Maternal Child Nursing Care 3rd CANADIAN Edition Keenan Lindsay Test Bank Chapter 01: Contemporary Perinatal and Pediatric Nursing in Canada Keenan-Lindsay: Perry’s Maternal Child Nursing Care in Canada, 3rd Edition MULTIPLE CHOICE 1. Which istrue re

Maternal Child Nursing Care 3rd CANADIAN Edition Keenan Lindsay Test Bank Chapter 01: Contemporary Perinatal and Pediatric Nursing in Canada Keenan-Lindsay: Perry’s Maternal Child Nursing Care in Canada, 3rd Edition MULTIPLE CHOICE 1. Which istrue regarding perinatal nurses? a. They provide care for only childbearing persons and babies. b. They require advanced practice education beyond an entry to practice degree. c. They work with patients and families from preconception throughout the child-bearing year. d. They provide care for families with children up to age 18 years. ANS: C Perinatal nurses are those nurses who work collaboratively with patients 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. DIF: Cognitive Level: Knowledge OBJ: 1 KEY: Nursing Process: N/A 2. Which istrue 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 patients 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 patients and familiesfrom 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. DIF: Cognitive Level: Knowledge OBJ: 1 KEY: Nursing Process: N/A 3. Which of the following would not be included in a discussion of the social determinants of health (SDOH)? a. Racism b. Daily exercise c. Chronic illness d. Presence of playgrounds ANS: C Chronic illness is not considered a SDOH. Racism, healthy behaviours (exercise) and healthy outdoor spaces (playgrounds) can all impact a person’s health. DIF: Cognitive Level: Application OBJ: 3 KEY: Nursing Process: Assessment 4. An Indigenous patient is pregnant with their first child. Which evidence-informed intervention is most important for the nurse to implement? a. Perform a nutrition assessment. b. Refer the patient to a social worker. c. Advise the patient to see an obstetrician, not a midwife. d. Explain to the patient the importance of keeping their prenatal care appointments. ANS: D Consistent prenatal care is associated with healthier infants. Nutritionalstatus 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 the pregnancy, but a referral to a social worker is not the most important aspect the nurse should address at this time. If the patient has identifiable high-risk problems, their health care may need to be provided by a physician. However, it cannot be assumed that all Indigenous patients have high-risk issues. In addition, advising the patient to see an obstetrician is not the most important aspect on which the nurse should focus at this time. DIF: Cognitive Level: Application OBJ: 1 KEY: Nursing Process: Planning 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. DIF: Cognitive Level: Application OBJ: 3 KEY: Nursing Process: Assessment 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: 3 KEY: Nursing Process: Assessment 7. What is the primary role of practicing nurses in the research process? a. Designing research studies b. Collecting data for other researchers c. Identifying areas for further research d. Seeking funding to support research studies ANS: C 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. DIF: Cognitive Level: Comprehension OBJ: 6 KEY: Nursing Process: Implementation 8. Which event shifted the focus of the Public Health Agency of Canada (PHAC) away from a population health and health promotion focus? a. Shift to home births b. Emergence of avian influenza c. United Nations Sustainable 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: 2 KEY: Nursing Process: N/A 9. The World Health Organization has identified which period as the most important for overall development throughout a person’s lifetime? a. Preconception b. Early childhood c. Young adult d. Adolescence ANS: B The period from prenatal development to eight years of age is critical for cognitive, social, emotional and physical development of the child. It is important to identify where children are most at risk for adversity and to intervene accordingly. DIF: Cognitive Level: Knowledge OBJ: N/A KEY: Nursing Process: Assessment 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. 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 honour the individual’s beliefs, values, and desires. Alternative and complementary therapies are part of an integrative approach to health care. DIF: Cognitive Level: Comprehension OBJ: 1 KEY: Nursing Process: Planning 11. Which of the following was highlighted in the Truth and Reconciliation Report (2015)? a. Increased transportation for Indigenous people to travel to tertiary care centresfor health care. b. Recognize the value of Indigenous healing practices and their use in the health care system. c. Treat health concerns of Indigenous people with Western ways of healing. d. Educate health care providers about Indigenous healing practicesto 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. DIF: Cognitive Level: Comprehension OBJ: 5 KEY: Nursing Process: Planning 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 ANS: B 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: 1 KEY: Nursing Process: Implementation 13. Which is the focus of the Code of Ethics for Registered Nurses? a. Collegiality b. Dependent role c. Evaluation 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, 2017) 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. DIF: Cognitive Level: Evaluation OBJ: 9 KEY: Nursing Process: N/A 14. Which reflects a future goal for perinatal and pediatric nursing? a. Limiting interprofessional 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 interprofessional 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. DIF: Cognitive Level: Knowledge OBJ: 1 KEY: Nursing Process: N/A 15. What isthe most important aspect of trauma-informed care? a. Providing counselling to patients who have be traumatized b. Minimize the potential for harm and re-traumatization c. Asking all patients about previous trauma in their life d. To provide a controlling environment for the patient ANS: B The focus of trauma and violence-informed approaches are to minimize the potential for harm and re-traumatization, and to enhance safety, control and resilience for all clients. While patients should be asked about trauma in their life this is not the most important point as not all patients will disclose the trauma. It is also important to enhance their own control over the situation and not for health care providers to control the situation. Providing counselling may be appropriate for some patients but it is not the focus of trauma-informed care. DIF: Cognitive Level: Application OBJ: 4 KEY: Nursing Process: Implementation 3 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 one-third of the total Indigenous population. ANS: D Indigenous children aged 14 and under made up one-third of the total Indigenous population. There are approximately 1.7 million Indigenous people in Canada and they comprise 4.9% of the total Canadian population. DIF: Cognitive Level: Knowledge OBJ: 5 KEY: Nursing Process: Assessment 17. Approximately what percentage of hospitalized patients experience an adverse event? a. 2.5% b. 5% c. 7.5% d. 10% ANS: C 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. DIF: Cognitive Level: Knowledge OBJ: N/A KEY: Nursing Process: N/A 18. Which organization offers certification for perinatal, general pediatrics, and pediatric intensive care nurses? a. SOGC b. CNA c. RNAO d. CAPWHN ANS: B The Canadian Nurses Association (CNA) offers specialty certification in many areas of nursing, including perinatal, general pediatrics, pediatric intensive care, and neonatal intensive care. The SOGC, RNAO, and CAPWHN develop guidelinesthat help guide nurses’ practice. DIF: Cognitive Level: Knowledge OBJ: 1 KEY: Nursing Process: N/A 19. Which is a United Nations Sustainable Development Goal? a. Safe, compassionate, and competent care b. Improve family health c. Reduce child morbidity d. Promote good health and well-being ANS: D One of the 17 United Nations Sustainable Development Goals is to promote good health and well-being. Safe, compassionate care is included in the Code of Ethics for RNs. DIF: Cognitive Level: Knowledge OBJ: 8 KEY: Nursing Process: N/A 20. Which statement is true of nursing care that is based on knowledge gained through various forms and sources of information? a. An outgrowth of telemedicine b. Known as evidence-informed practice c. Exclusive to maternity nursing practice d. At odds with the Cochrane Pregnancy and Childbirth Database ANS: B 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. DIF: Cognitive Level: Comprehension OBJ: 6 KEY: Nursing Process: Assessment 21. Which is a principle of the Canada Health Act? a. Justice b. Universality c. Health and well-being d. Informed decision making ANS: B 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. DIF: Cognitive Level: Knowledge OBJ: 2 KEY: Nursing Process: Assessment 22. Which is true of the Muskoka Declaration? a. It focused on a commitment to increase global health across the lifespan. b. It provided assistance in developing countriesto address health inequities with 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 Declaration, the Canadian government promised to assist developing countriesin addressing health inequities that affect mothers and infants. DIF: Cognitive Level: Knowledge OBJ: 2 KEY: Nursing Process: Assessment 23. Alternative and complementary therapies a. replace conventional Western modalities of treatment. b. are used by only a small number of Canadians. c. recognize the value of patients’ input into their health care. d. focus primarily on the disease an individual is experiencing. ANS: C Many popular alternative healing modalities offer human-centred care based on philosophies that recognize the value of the patient’s input and honour 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 patients 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. DIF: Cognitive Level: Comprehension OBJ: N/A KEY: Nursing Process: Planning 24. Through the use of social media technology, nurses can link with other nurses who may share similar interests, insights about practice, and advocate for patients. The most concerning pitfall for nurses using this technology is a. violation of patient privacy and confidentiality. b. institutions and colleagues may be cast in an unfavourable light. c. unintended negative consequences for using social media. d. lack of institutional policy governing online contact. ANS: A The most significant pitfall for nurses using this technology is the violation of patient privacy and confidentiality. Furthermore, institutions and colleagues can be cast in unfavourable lights with negative consequences for those posting information. Nursing students have been expelled from school and nurses have been fired or reprimanded by their Licensing Board for injudicious posts. All institutions should have policies guiding the use of social media, and nurses should be familiar with these guidelines. DIF: Cognitive Level: Analysis OBJ: 7 KEY: Nursing Process: N/A MULTIPLE RESPONSE 1. Which of the following social determinants of health (SDOH) are specifically related to Indigenous people? (Select all that apply.) a. Colonization b. Food security c. Working conditions d. Residential schools e. Biology and genetic endowment ANS: A, B, D All of the SDOH are important but the impact of colonization, food security, and residential schools are related specifically to Indigenous people’s health. DIF: Cognitive Level: Knowledge OBJ: 3 KEY: Nursing Process: Assessment 2. Which are included in the International Nurse Regulator Collaborative 6 P’s forsocial media use? (Select all that apply.) a. Positive b. Pause c. Probability d. Purpose e. Privacy f. Performance g. Professional ANS: A, B, E, G The 6 P’s ofsocial 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: 7 KEY: Nursing Process: N/A 3. When performing an assessment on a child, which aspects would be included to assess the impact of the social determinants of health (SDOH)? (Select all that apply.) a. History of symptoms b. Child’s age c. Exposure to toxins in environment d. Access to healthy foods e. Availability of community supports ANS: C, D, E Although the history of the symptoms and age of the child are important to assess they are not related to the SDOH. Access to healthy food, community support and exposure to toxins in environment are all SDOH that impact the health of all people. DIF: Cognitive Level: Knowledge OBJ: 3 KEY: Nursing Process: Assessment 4. What are some of the reasons that Indigenous people have poorer health outcomes? (Select all that apply.) a. Residential schools b. Use of traditional medicines c. Lack of understanding of modern medicine d. Remote geographical locations e. Fragmented healthcare funding ANS: A, D, E There are many reasons for poorer health outcomes for Indigenous people although their lack of understanding of modern medicine is not one. The use of traditional medicines may enhance the health of Indigenous people. Health care providers often have a lack of Indigenous traditional therapies that are used to enhance health. DIF: Cognitive Level: Comprehension OBJ: 5 KEY: Nursing Process Step: Assessment TRUE/FALSE 1. Prescription medications are considered part of Medicare in all provinces and territories in Canada. ANS: F Home care, extended care, pharmaceuticals, and dental care are not currently covered under Medicare provisions although different provinces do cover some of these items. DIF: Cognitive Level: Application OBJ: 2 KEY: Nursing Process: N/A 2. All patients should be cared for using a trauma-informed approach. ANS: T Not all patients will disclose trauma so it is important to treat everyone as if they have had some trauma in their life. The goal is to prevent re-traumatization. DIF: Cognitive Level: Application OBJ: 4 KEY: Nursing Process: Implementation Chapter 02: The Family and Culture Keenan-Lindsay: Perry’s Maternal Child Nursing Care in Canada, 3rd 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 describesthisfamily? a. Blended family b. Extended family c. Nuclear family d. Same-sex family ANS: A 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, living in the same household. A nuclear family is when male and female partners and their children live as an independent unit sharing roles, responsibilities, and economic resources. A same-sex family is a family with lesbian or gay partners who cohabit with or without children. DIF: Cognitive Level: Knowledge OBJ: 1 KEY: Nursing Process: Assessment 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 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. DIF: Cognitive Level: Knowledge OBJ: 1 KEY: Nursing Process: Planning 3. What is the focus of relational nursing? a. Therapeutic communication b. Provision of health services c. Health promotion d. Resiliency of the patient and their family ANS: C Relational nursing focuses on nurses being “in relation” with patients and family members, taking cues from the family and working together to identify capacity and adversity patterns and building knowledge together for health promotion. The focus of care has moved away from the provision of health service in order to focus on health promotion. The resiliency of the patient and their family is not the focus of relational nursing. Relational nursing practice is much more than just providing therapeutic communication. DIF: Cognitive Level: Knowledge OBJ: 4 KEY: Nursing Process: Implementation 4. A 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 attitudes c. Boundaries and channels d. Socialization processes ANS: B Values and attitudes about the appropriateness of the behaviour 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 attitudes 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. DIF: Cognitive Level: Comprehension OBJ: 4 KEY: Nursing Process: Planning 5. Using the family stress theory as an intervention approach for working with families experiencing parenting, a 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 elementsthat 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. DIF: Cognitive Level: Comprehension OBJ: 3 KEY: Nursing Process: Analysis 6. When planning interventions for diverse families, a nurse realizes that acceptance of the interventions will be most influenced by which factor? a. Educational achievement b. Income level c. Subcultural group d. Individual beliefs 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 patient’s concernsfrom their own point of view will have the most influence on their ability to carry out suggested interventions. DIF: Cognitive Level: Application OBJ: 6 KEY: Nursing Process: Planning 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 The phenomenological lens cues the nurse to learn more about the 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-ecological perspective encourages an understanding of health and health promotion that focuses on the family in their environmental context. DIF: Cognitive Level: Application OBJ: 4 KEY: Nursing Process: Assessment 8. Upon arriving for a follow-up postpartum and newborn home visit, the patient’s family members are present. Whatshould the nurse do? a. Observe the family members’ interactions with the newborn and with one another. b. Ask the patient to meet with the nurse and the baby alone. c. Do a brief assessment of all family members present. d. Reschedule the visit for another time so that the postpartum patient 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 postpartum patient and infant. Nurses should take the opportunity to provide health teaching while family members are present. The responsibility of the home care perinatal nurse is to provide care to the new postpartum patient and their 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 patient. Unless an indication is given that the patient would prefer privacy, the visit may continue. DIF: Cognitive Level: Application OBJ: 2 KEY: Nursing Process: Assessment 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: Knowledge OBJ: 6 KEY: Nursing Process: N/A 10. Which characteristic is reflective of cultural safety? a. Maximizing respectful relationships with diverse populations b. Examining one's own values and beliefs of various cultures c. Process and outcome to promote greater health equity d. Valuing diversity and inclusivity ANS: C Cultural safety is both a process and an outcome whose goal is to promote greater health equity. Maximizing respectful relationships with diverse populationsis part of cultural competence. Examining one’s own values and beliefs isrelated to personal reflections and is not part of cultural safety. Diversity and inclusivity are values that underpin cultural competence. DIF: Cognitive Level: Comprehension OBJ: 7 KEY: Nursing Process: N/A