TEST BANK INTRODUCTION OF MATERNITY AND PEDIATRIC NURSING 8TH EDITION BY GLORIA LEIFER, Exams of Nursing

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TEST BANK INTRODUCTION OF MATERNITY AND PEDIATRIC NURSING

8TH EDITION BY GLORIA LEIFER EXAM 2024-2025 QUESTIONS AND

CORRECT VERIFIED ANSWERS /100% PASS SOLUTION / ALREADY

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MULTIPLE CHOICE

1. Which statement best describes the 3-year-old child?

a. Boisterous, tattles on others

b. Aggressive, shows off

c. Helpful, wants to assist with chores

d. Talkative, inquisitive about the environment

ANS: C

Three-year-old children are helpful and can assist in simple household chores.

DIF: Cognitive Level: Comprehension REF: Page 424 OBJ: 3 TOP: Development KEY: Nursing Process Step: Data Collection

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

2. The parents of a 4-year-old boy are concerned because they have noticed him frequently touching his penis. What knowledge would act as the basis for the nurses response?

a. This behavior indicates a normal curiosity about sexuality.

b. Masturbation suggests the boy has an excessive fear of castration.

c. It is usually a result of discomfort from a penile rash or irritation.

d. The behavior is abnormal and the child should be referred for counseling. ANS: A

Masturbation at this age is common and indicates that the preschooler has a normal curiosity about sexuality.

DIF: Cognitive Level: Comprehension REF: Page 424 OBJ: 9 TOP: Masturbation KEY: Nursing Process Step: Implementation

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

3. A preschool-age child is asked, Why do trees have leaves? Which response would be an example of animism?

a. So I can have shade over my sandbox.

b. Because God made them that way.

c. To hide behind when they are scared.

d. For the squirrels to play in. ANS: C

Animism describes the tendency of preschool children to attribute human characteristics to nonhuman objects.

DIF: Cognitive Level: Application REF: Page 421 OBJ: 1

TOP: Cognitive Development KEY: Nursing Process Step: Data Collection MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

4. What tasks would be appropriate to expect of a 5-year-old?

a. Setting the table with paper plates

b. Washing the dirty knives

c. Carrying glasses from the table to the sink

d. Scrubbing out the sink with cleanser ANS: A

Parents must consider developmental level and safety when asking the 5-year-old child to help with chores.

DIF: Cognitive Level: Application REF: Page 430 OBJ: 3

TOP: DevelopmentSafety KEY: Nursing Process Step: Data Collection

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

5. A 3-year-old child, while playing with his favorite toy in the playroom of the pediatric unit, is approached by another child who also wants to play with the same toy. What behavior will the nurse anticipate from this child?

a. Will play well with the other child

b. Will give the toy up and then not play anymore

c. Will become angry and a physical response might ensue

d. Will ignore the toy and go on to something else ANS: C

The 3-year-old child is egocentric and likely will become angry when others attempt to take his or her possessions.

DIF: Cognitive Level: Application REF: Page 425 OBJ: 3

TOP: Display of Aggression KEY: Nursing Process Step: Data Collection MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

6. A parent is concerned about her childrens reaction should their grandmother die. What understanding will guide the nurses response?

a. Children are unlikely to notice their grandmothers absence if no one reminds them.

b. Young children often understand that other people die, but do not equate it with themselves.

c. The childrens response will depend entirely on whether they have been acquainted with death before this.

d. Children can understand the concept of a higher being much like adults can. ANS: B

Between 3 and 4 years of age, the child becomes curious about death and dying. They may realize that others die, but they do not relate death to themselves.

DIF: Cognitive Level: Comprehension REF: Page 425 OBJ: 7 TOP: Concept of Death KEY: Nursing Process Step: Planning

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

7. What is the most appropriate intervention when dealing with occasional aggression in a 4-year- old child?

a. Have the child take a time-out in the corner for 4 minutes.

b. Spank the child at the time of the incident.

c. Take away television privileges for the day.

d. Send the child to his room for 30 minutes. ANS: A

Time-out periods, usually lasting 1 minute per year of age, with the child sitting in a chair or corner, are considered an effective disciplinary technique.

DIF: Cognitive Level: Application REF: Page 425 OBJ: 8

TOP: Limit Setting KEY: Nursing Process Step: Implementation

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

8. A father is concerned about how long his preschool-age child will continue sucking his thumb. What is the most helpful response from the nurse?

a. Most children will stop thumb-sucking naturally by school age.

b. Over-the-counter treatments that give a bad taste can be placed on the thumb to discourage the practice.

c. Consistently touching the childs fingers whenever he sucks his thumb is most effective.

d. Thumb-sucking is detrimental to the eruption of the childs teeth and must be stopped as soon as possible.

ANS: A

Most children give up the habit of thumb-sucking by the time they reach school.

DIF: Cognitive Level: Application REF: Page 428 OBJ: 9

TOP: Thumb-Sucking KEY: Nursing Process Step: Implementation

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

9. How does the nurse characterize the play of 5-year-old children?

a. Enjoying rough and tumble play

b. Playing well-organized games

c. Following rules

d. Preferring inside activities ANS: C

The 5-year-old wants to play by the rules but cannot accept losing. The rules may be very strict or change as the game progresses.

DIF: Cognitive Level: Comprehension REF: Page 422, Table 18-1 | Page 425-426 OBJ: 13 TOP: Play KEY: Nursing Process Step: Data Collection

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

10. The nurse is discussing preschoolers sexual curiosity with the parent. What statement by the mother leads the nurse to determine that the mother understands the information?

a. Make up funny words for body parts.

b. Distract the child with a toy if they ask about sex.

c. Answer their questions when they ask.

d. Tell them to ask you again when they are 6 year old. ANS: C

Parents should provide sex education at the time the child asks about sex.

DIF: Cognitive Level: Analysis REF: Page 424 OBJ: 9

TOP: Sexual Curiosity KEY: Nursing Process Step: Evaluation

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

11. What type of play is most appropriate when planning care for a child with moderate intellectual deficiency?

a. Exercise leg and arm muscles.

b. Be educationally oriented to make up for lost time.

c. Be adjusted to mental age rather than chronological age.

d. Involve contact sports and aggressive physical activity with other children. ANS: C

The nurse must consider the childs mental age rather than her chronological age when selecting toys for play.

DIF: Cognitive Level: Application REF: Page 431 OBJ: 14 TOP: Play KEY: Nursing Process Step: Planning

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

12. What is the nurses best advice to a parent about a preschoolers imaginary friend?

a. Having imaginary friends is a sign that the child has low self-esteem.

b. It is common for preschoolers to have imaginary friends.

c. Preschoolers invent an imaginary friend when they feel overwhelmed.

d. The best approach to dealing with an imaginary friend is to ignore them. ANS: B

Imaginary friends are common and normal during the preschool period and serve many purposes, such as relief from loneliness, mastery of fears, and acting as a scapegoat.

DIF: Cognitive Level: Comprehension REF: Page 431, Nursing Tip OBJ: 13 TOP: Imaginary Friend

KEY: Nursing Process Step: Implementation

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

13. What intervention might the nurse suggest as helpful for the child with enuresis?

a. Applying an electric pad that gently shocks the child

b. Waking the child several times during the night to urinate

c. Decreasing fluid intake after the evening meal

d. Increasing dietary fiber intake ANS: C

If a child is experiencing enuresis, liquids after dinner should be limited and the child should routinely void before going to bed.

DIF: Cognitive Level: Application REF: Page 428-

OBJ: 9 TOP: Enuresis KEY: Nursing Process Step: Implementation

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

14. What should the nurse suggest as the most appropriate toy choice for a 3-year-old?

a. A board game

b. A small pet, such as a goldfish

c. A large construction set

d. Push-pull toys ANS: C

Large construction sets are suitable toys for the preschool-age child.

DIF: Cognitive Level: Application REF: Page 431 OBJ: 13 TOP: Play KEY: Nursing Process Step: Implementation

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

15. The parent of a 3 -year-old child tells the nurse, My daughter points instead of speaking whenever she wants me to get something for her, but she understands me when I ask her to do something. Based on the parents comment, what does the nurse suspect?

a. Age-appropriate language development

b. An expressive language delay

c. A receptive language delay

d. A potential hearing deficit ANS: B

An expressive language delay is suspected when the child understands spoken language but is not talking.

DIF: Cognitive Level: Application REF: Page 425, Table 18-3 OBJ: 3 TOP: Language Development

KEY: Nursing Process Step: Data Collection

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

16. The parent of a 4 -year-old child tells the nurse, Bedtime is difficult. I cant get my son to go to bed at night. The nurse and the childs mother discuss options. What intervention is the most appropriate choice?

a. Allow the child to put himself to bed when he is tired.

b. Let the child read in his room until he falls asleep.

c. Establish a bedtime routine and use it consistently.

d. Tire him out with physical activity before bedtime. ANS: C

Parents should engage the child in quiet activities before bedtime and establish a ritual that signals readiness for bedtime.

DIF: Cognitive Level: Application REF: Page 424 OBJ: 6

TOP: Bedtime Habits KEY: Nursing Process Step: Implementation

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

17. What fear is unique to the preschool period?

a. Water

b. Animals

c. Bodily harm

d. Death ANS: C

The fear of bodily harm, particularly the loss of body parts, is unique to this stage.

DIF: Cognitive Level: Knowledge REF: Page 425 OBJ: 3 TOP: Fear KEY: Nursing Process Step: Data Collection

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

18. A 4-year-old child tells the nurse she will not eat peas because they are green. Of what is this an example?

a. Egocentrism

b. Artificialism

c. Animism

d. Centering ANS: D

The tendency to concentrate on a single outstanding characteristic of an object while excluding other features is known as centering.

DIF: Cognitive Level: Application REF: Page 421 OBJ: 3 TOP: Centering KEY: Nursing Process Step: Data Collection

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

19. A 4-year-old child insists he has more money with a nickel than his father has with a dime. What is this perception, as described in Piagets theory?

a. Egocentrism

b. Artificialism

c. Animism

d. Intuition ANS: D

The intuitive stage, as described by Piaget, is prelogical thinking that is based on the outside appearance of objects. A nickel is larger than a dime and therefore more valuable.

DIF: Cognitive Level: Comprehension REF: Page 421 OBJ: 4

TOP: Cognitive Development KEY: Nursing Process Step: Data Collection MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

20. What will children who are unable to express themselves with words often do?

a. Become reclusive and introspective

b. Develop other methods of verbal communication

c. Engage in more creative play

d. Have tantrums and act out ANS: D

Children with delayed communication skills will frequently have tantrums and act out when they are unable to make their needs known.

DIF: Cognitive Level: Comprehension REF: Page 421 OBJ: 5 TOP: Tantrums KEY: Nursing Process Step: Implementation

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

21. Which is an example of associative play?

a. Two children playing house, one playing the role of the dad and the other playing the mom

b. Two children playing in a sand box, one building a wall and the other digging a hole

c. Two children playing with sports-associated items, one with a football and the other with a bat

d. Two children playing with a coloring book, one coloring pictures and the other looking at pictures

ANS: A

Associative play allows the preschoolers to use their enlarged vocabulary in play with other children to carry on conversations and describe scenarios for each to play.

DIF: Cognitive Level: Analysis REF: Page 424 OBJ: 13 TOP: Associative Play KEY: Nursing Process Step: N/A

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

22. The nurse is educating a group of preschool parents about the importance of safety. Which statement by a parent indicates the need for further education?

a. I continue to provide a great deal of indirect supervision for my child.

b. My stairway is always free of clutter.

c. I only leave my child in the car for brief moments.

d. Medications are kept in a locked cabinet. ANS: C

Children must not play in or around the car or be left alone, even for a brief moment, in the car. Preschool children still require a good deal of indirect supervision to protect them from dangers that arise from their immature judgment or social environment. Stairways should be free of clutter and medications kept out of reach.

DIF: Cognitive Level: Comprehension REF: Page 430 OBJ: 11 TOP: Safety KEY: Nursing Process Step: Implementation

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

23. Parents of a 5-year-old child tell the nurse they are concerned about their childs speech development by stating, No one can understand him but us. What clinical classification of

speech disorder does the nurse suspect?

a. Global language delay

b. Expressive language delay

c. Language loss

d. Articulation disorder ANS: D

When parents are the only people to understand their preschool child, an articulation disorder is suspected. (See Table 18-3.)

DIF: Cognitive Level: Application REF: Page 423 OBJ: 5 TOP: Safety KEY: Nursing Process Step: Implementation

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

24. What does including play in the plan of care for a 5-year-old allow the child to do? (Select all that apply.)

a. Exercise his imagination

b. Assume a role and act it out

c. Offers an emotional outlet

d. Avoid magical thinking

e. Interact with other children ANS: A, B, C, E

Benefits of play for the preschooler include exercising imagination, assuming a role and acting it out, offering an emotional outlet, and interaction with other children. Play employs the use of magical thinking.

DIF: Cognitive Level: Knowledge REF: Page 422, Table 18-1 | Page 425-426 OBJ: 10 TOP: Purpose of Play

KEY: Nursing Process Step: Planning

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

25. What developmental milestone(s) assist the 5-year-old boy toward developing his sexual identity? (Select all that apply.)

a. Begins to be less focused on his mother

b. Ignores both parents totally

c. Regresses to a more infantile level

d. Forms a romantic attachment to the mother

e. Identifies with the parent of the same sex ANS: A, D, E

Children of this age become less focused on the mother as the central person and begin to identify with the parent of the same sex, forming a romantic attachment to the parent of the opposite sex. This little boy might say, Im going to marry my mother. A little girl might say, Im going to marry my daddy.

DIF: Cognitive Level: Application REF: Page 425-426 OBJ: 2 TOP: Romantic Attachment to Parent

KEY: Nursing Process Step: Implementation

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

26. Which bedtime preparation rituals are the most appropriate for the nurse to suggest? (Select all that apply.)

a. Telling a story

b. Placing a favorite toy in bed

c. Placing a glass of water at the bedside

d. Turning on a night light

e. Playing energetically ANS: A, B, C, D

All options are soothing bedtime rituals except energetic playing, which would be stimulating and counterproductive to sleep.

DIF: Cognitive Level: Comprehension REF: Page 424 OBJ: 6 TOP: Bedtime Habits KEY: Nursing Process Step: Implementation

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

27. The nurse points out what advantage(s) of a nursery school or preschool experience? (Select all that apply.)

a. Increasing self-confidence

b. Fostering group cooperation

c. Detecting adjustment problems

d. Attainment of toilet training skills

e. Playing experiences with other children ANS: A, B, C, E

Nursery school increases self-confidence, group cooperation, social skills, and cooperative play. Objective observations by a nursery school instructor can detect early adjustment problems. The child is usually toilet trained prior to the start of preschool.

DIF: Cognitive Level: Comprehension REF: Page 429 OBJ: 12

TOP: Advantages of Nursery School KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

28. Which major developmental tasks will the nurse expect a child to accomplish by the end of the preschool years? (Select all that apply.)

a. Development of parallel play

b. Acceptance of separation

c. Increased communication skills

d. Consistent appetite

e. Control of bodily functions ANS: B, C, E

The major tasks of the preschool child include preparation to enter school, development of a cooperative type of play, control of body functions, acceptance of separation, and increase in communication skills, memory, and attention span. Appetite remains inconsistent.

DIF: Cognitive Level: Comprehension REF: Page 420 OBJ: 2

TOP: Major Developmental Tasks. KEY: Nursing Process Step: Data Collection MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

COMPLETION

29. When planning an activity for a 3-year-old, the nurse bases the plan on the average attention span of minutes.

ANS:

The average attention span of the preschooler is about 15 minutes.

DIF: Cognitive Level: Comprehension REF: Page 422, Table 18-1 OBJ: 3 TOP: Attention Span of Preschooler

KEY: Nursing Process Step: Planning

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

30. Play that is designed to retrain muscles or improve eye-hand coordination is considered

play.

ANS:

therapeutic

Therapeutic play, whether at home or in a clinic or rehab center, is designed to retrain muscles, strengthen muscles, or improve eye-hand coordination

DIF: Cognitive Level: Knowledge REF: Page 432 OBJ: 14 TOP: Therapeutic Play KEY: Nursing Process Step: N/A

MSC: NCLEX: Physiological Integrity: Physiological Adaptation

31. The gradual transfer of behavioral control from the parent to the child is accomplished through .

ANS:

discipline

Through discipline the parent gradually gives up behavior self-control to the child. DIF: Cognitive Level: Comprehension REF: Page 426 OBJ: 3

TOP: Discipline KEY: Nursing Process Step: N/A

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

32. is a preschoolers idea that the world and all of its contents are created by people.

ANS:

Artificialism

Artificialism is the belief that all things in the world have been created by people. DIF: Cognitive Level: Knowledge REF: Page 421 OBJ: 1

TOP: Artificialism KEY: Nursing Process Step: N/A

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

33. is seen in the play of children who pretend that an empty box is a fort; they create a mental image to stand for something that is not there.

ANS:

Symbolic functioning

Symbolic functioning is seen in the play of children who pretend that an empty box is a fort; they create a mental image to stand for something that is not there.

DIF: Cognitive Level: Knowledge REF: Page 421 OBJ: 1

TOP: Symbolic Functioning KEY: Nursing Process Step: Data Collection MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

34. Put the stages of separation anxiety in order from first to last. Put a comma and space between each answer choice (a, b, c, d, etc.)

a. Detachment

b. Regression

c. Despair

d. Protest

ANS:

D, C, A, B

The preschool child may feel abandoned by the parents and continues to be subject to separation anxiety. Separation anxiety is manifested by the stages of protest, despair, detachment, and regression.

DIF: Cognitive Level: Comprehension REF: Page 432 OBJ: 3

TOP: Separation Anxiety KEY: Nursing Process Step: Data Collection

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

Chapter 01: The Past, Present, and Future MULTIPLE CHOICE

1. A patient chooses to have the certified nurse midwife (CNM) provide care during her pregnancy. What does the CNMs scope of practice include?

a. Practice independent from medical supervision

b. Comprehensive prenatal care

c. Attendance at all deliveries

d. Cesarean sections ANS: B

The CNM provides comprehensive prenatal and postnatal care, attends uncomplicated deliveries, and ensures that a backup physician is available in case of unforeseen problems.

DIF: Cognitive Level: Comprehension REF: Page 6 OBJ: 12

TOP: Advance Practice Nursing Roles KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease

2. Which medical pioneer discovered the relationship between the incidence of puerperal fever and unwashed hands?

a. Karl Cred

b. Ignaz Semmelweis

c. Louis Pasteur

d. Joseph Lister ANS: B

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

DIF: Cognitive Level: Knowledge REF: Page 2 OBJ: 1 TOP: The Past KEY: Nursing Process Step: N/A

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

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

a. Maternal mortality in the United States is extremely low.

b. Anesthesia is available to relieve pain during labor and childbirth.

c. Tell me why you are afraid of childbirth.

d. Your condition will be monitored during labor and delivery. ANS: C

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

DIF: Cognitive Level: Application REF: Page 7-8 OBJ: 8

TOP: Cross-Cultural Care KEY: Nursing Process Step: Implementation MSC: NCLEX: Psychosocial Integrity: Psychological Adaptation

4. An urban area has been reported to have a high perinatal mortality rate. What information does this provide?

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

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

c. Deaths of infants up to 1 year of age per 1000 live births per year

d. Fetal and neonatal deaths per 1000 live births per year ANS: D

The perinatal mortality rate includes fetal and neonatal deaths per 1000 live births per year.

DIF: Cognitive Level: Comprehension REF: Page 12, Box 1-6 OBJ: 9 TOP: The Present-Child Care

KEY: Nursing Process Step: Implementation

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

5. What is the focus of current maternity practice?

a. Hospital births for the majority of women

b. The traditional family unit

c. Separation of labor rooms from delivery rooms

d. A quality family experience for each patient ANS: D

Current maternity practice focuses on a high-quality family experience for all families, traditional or otherwise.

DIF: Cognitive Level: Comprehension REF: Page 6 OBJ: 7

TOP: The Present-Maternity Care KEY: Nursing Process Step: N/A MSC: NCLEX: Health Promotion and Maintenance

6. Who advocated the establishment of the Childrens Bureau?

a. Lillian Wald

b. Florence Nightingale

c. Florence Kelly

d. Clara Barton ANS: A

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

DIF: Cognitive Level: Knowledge REF: Page 4 OBJ: 1 | 2 TOP: The Past KEY: Nursing Process Step: Implementation

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

7. What was the result of research done in the 1930s by the Childrens Bureau?

a. Children with heart problems are now cared for by pediatric cardiologists.

b. The Child Abuse and Prevention Act was passed.

c. Hot lunch programs were established in many schools.

d. Childrens asylums were founded. ANS: C

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

DIF: Cognitive Level: Knowledge REF: Page 4 OBJ: 2 | 3 TOP: The Past KEY: Nursing Process Step: N/A

MSC: NCLEX: Health Promotion and Maintenance: Coordinated Care

8. What government program was implemented to increase the educational exposure of preschool children?

a. WIC

b. Title XIX of Medicaid

c. The Childrens Charter

d. Head Start ANS: D

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

DIF: Cognitive Level: Knowledge REF: Page 3 OBJ: 5

TOP: Government Influences in Maternity and Pediatric Care KEY: Nursing Process Step: N/A

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

9. What guidelines define multidisciplinary patient care in terms of expected outcome and timeframe from different areas of care provision?

a. Clinical pathways

b. Nursing outcome criteria

c. Standards of care

d. Nursing care plan ANS: A

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

DIF: Cognitive Level: Knowledge REF: Page 12 OBJ: 14

TOP: Health Care Delivery Systems KEY: Nursing Process Step: N/A MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care

10. A nursing student has reviewed a hospitalized pediatric patient chart, interviewed her mother, and collected admission data. What is the next step the student will take to develop a nursing care plan for this child?

a. Identify measurable outcomes with a timeline.

b. Choose specific nursing interventions for the child.

c. Determine appropriate nursing diagnoses.

d. State nursing actions related to the childs medical diagnosis. ANS: C

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

DIF: Cognitive Level: Application REF: Page 11 OBJ: 13

TOP: Nursing Process KEY: Nursing Process Step: Nursing Diagnosis MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care

11. A nursing student on an obstetric rotation questions the floor nurse about the definition of the LVN/LPN scope of practice. What resource can the nurse suggest to the student?

a. American Nurses Association

b. States board of nursing

c. Joint Commission

d. Association of Womens Health, Obstetric and Neonatal Nurses ANS: B

The scope of practice of the LVN/LPN is published by the states board of nursing.

DIF: Cognitive Level: Comprehension REF: Page 3, Legal and Ethical Considerations OBJ: 18 TOP: Critical Thinking

KEY: Nursing Process Step: Implementation

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

12. What was recommended by Karl Cred in 1884?

a. All women should be delivered in a hospital setting.

b. Chemical means should be used to combat infection.

c. Podalic version should be done on all fetuses.

d. Silver nitrate should be placed in the eyes of newborns. ANS: D

In 1884 Karl Cred recommended the use of 2% silver nitrate in the eyes of newborns to reduce the incidence of blindness.

DIF: Cognitive Level: Knowledge REF: Page 2 OBJ: 1 TOP: Use of Silver Nitrate KEY: Nursing Process Step: N/A

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

13. What is the purpose of the White House Conference on Children and Youth?

a. Set criteria for normal growth patterns.

b. Examine the number of live births in minority populations.

c. Raise money to support well-child clinics in rural areas.

d. Promote comprehensive child welfare. ANS: D

White House Conferences on Children and Youth are held every 10 years to promote comprehensive child welfare.

DIF: Cognitive Level: Knowledge REF: Page 4 OBJ: 3

TOP: White House Conferences KEY: Nursing Process Step: N/A

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

14. How many hours of hospital stay does legislation currently allow for a postpartum patient who has delivered vaginally without complications?

a. 24

b. 48

c. 36

d. 72 ANS: B

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

DIF: Cognitive Level: Knowledge REF: Page 6 OBJ: 7 TOP: Hospital Terms for Postpartum Patients

KEY: Nursing Process Step: Planning

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

15. How does the clinical pathway or critical pathway improve quality of care?

a. Lists diagnosis-specific implementations

b. Outlines expected progress with stated timelines

c. Prioritizes effective nursing diagnoses

d. Describes common complications ANS: B

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

DIF: Cognitive Level: Comprehension REF: Page 12 OBJ: 14 TOP: Critical Pathway KEY: Nursing Process Step: Implementation MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care

16. A patient asks the nurse to explain what is meant by gene therapy. What is the nurses best response?

a. Gene therapy can replace missing genes.

b. Gene therapy evaluates the parents genes.

c. Gene therapy can change the sex of the fetus.

d. Gene therapy supports the regeneration of defective genes. ANS: A

Gene therapy can replace missing or defective genes.

DIF: Cognitive Level: Knowledge REF: Page 8 OBJ: 7

TOP: Gene Therapy KEY: Nursing Process Step: Implementation

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

17. The nurse is clarifying information to a patient regarding diagnosis-related groups (DRGs). What is the nurses best response when the patient asks how DRGs reduce medical care costs?

a. By determining payment based on diagnosis

b. By requiring two medical opinions to confirm a diagnosis

c. By organizing HMOs

d. By defining a person who will require hospitalization ANS: A

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

DIF: Cognitive Level: Comprehension REF: Page 8 OBJ: 11 TOP: DRGs KEY: Nursing Process Step: Implementation

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

18. What is the best example of a Nursing Interventions Classification (NIC) intervention?

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

b. Nurse will report temperature elevations to the charge nurse.

c. Nurse will offer extra liquids at all meals.

d. Patient will express pain relief after massage. ANS: C

NIC is a guide to nursing actions.

DIF: Cognitive Level: Comprehension REF: Page 12 | Page 14 OBJ: 15 TOP: NICs KEY: Nursing Process Step: N/A

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

19. How does electronic charting ensure comprehensive charting more effectively than handwritten charting?

a. Provides a uniform style of chart

b. Requires certain responses before allowing the user to progress

c. All documentation is reflective of the nursing care plan

d. Requires a daily audit by the charge nurse ANS: B

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

DIF: Cognitive Level: Comprehension REF: Page 15-16 OBJ: 22 TOP: Computer Charting KEY: Nursing Process Step: Implementation MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care

20. The nurse reminds family members that the philosophy of family-centered care is to provide control to the family over health care decisions. What is the appropriate term for this type of control?

a. Empowerment

b. Insight

c. Regulation

d. Organization ANS: A

The term empowerment refers to the control a family has over its own health care decisions.

DIF: Cognitive Level: Knowledge REF: Page 2 OBJ: 7

TOP: Empowerment KEY: Nursing Process Step: Implementation MSC: NCLEX: Physiological Integrity: Basic Care and Comfort

21. A patient in the prenatal clinic is concerned about losing her job because of her pregnancy. The nurse instructs her that the Family Medical Leave Act (FMLA) allows an employee to be absent from work without pay. How many weeks does the FMLA allow a woman to recover from childbirth or care for a sick family member without loss of benefits or pay status?

a. 4

b. 6

c. 10

d. 12 ANS: D

The FMLA allows for employees to leave work for up to 12 weeks to recover from childbirth or to care for an ill family member without losing benefits or pay status.

DIF: Cognitive Level: Knowledge REF: Page 3 OBJ: 5 TOP: FMLA KEY: Nursing Process Step: Implementation

MSC: NCLEX: Psychosocial Integrity: Coping and Adaptation

22. What term appropriately describes the nurse who is able to adapt health care practices to meet the needs of various cultures?

a. Culturally aware

b. Culturally sensitive

c. Culturally competent

d. Culturally adaptive ANS: C

The nurse who is able to adapt health care to meet the needs of various cultures is said to be culturally competent.

DIF: Cognitive Level: Knowledge REF: Page 7 OBJ: 8

TOP: Cultural Competency KEY: Nursing Process Step: N/A MSC: NCLEX: N/A

23. What is one major advantage to the application of critical thinking?

a. Problem-free care

b. Limitation of approaches to care

c. Decreased need for assessment

d. Problem prevention ANS: D

Critical thinking results in problem prevention in designing nursing care.

DIF: Cognitive Level: Comprehension REF: Page 14 OBJ: 19 TOP: Critical Thinking KEY: Nursing Process Step: N/A MSC: NCLEX: N/A

24. Student practical nurses are discussing the North American Nursing Diagnosis Association International (NANDA-I) taxonomy in post conference on the acute care clinical setting. The students are aware that the role of the LPN with nursing diagnosis formulation is what?

a. To initiate and identify nursing diagnosis specific to patient

b. To update changes in nursing diagnosis as needed

c. To have an understanding of nursing diagnosis terminology

d. To accurately document nursing diagnosis on patient plan of care ANS: C

The registered nurse is responsible to initiate, identify, update, and document nursing diagnoses. The licensed practical nurse is responsible to have an understanding of nursing diagnosis terminology.

DIF: Cognitive Level: Comprehension REF: Page 14 OBJ: 17

TOP: NANDA-I taxonomy KEY: Nursing Process Step: Nursing Diagnosis MSC: NCLEX: Health Promotion and Maintenance: Data Collection Techniques

MULTIPLE RESPONSE

25. What services are birthing centers able to provide? (Select all that apply.)

a. Prenatal care

b. Labor and delivery services

c. Classes for new mothers

d. Adoption referrals

e. Family planning ANS: A, B, C, E

Birthing centers are capable of providing full-service obstetric care, classes for new mothers, and family planning. Birthing centers do not offer adoption services.

DIF: Cognitive Level: Comprehension REF: Page 6 OBJ: 7

TOP: Birthing Centers KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: Coordinated Care

26. What developments in the early 20th century encouraged women to seek hospitalization for childbirth? (Select all that apply.)

a. Use of specialized obstetric instruments

b. Use of anesthesia

c. Physicians closer relationships with hospitals

d. Focus on family-centered care

e. Insurance coverage ANS: A, B, C

In the early 1900s, the development of specialized obstetric instruments, better modes of anesthesia, and the physicians reliance on hospital services were instrumental in encouraging women to seek hospitalization for childbirth.

DIF: Cognitive Level: Comprehension REF: Page 3 OBJ: 7

TOP: Hospitalization for Childbirth KEY: Nursing Process Step: Implementation MSC: NCLEX: Safe, Effective Care Environment: Safety and Infection Control

27. What nonfamily-centered policies were prevalent in the 1960s? (Select all that apply.)

a. Waiting room for fathers

b. Sedation of mother during labor

c. Delay of reunion of mother and infant

d. Lenient visiting hours

e. Restrictions of visitations by minor children ANS: A, B, C, E

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

DIF: Cognitive Level: Comprehension REF: Page 3 OBJ: 7

TOP: Nonfamily-centered Practices KEY: Nursing Process Step: Implementation MSC: NCLEX: Safe, Effective Care Environment: Safety and Infection Control

28. The nurse is aware that there is a legal responsibility to report certain diseases and conditions to county or state health authorities. Which would be included? (Select all that apply.)

a. Tuberculosis

b. Child abuse

c. Industrial accidents

d. Sexually transmitted diseases

e. Food-borne infections ANS: A, B, D, E

The nurse has a legal responsibility to report communicable diseases (such as tuberculosis

and sexually transmitted diseases), food-borne infections, child abuse, and threats of suicide.

DIF: Cognitive Level: Comprehension REF: Page 6, Legal and Ethical Considerations box OBJ: 6 TOP: Reportable Diseases

KEY: Nursing Process Step: Planning

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

29. An inservice program at a long-term care facility is reviewing the Nursing Outcomes Classification (NOC) with nursing staff. After the presentation the nurses review resident care plans. Which of the following are found to be appropriately written outcomes? (Select all that apply.)

a. Suction patient orally every 4 hours and as needed.

b. Auscultate lung sounds every 2 hours.

c. Provide Tylenol as ordered by health care provider.

d. Patient states Pain has decreased after medication administration.

e. Patient blood pressure recorded as 120/72 after dressing change. ANS: D, E

NOC was developed to identify outcomes of nursing care that are directly influenced by nursing actions. Outcomes are defined as the behaviors and feelings of the patient in response to the nursing care given. Suctioning patient, auscultating lung sounds, and providing Tylenol are nursing actions.

DIF: Cognitive Level: Application REF: Page 12-14 OBJ: 16 TOP: Nursing Outcomes Classification (NOC)

KEY: Nursing Process Step: Evaluation

MSC: NCLEX: Physiological Integrity: Basic Care and Comfort

30. Practical nursing students are using critical thinking skills to study for an upcoming test. What will these students include when studying? (Select all that apply.)

a. Memorization of facts first

b. Prioritizing information

c. Relating facts to other facts

d. Making assumptions

e. Reviewing before the test ANS: B, C, E

Using critical thinking when studying involves understanding facts before memorizing, prioritizing information to be memorized, relating facts to other facts, using all five senses, reviewing before tests, and reading critically. Critical thinking does not involve assumption as does general thinking.

DIF: Cognitive Level: Comprehension REF: Page 15 OBJ: 20 TOP: Critical Thinking KEY: Nursing Process Step: Evaluation MSC: NCLEX: Safe, Effective Care Environment

31. What factors have played a role in meeting the goals of Healthy People 2020 as it relates the goals for outcomes of pregnancy? (Select all that apply.)

a. Early prenatal care

b. Increased number of surgical births

c. NICU care

d. Use of prenatal glucocorticoids

e. Fetal surgery ANS: A, C, D, E

Early prenatal care, fetal surgery, use of prenatal glucocorticoids, technology, and NICU care have played a role in increasing the positive outcome of pregnancy, and the goals of Healthy People 2020 may well be met. Increase in surgical births and multiple gestations do not work toward meeting the goals of Healthy People 2020.

DIF: Cognitive Level: Comprehension REF: Page 16-17 OBJ: 21

TOP: Healthy People 2020 KEY: Nursing Process Step: Implementation

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

32. A community health nurse is providing specialized care to patients in the home setting. What kind of specialized care may this nurse be providing? (Select all that apply.)

a. Glucose monitoring

b. Heparin therapy

c. Family education

d. Total parenteral nutrition

e. Provision of referral services ANS: A, B, D

Glucose monitoring, heparin therapy, and total parenteral nutrition are categorized as specialized care that may be provided by the community health nurse. Family education and provision of referral are categorized as therapeutic care.

DIF: Cognitive Level: Application REF: Page 16-17 OBJ: 23

TOP: Community Health KEY: Nursing Process Step: Implementation MSC: NCLEX: Physiological Integrity: Basic Care and Comfort

COMPLETION

33. The nurse who is very conscientious about hand hygiene is following the concepts set out by and.

ANS:

Lister, Pasteur OR Pasteur, Lister

Both Lister and Pasteur set out that handwashing could reduce incidence of infection by cross- contamination.

DIF: Cognitive Level: Knowledge REF: Page 2 OBJ: 1

TOP: Handwashing KEY: Nursing Process Step: Implementation

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

34. The first White House Conference on Children and Youth was called by President

.

ANS:

Theodore Roosevelt

Theodore Roosevelt called the first White House Conference in 1909.

DIF: Cognitive Level: Knowledge REF: Page 4 OBJ: 1

TOP: White House Conferences KEY: Nursing Process Step: N/A

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

35. The nurse reviewing the specific recovery goals set out on a clinical pathway observed that two goals were not met by their designated timeline. The nurse records a negative

for these two goals.

ANS:

variance

Using a clinical pathway model with goals and associated timelines, the nurse must record a negative variance when a timeline is not met and consider a new approach or an extended timeline.

DIF: Cognitive Level: Comprehension REF: Page 12 OBJ: 14 TOP: Variances KEY: Nursing Process Step: Evaluation

MSC: NCLEX: Safe, Effective Care Environment: Management of Care

36.. is purposeful, goal-directed thinking based on scientific evidence rather than assumption or memorization.

ANS:

Critical thinking

Critical thinking is purposeful and goal-directed thinking as opposed to general thinking, which involves random or memorized thoughts.

DIF: Cognitive Level: Knowledge REF: Page 14 OBJ: 18 TOP: Critical Thinking KEY: Nursing Process Step: Evaluation

MSC: NCLEX: Safe, Effective Care Environment: Management of Care Chapter 02: Human Reproductive Anatomy and Physiology

MULTIPLE CHOICE

1. A 14-year-old boy is at the pediatric clinic for a checkup. What physical changes of puberty will the nurse indicate are related to the production of testosterone?

a. Stimulation of production of white cells and platelets

b. Promotion of growth of small bones

c. Increase in muscle mass and strength

d. Decrease in production of sebaceous gland secretions ANS: C

Testosterone increases muscle mass, promotes strength and growth of long bones, and enhances production of red blood cells.

DIF: Cognitive Level: Knowledge REF: Page 20-21 OBJ: 1 | 2 | 5

TOP: Male Reproductive System KEY: Nursing Process Step: Data Collection MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

2. The nurse is educating high school students about puberty. What will the nurse indicate regulates the production of sperm and secretion hormones?

a. Testes

b. Vas deferens

c. Ejaculatory ducts

d. Prostate gland ANS: A

The testes have two functions: manufacture of spermatozoa and secretion of androgens.

DIF: Cognitive Level: Knowledge REF: Page 21 OBJ: 3 | 5

TOP: Male Reproductive System KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

3. The nurse is speaking with a couple trying to conceive a child. What will the nurse remind the couple is a factor that can decrease sperm production?

a. Infrequent sexual intercourse

b. The man not being circumcised

c. The penis and testes being small

d. The testes being too warm ANS: D

The scrotum is suspended away from the perineum to lower the temperature of the testes for sperm production.

DIF: Cognitive Level: Comprehension REF: Page 22 OBJ: 3

TOP: Male Reproductive System KEY: Nursing Process Step: Implementation MSC: NCLEX: Physiological Integrity: Reduction of Risk