Chapter 1 Knowledge Questions for Nsg 211
1. How can interprofessional education improve client safety and quality of care?
2. What is a client safety bundle?
3. What are the Women’s Health and Perinatal Nursing Care Quality Measures?
4. How do labor, delivery, and recovery (LDR) rooms and labor, delivery, recovery, and postpartum (LDRP) rooms differ from birth centers and homes in their advantages and disadvantages?
5. What is the purpose of critical thinking?
6. How do “actual” client problems differ from “risk of” client problems?
7. How should goals and expected outcome criteria be stated?
8. Why are interventions sometimes difficult to implement? How can this difficulty be overcome?
Answers:
1. Interprofessional education can improve client safety and quality of care by promoting interprofessional team-based client care.
2. A safety bundle is a set of evidence-based practices performed together to improve client outcomes. Maternal safety bundles have been developed for mental health, including depression and anxiety, obstetric hemorrhage, severe hypertension in pregnancy, venous thromboembolism, safe reduction of primary cesarean birth, reduction of peripartum racial/ethnic disparities, support after a severe event, opioid use disorder, prevention of surgical site infections after gynecologic surgery, and enhanced recovery after surgery.
3. The Women’s Health Nursing Care Quality Measures include AWHONN’s practice standards, which provide standardization and a means to measure the quality of nursing care and practice briefs, which are quick reference guides providing standardized techniques with evidence-based rationales.
4. Birthing centers provide professional care during pregnancy and childbirth in a homelike environment for clients with low-risk pregnancies. They are associated with a nearby hospital to which the client can be transferred in case of unexpected complications. Although the home setting provides comfort and closeness, if transfer to a hospital for unexpected complications is necessary, the time may be an issue. In addition, the client and family must make arrangements for equipment and supplies needed for the birth and care for themselves and their new infant. Labor, delivery, and recovery (LDR) and labor, delivery, recovery, and postpartum (LDRP) rooms offer a comfortable setting that promotes family involvement for birth but within the hospital, where unexpected events and complications can be handled more easily.
5. The purpose of critical thinking is to help nurses make the best clinical judgments based on reason rather than preference or prejudice.
6. Actual client problems reflect health problems that can be validated by the presence of defining characteristics. Risk client problems indicate that risk factors are present that make the person vulnerable to the development of a particular problem that has not yet developed.
7. The terms goals and expected outcomes (outcome criteria) are often used interchangeably to describe desired endpoints of care, but they are different. Broad goals do not have the specific criteria of outcome criteria. Expected outcomes should (1) be stated in terms of the client, (2) be observable and measurable, (3) have a time frame, (4) be realistic, and (5) be worked out with the client and family.
8. Nursing interventions that are not specific and do not identify exactly what is to be done are difficult to implement. Clearly written interventions that provide detailed, objective instructions correct the problem./
CHAPTER 2 KNOWLEDGE QUESTIONS NSG 211
1. What are the characteristics of a functional family?
2. What factors may interfere with family functioning?
3. How can differences in Western and traditional cultural values be reconciled?
4. How can nurses show respect for traditional cultural practices that are harmless?
5. Why is it important for nurses to examine their own cultural beliefs and values?
6. What is meant by the term “cultural negotiation?”/
7. Why do many low-income clients delay seeking health care until the second or third trimester?
8. How do the attitudes of health care workers affect the care of poor families?
9. How do poverty and inadequate prenatal care affect infant mortality and morbidity?
10. What is the effect of health care disparities in the United StatesThese disparities often lead to unequal access to services, resulting in poorer health outcomes for marginalized populations. /
11. What is the effect of pregnancy on battering behavior?
12. How can nurses alter their practice to help prevent violence against clients?
13. What major cues indicate a client has been physically abused?
14. How can nurses intervene to help those being abused protect their safety if they choose to remain in a home situation with a partner who physically abuses them?
15. What are possible indicators that a client is a victim of human trafficking?
16. What is the difference between ethics and bioethics?
17. How do the deontologic, utilitarian, and human rights models differ within ethical theories?
18. When might two ethical principles conflict?
19. How do the steps of the nursing process relate to ethical decision-making?
21. What dangers are involved in punitive approaches to ethical and social problems?
22. What problems are involved in the use of advanced reproductive techniques?
23. Describe precautions the nurse should take to ensure the privacy of a person’s medical records.
24. How do state boards of nursing safeguard clients?
25. How do standards of care and agency policies influence judgments about malpractice?
26. How can standards of care be used to help defend malpractice claims against nurses?
27. What concerns do nurses have about unlicensed assistive personnel?
28. Why is early discharge a concern for nurses?
29. What are the important points in follow-up phone call?
ANSWERS:
1. Characteristics of a functional family include open communication, flexibility in role assignments, agreement of adults on the basic principles of parenting, and resiliency and adaptability.
2. Factors interfering with healthy family functioning include lack of financial resources, absence of adequate family support, birth of an infant who requires specialized care, presence of unhealthy habits such as substance abuse or impaired anger management, and the inability to make mature decisions that are necessary to provide care to an infant.
3. Differing cultures and lack of understanding of cultures (between the nurse and the childbearing family) may create difficulties related to communication style, decision making, eye contact, touch, spirituality and religiosity, and time orientation. Nurses should attempt to reconcile these differences by taking the opportunity to learn about the uniqueness of each client and the cultural beliefs and practices of the family.
4. Integrating harmless traditional cultural practices into the care of the childbearing client demonstrates respect for the culture./
5. Nurses should examine their own cultural values and beliefs to determine ways in which their beliefs may generate conflict with those who hold different cultural beliefs.
6. Cultural negotiation involves providing information while acknowledging that the client may hold views that are different from those of the nurse.
7. Poverty is the underlying factor that causes problems such as inadequate access to health care. The lack of access to health care includes the inability to pay for it, lack of transportation, lack of care for other children, inaccessible hours for appointments, and language barriers.
8. An important barrier to health care results from the unsympathetic attitude of some health care workers toward those who are unable to pay for prenatal care. Poor families may experience long delays, hurried examinations, rudeness, and arrogance from some members of the health care team. Staff may be overworked and frustrated with the workloads they carry. Clients may wait hours for an examination that lasts only a few minutes. Many never see the same health care provider more than once. These clients may not keep clinic appointments because they do not see the importance of the hurried, impersonal examinations.
9. Poverty is the underlying factor that causes problems such as inadequate access to health care. The lack of access to health care is a major reason for the large number of low-birth-weight infants and the high infant mortality rate.
10. Health care disparities in the United States across racial, geographic, socioeconomic status, age, and gender result in differences in the health outcomes for different groups of people.
11. Battering may start or become worse during pregnancy. The face, abdomen, genitalia, and breasts are frequent sites of injuries. Clients may start prenatal care late and miss appointments. They have an increased risk for uterine rupture, placental abruption, preterm birth, low-birth-weight infant, client and fetal death, sexually transmitted infections (STIs), and postpartum depression.
12. Nurses can examine their own biases to determine whether they accept a common myth that blames the victim. In addition, nurses can consciously practice in ways that empower clients and make it clear that they own their bodies and no one deserves to be beaten.
13. The physically abused person often appears hesitant, embarrassed, or evasive. Eye contact may be avoided, and they may appear ashamed, guilty, or frightened. Signs of present and past injury may be present, such as bruising, swelling, lacerations, burns, scars, and old fractures, as well as genital injuries.
14. Nurses can help establish short-term goals by helping the client acknowledge the abuse, develop a plan for protecting self and children, and identify community resources that provide protection.
15. Victims of human trafficking may have a pattern of “red flags.” One red flag may not be indicative of the client being a victim of trafficking in persons (TIP); the nurse should assess for the patterns of possible indicators, which include being accompanied by an individual who insists on answering all questions for the client; reluctance or inability of the victim to reveal their true situation; signs and symptoms of physical and mental abuse; evidence of being controlled; fearfulness; submissiveness; fear of authority figures; lack of identification documents; the client cannot communicate a physical residential address; inconsistencies in stories and/or histories; a client who is foreign or non-English-speaking; homelessness; a history of previous and/or current prostitution charges or sexual abuse; possession of expensive electronics, jewelry, and other luxury items; a history of substance abuse; markings on the body that appear to be branding; and a high number of sex partners relative to age.
16. Ethics examines conduct and distinctions between right and wrong to determine the best course of action. Bioethics applies specifically to the ethics of health care.
17. The deontologic model applies ethical principles to determine what is right. It does not vary the solution according to individual situations. The utilitarian model analyzes the benefits and burdens to determine a course of action that provides the greatest amount of good in a given situation. Belief that every client has basic human rights is the basis for the human rights model.
18. Ethical principles may conflict when the application of one principle violates another.
19. Assessment is used to gather data from all concerned persons. Ethical theories and principles are analyzed to determine whether an ethical dilemma exists. Planning involves identifying as many options as possible and choosing a solution. Interventions must be identified to implement the chosen solution, and the results are evaluated.
20. The belief that abortion is a private choice conflicts with the belief that abortion is taking a life.
21. Punitive approaches are against the ethical principles of autonomy, bodily integrity, and personal freedom. Although the intended plan may be to protect the fetus, such a plan can have unexpected outcomes, causing the client to avoid prenatal care or be dishonest with care providers, causing greater harm to the fetus.
22. Problems involved in the use of advanced reproductive techniques include high cost, low success rate, limitation to the affluent, control of unused embryos, and problem or unexpected pregnancy outcomes.
23. Log off of computer terminals when access is complete. Maintain secret identity codes that access private information. Direct reports to another professional should be done on a “need-to-know” basis rather than reporting to those who do not need to know. Verbal reports should be done in a private area. Care must be taken not to violate client or institutional confidentiality when having any discussion on the internet.
24. State boards of nursing administer the individual states’ nurse practice acts, which establish what the nurse is allowed and expected to do when practicing nursing in that state.
25. Standards of care and agency policies influence judgment about malpractice because they describe the level of care that can be expected from practitioners at the time of care.
26. Documentation that provides evidence that the standard of care has been maintained helps defend malpractice claims against nurses. Other actions that help defend malpractice claims include securing informed consent appropriately, acting appropriately as a client advocate in terms of taking a problem through the chain of command, and maintaining expertise.
27. Nurses, concerns about the use of unlicensed assistive personnel include the need to know the capabilities of each UAP and the need to supervise them sufficiently to ensure competence.
28. Short lengths of stay lead to concerns about the client’s ability to care for self and infant, potential complications that new parents may not identify, and the fact that parents will not have had time to absorb the necessary teaching. Follow-up phone calls help alleviate some concerns and identify some problems that develop after discharge. In nonmaternity medical situations, many older clients are often discharged early from the hospital. Because the cognitive abilities of a person may decline with advanced age, in these situations it is important to also provide teaching to the client’s care provider.
29. Facilities that use phone call follow-up should have regularly reviewed and updated protocols, good documentation forms, and specific instructions to the client about actions to take if further problems develop.
CHAPTER 3 KNOWLEDGE QUESTION NSG 211
1. What are the first noticeable changes of puberty in females and males?
2. What are basic differences between the mature male and female pelvis?
3. Why do males generally attain greater mature height than females?
4. What are common male and female secondary sex characteristics?
5. What is the vulva? Describe the location of each of these external female organs: labia majora and minora, clitoris, urinary meatus, vaginal introitus, hymen, and perineum.
6. What are the three divisions of the uterus? Where is the fundus located?
7. Describe the three myometrial layers of the uterus. What is the function of each layer?
8. How do the fallopian tubes propel the ovum from the ovary to the uterus? Why does the fertilized ovum first grow within the fallopian tube?
9. What are the two functions of the ovaries?5. What is the vulva? Describe the location of each of these external female organs: labia majora and minora, clitoris, urinary meatus, vaginal introitus, hymen, and perineum.
6. What are the three divisions of the uterus? Where is the fundus located?
7. Describe the three myometrial layers of the uterus. What is the function of each layer?
8. How do the fallopian tubes propel the ovum from the ovary to the uterus? Why does the fertilized ovum first grow within the fallopian tube?
9. What are the two functions of the ovaries?
/5. What is the vulva? Describe the location of each of these external female organs: labia majora and minora, clitoris, urinary meatus, vaginal introitus, hymen, and perineum.
6. What are the three divisions of the uterus? Where is the fundus located?
7. Describe the three myometrial layers of the uterus. What is the func