N200 EXAM 2
A 36-year-old woman has been a client of a fertility clinic for 2 years and has now scheduled an appointment, believing that she is pregnant. The nurse who provides care at the clinic should screen the woman for intimate partner violence (IPV) at what time? A) During the woman's first prenatal visit to the clinic B) As soon as an appointment can be scheduled with the woman's partner C) At a point when the woman states she is comfortable with being screened D) Once the woman begins her second trimester of pregnancy
A
A group of students is reviewing the events associated with the cycle of violence. Which statement by the students demonstrates understanding of the topic? A) It occurs in a predictable pattern. B) There are five phases in the cycle. C) During phase 2, the victim can often stop the abuser. D) Criticism is the defining part of phase 3.
A
A male Hispanic client describes the fact that he mixed hot and cold foods, causing them to lump together and ìget stuck in his intestines,î causing diarrhea and abdominal pain. The nurse would document this as which of the following? A) Empacho B) Susto C) Mal ojo D) Mal puesto
A
A nurse admits to a colleague, ìI sometimes tend to avoid clients from other cultures because it's awkward and it's usually frustrating for me and for the client.î This nurse is likely lacking in what construct of cultural competency? A) Cultural desire B) Cultural knowledge C) Cultural health D) Cultural harmony
A
A nurse is admitting a 30-year-old female client and recognizes the need to screen the client for abuse. Prior to doing so, the nurse should do which of the following? A) Ensure a private setting. B) Perform a physical assessment. C) Have the client sign an informed consent form. D) Teach the client about intimate partner violence (IPV).
A
A nurse is admitting a client who is from another culture. Prior to caring for a client from another culture, the nurse should place primary importance on which action? A) Examining personal biases and prejudices B) Researching characteristics of the specific culture C) Asking colleagues about ways to approach the client D) Developing awareness of the culture's health practices
A
A nurse is assessing a client of East Asian descent. Which biological variation would the nurse expect? A) Dry cerumen in the client's ears B) Profuse perspiration in the client's axillary area C) Strong body odor D) Longer eustachian tubes
A
A nurse is assessing an African-American client who has a longstanding diagnosis of hypertension. The nurse should be aware that the client may experience a greater-thanaverage effect of what medication? A) A diuretic B) An angiotensin-converting enzyme inhibitor C) A calcium channel blocker D) A beta-adrenergic blocker
A
A nurse is assessing an Asian client and observes several reddened and bruised areas on the skin. Further assessment reveals that the client was using cupping to treat back pain. The nurse understands this as which of the following? A) Placing heated glass jars on the skin that are allowed to cool B) Rubbing ointment into the skin with a spoon C) Attaching smoldering herbs to acupuncture needles D) Placing warm burning herbs directly on the skin
A
A nurse is preparing a program to address family violence prevention. Which of the following would be most important for the nurse to incorporate into the program? A) Children raised with intimate partner violence are more likely to use violence as adults. B) One out of ten women who are pregnant often fall victim to intimate partner violence. C) Victims of abuse account for approximately 2,500 visits to their health care providers yearly. D) Abuse is most commonly perpetrated by people with low levels of education
A
A nurse is preparing to discuss the cycle of violence with a group of women who have been victims of abuse. Which of the following would the nurse include as part of phase 3 of this cycle? A) A reconciliation period B) Shoving and slapping C) Victim separation from support group D) Acute battering
A
A nurse states, ìHispanic people have no clue about primary prevention of illness.î The nurse is demonstrating which of the following? A) Stereotyping B) Ethnicity C) Cultural incompetence D) Prejudice
A
A nurse's reflection of his practice reveals that he tends to see his own culture as the ìgold standardî to which all other cultures should aspire. This nurse should create learning goals to address what phenomenon? A) Ethnocentrism B) Unconscious incompetence C) Stereotyping D) Acculturation
A
A pediatric nurse is assessing a 7-year-old boy who is suspected of being the victim of psychological abuse by his stepfather. What criterion would the nurse use to determine whether the stepfather's actions constitute abuse? A) The behavior is a threat to the child's well-being. B) The child expresses a dislike for his stepfather. C) The behavior is not aimed at fostering the boy's growth and development. D) The child states that he gets punished if he does not behave appropriately
A
The nurse has identified that a female client desires to leave her abusive husband and move with her children to her parents' house. Which of the following would be the most appropriate nursing diagnosis? A) Readiness for enhanced family processes B) Grieving related to loss of ideal relationship C) Disturbed personal identity related to moving to parent's house D) Impaired parenting related to loss of relationship
A
The nurse is assisting a female client who has been physically abused about a safety plan. The client prefers to return home. Which of the following would the nurse need to do first? A) Have the client complete a danger assessment. B) Notify the neighbors about the abuse. C) Tell her to have her bags packed. D) Give the client the number of a shelter.
A
When assessing a client for possible abuse, which of the following would most likely suggest that the client is a victim of abuse? A) Repeated emergency department visits for injuries B) Poor or no prenatal care C) History of alcohol abuse D) Failure to gain weight in pregnancy
A
While the nurse is interviewing a client who is a victim of abuse, the client states that she blames herself for not satisfying her husband's demands. Applying Walker's Cycle of Violence theory, the client would be in which of the following phase? A) Tension-building phase B) Acute battering phase C) Honeymoon phase D) Reconciliation phase
A
The nurse is examining a 4-year-old girl who is being treated for a burn. When determining whether the burn may be the result of abuse, what assessment parameters should the nurse consider? Select all that apply. A) The presence of other scars on the child's skin B) The pattern or shape of the burn C) The location of the burn D) The child's explanation of how she got the burn E) The child's prognosis for recovering from the burn
A, B, C, D
The nurse is assessing the diet and nutritional status of a client from a different culture. Which of the following questions would be appropriate for the nurse to ask? Select all that apply. A) ìWhat foods do you commonly eat?î B) ìDo you have any special routines for eating?î C) ìAre there any foods that you can't eat?î D) ìDo you eat three meals a day?î E) ìDo you have certain foods to keep you healthy?î
A, B, C, E
. A clinic nurse is conducting a comprehensive assessment of a 70-year-old male client of Native American ethnicity. The nurse observes that the client rarely makes eye contact and holds his head low during the assessment. How should the nurse best interpret this practice? A) The client may not understand the purpose of the assessment. B) The client may be showing the nurse respect. C) The client may be a victim of intimate partner violence. D) The client may not trust the nurse's expertise
B
A client tearfully admits to the nurse that her husband beats her when he drinks alcohol excessively. How should the nurse best respond to the client's statement? A) ìThank you for implicating your husband in this illegal behavior.î B) ìIt took a great deal of courage for you to tell me that.î C) ìI will take action to make sure that this never happens again.î D) ìNow that this is out in the open, you can begin to rebuild your life.î
B
A group of students is reviewing material on cultural competence. The students demonstrate understanding of this concept when they identify which of the following as the starting point? A) Cultural awareness B) Cultural desire C) Cultural skill D) Cultural knowledge
B
A new graduate nurse asks a clinical nurse educator, ìI know abuse is a problem, but why must we screen all women during routine health contacts for potential abuse?î Which response by the more experienced nurse would be most appropriate? A) ìThe Family Violence Prevention Fund mandates it.î B) ìConsistent risk factors for women at risk have not been identified.î C) ìWomen who are being abused always try to hide the fact.î D) ìThe abuse is typically part of the presenting problem.î
B
A nurse educator is leading a group of nurses in exercises aimed at improving cultural competence. Which of the following would the educator use to best describe an aspect of the term ìcultureî? A) Transmission occurs to another generation through genetics. B) It is shared through norms for behaviors, values, and beliefs. C) It is adapted to a specific environment. D) It is experienced by all people even without human contact.
B
A nurse educator is reviewing the unit's resources about religious groups and their views about blood and blood products, organ donation, and autopsy. A member of which group is most likely to refuse a blood transfusion? A) Christian Scientists B) Jehovah's Witnesses C) Orthodox Jews D) Roman Catholics
B
A nurse is caring for a 70-year-old client from a different culture whose breast cancer has metastasized. The nurse observes that the client tends to defer responsibility for decision making around treatment options to her eldest son. How should the nurse respond to this? A) Explain the disconnect between the client's practice and the principle of client autonomy. B) Confirm that the client wants her son to make decisions and follow those decisions accordingly. C) Attempt to dialogue with the client when her son is not present. D) Refer the family to social work in order to further explore alternative decisionmaking practices.
B
A nurse is interviewing a child who is suspected of being abused. Which of the following would be most appropriate? A) Ask questions that are highly detailed. B) Use direct, nonleading questions. C) Offer the child a reward for answering questions. D) Use simple yes and no questions regardless of the child's age
B
A nurse is modifying an Asian client's diet to accommodate the concept of hot and cold. The nurse demonstrates an understanding of this concept when identifying which of the following as a cold condition? A) Diabetes B) Pneumonia C) Sore throat D) Hypertension
B
A nurse is preparing a presentation for a local community group on family violence and child abuse. Which of the following would be most appropriate for the nurse to research when defining child abuse in legal terms? A) The Prevent Child Abuse America group B) The Child Abuse Prevention and Treatment Act C) The Child Abuse Prevention Network D) The Child Well-being and Domestic Violence Project
B
A nurse is relying heavily on gestures and simplified language during the assessment of a client from another culture who speaks minimal English. During the lengthy assessment, the nurse asks the client if she is ìokayî by making a circle with his thumb and forefinger. The nurse should be aware of which of the following? A) In some cultures, this gesture denotes confusion. B) In some cultures, this gesture is offensive. C) This gesture has meaning only in American cultures. D) In some cultures, this gesture denotes pain.
B
A nurse will be working in a clinic in South Asia for several weeks, where the majority of residents have darkly pigmented skin. The nurse should expect a higher-than-average incidence of what integumentary health problem? A) Contact dermatitis B) Vitiligo C) Psoriasis D) Eczema
B
A woman and her partner come to the emergency department. The woman has bruising on both upper extremities and a fracture of the left arm. The client states that she fell down the stairs. Which of the following would lead the nurse to suspect that the client is a victim of violence? A) Client freely answers questions asked about the injury B) Partner states that client is very clumsy and accident prone C) Partner offers to leave the examination room D) Client holds partner's hand when arm is being examined
B
An African-American woman collapses at the funeral of her mother and later states that she could hear everything people were saying to her but, for a brief period, she could not move. The nurse interprets this as which of the following? A) Spell B) Falling out C) Empacho D) Susto
B
An emergency department nurse asks a client to complete an intimate partner violence assessment screening. How should the nurse best explain the rationale for this assessment? A) ìWe are required by law to ask you these questions.î B) ìWe routinely screen everyone because violence affects so many people.î C) ìWe don't think you're abused but we have to ask.î D) ìThis is just something we need to do for reimbursement.î
B
Based on a colleague's feedback, a nurse learns that she is aware of cultural differences in a general way but does not know what the specific differences are or how to communicate with a person of a specific culture. This nurse exhibits which of the following? A) Unconscious incompetence B) Conscious incompetence C) Conscious competence D) Unconscious competence
B
The nurse has completed an assessment of a 36-year-old woman who was assaulted by her boyfriend. The nurse should ensure that documentation is particularly detailed and accurate for what reason? A) The nurse's scope of practice requires extensive documentation. B) The nurse's documentation may be used as legal evidence. C) The documentation must be validated with the client. D) The nurse's documentation must be notarized once it is complete
B
When preparing a discussion about violence, which of the following would the nurse include? A) Abuse is primarily limited to lower socioeconomic groups. B) Family violence is a public health problem. C) Males experiencing intimate partner abuse have more options for help. D) Several states now require the reporting of child abuse.
B
A middle-aged client with a periorbital hematoma admits to the nurse that the injury occurred when her husband punched her in a rage. Following assessment and treatment, the client expresses her intention to return home to her husband. How should the nurse best respond? A) Remind the client that she waives her right to press charges if she willingly returns home. B) Inform the client that she will not be permitted to return to a known unsafe setting. C) Remind the client of the threat to her safety and of her options for shelter. D) Inform the client that a social worker must grant permission for her to return home.
C
A nurse is interviewing a client who is a suspected victim of abuse. Which of the following practices should the nurse avoid during this phase of assessment? A) Using direct questions about being injured B) Displaying a concerned, empathetic approach C) Interjecting often to clarify information D) Emphasizing the nurse's availability to talk
C
A nurse who provides care in a busy, inner-city clinic performs physical examinations on clients of various cultures. In a client from which group would the nurse expect to find the greatest amount of body odor from perspiration? A) Inuit B) Asian C) Caucasian D) Native American
C
A victim of intimate partner violence tells a nurse, ìI don't know how I'd live if I left my husband. And what about my children? I have no skills and haven't worked since I was a teenager.î When developing the plan of care for this client, which nursing diagnosis would most likely apply? A) Anxiety related to the physical escalation of the violence B) Impaired parenting related to family violence C) Low self-esteem related to lack of confidence in ability D) Risk for violence related to inadequate coping abilities
C
The nurse attends a Native-American Alcoholic Anonymous support group and develops close relationships with three group members. The nurse is demonstrating which of the following? A) Cultural desire B) Cultural awareness C) Cultural encounter D) Cultural knowledge
C
The nurse in a prenatal clinic is performing an assessment on a pregnant client. When it is noted that clumps of hair are missing from the client's scalp, the nurse should ask what assessment question? A) ìHave you ever been the victim of a crime?î B) ìWhat do you know about the problem of domestic violence?î C) ìDo you feel safe in your home setting?î D) ìCan you tell me if anyone recent attacked you?î
C
The nurse is interviewing a female Hispanic client who is scheduled for a cardiovascular education program. The client states, ìI can't eat and I don't sleep because my daughter left to return to Mexico. I am sad and nervous. I need rest.î The nurse suspects that she is suffering from susto. Which action by the nurse would be best? A) Give her a multivitamin supplement. B) Encourage her to exercise. C) Reschedule the education program. D) Refer her to a counselor.
C
The nurse recognizes the need to screen a middle-aged client for intimate partner violence, but the client's partner is remaining close to the client. As a result, the nurse is unable to screen the client in privacy. What action should the nurse next take? A) Document the fact that the client is suspected of being a victim of IPV. B) Prioritize the results of the physical assessment. C) Closely observe the client's interactions with the partner. D) Assess the client's psychosocial status and mental status.
C
When assessing an older adult about possible mistreatment, which of the following questions would be most appropriate to use initially? A) ìHave you ever been abused?î B) ìDid you ever sign papers you didn't understand?î C) ìWhat is a typical day in your life like?î D) ìAre you alone often at home?î
C
When reviewing cultural differences that relate to the incidence and prevalence of disease among various cultural groups, the nurse would expect to see the highest prevalence of asthma in which group? A) Non-Hispanic blacks B) Caucasians C) African Americans D) Southeast Asians
C
Which of the following principles should inform the nurse's practice when assessing a client for possible physical abuse? A) The abuse is usually part of the client's presenting health problem. B) Physical abuse is thought to occur in about 5% of women. C) Abuse may start at any time during a relationship. D) Abuse rarely occurs in women younger than age 25 years.
C
Which of the following would the nurse do first when collecting subjective data from a client when domestic violence is suspected? A) Discuss legal reporting requirements. B) Talk about limits of confidentiality. C) Create a safe environment. D) Have a witness to the conversation.
C
A cardiac care nurse works with a diverse client population. The nurse would assess a client from which cultural group for an increased effect of an antihypertensive medication? A) Eskimos B) Native Americans C) Hispanics D) Chinese
D
A group of community nurses are reviewing the theories associated with abuse. The nurses are addressing the psychopathology theory when they identify that violence results from which of the following? A) The abuser's need to control others B) The abuser's desire to show authority C) The abuser's need to be in charge D) The abuser's personality disorder
D
A nurse has identified the goal of becoming more culturally sensitive and competent. What is the primary rationale for cultural sensitivity in health care settings? A) Recognize that cultural diversity exists. B) Understand individual differences. C) Prevent offending the client. D) Obtain accurate assessment data.
D
A nurse is participating in an educational exercise in which she is conducting a selfexamination of her own biases. This activity addresses what construct of cultural competence? A) Cultural desire B) Cultural knowledge C) Cultural skill D) Cultural awareness
D
A nurse is validating assessment findings with a client, and the client proceeds to describe some of the psychological and spiritual components that she believes underlie her disease process. This understanding of the cause of illness is most closely associated with which of the following? A) Northern European cultures B) The Western biomedical model C) African-American culture D) Asian cultures
D
A nurse is working with a 22-year-old woman of Asian ethnicity who has been diagnosed with bipolar disorder. When planning culturally appropriate care, the nurse should consider which of the following? A) There may a lack of acceptance that the client's behavior is abnormal. B) The client's family may see her illness as punishment for misdeeds. C) The client's family may see her psychiatric disorder as evidence of bad character. D) There may be shame associated with having a psychiatric disorder
D
A nurse on a medical unit is reviewing a client's electronic health record. What finding should suggest to the nurse that the client has a possible history of intimate partner violence? A) Documentation of an incomplete immunization history B) A documented history of bipolar disorder C) A lack of consistent primary health care during her pregnancies D) Documentation of three separate injuries during her pregnancies
D
The nurse has completed the objective and subjective assessment of a client who required care after an incident of intimate partner violence. How should the nurse document the client's injuries? A) Ask the client to write out a description of his or her injuries. B) Describe the location of the injuries in detailed prose. C) Make a video recording of the client's skin surfaces. D) Document using an injury map
D
The nurse is preparing to lead a health promotion activity among a group of clients from different cultures. The nurse would expect that which client would require the least amount of personal space? A) Latin American B) Asian C) American D) Middle Easterner
D
When considering the various cultural aspects associated with death rituals, which of the following should guide a nurse's practice? A) Most cultures have similar durations for the length of time a person grieves. B) A person's view of death is likely to be different from the original ethnic group's practice. C) Responses to death and grief are fairly consistent among different cultures. D) Rituals for burial and bereavement are likely to reflect original cultural practices
D
