Maternal Child Nursing Care In Canada 2nd Edition Perry Lowdermilk Test Bank by rnstudent

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Chapter 01: Contemporary Perinatal and Pediatric Nursing in Canada Perry: Maternal Child Care Nursing in Canada, 2nd Canadian Edition MULTIPLE CHOICE 1. Which is true regarding perinatal nurses? a. They provide care for only mothers and babies. b. They require advanced practice education beyond an entry to practice degree. c. They work with women and families from preconception throughout the

child-bearing year. d. They provide care for families with children up to age 18 years. ANS: C

DIF: Cognitive Level: Knowledge OBJ: Nursing Process: Assessment

N G M AS TE R

Y. C

Perinatal nurses are those nurses who work collaboratively with women and families from the preconception period throughout the child-bearing year. Pediatric nurses care for children from birth up to age 18 years. Perinatal or pediatric nurses also provide care for the family. Perinatal nurses often do have advanced education, but this is not a requirement. REF: p. 3

2. Which is true regarding pediatric nurses? a. They provide care for children up to and including 13 years of age. b. They require advanced practice education beyond an entry to practice degree. c. They work with women and families throughout the child-bearing year. d. They provide care for children and families up to age 18 years.

ANS: D

Pediatric nurses care for children from birth up to age 18 years. Perinatal nurses are those nurses who work collaboratively with women and families from the preconception period throughout the child-bearing year. Perinatal and pediatric nurses also provide care for the family. Pediatric nurses often do have advanced education, but this is not a requirement.

.T HE

DIF: Cognitive Level: Analysis OBJ: Nursing Process: Assessment

REF: p. 3

3. According to the Institute of Safe Medication Practices Canada (ISMP) “Do Not Use” list,

which is correct? a. Administer heparin 100 U S/C QID b. Administer insulin 7 units OD c. Administer polysporin gtts to both eyes daily d. Administer 5 cc heparin into saline lock daily ANS: C

Polysporin gtts to both eyes daily is correct. Units should be written out and not abbreviated as “U”; S/C should be “SUBCUT”; OD should be written out as “daily”; and “cc” is not to be used, but “mL” is to be used for volume measurements. DIF: Cognitive Level: Application OBJ: Nursing Process: Implementation

REF: p. 10 | Table 1-2

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4. An Indigenous woman is pregnant with her first child. Which evidence-informed intervention

is most important for the nurse to implement? a. Perform a nutrition assessment. b. Refer the woman to a social worker. c. Advise the woman to see an obstetrician, not a midwife. d. Explain to the woman the importance of keeping her prenatal care appointments. ANS: D

REF: p. 8

OBJ: Nursing Process: Planning

N G M AS TE R

DIF: Cognitive Level: Application

Y. C

Consistent prenatal care is associated with healthier infants. Nutritional status is an important modifiable risk factor, but it is not the most important action a nurse should take in this situation. The patient may need assistance from a social worker at some time during her pregnancy, but a referral to a social worker is not the most important aspect the nurse should address at this time. If the woman has identifiable high-risk problems, her health care may need to be provided by a physician. However, it cannot be assumed that all Indigenous women have high-risk issues. In addition, advising the woman to see an obstetrician is not the most important aspect on which the nurse should focus at this time.

5. Which social determinant of health has the greatest influence on health status and behaviours? a. Education and literacy b. Income and social status c. Employment and working conditions d. Biology and genetic endowment ANS: B

Income and social status has the greatest influence on health status and behaviours and use of health care services. Lower-income Canadians have poorer health, with more chronic illness and earlier death, than that of higher-income Canadians, regardless of age, gender, culture, race, or residence. REF: p. 5 | Table 1-1

DIF: Cognitive Level: Application OBJ: Nursing Process: Evaluation

.T HE

6. Which is an example of invisible poverty? a. Insufficient clothing b. Limited employment opportunities c. Poor sanitation d. Deteriorating housing ANS: B

Invisible poverty refers to social and cultural deprivation, such as limited employment opportunities, inferior educational opportunities, lack of or inferior medical services and health care facilities, and an absence of public services. Visible poverty refers to lack of money or material resources, which includes insufficient clothing, poor sanitation, and deteriorating housing. DIF: Cognitive Level: Knowledge OBJ: Nursing Process: Assessment

REF: p. 4

7. What is the primary role of practicing nurses in the research process?

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a. b. c. d.

Designing research studies Collecting data for other researchers Identifying areas for further research Seeking funding to support research studies

ANS: C

REF: p. 8

Y. C

DIF: Cognitive Level: Comprehension OBJ: Nursing Process: Implementation

The primary role of the practicing nurse is to identify areas for further research in the health and health care of women, children, and families. When problems are identified, research can be conducted properly. Research of health care issues leads to evidence-informed practice guidelines. Designing research studies is only one factor of the research process. Data collection is one factor of research. Financial support is necessary to conduct research, but it is not the primary role of the nurse in the research process.

8. Which event shifted the focus of the Public Health Agency of Canada (PHAC) away from a

N G M AS TE R

population health and health promotion focus? a. Shift to home births b. Emergence of avian influenza c. United Nations Millennium Goals d. Increase in the maternal mortality rate ANS: B

The emergence of the avian influenza shifted the focus of the PHAC from population health and a health promotion focus to a focus on planning for a pandemic. There has been no shift to home births from hospital births in Canada. The United Nations Millennium Goals did not cause a focal shift for the PHAC. There has not been an increase in the maternal mortality rate.

DIF: Cognitive Level: Comprehension OBJ: Nursing Process: Implementation

REF: p. 4

ANS: B

.T HE

9. It is estimated that there are approximately how many homeless people in Canada? a. 100 000 b. 200 000 c. 500 000 d. 1 000 000

It is estimated that there is approximately 200 000 homeless people in Canada in any given year.

DIF: Cognitive Level: Knowledge OBJ: Nursing Process: Assessment

REF: p. 6

10. Which is a characteristic of integrative healing? a. It replaces conventional Western modalities of treatment. b. It is used by only a small number of Canadian adults. c. It recognizes the value of patients’ input into their health care. d. It focuses primarily on the disease an individual is experiencing.

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ANS: C

Integrative healing encompasses complementary and alternative therapies and healing modalities that offer human-centred care based on philosophies that recognize the value of the patient’s input and honor the individual’s beliefs, values, and desires. Alternative and complementary therapies are part of an integrative approach to health care. An increasing number of Canadian adults are seeking alternative and complementary health care options. Alternative healing modalities offer a holistic approach to health, focusing on the whole person, not just the disease. REF: p. 7

OBJ: Nursing Process: Planning

DIF: Cognitive Level: Comprehension

11. Which was highlighted in the Truth and Reconciliation Report (2015)? a. Increased transportation for Indigenous people to travel to tertiary care centers for

Y. C

health care

b. Recognize the value of Indigenous healing practices and their use in the health care

system

N G M AS TE R

c. Treat health concerns of Indigenous people with Western ways of healing d. Educate health care providers about Indigenous healing practices to eliminate the

role of the Elder ANS: B

The TRC (2015) final report calls on health care providers to recognize the value of Indigenous healing practices and to use them in the treatment of Indigenous patients in collaboration with Indigenous healers and Elders where requested by Indigenous patients. It is imperative that health care providers become knowledgeable in Indigenous healing practices, not to eliminate the role of the Elder but to work collaboratively with Elders. Health care services need to be available where Indigenous people work and live and not require increased transportation to tertiary care centres for health care. REF: p. 6

OBJ: Nursing Process: Planning

DIF: Cognitive Level: Comprehension

ANS: B

.T HE

12. Which has directly increased the life expectancy of children experiencing a chronic disease? a. Early postpartum discharges b. Enhanced technology c. The reduction in acceptable genetic screening options d. Rural health services delivered via telehealth

Enhanced technology has increased the life expectancy of many children with chronic diseases. Early postpartum discharges and genetic screening options have not increased the life expectancy of children with chronic disease. Rural health services delivered via telehealth are altering how services are delivered and may indirectly increase life expectancy, but it is not a direct contributing factor. DIF: Cognitive Level: Analysis OBJ: Nursing Process: Implementation

REF: p. 7

13. Which is the focus of the Code of Ethics for Registered Nurses? a. Collegiality b. Dependent role c. Evaluation

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d. Accountability ANS: D

The Code of Ethics for Registered Nurses, by the Canadian Nurses Association (CNA), provides the framework and core responsibilities for nursing practice. The Code of Ethics focuses on the nurse’s accountability and responsibility to the patient (CNA, 2008) and emphasizes the nursing role as an independent professional, one that upholds its own legal liability. Collegiality refers to a working relationship with one’s colleagues. Evaluation refers to examination of the effectiveness of interventions in relation to expected outcomes. REF: p. 11

OBJ: Nursing Process: Evaluation

DIF: Cognitive Level: Evaluation

N G M AS TE R

Y. C

14. Which reflects a future goal for perinatal and pediatric nursing? a. Limiting multiprofessional teams b. Maintaining existing power structures c. Advocating for an increased number of Caesarean births d. Addressing health inequities by engaging in policy analysis and advocacy ANS: D

Addressing health inequities by creating health policy and services that focus on both resources needed for health and access to health services is a future goal of perinatal nurses. Nurses should be expanding multiprofessional teams rather than limiting their existence. Existing power structures and practices need to be disrupted rather than maintained. Advocating for an increased number of Caesarean births is not a future goal for perinatal nursing. REF: p. 4

DIF: Cognitive Level: Knowledge OBJ: Nursing Process: Implementation

15. Which statement is true related to integrative healing? a. Its aim is to provide the same health care for all racial and ethnic groups. b. It blends complementary and alternative therapies with conventional Western

treatment.

ANS: B

.T HE

c. It focuses on the disease or condition rather than the background of the patient. d. It has been mandated by Health Canada.

Integrative healing tries to mix the old with the new at the discretion of the patient and health care providers. Integrative healing is a blending of new and traditional practices and focuses on the whole person, not just the disease or condition. Health Canada supports complementary and alternative therapies but does not mandate them. REF: p. 7

DIF: Cognitive Level: Application OBJ: Nursing Process: Implementation

16. Which is an accurate statistic related to Indigenous people in Canada? a. There are approximately half a million Indigenous people in Canada. b. Indigenous people comprise approximately 2% of the total Canadian population. c. The Indigenous population is increasing at a slower rate than non-Indigenous

populations. d. Children 14 years and under comprise approximately 28% of the total Indigenous

population.

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ANS: D

Indigenous children aged 14 and under made up 28% of the total Indigenous population and 7% of all children in Canada. There are approximately 1.4 million Indigenous people in Canada and they comprise 4.3% of the total Canadian population. The Indigenous population increased by 20% compared with 5.2% for the non-Indigenous population. DIF: Cognitive Level: Knowledge

REF: p. 6

OBJ: Nursing Process: Planning

Y. C

17. Approximately what percentage of hospitalized patients experience an adverse event? a. 2.5% b. 5% c. 7.5% d. 10% ANS: C

DIF: Cognitive Level: Knowledge

N G M AS TE R

According to the Canadian Adverse Events Study (Baker et al., 2004), the most quoted study in Canada regarding medical errors, 7.5% of hospitalized patients had an adverse event, and of these, 16% died as a result. REF: p. 9

OBJ: Nursing Process: Planning

18. What does the “A” in the SBAR technique for communication represent? a. Awareness b. Accountability c. Accessibility d. Assessment ANS: D

The situation-background-assessment-recommendation (SBAR) technique gives a specific framework for communication among health care providers; the “A” represents assessment.

DIF: Cognitive Level: Comprehension REF: p. 9 OBJ: Nursing Process: Planning | Nursing Process: Implementation

.T HE

19. Which is a United Nations Millennium Development Goal? a. Safe, compassionate, and competent care b. Improve family health c. Reduce child morbidity d. Ensure environmental sustainability

ANS: D

One of the eight United Nations Millennium Development Goals is to ensure environmental sustainability. Safe, compassionate care is included in the Code of Ethics for RNs. The Millennium Development Goals include improving maternal health and reducing child mortality. DIF: Cognitive Level: Knowledge OBJ: Nursing Process: Assessment

REF: p. 11 | Box 1-3

20. Which statement is true of nursing care that is based on knowledge gained through various

forms and sources of information?

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a. b. c. d.

An outgrowth of telemedicine Known as evidence-informed practice Exclusive to maternity nursing practice At odds with the Cochrane Pregnancy and Childbirth Database

ANS: B

REF: p. 8

ANS: B

N G M AS TE R

21. Which is a principle of the Canada Health Act? a. Justice b. Universality c. Health and well-being d. Informed decision making

Y. C

DIF: Cognitive Level: Comprehension OBJ: Nursing Process: Assessment

Evidence-informed practice (EIP) is the collection, interpretation, and integration of valid, important, and applicable patient-reported, nurse-observed, and research-derived information. Evidence-informed practice is practised within all disciplines of nursing and is not exclusive to maternity nursing practice. The Cochrane Pregnancy and Childbirth Database is based on systematically reviewed research trials and is part of the evidence-informed practice movement. Telemedicine uses communication technologies to support health care.

Universality is one of the five principles of the Canada Health Act. Justice is a guiding principle for perinatal and pediatric nursing in Canada. Informed decision making is a guiding principle for perinatal and pediatric nursing in Canada. Health and well-being is a guiding principle for perinatal and pediatric nursing in Canada. REF: p. 4

DIF: Cognitive Level: Knowledge OBJ: Nursing Process: Assessment

22. Which is true of the Muskoka Accord? a. It focused on a commitment to increase global health across the lifespan. b. It provided assistance in developing countries to address health inequities with

.T HE

mothers and infants.

c. It expressed an international commitment to develop a global partnership for

development of future health care goals. d. It was a strategy to promote gender equality and empower women in health care

decisions. ANS: B

In 2010, with the signature of the Muskoka Accord, the Canadian government promised to assist developing countries in addressing health inequities that affect mothers and infants. DIF: Cognitive Level: Knowledge OBJ: Nursing Process: Assessment

REF: p. 11

23. The obligation to minimize or prevent harm is which ethical principle? a. Autonomy b. Nonmaleficence c. Beneficence d. Justice

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ANS: B

Nonmaleficence is the obligation to minimize or prevent harm. Autonomy is the patient’s right to be self-governing; beneficence is the obligation to promote the patient’s well-being; and justice is the concept of fairness. DIF: Cognitive Level: Comprehension

REF: p. 11

OBJ: Nursing Process: Planning

MULTIPLE RESPONSE

1. Which abbreviations are included on the ISMP “Do Not Use” list? Select all that apply.

ANS: A, D, E, F, G

N G M AS TE R

Y. C

Express answer in small letters, with a comma followed by a space—e.g., a, b, c, d. a. OD b. mcg c. mL d. D/C e. U f. IU g. cc The following are not to be used: U, IU, OD, QOD, OS, OD, OU, D/C, μg, and cc. Acceptable abbreviations to use include mcg and mL. DIF: Cognitive Level: Knowledge OBJ: Nursing Process: Assessment

REF: p. 10 | Table 1-2

2. Which are included in the International Nurse Regulator Collaborative 6 P’s for social media

.T HE

use? Select all that apply. Express answer in small letters, followed by a comma and a space—e.g., a, b, c, d. a. Positive b. Pause c. Probability d. Purpose e. Privacy f. Performance g. Professional ANS: A, B, E, G

The 6 P’s of social media use are professional, positive, patient/person-free, protect, privacy, and pause. Probability, purpose, and performance are not part of the 6 P’s as identified by the International Nurse Regulator Collaborative. DIF: Cognitive Level: Knowledge OBJ: Nursing Process: Implementation

REF: p. 8 | Box 1-1

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Chapter 02: The Family and Culture Perry: Maternal Child Care Nursing in Canada, 2nd Canadian Edition MULTIPLE CHOICE 1. A married couple lives in a single-family house with their newborn son and the husband’s

daughter from a previous marriage. Which family form best describes this family? a. Blended family b. Extended family c. Nuclear family d. Same-sex family ANS: A

DIF: Cognitive Level: Knowledge OBJ: Nursing Process: Assessment

N G M AS TE R

Y. C

Blended families are formed as the result of divorce and remarriage. Unrelated family members join together to create a new household. Members of an extended family are kin, or family members related by blood, such as grandparents, aunts, and uncles. A nuclear family is a traditional family with a male and female partner along with the children resulting from that union. A same-sex family is a family with homosexual partners who cohabit with or without children. REF: p. 15

2. In what form do families tend to be most socially vulnerable? a. Blended family b. Extended family c. Nuclear family d. Lone-parent family

ANS: D

.T HE

The lone-parent family, particularly the female lone-parent family, is more likely to have a lower income and to experience poverty, which in turn can affect the health status of family members. The married-blended family, the extended family, and the nuclear family are not most socially vulnerable. DIF: Cognitive Level: Knowledge

REF: p. 16

OBJ: Nursing Process: Planning

3. What is the focus of relational nursing? a. Primarily disease prevention b. Provision of health services c. Recognition of determinants of health d. Resiliency of the woman and her family ANS: C

Relational nursing focuses primarily on the recognition of the determinants of health. It is more congruent with health promotion than disease prevention. The focus of perinatal nursing has moved away from the provision of health service in order to focus on the determinants of health. The resiliency of the woman and her family is not the focus of relational nursing. DIF: Cognitive Level: Knowledge

REF: p. 17

OBJ: Nursing Process: Planning

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4. The nurse should be aware that the criteria used to make decisions and solve problems within

families are based primarily on which factor(s)? a. Rituals and customs b. Values and beliefs c. Boundaries and channels d. Socialization processes ANS: B

REF: p. 20

OBJ: Nursing Process: Planning

N G M AS TE R

DIF: Cognitive Level: Comprehension

Y. C

Values and beliefs are the most prevalent factors in the decision-making and problem-solving techniques of families. Although culture may play a part in the decision-making process of a family, ultimately values and beliefs dictate the course of action taken by family members. Boundaries and channels affect the relationship between the family members and the health care team, not the decisions within the family. Socialization processes may help families interact with the community, but they are not the criteria used for decision making within the family.

5. Using the family stress theory as an intervention approach for working with families

experiencing parenting, the nurse can help the family change which internal context factor? a. Success in coping with stressors b. Maturation of family members c. The family’s perception of the event d. The prevailing cultural beliefs of society ANS: C

The family stress theory is concerned with the family’s reaction to, and perception of, stressful events; internal context factors include elements that a family can control, such as psychological defences. It is not concerned with maturation of family members or with the prevailing cultural beliefs of society. The family’s success in coping with stressors is an external rather than internal context. REF: p. 17

OBJ: Nursing Process: Diagnosis

.T HE

DIF: Cognitive Level: Comprehension

6. When planning interventions for diverse families, you realize that acceptance of the

interventions will be most influenced by which factor? Educational achievement Income level Subcultural group Individual beliefs

a. b. c. d.

ANS: D

The patient’s culture, beliefs, and values are ultimately the key to acceptance of health care interventions. However, these beliefs may be influenced by factors such as educational level, income level, and ethnic background. Educational achievement, income level, and subcultural group are all important factors. However, the nurse must understand that a woman’s concerns from her own point of view will have the most influence on her adherence to interventions. DIF: Cognitive Level: Application

REF: p. 20

OBJ: Nursing Process: Planning

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7. Which would be considered when viewing the family through a phenomenological lens? a. Professional relationships b. Experience of childbirth c. Cultural meanings and significance d. Health promotion within an environmental context ANS: B

REF: p. 20

Y. C

DIF: Cognitive Level: Application OBJ: Nursing Process: Assessment

The phenomenological lens cues the nurse to learn more about the woman’s and family members’ experiences of health and illness. Professional relationships would be considered when using the sociopolitical lens. The spiritual lens considers cultural meanings and significance. The socio-environmental perspective encourages an understanding of health and health promotion that focuses on the family in their environmental context.

8. Upon arriving for a follow-up postpartum and newborn home visit, the woman’s family

N G M AS TE R

members are present. What should the nurse do? a. Observe the family members’ interactions with the newborn and with one another. b. Ask the woman to meet with her and the baby alone. c. Do a brief assessment of all family members present. d. Reschedule the visit for another time so that the mother and infant can be assessed privately. ANS: A

The nurse should introduce herself to the patient and the other family members present. Family members in the home may be providing care and assistance to the mother and infant. However, this care may not be based on sound health practices. Nurses should take the opportunity to dispel myths while family members are present. The responsibility of the home care maternal-child nurse is to provide care to the new postpartum mother and her infant, not to briefly assess all family members. The nurse can politely ask about the other people in the home and their relationships with the woman. Unless an indication is given that the woman would prefer privacy, the visit may continue.

.T HE

DIF: Cognitive Level: Application OBJ: Nursing Process: Assessment

REF: p. 17

9. Canada’s official multiculturalism policy (1971) confirmed which statement? a. The rights of African-Canadian people b. The value and dignity of lesbian and gay people c. Canada’s two official languages: French and English d. Preservation of dignity among lone-parent families

ANS: C

Canada’s official multiculturalism policy (1971) confirmed Canada’s two official languages: French and English. The rights of people identified included Indigenous people. The value and dignity of all Canadians was confirmed, with no one group singled out. There was no mention of lone-parent families in this policy. DIF: Cognitive Level: Comprehension

REF: p. 20

OBJ: Nursing Process: Planning

10. Which characteristic is reflective of cultural safety?

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a. b. c. d.

Maximizing respectful relationships with diverse populations Examining one's own values and beliefs of various cultures Process and outcome to promote greater health equity Valuing diversity and inclusivity

ANS: C

REF: p. 21

Y. C

DIF: Cognitive Level: Comprehension OBJ: Nursing Process: Assessment

Cultural safety is both a process and an outcome whose goal is to promote greater health equity. Maximizing respectful relationships with diverse populations is part of cultural competence. Examining one's own values and beliefs is related to personal reflections and is not part of cultural safety. Diversity and inclusivity are values that underpin cultural competence.

N G M AS TE R

11. Why is the patient’s family important to the maternity perinatal and pediatric nurse? a. They provide financial support for the mother. b. The nurse will know which family member makes the decisions. c. They will provide care for the new mother when the nurse is unable to make a

home visit.

d. The family culture will influence nursing care decisions. ANS: D

Family culture influences a family’s feelings and attitudes toward health, their children, and health care delivery systems and is thus important to the nurse. Providing financial support for the mother is not related to why the family is important to the nurse. The nurse will not necessarily know which family member(s) makes the decisions. Family care is not a substitute for a nursing home visit. REF: p. 22

OBJ: Nursing Process: Planning

DIF: Cognitive Level: Comprehension

12. Which type of family is reflected when a mother’s household consists of her husband, his

ANS: A

.T HE

mother, and another child? a. Extended b. Lone-parent c. Married-blended d. Trinuclear

An extended family or multigenerational family includes blood relatives living with the nuclear family. Both parents and a grandparent are living in this extended family. Married-blended refers to families reconstructed after divorce. A lone-parent family only includes one parent. Both parents and a grandparent make up an extended family. DIF: Cognitive Level: Application OBJ: Nursing Process: Assessment

REF: p. 15

13. Which type of family represents a traditional family structure in which male and female

partners and their children live as an independent unit? a. Extended family b. Binuclear family c. Nuclear family

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d. Blended family ANS: C

In contemporary society, the traditional nuclear-family structure actually represents a relatively small number of families. Extended families have additional blood relatives other than the parents. A binuclear family involves two households. A blended family is reconstructed after divorce and involves the merger of two families. REF: p. 15

DIF: Cognitive Level: Knowledge OBJ: Nursing Process: Assessment

Y. C

14. Which statement about family systems theory is inaccurate? a. A family system is part of a larger suprasystem. b. A family as a whole is equal to the sum of the individual members. c. A change in one family member affects all family members. d. Family members’ behaviours are understood from a view of circular causality.

N G M AS TE R

ANS: B

A family as a whole is greater than the sum of its parts. A family system is a part of a larger suprasystem. A change in one family member affects all family members. Family members’ behaviours are best understood from a view of circular rather than linear causality. DIF: Cognitive Level: Comprehension OBJ: Nursing Process: Assessment

REF: p. 17

generations? Genogram Family values construct Ecomap Human development wheel

a. b. c. d.

15. Which is a pictorial tool that can assist the nurse in assessing aspects of family life over

ANS: A

.T HE

A genogram depicts the relationships of family members over generations. Family values construct does not depict the relationship of family members over generations. An ecomap depicts family social relationships. The human development wheel does not depict the relationship of family members over generations. REF: p. 17

DIF: Cognitive Level: Knowledge OBJ: Nursing Process: Assessment

16. Which term describes the process by which people retain some of their own culture while

adopting the practices of the dominant society? a. Acculturation b. Assimilation c. Ethnocentrism d. Cultural relativism ANS: A

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