amount of information that a patient needs to make decisions about the prescribed course of therapy, many factors affect his or her compliance with the regimen, including educational level and socioeconomic factors. Which additional factor affects compliance? 1. Gender 2. Lifestyle 3. Motivation 4. Family history
motivation
Sharing eating utensils with a person who has a contagious illness increases the risk of illness. This type of health risk arises from: 1. Lifestyle. 2. Community. 3. Family history. 4. Personal hygiene habits.
personal hygiene habits
A 42-year-old sexually active female is being assessed by a nurse during her annual physical. The woman states that she has not had a period for the last 2 months. The nurse knows that the most likely cause of this occurrence is: 1. Pregnancy. 2. Illicit drug use. 3. Chlamydia infection. 4. Early-onset menopause.
pregnancy
Middle-age adults frequently find themselves trying to balance responsibilities related to employment, family life, care of children, and care of aging parents. People finding themselves in this situation are frequently referred to as being a part of: 1. The sandwich generation. 2. The millennial generation. 3. Generation X. 4. Generation Y.
sandwich generation
A 34-year-old female executive has a job with frequent deadlines. She notes that, when the deadlines appear, she has a tendency to eat high-fat, high-carbohydrate foods. She also explains that she gets frequent headaches and stomach pain during these deadlines. The nurse provides a number of options for the executive, and she chooses yoga. In this scenario yoga is used as a (n): 1. Outpatient referral. 2. Counseling technique. 3. Health promotion activity. 4. Stress-management technique.
stress management technique
