Test Bank for Maternal Child Nursing Care with Women's Health Companion

1. The clinic nurse is working with a mother and her 3-year-old child who have arrived for the child’s routine checkup. The nurse encourages the mother to return for her child’s measles-mumps-rubella immunization prior to the child’s entering school. This intervention is an example of what type of care? A. Mandatory health care B. Primary health prevention C. Secondary health prevention D. Tertiary health prevention ANS: B Of the three levels of prevention, the most desirable level is primary prevention. This encompasses health promotion and activities specifically meant to prevent disease from occurring—in this case, scheduling vaccinations. Secondary prevention refers to early identification and prompt treatment ofa health problem before it has an opportunity to spread or become more serious. Tertiary preventionis intended to restore health to the highest functioning state that is possible. Cognitive Level: Knowledge/Remembering Content Area: Pediatrics/Maternity Patient Needs: Health Promotion and Maintenance Integrated Process: Teaching/Learning Difficulty: Moderate PTS: 1 2. A nurse wishing to be an advocate for access to health care would most likely choose to participatein which of the following activities? A. Lobby for improved insurance access for all individuals, whether or not they are employed. B. Help establish fast-track or minor illness areas in local emergency rooms. C. Partner with medical centers to provide free services for low-income patients. D. Work with visiting nurses associations to create on-site clinics at day-care centers. ANS: A The biggest determinant of access to and quality of health care is one’s insurance status. The other actions might help improve access too, but would not be as effective as lobbying for improved abilityfor all individuals to get insurance. Cognitive Level: Application/Applying Content Area: Pediatrics/Maternity Patient Needs: Health Promotion and Maintenance Integrated Process: Nursing Process: Implementation Difficulty: Moderate PTS: 1 3. A nurse working with an after-school program is concerned about the lack of health literacy in the students’ parents. What action would best address this need? A. Conduct a monthly health-related seminar for parents. B. Investigate grants or other funding for a computer bank. C. Invite parents to healthy cooking demonstrations. D. Provide brochures on a variety of health problems. ANS: B The disparity between people who have access to technology and those who do not is directly relatedto health literacy and knowledge. The amount of information doubles every 6 years, so it is not possible to keep track of all the latest health news by accessing brochures, books, or periodicals. Having access to computers would greatly increase health literacy. The other options are certainlyhelpful, but would not be as far-reaching as providing access to online material. Cognitive Level: Analysis/Analyzing Content Area: Pediatrics/Maternity Patient Needs: Health Promotion and Maintenance Integrated Process: Teaching/Learning Difficulty: Difficult PTS: 1 4. A nurse is caring for a patient near the end of life whose wishes regarding care are not known. Thetwo sons disagreed with the two daughters about future medical plans for the patient during a recent family conference, and now the sons and daughters are not talking to one another. What action by thenurse would be best to help resolve this dilemma? A. Call the facility’s ethics committee and request a formal consultation. B. Have social work coordinate another family meeting to discuss the issue. C. Meet with the sons and daughters separately to discuss their wishes. D. Request that the physician tell the family what is in the patient’s best interests. ANS: A Ethical principles in health care are often in conflict, and it takes a skilled person to negotiate and mediate these situations. Ethics committees exist in most health-care facilities that are experienced inconfronting these difficult situations. The best response would be for the nurse to request a consultation from the ethics committee. Another family meeting may not work, as the family alreadydisagrees and tensions are high. The other options may be helpful, but are not as vital as a formal ethics committee consultation. Meeting privately with the sons and daughters might give the nurse some insight into their positions, but would not be as effective as utilizing the expertise on the committee. The physician should not decide what is in the patient’s best interests, as this is paternalistic and violates the principle of autonomy. Cognitive Level: Application/Applying Content Area: Pediatrics/Maternity Patient Needs: Safe and Effective Care Environment: Management of CareIntegrated Process: Communication and Documentation Difficulty: Moderate PTS: 1