Test Bank For Potter And Perry's Canadian Fundamentals Of Nursing, 7th Edition By Astle

TestBankforPotterandPerry'sCanadianFundamentalsofNursing,7thEditionbyAstleCanadianFundamentalsofNursing7thEditionPotterTestBankCanadianFundamentalsofNursing7thEditionPotterTestBankCanadianFundamentalsofNursing7thEditionPotterTestBankChapter01:HealthandWellnessPotteretal:CanadianFundamentalsofNursing,7thEditionMULTIPLECHOICE1.Thenurseisusingthepopulationhealthpromotionmodeltodevelopactionsforimprovinghealth.Afterasking,Onwhatshouldwetakeaction?;Howshouldwetakeaction?;andWhyshouldwetakeaction?thenursewillaskwhichofthefollowingquestions?a.Withwhomshouldweact?b.Whenshouldwetakeaction?c.Whichgovernmentshouldtakeaction?d.Whereshouldwefirstact?ANS:AThenextquestiontoaskwhenusingthepopulationhealthmodelapproachisWithwhomshouldweact?Theotherchoicesarenotquestionsincludedinthismodel.DIF:ApplyREF:13,Figure1-5OBJ:Contrastdistinguishingfeaturesofhealthpromotionanddiseaseprevention.TOP:ImplementationMSC:CPNRE:FoundationsofPractice2.TheprincipleHealthpromotionismultisectoralmeanswhichofthefollowing?a.Relationshipsbetweenindividual,social,andenvironmentalfactorsmustberecognized.b.Physical,mental,social,ecological,cultural,andspiritualaspectsofhealthmustberecognized.NRIGB.CMc.InordertochangeunhealthUyliSvingNanTdworkiOngconditions,areasotherthanhealthmustalsobeinvolved.d.Healthpromotioninvolvestheuseofknowledgefromdisciplinessuchassocial,economic,political,environmental,medical,andnursingsciences,aswellasfromfirst-handexperience.ANS:CThestatementHealthpromotionismultisectoralistheprincipleexplainedbythenecessitytoinvolveareasotherthanhealthinordertochangeunhealthylivingandworkingconditions.DIF:UnderstandREF:11OBJ:Contrastdistinguishingfeaturesofhealthpromotionanddiseaseprevention.TOP:PlanningMSC:CPNRE:FoundationsofPractice3.AccordingtotheWorldHealthOrganization,whatisthebestdescriptionofhealth?a.Simplytheabsenceofdisease.b.Involvingthetotalpersonandenvironment.c.Strictlypersonalinnature.d.Statusofpathologicalstate.ANS:BCanadianFundamentalsofNursing7thEditionPotterTestBankNRIGTheWHOdefineshealthastheextenttowhichanindividualorgroupisable,ontheonehand,torealizeaspirationsandsatisfyneeds;and,ontheotherhand,tochangeorcopewiththeenvironment.Healthis,therefore,seenasaresourceforeverydaylife,nottheobjectiveofliving;itisapositiveconceptemphasizingsocialandpersonalresources,aswellasphysicalcapacities.Nursesattitudestowardhealthandillnessshouldaccountforthetotalperson,aswellastheenvironmentinwhichthepersonlives.Peoplefreeofdiseasearenotequallyhealthy.Viewsofhealthhavebroadenedtoincludemental,social,andspiritualwell-being,aswellasafocusonhealthatfamilyandcommunitylevels.Conditionsoflife,ratherthanpathologicalstates,arewhatdeterminehealth.DIF:KnowledgeREF:2OBJ:Discusswaysthatdefinitionsofhealthhavebeenconceptualized.TOP:EvaluateMSC:CPNRE:FoundationsofPractice4.WhatprioritystrategyforhealthpromotioninCanadaisoptionalbutseenasimportanttoincorporateinnursingeducationcurricula?a.Knowledgeofdiseaseprevention.b.Strategiesforhealthpromotion.c.Policyadvocacy.d.Conceptsofdeterminantsofhealth.ANS:CIncreasingly,policyadvocacyisincorporatedintonursingrolestatementsandnursingeducationcurricula.Nursesshouldthinkaboutpoliciesthathavecontributedtohealthproblems,policiesthatwouldhelptoalleviatehealthproblems,andhownursingchampionspublicpolicies.Diseasepreventionisanintegralpartofnursingcurricula.Healthpromotionisafundamentalpartofnursingcurricula.B.CMUSNTODIF:UnderstandREF:11|12OBJ:Analyzehowthenatureandscopeofnursingpracticeareinfluencedbydifferentconceptualizationsofhealthandhealthdeterminants.TOP:PlanningMSC:CPNRE:FoundationsofPractice5.Whichofthefollowingisaprerequisiteforhealth,asidentifiedbytheOttawaCharterforHealthPromotion?a.Education.b.Socialsupport.c.Self-esteem.d.Physicalenvironment.ANS:AEducationisoneofthenineprerequisitesforhealththatwereidentifiedintheOttawaCharterforHealthPromotion.Lackofsocialsupportandlowself-esteemwereidentifiedasapsychosocialriskfactorsbyLabonte(1993).DangerousphysicalenvironmentswereidentifiedassocioenvironmentalriskfactorsbyLabonte(1993).DIF:UnderstandREF:4OBJ:DiscusscontributionsofthefollowingCanadianpublicationstoconceptualizationsofhealthandhealthdeterminants:LalondeReport,OttawaCharter,EppReport,StrategiesforPopulationHealth,JakartaDeclaration,BangkokCharter,TorontoCharter.TOP:PlanningMSC:CPNRE:FoundationsofPracticeCanadianFundamentalsofNursing7thEditionPotterTestBank6.ThedeterminantofhealthwiththegreatesteffectonthehealthofCanadiansiswhichofthefollowing?a.Education.b.Healthservices.c.Socialsupportnetworks.d.Incomeandsocialstatus.ANS:DIncome,incomedistribution,andsocialstatusarethedeterminantsofhealththatinfluencemostotherdeterminants.Someinvestigatorssuggestthatliteracyandeducationareimportantinfluencesonhealthstatusbecausetheyaffectmanyotherhealthdeterminants.Approximately25%ofapopulationshealthstatusisattributedtothequalityofitshealthcareservices.Socialsupportaffectshealth,healthbehaviours,andhealthcareutilizationbutisnotthemostinfluentialdeterminantofhealth.DIF:UnderstandREF:6OBJ:Discusskeyhealthdeterminantsandtheirinterrelationshipsandhowtheyinfluencehealth.TOP:PlanningMSC:CPNRE:FoundationsofPractice7.Aparaplegicpatientinthehospitalforanelectrolyteimbalanceisreceivingcareatwhichpreventionlevel?a.Primaryprevention.b.Secondaryprevention.c.Tertiaryprevention.d.Healthpromotion.ANS:BThesecondarypreventionlevNeUlfRocSuIseNsGonTeBar.lyCdeMtectionofdiseaseoncepathogenesishasoccurred,sothatprompttreatmentcanbeinitiatedtohaltdiseaseandlimitdisability.Theprimarypreventionlevelfocusesonhealthpromotion,specificprotectionmeasuressuchasimmunizations,andthereductionofriskfactorssuchassmoking.Thetertiarypreventionlevelfocusesonminimizingresidualdisability.DIF:ApplyREF:11OBJ:Contrastdistinguishingfeaturesofhealthpromotionanddiseaseprevention.TOP:ImplementationMSC:CPNRE:FoundationsofPractice8.Thenurseincorporateslevelsofpreventiononthebasisofpatientneedsandthetypeofnursingcareprovided.Whichofthefollowingisanexampleoftertiarylevelpreventivecaregiving?a.Teachingapatienthowtoirrigateanewtemporarycolostomy.b.Providingalessononhygieneforanelementaryschoolclass.c.Informingapatientthatimmunizationsforherinfantareavailablethroughthehealthdepartment.d.Arrangingforahospicenursetovisitwiththefamilyofapatientwithcancer.ANS:DCanadianFundamentalsofNursing7thEditionPotterTestBankNRIGB.CMTertiarypreventionisprovidedwhenadefectordisabilityispermanentandirreversible.Atthislevel,thehospicenurseaimstohelpthepatientandhisorherfamilytoachieveahighleveloffunction,despitethelimitationscausedbythepatientsillness.Teachingapatienthowtoirrigateanewcolostomyisanexampleofsecondaryprevention.Ifthecolostomyistobepermanent,caremaylatermovetothetertiarylevelofprevention.Providingalessononhygieneforanelementaryschoolclassandinformingapatientaboutavailableimmunizationsareexamplesofprimaryprevention.DIF:ApplyREF:11OBJ:Discussthethreelevelsofdiseaseprevention.TOP:ImplementationMSC:CPNRE:FoundationsofPractice9.Thenurseisworkingonacommitteetoevaluatetheneedforincreasingthelevelsoffluorideinthedrinkingwaterofthecommunity.Indoingso,thenurseisfosteringwhichconcept?a.Anticipatoryprevention.b.Primaryprevention.c.Secondaryprevention.d.Tertiaryprevention.ANS:BFluoridationofmunicipaldrinkingwaterandfortificationofhomogenizedmilkwithvitaminDareexamplesofprimarypreventionstrategies.Withactivestrategiesofhealthpromotion,individualsaremotivatedtoadoptspecifichealthprogramssuchasweightreductionandsmokingcessationprograms.Anticipatorypreventionisnotaknownconcept.Secondarypreventionpromotesearlydetectionofdisease(e.g.,screening).Tertiarypreventionactivitiesareinitiatedintheconvalescencephaseofdisease.DIF:ApplyREF:11OBJ:Discussthethreelevelsofdiseaseprevention.TOP:ImplementationUSNMTSC:CPONRE:FoundationsofPractice10.Thenurseisworkinginaclinicthatisdesignedtoprovidehealtheducationandimmunizations.Assuch,thisclinicfocusesonwhichtypeofprevention?a.Primaryprevention.b.Secondaryprevention.c.Tertiaryprevention.d.Diagnosisandpromptintervention.ANS:APrimarypreventionprecedesdiseaseordysfunctionandisappliedtopeopleconsideredphysicallyandemotionallyhealthy.Healthpromotionincludeshealtheducationprograms,immunizations,andphysicalandnutritionalfitnessactivities.Secondarypreventionfocusesonindividualswhoareexperiencinghealthproblemsorillnessesandwhoareatriskfordevelopingcomplicationsorworseningconditions;activitiesaredirectedatdiagnosisandpromptintervention.Tertiarypreventionisprovidedwhenadefectordisabilityispermanentandirreversible.Itinvolvesminimizingtheeffectsoflong-termdiseaseordisabilitythroughinterventionsdirectedatpreventingcomplicationsanddeterioration.DIF:UnderstandREF:11OBJ:Discussthethreelevelsofdiseaseprevention.TOP:ImplementationMSC:CPNRE:FoundationsofPractice11.Apatientisadmittedtoarehabilitationfacilityafterastroke.Thepatienthasright-sidedparalysisandisunabletospeak.Thepatientwillbereceivingphysiotherapyandspeechtherapy.Whataretheseexamplesof?a.Primaryprevention.b.Secondaryprevention.c.Tertiaryprevention.d.Healthpromotion.ANS:CCanadianFundamentalsofNursing7thEditionPotterTestBankTertiarypreventionisprovidedwhenadefectordisabilityispermanentandirreversible.Itinvolvesminimizingtheeffectsoflong-termdiseaseordisabilitythroughinterventionsdirectedatpreventingcomplicationsanddeterioration.Secondarypreventionfocusesonindividualswhoareexperiencinghealthproblemsorillnessesandwhoareatriskfordevelopingcomplicationsorworseningconditions.Activitiesaredirectedatdiagnosisandpromptintervention.Primarypreventionprecedesdiseaseordysfunctionandisappliedtopeopleconsideredphysicallyandemotionallyhealthy.Healthpromotionincludeshealtheducationprograms,immunizations,andphysicalandnutritionalfitnessactivities.DIF:ApplyREF:11OBJ:Discussthethreelevelsofdiseaseprevention.TOP:ImplementationMSC:CPNRE:FoundationsofPractice12.Thepatientisadmittedtotheemergencydepartmentofthelocalhospitalfromhomewithreportsofchestdiscomfortandshortnessofbreath.Sheisadministeredoxygenandbreathingtreatments,laboratorytestsandbloodgasmeasurementsareperformed,andelectrocardiographyisconducted.Whatlevelofpreventivecareisthispatientreceiving?a.Primaryprevention.b.Secondaryprevention.c.Tertiaryprevention.d.Healthpromotion.ANS:BSecondarypreventionfocusesonindividualswhoareexperiencinghealthproblemsorillnessesandwhoareatriskfordevelopingcomplicationsorworseningconditions.Activitiesaredirectedatdiagnosisandpromptintervention.Primarypreventionprecedesdiseaseordysfunctionandisappliedtopeopleconsideredphysicallyandemotionallyhealthy.Healthpromotionincludeshealtheducationprograms,immunizations,andphysicalandnutritionalfitnessactivities.Tertiarypreventionisprovidedwhenadefectordisabilityispermanentandirreversible.Itinvolvesminimizingtheeffectsoflong-termdiseaseordisabilitythroughinterventionsdirectedatpreventingcomplicationsanddeterioration.DIF:ApplyREF:11OBJ:Discussthethreelevelsofdiseaseprevention.TOP:ImplementationMSC:CPNRE:FoundationsofPractice13.Riskfactorscanbeplacedinthefollowinginterrelatedcategories:geneticandphysiologicalfactors,age,physicalenvironment,andlifestyle.Thepresenceofanyoftheseriskfactorsmeanswhichofthefollowing?a.Apersonwiththeriskfactorwillgetthedisease.b.Thechancesofgettingthediseaseareincreased.c.Thediseaseisguaranteednottodevelopiftheriskfactoriscontrolled.d.Riskmodificationwillhavenoeffectondiseaseprevention.CanadianFundamentalsofNursing7thEditionPotterTestBankANS:BThepresenceofriskfactorsdoesnotmeanthatadiseasewilldevelop,butriskfactorsincreasethechancesthattheindividualwillexperienceaparticulardiseaseordysfunction.Controlofriskfactorsdoesnotguaranteethatadiseasewillnotdevelop.However,riskfactoridentificationassistspatientsinvisualizingareasinlifethatcanbemodifiedoreveneliminatedtopromotewellnessandpreventillness.DIF:KnowledgeREF:3OBJ:Identifyfactorsthathaveledtoeachapproachtohealth.TOP:AssessmentMSC:CPNRE:FoundationsofPractice14.Sincetheearly1990s,whichgrouphashadthehighestamountofabsenteeismofallworkersinCanada?a.Whitecollarsectorworkers.b.Nurses.c.Workersinthetrades.d.Transportandequipmentoperators.ANS:BThereisconsiderableconcernregardingnegativeworkplaceconditionsinthehealthcaresector.Nurseshavehadthehighestorsecond-highestrateofabsenteeismofallworkersinCanadasincetheearly1990s.Ratesofabsenteeismforthewhitecollarsector,forworkersinthetrades,andfortransportandequipmentoperatorsarenotavailable.DIF:AnalyzeREF:7OBJ:Analyzehowthenatureandscopeofnursingpracticeareinfluencedbydifferentconceptualizationsofhealthandhealthdeterminants.TOP:PlanningMSC:CPNRE:FoundationsofNPUraRctiSceINGTB.COM15.WhichofthefollowingisatruestatementaboutnutritioninCanada,accordingtotheresearch?a.Canadianshaveincreasedtheirtotalfatandsaltconsumption.b.Canadiansreportthattheirchildreneattherecommendeddailynumberoffruitsandvegetables.c.Fiftypercentofchildrenaged2to17yearswereoverweightorobese.d.The2004CanadianCommunityHealthSurvey(CCHS)revealedthat40%ofadultCanadianswereobese(bodymassindexof30ormore)and50%wereoverweight.ANS:AOnequarterofCanadiansoverall,andonethirdofteenagersaged14to18years,reportedeatingatafast-foodoutletthepreviousday;suchfoodsarehighinfatsandsalts.Ofchildrenaged4to8,70%atefewerthantheminimumservingsoffruitsandvegetablesdaily.Ofchildrenaged2to17years,26%wereoverweightorobese,not50%.The2004CanadianCommunityHealthSurvey(CCHS)revealedthat23%ofadultCanadianswereobese(bodymassindexof30ormore),not40%,and36%wereoverweight,not50%.DIF:ApplyREF:8|9OBJ:Discusskeyhealthdeterminantsandtheirinterrelationshipsandhowtheyinfluencehealth.TOP:PlanningMSC:CPNRE:FoundationsofPracticeCanadianFundamentalsofNursing7thEditionPotterTestBank16.Oneofthefivehealthpromotionstrategies,asidentifiedbytheOttawaCharterforHealthPromotion,iswhichofthefollowing?a.Creatingsupportiveenvironments.b.Strengtheningeducationalopportunities.c.Developingamedicalapproach.d.Minimizingstressfulsituations.ANS:ACreatingsupportiveenvironmentsisoneofthefivebroadhealthpromotionstrategiesidentifiedbytheOttawaCharterforHealthPromotion.Theotherstrategiesarebuildinghealthypublicpolicy,creatingsupportiveenvironments,strengtheningcommunityaction,developingpersonalskills,andreorientinghealthservices.Strengtheningeducationalopportunities,Developingamedicalapproach,andMinimizingstressfulsituationsarenotamongthefivestrategies.DIF:ApplyREF:11|12OBJ:DiscusscontributionsofthefollowingCanadianpublicationstoconceptualizationsofhealthandhealthdeterminants:LalondeReport,OttawaCharter,EppReport,StrategiesforPopulationHealth,JakartaDeclaration,BangkokCharter,TorontoCharter.TOP:PlanningMSC:CPNRE:FoundationsofPractice17.Whichofthefollowingisanexampleoftertiaryprevention?a.Reductionofriskfactors,suchassmoking.b.Breastself-examinationandtesticularself-examination.c.Cardiacrehabilitationprograms.d.Bloodpressurescreeningtodetecthypertension.ANS:CNURSINGTB.COMTertiarypreventionactivitiesareprovidedintheconvalescencestageofdiseaseandaredirectedtowardminimizingresidualdisabilityandhelpingpeopleliveproductivelywithlimitations.Anexampleisacardiacrehabilitationprogramafteramyocardialinfarction.Breastself-examinationandtesticularself-examinationareexamplesofsecondaryprevention,asisbloodpressurescreeningtodetecthypertension.Reducingriskfactors,suchassmoking,isanexampleofprimaryprevention.DIF:UnderstandREF:11OBJ:Describethethreelevelsofdiseaseprevention.TOP:ImplementationMSC:CPNRE:FoundationsofPractice18.Whenthenurseiseducatinganadultpatientabouthealthpromotionactivities,whichofthefollowingisthemostimportantinternalpatientfactorforthenursetoconsider?a.Emotionalwellness.b.Developmentalstage.c.Professedspirituality.d.Levelsofeducationandliteracy.ANS:DCanadianFundamentalsofNursing7thEditionPotterTestBankUSNTOLevelsofeducationandliteracyareimportantinfluencestoconsiderwhenthenurseiseducatinganadultpatientconcerninghealthpromotionactivities.Literacycaninfluencehealthbothdirectly(e.g.,medicationuse,safetypractices)andindirectlythroughuseofservices,lifestyles,income,workenvironments,andstresslevels.Spiritualityisreflectedinhowapersonliveshisorherlife,includingthevaluesandbeliefsexercised,therelationshipsestablishedwithfamilyandfriends,andtheabilitytofindhopeandmeaninginlife;however,itisnotthemostimportantfactortoconsider.Thenursemustconsiderthepatientslevelofgrowthanddevelopmentwhenusingthepatientshealthbeliefsandpracticesasabasisforplanningcare,butthisisnotthemostimportantpatientfactortoconsider.Inthiscase,thepatientisattheadultdevelopmentalstage.Thepatientsemotionalwellnessdegreeofstress,depression,orfear,forexamplecaninfluencehealthbeliefsandpractices.Themannerinwhichapersonhandlesstressthroughouteachphaseoflifewillinfluencethewayheorshereactstoillness.However,thisisnotthebestavailableoption.DIF:AnalyzeREF:7OBJ:Discusskeyhealthdeterminantsandtheirinterrelationshipsandhowtheyinfluencehealth.TOP:ImplementationMSC:CPNRE:FoundationsofPractice19.Whendiscussingtheeffectofaknownriskfactoronapatientshealth,whatwouldthenursesay?a.Itdoesntmeanthatyoullgetthedisease,justthattheoddsaregreaterforyou.b.Nowthatyouknowthepossibilityisthere,youcantakestepstopreventit.c.Thisriskfactorcanbemanagedbymakingachangetoyourlifestyle.d.Youreluckybecauseyouhavethebenefitofbeingabletodosomethingaboutit.ANS:ANRIGB.CMThepresenceofriskfactorsdoesnotmeanthatadiseasewilldevelop,butriskfactorsincreasethechancesthattheindividualwillexperienceaparticulardiseaseordysfunction.Whilethestatement,Nowthatyouknowthepossibilityisthere,youcantakestepstopreventitisnotincorrect;itdoesnotaddresstheimpactoftheriskfactoronthepatientshealth.Itisnotalwaystruethatariskfactorcanbemanagedbymakinglifestylechanges.Thestrategyoftellingthepatientthatheorsheisluckyandhasthebenefitofbeingabletodosomethingaboutariskfactorminimizesthepatientsconcern,anddoesnotaddresstheeffectoftheriskfactoronthepatientshealth.DIF:ApplyREF:3OBJ:Describekeycharacteristicsofmedical,behavioural,andsocioenvironmentalapproachestohealth.TOP:ImplementationMSC:CPNRE:FoundationsofPractice20.Classificationsofhealthconceptualizationsoccurinwhichfollowingway?a.Healthasstabilityandactualization.b.Healthasindividualandwellness.c.Healthasuniversalandbeingfreefromillness.d.Healthasempowermentandabsenceofdisease.e.Healthandwellness.ANS:AHealthcanbeconceptualized(Pender,2006)inthreeways:healthasstability,asactualization,andhealthasbothofthesetogether.CanadianFundamentalsofNursing7thEditionPotterTestBankDIF:UnderstandREF:2OBJ:Discusswaysthatdefinitionsofhealthhavebeenconceptualized.TOP:AssessmentMSC:CPNRE:FoundationsofPracticeNURSINGTB.COMCanadianFundamentalsofNursing7thEditionPotterTestBankNRIGB.CMChapter02:TheCanadianHealthCareDeliverySystemPotteretal:CanadianFundamentalsofNursing,7thEditionMULTIPLECHOICE1.Whatisthefastestgrowingcomponentofthehealthcaresystem?a.Primarycare.b.Respitecare.c.Homecare.d.Palliativecare.ANS:CCanadianhealthcareisshiftingfromaninstitution-basedsystemtooneinwhichcommunitycareisplayingagreaterrole.Homecareisoneofthefastestgrowingcomponentsofthehealthcaresystem,partlybecausepatientsaresenthomefromhospitalsoonerthantheyusedtobe.Primarycare,respitecare,andpalliativecarearenotthefastestgrowingcomponentsofthehealthcaresystem.DIF:ApplyREF:27OBJ:Describefivelevelsofhealthcareandassociatedtypesofservices.TOP:AssessmentMSC:CPNRE:FoundationsofPractice2.WhichofthefollowingisacontributingfactortotheshortageofnursesinCanada?a.Increasedbirthrate,whichcreatesagreaterdemandfornursingservices.b.Newtechnology,whichreplacesnursesatthebedside.c.FewerpeoplewishingtopractiseasnursesbecausehealthtrendsarefocusingonnaturalandalternativetherUapieSs.NTOd.Retirementofalargepercentageofnurses.ANS:DThenursingworkforceiscurrentlychallengedbytheagingofworkers,highretirementrates,ethicalproblemsininternationalrecruitment,andlackoffull-timepositions.TheaverageageofRNsinCanadais44.6years;forLPNs,itis41,andforRPNs,itis46.Theagingpopulationiscreatingthegreaterdemandfornursingservices.Neitherthereplacementofnursesatthebedsidebynewtechnologynorthefocusofhealthtrendsonnaturalandalternativetherapiesisafactoridentifiedascontributingtotheshortageofnurses.DIF:ApplyREF:19,Box2-1OBJ:Discussprincipalfactorsinfluencinghealthcarereformandthecurrenthealthcaredeliverysystem.TOP:PlanningMSC:CPNRE:FoundationsofPractice3.AnurseworkingwithagroupofIndigenousparentsreferstoTreaty6,whichincludesaprovisionforhealthcareservicesandisoftenreferredtoaswhichofthefollowing?a.TheTruthandReconciliationAct.b.Themedicinechestclause.c.TheIndigenousbandagreements.d.Thelandandrelationshipunderstanding.ANS:BCanadianFundamentalsofNursing7thEditionPotterTestBankTreaty6wasoftenreferredtoasthemedicinechestclause,asitincludedaprovisionforhealthcareservicestobeprovidedtoIndigenouscommunities.TheIndianAct,theIndianbandagreements(signedwiththeBritishgovernmentbeforeConfederation),andrelationshipagreementsdonotrefertoTreaty6.DIF:UnderstandREF:20OBJ:IdentifyinitiativesrelatedtoenhancingqualityoftheCanadianhealthcaredeliverysystem.TOP:PlanningMSC:CPNRE:FoundationsofPractice4.Whichofthefollowingisanexampleofatruehealthpromotionserviceprovidedbyanurse?a.Animmunizationclinic.b.Adiabeticsupportgroup.c.Aprenatalnutritionclass.d.Asmokingcessationclinic.ANS:CCommunityclinicsofferprenatalnutritionclassesthatpromotethehealthofthewoman,fetus,andinfant.Buildinghealthypublicpolicy,creatingsupportiveenvironments,strengtheningcommunityaction,developingpersonalskills,andreorientinghealthservicesarepartofhealthpromotionservice.Animmunizationclinicisanexampleofdiseaseandinjuryprevention.Adiabeticsupportgroupmaybeanexampleofarehabilitationservice,tohelppatientsadapttoachangeinlifestyle.Asmokingcessationclinicmaybeofferedaspartofarehabilitationserviceorasadiseaseandinjurypreventionintervention.DIF:ApplyREF:28OBJ:Describefivelevelsofhealthcareandassociatedtypesofservices.TOP:ImplementationMSC:CPNRE:FoundationsofPracticeNURSINGTB.COM5.WhenconductingahealthcaresystemclassforimmigrantstoCanada,thenurseinformsthemthatthefederalgovernmentisresponsibleforwhichofthefollowing?a.Providinghealthcareinsuranceplans.b.Managingandplanninginsurablehealthservices.c.Deliveringhealthservicestotargetedgroups.d.Providinglong-termcareservices.ANS:CThefederalgovernmentischargedwithdelivering,orco-delivering,healthcareservicesfortargetedgroups.Healthcareinsuranceplans,managingandplanninginsurablehealthservices,andprovidinglong-termcareservicesarethejurisdictionoftheprovincesorterritories.DIF:ApplyREF:22OBJ:IdentifyanddefinetheprinciplesoftheCanadaHealthActandsignificantlegislationrelatedtotheCanadianhealthcaresystem.TOP:ImplementationMSC:CPNRE:FoundationsofPractice6.Thenurseinitiatedasupportgroupforadolescentparentsandisteachingthemaboutchlorinatedwaterandchildimmunizations,whichareallexamplesofwhichofthefollowing?a.Healthpromotion.b.Diseaseandinjuryprevention.c.Supportivecare.CanadianFundamentalsofNursing7thEditionPotterTestBankd.Rehabilitation.ANS:BDiseaseandinjurypreventionincludesillnessprevention(chlorinatedwater,immunizations)andsupportgroups.Healthpromotionservicesincludeantismokingservices,advocacyforhealthypublicpolicy,andprovisionofwellnessservices.Supportivecaredescribesservicesprovidedoveraprolongedperiodtopeoplewhoaredisabled,whohaveneverbeenabletofunctionindependently,orwhohaveaterminaldisease.Rehabilitation,suchasphysiotherapy,involvesrestoringoptimalhealth.DIF:ApplyREF:28OBJ:Describefivelevelsofhealthcareandassociatedtypesofservices.TOP:ImplementationMSC:CPNRE:FoundationsofPractice7.Primarycareisbestdescribedaswhichofthefollowing?a.Earlydetectionandroutinecare,aswellasprevention.b.Provisionofaspecializedmedicalservice.c.Treatmentofallpatientswithaminimumlevelofhealthinsurance.d.Provisionofmedicalservicesinapatientshome.ANS:APrimarycareisthefirstcontactofapatientwiththehealthcaresystemthatleadstoadecisionregardingacourseofactiontoresolveanyactualorpotentialhealthproblem.Thefocusisonearlydetectionandroutinecare,withemphasisoneducationtopreventrecurrences.Provisionofaspecializedmedicalservicebyaspecialistorthroughreferralisanexampleofsecondarycare.Nopatientisrefusedtreatmentonthebasisoflevelofinsurance.Medicalservicesprovidedinthepatientshome,althoughnotverycommon,couldbecategorizedunderprimarycarebutwouldnotbNesUtRdeSscIriNbeGpTriBm.arCyOcaMre.DIF:UnderstandREF:28OBJ:IdentifyvarioussettingsandmodelsofcaredeliveryintheCanadianhealthcaredeliverysystem.TOP:AssessmentMSC:CPNRE:FoundationsofPractice8.ApatientcomestotheambulatorycareclinicformanagementofachronicconditionandasksthenurseforanexplanationoftheMedicaresystem.Thenursesresponseisbasedontheknowledgethatitiswhichofthefollowing?a.Canadasnationalhealthinsurancesystem.b.Afee-for-serviceinsuranceplan.c.Aplaninwhichmoniesfromprovincialtaxesareusedfornursinghomes.d.Asocialinsuranceprogramforlow-incomeearners.ANS:AMedicareisakeyelementofCanadassocialsafetynet.ItisCanadasnationalhealthinsurancesystem,inwhichtaxesareusedtofinancemedicallynecessaryservicesforallcitizens,thusprovidingfreehealthcaretoall.Medicareisnotafee-for-serviceinsuranceplan,aplaninwhichmoniesfromprovincialtaxesareusedfornursinghomes,orasocialinsuranceprogramforlow-incomeearners.DIF:UnderstandREF:19OBJ:DiscusstheevolutionofCanada'ssocialsafetynetandMedicare.TOP:ImplementationMSC:CPNRE:FoundationsofPracticeCanadianFundamentalsofNursing7thEditionPotterTestBank9.Inteachingagroupofolderpersonsabouthealthcarespending,anursetellsthemthatabout14%oftheCanadianpopulationiswithintheiragegroupandthatthisgroupaccountsforwhatpercentageofhealthcarespending?a.25%.b.35%.c.45%.d.55%.ANS:COlderpersonsaccountfor45%ofhealthcarespendinginCanada,not25%,not35%,andnot55%.DIF:ApplyREF:22OBJ:Discussprincipalfactorsinfluencinghealthcarereformandthecurrenthealthcaredeliverysystem.TOP:ImplementationMSC:CPNRE:FoundationsofPractice10.TowhomdotheprinciplesoftheCanadaHealthActof1984apply?a.MembersoftheCanadianArmedForces.b.InsuredresidentsofCanada.c.Inmatesoffederalpenitentiaries.d.RoyalCanadianMountedPolice(RCMP).ANS:BTheprinciplesoftheCanadaHealthActapplytoallinsuredresidentsofCanada(i.e.,eligibleresidents)butexcludemembersoftheCanadianArmedForces,RoyalCanadianMountedPolice(RCMP),eligibleveterans,inmatesoffederalpenitentiaries,andsomerefugeeclaimants.NURSINGTB.COMDIF:UnderstandREF:20OBJ:IdentifyanddefinetheprinciplesoftheCanadaHealthActandsignificantlegislationrelatedtotheCanadianhealthcaresystem.TOP:AssessmentMSC:CPNRE:FoundationsofPractice11.Whenamotherbringsherchildtobeseeninanurse-managedsetting,overconcernsthatherchildsrashcouldbemeasles,whattypeofcareisrendered?a.Respitecare.b.Primarycare.c.Supportivecare.d.Secondarycare.ANS:BPrimarycarefocusesonearlydetectionandroutinecareandcanbeofferedinnurse-managedclinics.Respitecareisacomponentofsupportivecare.Supportivecaredescribesservicesprovidedtodisabledandterminallyillpatientsoveraprolongedtimeperiod.Secondarycareistheprovisionofspecializedmedicalservicesbyaphysicianspecialistorthroughreferralfromaprimarycareprovider.DIF:UnderstandREF:28OBJ:Describefivelevelsofhealthcareandassociatedtypesofservices.TOP:AssessmentMSC:CPNRE:FoundationsofPracticeCanadianFundamentalsofNursing7thEditionPotterTestBankUSNT12.Whichofthefollowingisoneofthefourpillarsofprimaryhealthcare,asdescribedbytheNationalPrimaryHealthCareAwarenessStrategy(2006)?a.Teams.b.Universality.c.Healthpromotion.d.Immediateaccesstoprimarycare.ANS:ATeamsareoneofthefourpillars,alongwithaccess,information,andhealthyliving.Thefourpillarsdonotincludeuniversality,healthpromotion,orimmediateaccesstoprimaryhealthcare.DIF:UnderstandREF:25,Box2-3OBJ:IdentifyvarioussettingsandmodelsofcaredeliveryintheCanadianhealthcaredeliverysystem.TOP:PlanningMSC:CPNRE:FoundationsofPractice13.Mr.Jonesis72yearsold.Heisambulatoryandistobedischargedfromhospitalafteratotalhipreplacement,withrequirementsfordailyphysiotherapyandrespiratorytherapy.Whatisthemostappropriatefacilityreferralforthenursetomake?a.Arehabilitationcentre.b.Anassisted-livingfacility.c.Acommunityhealthclinic.d.Ahomecareagency.ANS:DAhomecareagencyprovideshealthservicestoindividualsandfamiliesintheirhomes.HomecarewascreatedtoprovideindividualizedcareforpeopleafterhospitaldischargebuthasincreasinglyincludedpatientNsinRaraIngeGofBag.esCfroMmveryyoungtoveryold;thosewithmental,physical,ordevelopmentalchallenges;andthoserequiringrecoverytoend-stagecare.Arehabilitationcentreisnotrequired,asMr.Jonesisambulatory.Assisted-livingfacilitiesarecommunity-basedresidentialfacilitiesinwhichadultsliveintheirownapartmentsandareprovidedwitharangeofsupportservicessuchasmeals,socialandrecreationalprograms,andlaundryAcommunityhealthclinicisthefirstpointofcontact,offeringarangeofprimaryservicesthatemphasizeprevention,healthpromotion,healtheducation,communitydevelopment,andpartnershipstodevelopahealthylocalcommunity.DIF:ApplyREF:26|27OBJ:IdentifyvarioussettingsandmodelsofcaredeliveryintheCanadianhealthcaredeliverysystem.TOP:ImplementationMSC:CPNRE:FoundationsofPractice14.Whatisanappropriatereferralforanolderpatientwhorequiressomeassistancewithdailyactivitieswithinapartiallyprotectiveenvironment?a.Respitecare.b.Rehabilitativecare.c.Assistedliving.d.Extendedcare.ANS:CCanadianFundamentalsofNursing7thEditionPotterTestBankSuchapatientrequiresassistedliving.Assistedlivingallowsadultstoreceivearangeofsupportservices,includingpersonalizedassistanceinachievingalevelofindependence.Personalassistanceservicesaredesignedtopromotemaximumdignityandindependence,includingmealpreparation,personalhygienepractice,mobility,andsocialization.Respitecareisaservicethatprovidesshort-termreliefforfamilycaregiversorpersonsprovidinghomecaretotheillordisabled.Rehabilitativecareprovidestherapyandtraining,withthegoalofdecreasingthepatientsdependenceoncare.Anextended,orlong-term,carefacilityprovidesintermediatemedical,nursing,orcustodialcareforpatientsrecoveringfromacuteorchronicillnessordisabilities.DIF:ApplyREF:26|27OBJ:IdentifyvarioussettingsandmodelsofcaredeliveryintheCanadianhealthcaredeliverysystem.TOP:ImplementationMSC:CPNRE:FoundationsofPractice15.TheCanadianPatientSafetyInstitute(CPSI)providesleadershipinbuildingandadvancingasaferhealthcaresystem.AccordingtotheCPSI,abouttwothirdsofpreventableincidentsthatoccurduringhospitalizationarerelatedtowhat?a.Procedures.b.Careormedication.c.Patientaccidents.d.Infectioncontrol.ANS:BAccordingtotheCPSI,abouttwothirdsofpreventableeventsareeithercarerelatedormedicationrelated.Aboutonethirdoftheeventsarerelatedtoproceduresorpatientaccidents.InfectionsfallundNerthRecIategGoryBo.fcCareM.DIF:RememberREF:30USNTOOBJ:Discussprincipalfactorsinfluencinghealthcarereformandthecurrenthealthcaredeliverysystem.TOP:PlanningMSC:CPNRE:FoundationsofPractice16.Residentstemporarilyabsentfromtheirhomeprovincearetohavetheirincurredservicespaidforbythehomeprovince,inthesameamountthatwouldhavebeenpaidbythehomeprovince.ThisstatementreflectswhichprincipleoftheCanadaHealthAct(1984)?a.Portability.b.Universality.c.Publicadministration.d.Accessibility.ANS:AThisstatementdescribestheprincipleofportability.Theprincipleofuniversalitymeansthat100%oftheinsuredpersonsofaprovincearecoveredbythehealthcareplan.Theprincipleofpublicadministrationmeansthatthehealthcareplanmustbeadministeredandoperatedonanonprofitbasisbyapublicauthority,responsibletotheprovincialgovernmentandsubjecttoauditsofitsaccountsandfinancingtransactions.Theprincipleofaccessibilitymeansthatthehealthcareplanofaprovincemustprovidefor(1)insuredhealthservicesandreasonableaccessbyinsuredpersons;(2)reasonablecompensationtophysiciansanddentistsforallinsuredservicesrendered;and(3)paymentstohospitalsinregardtothecostofinsuredhealthservices.CanadianFundamentalsofNursing7thEditionPotterTestBankDIF:UnderstandREF:21,Table2-1OBJ:IdentifyanddefinetheprinciplesoftheCanadaHealthActandsignificantlegislationrelatedtotheCanadianhealthcaresystem.TOP:PlanningMSC:CPNRE:FoundationsofPractice17.ACanadianisexplainingtoanon-CanadianfriendthebenefitsoftheCanadianhealthcaresystem.TheCanadiandiscussesbeingabletoaccesssurgicalormedicalhospital-basedcarewithnoout-of-pocketcharges;mentionsthatifheorshemusttravelforworktoanotherprovincewithinCanada,heorsheisstillcovered;andexplainsthatitiseasytoaccesshealthcareservicesandthecarereceivedisrespectfulandembracesdiversity.WhichofthefollowingprinciplesoftheCanadaHealthActof1984istheCanadiandescribing?a.Universality,publicadministration,andprotection.b.Comprehensiveness,publicadministration,andportability.c.Universality,accessibility,andprotection.d.Accessibility,portability,andcomprehensiveness.ANS:DTheprinciplesdescribedbytheCanadianincludeuniversality,portability,accessibility,andcomprehensiveness.Theabilitytoaccesssurgicalormedicalhospital-basedcarewithnoout-of-pocketchargesreferstocomprehensiveness;theabilitytoreasonablyaccesshealthcareservicesreferstoaccessibility;andrespectfulcarethatembracesdiversityreferstouniversality.Portabilityreferstotheabilitytoaccesshealthcareservicesinanotherprovince.PublicadministrationisanotherprincipleoftheCanadianHealthActbutisnotdescribedbytheCanadian.ProtectionisnotaprincipleoftheCanadianHealthAct.DIF:ApplyREF:21OBJ:IdentifyanddefinetheprinciplesoftheCanadaHealthActandsignificantlegislationrelatedtotheCanadianhealthcaresystemN.URSINGTTOBP:.CAsOseMssmentMSC:CPNRE:FoundationsofPracticeCanadianFundamentalsofNursing7thEditionPotterTestBankChapter03:TheDevelopmentofNursinginCanadaPotteretal:CanadianFundamentalsofNursing,7thEditionMULTIPLECHOICE1.WhichofthefollowingwasthemainhealthreasonwhyhealthcarefacilitiesintheBritishcolonieswereincreasinglyneededduringtheeighteenth-centuryBritishregime?a.Scurvy.b.Bubonicplague.c.Increasedbirthrate.d.Infectiousdiseases.ANS:DInfectiousdiseasescarriedbyimmigrantsandtravellersspreadrapidlyintheBritishcolonies,creatinganeedformorehealthcarefacilities.Neitherscurvynorbubonicplaguewasthemainhealthreasonforincreasedhealthcarefacilities.Theincreasingbirthratehadnothingtodowithanincreasedneedforhealthcarefacilities.DIF:UnderstandREF:35|36OBJ:DiscussthehistoricaldevelopmentofnursingpracticeinCanada.TOP:AssessmentMSC:CPNRE:FoundationsofPractice2.Whatwasthemaindrivingforceforthemodernizationofnursing?a.Globalization.b.TheCrimeanWar.c.Missionarynursing.NRIGB.CMd.ThewomenssuffragemovUemSent.NTOANS:AThehistoryofmodernnursing,atitsheart,isastoryofglobalization.Nursesoftentravelledacrossgeographicandnationalboundariestobringnursingserviceandtrainingtocommunitiesinneed.AlthoughFlorenceNightingalereducedmorbidityandmortalityratesbyapplyingmodernprinciplesofcleanlinessandcomfortduringtheCrimeanWar,thiswarwasnotthemaindrivingforceforthemodernizationofnursing.Missionarynursingwastheresultofaseriesofsociopoliticalfactorsconvergingatthesametimebutwasnotthemaindrivingforceforthemodernizationofnursing.Thewomenssuffragemovementwasalsonotthemaindrivingforceforthemodernizationofnursing,althoughnursingdidbecomeaninstrumentofwomensemancipationfromrestrictionsofmiddle-classwomen.DIF:UnderstandREF:37OBJ:DiscussthehistoricaldevelopmentofnursingpracticeinCanada.TOP:PlanningMSC:CPNRE:FoundationsofPractice3.WheredidthefirsthospitaldiplomaschoolinCanadaopen?a.Manitoba.b.Ontario.c.Quebec.d.Newfoundland.ANS:BCanadianFundamentalsofNursing7thEditionPotterTestBankOntarioopenedthefirsthospitaldiplomaschoolinCanada,theSt.CatharinesTrainingSchool,in1874,atSt.CatharinesGeneralandMarineHospital.Manitoba,Quebec,andNewfoundlandopenedtheirslater.DIF:RememberREF:39OBJ:DiscussthehistoricaldevelopmentofnursingeducationinCanada.TOP:PlanningMSC:CPNRE:FoundationsofPractice4.WhatpromptedtheformationoftheVictorianOrderofNurses(VON)in1898?a.Fluepidemic.b.Measlesoutbreak.c.Labourandbirthdifficulties.d.Warcasualties.ANS:CLadyIshbelAberdeen,wifeofthegovernorgeneralofCanada,conceivedoftheideaofestablishingtheVONafterlearningtheplightofwomeninwesternCanadawhohadtogivebirthinremotelocationswithnoassistance.Afluepidemic,ameaslesoutbreak,andwarcasualtieswerenotthehealthcareissueresponsibleforthecreationoftheVON.DIF:UnderstandREF:39OBJ:Discussthehistoricaldevelopmentofprofessionalnursing.TOP:PlanningMSC:CPNRE:FoundationsofPractice5.WhichwasthefirstprovinceinCanadatogainlegislationrelatedtonursingregistration?a.Ontario.b.NovaScotia.c.NewBrunswick.d.BritishColumbia.ANS:BNURSINGTB.COMNovaScotiawasthefirstprovinceinCanadatopasslegislationrelatedtonursingregistration,withthepassingofavoluntaryregistrationactin1910.Ontario,NewBrunswick,andBritishColumbiapassedlegislationrelatedtonursingregistrationlater.DIF:UnderstandREF:40OBJ:Discussthehistoricaldevelopmentofprofessionalnursing.TOP:PlanningMSC:CPNRE:FoundationsofPractice6.WhatisafundamentalandguidingprincipleofFrench-Canadianhospitalsthatsurvivedintothetwentiethcentury?a.Universalprecautionsarefundamentalinpreventingnosocomialinfections.b.Nursingisprimarilyfocusedonthetertiarylevelofcare.c.Nursesneedtorecognizetheeffectoftheirhealth,values,andbeliefsonpractice.d.Careisaccessibletoall,regardlessoftheirbackground,statusinlife,orabilitytopay.ANS:DCanadianFundamentalsofNursing7thEditionPotterTestBankAfundamentalandguidingprincipleoftheFrench-Canadianhospitalsthatsurvivedlargelyintactintothetwentiethcenturywasthatcareisavailabletoallpeople,regardlessofbackground,statusinlife,orabilitytopay.Thiscontinuestobeaprincipleforwhichnurses,throughtheirprofessionalorganizations,havearguedfordeterminedlyinnationaldebatesonthenatureandcontinuingdirectionofCanadasnationalhealthcareinsuranceprogram.ThestatementUniversalprecautionsarefundamentalinpreventingnosocomialinfectionswasnotaguidingprincipleofFrench-Canadianhospitals.ThestatementsNursingisprimarilyfocusedonthetertiarylevelofcareandNursesneedtorecognizetheeffectoftheirhealth,values,andbeliefsonpracticedonotreflectacontributionfromthepasttocurrentnursingbeliefsandpractices.DIF:ApplyREF:45OBJ:DiscussthehistoricaldevelopmentofnursingpracticeinCanada.TOP:ImplementationMSC:CPNRE:FoundationsofPractice7.Whatistheprimarymotivatorofnursing?a.Money.b.Altruism.c.Self-efficacy.d.Acurativemodelofcare.ANS:BNursingispracticalandtheoretical,ismotivatedbyaltruism,andisbasedonprofessionalandethicalstandards.Money,self-efficacy,andthecurativemodelofcarearenottheprimarymotivatorsofnursing.DIF:ApplyREF:45OBJ:DiscussthehistoricaldeNveUloRpmSeIntNoGfnTuBrs.inCgpOraMcticeinCanada.TOP:AssessmentMSC:CPNRE:FoundationsofPractice8.TheproportionofmalenursesinCanadain2012was,incomparisonwithintheyear2000.a.2.1%;0.9%.b.6.4%;4.7%.c.12.4%;8.6%.d.18.2%;12.4%.ANS:BAccordingtothemostrecentstatistics,theproportionofmalenursesasonly6.4%ofthetotalnursepopulationin2012,aslightincreaseoverthe4.7%itrepresentedin2000.DIF:UnderstandREF:39OBJ:DiscussthehistoricaldevelopmentofnursingpracticeinCanada.TOP:AssessmentMSC:CPNRE:FoundationsofPractice9.TheCanadianNursesAssociation(CNA)hasmadeavailabletoallnursesacrossCanadaanursingportaldatabase;whatisitcalled?a.TheNurse.b.NurseOne.c.NursingInitiatives.d.Evidence-informedNursing.CanadianFundamentalsofNursing7thEditionPotterTestBankANS:BNurseOneistheCNAsnursingportaldatabaseandisavailabletoallnursesacrossCanada.TheNurse,NursingInitiatives,andEvidence-basedNursingarenotnamesbywhichtheCNAsnursingportaldatabaseisknown.DIF:ApplyREF:43OBJ:DiscussthehistoricaldevelopmentofnursingpracticeinCanada.TOP:PlanningMSC:CPNRE:FoundationsofPractice10.WhowasthemostinfluentialwomanintheadvancementofnursinginCanada?a.MarieRolletHbert.b.FlorenceNightingale.c.MaryAgnesSnively.d.JeanneMance.ANS:DJeanneMance(1606-1673)cametoVilleMarie(NewFrance)in1642.AswellasfoundingandmanagingHtel-Dieu,ManceassistedMaisonneuveinrunningthecolonyasconfidant,advisor,andaccountant.SheishailedasafounderofthecityofMontreal.Today,theCNAawardsitshighesthonourinthenameofthiscourageouspioneer.MarieRolletHbert(1580-1649)wasthefirstlaywomantoprovidenursingcareinNewFrancein1617.FlorenceNightingale(1820-1910),whoisconsideredthefounderofmodernnursing,wasanineteenth-centuryBritishnurse.MaryAgnesSnively(1847-1933)wasateacherbeforebecominganurse.UpongraduationfromtheschoolofnursingatBellevueHospitalinNewYork,shebecamesuperintendentofnursesatTorontoGeneralHospital.TorontoGeneralHospitalsubsequentlybecamethelargestschoolofnursinginCanadaandamodeltoothers.DIF:RememberREF:36N,BUoRxS3-I1NGTB.COMOBJ:Discussthehistoricaldevelopmentofprofessionalnursing.TOP:PlanningMSC:CPNRE:FoundationsofPractice11.Whatistheprimarypurposeoflicensurelawsforthenursingprofession?a.Toprotectthepublicagainstunqualifiedandincompetentpractitioners.b.ToenhancethequalityofnursingcareandimproveCanadianshealthoutcomes.c.Toensurethatnursesdemonstrateknowledgeandskillsinavarietyofprofessionalroles.d.Toprovideanopportunityforpractitionerstovalidatetheirexpertiseinaspecialty.ANS:ALicensurelawsaredesignedtoprotectthepublicagainstunqualifiedandincompetentpractitioners.Becauseconstitutionalresponsibilityforeducationandhealthfallsunderthepurviewoftheprovincesandterritories,eachhasanursingpracticeacttoregulatethelicensureandpracticeofnursing.TheotherstatementsToenhancethequalityofnursingcareandimproveCanadianshealthoutcomes;Toensurethatnursesdemonstrateknowledgeandskillsinavarietyofprofessionalroles;andToprovideanopportunityforpractitionerstovalidatetheirexpertiseinaspecialtydonotreflecttheprimarypurposeoflicensurelaws.DIF:ApplyREF:40|41OBJ:Discussthehistoricaldevelopmentofprofessionalnursing.TOP:ImplementationMSC:CPNRE:FoundationsofPracticeCanadianFundamentalsofNursing7thEditionPotterTestBank12.WheredidthetraditionsofgoodnursingpracticethatanchornursinginCanadaoriginate?a.England.b.UnitedStates.c.Germany.d.NewFrance.ANS:DNursinginCanadaisrootedinthetraditionsofgoodnursingpracticethatdevelopedinNewFrance,notinEngland,theUnitedStates,orGermany.DIF:UnderstandREF:45OBJ:Discussthehistoricaldevelopmentofprofessionalnursing.TOP:AssessmentMSC:CPNRE:FoundationsofPracticeNURSINGTB.COMCanadianFundamentalsofNursing7thEditionPotterTestBankNRIGB.CChapter04:CommunityHealthNursingPracticePotteretal:CanadianFundamentalsofNursing,7thEditionMULTIPLECHOICE1.Howdoespublichealthnursingdifferfromcommunityhealthnursing?a.Publichealthnursesfocusonindividualsandfamilies.b.Publichealthnursesunderstandtheneedsofapopulation.c.Publichealthnursesignorepoliticalprocesses.d.Publichealthnursesconsidertheindividualasonememberofagroup.ANS:BPublichealthnursingrequiresunderstandingtheneedsofapopulation.Apublichealthnurseunderstandsfactorsthatinfluencethepoliticalprocessesusedtoaffectpublicpolicy.Theprimaryfocusofcommunityhealthnursingisthecareofindividuals,families,andgroupsinthecommunity.Byfocusingonsubpopulations,thecommunityhealthnursecaresforthecommunityasawholeandconsiderstheindividualorfamilyasonlyonememberofagroupatrisk.DIF:UnderstandREF:51|52OBJ:Differentiatebetweenpublichealthnursingandhomehealthnursing.TOP:AssessmentMSC:CPNRE:FoundationsofPractice2.Whendiscussingsocialjustice,howdoesthenursedescribeit?a.Thefocusofsocialjusticeisondiseaseprevention.b.Socialjusticeisusedonlywithpeopleinprecarioussituations.c.SocialjusticeisrootedinsUocieStalrNespTonsibiliOtyandfairness.d.Socialjusticeisaprocesstoexercisetheabilitytoenhancecontrol.ANS:CSocialjusticeisrootedinnotionsofsocietal(social)responsibilityandfairness(justice).Socialjusticeistheequitable,orfair,distributionofsociety'sbenefits,responsibilitiesandtheirconsequences.Itfocusesontherelativepositionofsocialadvantageofoneindividualorsocialgroupinrelationtoothersinsocietyaswellasontherootcausesofinequitiesandwhatcanbedonetoeliminatethem(CNA,2010,p.13).Afocusofprimaryhealthcareisdiseaseprevention,notsocialjustice.Socialjusticeappliestoallpeople,notjustthoseinprecarioussituations,anditisnottobeusedasameanstoenhancecontrol.DIF:ApplyREF:49OBJ:Describethestandards,competencies,roles,andactivitiesimportantforsuccessincommunityhealthnursingpractice.TOP:ImplementationMSC:CPNRE:FoundationsofPractice3.Howdoesthecommunityhealthnursedifferfromthecommunity-basednurse?a.Thecommunityhealthnurseunderstandstheneedsofthepopulation.b.Thecommunityhealthnursefocusesontheneedsoftheindividual.c.Thecommunityhealthnurseisthefirstlevelofcontactinthehealthcaresystem.d.Thecommunityhealthnurseinvolvesthefamilyindecisionmaking.ANS:ACanadianFundamentalsofNursing7thEditionPotterTestBankThecommunityhealthnurseunderstandstheneedsofapopulationorcommunitythroughexperiencewithindividualfamiliesinworkingthroughtheirsocialandhealthcareissues.Thecommunity-basednurse(homehealthnurse)focusesontheneedsoftheindividualorfamily.Community-basednursingcentresfunctionasthefirstpointofcontactbetweenmembersofacommunityandthehealthcaresystem.Thecommunity-basednurselearnstopartnerwithpatientsandfamiliessothatultimatelythepatientandthefamilybecomeinvolvedinplanning,decisionmaking,implementation,andevaluationofhealthcareapproaches.DIF:UnderstandREF:50OBJ:Differentiatebetweenpublichealthnursingandhomehealthnursing.TOP:AssessmentMSC:CPNRE:FoundationsofPractice4.Thetypeofnursingthatfocusesonacuteandchroniccareofindividualsandfamilieswhileenhancingpatientautonomyisknownaswhatkindofnursing?a.Publichealthnursingb.Communityhealthnursingc.Homehealthnursingd.Community-focusednursingANS:CHomehealthnursinginvolvesacuteandchroniccareofindividualsandfamiliesandenhancestheircapacityforself-carewhilepromotingautonomyindecisionmaking.Publichealthnursingfocusesontheneedsofapopulation.Communityhealthnursinginvolvescaringforthecommunityasawhole,andtheindividualorthefamilyisconsideredonlyonememberofagroupatrisk.Community-focusednursingentailsanunderstandingoftheneedsofapopulationorcommunity.DIF:UnderstandREF:53NURSINGTB.COMOBJ:Differentiatebetweenpublichealthnursingandhomehealthnursing.TOP:AssessmentMSC:CPNRE:FoundationsofPractice5.Thecommunityhealthnurseisadministeringflushotstochildrenatalocalplayground.Indoingso,thenursesfocusisonwhat?a.Preventingindividualillness.b.Preventingcommunityoutbreakofillness.c.Preventingoutbreakofillnessinthefamily.d.Theneedsoftheindividualorfamily.ANS:BInadministeringflushotstomembersofasubpopulation,thecommunityhealthnurseattemptstopreventoutbreaksofillnessinthecommunityasawhole,notnecessarilyonpreventingillnessinormeetingtheneedsofaspecificindividualorfamily.DIF:UnderstandREF:50OBJ:Discusstherolesandfunctionsofthecommunityhealthnurse.TOP:ImplementationMSC:CPNRE:FoundationsofPractice6.Agroupofteenagegirlsisreceivingcounsellingrelatedtobirthcontrolanddiseaseprevention.Whydoesthecommunityhealthnurseprovidesuchcounselling?a.Focusingonsubpopulationsleadstocommunityhealth.b.Communityhealthnursingfocusesonindividualsonly.CanadianFundamentalsofNursing7thEditionPotterTestBankc.Communityhealthnursingexcludesdirectcaretosubpopulations.d.Thefocusisonpreventingillnessandunwantedpregnancy.ANS:AByfocusingonsubpopulations,thecommunityhealthnursecaresforthecommunityasawholeandconsiderstheindividualorthefamilyasonlyonememberofagroupatrisk.Incommunityhealthnursing,theprimaryfocusisonthehealthcareofindividuals,families,andgroupsinacommunity.Subpopulationsareoftenaclinicalfocus.Thegoalistoprotect,promote,ormaintainhealth,nottopreventillnessorunwantedpregnancy.DIF:UnderstandREF:50OBJ:Discusstherolesandfunctionsofthecommunityhealthnurse.TOP:ImplementationMSC:CPNRE:FoundationsofPractice7.Community-basednursingcaretakesplaceincommunitysettingssuchasthehomeoraclinic.Whyisthisanidealsetting?a.Toexertgreatercontroloverindividualorfamilydecisions.b.Toprovideservicesclosetowherepatientslive.c.Toisolatepatientsandpreventthespreadofdisease.d.Toreducetheneedforself-care.ANS:BTheidealistoprovidehealthcareservicesclosetowherepatientslive.Thislessensthecostofcare,aswellasthestressassociatedwiththefinancialburdensofcare.Thefocusisontheneedsoftheindividualorfamily,notoncontrollingtheirdecisionsormakingpatientsdependentonnurses.Thenurselearnstopartnerwithpatientsandfamiliessothattheyassumeresponsibilityfortheirhealthcaredecisions.ThisformofnursingisnotconcernedwithpreventingthespreadofNdUisReaSseI.NGTB.COMDIF:UnderstandREF:53OBJ:Discusstherolesandfunctionsofthecommunityhealthnurse.TOP:PlanningMSC:CPNRE:FoundationsofPractice8.Thecommunity-basednurseiscaringforapatientwhoishomeboundbyarthritisandchroniclungproblems.Thepatient,however,receivesmanyvisitorsfromtheneighbourhoodandfromformercoworkers,aswellasfrequentphonecallsfromextendedfamily.Whenconcernedabouthowthelargenumberofvisitorsmaybefatiguingthepatient,whatshouldthenursedo?a.Restrictthenumberofvisitorsforthepatientswelfare.b.Voiceconcernstothepatientandproceedaccordingtothepatientswishes.c.Allowvisitorstocomeandgofreelyastheyhavebeen.d.Createvisitinghourswhenthepatientmayseenon-familymembers.ANS:BThenurselearnstopartnerwithpatientsandfamilies,sothatultimatelythepatientandthefamilyassumeresponsibilityfortheirhealthcaredecisions,suchasthenumberandfrequencyofvisitsbyfamilyandfriends.DIF:ApplyREF:53OBJ:Discusstherolesandfunctionsofthecommunityhealthnurse.TOP:ImplementationMSC:CPNRE:FoundationsofPracticeCanadianFundamentalsofNursing7thEditionPotterTestBankNRIGB.CM9.Thestudentnurseistryingtodeterminewhattypeofnurseshewantstobeaftergraduation.Inclass,shestatesthatcommunityhealthnursingisprobablynotforherbecausecommunitynursingfocusesonlyoncommunityissuessuchaspreventingepidemics.Whatwouldbetheinstructorsmostappropriateresponse?a.Communityhealthnursingfocusesonthehealthcareofindividuals,families,andgroupsinacommunity.b.Communityhealthnursingfocusesonlyonthehealthofaspecificsubgroupinacommunity.c.Communityhealthnursingrequiresanadvancednursingdegree,andsothestudentneednotworry.d.Communityhealthnursingfocusesonlyonmaintainingthehealthofthecommunity.ANS:ATheprimaryfocusofcommunityhealthnursingisonthehealthcareofindividuals,families,andgroupsinacommunity.Communityhealthnursingincludespublichealthnursing,homehealth(community-based)nursing,andcommunitymentalhealthnursing,aswellasavarietyofotherareasofspecializationsuchasstreethealthandparishnursing.Thegoalsaretopreserve,protect,promote,andmaintainhealth.Notallhiringagenciesrequirecommunityhealthnursestohaveanadvanceddegree.DIF:ApplyREF:49|50OBJ:Describethestandards,competencies,roles,andactivitiesimportantforsuccessincommunityhealthnursingpractice.TOP:ImplementationMSC:CPNRE:FoundationsofPractice10.Vulnerablepopulationsincludepatientswhoaremorelikelythanotherstodevelophealthproblemsasaresultofwhat?USNTOa.Pregnancy.b.Nontraditionalhealingpractices.c.Exposuretoexcessiverisk.d.Unlimitedaccesstohealthcare.ANS:CVulnerablepopulationsarethosepatientswhoaremorelikelytodevelophealthproblemsasaresultofexposuretoexcessiverisk,whoexperiencebarrierswhentryingtoaccesshealthcareservices,orwhoaredependentonothersforcare.Pregnancyisnotacauseofvulnerability,exceptformotherswhoareadolescents,areaddictedtodrugs,orareathighriskforotherreasons.NontraditionalhealingpracticesarepartofthecultureofmanyimmigrantandIndigenouspopulations.Manyofthesehealingpracticesareeffectiveandcomplementtraditionaltherapies.DIF:KnowledgeREF:54OBJ:Explainthecharacteristicsofpatientsfromvulnerablepopulationsthatinfluenceanurse'sapproachtocare.TOP:AssessmentMSC:CPNRE:FoundationsofPractice11.Theinstructoristeachingstudentnursesaboutidentifyingmembersofvulnerablepopulationswhenthenursingstudentasks,Whyisitthatnotallpoorpeopleareconsideredmembersofvulnerablepopulations?Whatwouldbetheinstructorsbestanswer?a.Allpoorpeoplearemembersofavulnerablepopulation.b.Poorpeoplearemembersofavulnerablepopulationonlyiftheytakedrugs.CanadianFundamentalsofNursing7thEditionPotterTestBankUSNTc.Poorpeoplearemembersofavulnerablepopulationonlyiftheyarehomeless.d.Membersofvulnerablegroupsfrequentlyhaveacombinationofriskfactors.ANS:DMembersofvulnerablegroupsfrequentlyhavemanyriskfactorsoracombinationofriskfactorsthatincreasetheirvulnerabilitytodiseaseanddisability.Individualriskfactorsarenotalwaysoverwhelming,dependingonthepatientsbeliefsandvaluesandsourcesofsocialsupport.DIF:UnderstandREF:54OBJ:Explainthecharacteristicsofpatientsfromvulnerablepopulationsthatinfluenceanurse'sapproachtocare.TOP:AssessmentMSC:CPNRE:FoundationsofPractice12.ThenurseismakingahomevisittoaKoreanfamilywhosedaughtergavebirth6weeksearlier.Shefindsthedaughterinbedwithasevereheadache.Thedaughtersfatherisholdingherhandandispressingdifferentpartsofthehandandlowerarm.Themotherexplainsthatthefatheristryingtocuretheheadachebyusingpressurepoints.Whatisthenursesbestresponse?a.TellthefathertostopandgivethedaughterTylenol.b.Askthemotherorfather,orboth,toexplaintheprocedure.c.Explaintothefatherthatwhatheisdoingwillnotwork.d.LetthefatherfinishandthengivethedaughterTylenol.ANS:BThenurseshouldnotjudgethepatients/familysbeliefsandvaluesabouthealth.Thenurseneedstocreateacomfortable,nonthreateningenvironmentandtolearnasmuchaspossibleaboutthepatientscultureandvaluesthatinfluencehisorherhealthcarepractices.TylenolmaynotbeanacceptablealteNrnaRtiveIforGthisBf.amCilyM.Criticizingthefamilysbeliefsandpracticeswillonlycreateabarriertocare.DIF:ApplyREF:54,Box4-5OBJ:Explainthecharacteristicsofpatientsfromvulnerablepopulationsthatinfluenceanurse'sapproachtocare.TOP:ImplementationMSC:CPNRE:FoundationsofPractice13.Thenurseisworkinginacommunityclinicwhenamanandwomanbringa12-year-oldboyin,statingthatthechildfelldownaflightofstairsandhurthisarm.Thenursenoticesseveralotherbruisesonthechildsbodyatvaryingstagesofhealing.Theboyisplacedonthestretcher.Whenaskedhowhehurthimself,hestatesthathedoesnotremember.However,thenursenoticesthattheboycontinuouslyavoidslookingattheman,whilethemanstaresathimconstantly.Whatshouldthenursedo?a.Asktheboyifthemanhurthim.b.Confrontthemandirectly.c.Askthemanandwomantostepoutoftheroom.d.Askthewomanifthemanhurttheboy.ANS:CCanadianFundamentalsofNursing7thEditionPotterTestBankThenurseshouldaskthemanandwomantostepout.Indealingwithpatientsatriskfororwhohavesufferedabuse,itisimportanttoprovideprotectionandtointerviewthepatientatatimewhenheorshehasprivacyandtheindividualsuspectedofbeingtheabuserisnotpresent.Theboymaybelesslikelytobeforthcomingwithhisattackerintheroom.Confrontingeitheradultdirectlymayleadtoviolence.Theotheradultmayalsobeavictimofabuseandmayfearretributioniftheirproblemsarediscussedwithhealthcareproviders.DIF:ApplyREF:55OBJ:Explainthecharacteristicsofpatientsfromvulnerablepopulationsthatinfluenceanurse'sapproachtocare.TOP:ImplementationMSC:CPNRE:FoundationsofPractice14.Thenurseisworkingwitha16-year-oldpregnantgirlwhotellsthenursethatsheneedsanabortion.Thenurseprovidesthepatientwithinformationonalternativestoabortion,butafterseveralsessions,thepatientstillinsistsonhavingtheabortion.Thecompetencyofthenurseasaconsultantrequireswhatofthenurse?a.Insistthatthepatientspeakwitharight-to-lifeadvocate.b.Provideareferraltoanabortionservice.c.Refusetoprovidereferraltoanabortionservice.d.Delayreferraltoanabortionservice.ANS:BAsaconsultant,thenurseisresponsibleforprovidinginformation,listeningobjectively,andbeingsupportive,caring,andtrustworthy.Thenursedoesnotmakedecisionsbutratherhelpsthepatientreachdecisionsthatarebestforhimorher.Torefusetoprovideareferral,todelayreferral,ortoinsistthatthepatientspeakwitharight-to-lifeadvocatewouldnotbesupportiveofthepatientsdeNcisiRon.ICouGnseBllo.rsCusMuallysuggestandrarelyinsist.DIF:ApplyREF:57USNTOOBJ:Describethestandards,competencies,roles,andactivitiesimportantforsuccessincommunityhealthnursingpractice.TOP:ImplementationMSC:CPNRE:FoundationsofPractice15.Thepatientisinthehospitalwiththediagnosisofearly-onsetAlzheimersdisease.Beforethepatientisdischarged,thecommunity-basednurseismakingavisittothepatientshome,whereheliveswithhisdaughterandherfamily.Whatwouldbeamajorfocusofthisvisit?a.Demonstratetothecaregivertechniquesforprovidingcare.b.Stresstothefamilyhowdifficultitwillbetoprovidecareathome.c.Encouragethefamilytosendthepatienttoanextended-carefacility.d.Teachthefamilyhowtohavethepatientdeclaredincompetent.ANS:ATheroleofthecommunity-basednurse,indealingwithpatientswithAlzheimersdisease,istomaintainthebestpossiblefunctioning,protection,andsafetyforthepatient.Thenurseshoulddemonstratetotheprimaryfamilycaregiverthetechniquesfordressing,feeding,andtoiletingthepatientwhileprovidingencouragementandemotionalsupporttothecaregiver.Thenurseshouldprotectthepatientsrightsandmaintainfamilystability.DIF:ApplyREF:55OBJ:Describethestandards,competencies,roles,andactivitiesimportantforsuccessincommunityhealthnursingpractice.TOP:ImplementationCanadianFundamentalsofNursing7thEditionPotterTestBankMSC:CPNRE:FoundationsofPractice16.Thecommunityhasthreecomponents:structureorlocale,thepeople,andthesocialsystems.Whileconductingacommunityassessment,thenurseseeksdataontheaveragehouseholdincomeandthenumberofresidentsonpublicassistance.Indoingso,thenurseisevaluatingwhichofthefollowing?a.Structureb.Populationc.Welfaresystemd.SocialsystemANS:AEconomicstatusispartofthecommunitystructure.Populationwouldinvolveageandgenderdistribution,growthtrends,density,educationlevel,andethnicorreligiousgroups.Thewelfaresystemispartofthesocialsystemthatalsoincludestheeducation,government,communication,andhealthsystems.DIF:UnderstandREF:58|59OBJ:Describeelementsofacommunityassessment.TOP:ImplementationMSC:CPNRE:FoundationsofPractice17.Thepatientisbeingreadmittedtoaninner-cityhospitalforchestpain3monthsafterhavingaheartattack.Thepatientwasreferredtothehospitalscardiacrehabilitationprogramafterherpreviousadmission.Thepatientstatesthatshebegangoingtoprogramandlikeditbutstopped.Whenaskedwhy,shestatesthat,atthebeginning,theclasseswereat9a.m.,butthengotswitchedto7p.m.,whenitisdarkout.Thecardiacrehabilitationprogramwaswithinwalkingdistanceofthepatientshome.WhatisthemostlikelycauseofthepatientsunwillingnesstogototheproNgraRm?IGB.CMa.Lackoftransportationb.Fearofwalkingatnightc.Reimbursementissuesd.NoncomplianceANS:BUSNTOAcommunityassessmentshouldbedonetodeterminethelevelofcommunityviolenceatnightinthepatientsneighbourhood.Sheclaimedthatshelikedtheprogramwhenitwasat9a.m.Shedidnotmentionfinancesasareasonfornotgoing,andtheprogramwaswithinwalkingdistancetoherhouse.Noncomplianceisalabelgivenunfairlytopatients.Mostnoncompliancehasacause.Thecauseshouldbeidentifiedanddealtwith,sothatthetherapywillbesuccessful.DIF:ApplyREF:58|59OBJ:Describeelementsofacommunityassessment.TOP:ImplementationMSC:CPNRE:FoundationsofPractice18.Community-basednursingrequiresastrongknowledgebaseincommunication,culturaldiversity,groupdynamics,andwhichotherfollowingelement?a.Familytheoryb.Nursingresearchdesigns.c.Tertiarycare.d.FocusontheindividualANS:ACanadianFundamentalsofNursing7thEditionPotterTestBankWiththeindividualandfamilyasthepatients,thecontextofcommunity-basednursingisfamily-centredcarewithinthecommunity.Thisfocusrequiresastrongknowledgebaseinfamilytheory,principlesofcommunication,groupdynamics,andculturaldiversity.Thenurseleanstopartnerwithpatientsandfamilies,notjustwithindividuals.Nursingresearchdesignsandtertiarycarearenotthemainfocusofcommunity-basednursing.DIF:KnowledgeREF:49-51OBJ:Discusstherolesandfunctionsofthecommunityhealthnurse.TOP:AssessmentMSC:CPNRE:FoundationsofPractice19.Ofthefollowinglistofpatients,whichonewouldbeconsideredatlowriskforbeingamemberofavulnerablepopulation?a.AnimmigrantwhospeaksonlyChinese.b.AGuatemalantruckdriverwhospeakslimitedEnglish.c.A22-year-oldpregnantwoman.d.A15-year-oldrapevictim.e.A40-year-oldschizophrenic.ANS:CImmigrantpopulationsfacemultiplediversehealthissuesthatcities,counties,andstatesneedtoaddress.Thesehealthcareneedsposesignificantlegalandpolicyissues.Forsomeimmigrants,accesstohealthcareislimitedbecauseoflanguagebarriersandlackofbenefits,resources,andtransportation.Low-riskmothersandbabiesusuallyarenotconsideredvulnerablepopulationsunlessotherfactorsarenoted.Physical,emotional,andsexualabuse(suchasrape),aswellasneglect,aremajorpublichealthproblemsaffectingolderpersons,women,andchildren.Whenapatienthasaseverementalillnesssuchasschizophrenia,multiplehealthandsocioeconNomRicpIrobGlemBsm.CustbMeexplored.UDIF:AnalyzeREF:53-56SNTOOBJ:Explainthecharacteristicsofpatientsfromvulnerablepopulationsthatinfluenceanurse'sapproachtocare.TOP:PlanningMSC:CPNRE:FoundationsofPracticeCanadianFundamentalsofNursing7thEditionPotterTestBankChapter05:TheoreticalFoundationsofNursingPracticePotteretal:CanadianFundamentalsofNursing,7thEditionMULTIPLECHOICE1.Howistheideaofatheorybestexplained?a.Mentalmapsthatmakesenseofinformationanddecisionalprocesses.b.Mentalformulationsofobjectsorevents.c.Aspectsofrealitythatcanbeconsciouslysensed.d.Apurposefulsetofassumptionsthatidentifyrelationshipsbetweenconcepts.ANS:DAtheoryisapurposefulsetofassumptionsthatidentifytherelationshipsbetweenconcepts.Theoriesareusefulbecausetheyprovideasystematicviewofexplaining,predicting,andprescribingphenomena.ThedescriptionMentalmapsthatmakesenseofinformationanddecisionalprocessesexplainstheideaofconceptualframeworks,whichlinkideastogether.ThedescriptionMentalformulationsofobjectsoreventsexplainstheideaofconcepts.ThedescriptionAspectsofrealitythatcanbeconsciouslysensedexplainstheideaofphenomena.DIF:UnderstandREF:63OBJ:Describeselectedtheoriesofnursingpracticeanddifferentiatebetweenthem.TOP:AssessmentMSC:CPNRE:FoundationsofPractice2.Differenttypesoftheoriesmaybeusedbynursesseekingtostudythebasisofnursingpractice.ThetheoryaboutwNhypRhenIomeGnaBoc.cCurisMwhichofthefollowing?a.Prescriptive.b.Descriptive.c.Grand.d.Middle-range.ANS:BUSNTODescriptivetheoriesaredescriptionsofphenomena,speculationsonwhyphenomenaoccur,andexplanationsoftheconsequencesofphenomena.Prescriptivetheoriesaddressnursinginterventionsandhelppredicttheconsequencesofaspecificnursingintervention.Grandtheoriesprovidethestructuralframeworkforbroad,abstractideasaboutnursing.Middle-rangetheoriesaddressspecificphenomenaorconceptsandreflectpractice.DIF:UnderstandREF:65,Table5-2OBJ:Describeselectedtheoriesofnursingpracticeanddifferentiatebetweenthem.TOP:AssessmentMSC:CPNRE:FoundationsofPractice3.Abodyofknowledgethatencompassesdefinitionsofperson,environment,health,andnursingisreferredtoaswhichofthefollowing?a.Familynursingpractice.b.Prescriptivenursingtheory.c.Advancednursingpractice.d.Metaparadigmofnursing.ANS:DCanadianFundamentalsofNursing7thEditionPotterTestBankThemajorcomponentsofnursingtheory,sometimescalledthemetaparadigmconcepts,areperson,environment,health,andnursing.Familynursingpractice,althoughperhapsfocusingonalloftheseconcepts,isnotabodyofknowledge.Prescriptivenursingtheoryaddressesnursinginterventionsandhelpspredictconsequencesofaspecificintervention.Advancednursingpracticemayfocusontheseconceptsbutisnotabodyofknowledgespecifictotheseconcepts.DIF:UnderstandREF:65|66OBJ:Describeselectedtheoriesofnursingpracticeanddifferentiatebetweenthem.TOP:AssessmentMSC:CPNRE:FoundationsofPractice4.WithinahealthcaresystemthatisbasedonBettyNeumanstheory,whatisthenursesgoalincaringforapatientwhoishavingdifficultybreathingandrequiresoxygenandmedication?a.Strengthenthelineofdefencesandfocusonprevention.b.Promoteattainmentofbiologicalself-carerequisites.c.Assistinphysiologicaladaptationtointernalchanges.d.Achievethe14basicneeds.ANS:ANeumansframeworkforpracticeincludesnursingactionsthatfocusonactualorpotentialstressors,andthusonprevention.DorotheaOremstheoryfocusesontheattainmentofself-care.SisterCallistaRoystheoryfocusesonadaptation.VirginiaHendersonstheoryfocusesonhelpingthepatienttoachieve14basicneeds.DIF:ApplyREF:69|70OBJ:Recognizeselectedconceptualframeworksassociatedwithnursingpractice.TOP:ImplementationMSC:CPNRE:FoundationsofPracticeNURSINGTB.COM5.Althoughthedifferentnursingtheorieshavesimilarities,keyelementsdistinguishonefromanother.WhatistheemphasisofJeanWatsonsconceptualmodel?a.Self-caremaintainswholeness.b.Subsystemsexistindynamicstability.c.Stimulidisruptanadaptivesystem.d.Caringiscentraltotheessenceofnursing.ANS:DWatsonbelievedthatnursesmustdofarmorethandealwithphysicalillness;theymustattendtotheirprimaryfunction,whichiscaring.FromWatsonsperspective,caringinfusesallaspectsofanursesroleanddrawsattentiontonursingactsasembodyinganestheticthatfacilitatesbothhealingandgrowth.Self-careiscentraltoDorotheaOremstheory.ThekeyemphasisofDorothyJohnsonstheoryisthatsubsystemsexistindynamicstability.ThekeyemphasisofSisterCallistaRoystheoryisthatstimulidisruptanadaptivesystem.DIF:UnderstandREF:71OBJ:Recognizeselectedconceptualframeworksassociatedwithnursingpractice.TOP:PlanningMSC:CPNRE:FoundationsofPractice6.Acommunityhealthnurseisworkingwithavarietyofpatientsanddecidestouseasystemstheoryapproachtohelpthemtomeettheirhealthcareneeds.Whenusingsystemstheory,thenursefocusesonwhichofthefollowing?a.Thepatientsinteractionwithhisorherenvironment.CanadianFundamentalsofNursing7thEditionPotterTestBankb.Thehierarchyofthepatientshumanneeds.c.Thepatientsattitudestowardhealthbehaviours.d.Theresponseofthepatienttotheprocessofgrowthanddevelopment.ANS:AAccordingtosystemstheory,asystemismadeupofpartsthatdependononeanother,areinterrelated,shareacommonpurpose,andtogetherformawhole.Apatientsinteractionwiththeenvironmentisanexampleofanopensystem.Thenurseunderstandsthatfactorsthatchangetheenvironmentalsocanhaveaneffectonthesystem.AbrahamMaslowshierarchyofhumanneedsisaninterdisciplinarytheoryusefulinplanningindividualizedcare.Determiningapatientsattitudestowardhealthbehavioursfollowsahealthandwellnesstheoreticalmodel.Focusingontheresponseofapatienttotheprocessofgrowthanddevelopmentisconsistentwithdevelopmentaltheories.DIF:UnderstandREF:70OBJ:Describeselectedtheoriesofnursingpracticeanddifferentiatebetweenthem.TOP:PlanningMSC:CPNRE:FoundationsofPractice7.Whileworkingonapostoperativeunit,thenurseisapplyingelementsofself-caretheoryandisassistingapatienttoattainandmanageself-careinwoundmanagement.Whowasthenursingpioneerwhodevelopedthistheory?a.FlorenceNightingale.b.VirginiaHenderson.c.DorotheaOrem.d.HildegardPeplau.ANS:CThegoalofOremstheoryisNtoUhReSlpIthNeGpTatBie.ntCperMformself-care.ThegoalofNightingalestheoryistoshiftthefocusfromthediseaseprocesstowardanenvironmentconducivetohealing.Hendersondefinednursingpracticeasassistingtheindividual,sickorwell,intheperformanceofactivitiesthatwillcontributetohealth,recovery,orapeacefuldeath.Peplaustheorydefinedthecoreofnursingastheinterpersonalrelationshipbetweenthenurseandthepatient.DIF:UnderstandREF:68-70OBJ:Describeselectedtheoriesofnursingpracticeanddifferentiatebetweenthem.TOP:ImplementationMSC:CPNRE:FoundationsofPractice8.WhatisanelementthatiskeytotheframeworkforpracticeinMarthaRogersstheory?a.Humanbecoming.b.Manipulationofthepatientsenvironment.c.Sevencategoriesofbehaviourandbehaviouralbalance.d.Focusuponthelifeprocessofahumanbeingalongatime-spacecontinuum.ANS:DCanadianFundamentalsofNursing7thEditionPotterTestBankNRIGB.CMTheframeworkforpractice,accordingtoRogersstheory,consistedofpresentingthepatientofnursingnotsimplyasapersonbutasanenergyfieldinconstantinteractionwiththeenvironment,whichitselfwasalsoanirreducibleenergyfield,coextensivewiththeuniverse.Nursingsrolewastofocusuponthelifeprocessofahumanbeingalongatime-spacecontinuum.RosemarieParse,inhertheoryofhumanbecoming(1997),viewedtheindividualasaunitarybeingwhoisindivisible,unpredictable,andever-changingandafreelychoosingbeingwhocanberecognizedthroughparadoxicalpatternsco-createdall-at-onceinmutualprocesswiththeuniverse.Nightingalestheoryincludesmanipulationofthepatientsenvironment(i.e.,appropriatenoise,nutrition,hygiene,light,comfort,socialization,andhope)intheframeworkforpractice.DorothyJohnsonstheoryincludessevencategoriesofbehaviourandbehaviouralbalanceintheframeworkforpractice.DIF:UnderstandREF:71OBJ:Describeselectedtheoriesofnursingpracticeanddifferentiatebetweenthem.TOP:PlanningMSC:CPNRE:FoundationsofPractice9.Whosetheoryismostpertinentinassistingthenursewhoishelpingapatientfocusonstressreduction?a.HildegardPeplaus.b.VirginiaHendersons.c.BettyNeumans.d.RosemarieParses.ANS:CNeumanstheoryfocusesonstressreductionasthegoalofthesystemsmodelofnursingpractice.Peplaustheoryfocusesoninterpersonalrelationshipsbetweennursesandpatientsandtheinteractive,therapeuticnatureofthenursingprocess.Hendersonstheoryfocusesonthe14basichumanneeds.ParsUesStheoNryTfocusesOonthenotionofnursesengagementwith,andcareof,peopleinacontinuousprocessofmakingchoicesandchanginghealthpriorities.DIF:ApplyREF:69-71OBJ:Describeselectedtheoriesofnursingpracticeanddifferentiatebetweenthem.TOP:ImplementationMSC:CPNRE:FoundationsofPractice10.Whatdoesthetheorizingtermpropositionmean?a.Apurposefulsetofassumptions.b.Adeclarativeassertion.c.Theprocessofformulatingconcepts.d.Thestructurethatlinksconceptstogether.ANS:BApropositionisadeclarativeassertion.Apurposefulsetofassumptionsisatheory.Theprocessofformulatingconceptsisconceptualization.Thestructurethatlinksconceptstogetherisaconceptualframework.DIF:UnderstandREF:64,Table5-1OBJ:Describerelationshipsbetweentheorizingandotherformsofnursingknowledge.TOP:PlanningMSC:CPNRE:FoundationsofPractice11.Whatisacharacteristicofcomplexityscience?a.Patternsofknowledgeapplication.CanadianFundamentalsofNursing7thEditionPotterTestBankb.Arigidapproachfordescribingexperiences.c.Reducingphenomenatosmallestproperties.d.Orientationtostudyingthenatureofpeoplesneeds.ANS:CComplexityscienceconsistsofdynamicandinteractivephenomenareducedtothesmallestpropertiesthatcanbeobservedwithintheirnaturalcontextsothattheirinteractionscanbeinterpretedwithaslittleinterferenceaspossiblefrompriorassumptions.Patternsofknowledgeapplicationarenotcharacteristicofcomplexityscience.Complexityscienceisnotarigidapproachfordescribingexperiences,anditisnotcharacterizedbyanorientationtostudyingthenatureofpeoplesneeds.DIF:UnderstandREF:67OBJ:Interpretcurrentdebatessurroundingvarioustheoriesofnursingpractice.TOP:PlanningMSC:CPNRE:FoundationsofPractice12.WhatisacurrentconcernwiththeuseofthenursingdiagnosesapprovedbytheNorthAmericanNursingDiagnosesAssociation(NANDA)?a.NANDAsliststiflescriticalthinking.b.NANDAslistshouldreplaceconceptualnursingmodels.c.NANDAslistisaninherentbarriertoindividualizedcare.d.NANDAslistdoesnotreflectpracticaldiagnoses.ANS:CNANDAslistofnursingdiagnosesisrecognizedbymanynursesasasystemthatreliesentirelyuponanagreementaboutwhatconstitutesaveragewellnessandillnessexperiences.Assuch,itcancreateworrisomebarrierstotheindividualizedcareofpatients.NANDAslistofnursingdiagnosesmaystifNleUcRritSicIalNtGhinTkBin.gC,buMtthishasnotbeenrecognizedasaconcern;itisoftenconsideredtobelessthoroughthanconceptualmodelsofnursing,asitinvolvesonlyoneaspectofcaringforpatients;anditdoesreflectpracticaldiagnoses.DIF:UnderstandREF:67OBJ:Describechallengesinherentintheorizingaboutnursingpractice.TOP:PlanningMSC:CPNRE:FoundationsofPractice13.Inthelate1980s,theshiftinscholarlyworkregardingnursingtheorieschallengednurseswhentheorizingtoincludeconsiderationofwhattypeofknowledge?a.Clinical.b.Intuitive.c.Theoretical.d.Substantive.ANS:DAfafMeleis(1987)challengednursestodirecttheirtheorizingawayfromtheprocessesbywhichnursesuseknowledgeandtowardtheequallychallengingissuesassociatedwiththesubstanceofthatknowledgethatis,toincludesubstantiveknowledge.Neitherclinicalknowledgenorintuitiveknowledgewasrelatedtothischallenge.Theoreticalknowledgehadbeenthefocusoftheorizingformanyyearsbeforethelate1980s.DIF:UnderstandREF:71OBJ:Appreciatetheroleoftheorizingabouttheessenceofnursing.TOP:AssessmentMSC:CPNRE:FoundationsofPracticeCanadianFundamentalsofNursing7thEditionPotterTestBank14.Interactionisttheoriesfocusedontherelationshipsbetweennursesandtheirpatients.Whichofthefollowingwasaninteractionisttheorist?a.HildegardPeplaub.DorotheaOremc.FlorenceNightingaled.BettyNeumanANS:AHildegardPeplauwasaninteractionisttheorist.DorotheaOremwasaneedstheorist,FlorenceNightingalewasapractice-basedtheorist,andBettyNeumanwasasystemstheorist.DIF:ApplyREF:69|70OBJ:Describeselectedtheoriesofnursingpracticeanddifferentiatebetweenthem.TOP:AssessmentMSC:CPNRE:FoundationsofPracticeNURSINGTB.COMCanadianFundamentalsofNursing7thEditionPotterTestBankUSNTOChapter06:Evidence-InformedPracticePotteretal:CanadianFundamentalsofNursing,7thEditionMULTIPLECHOICE1.Theextenttowhichthefindingsofaqualitativestudyarethoughttobemeaningfulandapplicabletosimilarcasesorothersituationsisknownaswhichofthefollowing?a.Credibility.b.Transferability.c.Validity.d.Reliability.ANS:BTransferabilityreferstotheextenttowhichthefindingsofaqualitativestudyarethoughttobemeaningfulandapplicabletosimilarcasesorothersituations.Credibilityconcernswhethertheresearchandresultsaretrustworthy.Validityreferstowhetherthestudymeasuredwhatitwasintendedto.Reliabilityconcernswhetherthestudyresultsarerepeatable.DIF:UnderstandREF:83OBJ:Definethekeytermslisted.TOP:EvaluateMSC:CPNRE:FoundationsofPractice2.Incaringforpatients,itisimportantforthenursetorealizethatevidence-informeddecisionmakingiswhichofthefollowing?a.Theonlyvalidsourceofknowledgethatshouldbeused.b.Secondarytotraditionalorstandardcareknowledge.c.DependentonpatientvalNuesRandIexpGectaBti.onCs.Md.NotrelatedtoqualityimprovementstudiesANS:CEvenwhenthebestevidenceavailableisused,applicationandoutcomeswilldifferaccordingtopatientsvalues,preferences,concerns,andexpectations.Nursesoftencareforpatientsonthebasisoftraditionorconvenience,orinthestandardIthasalwaysbeendonethisway.Althoughthesesourceshavevalue,itisimportanttolearntorelymoreonresearchevidencethanonnonresearchevidence.Evidence-informeddecisionmakingiscloselyrelatedtoqualityimprovement.DIF:UnderstandREF:76|77,Box6-1OBJ:Explaintheneedforevidencetoinformnursesdecisionmaking.TOP:EvaluateMSC:CPNRE:FoundationsofPractice3.Thefirststepinevidence-informedpracticeistoaskaclinicalquestion.Indoingso,whatdoesthenurseneedtorealizewithregardtoresearchinginterventions?a.Thequestionismoreimportantthanitsformat.b.Thequestionwillleadtheresearchertohundredsofarticlesthatmustberead.c.ThequestionmaybeeasierifitisinPICOTformat.d.Thequestionmaybemoreusefulthemoregeneralitis.ANS:CCanadianFundamentalsofNursing7thEditionPotterTestBankThePICOTformatallowsthenursetoaskquestionsthatareinterventionfocused.Inappropriatelyformedquestionswillprobablyleadtoirrelevantsourcesofinformation.Itisnotbeneficialtoreadhundredsofarticles.Itismorebeneficialtoreadthebestfourtosixarticlesthatspecificallyaddressthequestion.Themorefocusedthequestionaskedis,theeasieritwillbecometosearchforevidenceinthescientificliterature.DIF:UnderstandREF:77OBJ:Discussthestepsoftheresearchprocess.TOP:EvaluateMSC:CPNRE:FoundationsofPractice4.Whenthebestevidenceiscollected,whatisthegoldstandardforresearch?a.Therandomizedcontrolledtrial(RCT).b.Thepeer-reviewedarticle.c.Qualitativeresearch.d.Theopinionofexpertcommittees.ANS:AIndividualRCTsarethegoldstandardforresearch.Apeer-reviewedarticleisonethathasbeenreviewedbyapanelofexperts;thisisnotaresearchmethod.Qualitativeresearchisvaluableinidentifyinginformationabouthowpatientscopewithormanagevarioushealthproblemsandtheirperceptionsofillness.ItdoesnotusuallyhavetherobustnessofanRCT.Expertopinionisonthebottomofthehierarchicalpyramidofevidence.DIF:KnowledgeREF:83OBJ:Discussmethodsfordevelopingnewnursingknowledge.TOP:AssessmentMSC:CPNRE:FoundationsofPractice5.Thenursingteamiswritingaresearcharticleonapatientcaretopic.WhichsectionwillgetthereadertoreadthearticlebNeUcaRuSseIoNftGhTevBa.luCeOofMthetopicforthereader?a.Abstract.b.Introduction.c.Literaturerevieworbackground.d.Results.ANS:BTheintroductioncontainsinformationaboutitspurposeandtheimportanceofthetopictotheaudiencewhoreadsthearticle.Theabstractisabriefsummaryofthearticle.Theliteraturerevieworbackgroundoffersadetailedbackgroundofthelevelofscienceorclinicalinformationthatisavailableaboutthetopicofthearticle.Theresultssectionisthesummarysectionofthearticle.DIF:UnderstandREF:78OBJ:Discussthestepsoftheresearchprocess.TOP:AssessmentMSC:CPNRE:CollaborativePractice6.Thenurseiscaringforapatientwithchroniclowbackpain.Inprovidingcareforthispatient,thenursewonderswhetherthereisliteratureonnursinginterventionsforchroniclowbackpain.Whatarethebest-knowndatabasesfornursingliterature?a.MEDLINEandCINAHLb.EMBASEandPsycInfoc.PsycINFOandCINAHLd.MEDLINEandEMBASEANS:ACanadianFundamentalsofNursing7thEditionPotterTestBankThebest-knowndatabasesfornursingliteratureareMEDLINEandCINAHL.EMBASEincludesbiomedicalandpharmaceuticalstudies.PsycINFOdealswithpsychologyandrelatedhealthcaredisciplines.DIF:UnderstandREF:78OBJ:Discussmethodsfordevelopingnewnursingknowledge.TOP:ImplementationMSC:CPNRE:FoundationsofPractice7.ThenurseisdevelopingaPICOTquestionrelatedtosucroseadministrationbeforephlebotomyininfants:Isthepainscorelowerininfantswhoareadministeredsucroseoneminutebeforephlebotomythanininfantswhodonotreceivesucroseatall?WithaPICOTquestion,Pisthepopulationofinterest,Iistheinterventionofinterest,Cisthecomparisonofinterest,Oistheoutcome,andTisthetime;isthisatruePICOquestion?a.Yes,becausetheoutcomealwayscomesbeforetheintervention.b.Yes,regardlessofplacementofelements.c.No,becausethecomparisoncomesaftertheintervention.d.No,becausetheoutcomecomesafterthepopulation.ANS:BAwell-designedPICOTquestiondoesnothavetofollowthesequenceofP,I,C,O,andT.TheaimistoaskaquestionthatcontainsasmanyofthePICOTelementsaspossible.DIF:UnderstandREF:77OBJ:Discussmethodsfordevelopingnewnursingknowledge.TOP:ImplementationMSC:CPNRE:FoundationsofPractice8.Inareviewofliteratureforanevidence-informedpracticestudy,whatisthemostreliablelevelofevidence?NURSINGTB.COMa.Systematicreviewandmeta-analysis.b.Randomizedcontroltrial(RCT).c.Casecontrolstudy.d.Controltrialwithoutrandomization.ANS:AInasystematicreviewormeta-analysis,anindependentresearcherreviewsalltheRCTsconductedonthesameclinicalquestionandreportswhethertheevidenceisconclusiveorwhetherfurtherstudyisneeded.AsingleRCTisnotasconclusiveasareviewofseveralRCTsonthesamequestion.Controltrialswithoutrandomizationmayinvolvebiasinhowthestudyisconducted.Case-controlstudiesalsohaveroomforbias.DIF:AnalyzeREF:83OBJ:Discussmethodsfordevelopingnewnursingknowledge.TOP:AssessmentMSC:CPNRE:CollaborativePractice9.Whyisqualitativenursingresearchvaluable?a.Itexcludesallbias.b.Itentailstheuseofrandomizationinstructure.c.Ithelpdetermineassociationsbetweenvariablesandconditions.d.Itentailsthestudyofphenomenathataredifficulttoquantify.ANS:DCanadianFundamentalsofNursing7thEditionPotterTestBankQualitativenursingresearchisthestudyofphenomenathataredifficulttoquantifyorcategorize,suchaspatientsperceptionsofillness.Nostudycantotallyexcludebias.However,randomization,suchasthatusedinrandomizedcontrolstudies,helps,butinqualitativenursingresearch,randomizationisnotusuallyused.Controlstudiesdeterminewhetherthereisanassociationbetweenoneormorepredictorvariablesandthecondition.DIF:KnowledgeREF:83OBJ:Definethekeytermslisted.TOP:AssessmentMSC:CPNRE:FoundationsofPractice10.ThenursesontheunithaveusedaPICOTquestiontodevelopanevidence-informedchangeinprotocolforacertainnursingprocedure.However,tomakethesechangesthroughouttheentireinstitutionwouldrequiremoresupportstaffthanisavailableatthistime.Whatisthenursesbestoption?a.Droptheideaofmakingthechangeatthistime.b.Insistthatmanagementhiretheneededstafftofacilitatethechange.c.Seekemploymentinanotherinstitutionthatmayhavethestaffneeded.d.Conductapilotstudytodevelopevidencetosupportthechange.ANS:DWhenevidenceisnotstrongenoughtoapplyinpractice,orifresourcesarelimited,thenextoptionistoconductapilotstudytoinvestigatethePICOquestion.Droppingtheideawouldbecounterproductive;insistingthatmanagementhirestaffcouldbeseenasamandateandcouldproducenegativeresults.Seekingemploymentatanotherinstitutionmostlikelywouldnotbetheanswerbecausemostinstitutionsoperateundersimilarestablishedguidelines.DIF:ApplyREF:79OBJ:Discussmethodsfordevelopingnewnursingknowledge.TOP:ImplementationMSC:CPNRE:CollaborativePNraUctRicSeINGTB.COM11.Accordingtohospitalpolicy,whenstartinganintravenous(IV)catheter,thenursemustfirstpreparethepotentialIVsitewithalcoholanddressitwithagauzedressing.Thenursehasdonealiteraturereviewandbelievesthatevidence-informedpracticedictatestheuseofatransparentdressingtopreventcatheterdislodgement.Whatshouldthenursedo?a.Begintousetransparentdressinginsteadofgauzedressings.b.Bringfindingstothepolicyandprocedurecommittee.c.UsetransparentdressingsonhalfofherIVstartsandgauzeontheother.d.Continuefollowinghospitalpolicywithoutsayinganything.ANS:BAsaresultofherfinding,thenurseshouldmeetwiththepolicyandprocedurecommitteetorecommendroutineuseoftransparentdressings.However,untilthepolicyischanged,orthenursereceivesapprovaltoconductapilotstudy,thenurseisobligatedtofollowhospitalprocedure.Ifthenursehasinformationthatcanleadtobetterpatientcare,heorshehasanobligation(moralandprofessional)tobringittotheattentionofpolicymakers.DIF:ApplyREF:79OBJ:Discussthestepsofevidence-informeddecisionmaking.TOP:ImplementationMSC:CPNRE:CollaborativePracticeCanadianFundamentalsofNursing7thEditionPotterTestBank12.Thenursingteamistryingtoidentifycommongeneralthemesrelativetotheeffectivenessofcardiacrehabilitationforpatientswhohavehadheartattacksandhavegonethroughcardiacrehabilitationprograms.Thenursesconductinterviewsandfocusgroups.Whattypeofresearchisbeingimplemented?a.Evaluationresearchb.Experimentalresearchc.Qualitativeresearchd.NonexperimentalresearchANS:CQualitativeresearchinvolvesusinginductivereasoningtodevelopgeneralizationsortheoriesfromspecificobservationsorinterviews.Evaluationandexperimentalresearchareformsofquantitativeresearch.Nonexperimentaldescriptivestudiesdescribe,explain,orpredictphenomena,suchasfactorsthatleadtoanadolescentsdecisiontosmokecigarettes.DIF:UnderstandREF:83OBJ:Discussmethodsfordevelopingnewnursingknowledge.TOP:AssessmentMSC:CPNRE:CollaborativePractice13.Inconductingaresearchstudy,theresearchermustinformtheparticipants,inlaylanguage,abouttherisksandbenefitsofparticipating.Thisisanimportantaspectofwhat?a.Anonymity.b.Confidentiality.c.Informedconsent.d.Theresearchprocess.ANS:CInformedconsentmeansthatNreUsReaSrcIhNsuGbjTeBct.s(C1)OaMregivenfullandcompleteinformationaboutthepurposeofthestudy,procedures,datacollection,potentialharmandbenefits,andalternativemethodsoftreatment;(2)arecapableoffullyunderstandingtheresearch;(3)havethepowertovoluntarilyconsentordeclineparticipation;and(4)understandhowconfidentialityoranonymityismaintained.Confidentialityguaranteesthatanyinformationthesubjectprovideswillnotbereportedinanymannerthatidentifiesthesubjectandwillnotbeaccessibletopeopleoutsidetheresearchteam.Anonymityistheconditionwheneventheresearchercannotlinkthesubjecttothedata.Theresearchprocessisabroaderconceptthatprovidesanorderlyseriesofstepsthatallowtheresearchertomovefromaskingaquestiontofindingtheanswer.DIF:KnowledgeREF:84|85OBJ:Discussthestepsoftheresearchprocess.TOP:AssessmentMSC:CPNRE:FoundationsofPractice14.Whenevaluatingqualityimprovement(QI)programsinrelationtoevidence-informeddecisionmaking,whatshouldthenursenote?a.Botharedesignedtoimproveperformance.b.Whenevidence-informedpractice(EIP)projectsareimplemented,itisimportanttoreviewQIdata.c.EIPisnotatallrelatedtoQI.d.Evaluationofprocessesistherealmofperformanceimprovement,notQI.ANS:BCanadianFundamentalsofNursing7thEditionPotterTestBankEIPandQIgohandinhand.WhenanEIPprojectisimplemented,itisimportanttoreviewavailableQIdata.ReliableQIdataimprovetherelevanceandscopeofanEIPproject.Performanceimprovementisconcernedwithperformance.QIisconcernedwithprocesses.DIF:UnderstandREF:76OBJ:Discussmethodsfordevelopingnewnursingknowledge.TOP:PlanningMSC:CPNRE:CollaborativePractice15.Thequalityimprovementcommitteehasbeenalertedtoanincreasednumberoffallsinthehospital.Mostofthesefallshaveoccurredatnightandhaveinvolvedpatientswhoweretryingtocrawloverbedrails.Aliteraturereviewrevealedthatmostfallsoccurbecausepatientsaretryingtogotothebathroom.Thecommitteecreatedapracticechangethatbedrailsshouldbeleftinthedownposition,andhourlynursingroundsshouldbeconducted.Whatisthecommitteesnextstep?a.Evaluatethechangesin1month.b.Waitamonthbeforeimplementingthechanges.c.Implementthechangesasapilotstudy.d.Communicatetostafftheresultsofthisinquiry.ANS:DQualityimprovementcombinedwithevidence-informedpracticeisthefoundationforexcellentpatientcareandoutcomes.OnceaQIcommitteemakesapracticechange,itisimportanttocommunicatetheresultstostaff.PracticechangeswillprobablynotlastwhenQIcommitteesfailtoreportfindingsandresultsofinterventions.Oncecommunicated,changesshouldbeputinplaceasthecommitteedeemsreasonable(i.e.,eitherfullyorasapilotstudy)andassoonaspractical;thisshouldbefollowedbyre-evaluation.DIF:ApplyREF:78N|U79RSINGTB.COMOBJ:Discussmethodsfordevelopingnewnursingknowledge.TOP:ImplementationMSC:CPNRE:CollaborativePractice16.Asnursesmoveforwardintheireducation,differentrolesmaybeassumedwithregardtoresearch.Whatistheexpectedresearchrolefortheentry-levelnurse?a.Toassumetheroleofaclinicalexpert.b.Toincorporateevidence-informedpracticeactivitiesintonursingpractice.c.Todevelopmethodsofinquiryrelevanttonursing.d.Toacquirefundingforresearchprojects.ANS:BNursescanmakelinksbetweenresearchfindingandnursingcarebyidentifyingappropriateclinicalproblems,readingpeer-reviewedliteraturefromnumeroussources,andincorporatingevidence-informedpracticeactivitiesintothenursingpracticeoftheirunitoragency.Nurses,withexperience,willdevelopclinicalexpertise,butthisisnottheirexpectedresearchrole.Nurseswithadvancededucationorthosethathavearesearchfocuswillberesponsiblefordevelopingmethodsofinquiryrelevanttonursingandforacquiringfundingforresearchprojects.DIF:UnderstandREF:85OBJ:Explaintheneedforevidencetoinformnursesdecisionmaking.TOP:ImplementationMSC:CPNRE:CollaborativePracticeCanadianFundamentalsofNursing7thEditionPotterTestBank17.Anurseresearcherisconductingaresearchprojectonoptimaltimeframesforpostoperativeambulationofpatients.Aftertheresearcheridentifiestheproblem,whatisthenextstepintheresearchprocess?a.Selectingthepopulation.b.Reviewingtheliterature.c.Identifyingtheinstrumenttousefordataanalysis.d.Obtainingapprovaltoconductthestudy.ANS:BAftertheproblemisidentified,thenextstepintheresearchprocessisreviewingtheliteratureinordertodeterminewhatisknownabouttheproblem.Afteridentificationoftheproblemandreviewoftheliterature,theresearcherwilldesignthestudyprotocol.Selectingthepopulationisacomponentofthisphaseoftheresearchprocess.Theinstrumenttousefordataanalysisisidentifiedduringtheprocessofdesigningthestudyprotocol.Thisstepoccursduringthestudydesignphaseoftheresearchprocessafterproblemidentificationandliteraturereviewhavetakenplace.Obtainingnecessaryapprovalsispartofconductingthestudy,apartthatfollowsthedesignphaseintheresearchprocess.DIF:AnalyzeREF:80|81OBJ:Definenursingresearch.TOP:ImplementationMSC:CPNRE:CollaborativePractice18.Thenurseresearcherispreparingtoconductresearchthatwillallowprecisemeasurementofaphenomenon.Whichofthefollowingmethodswillprovidethenursewiththerightkindofdata?a.Experimentalresearch.b.Phenomenology.c.Groundedtheory.d.Ethnography.ANS:ANURSINGTB.COMExperimentalresearchisatypeofquantitativeresearch.Phenomenology,groundedtheory,andethnographyarealltypesofqualitativeresearch.DIF:UnderstandREF:81-83OBJ:Definethekeytermslisted.TOP:AssessmentMSC:CPNRE:CollaborativePractice19.Thenurseresearcherisreviewingliteraturerelatedtoapotentialproblemthathasbeenidentifiedonthenursingunit.Thenurserealizesthatnursingresearchisimportantbecauseitisdesignedtodowhichofthefollowing?a.Enhancethenurseschanceatpromotion.b.Maintainpublicfundingc.Improveprofessionalpractice.d.Leadtodecreasesinbudgetexpenditures.ANS:CNursingresearchisawaytoidentifynewknowledge,improveprofessionaleducationandpractice,anduseresourceseffectively.Theresearchdoesnotalwaysresultinlowerbudgetexpenditures;rather,itenhancesmoreeffectiveuseofresources.Maintainingpublicfundingisnotadirectresultofresearch.DIF:UnderstandREF:75-77OBJ:Discussthestepsoftheresearchprocess.CanadianFundamentalsofNursing7thEditionPotterTestBankTOP:AssessmentMSC:CPNRE:FoundationsofPracticeNURSINGTB.COMCanadianFundamentalsofNursing7thEditionPotterTestBankNRIGB.CMChapter07:NursingValuesandEthicsPotteretal:CanadianFundamentalsofNursing,7thEditionMULTIPLECHOICE1.Fourpatientsinlabourallrequestepiduralanalgesiatomanagetheirpainatthesametime.Whichethicalprincipleiscompromisedwhenonlyonenurseanaesthetistisoncall?a.Justice.b.Nonmaleficence.c.Beneficence.d.Fidelity.ANS:AJusticereferstofairnessandisusedfrequentlyindiscussionregardingaccesstohealthcareresources.Inthissituation,thejustdistributionofresourcesinthiscasepainmanagementcannotbejustlyapportioned.Nonmaleficencemeanstodonoharm,beneficencemeanstodogood,andfidelitymeanstobetruetoortobehonest.Eachoftheseprinciplesispartiallyalludedtointhequestion;however,justiceistheprinciplemostcomprisedbecausenotalllabouringpatientshaveequalaccesstopainmanagementowingtolackofpersonnelresources.DIF:UnderstandREF:91|92OBJ:Explaintherelationshipbetweenethicsandprofessionalnursingpractice.TOP:ImplementationMSC:CPNRE:Professional,Ethical,andLegalPractice2.ThepatienttellsthenursethatsheisafraidtospeakupregardingherdesiretoendcareforfearofupsettingherhusbandaUndcShildNrenT.WhichOprincipleinthenursingcodeofethicsensuresthatthenursewillpromotethepatientscause?a.Responsibility.b.Advocacy.c.Confidentiality.d.Accountability.ANS:BNursesadvocateforpatientsbysupportingthepatientscause.Anursesabilitytoadvocateadequatelyforapatientisbasedontheuniquerelationshipthatdevelopsbetweennurseandpatientandontheopportunitytobetterunderstandthepatientspointofview.Responsibilityreferstorespectingonesprofessionalobligationsandfollowingthroughonpromises;confidentialitydealswithprivacyissues;andaccountabilityreferstoowningonesactions.DIF:UnderstandREF:89|90OBJ:Explaintherelationshipbetweenethicsandprofessionalnursingpractice.TOP:DiagnosisMSC:CPNRE:Professional,Ethical,andLegalPractice3.Thepatientssonrequeststoviewthedocumentationinhismothersmedicalrecord.Whatisthenursesbestresponsetothisrequest?a.Illbehappytogetthatforyou.b.Youwillhavetotalktothephysicianaboutthat.c.Youwillneedyourmotherspermission.d.Youarenotallowedtoseeit.CanadianFundamentalsofNursing7thEditionPotterTestBankANS:CNursesshouldprotectapatient'srighttoprivacyandconfidentialitybyhelpingthepatientaccesshisorherhealthrecords(subjecttolegalrequirements),interveningifothermembersofthehealthcareteamfailtorespectthepatient'sprivacy,andfollowingpoliciesthatprotectthepatient'sprivacy.Privatehealthinformationcannotbesharedwithoutthepatientsspecificpermission.Theotherthreeresponseseitherareoutrightfalseorusepoorcommunicationtechniques.DIF:ApplyREF:90OBJ:Explaintherelationshipbetweenethicsandprofessionalnursingpractice.TOP:EvaluateMSC:CPNRE:Professional,Ethical,andLegalPractice4.Whenindividualsworktogethertosolveethicaldilemmas,theymustexaminetheirownvalues.Thisstepiscrucialtoensurewhat?a.Thegroupidentifiestheonecorrectsolution.b.Factisseparatedfromopinion.c.Judgmentalattitudesarenotprovoked.d.Differentperspectivesarerespected.ANS:DValuesarepersonalbeliefsthatinfluenceopinions;tobeabletonegotiatedifferencesinopinions,thenursemustfirstbeclearaboutpersonalvalues,whichwillinfluencebehaviours,decisions,andactions.Ethicaldilemmasareaprobleminthatnosinglecorrectsolutionexists.DIF:RememberREF:88OBJ:Discusshowvaluesinfluencepatientcare.TOP:EvaluateMSC:CPNNRRE:PIrofeGssioBna.l,CEthMical,andLegalPracticeUSNTO5.Ethicaldilemmasarecommonoccurrenceswhencaringforpatients.Thenurseunderstandsthatdilemmasarearesultofwhichofthefollowing?a.Presenceofconflictingvalues.b.Hierarchicalsystems.c.Judgementalperceptionsofpatients.d.Poorcommunicationwiththepatient.ANS:ATheprimaryunderlyingreasonthatethicaldilemmasoccuristhattherearenoclear-cut,universallyacceptedsolutionstoaproblemwhenparticipatingindividualsdonotsharethesamevalues.Poorcommunicationandthehierarchicalsystemsthatexistinhealthcare,suchasreportingstructureswithinthehospital,orthehistoricallyunequalrelationshipbetweenphysiciansandnurses,maycomplicatedilemmas.Withoutclarificationofvalues,thenursemaynotbeabletodistinguishfactfromopinionorvalue,andthiscanleadtojudgementalattitudes.DIF:UnderstandREF:88OBJ:Discusstheroleofvaluesinthestudyofethics.TOP:AssessmentMSC:CPNRE:Professional,Ethical,andLegalPractice6.Thenursequestionsaphysiciansordertoadministeraplacebotothepatient.Thenursesactionisbasedonwhichethicalprinciple?a.Autonomy.b.Beneficence.CanadianFundamentalsofNursing7thEditionPotterTestBankUSNTOc.Justice.d.Fidelity.ANS:AAutonomyisthefreedomtomakedecisionswithoutexternalcontrol.Inthiscase,thenursequestionsthephysiciansorderforaplacebobecausesuchadecisionwasmadewithoutconsultationwiththepatient.Beneficencereferstotakingapositiveactionforothers,andalthoughithasimplicationsinthissituation,itisnottheprimaryoperatingprinciple.Justicereferstofairnessandismostoftenusedindiscussionsaboutaccesstohealthcareresources.Fidelityreferstotheagreementtokeeppromises.DIF:UnderstandREF:91|92OBJ:Examineandclarifypersonalvalues.TOP:ImplementationMSC:CPNRE:Professional,Ethical,andLegalPractice7.Thenursefindsitdifficulttocareforapatientwhoseadvancedirectivestatesthatnoextraordinaryresuscitationmeasuresshouldbetaken.Whichstepmayhelpthenursetofindresolutioninthisassignment?a.Callingforanethicalcommitteeconsult.b.Decliningtheassignmentonreligiousgrounds.c.Clarifyingthenursesownpersonalvalues.d.Persuadingthefamilytochallengethedirective.ANS:CValuesdevelopovertimeandareinfluencedbyfamily,schools,religioustraditions,andlifeexperiences.Thenursemustrecognizethatnotwoindividualshavethesamesetofexperiences,andsodifferencesinvaluesaremorelikelytobethenormthantheexception.Closerinspectionofonesvaluesmaybeastepingaininganunderstandingofanotherpersonsperspective.CallingNforRacoInsuGlt,dBe.clCininMgtheassignment,andpersuadingthefamilytochallengethepatientsdirectivearenotidealresolutionsbecausetheydonotaddressthereasonforthenursesdiscomfort,whichistheconflictbetweenthenursesvaluesandthoseofthepatient.DIF:ApplyREF:88OBJ:Examineandclarifypersonalvalues.TOP:AssessmentMSC:CPNRE:Professional,Ethical,andLegalPractice8.Thenursevaluesautonomyaboveallotherprinciples.Whichpatientassignmentwillthenursefindmostdifficulttoaccept?a.Teenagerinlabourwhorequestsepiduralanaesthesia.b.Middle-agedfatherofthreewithanadvancedirectivedeclininglifesupport.c.Elderlypatientwhorequiresdialysis.d.Familyelderwhoismakingthedecisionsfora30-year-oldfemalemember.ANS:DAutonomyisthefreedomtomakedecisionswithoutexternalcontrol.Anursewhovaluesautonomyhighlymayfinditdifficulttoacceptsituationsinwhichthepatientisnottheprimarydecisionmakerregardinghisorhercare.Ateenagerrequestinganepiduralanaesthetic,afatherwithanadvanceddirective,andanelderlypatientrequiringdialysisareallpatientswhoaremakingtheirowndecisionsandchoicesregardingcare.DIF:AnalyzeREF:91OBJ:Examineandclarifypersonalvalues.TOP:EvaluateMSC:CPNRE:Professional,Ethical,andLegalPracticeCanadianFundamentalsofNursing7thEditionPotterTestBank9.Whichphilosophyofhealthcareethicswouldbeparticularlyusefulformakingethicaldecisionsaboutvulnerablepopulations?a.Feministethics.b.Deontology.c.Bioethics.d.Utilitarianism.ANS:AFeministethicsfocusesparticularlyonthenatureofrelationships,especiallythoseinwhichthereisapowerimbalanceorinwhichapointofviewisnotroutinelyaccepted.Examplesofpopulationsthatareconsideredvulnerableincludechildren,pregnantwomen,incarceratedpersons,andminoritygroups.Deontologyreferstomakingdecisionsorright-makingcharacteristics;bioethicsfocusesonconsensusbuilding;andutilitarianismreferstothegreatestgoodforthegreatestnumber.DIF:RememberREF:92OBJ:Describesomebasicethicalphilosophiesrelevanttohealthcare.TOP:AssessmentMSC:CPNRE:Professional,Ethical,andLegalPractice10.Anursearguesthatthehealthcaresystemneedsreformbecausealargenumberofpatientsareuninsuredandendupneedingexpensiveemergencycarewhenlow-costmeasurescoveredbyinsurancecouldhavepreventedtheirillnesses.Whatethicalframeworkissheusingtomakethiscase?a.Deontology.b.Ethicsofcare.c.Feministethics.d.Utilitarianism.ANS:DNURSINGTB.COMUtilitarianismisasystemofethicswhereinvalueisdeterminedbyusefulness.Thissystemofethicsfocusesontheoutcomeofthegreatestgoodforthegreatestnumberofpeople.Deontologywouldnotaccountforconsequencesofactions.Theethicsofcarewouldnotbehelpfulbecauseconsensusonthisissueisnotachievable.Feministethics,whichfocusonrelationships,arenotaddressedinthiscase.DIF:EvaluateREF:91OBJ:Describesomebasicethicalphilosophiesrelevanttohealthcare.TOP:AssessmentMSC:CPNRE:Professional,Ethical,andLegalPractice11.Thenursehasbecomeawarethatnarcoticsaremissinginthepatientcarearea.Whichethicalprincipleobligatesthenursetoreportthemissingmedications?a.Advocacy.b.Responsibility.c.Confidentiality.d.Accountability.ANS:BCanadianFundamentalsofNursing7thEditionPotterTestBankNRIGB.CResponsibilityreferstooneswillingnesstorespectandadheretoonesprofessionalobligations.Oneoftheobligationsnursinghasistoprotectpatientsandcommunities,includingothernurses.Ifnarcoticsaremissing,thismayindicatethatpatientshavenotreceivedmedicationsorderedfortheircare,oritmaysuggestthatahealthcareprofessionalmaybeworkingundertheinfluenceofthesedrugs.Accountabilityreferstotheabilitytoanswerforonesactions.Advocacyreferstothesupportofaparticularcause.Confidentialityinvolvesprotectingpatientspersonalhealthinformationandprivacy.DIF:UnderstandREF:89|90OBJ:Explaintherelationshipbetweenethicsandprofessionalnursingpractice.TOP:EvaluateMSC:CPNRE:Professional,Ethical,andLegalPractice12.Ayoungpregnantwomanwhosefetushasbeenexposedtomultipleteratogensconsentstoundergoserialpercutaneousumbilicalbloodsampling(PUBS)toexaminehowexposureaffectsthefetusovertime.Althoughthesetestswillnotimprovethefetussoutcomesandwillexposeittosomerisks,theinformationgatheredmayhelpinfantsinthefuture.Whichethicalprincipleisatgreatestrisk?a.Autonomy.b.Fidelity.c.Nonmaleficence.d.Beneficence.ANS:CNonmaleficenceistheethicalprinciplethatfocusesonavoidanceofharmorhurt.Thenursemustbalancerisksandbenefitsofcare.RepeatedPUBSmayplacethemotherandfetusatriskforinfectionandincreasedpain,andthemothermaybeatriskforincreasedemotionalhealthstress.Fidelityreferstotheagreementtokeeppromises,autonomyreferstofreedomtomakedecisionswithoutexternaUlcoSntrNol,aTndbeneOficencereferstotakingpositiveactionstohelpothers.DIF:ApplyREF:91|92OBJ:Describesomebasicethicalphilosophiesrelevanttohealthcare.TOP:EvaluateMSC:CPNRE:Professional,Ethical,andLegalPractice13.Ahighschoolteacherwithadvancedmultiplesclerosisteachesfromherwheelchairbutinsistsonbeingtreatedthesameasothercolleagues.Whichofthefollowingistheteacherdemonstrating?a.Preservingdignity.b.Choosingfromalternatives.c.Consideringallconsequences.d.Actingwithapatternofconsistency.ANS:ATheteacherschoiceispreservingdignity,Shecherishesherchoiceofbeingtreatedlikeeveryoneelsedespitehermedicalconditionandpubliclyaffirmsthechoicebyteachingfromherwheelchair.Atthispoint,havingalreadymadeachoice,theteacherisnotchoosingfromalternativesshecouldhavechosentoquitteaching,butshedidnotandisnotdemonstratingthatsheisstillconsideringallconsequences.Thesituationdoesnotreflectthatheractionshaveapatternofconsistency;sheisnotrepeatingaparticularbehaviour.DIF:AnalyzeREF:89|90CanadianFundamentalsofNursing7thEditionPotterTestBankUSNTOBJ:Describesomebasicethicalphilosophiesrelevanttohealthcare.TOP:AssessmentMSC:CPNRE:Professional,Ethical,andLegalPractice14.Whichofthefollowingisanexampleofethicalresponsibility?a.Deliveryofcompetentcare.b.Formationofinterpersonalrelationships.c.Applicationofthenursingprocess.d.Evaluationofnewcomputerizedtechnologies.ANS:AProvidingcompetentcareisoneofthevaluesthatnursesmustuphold.Formationofinterpersonalrelationships,applicationofthenursingprocess,andevaluationofnewcomputerizedtechnologiesarenotethicalresponsibilities.DIF:UnderstandREF:89OBJ:Explaintherelationshipbetweenethicsandprofessionalnursingpractice.TOP:AssessmentMSC:CPNRE:Professional,Ethical,andLegalPractice15.Thenurseiscaringforaseverelyillpatientwithacquiredimmunedeficiencysyndrome(AIDS)whonowrequiresventilatorsupport.Whichinterventionisconsideredfutile?a.Administeringtheinfluenzavaccine.b.Providingoralcareevery5hours.c.Applyingfentanylpatchesprnforpain.d.Supportingthepatientslowerextremitieswithpillows.ANS:AFutilereferstosomethingthatishopelessorservesnousefulpurpose;innursing,itreferstointerventionsthatareunlikelNytoRproIducGebeBne.fiCtfoMrthepatient.Avaccineisadministeredtopreventorlessenthelikelihoodofcontractinganinfectiousdiseaseatsometimeinthefuture;atthispoint,thepatientisdying.Caredeliveredtoapatientattheendoflifeisfocusedonpainmanagementandcomfortmeasures,suchasprovidingoralcare,applyingfentanylpatches,andsupportingthepatientslowerextremities.DIF:UnderstandREF:95OBJ:Identifycontemporaryethicalissuesinnursingpractice.TOP:ImplementationMSC:CPNRE:Professional,Ethical,andLegalPractice16.Duringasevererespiratoryepidemic,thelocalhealthcareorganizationsdecidetogivehealthcareproviderspriorityaccesstoventilatorsoverothermembersofthecommunitywhoalsoneedthatresource.Whichphilosophywouldgivethestrongestsupportforthisdecision?a.Feministethics.b.Utilitarianism.c.Deontology.d.Ethicsofcare.ANS:BFocusingonthegreatestgoodforthemostpeople,theorganizationsdecidetoensurethatasmanyhealthcareworkersaspossiblewillsurvivetocareforothermembersofthecommunity.DIF:UnderstandREF:91OBJ:Identifycontemporaryethicalissuesinnursingpractice.TOP:ImplementationCanadianFundamentalsofNursing7thEditionPotterTestBankMSC:CPNRE:Professional,Ethical,andLegalPractice17.Howaredeterminationsregardingqualityoflifecharacterized?a.Theyarebasedonapersonsabilitytoactaccordingtoethicalprinciples.b.Theyarebasedonapatientsself-determination.c.Theyarevaluejudgementsthatcanvaryfrompersontoperson.d.Theyareconsistentandstableoverthecourseofoneslifetime.ANS:CDeterminationsregardingqualityoflifearevaluejudgements,whicharebasedonwhatindividualsbelieveisdesirable.Beliefsaboutwhatpeoplefinddesirablevaryfrompersontoperson.Determinationsregardingqualityoflifearenotbasedonapersonsabilitytoactaccordingtoethicalprinciplesoronapatientsself-determination,andtheymaychangeoverthecourseofoneslifetime.DIF:UnderstandREF:95OBJ:Identifycontemporaryethicalissuesinnursingpractice.TOP:ImplementationMSC:CPNRE:Professional,Ethical,andLegalPractice18.Thenurseiscaringforapatientwhohasbeenunresponsivesincearrivalviaambulance8daysago.Thepatienthasnotbeenidentified,andnofamilymembershavebeenfound.Thenurseisconcernedabouttheplanofcareregardingmaintenanceorwithdrawaloflifesupportmeasures.Thenursedeterminesthatthisisanethicaldilemmanotresolvedbyscientificdata.Toresolvethisethicaldilemma,whichsequenceofthefollowingstepsiscorrect?1.Thenurseidentifiespossiblesolutionsoractionstoresolvethedilemma.2.Thenursereviewsthemedicalrecord,includingentriesbyallhealthcaredisciplines,togatherinformationrelevanttothispatientssituation.3.HealthcareprovidersuseNnUeRgoStiIatNioGnTtoBre.dCefOinMethepatientsplanofcare.4.Thenurseevaluatestheplanandrevisesitwithinputfromotherhealthcareprovidersasnecessary.5.Thenursearrangesameetingwithhealthcareteammemberstoclarifyopinions,values,andfacts.6.Thenursestatestheproblem.a.2,5,6,1,3,4.b.5,3,2,1,6,4.c.6,5,2,1,3,4.d.2,6,5,3,1,4.ANS:AOncethenursedeterminesthatanethicaldilemmaexists,thenursethenusesthestepsofprocessinganethicaldilemmatogatherinformationrelevanttothecase;meetswithmembersofthehealthcareteamtoclarifyvaluesanddistinguishesbetweenfact,opinion,andvalues;andverbalizestheproblem.Thenthenurseidentifiespossiblesolutionsoractions,workswiththehealthcareteamtonegotiateaplan,andevaluatestheplanovertime.DIF:ApplyREF:92-95OBJ:Applyamethodofethicalanalysistoaclinicalsituation.TOP:Assessment|Diagnosis|Evaluate|Implementation|PlanningMSC:CPNRE:Professional,Ethical,andLegalPracticeCanadianFundamentalsofNursing7thEditionPotterTestBankNRIGB.CMChapter08:LegalImplicationsinNursingPracticePotteretal:CanadianFundamentalsofNursing,7thEditionMULTIPLECHOICE1.Anewlyhiredexperiencednurseispreparingtochangeapatientsabdominaldressingandhasntdoneitbeforeatthishospital.Whichactionbythenurseisbest?a.Askanothernursetodoitsothecorrectmethodcanbeviewed.b.Checkthepolicyandproceduremanualfortheagencysmethod.c.Changethedressingusingthemethodtaughtinnursingschool.d.Askthepatienthowthedressingchangehasbeenrecentlydone.ANS:BTheCanadianCouncilonHealthServicesrequiresaccreditedhospitalstohavewrittennursingpoliciesandprocedures.Theseinternalstandardsofcarearespecificandneedtobeaccessibleonallnursingunits.Forexample,apolicy/procedureoutliningthestepstofollowinchangingadressingoradministeringmedicationprovidesspecificinformationabouthownursesaretodoit.Thenursebeingobservedmaynotbedoingtheprocedureaccordingtotheagencyspolicyorprocedure.Theproceduretaughtinnursingschoolmaynotbeconsistentwiththepolicyorprocedureforthisagency.Thepatientisnotresponsibleformaintainingthestandardsofpractice;patientinputisimportant,butitsnotwhatdirectsnursingpractice.DIF:ApplyREF:103OBJ:Listsourcesforstandardsofcarefornurses.TOP:PlanningMSC:CPNRE:Professional,Ethical,andLegalPractice2.AnewnurseatahealthcareunitnotesthatalistingofpatientnamesiskeptinaclosedbookbehindthefrontdeskofthenuUrsinSgstaNtionTsothaOtpatientscanbelocatedeasily.Whatactionismostappropriateforthenursetotake?a.Movethebooktotheupperledgeofthenursingstationforeasieraccess.b.Talkwiththenursemanageraboutthelistingbeingaviolationofconfidentiality.c.Usethebookasneededwhilekeepingitawayfromindividualsnotinvolvedinpatientcare.d.Askthenursemanagertomovethebooktoamoresecludedarea.ANS:CPatientsareentitledtoconfidentialityinhealthcare.Nursingstandardsforwhatconstitutesconfidentialinformationarebasedonprofessionalethicsandthecommonlaw.Thenursesjudgementmustbeguidedbytheidealsofprivacyandsensitivitytotheneedsandrightsofpatientswhomaynotchoosetohavenursesintrudeontheirlivesbutwhodependonnursesfortheircare.Thenurse'sfiduciarydutyrequiresthatconfidentialinformationnotbesharedwithanyoneelseexceptonaneed-to-knowbasis.Thebookislocatedwhereonlystaffwouldhaveaccess.Itisnottheresponsibilityofthenewnursetomoveitemsusedbyothersonthepatientunit.Thelistingsconfidentialityisprotectedaslongasitisusedappropriatelyasneededtoprovidecare.Thereisnoneedtomovethebooktoamoresecludedarea.DIF:ApplyREF:103|104OBJ:Describethelegalresponsibilitiesandobligationsofnurses.TOP:ImplementationMSC:CPNRE:Professional,Ethical,andLegalPracticeCanadianFundamentalsofNursing7thEditionPotterTestBankUSNTO3.Thelawthatwouldbestdealwithanurseaccidentallyadministeringanincorrectdoseofmorphinesulphatetoapatientiswhichofthefollowing?a.Civillaw.b.Criminallaw.c.Humanrightslaw.d.Statutelaw.ANS:ACivillawsprotecttherightsofindividuals.Accidentaladministrationofanincorrectdoseofmorphinesulphatewouldfallundercivillawbecauseitcouldcauseharmtoanindividual.Criminallawaimstoprotectsocietyfromharmandprovidepunishmentforintentionalcrimes(oftenimprisonment).Humanrightslawrelatestopublicmatters,notindividualmatters.Statutelawiscreatedbyparliamentary,provincial,andterritoriallegislatures.DIF:ApplyREF:101|102OBJ:Definelegalaspectsofnurse-patient,nurse-physician,nurse-nurse,andnurse-employerrelationships.TOP:ImplementationMSC:CPNRE:Professional,Ethical,andLegalPractice4.Thenursehasjustobtainedthelicencetopractiseandisdeterminingwhetherindividualmalpracticeinsuranceisnecessary.Whichofthefollowingisthemostimportantfactorinthenursesdecisiontocarrymalpracticeinsurance?a.Theamountofthemalpracticeinsuranceprovidedbytheemployer.b.Workinginacriticalareaofnursinginwhichmorbidityandmortalityratesarehigh.c.Employmentstatusandprofessionalliabilitycoverage.d.ThenursesknowledgeleNvelRofGIooGdSaBm.aCritanMlaws.ANS:CAllnursesshouldhaveclearknowledgeoftheiremploymentstatusandprofessionalliabilitycoverage.Publiclyfundedhealthcarefacilitiescarrymalpracticeinsurance.Thefacilityisconsideredtheemployerandisliableforthenegligentactsofitsemployeesaslongastheiractionswerewithintheirscopeofpractice.Theamountofthemalpracticeinsuranceprovidedbytheemployerisnotthemostimportantfactorindecidingaboutprivateinsurance.Ingeneral,theemployersmalpracticeinsurancecoverageismuchgreaterthanprivateinsurancecoverage.Theareaofnursingisnotthemostimportantfactorindecidingwhethertocarrymalpracticeinsurance;lawsuitscanoccuranywhere.ThenurseshouldbeawareofGoodSamaritanlaws,butthiswouldnotensuresufficientcoverageformostnursingpractice;therefore,itisnotthemostimportantfactorindeterminingwhethertopurchaseprivatemalpracticeinsurance.DIF:ApplyREF:107OBJ:Explainlegalconceptsthatapplytonurses.TOP:PlanningMSC:CPNRE:Professional,Ethical,andLegalPractice5.Anurseperformscardiopulmonaryresuscitation(CPR)ona92-year-oldpatientwithbrittlebonesandbreaksaribduringtheprocedure,whichthenpuncturesalung.Thepatientrecoverscompletelywithoutanyresidualproblemsandsuesthenurseforpainandsufferingandformalpractice.Whatkeypointwilltheprosecutionattempttoprove?a.TheCPRprocedurewasdoneincorrectly.b.Thepatientwouldhavediedifnothingwasdone.c.Thepatientwasresuscitatedaccordingtopolicy.CanadianFundamentalsofNursing7thEditionPotterTestBankd.Patientswithbrittlebonesmightsustainfractureswhenchestcompressionsaredone.ANS:ACertaincriteriaarenecessarytoestablishnursingmalpractice.Inthissituation,althoughharmwascaused,itwasnotbecauseoffailureofthenursetoperformadutyaccordingtostandardsthewayothernurseswouldhaveperformedinthesamesituation.Ifthenursehaddonetheprocedureincorrectly,thepatientprobablywouldnothavesurvivedwithoutanyresidualproblemssuchasbraindamage.Thefactthatthepatientsustainedinjuryasaresultofageandphysicalstatusdoesnotmeanthenursebreachedanydutytothepatient.Thenursewouldneedtomakesurethedefenceattorneyknewthatthecardiopulmonaryresuscitation(CPR)wasdonecorrectlyandthatwithoutintervention,thepatientprobablywouldnothavesurvived.Theprosecutionwouldtrytoprovethatabreachofdutyhadoccurred,whichhadcausedinjury,notthatcardiopulmonaryresuscitationwasdonecorrectly.Thedefenceteam,nottheprosecution,wouldexplainthecorrelationbetweenbrittlebonesandribfracturesduringCPR.DIF:UnderstandREF:104|105OBJ:Listtheelementsneededtoprovenegligence.TOP:ImplementationMSC:CPNRE:Professional,Ethical,andLegalPractice6.ArecentimmigrantwhodoesnotspeakEnglishisalertandrequireshospitalization.Whatistheinitialactionthatthenursemusttaketoobtaininformedconsent?a.Askafamilymembertotranslatewhatthenurseissaying.b.NotifythehealthcareproviderthatthepatientdoesntspeakEnglish.c.Requestanofficialinterpretertoexplainthetermsofconsent.d.UsehandgesturesandmedicalequipmentwhileexplaininginEnglish.ANS:CNURSINGTB.COMAnofficialinterpretermustbepresenttoexplainthetermsofconsenttoapatientwhospeaksonlyaforeignlanguage.Afamilymemberoracquaintancewhospeaksapatientslanguageshouldnotinterprethealthinformation.Familymemberscantellthosecaringforthepatientwhatthepatientissaying,butprivacyregardingthepatientscondition,assessment,andothermedicalmattersmustbeprotected.Thereisnowaytoconfirmthatthefamilymemberistranslatingexactlywhatthenurseissaying.Privacymustbeensuredandaccurateinformationmustbeprovidedtothepatient.Afterconsentisobtainedfortreatment,thehealthcareproviderwouldbenotifiedbecauselittlecanbedonewithoutconsent.Thehealthcareproviderneedstohavethetranslatoravailableduringthehistoryandphysicalexamination,aswellasatothertimes,butthefirststepistogetatranslatortoobtaininformedconsentbecausethisisnotanemergencysituation.Usinghandgesturesandmedicalequipmentisinappropriatewhencommunicatingwithapatientwhodoesnotunderstandthelanguagespokenbecause(1)certainhandgesturesmaybeacceptableinonecultureandnotappropriateinanother,(2)themedicalequipmentmaybeunknownandfrighteningtothepatient,and(3)thepatientstilldoesnotunderstandwhatisbeingsaid.DIF:ApplyREF:106OBJ:Giveexamplesoflegalissuesthatariseinnursingpractice.TOP:ImplementationMSC:CPNRE:Professional,Ethical,andLegalPractice7.Apediatriconcologynurseisfloatedtoanorthopedictraumaunit.Whatactionsshouldthenursemanageroftheorthopedicunittaketoenablethisfloatednursetogivesafecare?a.Provideacompleteorientationtothefunctioningoftheentireunit.CanadianFundamentalsofNursing7thEditionPotterTestBankb.Determineacuityofpatientsconditionsandthecarethenursecansafelyprovide.c.Allowthenursetochoosewhichmealtimeshewouldlike.d.Assignunregulatedcareproviderstoassistherwithcare.ANS:BNurseswhofloatneedtoinformthesupervisorofanylackofexperienceincaringforthetypeofpatientsonthenursingunit.Theyalsoneedtorequestandreceiveabasicorientationtotheunit.Supervisorsareliableiftheygiveastaffnurseanassignmentthatheorshecannotsafelyhandle.Beforeacceptingemployment,thenursemustlearnthepoliciesoftheinstitutionwithregardtofloatingandmusthaveanunderstandingofwhatisexpectedofafloatingnurse.Acompleteorientationofthefunctioningoftheentireunitwouldtakeaperiodoftimethatwouldexceedwhatthenursehastospendonorientation.Allowingthenursetochoosewhichmealtimeshewouldlikeisanicegestureofthanksforthenurse,butitdoesnotenablesafecare.Unregulatedcareprovidersmayhelpthenursecompletebasictaskssuchashygieneandturning,buttheirhelpdoesnotenablesafenursingcareforwhichthenurseisultimatelyresponsible.DIF:ApplyREF:108OBJ:Giveexamplesoflegalissuesthatariseinnursingpractice.TOP:ImplementationMSC:CPNRE:Professional,Ethical,andLegalPractice8.Anunconsciouspatientwithaheadinjuryneedsimmediatelife-savingsurgery.HiswifespeaksonlyFrench,andthehealthcareproviders,whoarenotfluentinFrench,arehavingadifficulttimeexplaininghisconditiontoher.Inthissituation,whatmustthenurseknow?a.TwolicensedhealthcareworkersshouldwitnessandsignthepreoperativeconsentformindicatingthattheyheardanexplanationoftheproceduregiveninEnglish.b.AnethicalreviewboardmNusRtbeIconGtactBed.tCogiMveitsemergencyadviceonthesituation.USNTOc.Afriendofthefamilymayactasaninterpreter,buttheexplanationcannotcontaindetailsofthepatientsaccidentbecauseofconfidentialitylaws.d.Thehealthcareteamshouldcontinuewiththesurgeryafterprovidinginformationinthebestmannerpossible.ANS:DInemergencysituations,ifitisimpossibletoobtainconsentfromthepatientoranauthorizedperson,thebeneficialorlife-savingproceduremaybeundertakenwithoutliabilityforfailuretoobtainconsent.Insuchcases,accordingtothelaw,thehealthcareteamwouldassumethatthepatientwouldwishtobegiventhetreatment.Thisisreferredtoastheemergencydoctrine.Twowitnessesarerequiredusuallywhentelephoneconsentsareinvolved.Thisisnotthecaseinthissituation.Inanemergency,itisnotnecessarytocontacttheinstitutionalreviewboard;doingsowouldtakeupvaluabletime.Afamilymemberoracquaintancewhoisabletospeakthepatientslanguageshouldnotbeusedtointerprethealthcareinformation.Anofficialinterpretermustbeavailabletoexplainthetermsofconsent(exceptinanemergencysituation).DIF:AnalyzeREF:106|107OBJ:Giveexamplesoflegalissuesthatariseinnursingpractice.TOP:ImplementationMSC:CPNRE:Professional,Ethical,andLegalPracticeCanadianFundamentalsofNursing7thEditionPotterTestBankUSNTO9.Becauseofaninfluenzaepidemicamongthenursingstaff,anursehasbeenmovedfromtheophthalmologyunittothegeneralsurgeryunit.Thesupervisorrecognizesthatthenurseisinexperiencedinthisspecialty.Whatshouldthenursedo?a.Politelyrefusetomove,takethedayoff,andgohome.b.Asktoworkwithanexperiencedgeneralsurgerynurse.c.Submitareportnotingtheirdissatisfaction.d.Notifythenursingregulatorybodyoftheissue.ANS:BNurseswhoaretemporarilyreassignedtoanotherunit(i.e.,float)shouldinformthesupervisoroftheirlackofexperienceincaringforpatientsonaparticularnursingunit.Theyalsoshouldrequest,andbegiven,basicorientationtotheunit.Askingtoworkwithanexperiencedgeneralsurgerynursewouldbeanappropriateaction.Refusingtoacceptanassignmentmaybeconsideredinsubordination,andpatientswillsufferifthenumberofavailablestaffdrops.Thenursecanmakeawrittenprotesttonursingadministrators,butitshouldnotbethenursesinitialrecourse.Notifyingthenursingregulatorybodyshouldnotbethenursesinitialrecourse.Thenurseshouldfirstnotifythesupervisorandrequestappropriateorientationandtraining.DIF:ApplyREF:108OBJ:Giveexamplesoflegalissuesthatariseinnursingpractice.TOP:ImplementationMSC:CPNRE:Professional,Ethical,andLegalPractice10.Aconfusedpatientwithaurinarycatheter,nasogastrictube,andintravenouslinekeepstouchingtheseitems,whichareneededforcare.Thenursehastriedtoexplaintothepatientthatheshouldnottouchthem,butthepatientcontinues.Whatisthebestactionbythenurseatthistime?NRIGB.CMa.Applyrestraintslooselyonthepatientsdominantwrist.b.Tryotherapproachestopreventthepatientfromtouchingthesecareitems.c.Notifythehealthcareproviderthatrestraintsareneededimmediatelytomaintainthepatientssafety.d.Allowthepatienttopulloutlinestoprovethatthepatientneedstoberestrained.ANS:BTherisksassociatedwiththeuseofrestraintsareserious.Withregardtorestraints,arestraint-freeenvironmentisthefirstgoalofcareforallpatients.Manyalternativestotheuseofrestraintsareavailable,andthenurseshouldtryallofthembeforenotifyingthepatientshealthcareprovider.Inthissituation,thepatientistouchingtheitems,nottryingtopullthemout;therefore,atthistime,thepatientswell-beingisnotatrisk.Thenursewillhavetocheckonthepatientfrequentlyandthenwilldeterminewhetherthehealthcareproviderneedstobeinformedofthesituation.Theinappropriateorunjustifieduseofrestraints(e.g.,byconfiningapersontoanarea,orbyusingphysicalorchemicalrestraints)mayalsobeviewedasfalseimprisonment.Thehealthcareproviderneedstoknowthesituationbutalsoneedstoknowthatallapproachespossiblehavebeenusedbeforewritinganorderforrestraints.Allowingthepatienttopulloutanyoftheseitemscouldcauseharmtothepatient.DIF:ApplyREF:104OBJ:Giveexamplesoflegalissuesthatariseinnursingpractice.TOP:ImplementationMSC:CPNRE:Professional,Ethical,andLegalPracticeCanadianFundamentalsofNursing7thEditionPotterTestBankNRIGB.CM11.Anurseisworkingwithaphysicianwhoprovidesmedicalassistanceindying(MAID)inCanada.Whatmustthenursebeawareof?a.ThenursecanprovideMAIDtoapatientbyadministeringasubstanceprescribedbythephysician.b.ThepatientrequestingMAIDmustbeatleast16yearsofageandcapableofmakinghealthcaredecisions.c.ThepatientsnaturaldeathmustbeunforeseeabletobeabletorequestMAID.d.ThepatientrequestingMAIDmustbeeligibleforpubliclyfundedhealthservicesinCanada.ANS:DThepatientrequestingMAIDmustbeeligibleforpubliclyfundedhealthservicesinCanada.OnlyaphysicianornursepractitionercanprovideapersonwithMAIDbyadministeringasubstancethatcausesdeath.ThepatientrequestingMAIDmustbeatleast18yearsofageandcapableofmakinghealthcaredecisions.Thepatientsnaturaldeathmustbereasonablyforeseeable,inviewofallofthepersonsmedicalcircumstances.DIF:ApplyREF:110,Box8-2OBJ:Describethelegalresponsibilitiesandobligationsofnurses.TOP:PlanningMSC:CPNRE:Professional,Ethical,andLegalPractice12.Thenurseisawarethatwhencaringforpatientswithcommunicablediseases,suchassevereacuterespiratorysyndrome(SARS)andacquiredimmunodeficiencysyndrome(AIDS),ofwhichofthefollowing?a.EveryhealthcareworkerwhocomesintocontactwithapatienthastherighttoknowthepatientsHIVinfectionstatus.b.TheycanrefusetocareforapatientwithSARSorAIDSifthereisalackofresourcesorongoingthreatUstoSperNsonTalwell-Obeing.c.Nursesareresponsibleforprovidingtheirownpersonalprotectiveequipmenttocareforpatientswithcommunicablediseases.d.InknowncasesofAIDSorSARS,informationcanbedisclosedwithoutthepatientsconsent.ANS:BNursesareabletorefusetoprovidecarewhentheyexperienceanunreasonableburden.Anunreasonableburdenexistswhenthenursesabilitytoprovidesafecareandmeetthestandardsofpracticeiscompromisedbyunreasonableexpectations,lackofresources,orongoingthreatstopersonalwell-being.NoteveryhealthcareworkerwhocomesincontactwithapatientneedstoknowthepatientsHIVstatus.Confidentialinformationmustbeprotected.Strictcompliancewithstandardprecautionsorroutinepracticesandtheuseoftransmission-based(e.g.,airborneordroplet)precautionsforpatientsknowntohaveorsuspectedofhavingseriouscommunicableillnessesisthenurseswiseststrategy;however,itisnotthenursesresponsibilitytoprovidethepersonalprotectiveequipment.Theemployerhasanobligationtoprovideitsemployeeswithnecessaryprotectivegear.Wheneverinformationaboutapatientisrequestedbyanythirdparties,includinginsurancecompaniesoremployers,nursesmustobtainasignedreleasefromthepatientbeforereleasingconfidentialinformation.DIF:ApplyREF:109OBJ:Listsourcesforstandardsofcarefornurses.TOP:ImplementationMSC:CPNRE:Professional,Ethical,andLegalPracticeCanadianFundamentalsofNursing7thEditionPotterTestBankNRIGB.C13.Anursingstudenthasbeenwrittenupseveraltimesforbeinglatewithprovidingpatientcareandforomittingaspectsofpatientcareandnotknowingbasicproceduresthatweretaughtintheskillscourseonetermearlier.Thenursingstudentsays,Idontunderstandwhatthebigdealis.Asmyinstructor,youaretheretoprotectmeandmakesureIdontmakemistakes.Whatisthebestresponsefromthenursinginstructor?a.Youareexpectedtoperformatthelevelofaprofessionalnurse.b.Youareexpectedtoperformatthelevelofanursingstudent.c.Youarepracticingunderthelicenceofthenurseassignedtothepatient.d.Youareexpectedtoperformatthelevelofaskillednursingassistant.ANS:AAlthoughnursingstudentsarenotemployeesofthehealthcareagencywheretheyarehavingtheirclinicalexperience,theyareexpectedtoperformasprofessionalnurseswouldinprovidingsafepatientcare.Differentlevelsofstandardsdonotapply.Nursingstudents,likenurses,mustprovidesafe,completepatientcare.Nostandardisusedfornursingstudents,otherthanthattheymustmeetthestandardsofaprofessionalnurse.Thenursinginstructor,notthenurseassignedtothepatient,isresponsiblefortheactionsofthenursingstudent.DIF:ApplyREF:107OBJ:Describethelegalresponsibilitiesandobligationsofnurses.TOP:ImplementationMSC:CPNRE:Professional,Ethical,andLegalPractice14.Whichofthefollowingisanexampleofcareinwhichanursemaybeliableforactionsthatconstituteanunintentionaltort?a.Physicalrestrainingapatientwhorefusescare.b.Takingphotosofapatientssurgicalwoundswithoutthepatientspermission.c.Thepatientfallingandbeinginjuredasaresultofsiderailsbeingleftdown.d.TalkingaboutapatientshUistorSyoNfsexTuallytrOansmittedinfections.ANS:CAnunintentionaltortisanunintendedwrongfulactagainstanotherpersonthatproducesinjuryorharm.Anexampleofanunintentionaltortwouldbeleavingthesiderailsdown,whichcausesthepatientsfallandinjury.Physicallyrestrainingapatientwhorefusescarewouldbeanexampleofassaultandbattery.Takingphotosofapatientssurgicalwoundswithoutthepatientspermissionandtalkingaboutapatientshistoryofsexuallytransmittedinfectionsareexamplesofinvasionofprivacy.Personalinformationaboutthepatientshouldbekeptconfidential.DIF:AnalyzeREF:104|105OBJ:Describethelegalresponsibilitiesandobligationsofnurses.TOP:AssessmentMSC:CPNRE:Professional,Ethical,andLegalPractice15.Anursingstudentinthefinaltermofnursingschoolisoverheardbyanursingfacultymembertellinganotherstudentthatshegottoinsertanasogastrictubeintheemergencydepartmentwhileshewasworkingasanursingassistant.Whatadviceisbestforthenursingfacultymembertogivetothenursingstudent?a.Justbecarefulwhenyouaredoingnewproceduresandmakesureyouarefollowingdirectionsbythenurse.b.Reviewyourproceduresbeforeyougotowork,soyouwillbepreparedtodothemifyouhaveachance.c.ThenurseshouldnothaveallowedyoutoinsertthenasogastrictubebecauseCanadianFundamentalsofNursing7thEditionPotterTestBanksomethingbadcouldhavehappened.d.Youarenotallowedtoperformanyproceduresotherthanthoseinyourjobdescriptionasanursingassistant,evenwiththenursespermission.ANS:DWhennursingstudentsworkasnursingassistantsornursesaideswhennotattendingclasses,theyshouldnotperformtasksthatdonotappearinajobdescriptionforanursesaideorassistant.Thenursingstudentshouldalwaysfollowthedirectionsofthenurse,unlessdoingsoviolatestheinstitutionsguidelinesorjobdescriptionunderwhichthenursingstudentwashired.Thenursingstudentshouldbeabletosafelycompletetheproceduresdelegatedasanursingassistant,andreviewingthosenotdonerecentlyisagoodidea,butithasnothingtodowiththesituation.Thisoptiondoesnotaddressthesituationthatthenursingstudentactedoutsidethejobdescriptionforthenursingassistantposition.Thefocusofthediscussionbetweenthenursingfacultymemberandthenursingstudentshouldbeonfollowingthejobdescriptionunderwhichthenursingstudentisworking.DIF:ApplyREF:107OBJ:Listsourcesforstandardsofcarefornurses.TOP:ImplementationMSC:CPNRE:Professional,Ethical,andLegalPractice16.Thenursecalculatesthemedicationdoseforaninfantonthepediatricunitanddeterminesthatthedoseistwicewhatitshouldbe.Thepediatricianiscontactedandsaystoadministerthemedicationasordered.Whatisthenextactionthatthenurseshouldtake?a.Notifythenursingsupervisor.b.Givethemedicationasordered.c.Givetheamountcalculatedtobecorrect.d.Contactthepharmacyforclarification.ANS:ANURSINGTB.COMNursesfollowhealthcareprovidersordersunlesstheybelievetheordersareinerrorormayharmpatients.Therefore,thenurseneedstoassessallorders.Ifanorderseemstobeerroneousorharmful,furtherclarificationfromthehealthcareproviderisnecessary.Ifthehealthcareproviderconfirmsanorderandthenursestillbelievesthatitisinappropriate,thenurseshouldinformthesupervisingnurse.Thesupervisingnurseshouldbeabletohelpresolvethequestionableorder,butonlythehealthcareproviderwhowrotetheorderorahealthcareprovidercoveringfortheonewhowrotetheordercanchangetheorder.Harmtotheinfantcouldoccurifthemedicationdosageistoohigh.Thenursecannotchangeanorder.Givingtheamountcalculatedtobecorrectwouldnotbewhatanothernursewoulddointhesamesituation.Althoughthepharmacyisanexcellentresource,onlythehealthcareprovidercanchangetheorder.DIF:ApplyREF:108OBJ:Definelegalaspectsofnurse-patient,nurse-physician,nurse-nurse,andnurse-employerrelationships.TOP:ImplementationMSC:CPNRE:Professional,Ethical,andLegalPractice17.Anursegivesanincorrectmedicationtoapatientwithoutdoingallofthemandatorychecks,butthepatienthasnoilleffectsfromthemedication.Whatactionsshouldthenursetakeafterreassessingthepatientandcompletinganincidentreport?a.Notifythehealthcareproviderofthesituation.b.Documentinthepatientsmedicalrecordthatanincidentreportwasfiled.c.Documentinthepatientsmedicalrecordwhytheomissionoccurred.CanadianFundamentalsofNursing7thEditionPotterTestBankd.Discusswhathappenedwithalloftheothernursesandstaffontheunit.ANS:AExamplesofanincidentincludeanerrorintechniqueorproceduresuchasfailingtoproperlyidentifyapatient.Institutionsgenerallyhavespecificguidelinestodirecthealthcareprovidershowtocompletetheincidentoradverseoccurrencereport.Thereportisconfidentialandseparatefromthemedicalrecord.Thenurseisresponsibleforprovidinginformationinthemedicalrecordabouttheoccurrence.Itisalsobestforthenursetodiscusstheoccurrencewithnursingmanagementonly.Theriskmanagementdepartmentoftheinstitutionalsorequirescompletedocumentation.Thefactthatanincidentreportwascompletedisnotdocumentedinthepatientsmedicalrecord.Nodiscussionofwhytheomissioninprocedureoccurredshouldbedocumentedinthepatientsmedicalrecord.Errorsshouldbediscussedonlywiththosewhoneedtoknow,suchasthehealthcareprovider,appropriateadministrativepersonnel,andriskmanagement.DIF:ApplyREF:111OBJ:Giveexamplesoflegalissuesthatariseinnursingpractice.TOP:ImplementationMSC:CPNRE:Professional,Ethical,andLegalPractice18.Thenurseisprovidingcaretoafemalepatientwhohasreceivedadiagnosisofterminalcancerandwhohasapoorprognosis.Whenthepatientshusbandcomesintothehospitalcafeteriaduringabusyperiod,thenurseapproacheshimandopenlyexpresseshersympathytothemanforhiswifesterminalillness.Thepatientshusbandburstsintotearsandsaysthathedidnotknowabouthiswifesdiagnosis.Thenursethentakeshimtoaprivateareatodiscusshisfeelings.Thisnursesactionexemplifieswhichofthefollowingviolations?(Selectallthatapply.)a.Intentionaltort.b.Unintentionaltort.c.Negligence.d.Assault.ANS:ANURSINGTB.COMThiscanbeconsideredanintentionaltortbecausethenurseisawarethatheorsheshouldnothavebreachedconfidentialityandthatthepatientsrightswereviolated.Thenursecanbeheldliableforslanderasthenursediscussesprivateinformationaboutapatientthatisoverheardbyothersinthecafeteria.Thisactionisalsoanexampleofinvasionofprivacyandoccursifapatientsmedicalinformationisdiscussedwithouttheconsentofthepatient.Thisactionisnotanexampleofnegligenceorofassault.DIF:AnalyzeREF:103-105OBJ:Giveexamplesoflegalissuesthatariseinnursingpractice.TOP:ImplementationMSC:CPNRE:Professional,Ethical,andLegalPracticeCanadianFundamentalsofNursing7thEditionPotterTestBankNRIGB.CMChapter09:GlobalHealthPotteretal:CanadianFundamentalsofNursing,7thEditionMULTIPLECHOICE1.Thenurserecognizestheterminologythatappliestocultureandethnicity.Ethnicityisdefinedaswhat?a.Anappreciationfordifferenceswithinanothergroupandthepromotionofrespectforthosedifferences.b.Acommonidentitywithmemberssharingsocialandculturalheritage.c.Manyculturescoexistingandmaintainingculturaldifferences.d.Thebeliefthatonesownraceorcultureismorevaluablethanthoseofothers.ANS:BEthnicityreferstoasharedidentityrelatedtosocialandculturalheritage,includingvalues,language,geographicspace,andracialcharacteristics.Themostimportantcharacteristicofanethnicgroupisthatitsmembersfeelasenseofcommonidentity.Culturalpluralismisaperspectivethatappreciatesanothergroupforbeingdifferentandpromotesrespectfortherightofotherstohavedifferentbeliefs,values,behaviours,andwaysoflife(Racher&Annis,2012,p.159).MulticulturalismisregardedasafundamentalcharacteristicofCanadiansociety;manyculturescoexistinCanadiansocietyandmaintaintheirculturaldifferences.Ethnocentrismisatendencytoholdonesownraceorcultureasmorevaluablethanthoseofothers.DIF:UnderstandREF:122|123OBJ:Definekeyconceptsrelatedtohealth,illness,anddiversity.TOP:AssessmentMSC:CPNURES:ProNfessTional,EOthical,andLegalPractice2.Preventionprogramsforpopulationsisthemainfocusofwhichofthefollowing?a.Globalhealth.b.Publichealth.c.Internationalhealth.d.Transculturalhealth.ANS:BThemainfocusofpublichealthispreventionprogramsforpopulations.Globalhealthandinternationalhealthembracebothpreventioninpopulationsandclinicalcareofindividuals.Transculturalhealthisnotadomainofmedicalhealth.DIF:UnderstandREF:116,Table9-1OBJ:Differentiatebetweenglobalhealth,internationalhealth,andpublichealthinthecontextofprofessionalnursing.TOP:AssessmentMSC:CPNRE:FoundationsofPractice3.Inunderstandinghealthinequity,whatdoesthenurseknow?a.Healthdifferencesareunavoidable.b.Povertyisnotarootcauseofhealthinequity.c.Healthinequityistheabsenceofsystematicdisparitiesinhealth.d.Healthinequityreferstounnecessaryandunfairdifferencesinhealth.ANS:DCanadianFundamentalsofNursing7thEditionPotterTestBankHealthinequitiesaredifferencesinhealththatarenotonlyunnecessaryandavoidablebutalsoareconsideredunfairandunjust.Healthdifferencesareseenasavoidable.Povertyisoftenarootcauseofhealthinequity.Theabsenceofsystematicdisparitiesinhealthischaracteristicofhealthequity.DIF:RememberREF:117OBJ:Definekeyconceptsrelatedtohealth,illness,anddiversity.TOP:AssessmentMSC:CPNRE:Professional,Ethical,andLegalPractice4.Whenaskedtodescribethedifferencesbetweenethnicityandrace,whatshouldthestudentnurseexplain?a.Ethnicityreferstoasharedidentity,whereasraceislimitedtobiologicalattributes.b.Ethnicityandraceareactuallythesameandarebasedinculturalnorms.c.Ethnicitycanbeunderstoodonlythroughaneticworldview.d.Racereferstoasharedidentity,whereasethnicityislimitedtobiologicalattributes.ANS:AEthnicityreferstoasharedidentityrelatedtosocialandculturalheritagesuchasvalues,language,geographicalspace,andracialcharacteristics.Ethnicityisdifferentfromrace,whichislimitedtothecommonbiologicalattributessharedbyagroupsuchasskincolourorbloodtype.Inanyinterculturalencounter,thereisaninsiderornativeperspective(emicworldview)andanoutsidersperspective(eticworldview).Ethnicityisbestunderstoodbythosewhoareapartofthatethnicityandhaveanemicworldview.DIF:UnderstandREF:122|123OBJ:Definekeyconceptsrelatedtohealth,illness,anddiversity.TOP:AssessmentMSC:CPNNURRES:PIroNfeGssTioBna.l,CEOthMical,andLegalPractice5.Thenurselearnsaboutculturalissuesinvolvedinthepatientshealthcarebeliefsystemandenablespatientsandfamiliestoachievemeaningfulandsupportivecare.Suchcareisknownaswhat?a.Ethnocentrism.b.Culturallycompetentcare.c.Culturalimposition.d.Culturallycongruentcare.ANS:BCulturallycompetentcarereflectstheabilityofanursetobridgeculturalgapsincaringandenablespatientsandfamiliestoachievemeaningfulandsupportivecaring.Itisasteptowardreachingculturallycongruentcare.Culturallycongruentcare,orcarethatfitsthepersonsvaluedlifepatternsandsetofmeanings,isthegoaloftransculturalnursing.Ethnocentrismisatendencytoholdonesownwayoflifeassuperiortothoseofothers.Itisthecauseofbiasesandprejudices.Culturalimpositionistheuseofonesownvaluesandlifestylesastheabsoluteguideindealingwithpatientsandinterpretingbehaviours.DIF:RememberREF:123OBJ:Describethehistoricaldevelopmentoftheconceptofculture,culturalcompetence,culturalsafety,andculturalhumilityinrelationtonursingpractice.TOP:AssessmentMSC:CPNRE:Professional,Ethical,andLegalPracticeCanadianFundamentalsofNursing7thEditionPotterTestBankNRIGB.CM6.ThenurseiscaringforanIndigenouspatientwhohashadrecentsurgery.Inthepatientsculture,itisasignofweaknesstocomplainofpain.Inthenursesculture,peoplewhoarehavingpainaskforpainmedicine.Thenursehasassumedthatthepatienthasnotbeenhavingpainanddoesnotneedmedicationbecausehehasnotcomplainedofpain.Whatisthenursedoing?a.Utilizingculturalimpositionbynotaskingthepatientabouthispain.b.Strivingtoprovideculturallycongruentcarebyallowingthepatienttosuffer.c.Operatingfromanemicworldviewofthepatientsculturalbeliefs.d.Practisingdiscriminationbynotgivingthepatientpainmedicine.ANS:AHealthcarepractitionerswhohaveculturalignoranceorculturalblindnessaboutdifferencesgenerallyresorttoculturalimpositionandusetheirownvaluesandlifestylesastheabsoluteguideindealingwithpatientsandinterpretingtheirbehaviours.Culturallycompetentcareisthecareprovidedbythenursewhoattemptstobridgeculturalgapsincaring,workwithculturaldifferences,andenablepatientsandfamiliestoachievemeaningfulandsupportivecaring.Thenurseinthiscasehasnotbeenabletodothis.Anyinterculturalencounterconsistsofaninsideornativeperspective(emicworldview)andanoutsidersperspective(eticworldview).Thenurseisobviouslyutilizinganeticworldview.Thenursedidnotpurposefullyignorethepatientsneed.DIF:ApplyREF:123OBJ:Analyzecomponentsofculturalassessmentcriticaltounderstandingthevalues,beliefs,andpracticescriticalinthenursingcareofpeopleexperiencingculturaltransitions.TOP:ImplementationMSC:CPNRE:Professional,Ethical,andLegalPractice7.Whenaculturalassessmentisperformed,knowledgeofapatientscountryoforiginanditshistoryandecologicalcontextsUiskSnowNnaTswhat?Oa.Ethnohistory.b.Bioculturalhistory.c.Socialorganization.d.Religiousandspiritualbeliefs.ANS:AApatientscountryoforiginanditshistoryandecologicalcontextsisknownasethnicheritageandethnohistory,andknowledgeaboutitissignificantinhealthcare.Bioculturalhistorycanhelpidentifyapatientshealthrisksinrelationtotheecologicalcontextoftheculture.Socialorganizationreferstounitsoforganizationinaculturalgroupdefinedbykinshipstatusandappropriaterolesfortheirmembers.Religiousandspiritualbeliefsaremajorinfluencesinthepatientsworldviewabouthealthandillness,painandsuffering,andlifeanddeath.Nursesneedtounderstandtheemicperspectiveoftheirpatients.DIF:RememberREF:126|127OBJ:Analyzecomponentsofculturalassessmentcriticaltounderstandingthevalues,beliefs,andpracticescriticalinthenursingcareofpeopleexperiencingculturaltransitions.TOP:AssessmentMSC:CPNRE:Professional,Ethical,andLegalPractice8.AnursingstudentiscaringforapatientwhohasjustimmigratedtoCanadafromGhana.Thestudentjusthadaclassonculturalsafetyandwantstopractisedoingaculturalassessment.Whatshouldthenursingstudentknow?a.Patientswhocomefromthesameregionorcountrysharesimilarvalues,beliefs,CanadianFundamentalsofNursing7thEditionPotterTestBankUSNTOattitudes,andexperiences.b.Culturalassessmentisasystematicandcomprehensiveexaminationoftheculturalcarevalues,beliefs,andpracticesofindividuals,familiesandcommunities.c.Thepatientshouldbediscouragedfromsharingpersonalstoriesbecauseitwilltakeuptoomuchtime.d.Thestudentshouldaskonlyopen-endedquestions.ANS:BCulturalassessmentisasystematicandcomprehensiveexaminationoftheculturalcarevalues,beliefs,andpracticesofindividuals,familiesandcommunities.Notallpatientswhocomefromthesameregionorcountrysharesimilarvalues,beliefs,attitudes,andexperiences.Thepatientshouldbeencouragedtosharepersonalstoriestorevealhowheorshethinksandtheculturallifestylethatheorsheembraces.Thestudentshoulduseopen-endedquestions,focusedquestions,andcontrastquestions.DIF:ApplyREF:126OBJ:Analyzecomponentsofculturalassessmentcriticaltounderstandingthevalues,beliefs,andpracticescriticalinthenursingcareofpeopleexperiencingculturaltransitions.TOP:ImplementationMSC:CPNRE:Professional,Ethical,andLegalPractice9.Thenurseiscaringforapatientwhohasemigratedfromanothercountry.Thepatientneedsabdominalsurgerybutseemsreluctanttosignthesurgicalpermits.Whatisonetacticthatthenurseshoulduse?a.Determinethefamilysocialhierarchy.b.Encouragethepatienttosignthepermits.c.Callthephysiciansothatsurgerycanbecancelled.d.ImpressonthepatientthaNtheRrlifIeisGinjBeo.pCardyM.ANS:ANursesshoulddeterminethefamilysocialhierarchyassoonaspossibletopreventoffendingpatientsandtheirfamilies.Workingwithestablishedfamilyhierarchypreventsdelaysandachievesbetterpatientoutcomes.Encouragingthepatienttosignagainsthersocialbeliefscancausefamilialstrife.Explainingthelevelofjeopardymaycreateunduestress.Nursesshouldbeabletodeterminethecorrecthierarchyandshouldnotinvolvethephysicianatthistime.DIF:ApplyREF:126OBJ:Analyzecomponentsofculturalassessmentcriticaltounderstandingthevalues,beliefs,andpracticescriticalinthenursingcareofpeopleexperiencingculturaltransitions.TOP:ImplementationMSC:CPNRE:Professional,Ethical,andLegalPractice10.Whichofthefollowingisanoutcomeofnursingeducationthatenablessafeservicetobedefinedbythosewhoreceivetheservice?a.Culturalawareness.b.Culturalsafety.c.Culturalsensitivity.d.Self-awareness.ANS:BCanadianFundamentalsofNursing7thEditionPotterTestBankCulturalsafetyisanoutcomeofnursingeducationthatenablessafeservicetobedefinedbythosewhoreceivetheservice.Culturalsafetyinvolvesconsideringtheredistributionofpowerandresourcesinarelationship.Culturalawarenessisabeginningsteptowardunderstandingthattherearedifferencesbetweencultures.Culturalsensitivityalertsnursestothelegitimacyofdifferenceandbeginsaprocessofself-exploration.Self-awarenessistheresultofreflection.DIF:UnderstandREF:124OBJ:Definekeyconceptsrelatedtohealth,illness,anddiversity.TOP:AssessmentMSC:CPNRE:Professional,Ethical,andLegalPractice11.Anursingstudentisdoingaculturalassessmentofapatient.Whenthestudentasks,Whomakesthedecisionsforyouoryourfamily?whatisthenurseassessing?a.Languageandcommunication.b.Caringbeliefsandpractices.c.Socioeconomicstatus.d.Socialorganization.ANS:DThequestionWhomakesthedecisionsforyouoryourfamily?wouldbeusedtoassesssocialorganizationduringtheculturalassessment.Thequestiondoesnotaddresscaringbeliefsandpractices,socioeconomicstatus,orlanguageandcommunication.DIF:ApplyREF:127OBJ:Analyzecomponentsofculturalassessmentcriticaltounderstandingthevalues,beliefs,andpracticescriticalinthenursingcareofpeopleexperiencingculturaltransitions.TOP:AssessmentMSC:CPNRE:Professional,Ethical,andLegalPracticeNURSINGTB.COM12.MembersofaChinesefamilythathasbeeninCanadafor5yearshavelearnedtospeakEnglishandhaveadoptedcertainWesterncustomsbuthavecontinuedtoadheretotheirvalues,beliefs,andtraditions.Whatisthisprocessreferredtoas?a.Assimilation.b.Enculturation.c.Acculturation.d.Multiculturalism.ANS:CAcculturationistheprocessofadaptingtooradoptingthecharacteristicsofanewculture.Assimilationisaprocesswherebyaminoritygroupgraduallyacquirestheattitudesandcustomsofthemainstreamculture.Socializationintoonesprimarycultureasachildisknownasenculturation.MulticulturalismthecoexistenceofmanyculturesandthemaintenanceofculturaldifferencesisprevalentinCanadiansociety.DIF:UnderstandREF:123OBJ:Analyzecomponentsofculturalassessmentcriticaltounderstandingthevalues,beliefs,andpracticescriticalinthenursingcareofpeopleexperiencingculturaltransitions.TOP:AssessmentMSC:CPNRE:Professional,Ethical,andLegalPractice13.Whencaringforapatientofadifferentculture,itisimportantforthenursetounderstandwhichofthefollowing?a.ThenurseshouldprotectthepatientfromfamilyintrusioninherhealthcareCanadianFundamentalsofNursing7thEditionPotterTestBankUSNTOdecisions.b.Workingwithintheestablishedfamilyhierarchyproducesbetteroutcomes.c.Womenasprimarycaregiversmakeindependenthealthdecisions.d.Genderisnotafactorwhenitcomestoroleexpectations.ANS:BWorkingwithestablishedfamilyhierarchypreventsdelaysandachievesbetterpatientoutcomes.Nursesneedtodeterminewhohasauthorityformakingdecisionswithinthefamilyandhowtocommunicatewiththeproperindividuals.Thenursemustnotassumethatjustbecauseawomanistheprimarycaregiver,shewillmakedecisionsindependently.Thenurseshoulddeterminethefamilysocialhierarchyassoonaspossible.Gendermayalsodifferentiateroleexpectations.DIF:ApplyREF:126OBJ:Analyzecomponentsofculturalassessmentcriticaltounderstandingthevalues,beliefs,andpracticescriticalinthenursingcareofpeopleexperiencingculturaltransitions.TOP:PlanningMSC:CPNRE:Professional,Ethical,andLegalPractice14.Timetakesondifferentmeaningsfromoneculturetoanother.Understandingthis,whenplanningnursinginterventions,whatshouldthenursedo?a.Avoidusingsettimesforprocedures.b.Mutuallynegotiatetimescheduleswithpatients.c.Encouragepatientstosettheirowntimesforcare,regardlessoftheschedule.d.Maintainthesettimesfortreatmentsandinformpatientsoftheschedule.ANS:BDifferencesexistinthedimensionsoftimethatculturesemphasizeandhowtimeisexpressed.PatientsaccesstoNheRalthIservGiceBsm.CaybMeachievedthroughtimeschedulesthataremutuallynegotiated,soastoallowforculturalpatternstoberespected.Fororganizationalpurposes,thenurseshouldseekthepatientsinput,andtogetherthenurseandthepatientmaysetatimetoperformprocedures.Althoughthepatientsinputshouldbesought,itisnotrealistictohavepatientssettheirowntimesfornursingcareactivitiesregardlessoftheschedule.Someproceduresmayberequiredmorefrequentlythanthepatientwouldset,orthenursemaybeunabletomeettheneedsofseveralpatientsontheunitatthesametime.Maintainingsettimesfortreatmentsandinformingthepatientofthescheduledoesnottakeintoconsiderationthepatientstimeorientation.DIF:ApplyREF:127|128OBJ:Analyzecomponentsofculturalassessmentcriticaltounderstandingthevalues,beliefs,andpracticescriticalinthenursingcareofpeopleexperiencingculturaltransitions.TOP:ImplementationMSC:CPNRE:Professional,Ethical,andLegalPractice15.Whatcharacterizesculturallycongruentcare?a.Itfitsthepatientsvaluedlifepatternsandsetofmeanings.b.Itisbasedonmeaningsgeneratedbypredeterminedcriteria.c.Itisthesameasthevaluesoftheprofessionalhealthcaresystem.d.Itisbasedontheassumptionthatapersonsownwayoflifeassuperiortothoseofotherpeople.ANS:ACanadianFundamentalsofNursing7thEditionPotterTestBankThegoaloftransculturalnursingisculturallycongruentcare,orcarethatfitsthepersonsvaluedlifepatternsandsetofmeanings.Patternsandmeaningsaregeneratedfrompeoplethemselves,ratherthanfrompredeterminedcriteria.Culturallycongruentcareissometimesdifferentfromthevaluesandmeaningsoftheprofessionalhealthcaresystem.Ethnocentrismisatendencytoholdonesownwayoflifeassuperiortothoseofothers,anditisnotpartofculturallycongruentcare.DIF:UnderstandREF:123OBJ:Applyresearchfindingstotheprovisionofculturallycompetentcarewithconsiderationsforculturalsafetyandrelationalpractice.TOP:AssessmentMSC:CPNRE:Professional,Ethical,andLegalPractice16.Thenursemayworkwithpatientsfrommanydifferentculturalbackgrounds.Nurses,unfortunatelyandinadvertently,mayimposetheirownculturalbeliefsonpatients.Whichofthefollowingisanexampleofanurseimposingpersonalperspectivesonapatient?a.Adaptingthepatientsroomtoaccommodateextrafamilymemberswhoarevisiting.b.Seekinginformationongender-congruentcareforanEgyptianpatient.c.DirectinganolderChinesepatienttodorehabilitationexercisesaftershehasrefusedtodothemuntilherdaughterarrives.d.Encouragingfamilymemberstoassistwiththepatientscarewhenitisappropriateforthemtodoso.ANS:CIncollectivisticculturesthatvaluegrouprelianceandinterdependence,suchastraditionalSouthAsiancultures,caringbehavioursaremanifestedbyactivelyprovidingphysicalandpsychologicalsupportforkinmembers.ThenursemayperceivethepatientsrefusalofexerciseaslackofmotivationNfUoRrsSeIlf-NcaGreT,Ban.dCinOtMhiscasethenurseisimposingherownbeliefsystemonthepatient.Adaptationofthepatientsroomtoaccommodateextrafamilymembersisnotanexampleofculturalimpositiononapatientbutratherismeetingthepatientsneedbyprovidingculturallycongruentcare.Seekinginformationongender-congruentcareforanEgyptianpatientisanexampleofthedesiretoprovideculturallycongruentcare.Encouragingfamilymemberstoassistwiththepatientscareisnotanexampleofculturalimpositiononapatient.Westernculturetendstofollowapatternofcaringthatfocusesonself-careandself-determination,whereasinnon-Westerncultures,peopletypicallyhavecareprovidedbyothers.DIF:ApplyREF:123OBJ:Applyresearchfindingstotheprovisionofculturallycompetentcarewithconsiderationsforculturalsafetyandrelationalpractice.TOP:ImplementationMSC:CPNRE:Professional,Ethical,andLegalPractice17.Whichofthefollowingisconsideredacommunicabledisease?a.Diabetes.b.Cardiovasculardisease.c.Influenza.d.Chronicrespiratorydisease.ANS:CCanadianFundamentalsofNursing7thEditionPotterTestBankInfluenzaiscontagiousandcanbetransmittedfromonepersontoanother;therefore,itiscommunicable.Noncommunicablediseasesarenotcontagious,meaningtheyarenotpassedfromoneindividualtoanother.Thefourmaintypesofnoncommunicablediseasesarediabetes,cardiovasculardiseases,chronicrespiratorydiseases,andcancers.DIF:UnderstandREF:118OBJ:Describekeychallengesinthepreventionandcontrolofcommunicabledisease,noncommunicabledisease(NCDs),andneglectedtropicaldisease(NTDs).TOP:PlanningMSC:CPNRE:FoundationsofPracticeNURSINGTB.COMCanadianFundamentalsofNursing7thEditionPotterTestBankChapter10:IndigenousHealthPotteretal:CanadianFundamentalsofNursing,7thEditionMULTIPLECHOICE1.Thenurseisawarethat,historically,Indigenouscommunitiesexperiencedhealthandwell-beingthroughwhichofthefollowing?a.Aholisticview.b.Abiomedicalview.c.Aspiritualview.d.Aphysicalview.ANS:AHistorically,Indigenouscommunitiesexperiencedhealingandwell-beingthroughaholisticviewofhealth,inwhichillnessandtreatmentconsistedofphysical,emotional,mentalandspiritualdimensions.DIF:UnderstandREF:136OBJ:DifferentiatebetweenIndigenoushealthfromaglobalperspectiveandIndigenoushealthfromaCanadianperspectiveTOP:PlanningMSC:CPNRE:Professional,Ethical,andLegalPractice2.Thesignificanteducational,income,healthandsocialdisparitiesbetweenIndigenouspeopleandotherCanadiansisareflectionofwhat?a.ThegeographicalspreadofCanadaspopulation.b.Geneticdiseasesthatarepassedthroughgenerations.c.PhysicalandpsychologicNalUaRbuSsIefNroGmTtBhe.ICndOiaMnresidentialschoolsystem.d.Infectiousdiseasesprocesses.ANS:COverseveralgenerations,theIndianresidentialschoolsystemleftalegacyofphysicalandpsychologicalabusethatisreflectedinthesignificanteducational,income,healthandsocialdisparitiesbetweenAboriginalpeopleandotherCanadians(TRC,2015b,p.135).DIF:UnderstandREF:137OBJ:Examinethelegacyofresidentialschools,whichhashaddevastatingconsequencesforIndigenouscommunitiesacrossCanada.TOP:DiagnosisMSC:CPNRE:Professional,Ethical,andLegalPractice3.Accordingtotherecordskept,itisestimatedthatatleasthowmanychildrendiedfrommalnourishment,diseasessuchastuberculosis(TB),andabuseatresidentialschoolsinCanada?a.150.b.1500.c.3200.d.5000.ANS:CCanadianFundamentalsofNursing7thEditionPotterTestBankUSNTOItisestimatedthatatleast3200childrendiedfrommalnourishment,diseasessuchasTB,andabuse;thisnumberincludesthosewhoranawayandthosewhofrozetodeath.Thenumberofchildrenwhodiedcouldbe5to10timeshigher;however,becauseofpoorrecord-keeping,thefullnumbermayneverbeknown.DIF:RememberREF:137OBJ:Examinethelegacyofresidentialschools,whichhashaddevastatingconsequencesforIndigenouscommunitiesacrossCanada.TOP:EvaluateMSC:CPNRE:Professional,Ethical,andLegalPractice4.Whichofthefollowingcanbedefinedasthepathwaysbywhichtraumaistransmittedfromonegenerationtothenext?a.Birthtrauma.b.Post-traumaticstressdisorder.c.Intergenerationaltrauma.d.Generationaltraumaticdisorder.ANS:CIntergenerationaltraumaisdefinedasthepathwaysbywhichthenatureoftraumaisunderstoodandexperiencedbyIndigenoussurvivorsoftheresidentialschoolsystemandtheirdescendants,aswellasthepathwaysbywhichthistraumaistransmittedfromonegenerationtothenext(Aguiar&Halseth,2015,p.23).DIF:UnderstandREF:137OBJ:Examinethelegacyofresidentialschools,whichhashaddevastatingconsequencesforIndigenouscommunitiesacrossCanada.TOP:EvaluateMSC:CPNRE:Professional,Ethical,andLegalPracticeNRIGB.CM5.TheTruthandReconciliationCommissionissueditsfinalreportin2015.ItstatedthatCanadawasguiltyofthedestructionofthosestructuresandpracticesthatallowagrouptocontinueasagroup.Suchdestructionisknownaswhichofthefollowing?a.Structuralracism.b.Culturalgenocide.c.Intergenerationaltrauma.d.Colonialism.ANS:BTheTruthandReconciliationCommissionstatedthatCanadawasguiltyofculturalgenocidewithregardtoIndigenouspeopleinCanada,whichisthedestructionofthosestructuresandpracticesthatallowthegrouptocontinueasagroup(TruthandReconciliationCommission,2015a,p.3).Suchdestructionofpracticesandstructuresincludedoccupyingandseizingland;forcingrelocationofIndigenouspeoplesandconfiningthemtoreserves;disempoweringthemthroughreplacementofexistingformsofIndigenousgovernment;anddenyingthembasicrights,suchastherighttopractisetheirfaith,therighttoassemble,andtherighttolegalcounsel.DIF:UnderstandREF:138OBJ:ExaminetheCanadianhistoryofcolonizationthatincludespre-Europeanandpost-Europeancontact.TOP:AssessmentMSC:CPNRE:Professional,Ethical,andLegalPracticeCanadianFundamentalsofNursing7thEditionPotterTestBankUSNT6.HealthcareforIndigenouschildrenlivingonreservesisfundedthroughthefederalgovernmentbutisregulatedthroughprovincial/territorialsystemsandpolicies.Thiscomplexfundingsystem,resultingindenial,delay,ordisruptionofservices,isanexampleofwhat?a.Holistichealthcare.b.Culturalgenocide.c.Intergenerationaltrauma.d.Structuralracism.ANS:DThecomplexfundingsystemforIndigenouschildrenlivingonreservesisoneexampleofstructuralracism.Structuralracismisthelegitimizedandnormalizedspectrumofattitudes,practices,andpoliciesthatconsistentlyresultinchronicandcontinuoussubstandardoutcomesforIndigenouspeoples.DIF:ApplyREF:138OBJ:Describetheconceptsofstructuralracism,childwelfare,poverty,andthejusticesysteminrelationtonursingpractice.TOP:EvaluateMSC:CPNRE:Professional,Ethical,andLegalPractice7.Incomparisonwithnon-Indigenouschildren,IndigenouschildrenarewhatintheCanadianchildwelfaresystem?a.Overrepresented.b.Underrepresented.c.Equallyrepresented.d.Nonexistent.ANS:AAcrossCanada,IndigenouscNhildRrenIareGoveBrr.epCreseMntedinthechildwelfaresystem.Insomeprovinces,therateofout-of-homecareforIndigenouschildrenismorethan10timesthatofnon-Indigenouschildren.DIF:RememberREF:140OBJ:Describetheconceptsofstructuralracism,childwelfare,poverty,andthejusticesysteminrelationtonursingpractice.TOP:AssessmentMSC:CPNRE:Professional,Ethical,andLegalPractice8.WhichofthefollowingplaysaroleintheincarcerationratesofIndigenouspeople?a.Violence.b.Fetalalcoholspectrumdisorder.c.Schizophrenia.d.Depression.ANS:BFetalalcoholspectrumdisorder(FASD)playsaroleintheincreasingincarcerationratesofIndigenouspeople.Itisestimatedthat10to25%ofallCanadianswhoareincarceratedsufferfromFASD.ForIndigenouspeople,thereisoftenaconnectionbetweenresidentialschoolexperience,addiction,andFASD.DIF:ApplyREF:141OBJ:Describetheconceptsofstructuralracism,childwelfare,poverty,andthejusticesysteminrelationtonursingpractice.TOP:EvaluateMSC:CPNRE:Professional,Ethical,andLegalPracticeCanadianFundamentalsofNursing7thEditionPotterTestBankUSNTO9.AnursecaringforanIndigenousfamilyisawarethatglobally,Indigenouspeopleshavemuchincommonintermsofworldviews.Howistheconceptoftimeconsidered?a.Itisfocusedonminutesratherthandays.b.Itisfocusedonyearsratherthanmonths.c.Itisfocusedonseasonsratherthanhours.d.Itisfocusedonlunarcyclesratherthanmonths.ANS:CThesenseoftimeinIndigenousworldviewsiselastic,focusedonseasonsratherthanhours.Itisnotfocusedonminutesratherthandays,yearsratherthanmonths,orlunarcyclesratherthanmonths.DIF:UnderstandREF:141OBJ:DescribecomponentsofIndigenousculturalorientationsinrelationtonursingpractice.TOP:PlanningMSC:CPNRE:Professional,Ethical,andLegalPractice10.Indigenousyouthwhowereadoptedhaveshownextremelypoorself-esteemastheystrugglewithreconfiguringtheiridentity.Thishasbeenexpressedinhighratesofwhichproblem?a.Eatingdisorders.b.Suicidalideation.c.Schizophrenia.d.Dissociativeidentitydisorder.ANS:BIndigenousyouthwhowereadoptedhaveshownextremelypoorself-esteemandhighratesofsuicidalideationastheystrugglewithreconfiguringtheiridentity.MentalhealthdisordersingeneralaremoreprevalentinNthiRspoIpulGationBt.hCaninMothers;however,suicidalideationisdirectlylinkedtothereconfigurationofidentity.DIF:ApplyREF:142OBJ:ExamineselectedchronicillnessexperiencesrelevanttotheIndigenouspeoplesofCanada.TOP:DiagnosisMSC:CPNRE:Professional,Ethical,andLegalPractice11.Aprocessthatisreciprocal,inwhichpeopleareviewedandtreatedasinherentlyworthyandequal,isafundamentalaspectofnursingpracticeknownaswhichofthefollowing?a.Respect.b.Dignity.c.Justice.d.Acceptance.ANS:ARespectisaprocessthatisreciprocal,inwhichpeopleareviewedandtreatedasinherentlyworthyandequalinprinciple.Respectisdemonstratedbyawillingnesstobeacceptingandtolistenactively,aswellasgenuinelytryingtounderstandthesituationspatientsfoundthemselvesin.Respectaddressesdignityandjustice.DIF:ApplyREF:143OBJ:Differentiatebetweenrespect,trust,andspiritualityinthecontextofcaringforIndigenouspeople.TOP:PlanningMSC:CPNRE:Professional,Ethical,andLegalPractice12.AnursewhoiscaringforanIndigenousfamilymustbeawareofwhichofthefollowing?CanadianFundamentalsofNursing7thEditionPotterTestBanka.AllIndigenouspeoplespractiseburningsweetgrassasacleansingactivity.b.ManyIndigenouspeoplespractiseculturalknowledgebecauseofcolonization.c.NotallIndigenouspeoplefollowtraditionalIndigenousfaiths.d.Itemsplacedinthebedorpinnedtothepatientsgownmaybemovedasneeded.ANS:CNotallIndigenouspeoplefollowtraditionalIndigenousfaiths.ManyIndigenouspeopleshavelosttheirculturalknowledgebecauseofcolonizationandculturalgenocide.SomeIndigenouspeopleburnsweetgrassasacleansingactivity,butthenursecannotassumethatallIndigenouspeoplespractisethisactivity.Itemsplacedinthebedorpinnedtothepatientsgownshouldnotbemovedasneeded,astheymayholdspiritualandhealingsignificanceforthepatientandfamily.DIF:AnalyzeREF:143OBJ:DescribecomponentsofIndigenousculturalorientationsinrelationtonursingpractice.TOP:ImplementationMSC:CPNRE:Professional,Ethical,andLegalPractice13.ThenurseisdocumentinganadmissionhistoryforanIndigenousyouth.Whichofthefollowingquestionsmightthenurseask,inordertoassessintermediatedeterminantsofhealth?a.Whatdidyoueatinthelast24hours?b.Whatgradeareyouin?c.Doyousmoke?d.Howmuchphysicalactivitydoyoudoeachweek?ANS:BIntermediatedeterminantsofhealthincludeeducation,communityinfrastructure,resourcesandsystems.AskingtheyouNthUabRoSutIaNccGesTsBto.eCducMationwouldhelpthenurseassessintermediatedeterminantsofhealth.Diet,physicalactivity,andsmokingareallconsideredproximaldeterminantsofhealth.DIF:AnalyzeREF:144OBJ:ExamineselectedchronicillnessexperiencesrelevanttotheIndigenouspeoplesofCanada.TOP:AssessmentMSC:CPNRE:FoundationsofPractice14.Whichofthefollowingwouldbeconsideredadistaldeterminantofhealth?a.Effectivepolicingservices.b.Accesstowalkingtrails.c.Eatingnutritiousmeals.d.Exercisingdaily.ANS:ADistaldeterminantsofhealthhavethemostinfluenceonapopulationshealthandencompassthehistorical,political,social,andeconomiccontextsfromwhichintermediateandproximaldeterminantsofhealthareconstructed(suchasstablegovernmentstructures,competentleadership,andeffectivepolicingservices).Accesstowalkingtrailsisconsideredanintermediatedeterminantofhealth.Eatingnutritiousmealsandexercisingdailyareconsideredproximaldeterminantsofhealth.DIF:ApplyREF:144OBJ:ExamineselectedchronicillnessexperiencesrelevanttotheIndigenouspeoplesofCanada.TOP:EvaluateMSC:CPNRE:FoundationsofPracticeCanadianFundamentalsofNursing7thEditionPotterTestBankUSNT15.Whichofthefollowinggroupshasthehighestrateoftype2diabetesmellitus?a.Indigenouspeoplelivinginanurbansetting.b.Indigenouspeoplelivinginaruralsetting.c.Non-Indigenouspeoplelivinginanurbansetting.d.Non-Indigenouspeoplelivinginaruralsetting.ANS:BIndigenouspeoplelivinginruralareashaveahigherrateofdiabetesthandothoselivinginanurbansetting.Indigenousmenandwomenhaveagreaterriskofdiabetesatamuchyoungeragethandonon-Indigenouspeople.DIF:UnderstandREF:145OBJ:ExamineselectedchronicillnessexperiencesrelevanttotheIndigenouspeoplesofCanada.TOP:DiagnosisMSC:CPNRE:FoundationsofPractice16.Incomparisonwiththeirnon-Indigenouscounterparts,IndigenouspersonswithadiagnosisofHIVinfectionaremorelikelytobewhat?a.Older.b.Male.c.Infectedthroughintravenousdruguse.d.Transgender.ANS:CIncomparisonwiththeirnon-Indigenouscounterparts,IndigenouspersonswithadiagnosisofHIVinfectionaremorelikelytobeyounger,female,andinfectedthroughintravenousdruguse.ThereiscurrentlynoresearchontheeffectofHIV/AIDSonTwoSpiritpeople(thetermTwoSpiritisusedbyIndigenNousRpeoIpleGtoiBde.nCtifyMarangeofrolesandidentitiesthatincludegender,sex,andsexualidentity).DIF:UnderstandREF:147OBJ:ExamineselectedchronicillnessexperiencesrelevanttotheIndigenouspeoplesofCanada.TOP:AssessmentMSC:CPNRE:FoundationsofPractice17.Whichofthefollowingpopulationshasthehighestrateoflungcancerintheworld?a.Indigenouspeoplewholiveonreserves.b.MtiswholiveinQuebec.c.Indigenouselders.d.ThecircumpolarInuitpopulation.ANS:DThecircumpolarInuitpopulationhasthehighestrateoflungcancerintheworld.SmokingishighlyprevalentamongtheInuit;almost63%ofCanadianInuitaredailysmokers.Theeffectsofcolonization,residentialschools,dietchanges,andalterationsinlifestylehaveallbeencitedasfactorsintheincreaseofcancersamongIndigenouspeopleinCanada.DIF:RememberREF:147OBJ:ExamineselectedchronicillnessexperiencesrelevanttotheIndigenouspeoplesofCanada.TOP:EvaluateMSC:CPNRE:FoundationsofPracticeCanadianFundamentalsofNursing7thEditionPotterTestBank18.ThenurseiscaringforanIndigenouswomanwhodescribeshavingbeentakenawayfromherfamilyandplacedinanon-Indigenoushomewhenshewasachild.Whatisthetermforthisphenomenon?a.TheChildCareAct.b.Forcedadoption.c.TheSixtiesScoop.d.TheProtectionAct.ANS:CTheSixtiesScoopwasaphenomenonthatcontinuedintothe1990s,inwhichchildrenwereapprehendedfromreservationsandIndigenousfamiliesontheslightestpretextinordertosavethemfromtheeffectsofcrushingpoverty,unsanitaryhealthconditions,poorhousingandmalnutrition(Johnson,1983,p.23).Manyofthechildrenwhowereremovedfromtheirhomesandplacedwithnon-Indigenousfamiliesdidnotfarewell.ThisphenomenonisnottermedtheChildCareAct,forcedadoption,ortheProtectionAct.DIF:ApplyREF:139OBJ:Describetheconceptsofstructuralracism,childwelfare,poverty,andthejusticesysteminrelationtonursingpractice.TOP:AssessmentMSC:CPNRE:Professional,Ethical,andLegalPractice19.WhichofthefollowingisanintermediatedeterminantofhealththathascontributedtohealthproblemsinIndigenouscommunities?a.Changeindiet.b.Sedentarylifestyle.c.Contaminationofwildlife,vegetation,andwater.d.Smoking.ANS:CNURSINGTB.COMPoorenvironmentalstewardship,disempowerment,andcontaminationofwildlife,vegetation,andwaterhavecontributedtohealthproblems.Dietchanges,sedentarylifestyle,andsmokingwouldbeconsideredproximaldeterminantsofhealth,notintermediate.DIF:UnderstandREF:144|145OBJ:ExamineselectedchronicillnessexperiencesrelevanttotheIndigenouspeoplesofCanada.TOP:EvaluateMSC:CPNRE:FoundationsofPracticeCanadianFundamentalsofNursing7thEditionPotterTestBankNRIGB.CMChapter11:NursingLeadership,Management,andCollaborativePracticePotteretal:CanadianFundamentalsofNursing,7thEditionMULTIPLECHOICE1.Whichofthefollowingisarequirementforanewnurseindelegatingtaskstoanunregulatedcareprovider(UCP)?a.ObtainingtheUCPsvoluntaryacceptanceofthetask.b.Communicatingthetaskinunderstandableterms.c.Functioningwithalaissez-fairestyleofleadership.d.AlwayssupervisingtheUCP.ANS:BWhendelegating,thenurseshouldalwaysprovideunambiguousandcleardirectionsbydescribingthetask,thedesiredoutcome,andtheperiodwithinwhichthetaskshouldbecompleted.TasksshouldbedelegatedtoUCPswhoarecapable,notnecessarilytothosewhoarewilling.Alaissez-fairestyleofleadershipisnotarequirementfordelegation.ThenursedoesnotnecessarilyhavetosupervisetheUCP,unlessitisrequiredbypolicyorunlessthenurseisunsureoftheUCPsabilitytoperformthetask.DIF:UnderstandREF:166|167OBJ:Discussprinciplesfortheappropriatedelegationofpatientcareactivities.TOP:ImplementationMSC:CPNRE:CollaborativePractice2.Tobeabletomeettheneedsofassignedpatientsandtheresponsibilitiesassociatedwiththeposition,nursesmustbeawareoftimemanagementtechniques.AtimemanagementskillforthenurseiswhichofthefollowUingS?NTOa.Meetingallofthepatientsneedsintheearly-morninghours.b.Planningeffectivelyandbeingawareofcompetingpriorities.c.Conductingpatientassessmentsindividuallyatseparatetimesthroughouttheday.d.Leavingeachdayunplannedtoallowforadaptationsintreatments.ANS:BTimemanagementskillsfornursesincludereflectingonhowtheyusetheirtime,planningeffectively,andbeingawareofcompetingpriorities.Learningnewtechnologies,jugglingvariouspriorities,andrespondingtomultipledemandsareissuestowhichnursesarerequiredtorespondinatimelymanner.Meetingallofthepatientsneedsintheearly-morninghourswouldbeanunrealisticgoalbecause(1)someactivitieshavespecifictimelimitsintermsofaddressingpatientneeds,andsomeactivitiesfollowscheduledroutinesaccordingtohospitalpolicyand(2)thenursemayalsohavetoworkaroundchangesinschedules,suchasatestthatwasorderedforthemorning.Timemanagementinvolvesusingpatientgoalsasawaytoidentifypriorities.Thenurse,inreviewingthecarerequirements,organizeshisorhertimesotheactivitiesofcareandpatientgoalscanbeachieved.Thenurseshouldcompletetheactivitiesstartedwithonepatientbeforemovingontoanother.Becausethenursehasalimitedamountoftimewithpatients,itisessentialtoremaingoal-orientedandmakeaplanforusingtimewisely,whichmightincludeconductingpatientassessmentstogetherthanatseparatetimesoftheday.DIF:ApplyREF:166OBJ:Discusswaystoapplyskillsofclinicalcarecoordinationinnursingpractice.CanadianFundamentalsofNursing7thEditionPotterTestBankTOP:ImplementationMSC:CPNRE:Professional,Ethical,andLegalPractice3.Nursingmanagementinafacilityisconsideringanursingcaredeliverymodelthatinvolvesthedivisionoftasks,witheachnurseassumingtheresponsibilityforparticulartasks.Whatisthismodelreferredtoas?a.Totalpatientcare.b.Functionalnursing.c.Teamnursing.d.Primarynursing.ANS:BFunctionalnursingistaskfocused,notpatientfocused.Inthismodel,tasksaredivided,withonenurseassumingresponsibilityforspecifictasks.Inthetotalpatientcaremodel,aregisterednurse(RN)isresponsibleforallaspectsofcareforoneormorepatients.TheRNmaydelegateaspectsofcarebutretainsaccountabilityforcareofallassignedpatients.Inteamnursing,anRNleadsateamthatiscomposedofotherRNs,registeredpsychiatricnursesorlicensedpracticalnurses,andunregulatedcareproviders(UCPs).Theteammembersprovidedirectpatientcaretogroupsofpatients,underthedirectionoftheRNteamleader.UCPsaregivenpatientassignmentsratherthanbeingassignedparticulartasks.Intheprimarynursingmodel,anRNassumesresponsibilityforacaseloadofpatientsovertime.Typically,theRNselectsthepatientsforhisorhercaseloadandcaresforthesamepatientsduringtheirhospitalizationorstayinthehealthcaresetting.DIF:UnderstandREF:162OBJ:Describethepurpose,elements,andmodelsforqualitypracticeenvironmentsandpatientsafety.TOP:AssessmentMSC:CPNRE:CollaborativePractice4.ThemedicalcentrehaschangNeUdRitsSoIvNerGalTlmBa.nCagOemMentphilosophyfromcentralizedtodecentralizedmanagement.Whatisoneadvantageofadecentralizedmanagementstructureoveracentralizedstructureforthenursingunits?a.Staffmembersarenotresponsiblefordefiningtheirroles.b.Nursemanagershandlethedifficultdecisions.c.Communicationpathwaysaresimplified.d.Eachstaffmemberisactivelyinvolved.ANS:DIndecentralizedmanagement,decisionmakingismoveddowntothelevelofstaff.Theadvantageofthisstructureisthatmanagersandstaffareactivelyinvolvedinshapinganorganizationsidentityanddeterminingitssuccess.Ifdecentralizeddecisionmakingisinplace,professionalstaffmembershaveavoiceinidentifyingtheLPN/RPNrole.EachLPN/RPNontheworkteamisresponsibleforknowinghisorherroleandhowitistobeimplementedonthenursingunit.Decentralizedmanagementischaracterizedbyautonomy(freedomtodecideandact).Thenursemanagerdoesnotnecessarilyhandlethedifficultdecisions;thestaffmemberswhoarebestinformedaboutaproblemorissuemakedecisionsonthebasisoftheirknowledge.Communicationpathwaysarenotnecessarilysimplifiedinadecentralizedmanagementstructure.DIF:UnderstandREF:163OBJ:Describetherelationshipsbetweennursingleadershipandhealthypracticeenvironments,patientsafety,andqualitypatientcareoutcomes.TOP:ImplementationMSC:CPNRE:Professional,Ethical,andLegalPracticeCanadianFundamentalsofNursing7thEditionPotterTestBankUSNT5.Whichofthefollowingisoneofthefourelementsofdecisionmaking?a.Justice.b.Responsibility.c.Accessibility.d.Resourceallocation.ANS:BResponsibilityisoneofthefourelementsofdecisionmaking.Theotherthreeelementsareautonomy,authority,andaccountability.Justiceandresourceallocationareethicalprinciplesandarenotamongthefourelementsofdecisionmaking.AccessibilityisoneofthefiveprinciplesoftheCanadaHealthAct.DIF:RememberREF:164|165OBJ:Identifystrategiesfordevelopingentry-levelcompetenciesrelatedtomanagementandleadershipinnursing.TOP:PlanningMSC:CPNRE:Professional,Ethical,andLegalPractice6.Thechargenurseasksanexperiencednursetoadmitapalliativepatientwhoarrivesonthepediatricunit.Whatdoesthisactionexemplify?a.Evaluation.b.Supervision.c.Assignment.d.Delegation.ANS:CAssignmentistheactiontakenwhenthepatientorinterventionsarewithinthenursesscopeofpractice.TheexperiencedNnursReisIcapGablBe.ofCtakMingonthispatientassignment.Delegationistransferringtheresponsibilitytoperformafunctionorinterventiontosomeonewhowouldnototherwisehavetheauthoritytoperformit(i.e.,thefunctionorinterventionisnotwithinthescopeofpracticeorscopeofemploymentofthecareprovidertowhomthecareisbeingdelegated).Thisisnotanexampleofevaluationorsupervision.DIF:UnderstandREF:167OBJ:Discussprinciplesfortheappropriatedelegationofpatientcareactivities.TOP:PlanningMSC:CPNRE:Professional,Ethical,andLegalPractice7.ThenursingmanagementteaminafacilityisinvestigatinganursingcaredeliverymodelthatinvolvesstaffmembersworkingunderthedirectionofanRNleader.Whatdoesthismodelreflect?a.Teamnursing.b.Primarynursing.c.Functionalnursing.d.Totalpatientcare.ANS:ACanadianFundamentalsofNursing7thEditionPotterTestBankNRIGB.CMInteamnursing,anRNleadsateamthatiscomposedofotherRNs,registeredpsychiatricnursesorlicensedpracticalnurses,andUCPs.Theteammembersprovidedirectpatientcaretogroupsofpatients,underthedirectionoftheRNteamleader.PrimarynursingisamodelofcaredeliverywherebyanRNassumesresponsibilityforacaseloadofpatientsovertime.Typically,theRNselectsthepatientsforhisorhercaseloadandcaresforthosepatientsduringtheirhospitalizationorstayinthehealthcaresetting.Functionalnursingistaskfocused,notpatientfocused;inafunctionalnursingmodel,tasksaredivided,witheachnurseassumingresponsibilityforspecifictasks.Inatotalpatientcaremodel,anRNisresponsibleforallaspectsofcareforoneormorepatients.TheRNmaydelegateaspectsofcarebutretainsaccountabilityforcareofallassignedpatients.DIF:UnderstandREF:162OBJ:Describetherelationshipsbetweennursingleadershipandhealthypracticeenvironments,patientsafety,andqualitypatientcareoutcomes.TOP:ImplementationMSC:CPNRE:CollaborativePractice8.Accountabilityisacriticalaspectofnursingcare.Whichofthefollowingisanexampleofaspecificdecision-makingprocessofaccountability?a.Selectingthemedicationscheduleforthepatient.b.Implementingdischargeteachingplansthatmeetindividualpatientsneeds.c.Evaluatingthepatientsoutcomesafterimplementationofcare.d.Promotingparticipationofallstaffmembersinunitmeetings.ANS:CAccountabilityreferstobeinganswerableforactions.Itinvolvesfollow-upandareflectiveanalysisofanursesdecisionstoevaluatetheireffectiveness.Selectingthemedicationscheduleforthepatientisanexampleoftakingresponsibility.ImplementingdischargeteachingplansthatmeetindiviUduaSlpatNientTsneedOsisanexampleofautonomy.Promotingparticipationofallstaffmembersinunitmeetingsisanexamplebothofdecentralizedmanagementandofpromotingauthority.DIF:UnderstandREF:165OBJ:Describeentry-levelprofessionalnursecompetenciesrelatedtoleadership,management,andcollaborativepractice.TOP:EvaluateMSC:CPNRE:Professional,Ethical,andLegalPractice9.Thestudentnurseisseekingtolearnskillsassociatedwithprioritysetting.Amongthedifferentprioritiesofcare,whichofthefollowingisanexampleofanintermediatepriority?a.Anobstructedairway.b.Theneedtourinate.c.Lossofconsciousness.d.Activitiesofdailylivinginthehomeenvironment.ANS:BTheneedtourinateisanintermediateprioritybecauseitisanonemergency,non-life-threateningactualorpotentialneed.Anobstructedairwayandlossofconsciousnessareofhighprioritybecausebothareanimmediatethreattoapatientssurvivalorsafety.Activitiesofdailylivinginthehomeenvironmentareafourth-orderpriority;theyrepresentanactualorpotentialproblemwithwhichthepatientorfamilymembersmayneedhelpinthefuture.CanadianFundamentalsofNursing7thEditionPotterTestBankDIF:ApplyREF:166OBJ:Discusswaystoapplyskillsofclinicalcarecoordinationinnursingpractice.TOP:AssessmentMSC:CPNRE:FoundationsofPractice10.Thenurseontheunitisdeterminingwhichactivitiesmaybedelegatedtoanunregulatedcareprovider(UCP).Anumberoffactorsareincludedinthenursesdecision.AssumingthattheUCPiscompetent,thenursemaysafelydelegatewhichofthefollowingactivities?a.Ambulationofstablepatients.b.Documentinganadmissionhistoryforanewpatient.c.Performanceoftheinitialtransferofapostoperativepatient.d.Administeringmedicationspreparedbythenurse.ANS:AAninstitutionspoliciesandproceduresandjobdescriptionforaUCPprovidespecificguidelineswithregardtowhichtasksoractivitiescanbedelegated.Thenurseshouldmatchtaskstothedelegatesskills,suchasambulatingstablepatients.AnadmissionhistoryforanewpatientshouldnotbepreparedbyaUCP;thenurseshouldperformthistask.TheinitialtransferofapostoperativepatientshouldnotbedelegatedtoaUCP,asthepatientwouldbeconsideredunstable;thenurseshouldperformthistask.Thenurseshouldnotdelegatemedicationadministrationtoanyone,ifthenursepreparedit;theUCPisnotlicensedtoadministermedication.DIF:ApplyREF:166|167OBJ:Discussprinciplesfortheappropriatedelegationofpatientcareactivities.TOP:ImplementationMSC:CPNRE:CollaborativePractice11.UCPsareallowedtoperformtaskswithpatientsinwhichsituation?a.WhentasksaredelegatedNbUyRanSoIthNerGUTCBP..COMb.Whenaskedbythepatient.c.WithanotherUCP.d.Whentasksaredelegatedbyanurse.ANS:DAninstitutionspolicies,procedures,andjobdescriptionsforUCPsprovidespecificguidelinesregardingwhichtasksoractivitiescanbedelegated.UCPsarenotallowedtoperformactsauthorizedfornursesunlessthesetaskshavebeenproperlydelegatedbyanurse,andtheycanperformsuchactionsonlyiftheyarewithintheUCPsjobdescriptionandemployerpolicy.ItisnotappropriatetoperformtasksthataredelegatedbyanotherUCP,whenaskedbythepatient,orwithanotherUCP.DIF:UnderstandREF:166|167OBJ:Discussprinciplesfortheappropriatedelegationofpatientcareactivities.TOP:ImplementationMSC:CPNRE:CollaborativePractice12.Onetypeofnursingmodelisanemergingmodelamongintraprofessionalnursingteamsandotherhealthcareproviderswhoaremembersoftheinterprofessionalteam.Whatisthismodelcalled?a.Primarynursingmodel.b.Functionalnursingmodel.c.Teamnursingmodel.d.Collaborativepracticemodel.CanadianFundamentalsofNursing7thEditionPotterTestBankUSNTANS:DTheRegisteredNursesAssociationofOntario(2016)hasdevelopedevidence-informedBestPracticeGuidelinesforcollaborativepracticeamongnurses,interprofessionalhealthteams,andhealthprofessionals.Theothermodelsarenotconsideredemergingmodels.Theprimarynursingmodelwaspopularinthe1970sand1980s;thefunctionalnursingmodelwaspopularduringWorldWarIIinresponsetoanursingshortage;andtheteamnursingmodelwasdevelopedinresponsetoanursingshortageafterWorldWarII.DIF:UnderstandREF:162|163OBJ:Discusshowanurseleadercancontributetocollaborativepracticeandbestpracticesimplementation.TOP:ImplementationMSC:CPNRE:CollaborativePractice13.Amanagementstructureinwhichtraditionalunitsarereorganizedintobusinessunitsiscalledwhat?a.Matrix.b.Centralized.c.Decentralized.d.Participatory.ANS:AInamatrixmanagementstructure,traditionalunitsarereorganizedintobusinessunits.Staffmayreporttoseveralmanagerswhomaybefromavarietyofprofessionalpracticebackgrounds.Traditionalunitsarenotreorganizedintobusinessunitsincentralized,decentralized,orparticipatorymanagementstructures.DIF:UnderstandREF:164,Table11-1OBJ:DiscusshowanurseleaNdercRancIontrGibutBe.toCcollMaborativepracticeandbestpracticesimplementation.TOP:ImplementationMSC:CPNRE:Professional,Ethical,andLegalPractice14.Whichtermcharacterizesthedutiesandactivitiesthatanindividualisemployedtoperform?a.Autonomy.b.Authority.c.Responsibility.d.Accountability.ANS:CThedutiesandactivitiesthatanindividualisemployedtoperformreflectresponsibility.Autonomyisthefreedomofchoiceandresponsibilityforchoices.Authorityistherighttoactinareasinwhichanursehasbeengivenandacceptsresponsibilityaccordingtolegislation,standards,andthecodeofethics.Accountabilityreferstobeinganswerableforonesactions.DIF:UnderstandREF:164|165OBJ:Describeentry-levelprofessionalnursecompetenciesrelatedtoleadership,management,andcollaborativepractice.TOP:ImplementationMSC:CPNRE:Professional,Ethical,andLegalPractice15.Whatisanursingmanagersgreatestchallenge?a.Delegation.b.Communication.c.Timemanagement.CanadianFundamentalsofNursing7thEditionPotterTestBankd.Clinicaldecisionmaking.ANS:BCommunicationwithstaffisoneofthenursingmanagersgreatestchallenges,especiallyinalargeworkgroupinwhichchangeisconstant.Thenursingmanagersgreatestchallengeisnotdelegation,timemanagement,orclinicaldecisionmaking.DIF:UnderstandREF:165OBJ:Discusshowanurseleadercancontributetocollaborativepracticeandbestpracticesimplementation.TOP:PlanningMSC:CPNRE:CollaborativePractice16.Anursehasdelegatedatasktoanunregulatedcareprovider(UCP).Whatisthenurseresponsiblefor?a.Performingthetasksafely.b.Maintainingaccountabilityforthetask.c.WeeklyperformanceevaluationsoftheUCP.d.ReportinganymistakesmadebytheUCPtoallstaffontheunit.ANS:BWhendelegatingatasktoaUCP,thenurseisresponsibleformaintainingaccountabilityforthetask.TheUCPisresponsibleforperformingthetasksafely.FrequencyofevaluationoftheUCPsperformancewouldvary.IftheUCPsperformanceisunsatisfactory,thenursemustgiveconstructivefeedback,specificallydiscussingmistakesandhowtheycouldhavebeenavoided.DIF:UnderstandREF:166OBJ:Discussprinciplesfortheappropriatedelegationofpatientcareactivities.TOP:PlanningMSC:CPNNRRE:CIollaGborBati.veCPraMcticeUSNTOCanadianFundamentalsofNursing7thEditionPotterTestBankUSNTOChapter12:CriticalThinkinginNursingPracticePotteretal:CanadianFundamentalsofNursing,7thEditionMULTIPLECHOICE1.Criticalthinkingcharacteristicsincludewhichofthefollowing?a.Consideringwhatisimportantinagivensituation.b.Acceptingone,establishedwaytoprovidepatientcare.c.Makingdecisionsonthebasisofintuition.d.Beingabletoreadandfollowprescriberorders.ANS:ACriticalthinkinginvolvesbeingabletodecipherwhatisrelevantandimportantinagivensituationandtomakeaclinicaldecisiononthebasisofthatimportance.Patientcarecanbeprovidedinmanyways,notjustone.Clinicaldecisionsshouldbebasedonevidenceandresearch.Followingprescriberordersisnotconsideredacriticalthinkingskill.DIF:RememberREF:174|175OBJ:Describecharacteristicsofacriticalthinker.TOP:AssessmentMSC:CPNRE:Professional,Ethical,andLegalPractice2.Whichofthesepatientscenariosismostindicativeofcriticalthinking?a.Administeringpainreliefmedicationaccordingtowhatwasgivenlastshift.b.Askingapatientwhatpainreliefmethods,pharmacologicalandnonpharmacological,haveworkedinthepast.c.Offeringpainreliefmedicationonthebasisofprescriberorders.d.ExplainingtothepatientNthatRhisIrepGortsBo.fsCeveMrepainarenotconsistentwiththeminorprocedurethatwasperformed.ANS:BAskingthepatientwhatpainreliefmethodshaveworkedinthepastisanexampleofexploringmanyoptionsforpainrelief.Administeringmedicationonthebasisofapreviousassessmentisnotpractisingaccordingtostandardsofcare.Thenurseistoassessapatientduringeachshiftandinterveneaccordingly.Nonpharmacologicalpainreliefmethodsareavailable,asaremedicationsforpain.Painissubjective;thenurseshouldofferpainreliefmethodsonthebasisofthepatientsreportswithoutbeingjudgemental.DIF:ApplyREF:174175OBJ:Describecharacteristicsofacriticalthinker.TOP:AssessmentMSC:CPNRE:Professional,Ethical,andLegalPractice3.Professionalnursesareresponsibleformakingclinicaldecisionsinordertodowhat?a.Provetheefficacyoftraditionalmethodsofprovidingnursingcaretopatients.b.Takeimmediateactionwhenapatientsconditionworsens.c.Applycleartextbooksolutionstopatientsproblems.d.Formulatestandardizedcareplansforgroupsofpatients.ANS:BProfessionalnursesareresponsibleformakingclinicaldecisionstotakeimmediateactionwhenapatientsconditionworsens.Patientcareshouldbebasedonevidence-informedpractice,notontradition.Cleartextbooksolutionstopatientproblemsarenotalwaysavailable.Careplansshouldbeindividualized.CanadianFundamentalsofNursing7thEditionPotterTestBankUSNTODIF:UnderstandREF:176|177|180OBJ:Discussthenursesresponsibilityinmakingclinicaldecisions.TOP:ImplementationMSC:CPNRE:Professional,Ethical,andLegalPractice4.Thenurseneedsareminderofprofessionalresponsibilitywhenperformingwhichoftheseactions?a.Makinganinformedclinicaldecision.b.Makinganethicalclinicaldecision.c.Makingaclinicaldecisioninthepatientsbestinterest.d.Makingaclinicaldecisionthatisbasedonpreviousshiftassessments.ANS:DTheprofessionalnurseisresponsibleforassessingpatientseachshift.Makinginformed,ethicaldecisionsinthepatientsbestinterestispractisingresponsibly.DIF:UnderstandREF:180|181OBJ:Discussthenursesresponsibilityinmakingclinicaldecisions.TOP:EvaluateMSC:CPNRE:Professional,Ethical,andLegalPractice5.Whichofthefollowingdemonstratesanurseutilizingself-reflectiontoimproveclinicaldecisionmaking?a.Usinganobjectiveapproachinallsituations.b.Obtainingdatainanorderlymanner.c.Improvingaplanofcarewhilethinkingbackoninterventionsperformed.d.Providingevidence-informedexplanationsforallnursinginterventions.ANS:CNRIGB.CMInself-reflection,thenurseutilizescriticalthinkinginevaluatingtheeffectivenessofinterventionsandhowtheywereperformed.Theotheroptionsdorepresentgoodnursingpracticebutarenotthebestexamplesofself-reflection.Usinganobjectiveapproachandobtainingdatainanorderlymannerdoesnotinvolvepurposefullythinkingbacktodiscoverthemeaningorpurposeofasituation.Providingevidence-informedexplanationsfornursinginterventionsdoesnotalwaysinvolvethinkingbacktodiscoverthemeaningofasituation.DIF:UnderstandREF:182|183OBJ:Discusscriticalthinkingcompetenciesusedinnursingpractice.TOP:EvaluateMSC:CPNRE:Professional,Ethical,andLegalPractice6.Anursinginstructorneedstoevaluatestudentsabilitiestosynthesizedataandidentifyrelationshipsbetweennursingdiagnoses.Whichlearningassignmentisbestsuitedforthisinstructorsneeds?a.Conceptmapping.b.Reflectivejournalling.c.Readingassignmentwithawrittensummary.d.Lectureanddiscussion.ANS:AConceptmapschallengethestudenttosynthesizedataandidentifyrelationshipsbetweennursingdiagnoses.Reflectivejournallinginvolvesthinkingbacktoclarifyconcepts.Readingassignmentsandlecturedonotbestprovideaninstructortheabilitytoevaluatestudentsabilitiestosynthesizedata.CanadianFundamentalsofNursing7thEditionPotterTestBankDIF:UnderstandREF:182|183OBJ:Discusshowconceptmapscanimproveanursesabilitytothinkcritically.TOP:ImplementationMSC:CPNRE:Professional,Ethical,andLegalPractice7.Whatisthefirstcomponentofthecriticalthinkingmodelforclinicaldecisionmaking?a.Experience.b.Nursingprocess.c.Attitude.d.Ascientificknowledgebase.ANS:DAscientificknowledgebaseisthefirstcomponentforclinicaldecisionmaking.Afteracquiringasoundknowledgebase,thenursecanthenapplyknowledgetodifferentclinicalsituationsandusethenursingprocesstogainvaluableexperience.Acriticalthinkingattitudeisaguidelineforhowtoapproachaproblemandapplyknowledgetomakeaclinicaldecision.DIF:RememberREF:177,Box12-2OBJ:Describethecomponentsofacriticalthinkingmodelforclinicaldecisionmaking.TOP:ImplementationMSC:CPNRE:Professional,Ethical,andLegalPractice8.Anewgraduatenursewillmakethebestclinicaldecisionsbyapplyingthecomponentsofthenursingcriticalthinkingmodelandwhichofthefollowing?a.Drawingonpastclinicalexperiencestoformulatestandardizedcareplans.b.Relyingonrecallofinformationfrompastlecturesandtextbooks.c.Dependingonthechargenursetodetermineprioritiesofcare.d.UsingthenursingprocesNs.URSINGTB.COMANS:DUsingthenursingprocessalongwithapplyingcomponentsofthenursingcriticalthinkingmodelwillhelpthenewgraduatenursemakethemostappropriateclinicaldecisions.Careplansshouldbeindividualized,andrecallingfactsisnotauseofcriticalthinkingskillstomakeclinicaldecisions.Thenewnurseshouldnotrelyonthechargenursetodetermineprioritiesofcare.DIF:ApplyREF:181OBJ:Describethecomponentsofacriticalthinkingmodelforclinicaldecisionmaking.TOP:ImplementationMSC:CPNRE:Professional,Ethical,andLegalPractice9.Thecriticalthinkingskillofevaluationinnursingpracticecanbebestdescribedaswhichofthefollowing?a.Examiningthemeaningofdata.b.Reviewingtheeffectivenessofnursingactions.c.Supportingfindingsandconclusions.d.Searchingforlinksbetweendataandthenursesassumptions.ANS:BReviewingtheeffectivenessofinterventionsbestdescribesevaluation.Examiningthemeaningofdataisaformofinference.Supportingfindingsandconclusionsisawayofprovidingexplanations.Searchingforlinksbetweenthedataandthenursesassumptionsisatypeofanalysis.CanadianFundamentalsofNursing7thEditionPotterTestBankUSNTODIF:UnderstandREF:176|182,Table12-1OBJ:Discusscriticalthinkingcompetenciesusedinnursingpractice.TOP:EvaluateMSC:CPNRE:Professional,Ethical,andLegalPractice10.Thepatientappearstobeinnoapparentdistress,butvitalsignsmeasuredbyanunregulatedcareproviderrevealthatthepulseisextremelylow.Thenursethenauscultatesanapicalpulseandasksthepatientwhetherhehasanycomplaintsorahistoryofheartproblems.Thenurseisutilizingwhichcriticalthinkingskill?a.Interpretation.b.Evaluation.c.Self-regulation.d.Explanation.ANS:AInterpretationinvolvescollectingdatainanorderlymanner,lookingforpatternstocategorizedata,andclarifyinguncertaindata.Thisnurseisclarifyingthedatainthissituation.Evaluationinvolvesdeterminingtheeffectivenessofinterventions.Thenurseinthisscenarioisassessingthepatient,notevaluatinginterventions.Self-regulationinvolvesreflectingonexperiences.Explanationentailssupportingfindingsandconclusions.Thenurseinthisquestionisclarifyinguncertaindata(determiningcauseofthelowpulse),notsupportingthefindingofalowpulse.DIF:ApplyREF:176,Table12-1OBJ:Discusscriticalthinkingcompetenciesusedinnursingpractice.TOP:AssessmentMSC:CPNRE:Professional,Ethical,andLegalPractice11.ApatientcontinuestoreportNposRtsurIgicaGlinBci.sioCnpMainatalevelof9outof10afterpainmedicineisgiven.Thenextdoseofpainmedicineisnotdueforanotherhour.Whatshouldthecriticallythinkingnursedofirst?a.Explaintothepatientthatnothingelsehasbeenordered.b.Exploreotheroptionsforpainrelief.c.Offertonotifythehealthcareprovideraftermorningroundsarecompleted.d.Discussthesurgicalprocedureandreasonforthepain.ANS:BThecriticallythinkingnurseshouldexplorealloptionsforpainrelieffirst.Thenurseshouldusecriticalthinkingtodeterminethecauseofthepainanddeterminevariousoptionsforpain,inadditiontotheorderedpainmedications.Thenursecanactindependentlytodeterminealloptionsforpainreliefanddoesnothavetowaituntilafterthehealthcareproviderroundsarecompleted.Explainingthecauseofthepaindoesnotaddressoptionsforpainrelief.DIF:ApplyREF:177OBJ:Discusscriticalthinkingcompetenciesusedinnursingpractice.TOP:ImplementationMSC:CPNRE:Professional,Ethical,andLegalPractice12.Thenursingstudentcanbestdevelopcriticalthinkingskillsbydoingwhichofthefollowing?a.Studying3hoursmoreeachnight.b.Activelyparticipatinginallclinicalexperiences.c.Interviewingstaffnursesabouttheirnursingexperiences.d.Attendingallopenskillslaboratoryopportunities.CanadianFundamentalsofNursing7thEditionPotterTestBankANS:BNursingisanappliedscience,andtoapplyknowledgelearnedanddevelopcriticalthinkingskillstomakeclinicaldecisions,thestudentshouldvalueandactivelyparticipateinallclinicalexperiences.Studyingforlongerhours,interviewingnurses,andattendingskillslaboratorysessionsdonotprovideopportunitiesforclinicaldecisionmaking,asdoactualclinicalexperiences.DIF:UnderstandREF:178OBJ:Explaintherelationshipbetweenclinicalexperienceandcriticalthinking.TOP:ImplementationMSC:CPNRE:Professional,Ethical,andLegalPractice13.Whilecaringforahospitalizedolderwomanafterhipsurgery,thenewgraduatenurseisfacedwiththetaskofinsertinganindwellingurinarycatheter,whichinvolvesrotatingthehipintoacontraindicatedposition.Thenurseexhibitscriticalthinkingtoperformthistaskbydoingwhat?a.Followingtextbookprocedure.b.Notifyingthephysicianoftheneedforaurologistconsult.c.Adaptingthepositioningtechniquetothesituation.d.Postponingcatheterinsertionuntilthenextshift.ANS:CThenursemustusecriticalthinkingskillsandproblemsolvinginthissituationtoadaptpositioningtechnique.Inpractice,patientproceduresarenotalwayspresentedasinatextbook,buttheyareindividualized.Aurologyconsultisnotwarrantedforposition,butitmaybewarrantedifthenurseencountersdifficultyininsertion.Postponinginsertionofthecatheterisnotanappropriateaction.DIF:ApplyREF:17N9URSINGTB.COMOBJ:Explaintherelationshipbetweenclinicalexperienceandcriticalthinking.TOP:ImplementationMSC:CPNRE:Professional,Ethical,andLegalPractice14.Thenurseentersaroomtofindthepatientsittingupinbedcrying.Howwouldthenursedisplayacriticalthinkingattitudeinthissituation?a.Tellthepatientshellbebackin30minutes.b.Setaboxoftissuesatthepatientsbedsidebeforeleavingtheroom.c.Askthepatientwhysheiscrying.d.Limitvisitorswhilethepatientisupset.ANS:CThenurseshouldtrytofindoutwhythepatientiscrying.Byusinginterpretationskills,thenursecancollectinformationtobeabletomakeappropriateinterventions.Tellingthepatientthatshewillreturn,providingtissues,andlimitingvisitorsmaybeappropriateactionsbutdonotaddressthereasonwhythepatientiscrying.DIF:ApplyREF:176OBJ:Discusscriticalthinkingcompetenciesusedinclinicaldecisionmaking.TOP:AssessmentMSC:CPNRE:Professional,Ethical,andLegalPractice15.Whichofthefollowingisastrategyusedbylearnerstoexplorecomplexproblemsandengageindecisionmakingwithouttheriskofharmingapatient?a.Lecturesandreading.CanadianFundamentalsofNursing7thEditionPotterTestBankb.Conceptmapping.c.Reflectivewriting.d.Case-basedlearning.ANS:DCase-basedlearningisastrategythatallowslearnerstoexplorecomplexproblemsandengageindecisionmakingwithouttheriskofharmingapatient.Lecturesandreadingsdonotalwaysengagethelearnerindecisionmaking.Conceptmappingisavisualrepresentationofpatientproblemsandinterventionsthatdepictstheirrelationshiptooneanother.Reflectivewritingisusedwhenalearnerexplainsaclinicalexperienceandexploreshisorherunderstandingandperceptionofthesituation.DIF:UnderstandREF:182OBJ:Describehowcase-basedlearningfosterscriticalthinking.TOP:ImplementationMSC:CPNRE:Professional,Ethical,andLegalPractice16.Howdoprofessionalstandardsinfluenceanursesclinicaldecisions?a.Theybypassthepatientsfeelingstopromoteethicalstandards.b.Theysetminimalpassingstandardsfortesting.c.Theyrequirethenursetousecriticalthinkingforthehighestlevelofqualitynursingcare.d.Theyrequirethenursetouseevidence-informedpracticethatisbasedonnursesneeds.ANS:CUpholdingprofessionalstandardsrequiresnursestousecriticalthinkingforthehighestlevelofqualitynursingcare.Bypassingthepatientsfeelingsisnotpractisingaccordingtoprofessionalstandards.ThepNriUmRarSyIpuNrGpoTseBo.fCproMfessionalstandardsisnottoestablishminimalpassingstandardsfortesting.Patientcareshouldbebasedonpatientsneeds,notonnursesneeds.DIF:RememberREF:181OBJ:Explainhowprofessionalstandardsinfluenceanursesclinicaldecisions.TOP:PlanningMSC:CPNRE:Professional,Ethical,andLegalPractice17.Anursewhoiscaringforapatientwithapressureulcerfailstoapplytherecommendeddressingaccordingtohospitalpolicy.Ifthepatientisharmed,thenursecouldbesubjecttolegalactionfornotadheringtowhichofthefollowing?a.Fairness.b.Intellectualstandards.c.Independentreasoning.d.Institutionalpracticeguidelines.ANS:DInstitutionalpracticeguidelinesareestablishedstandardsandpoliciesthatcanbeusedincourttomakejudgementsaboutnursingactions.Intellectualstandardsareguidelinesorprinciplesforrationalthought.Fairnessandindependentreasoningaretwoexamplesofcriticalthinkingattitudesthataredesignedtohelpnursesmakeclinicaldecisions.DIF:ApplyREF:181OBJ:Explainhowprofessionalstandardsinfluenceanursesclinicaldecisions.TOP:ImplementationMSC:CPNRE:Professional,Ethical,andLegalPracticeCanadianFundamentalsofNursing7thEditionPotterTestBankUSNT18.Whichofthesefindings,ifidentifiedinaplanofcare,shouldthenurserevisebecauseitisnotcharacteristicofcriticalthinkingandthenursingprocess?a.Patientsreactionstodiagnostictesting.b.Nursesassumptionsabouthospitaldischarge.c.Identificationoffivedifferentnursingdiagnoses.d.Documentationofpatientsabilitytocopewithloss.ANS:BThenurseshouldnotassumewhenapatientisgoingtobedischargedanddocumentthisinformationinaplanofcare.Makingassumptionsisnotanexampleofacriticalthinkingskill.Thepatientsreactionstotesting,havingseveralnursingdiagnoses,andadescriptionofthepatientscopingabilitiesareallappropriatetodocumentinthenursingplanofcare.DIF:AnalyzeREF:174-176OBJ:Discusstherelationshipofthenursingprocesstocriticalthinking.TOP:EvaluateMSC:CPNRE:Professional,Ethical,andLegalPractice19.Thenursingprocessinvolveswhichofthefollowingstepsintheclinicaldecision-makingprocess?a.Diagnosingthediseaseprocess.b.Performingnursinginterventions.c.Settingprofessionalnursinglearninggoals.d.Evaluatingeffectivenessofmedicaltreatments.ANS:BImplementingnursinginterventionsisonestepintheclinicaldecision-makingprocess.DiagnosingdiseaseandevaluNatinRgeIffecGtiveBne.ssCofMmedicaltreatmentsarenotnursingactions.Nursesaretousethenursingprocesstosetpatientgoals,notthenurseslearninggoals.DIF:UnderstandREF:181OBJ:Discusstherelationshipofthenursingprocesstocriticalthinking.TOP:ImplementationMSC:CPNRE:Professional,Ethical,andLegalPracticeCanadianFundamentalsofNursing7thEditionPotterTestBankNRIChapter13:NursingAssessment,Diagnosis,andPlanningPotteretal:CanadianFundamentalsofNursing,7thEditionMULTIPLECHOICE1.Aftercompletingathoroughdatabasereviewandanalyzingthedatatoidentifyanyproblems,thenurseshouldproceedtowhatstepofthenursingprocess?a.Assessment.b.Planning.c.Implementation.d.Evaluation.ANS:BInthefive-stepnursingprocess,thenurseshouldestablishmutualgoalswiththepatientandprioritizecareintheplanningphase,whichfollowsthediagnosisphase.Theassessmentphaseofthenursingprocessinvolvesgatheringdata.Theimplementationphaseinvolvescarryingoutappropriatenursinginterventions.Duringtheevaluationphase,thenurseassessestheeffectivenessofinterventions.DIF:UnderstandREF:188OBJ:Identifyanddiscussthestepsofnursingassessment.TOP:PlanningMSC:CPNRE:FoundationsofPractice2.Apatientsplanofcareincludesthegoalofincreasingmobilitythisshift.Asthepatientisambulatingtothebathroomatthebeginningoftheshift,thepatientsuffersafall.Howshouldthenursefirstrevisetheplanofcare?GB.CMa.AskingphysiotherapytoasUsistStheNpatiTentbecOauseofthenewinjuries.b.Disregardingallpreviousdiagnosesandestablishinganewplanofcare.c.Reassessingthepatient.d.Settingnewprioritiesforthepatient.ANS:CThenurseneedstoreassessthepatientafteranytypeofchangeinhealthstatus.Thenursingprocessisdynamicandongoing.Askingphysiotherapytoassistthepatientisprematurebeforethepatientisreassessedandbeforeprescriberordershavebeenmade.Thenursemaynotneedtodisregardallpreviousdiagnoses.Somediagnosesmaystillapply,butthepatientneedstobereassessedfirst.Settingnewprioritiesisnotrecommendedbeforeassessmentandestablishingdiagnoses.DIF:ApplyREF:188OBJ:Discusscriteriausedinprioritysetting.TOP:PlanningMSC:CPNRE:FoundationsofPractice3.Intheplanningofpatientcare,agoalcanbedescribedaswhichofthefollowing?a.Astatementdescribingthepatientsaccomplishmentswithoutatimerestriction.b.Arealisticstatementpredictinganynegativeresponsestotreatments.c.Abroadstatementdescribingadesiredchangeinpatientbehaviour.d.Anidentifiedlong-termnursingdiagnosis.ANS:CCanadianFundamentalsofNursing7thEditionPotterTestBankAgoalisabroadstatementthatdescribesadesiredchangeinapatientsconditionorbehaviour.Agoalismutuallysetwiththepatientandistime-limited,patient-centred,measurable,andrealistic.DIF:RememberREF:204|205OBJ:Describegoalsettinganddiscussthedifferencebetweenagoalandanexpectedoutcome.TOP:PlanningMSC:CPNRE:FoundationsofPractice4.Whenevaluatingaplanofcare,thenursereviewsthegoalsforthepatient.Whichgoalstatementisrealistictoassigntoapatientwithapelvicfracturewhoisonbedrest?a.Thepatientwillincreasemobilitybyambulatinginthehallwaytwotimesthisshift.b.Thepatientwillincreasemobilitybyturningsidetobacktosidewithassistanceevery2hours.c.Thepatientwillincreasemobilitybyusingthewalkercorrectlytoambulatetothebathroomasneeded.d.Thepatientwillincreasemobilitybyusingaslidingboardcorrectlytotransfertothebedsidecommodeasneeded.ANS:BThepatientisorderedtobeonbedrest;therefore,turningthepatientinbedistheonlyoptionthatisappropriate.Whendetermininggoals,thenurseneedstoensurethatthegoalisindividualizedandrealisticforthepatient.Goalsmustreflectthehighestpossiblelevelofwellnessandindependenceinfunction,whichforthispatientwouldbeturninginbed.DIF:EvaluateREF:205OBJ:Describegoalsettinganddiscussthedifferencebetweenagoalandanexpectedoutcome.TOP:PlanningMSC:CPNNURRES:FIoNunGdaTtiBon.sCofOPMractice5.Thefollowingstatementsareonapatientsnursingcareplan.Whichofthefollowingstatementsrepresentsanexpectedoutcome?a.Thepatientwillverbalizeadecreasedpainlevellessthan3ona0-to-10scalebytheendofthisshift.b.Thepatientwilldemonstrateincreasedmobilityin2days.c.Thepatientwilldemonstrateincreasedtolerancetoactivityoverthenextmonth.d.Thepatientwillunderstandneededdietarychangesbydischarge.ANS:AAnexpectedoutcomeisaspecificandmeasurablechangethatisexpectedasaresultofnursingcare.Theotherthreeoptionsinthisquestionaregoals.Demonstratingincreasedmobilityin2daysandunderstandingnecessarydietarychangesbydischargeareshort-termgoalsbecausetheyareexpectedtooccurinlessthanaweek.Demonstratingincreasedtolerancetoactivityoveramonth-longperiodisalong-termgoalbecauseitisexpectedtooccuroveralongerperiodoftime.DIF:UnderstandREF:205|206OBJ:Describegoalsettinganddiscussthedifferencebetweenagoalandanexpectedoutcome.TOP:PlanningMSC:CPNRE:FoundationsofPractice6.Whichpatientoutcomestatementincludesallsevenguidelinesforwritinggoalandoutcomestatements?CanadianFundamentalsofNursing7thEditionPotterTestBanka.Thepatientwillambulateinhallways.b.Thenursewilladministerpainmedicationevery4hourstokeepthepatientfreefromdiscomfort.c.Thenursewillmonitorthepatientsheartrhythmcontinuouslythisshift.d.Thepatientwillfeedselfatallmealtimestodaywithoutcomplaintsofshortnessofbreath.ANS:DAgoaloroutcomestatementshouldbepatient-centred;shouldaddressonepatientresponse;shouldbeobservable,measurable,andtime-limited;shouldbemutuallysetbynurseandpatient;andshouldberealistic.ThestatementThepatientwillfeedselfatallmealtimestodaywithoutcomplaintsofshortnessofbreathincludesallsevencriteriaforgoalwriting.Thepatientwillambulateinhallwaysismissingatimelimit.Administeringpainmedicationandmonitoringthepatientsheartrhythmarenursinginterventions;theyarenotpatientbehavioursoractions.DIF:UnderstandREF:206OBJ:Describegoalsettinganddiscussthedifferencebetweenagoalandanexpectedoutcome.TOP:PlanningMSC:CPNRE:FoundationsofPractice7.Anursingassessmentforapatientwithaspinalcordinjuryrevealsseveralpertinentproblemsthatanursecantreat.Whiletheplanofcareisdeveloped,whichnursingdiagnosisisthehighestpriorityforthispatient?a.Riskforimpairedskinintegrity.b.Riskforinfection.c.Spiritualdistress.d.ReflexurinaryincontinenNce.RIGB.CMANS:DUSNTOReflexurinaryincontinenceishighestpriority.Ifapatientsincontinenceisnotaddressed,thenthepatientisathigherriskforimpairedskinintegrityandinfection.Riskfordiagnosesarepotentialproblems.Theymaybeprioritizedhigherinsomecases,butnotinthissituation.Spiritualdistressisanactualdiagnosis,buttheadverseeffectsthatcouldresultfromnotassistingthepatientwithurinaryeliminationtakepriorityinthiscase.Physiologicalproblemsdonotalwaystakepriority,buturinaryincontinencecouldcausethegreatestharmifitisnotaddressed.DIF:ApplyREF:203OBJ:Developaplanofcarefromanursingassessment.TOP:PlanningMSC:CPNRE:FoundationsofPractice8.Thenurseiscaringforsevenpatientsthisshift.Aftercompletingtheirassessments,thenursestatesthathedoesnotknowwheretobeginindevelopingcareplansforthesepatients.Whichofthefollowingisanappropriatesuggestionbyanothernurse?a.Choosealltheinterventionsandperformtheminorderoftimeneededforeachone.b.Makesureyouidentifythescientificrationaleforeachinterventionfirst.c.Decideongoalsandoutcomesyouhavechosenforthepatients.d.Beginwiththehighestprioritydiagnoses,andthenselectappropriateinterventions.ANS:DCanadianFundamentalsofNursing7thEditionPotterTestBankNRIGB.CMWhendevelopingaplanofcare,thenurseneedstorankthenursingdiagnosesinorderofpriorityandthenselectappropriateinterventions.Choosingalltheinterventionsshouldtakeplaceafterthediagnosesareranked,andinterventionsshouldbeprioritizedbypatientneeds,notjustbytime.Thechoseninterventionsshouldbeevidenceinformedwithscientificrationales,butthediagnosesneedtobeprioritizedfirstinordertoprioritizeinterventions.Goalsforapatientshouldbemutuallyset,notchosenjustbythenurse.DIF:ApplyREF:203|204OBJ:Developaplanofcarefromanursingassessment.TOP:PlanningMSC:CPNRE:FoundationsofPractice9.Apatientssondecidestostayatthebedsidewhilehisfatherisconfused.Whenthenursedevelopstheplanofcareforthispatient,whatshouldthenursedo?a.Individualizethecareplanonlyaccordingtothepatientsneeds.b.Requestthatthesonleaveatbedtime,sothepatientcanrest.c.Suggestthatafemalememberofthefamilystaywiththepatient.d.Involvethesonintheplanofcareasmuchaspossible.ANS:DFamilyshouldbeincludedinapatientsplanofcareasmuchaspossible.Thefamilycanhelppatientsmeethealthcaregoals.Meetingsomeofthefamilysneedaswellasthepatientsneedsmayimprovethepatientslevelofwellness.Thesonshouldnotbeaskedtoleaveifatallpossible.Insomesituations,itmaybebestthatfamilymembersnotremainintheroom,butthisquestionstemdoesnotindicatethatthisisthecaseinthissituation.Suggestingthatafemalememberofthefamilystayisnotjustifiedwithoutalegitimatereason,andnoreasonisgiveninthisquestionstemforsuchasuggestion.DIF:ApplyREF:203OBJ:Developaplanofcarefromanursingassessment.TOP:PlanningMSC:CPNURES:FoNundaTtionsofOPractice10.WhichoftheseoutcomeswouldbemostappropriateforapatientwithanursingdiagnosisofConstipationrelatedtoslowedgastrointestinalmotilitysecondarytopainmedications?a.Patientwillhaveonesoft,formedbowelmovementbyendofshift.b.Patientwillnottakeanypainmedicationsthisshift.c.Patientwillwalkunassistedtobathroombytheendofshift.d.Patientwillnottakelaxativesorstoolsoftenersthisshift.ANS:ATheidentifiedproblem,ornursingdiagnosis,isconstipation.Therefore,theoutcomeshouldbethattheconstipationisrelieved.Tomeasureconstipationrelief,thenursewillbeobservingforthepatienttohaveabowelmovement.Nottakingpainmedicationsmayormaynotrelievetheconstipation.Althoughnottakingpainmedicinesmightbeanintervention,thepatientshouldnothavetobeinpaintorelieveconstipation.Othermeasures,suchasadministeringlaxativesorstoolsofteners,mightbeappropriateinterventions,buttheyarenotoutcomes.Thepatientwalkingunassistedtothebathroomaddressesmobility,notconstipation.Thepatientmayneedtowalktothebathroomtohaveabowelmovement,buttheappropriateoutcomeforconstipationisthattheconstipationisrelievedasevidencedbyabowelmovementsomethingthatthenursecanobserve.DIF:ApplyREF:204-206OBJ:Developaplanofcarefromanursingassessment.TOP:PlanningMSC:CPNRE:FoundationsofPracticeCanadianFundamentalsofNursing7thEditionPotterTestBank11.Thenurseisworkingwithapatientwhoisbeingpreparedforadiagnostictestthisafternoon.Thepatienttellsthenursethatshewantstohaveherhairshampooed.Whichofthefollowingisthemostappropriatelabelwithregardtoassigningapriorityforthepatientsrequest?a.Lowpriority.b.Anunmetneed.c.Intermediatepriority.d.Asafetyandsecurityneed.ANS:AThepatientsrequestwouldbeoflowprioritybecauseitisnotdirectlyrelatedtoaspecificillnessorprognosis.Thepatientsrequestdoesnotrepresentanunmetneedandisnotanintermediatepriority.Anintermediatepriorityisonethatinvolvesthenonemergency,non-life-threateningneedsofthepatient.Thepatientsrequestdoesnotreflectasafetyandsecurityneed;theoutcomedoesnotthreatenherwell-being.DIF:AnalyzeREF:203OBJ:Discusscriteriausedinprioritysetting.TOP:PlanningMSC:CPNRE:FoundationsofPractice12.Whichofthefollowingoptionscorrectlyexplainswhatthenurseshoulddowiththeplanofcareforapatientafteritisdeveloped?a.Placetheoriginalcopyinthechart,soitcannotbetamperedwithorrevised.b.Communicatetheplanofcaretoallhealthcareprofessionalsinvolvedinthepatientscare.c.Sendtheplanofcaretotheadministrationofficetobefiled.d.Sendtheplanofcaretoqualityassuranceforreview.ANS:BThepatientsnursingplanofNcUarReSisIaNdyGnTamBi.cCpiOecMeofworkthatneedstobeupdatedandrevisedasthepatientsconditionchanges.Allhealthcareprovidersinvolvedinthepatientscareneedtobeinformedoftheplanofcare.Theplanofcareisnotplacedonthechartandthenneverlookedatagain.Theplanofcareisnotsenttotheadministrativeofficeorthequalityassuranceoffice.DIF:UnderstandREF:206|207OBJ:Developaplanofcarefromanursingassessment.TOP:PlanningMSC:CPNRE:FoundationsofPractice13.Whatisthepurposeanddistinctionofusingaconceptmapwhenaplanofcareisimplemented?a.Qualityassuranceinthehealthcarefacility.b.Multidisciplinarycommunication.c.Provisionofastandardizedformatforpatientproblems.d.Identificationoftherelationofpatientproblemsandinterventions.ANS:DAconceptmapisadiagramofpatientproblemsandinterventionsthatshowstheirrelationstooneanother.Theuseofaconceptmappromotescriticalthinkingandhelpsthenurseorganizecomplexpatientdata,processcomplexrelationships,andachieveaholisticviewofthepatientssituation.Thepurposeisnotqualityassuranceinthehealthcarefacility.Multidisciplinarycommunicationisenhancedwiththeuseofcriticalpathways,notconceptmaps.Standardizedorcomputerizedcareplans,notconceptmaps,provideastandardizedformatforpatientproblems.Aconceptmapishighlyindividualized.CanadianFundamentalsofNursing7thEditionPotterTestBankDIF:ApplyREF:195|196OBJ:Explaintherelationshipofcriticalthinkingtoassessment,diagnosis,andplanning.TOP:PlanningMSC:CPNRE:FoundationsofPractice14.Theuseofcriticalthinkingskillsduringtheassessmentphaseofthenursingprocessensuresthatthenursedoeswhichofthefollowing?a.Completesacomprehensivedatabase.b.Identifiespertinentnursingdiagnoses.c.Intervenesonthebasisofpatientgoalsandprioritiesofcare.d.Determineswhetheroutcomeshavebeenachieved.ANS:ATheassessmentphaseofthenursingprocessinvolvesdatacollectiontocompleteathoroughpatientdatabase.Identifyingnursingdiagnosesoccursduringthediagnosisphase.Thenursecarriesoutinterventionsduringtheimplementationphase,anddetermineswhetheroutcomeshavebeenachievedduringtheevaluationphase.DIF:UnderstandREF:188OBJ:Explaintherelationshipofcriticalthinkingtoassessment,diagnosis,andplanning.TOP:AssessmentMSC:CPNRE:FoundationsofPractice15.Subjectivedataincludewhichofthefollowing?a.Apatientsfeelings,perceptions,andreportedsymptoms.b.Adescriptionofthepatientsbehaviour.c.Observationsofapatientshealthstatus.d.Measurementsofapatientshealthstatus.ANS:ANURSINGTB.COMSubjectivedataincludethepatientsfeelings,perceptions,andreportedsymptoms.Onlypatientsprovidesubjectivedatarelevanttotheirhealthcondition.Datasometimesreflectphysiologicalchanges,whichthenurseexploresfurtherthroughobjectivedatacollection.Describingthepatientsbehaviour,observationsmade,andmeasurementsofapatientshealthstatusareallexamplesofobjectivedata.DIF:RememberREF:191OBJ:Differentiatebetweensubjectiveandobjectivedata.TOP:EvaluateMSC:CPNRE:FoundationsofPractice16.Apatientexpressesfearofgoinghomeandbeingalone.Hervitalsignsarestableandherincisionisnearlycompletelyhealed.Whatcanthenursecaninferfromthesubjectivedata?a.Thepatientcannowperformthedressingchangesherself.b.Thepatientcanbeginretakingallherpreviousmedications.c.Thepatientisapprehensiveaboutdischarge.d.Surgerywasnotsuccessful.ANS:CSubjectivedataincludeexpressionsoffearofgoinghomeandbeingalone.Thesedataindicatethatthepatientisapprehensiveaboutdischarge.Expressingfearisnotanappropriatesignthatapatientisabletoperformdressingchangesindependently.Anorderfromahealthcareproviderisrequiredbeforeapatientistaughttoresumepreviousmedications.Thenursecannotinferthatsurgerywasnotsuccessfuliftheincisionisnearlycompletelyhealed.CanadianFundamentalsofNursing7thEditionPotterTestBankDIF:ApplyREF:191OBJ:Differentiatebetweensubjectiveandobjectivedata.TOP:AssessmentMSC:CPNRE:FoundationsofPractice17.Whichofthefollowingmethodsofdatacollectionisutilizedtoestablishapatientsnursingdatabase?a.Reviewingthecurrentliteraturetodetermineevidence-informednursingactions.b.Ordersfordiagnosticandlaboratorytests.c.Physicalexamination.d.Anticipatedmedicationstobeordered.ANS:CAnursingdatabaseincludesresultsofaphysicalexamination.Ordersareincludedintheordersectionofthepatientschart.Thenursereviewsthecurrentliteratureintheimplementationphaseofthenursingprocesstodetermineevidence-informedactions,andthehealthcareproviderisresponsiblefororderingmedications.Medicationordersareusuallywrittenafterthedatabaseiscompleted.DIF:RememberREF:188OBJ:Identifyanddiscussthestepsofnursingassessment.TOP:AssessmentMSC:CPNRE:FoundationsofPractice18.Togatherinformationaboutapatientshomeandworksurroundings,thenursewillneedtoutilizewhichmethodofdatacollection?a.Carefullyreviewinglaboratoryresults.b.Conductingthephysicalassessmentbeforecollectingsubjectiveinformation.c.PerformingathoroughnuNrsUinRgShIeaNltGhThiBst.orCy.OMd.Prolongingtheterminationphaseoftheinterview.ANS:CAthoroughnursinghistoryincludesinformationaboutthepatientshomeandworksurroundings.Neitherlaboratoryresultsnorthephysicalassessmentwillrevealmuchaboutthehomeandworksurroundings.Collectingdataispartoftheworkingphaseoftheinterview.DIF:UnderstandREF:189OBJ:Describetherelationshipbetweendatacollectionanddataanalysis.TOP:AssessmentMSC:CPNRE:FoundationsofPractice19.WhileinterviewinganolderfemalepatientofAsiandescent,thenursenoticesthatthepatientlooksatthegroundwhenansweringquestions.Whatshouldthenursedo?a.Notifythephysiciantorecommendapsychologicalevaluation.b.Considerculturaldifferencesduringthisassessment.c.Askthepatienttomakeeyecontacttodetermineheraffect.d.Continuewiththeinterviewanddocumentthatthepatientisdepressed.ANS:BOlderwomenofAsiandescentconsideritrudetolookanauthorityfigure,suchasahealthcareprovider,intheeye.Thisnurseneedstopractiseculturallycompetentcareandappreciatetheculturaldifferences.Assumingthatthepatientisdepressedorinneedofapsychologicalevaluationisinappropriate,asisaskingthepatienttomakeeyecontact.CanadianFundamentalsofNursing7thEditionPotterTestBankDIF:ApplyREF:193OBJ:Describetherelationshipbetweendatacollectionanddataanalysis.TOP:AssessmentMSC:CPNRE:FoundationsofPractice20.Afterreviewingtheinterviewprocessandobjectivesduringapatient-centredinterview,whatwillthenursedo?a.Beginbyintroducinghimselforherself.b.Documentanursinghealthhistory.c.Explainthattheinterviewwillbeoverinafewmoreminutes.d.Tellthepatientthathellbebacktoadministermedicationsin1hour.ANS:BAfterbeginningwithanintroductionandreviewingtheinterviewprocessandobjectives,thenurseshouldconducttheactualinterviewandproceedwithdatacollection.Theterminationphaseincludestellingthepatientwhentheinterviewisnearinganend.Tellingthepatientthatmedicationswillbegivenlaterwhenthenursereturnswouldtypicallytakeplaceduringtheterminationphaseoftheinterview.DIF:UnderstandREF:193OBJ:Identifyanddiscussthestepsofnursingassessment.TOP:AssessmentMSC:CPNRE:FoundationsofPractice21.Thenurseisattemptingtopromptthepatienttoelaborateonhercomplaintsofdaytimefatigue.Whichquestionshouldthenurseask?a.Isthereanythingthatyouarestressedaboutrightnow?b.Whatreasonsdoyouthinkarecontributingtoyourfatigue?c.WhatareyournormalwNoUrkRhSouIrsN?GTB.COMd.Areyousleeping8hoursanight?ANS:BThequestionaboutwhatfactorsmightbecontributingtothepatientsfatiguewillelicitthebestopen-endedresponse.Askingwhetherthepatientisstressedandaskingwhetherthepatientissleeping8hoursanightareclosed-endedquestionselicitingsimpleyesornoresponses.Askingaboutnormalworkhourswillelicitamatter-of-factresponseanddoesnotpromptthepatienttoelaborateonhercomplaintsofdaytimefatiguenorelicitthecontributingreasons.DIF:ApplyREF:193OBJ:Identifyanddiscussthestepsofnursingassessment.TOP:AssessmentMSC:CPNRE:FoundationsofPractice22.Componentsofanursinghealthhistoryincludea.Currenttreatmentorders.b.Nursesconcerns.c.Nursesgoalsforthepatient.d.Patientexpectations.ANS:DCanadianFundamentalsofNursing7thEditionPotterTestBankComponentsofanursinghealthhistoryincludephysicalexaminationfindings,patientexpectations,environmentalhistory,anddiagnosticdata.Currenttreatmentordersarelocatedintheordersectioninthepatientschartandarenotapartofthenursinghealthhistory.Patientconcerns,notnursesconcerns,areincludedinthedatabase.Goalsthataremutuallyestablished,notnursesgoals,arepartofthenursingcareplan.DIF:RememberREF:194OBJ:Describethecomponentsofanursinghistory.TOP:AssessmentMSC:CPNRE:FoundationsofPractice23.Whilethepatientslowerextremity,whichisinacast,isassessed,thepatienttellsthenurseaboutaninabilitytorestatnight.Thenursedisregardsthiscomplaint,thinkingthatnocorrelationhasbeennotedbetweenhavingalegcastanddevelopingrestlesssleep.Whatwouldbeamoretheoreticallysoundapproach?a.Documentthesleeppatternsandcomplaintinthepatientschart.b.Tellthepatientyouarejustfocusedonthelegrightnow.c.Explainthatamorethoroughassessmentwillbeneedednextshift.d.Askthepatientabouthisusualsleeppatternsandtheonsetofhavingdifficultyresting.ANS:DThenursemustusecriticalthinkingskillstoassessthissituationfirst.Thebestresponseistogathermoreassessmentdatabyaskingthepatientaboutusualsleeppatternsandtheonsetofhavingdifficultyresting.Thenurseshouldassessbeforedocumentingandshouldnotignorethepatientscomplaints.DIF:ApplyREF:191OBJ:Explaintherelationshipofcriticalthinkingtoassessment,diagnosis,andplanning.TOP:AssessmentMSC:CPNNURRES:FIoNunGdaTtiBon.sCofOPMractice24.Anursecomparingdatavalidationanddatainterpretationcorrectlyexplainsthedifferencewithwhichstatement?a.Validationinvolveslookingforpatternsinprofessionalstandards.b.Datainterpretationinvolvesdiscoveringpatternsinprofessionalstandards.c.Validationinvolvescomparingdatawithothersourcesforaccuracy.d.Datainterpretationoccursbeforedatavalidation.ANS:CValidation,bydefinition,involvescomparingdatawithothersourcesforaccuracy.Datainterpretationinvolvesidentifyingabnormalfindings,clarifyinginformation,andidentifyingpatientproblems.Thenurseshouldvalidatedatabeforeinterpretingthedataandmakinginferences.Thenurseisinterpretingandvalidatingpatientdata,notprofessionalstandards.DIF:UnderstandREF:194|195OBJ:Explaintherelationshipbetweendatainterpretation,validation,andclustering.TOP:AssessmentMSC:CPNRE:FoundationsofPractice25.Whilecompletinganadmissiondatabase,thenurseisinterviewingapatientwhostatesthatheisallergictolatex.Whatisthemostappropriatefirstnursingaction?a.Leavetheroomandplacethepatientinisolation.b.Askthepatienttodescribethetypeofreaction.c.Proceedtotheterminationphaseoftheinterview.CanadianFundamentalsofNursing7thEditionPotterTestBankGB.CMd.Documentthelatexallergyonthemedicationadministrationrecord.ANS:BThenurseshouldfurtherassessandaskthepatienttodescribethetypeofreaction.Thepatientwillnotneedtobeplacedinisolation;beforeterminatingtheinterviewordocumentingtheallergy,healthcarepersonnelneedtobeawareofwhattypeofresponsethepatientsuffered.DIF:ApplyREF:189-191OBJ:Identifyanddiscussthestepsofnursingassessment.TOP:AssessmentMSC:CPNRE:FoundationsofPractice26.Apatientverbalizesalowpainlevelof2outof10butexhibitsextremefacialgrimacingwhilemovingaroundinbed.Whatisthenursesbestactioninresponsetoherobservation?a.Proceedtothenextpatientsroomwhilemakingrounds.b.Offeramassagebecausethepatientdoesnotwantanymorepainmedicine.c.Administerthepainmedicationorderedformoderatetoseverepain.d.Askthepatientaboutthefacialgrimacingwithmovement.ANS:DThenurseneedstoclarifywhatsheobserveswithwhatthepatientstates.Proceedingtothenextroomisignoringthisvisualcue.Thenursecannotassumethepatientdoesnotwantpainmedicinejustbecausethepainlevelisratedat2outof10.Thenurseshouldnotadministermedicationformoderatetoseverepainifitisnotnecessary.DIF:ApplyREF:189|191OBJ:Identifyanddiscussthestepsofnursingassessment.TOP:AssessmentMSC:CPNRE:FoundationsofNPraRcticeIUSNTO27.Thenurseisassessingapatientwithahearingdeficit.Whereisthebestplacetoconductthisinterview?a.Thepatientsroomwiththedoorclosed.b.Thewaitingareawiththetelevisionturnedoff.c.Thepatientsroombeforeadministrationofpainmedication.d.Thepatientsroomwhiletheoccupationaltherapistisworkingonlegexercises.ANS:ADistractionsshouldbeeliminatedasmuchaspossibleduringaninterviewwithapatientwithahearingdeficit.Thebestplacetoconductthisinterviewisinthepatientsroomwiththedoorclosed.Thewaitingareadoesnotprovideprivacy.Paincansometimesinhibitsomeonesabilitytoconcentrate,sointerviewingbeforepainmedicationisadministeredisnotadvisable.Itisbestforthepatienttobeascomfortableaspossibleduringaninterview.Assessingapatientwhileanothermemberofthehealthcareteamisworkingwouldbedistractingandisnotthebesttimeforassessmenttotakeplace.DIF:ApplyREF:192|193OBJ:Discussthepurposesofapatientinterviewandtheuseofinterviewtechniquesinobtainingahealthhistory.TOP:AssessmentMSC:CPNRE:FoundationsofPractice28.Anursingstudentiscompletinganassessmentonan80-year-oldpatientwhoisalertandoriented.Thepatientsdaughterispresentintheroom.Whichofthefollowingactionsmadebythenursingstudentrequiresthenursingprofessortointervene?CanadianFundamentalsofNursing7thEditionPotterTestBanka.Thenursingstudentismakingeyecontactwiththepatient.b.Thenursingstudentisspeakingonlytothepatientsdaughter.c.Thenursingstudentnodsperiodicallywhilethepatientisspeaking.d.Thenursingstudentleansforwardwhiletalkingwiththepatient.ANS:BWhenassessinganolderperson,nursesneedtolistencarefullyandallowthepatienttospeak.Positivenonverbalcommunication,suchasmakingeyecontact,nodding,andleaningforward,showsinterestinthepatient.Gatheringdatafromfamilymembersisacceptable,butwhenapatientisabletointeract,nursesneedtoincludeinformationfromthepatienttocompletetheassessment.DIF:EvaluateREF:192|193OBJ:Identifyanddiscussthestepsofnursingassessment.TOP:AssessmentMSC:CPNRE:FoundationsofPractice29.Whichofthefollowingisanexampleofsubjectivedata?a.Patientswoundappearance.b.Patientsexpressionoffearregardingupcomingsurgery.c.Patientpacingthefloorwhileawaitingtestresults.d.Patientstemperature.ANS:BSubjectivedataincludepatientsfeelings,perceptions,andreportedsymptoms.Expressingfeelingssuchasfearisanexampleofsubjectivedata.Objectivedataareobservationsormeasurementsofapatientshealthstatus.Inthisquestion,theappearanceofthewoundandthepatientstemperatureareobjectivedata.PacingisanobservablepatientbehaviourandisalsoconsideredobjectivedatNa.URSINGTB.COMDIF:UnderstandREF:191OBJ:Differentiatebetweensubjectiveandobjectivedata.TOP:AssessmentMSC:CPNRE:FoundationsofPracticeCanadianFundamentalsofNursing7thEditionPotterTestBankNRIGB.CChapter14:ImplementingandEvaluatingNursingCarePotteretal:CanadianFundamentalsofNursing,7thEditionMULTIPLECHOICE1.Inwhichstepofthenursingprocessdoesthenursedeterminewhetherthepatientsconditionhasimprovedandwhetherthepatienthasmetexpectedoutcomes?a.Assessment.b.Planning.c.Implementation.d.Evaluation.ANS:DInthefive-stepnursingprocess,theevaluationphaseisthefinalstepinvolvingconductingevaluativemeasurestodeterminewhethernursinginterventionshavebeeneffectiveandwhetherthepatienthasmetexpectedoutcomes.Assessment,thefirststepoftheprocess,includesdatacollection,validation,sorting,anddocumentation.Planning,thethirdstepoftheprocess,involvessettingpriorities,identifyingpatientgoalsandoutcomes,andprescribingnursinginterventions.Duringimplementation,nursesinitiatenursingcare,whichisnecessarytohelppatientsachievetheirgoals.DIF:RememberREF:222|223OBJ:Discusstherelationshipbetweencriticalthinkingandevaluation.TOP:EvaluateMSC:CPNRE:FoundationsofPractice2.Afterassemblingathoroughdatabaseandcarryingoutnursinginterventionsbasedonprioritydiagnoses,thenurseproceedstUowShichNsteTpoftheOnursingprocess?a.Assessment.b.Planning.c.Implementation.d.Evaluation.ANS:DInthefive-stepnursingprocess,evaluationisthelaststep,afterassessment,diagnosis,planning,andimplementation.Assessmentinvolvesgatheringinformationaboutthepatient.Next,nursingdiagnosesaredetermined.Duringtheplanningphase,patientoutcomesaredetermined.Implementationinvolvescarryingoutappropriatenursinginterventions.DIF:UnderstandREF:222|223OBJ:Discusstherelationshipbetweencriticalthinkingandevaluation.TOP:EvaluateMSC:CPNRE:FoundationsofPractice3.Anursingstudentaskshernursinginstructortodescribetheprimarypurposeofevaluation.Whichofthefollowingstatementsmadebythenursinginstructorismostaccurate?a.Duringevaluation,youdeterminewhetherallnursinginterventionswerecompleted.b.Duringevaluation,youdeterminewhentodownsizestaffingonnursingunits.c.Nursesuseevaluationtodeterminetheeffectivenessofnursingcare.d.Evaluationeliminatesunnecessarypaperworkandcareplanning.CanadianFundamentalsofNursing7thEditionPotterTestBankANS:CThepurposeofevaluationistodeterminetheeffectivenessofnursingcare.Theotheroptionsarenottruestatements.Duringevaluation,thenursedoesnotsimplydeterminewhethernursinginterventionswerecompleted.Theevaluationprocessisnotusedtodeterminewhentodownsizestaffingorhowtoeliminatepaperworkandplanning.DIF:UnderstandREF:222|223OBJ:Discusstherelationshipbetweencriticalthinkingandevaluation.TOP:EvaluateMSC:CPNRE:FoundationsofPractice4.Afterassessingthepatientandidentifyingtheneedforheadacherelief,thenurseadministersacetaminophen(Tylenol)forthepatientsheadache.Whatisthenursesnextpriorityactionforthispatient?a.EliminateAcutepainfromthenursingcareplan.b.Directthenursingassistanttoaskwhetherthepatientsheadacheisrelieved.c.Reassessthepatientspainlevelin30minutes.d.Revisetheplanofcare.ANS:CThenursesnextpriorityactionforthispatientistoevaluatewhetherthenursinginterventionofadministeringacetaminophenwaseffective.ThenursedoesnothaveenoughevaluativedataatthispointtodeterminewhetherthenursingdiagnosisofAcutepainneedstobedeleted.Assessmentisthenursesresponsibilityandisnottobedelegatedtoanunregulatedcareprovider.Thenursedoesnothaveenoughevaluativedatatodeterminewhetherthepatientsplanofcareneedstoberevised.DIF:ApplyREF:225OBJ:ExplaintherelationshipNbeUtwReSenIgNoaGlsToBfc.arCe,OeMxpectedoutcomes,andevaluativemeasuresinevaluatingnursingcare.TOP:EvaluateMSC:CPNRE:FoundationsofPractice5.AnurseisgettingreadytodischargetohomeapatientwhohasanursingdiagnosisofImpairedphysicalmobility.Beforediscontinuingthepatientsplanofcare,whatdoesthenurseneedtodo?a.Determinewhetherthepatienthastransportationtogethome.b.Evaluatewhetherpatientgoalsandoutcomeshavebeenmet.c.Establishwhetherthepatienthasafollow-upappointmentscheduled.d.Ensurethatthepatientsprescriptionshavebeenfilled.ANS:BThenurseneedstoevaluatewhethergoalsandoutcomeshavebeenmetbeforerevising,continuing,ordiscontinuingaplanofcare.Thepatientneedstransportation,butthatdoesnotaddressthepatientsmobilitystatus.Whetherthepatienthasafollow-upappointmentandensuringthatprescriptionsarefilledarenotimmediatelyrelevanttotheproblemofmobility.DIF:ApplyREF:224|225OBJ:Describehowevaluationleadstodiscontinuation,review,ormodificationofaplanofcare.TOP:EvaluateMSC:CPNRE:FoundationsofPractice6.Thenurseisevaluatingwhetherpatientgoalsandoutcomeshavebeenmet.Ofthefollowing,whichisanexpectedoutcomeforapatientwithadiagnosisofImpairedphysicalmobility?CanadianFundamentalsofNursing7thEditionPotterTestBankUSNTa.Thepatientisabletoambulateinthehallwaywithcrutches.b.Thepatientslevelofmobilitywillimprove.c.Thenurseprovidesassistancewhilethepatientiswalkinginthehallways.d.Thepatientwilldenypainwhilewalkinginthehallway.ANS:AAnoutcomeisanexpected,favourable,andmeasurableresultofnursingcare.Thepatientsbeingabletoambulateinthehallwaywithcrutchesisanexpectedoutcomeofnursingcare.Improvementinthepatientslevelofmobilityisabroadergoal.Thenursesassistingapatienttoambulateisanintervention.ThepatientsdenialofpainisanexpectedoutcomeforAcutepain,notforImpairedphysicalmobility.DIF:ApplyREF:224|225OBJ:Explaintherelationshipbetweengoalsofcare,expectedoutcomes,andevaluativemeasuresinevaluatingnursingcare.TOP:EvaluateMSC:CPNRE:FoundationsofPractice7.Thenurseisevaluatingwhetherapatientsturningschedulewaseffectiveinpreventingtheformationofpressureulcers.Whichfindingindicatessuccessoftheturningschedule?a.Staffdocumentationofturningthepatientevery2hours.b.Absenceofskinbreakdown.c.Presenceofrednessonlyontheheelsofthepatient.d.Patientseating100%ofallmeals.ANS:BTodeterminewhetheraturningscheduleissuccessful,thenurseneedstoassessforthepresenceofskinbreakdown.Rednessonanypartofthebody,evenifonlyonthepatientsheels,indicatesthattheturniNngsRcheIduleGwaBs.noCtsuMccessful.Documentationofinterventionsdoesnotevaluatewhetherpatientoutcomesweremet.Thepatientseating100%ofmealsdoesnotindicatetheeffectivenessofaturningschedule.DIF:EvaluateREF:224|225OBJ:Explaintherelationshipbetweengoalsofcare,expectedoutcomes,andevaluativemeasuresinevaluatingnursingcare.TOP:EvaluateMSC:CPNRE:FoundationsofPractice8.Anewnursestatesthatsheisconfusedaboutusingevaluativemeasureswhencaringforpatientsandasksthechargenurseforexamplesandanexplanation.Whichofthefollowingisthemostaccurateresponsefromthechargenurse?a.Evaluativemeasuresaremultiple-pagedocumentsusedtoevaluatenurseperformance.b.Evaluativemeasuresincludeassessmentdatausedtodeterminewhetherpatientshavemettheirexpectedoutcomesandgoals.c.Evaluativemeasuresareusedbyqualityassurancenursestodeterminetheprogressanurseismakingfromnovicetoexpertnurse.d.Evaluativemeasuresareobjectiveviewsofincidentreports.ANS:BEvaluativemeasuresareusedtodeterminewhetherpatientshavemettheirgoalsandoutcomes.Evaluativemeasuresarenotmultiple-pagedocuments,andtheyareusedtoassessthepatientsstatus,notthenursesperformance.Evaluativemeasuresarenotusedforcompletinganincidentreport.CanadianFundamentalsofNursing7thEditionPotterTestBankDIF:UnderstandREF:224-226OBJ:Giveanexampleofevaluativemeasuresfordeterminingpatientsprogresstowardanoutcome.TOP:EvaluateMSC:CPNRE:FoundationsofPractice9.Thenurseiscaringforapatientwhohasanopenwound.Forevaluatingtheprogressofwoundhealing,whatisthenursespriorityaction?a.Asktheunregulatedcareproviderswhetherthewoundlooksbetter.b.Documentingtheprogressofwoundhealingasbetterinthepatientschart.c.Measuringthewoundandobserveforredness,swelling,ordrainage.d.Leavingthedressingoffthewoundforeasieraccessandmorefrequentassessments.ANS:CThenurseperformsevaluativemeasures,suchascompletingawoundassessment,toevaluatewoundhealing.Nursesdonotdelegateassessmenttounregulatedcareproviders.Documentingbetterissubjectiveanddoesnotobjectivelydescribethewound.Leavingthedressingoffforthenursesbenefitofeasieraccessisnotapartoftheevaluationprocess.DIF:ApplyREF:225|226OBJ:Giveanexampleofevaluativemeasuresfordeterminingpatientsprogresstowardanoutcome.TOP:EvaluateMSC:CPNRE:FoundationsofPractice10.Thenurseiscaringforapatientwhohasanordertochangeadressingtwiceaday,at0600and1800hours.At1400hours,thenursenoticesthatthedressingissaturated.Whatisthenursesnextaction?a.Waitandchangethedressingat1800asordered.b.RevisetheplanofcareanNdUcRhaSnIgeNtGheTdBre.ssCinOgMnow.c.Reassessthedressingandthewoundin1hour.d.Discontinuetheplanofcare.ANS:BOnthebasisofevaluativedata,thenurserevises,discontinues,orcontinuesapatientsplanofcare.Becausethedressingissaturated,thenurseneedstorevisetheplanofcareandchangethedressingnow.Waitinguntil1800hoursorforanotherhourisnotappropriatebecauseassessmentdatathatthedressingissaturatedindicatethatthedressingneedstobechangednow.Dataareinsufficienttosupportdiscontinuingtheplanofcare.DIF:ApplyREF:226-228OBJ:Describehowevaluationleadstodiscontinuation,review,ormodificationofaplanofcare.TOP:EvaluateMSC:CPNRE:FoundationsofPractice11.AgoalforapatientwithanursingdiagnosisofIneffectivecopingistodemonstrateeffectivecopingskills.Whichofthesepatientbehavioursindicatesthatinterventionsperformedtomeetthisoutcomehavebeensuccessful?a.Statinghefeelsbetteraftertalkingwithhisfamilyandfriends.b.Continuingtoconsumeseveralalcoholicbeveragesaday.c.Dislikingthesupportgroupmeetings.d.Spendingmostofthedayinbed.ANS:ACanadianFundamentalsofNursing7thEditionPotterTestBankEvaluativedataindicativeofeffectivecopinghelpthenursedeterminewhetherthepatienthasmettheoutcome.Amongtheoptionslisted,talkingtofamilyandfriendsistheonlypositiveone.Theotherbehavioursindicatelackofprogresstowardmeetingthepatientsgoal.DIF:ApplyREF:225-227OBJ:Giveanexampleofevaluativemeasuresfordeterminingpatientsprogresstowardanoutcome.TOP:EvaluateMSC:CPNRE:FoundationsofPractice12.Anurseisprovidingeducationtoapatientaboutself-administeringsubcutaneousinjections.Whichofthesepatientstatementsindicatesthatthepatientunderstandstheinstructions?a.Ineedtouseaneedle1/2inch(1.3cm)longerthanmythumb.b.Iwillgivethemedicinedeepintomydeltoid.c.Mybellyisagoodplacetogivemyinjection.d.IneedtothrowthesyringeandneedleintothegarbagewhenIamdonegivingmyselfmyshot.ANS:CTheskinismadeupofseverallayers.Theouterlayeriscalledtheepidermis.Thesecondlayerofskinisthedermis.Theconnectivetissueunderthedermisiscalledthesubcutaneoustissue.Thisiswheresubcutaneousinjectionsaregiven.Theabdomenisagoodsiteforsubcutaneousinjectionsbecausethisisanareathathasalotofsubcutaneoustissue.Usinganeedle1/2inch(1.3cm)longerthanapersonsthumbisnotanevidence-informedmethodformeasuringneedlelengthneededforsubcutaneousinjection.Thedeltoidisamuscle,notasubcutaneoussite.Disposingofneedlesandsyringesintoagarbagecancreatesabiomedicalhazardandthereforeisnotappropriate.DIF:EvaluateREF:226OBJ:DiscusstheprocessofseNleUctRinSgInuNrsGinTgBin.terCveOnMtions.TOP:EvaluateMSC:CPNRE:FoundationsofPractice13.WhichofthesestatementsmadebyapatientwhohasanursingdiagnosisofDisturbedbodyimageisthebestindicatorofthepatientsearlyacceptanceofbodyimage?a.Ijustwontgotothepoolthissummer.b.Imworriedaboutwhatthoseothergirlswillthinkofme.c.Icantwearthatcolour.Itmakesmyhipsstickout.d.Illwearthebluedress.Itmatchesmyeyes.ANS:DThenurseevaluatinginterventionsforthediagnosisDisturbedbodyimageisassessingforpositivecommentsmadebythepatientthatindicateacceptanceofthepatientslooksandbodyimage.Theonlypositivecommentamongtheoptionsisthatthepatientiswearingthebluedresstomatchhereyes.Theothercommentsdonotreflectpositivechangesinbodyimage.DIF:EvaluateREF:216|217,Table14-2OBJ:Giveanexampleofevaluativemeasuresfordeterminingpatientsprogresstowardanoutcome.TOP:EvaluateMSC:CPNRE:FoundationsofPractice14.WhichoftheseoptionsisapatientoutcomeindicatingpositiveprogresstowardresolvingthenursingdiagnosisofAcuteconfusion?a.Siderailsareupwithbedalarmactivated.CanadianFundamentalsofNursing7thEditionPotterTestBankb.Patientdeniespainwhileambulatingwithassistance.c.Patientwandershallsatnight.d.Patientcorrectlystatesnamesoffamilymembersintheroom.ANS:DTheoutcomefortheidentifiednursingdiagnosisAcuteconfusionwouldaddressadecreaseinorabsenceofconfusion.Onesignoforientationiswhenapatientrespondstoquestionsappropriately.Thusonepossiblesignthatapatientsconfusionisimprovingisthatapatientcancorrectlystatethenamesoffamilymembersintheroom.Keepingthesiderailsupandusingabedalarmareinterventionstopromotepatientsafetyandpreventfalls.ThepatientsdenyingpainindicatespositiveprogresstowardresolvingadiagnosisofAcutepainorChronicpain.Thepatientswanderingthehallsisasignofconfusion.DIF:EvaluateREF:216|217,Table14-2OBJ:Giveanexampleofevaluativemeasuresfordeterminingpatientsprogresstowardanoutcome.TOP:EvaluateMSC:CPNRE:FoundationsofPractice15.AnurseidentifiesanursingdiagnosisofRiskforfallswhenassessingapatientuponadmission.Thenurseandthepatientagreethatthegoalisforthepatienttoremainfreefromfalls.However,thepatientfelljustbeforeshiftchange.Whatisthenursespriorityactionwhenevaluatingthepatientsplanofcare?a.Counseltheunregulatedcareproviderondutywhenthepatientfell.b.Identifyfactorsinterferingwithgoalachievement.c.RemovetheFallRisksignfromthepatientsdoorbecausethepatienthassufferedafall.d.Requestthatthemoreexperiencedchargenursecompletethedocumentationaboutthefall.ANS:BNURSINGTB.COMAfterachangeinthepatientsconditionoranuntowardevent,thenurseattemptstoidentifyfactorsinterferingwithgoalachievement.Inthiscase,thenurseidentifiesfactorsthatinterferedwithgoalachievementtodeterminethecauseofthefall.Thefallmaynothavebeenduetoanerrorbytheunregulatedcareprovider;therefore,counsellingshouldbereserveduntilafterthecausehasbeendetermined.Thepatientremainsatriskforfalls,sotheFallRisksignshouldremainonthedoor.Thenursewitnessingthefallorthenurseassignedtothepatientneedstocompletethedocumentation.Thechargenursecanbeconsultedtoreviewthedocumentation.DIF:UnderstandREF:227OBJ:Describehowevaluationleadstodiscontinuation,review,ormodificationofaplanofcare.TOP:EvaluateMSC:CPNRE:FoundationsofPractice16.Apatientrecentlyreceivedadiagnosisofpneumonia.Thenurseandthepatienthaveestablishedagoalthatthepatientwillnotexperienceshortnessofbreathwithactivityin3days,withanexpectedoutcomeofhavingnosecretionspresentinthelungsin48hours.Whichofthefollowingisanappropriateevaluativemeasuredemonstratingprogresstowardthisgoal?a.Nonproductivecoughpresentin4days.b.Scatteredrhonchithroughoutalllungfieldsin2days.c.Respirations30/minutein1day.d.Lungscleartoauscultationafteruseofinhaler.CanadianFundamentalsofNursing7thEditionPotterTestBankANS:DGoalsarebroadstatementsthatdescribechangesinapatientsconditionorbehaviour.Expectedoutcomesareshorter-termmeasurablecriteriausedtoevaluategoalachievement.Whenanoutcomeismet,thepatientismakingprogresstowardgoalachievement.Inthiscase,thepatientsgoalistonotexperienceshortnessofbreathwithactivityin3days.Onewaytoachievethisgoalistoeliminaterespiratorysecretionsintheairway.Thenursecanevaluatethisexpectedoutcomebyassessingthepatientslungsounds.Ifthelungsoundsareclear,atleastperiodicallythroughouttheday,thenursecandeterminethatthepatientismakingprogresstowardachievingtheexpectedoutcome.Thetimeframeof4daysinthefirstoptionisnotappropriatebecausethistimeframeexceedsthetimeframestatedinthegoal.Scatteredrhonchiindicatefluidinthelungs,andarespiratoryrateof30perminuteishigherthannormal.Eitheroftheseindicatesthatthepatientisstillprobablyexperiencingrespiratorydistress.DIF:ApplyREF:224|225OBJ:Explaintherelationshipbetweengoalsofcare,expectedoutcomes,andevaluativemeasuresinevaluatingnursingcare.TOP:EvaluateMSC:CPNRE:FoundationsofPractice17.Anurseadministratorisatameetingwithnursesonthequalitycouncil.Severalnewmembersaresittingonthecouncil.Theyaskthenurseadministratortoclarifywhatanursing-sensitiveoutcomeis.Whichresponsebythenurseadministratorbestdefinesnursing-sensitiveoutcomes?a.Nursing-sensitiveoutcomesdeterminethepatientsprogressasaresultofprescribedtreatments,suchasmedications.b.Patientfallsisanexampleofanursing-sensitiveoutcomebecausetheyaredirectlyaffectedbynursiNngUiRntSerIveNnGtioTnBs..COMc.Nursing-sensitiveoutcomespromoteuniversalhealthcare.d.Weusenursing-sensitiveoutcomesatthishospitaltoevaluatenursingtasksandtodeterminesafestaffingratios.ANS:BAnursing-sensitiveoutcomeisameasurablepatientorfamilystate,behaviour,orperceptionthatislargelyinfluencedbyandsensitivetonursinginterventions.Patientfallsareonenursing-sensitiveoutcomebecausetheyareadirectmeasureofnursingcare.Becausetheprescriber,notthenurse,prescribestreatments,theprogressofthepatientsconditionasaresultofprescribedtreatmentsisnotanevaluationofanursing-sensitiveoutcome.Promotionofuniversalhealthcareanddeterminingstaffingratiosarenotcomponentsofnursing-sensitiveoutcomes.DIF:ApplyREF:225OBJ:Giveanexampleofevaluativemeasuresfordeterminingpatientsprogresstowardanoutcome.TOP:EvaluateMSC:CPNRE:FoundationsofPractice18.Whichscenariobestillustratestheuseofdatavalidationwhenanindependentnursingclinicaldecisionismade?a.Thenursedeterminesthatsheneedstoremoveawounddressingwhenthepatientrevealsthetimeofthelastdressingchange,andshenoticesthatthepresentdressingissaturatedwithfreshandoldblood.b.Thenurseadministerspainmedicinedueat1700hoursat1600hoursbecausetheCanadianFundamentalsofNursing7thEditionPotterTestBankpatientcomplainsofincreasedpain.c.Thenurseremovesalegcastwhenthepatientcomplainsofdecreasedmobility.d.Thenurseadministerspotassiumwhenapatientcomplainsoflegcramps.ANS:AChangingthewounddressingistheonlyindependentnursingactiongiven.Thenursevalidateswhatthepatientsaysbyobservingthedressing.Inaddition,thisoptionistheonlyassessmentoptionthatinvolvesdatavalidation.Administeringpainmedicineorpotassiumandremovingalegcastareexamplesofnursinginterventions.DIF:ApplyREF:194|195OBJ:Describeandcomparedirectandindirectnursinginterventions.TOP:AssessmentMSC:CPNRE:FoundationsofPractice19.Anothertermforacollaborativenursinginterventioniswhichofthefollowing?a.Dependentintervention.b.Independentintervention.c.Interdependentintervention.d.Physician-initiatedintervention.ANS:CAcollaborative,orinterdependent,interventionrequiresthecombinedknowledge,skill,andexpertiseofmultiplehealthcareproviders.Adependentinterventionrequiresanorderfromahealthcareprovider.Anindependentinterventionisanactionthatthenurseinitiates.DIF:RememberREF:214OBJ:Describeandcomparedirectandindirectnursinginterventions.TOP:PlanningMSC:CPNNRRE:CIollaGborBati.veCPraMcticeUSNTO20.Aregisterednurseadministerspainmedicationtoapatientsufferingfromfracturedribs.Whattypeofnursinginterventionisthisnurseimplementing?a.Collaborative.b.Independent.c.Interdependent.d.Dependent.ANS:DThenursedoesnothaveprescriptiveauthoritytoorderpainmedications,unlessthenurseisanadvancedpracticenurse.Theinterventionisthereforedependent.Acollaborative,orinterdependent,interventioninvolvestherapiesthatrequirecombinedknowledge,skill,andexpertisefrommultiplehealthcareproviders.Anindependentinterventiondoesnotrequireanorderorcollaborationwithotherhealthcareproviders.DIF:ApplyREF:214OBJ:Describeandcomparedirectandindirectnursinginterventions.TOP:PlanningMSC:CPNRE:CollaborativePractice21.WhichinterventionismostappropriateforthenursingdiagnosisImpairedverbalcommunicationrelatedtolossoffacialmotorcontrolanddecreasedsensation?a.Obtainaninterpreterforthepatientassoonaspossible.b.Assistthepatientinperformingswallowingexerciseseachshift.c.Askthefamilytoprovideasittertoremainwiththepatientatalltimes.CanadianFundamentalsofNursing7thEditionPotterTestBankUSNTOd.Providethepatientwithawritingboardeachshift.ANS:DThecauseofthepatientsproblemwillhelpguidethenursetothepropernursingintervention.Ifthepatienthasaproblemwithverbalcommunication,thenthenurseshouldchooseaninterventionthatwilladdresstheproblem.Providingthepatientwithawritingboardwillallowthepatienttocommunicatebywritingbecausethepatientisunabletocommunicateverballyatthistime.Obtaininganinterpretermightbeanappropriateinterventionifthepatientspokeaforeignlanguage.Assistingwithswallowingexerciseswillhelpthepatientwithswallowing,thediagnosisforwhichisdifferentfromImpairedverbalcommunication.Askingthefamilytoprovideasitteratalltimesisoftenunrealisticanddoesnotpromotethepatientsindependence,asdoesuseofawritingboard.DIF:ApplyREF:215-218OBJ:Discusstheprocessofselectingnursinginterventions.TOP:PlanningMSC:CPNRE:FoundationsofPractice22.WhichinterventionismostappropriateforthenursingdiagnosisImpairedskinintegrityrelatedtoshearingforces?a.Administerpainmedicationevery4hoursasneeded.b.Performtheordereddressingchangetwicedaily.c.Donotdocumentthewoundappearanceinthechart.d.Keepthebedsiderailsupatalltimes.ANS:BThemostappropriateinterventionforthediagnosisofImpairedskinintegrityistoperformtheordereddressingchange.Theotheroptionsdonotdirectlyaddresstheskinintegrity.ThepatientmayneedpainmedicNatioRnbeIforeGdreBs.sinCgcMhanges,butAcutepainwouldbeanothernursingdiagnosis.Documentingallobjectivefindingsisthenursesresponsibility,evenifawoundorinfectionisahealthcare-associatedproblem.Keepingthesiderailsupaddressessafety,notskinintegrity.DIF:ApplyREF:215-218OBJ:Discusstheprocessofselectingnursinginterventions.TOP:PlanningMSC:CPNRE:FoundationsofPractice23.Apatienthasreducedmusclestrengthafteraleft-sidedstrokeandisatriskforfalling.WhichinterventionismostappropriateforthenursingdiagnosisRiskforfalls?a.Encouragingthepatienttoremaininbedmostoftheshift.b.Keepingallsiderailsdownatalltimes.c.Placingthepatientinaroomawayfromthenursesstationifpossible.d.Assistingpatientintoandoutofbedevery6hoursorastolerated.ANS:DCanadianFundamentalsofNursing7thEditionPotterTestBankUSNTORiskforfallsisapotentialnursingdiagnosis;therefore,thenurseneedstoimplementactionsthatwillpreventafall.Assistingthepatientintoandoutofbedisthemostappropriateinterventiontopreventthepatientfromfalling.Encouragingthepatienttostayinbedwillnothelpthepatientincreasemusclestrength;decreasedmusclestrengthistheriskfactorplacingthepatientinjeopardyoffalling.Thesiderailsshouldbeup,notdown,accordingtoagencypolicy.Thiswillremindthepatenttoaskforhelptogetupandwillkeepthepatientfromrollingoutofbed.Thepatientshouldbeplacednearthenursesstation,soastaffmembercanquicklygettotheroomandassistthepatientifnecessary.DIF:ApplyREF:215-218OBJ:Discusstheprocessofselectingnursinginterventions.TOP:PlanningMSC:CPNRE:FoundationsofPractice24.AnurseisplanningcareforapatientwithanursingdiagnosisofImpairedskinintegrity.Thepatientneedsmanynursinginterventions,includingadressingchange,severalintravenousantibiotics,andawalk.Whichfactordoesthenurseconsiderwhenprioritizinginterventions?a.Puttingallofthepatientsphysician-initiatedinterventionsasfirstpriority.b.Consideringtimeasaninfluencingfactor.c.Settingprioritiesbasedsolelyonphysiologicalfactors.d.Notchangingprioritiesoncetheyvebeenestablished.ANS:BPrioritizingisbasedonthepatientneeds.Timeisafactortobeincludedinplanningbeforecontinuingontotheimplementationphase.Thenurseavoidssettingprioritiessolelyonthebasisofphysiologicalfactorsandconsiderspsychosocialfactorsaswell.Prioritiescanchangeaccordingtothepatientsneedsandresponsestotreatments.ThenurseavoidssettingprioritiesonthebasisofthetNypeRofnIursGingBin.teCrveMntion.DIF:RememberREF:215-218OBJ:Discusstheprocessofselectingnursinginterventions.TOP:PlanningMSC:CPNRE:FoundationsofPractice25.Whichofthefollowingisanelementoftheevaluationprocess?a.Settingprioritiesforpatientcare.b.Collectingsubjectiveandobjectivedatatodeterminewhethercriteriaorstandardsaremet.c.Ambulating7.6m(25feet)inthehallway.d.Administeringoxygenasordered.ANS:BDuringtheevaluationprocess,thenursegathersanddocumentsobjectiveandsubjectivedatatodeterminewhetherthepatientismeetingexpectedoutcomesandisworkingtowardachievementofgoals.Theevaluationprocessrequirestheuseofcriticalthinkingaboutattitudesandstandardstoanalyzethenursesfindingsandtodeterminewhetheraplanofcareneedstobeterminated,continued,orrevised.Settingprioritiesispartofplanning.Ambulatingwithapatientinthehallwayandadministeringoxygenareinterventions,sotheyareincludedintheimplementationstepofthenursingprocess.DIF:UnderstandREF:224-228OBJ:Discusstherelationshipbetweencriticalthinkingandevaluation.TOP:EvaluateMSC:CPNRE:FoundationsofPracticeCanadianFundamentalsofNursing7thEditionPotterTestBankUSNTOChapter15:DocumentingandReportingPotteretal:CanadianFundamentalsofNursing,7thEditionMULTIPLECHOICE1.Anursepreceptorisworkingwithastudentnurse.Whichbehaviourbythestudentnursewillpromptthenursepreceptortointervene?a.Thestudentnursereviewsthepatientsmedicalrecord.b.Thestudentnursereadsthepatientsplanofcare.c.Thestudentnursesharespatientinformationwithafriend.d.Thestudentnursedocumentsmedicationadministeredtothepatient.ANS:CThePersonalInformationProtectionandElectronicDocumentsAct(PIPEDA)isfederallegislationthatprotectspersonalinformation,includinghealthinformation,andispartofprofessionalpractice.ConfidentialityandcompliancewithPIPEDAaremandatory.Whenastudentnursesharespatientinformationwithafriend,confidentialityandPIPEDAstandardshavebeenviolated.Astudentcanreviewpatientsmedicalrecordsonlytoseekinformationneededtoprovidesafeandeffectivepatientcare.Forexample,whennursesareassignedtocareforapatient,theyneedtoreviewthepatientsmedicalrecordandplanofcare.Theydonotsharethisinformationwithclassmates,andtheydonotaccessthemedicalrecordsofotherpatientsontheunit.DIF:ApplyREF:237|238OBJ:Identifywaystomaintainconfidentialityofrecordsandreports.TOP:EvaluateMSC:CPNNRRE:PIrofeGssioBna.l,CEthMical,andLegalPractice2.Anursepreparedanaudio-recordedexchangewithanothernurseofinformationaboutapatient.Whichactiondidthenursecomplete?a.Report.b.Record.c.Consultation.d.Referral.ANS:AReportsareoral,written,oraudio-recordedexchangesofinformationamongcaregivers.Apatientsrecordorchartisaconfidential,permanentlegaldocumentconsistingofinformationrelevanttohisorherhealthcare.Consultationsareanotherformofdiscussioninwhichoneprofessionalcaregivergivesformaladviceaboutthecareofapatienttoanothercaregiver.Nursesdocumentreferrals(arrangementsfortheservicesofanothercareprovider).DIF:RememberREF:238OBJ:Describethepurposeandcontentofachange-of-shiftreport.TOP:ImplementationMSC:CPNRE:Professional,Ethical,andLegalPractice3.Whichsituationbestindicatesthatthenursehasagoodunderstandingofauditingandmonitoringofpatientshealthrecords?a.Thenursedeterminesthedegreetowhichstandardsofcarearemetbyreviewingpatientshealthrecords.b.ThenurserealizesthatcarenotdocumentedinpatientshealthrecordsstillCanadianFundamentalsofNursing7thEditionPotterTestBankqualifiesascareprovided.c.Thenurseknowsthatreimbursementisbasedonthediagnosis-relatedgroupsdocumentedinpatientsrecords.d.Thenursecomparesdatainpatientsrecordstodeterminewhetheranewtreatmenthadbetteroutcomesthanthestandardtreatment.ANS:AThepatientrecordisavaluablesourceofdataforallmembersofthehealthcareteam.Itspurposesincludecommunication,legaldocumentation,financialbilling,education,research,andauditing/monitoring.Theauditing/monitoringpurposeinvolvesnursesauditingrecordsthroughouttheyeartodeterminethedegreetowhichstandardsofcarearemetandtoidentifyareasneedingimprovementandstaffdevelopment.Thelegaldocumentationpurposeinvolvestheconceptthateventhoughnursingcaremayhavebeenexcellent,inacourtoflaw,carenotdocumentediscarenotprovided.Thefinancialbillingorreimbursementpurposeinvolvesdiagnosis-relatedgroups(DRGs)asthebasisforestablishingreimbursementforpatientcare.Forresearchpurposes,theresearchercomparesthepatientsrecordedfindingstodeterminewhetherthenewmethodwasmoreeffectivethanthestandardprotocol.Analysisofdatafromresearchcontributestoevidence-informednursingpracticeandqualityhealthcare.DIF:AnalyzeREF:234OBJ:Identifypurposesofahealthcarerecord.TOP:EvaluateMSC:CPNRE:Professional,Ethical,andLegalPractice4.Afterprovidingcare,anursechartsinthepatientsrecord.Whichentryshouldthenursedocument?a.Appearsrestlesswhensittinginthechair.b.Drankadequateamountsofwater.c.ApparentlyisasleepwitNheyRescIlosGed.B.CMd.Skinpaleandcool.ANS:DUSNTOAfactualrecordcontainsdescriptive,objectiveinformationaboutwhatanursesees,hears,feels,andsmells.Anobjectivedescriptionistheresultofdirectobservationandmeasurement:forexample,BP80/50,patientdiaphoretic,heartrate102andregular.Vaguetermssuchasappears,seems,orapparentlyshouldbeavoidedbecausethesewordsaresuggestiveofanopinion,donotaccuratelycommunicatefacts,anddonotinformanothercaregiverofdetailsregardingbehavioursexhibitedbythepatient.Useofexactmeasurementsestablishesaccuracy.Forexample,adescriptionsuchasIntake,360mLofwaterismoreaccuratethanDrankadequateamountsofwater.DIF:ApplyREF:239-241OBJ:Describesixqualityguidelinesfordocumentationandreporting.TOP:EvaluateMSC:CPNRE:Professional,Ethical,andLegalPractice5.Anursehasprovidedcaretoapatient.Whichentryshouldthenursedocumentinthepatientsrecord?a.Patientseemstobeinpainandstates,Ifeeluncomfortable.b.Statusunchanged,doingwell.c.Leftabdominalincision5cminlengthwithoutredness,drainage,oredema.d.Patientishardtocareforandrefusesalltreatmentsandmedications.Familypresent.CanadianFundamentalsofNursing7thEditionPotterTestBankNRIGB.CMANS:CUseofexactmeasurementsestablishesaccuracy.Chartingthatanabdominalwoundis5cminlengthwithoutredness,drainage,oredemaismoredescriptivethanLargewoundhealingwell.Thepatientsrecordshouldincludeobjectivedatatosupportsubjectivedata,sothatchartingisasdescriptiveaspossible.Vaguetermssuchasappears,seems,orapparentlyconveyopinionratherthanfact,donotaccuratelycommunicatefacts,anddonotinformanothercaregiverofdetailsregardingbehavioursexhibitedbythepatient.Thenurseshouldavoidusinggeneralized,uninformativephrasessuchasStatusunchangedorHadagoodday.Itisessentialtoavoidtheuseofunnecessarywordsandirrelevantdetailsorpersonalopinions.AstatementsuchasPatientishardtocareforisapersonalopinionandshouldbeavoided.Itisalsoacriticalcommentthatcanbeusedasevidenceofnonprofessionalbehaviourorpoorqualityofcare.TheonlystatementtochartwouldbeRefusesalltreatmentsandmedications.DIF:ApplyREF:239-241OBJ:Describesixqualityguidelinesfordocumentationandreporting.TOP:EvaluateMSC:CPNRE:Professional,Ethical,andLegalPractice6.Apreceptorisworkingwithanewnurseondocumentation.Whichsituationwillcausethepreceptortointervene?a.Thenewnurseusesablackinkpentochart.b.Thenewnursechartsconsecutivelyoneveryotherline.c.Thenewnurseendseachentrywithsignatureandtitle.d.Thenewnursekeepsthepasswordsecure.ANS:BChartshouldbeconsecutive,linebyline(noteveryotherline);ifspaceisleft,alineshouldbedrawnhorizontallythroughUit,aSndtNhenTursesOnameshouldbesignedattheend.Nolinesshouldbeleftblank.Allentriesshouldbewrittenlegiblyandinblackink.Eachentryshouldendwiththenursessignatureandtitle.Forcomputerdocumentation,thenurseshouldkeepthepasswordsecure.DIF:ApplyREF:235,Table15-1OBJ:Discusslegalguidelinesfordocumentation.TOP:EvaluateMSC:CPNRE:Professional,Ethical,andLegalPractice7.Anurseischartingonapatientsrecord.Whichactionismostaccuratelegally?a.Chartinglegibly.b.Statingthatthepatientisbelligerent.c.Usingcorrectionfluidtocorrecterror.d.Writingentryforanothernurse.ANS:AThenurseshouldrecordallentrieslegibly.Personalopinionsshouldbeavoided;onlyobjectiveandfactualobservationsofpatientsbehaviourshouldbeentered.Allpatientcommentsshouldbenoted;forexample,Patientrefusestocoughanddeepbreathe,saying,Idontcarewhatyousay,Iwillnotdoit.Entriesshouldnotbeerased,coveredwithcorrectionfluid,orscratchedout,eveniftheyareinerror.Chartingshouldbedoneonlybythenursewhoperformedtheactionormadetheobservation.DIF:UnderstandREF:239-241OBJ:Discusslegalguidelinesfordocumentation.CanadianFundamentalsofNursing7thEditionPotterTestBankTOP:PlanningMSC:CPNRE:Professional,Ethical,andLegalPractice8.Anursewantstointegrateallpertinentpatientinformationintoonerecord,regardlessofthenumberoftimesapatiententersthehealthcaresystem.Whichtermshouldthenurseusetodescribethissystem?a.Electronicmedicalrecord.b.Electronichealthrecord.c.Electronicchartingrecord.d.Electronicproblemrecord.ANS:BAuniquefeatureofanelectronichealthrecord(EHR)isitsabilitytointegrateallpertinentpatientinformationintoonerecord,regardlessofthenumberoftimesapatiententersahealthcaresystem.Theelectronicmedicalrecord(EMR)containspatientdatagatheredinahealthcaresettingataspecifictimeandplaceandisapartoftheEHR;thetwotermsarefrequently(andmistakenly)usedinterchangeably.Therearenosuchtermsaselectronicchartingrecordorelectronicproblemrecord.DIF:UnderstandREF:236OBJ:Discusstheuseofelectronichealthrecordsindocumentation.TOP:DiagnosisMSC:CPNRE:Professional,Ethical,andLegalPractice9.Anursehastaughtthepatienthowtousecrutches.Thepatientwentupanddownthestairsusingcrutcheswithnodifficulties.WhichinformationwillthenurseusefortheIinPIEcharting?a.Patientwentupanddownstairs.b.Deficientknowledgeregardingcrutches.c.DemonstrateduseofcruNtcUhResS.INGTB.COMd.Usedcrutcheswithnodifficulties.ANS:CAsecondprogressnotemethodisthePIEformat.Thenarrativenoteincludesastatementoftheproblem(P),theintervention(I),andtheevaluation(E).TheIisDemonstrateduseofcrutches.PatientwentupanddownstairsandUsedcrutcheswithnodifficultiesareexamplesoftheE.DeficientknowledgeregardingcrutchesistheP.DIF:ApplyREF:242OBJ:Describethedifferentmethodsusedinrecordkeeping.TOP:ImplementationMSC:CPNRE:Professional,Ethical,andLegalPractice10.Anurseisusingthesourcerecordandwantstofindthepatientsdailyweights.Whereshouldthenurselook?a.Database.b.Medicalhistoryandexamination.c.Progressnotes.d.Graphicsheetandflowsheet.ANS:DCanadianFundamentalsofNursing7thEditionPotterTestBankUSNTOInasourcerecord,thepatientscharthasaseparatesectionforeachdiscipline(e.g.,nursing,medicine,socialwork,respiratorytherapy)inwhichtorecorddata.Graphicsheetsandflowsheetsarerecordsofrepeatedobservationsandmeasurementssuchasvitalsigns,dailyweights,andintakeandoutput.Intheproblem-orientedmedicalrecord,thedatabasesectioncontainsallavailableassessmentinformationpertainingtothepatient(e.g.,historyandphysicalexamination,thenursesadmissionhistoryandongoingassessment,thedietitiansassessment,laboratoryreports,radiologicaltestresults).Inthesourcerecord,themedicalhistoryandexaminationsectioncontainsresultsoftheinitialexaminationperformedbythephysician,includingfindings,familyhistory,confirmeddiagnoses,andmedicalplanofcare.Alsointhesourcerecord,theprogressnotesconstituteanongoingrecordofthepatientsprogressandresponsetomedicaltherapyandareviewofthediseaseprocess;thesenotesareofteninterdisciplinaryandincludedocumentationfromhealth-relateddisciplines(e.g.,healthcareproviders,physiotherapy,socialwork).DIF:ApplyREF:243,Table15-3OBJ:Describethedifferentmethodsusedinrecordkeeping.TOP:PlanningMSC:CPNRE:Professional,Ethical,andLegalPractice11.Anurseisamemberofaninterdisciplinaryteamthatusescriticalpathways.Accordingtothecriticalpathway,onday2ofthehospitalstay,thepatientshouldbesittinginthechair.Itisday3,andthepatientcannotsitinthechair.Whatshouldthenursedo?a.Focuscharting,usingtheDARformat.b.Addthisobservationtotheproblemlist.c.Documentthevarianceinthepatientsrecord.d.Reportapositivevarianceinthenextinterdisciplinaryteammeeting.ANS:CNRIGB.CMAvarianceisthesituationwhentheactivitiesonthecriticalpathwayarenotcompletedaspredictedorthepatientdoesnotmeetexpectedoutcomes.Anexampleofavarianceiswhenapatientdevelopspulmonarycomplicationsaftersurgery,andoxygentherapyandmonitoringwithpulseoximetryareneeded.Apositivevarianceisasituationwhenapatientprogressesmorerapidlythanexpected(e.g.,useofaFoleycathetermaybediscontinuedadayearly).Whenanurseisusingtheproblem-orientedmedicalrecord,afteranalyzingdata,healthcareteammembersidentifyproblemsandmakeasingleproblemlist.Atypeofnarrativeformatchartingisfocuscharting.ItinvolvestheuseofDARnotes,whichincludedata(bothsubjectiveandobjective),actionornursingintervention,andresponseofthepatient(i.e.,evaluationofeffectiveness).DIF:ApplyREF:243|244OBJ:Describetheroleofcriticalpathwaysinmultidisciplinarydocumentation.TOP:ImplementationMSC:CPNRE:Professional,Ethical,andLegalPractice12.Anurseneedstobegindischargeplanningforapatientadmittedwithpneumoniaandaproductivecough.Whenisthebesttimeforthenursetostartdischargeplanningforthispatient?a.Uponthepatientsadmission.b.Rightbeforethepatientsdischarge.c.Afterthecongestionistreated.d.Whentheprimarycareproviderwritestheorder.ANS:ACanadianFundamentalsofNursing7thEditionPotterTestBankNRIGB.CIdeally,dischargeplanningbeginsatadmission.Rightbeforedischargeistoolatefordischargeplanning.Afterthecongestionistreatedisalsotoolatefordischargeplanning.Usuallytheprimarycareproviderwritestheordertooclosetodischarge,andnursesdonotneedanordertobegintheteachingthatwillbeneededfordischarge.Byidentifyingdischargeneedsearly,nursingandotherhealthcareproviderscanbeginplanningforhomecare,supportservices,andanyequipmentneedsatthepatientshome.DIF:ApplyREF:245OBJ:Identifyelementstoincludewhendocumentingapatientdischargeplan.TOP:PlanningMSC:CPNRE:FoundationsofPractice13.Apatientisbeingdischargedhome.Whichinformationshouldthenurseinclude?a.Acuitylevel.b.Communityresources.c.Standardizedcareplan.d.Kardex.ANS:BDischargedocumentationincludesinformationaboutmedications,diet,communityresources,follow-upcare,andwhomtocontactincaseofanemergencyorforquestions.Apatientslevelofmedicalacuity,usuallydeterminedbyacomputerprogram,isbasedonthetypeandnumberofnursinginterventions(e.g.,intravenous[IV]therapy,woundcare,ambulationassistance)requiredovera24-hourperiod.Acuitylevelcanbeusedforstaffingandbilling.Someinstitutionsusestandardizedcareplanstomakedocumentationmoreefficient.Theplans,basedontheinstitutionsstandardsofnursingpractice,arepreprinted,establishedguidelinesusedtocareforpatientswhohavesimilarhealthproblems.Insomesettings,aKardex,aportableflip-overfileornotebook,iskeptatthenursesstation.MostKardexformshaveanactivityandtreaUtmeSntsNectiTonandaOnursingcareplansection,whichorganizeinformationforquickreference.DIF:ApplyREF:245OBJ:Identifyelementstoincludewhendocumentingapatientdischargeplan.TOP:PlanningMSC:CPNRE:Professional,Ethical,andLegalPractice14.Anursedevelopedthefollowingdischargesummarysheet.Whichcriticalinformationshouldbeadded?Topic:DischargeSummaryMedicationDietActivitylevelFollow-upcareWoundcarePhonenumbersWhentocallthedoctorTimeofdischargea.Kardexform.b.Admissionnursinghistory.c.Modeoftransportation.d.SOAPnotes.ANS:CCanadianFundamentalsofNursing7thEditionPotterTestBankUSNTOIndischargesummaryinformation,thenurselistsactualtimeofdischarge,modeoftransportation,andwhoaccompaniedthepatient.Insomesettings,aKardex,aportableflip-overfileornotebook,iskeptatthenursesstation.AKardexisfornurses,notforpatientstotakeupondischarge.Anursecompletesanursinghistoryformwhenapatientisadmittedtoanursingunit,notwhenthepatientisdischarged.SOAPnotesarenotgiventopatientswhoarebeingdischarged.SOAPnotesareatypeofdocumentationstyle.DIF:EvaluateREF:245,Box15-5OBJ:Identifyelementstoincludewhendocumentingapatientdischargeplan.TOP:EvaluateMSC:CPNRE:Professional,Ethical,andLegalPractice15.Accordingtodocumentationguidelines,whichnotationisthemostappropriate?a.1230hours:Patientsvitalsignstaken.b.0700hours:Patientdrankadequateamountoffluids.c.0900hours:Morphinegivenforlowerabdominalpain.d.0830hours:IncreasedIVfluidrateto100mLperhour.ANS:DInformationwithinarecordedentrymustbecomplete,containingappropriateandessentialinformation.Thenotation0830hours:IncreasedIVfluidrateto100mLperhourprovidesthetimeandactiontakenbythenurse,includingthereasonfordoingso.Theentry1230hours:Patientsvitalsignstakendoesnotindicatewhatthepatientsvitalsignswere.Theentry0700hours:Patientdrankadequateamountoffluidsdoesnotprovidethespecificamountthatthepatientdrank.Statingadequateissubjective,notobjective.Thenotation0900hours:Morphinegivenforlowerabdominalpaindoesnothavethepatientdescribehisorherpain,orrateitaccordingtoapainscaleforcomparisonlater.ItalsodoesnotindicatewhetherthepatientsNpaRinwIasiGnthBe.loCwerMleftorlowerrightquadrant,orboth.DIF:ApplyREF:239-241OBJ:Describesixqualityguidelinesfordocumentationandreporting.TOP:ImplementationMSC:CPNRE:Professional,Ethical,andLegalPractice16.ThefinalRwhenusingtheI-SBAR-Rcommunicationtechniquerepresentswhichofthefollowing?a.Recovery.b.Repeatback.c.Reorganization.d.Reintegration.ANS:BThefinalRinI-SBAR-Rrepresentsrepeatback,whichincludesrepeatingbackordersthathavebeengivenorclarifyinganyquestions.ThefinalRinI-SBAR-Rdoesnotstandforrecovery,reorganization,orreintegration.DIF:ApplyREF:248,Box15-9OBJ:Discusstheadvantagesofstandardizeddocumentationforms.TOP:ImplementationMSC:CPNRE:Professional,Ethical,andLegalPractice17.Anurseisgivingahand-offreporttothenurseonthenextshift.Whichinformationiscriticalforthenursetoreport?a.Thepatienthadagooddaywithnocomplaints.CanadianFundamentalsofNursing7thEditionPotterTestBankb.Thefamilyisdemandingandargumentative.c.Thepatienthasanewpainmedication,hydrocodonebitartrateandacetaminophen(Lortab).d.Thefamilyispoorandhadtogoonwelfare.ANS:CSignificantchangesinthewaytherapiesaretobegiven(e.g.,Differentpositionforpainrelief,newmedication)shouldbedescribedtostaff.Resultsshouldnotbedescribedsimplyasgoodorpoor;theyshouldbespecific.Criticalcommentsaboutpatientsorfamilysbehaviourareconsideredidlegossipandshouldnotbementioned.DIF:ApplyREF:246-248OBJ:Describethepurposeandcontentofachange-of-shiftreport.TOP:ImplementationMSC:CPNRE:Professional,Ethical,andLegalPractice18.Anewnurseasksthepreceptorwhyachange-of-shiftreportisimportant,inasmuchascareisdocumentedinthechart.Whatisthepreceptorsbestresponse?a.Achange-of-shiftreportprovidesanopportunitytoshareessentialinformationtoensurepatientsafetyandcontinuityofcare.b.Achange-of-shiftreportprovidestheoncomingnursewithdatatohelpsetprioritiesandestablishreimbursementcosts.c.Achange-of-shiftreportprovidesanopportunityfortheoncomingnursetoaskquestionsanddetermineresearchpriorities.d.Achange-of-shiftreportprovidesimportantinformationtocaregiversanddevelopsrelationshipswithinthehealthcareteam.ANS:AProperlyperformed,achangeN-oUfR-sShiIftNreGpoTrBtp.roCvidMesanopportunitytoshareessentialinformationtoensurepatientsafetyandcontinuityofcare.Reimbursementcostsandresearchpriorities/opportunitiesarefunctionsofthemedicalrecord.Establishingrelationshipsisnotthepurposeofthechange-of-shiftreport.DIF:RememberREF:246-248OBJ:Describethepurposeandcontentofachange-of-shiftreport.TOP:ImplementationMSC:CPNRE:Professional,Ethical,andLegalPractice19.Anurseispreparingachange-of-shiftreportforapatientwhohadchestpain.Whichinformationiscriticalforthenursetoinclude?a.Pupilsequalandreactivetolight.b.Thefamilyisapain.c.Hadpoorresultsfromthepainmedication.d.Sharppainof8onascaleof1to10.ANS:DElementsinachange-of-shiftreportincludeidentificationofsignificantchangesinmeasurableterms(e.g.,painscale)andbyobservation.Reportelementsdonotincludenormalfindingsorroutineinformationretrievablefromothersourcesorderogatoryorinappropriatecommentsaboutthepatientorfamily,whichcouldpossiblyleadtolegalchargesifoverheardbythepatientorfamily.Thiskindoflanguagecontributestoprejudicialopinionsaboutthepatient.Resultsshouldnotbedescribedsimplyasgoodorpoor;theyshouldbespecific.DIF:UnderstandREF:246-248CanadianFundamentalsofNursing7thEditionPotterTestBankOBJ:Describethepurposeandcontentofachange-of-shiftreport.TOP:PlanningMSC:CPNRE:Professional,Ethical,andLegalPractice20.Whichsituationwillrequirethenursetoobtainatelephoneorder?a.Asthenurseandprimarycareproviderleaveapatientsroom,theprimarycareprovidergivesthenurseanorder.b.At0100hours,apatientsbloodpressuredropsfrom120/80to90/50andtheincisiondressingissaturatedwithblood.c.At0800,thenurseandprimarycareprovidermakeroundsandtheprimarycareprovidertellsthenurseadietorder.d.Anursereadsanordercorrectlyaswrittenbytheprimarycareproviderinthepatientsmedicalrecord.ANS:BAnursemakesatelephonereportwhensignificanteventsorchangesinapatientsconditionhaveoccurred.Telephoneordersandverbalordersusuallyoccuratnightorduringemergencies.Becausethetimeis0100hours(1a.m.)andtheprimarycareproviderisnotpresent,thenursewillneedtocalltheprimarycareproviderforatelephoneorder.Averbalorderinvolvesthehealthcareprovidergivingorderstoanursewhiletheyarestandingneareachother.Justreadinganorderthatiscorrectlywritteninthechartdoesnotrequireatelephoneorder.DIF:ApplyREF:246OBJ:Explainhowtoverifytelephoneorders.TOP:AssessmentMSC:CPNRE:Professional,Ethical,andLegalPractice21.Anurseobtainedatelephoneorder(TO)fromaprimarycareproviderforapatientinpain.Whichchartentryshouldthenursedocument?a.12/16/200915Tylenol3N,U2RtaSblIetNs,GevTeBry.6ChOouMrsforincisionalpain.VODr.Day/J.Winds,LPN,readback.b.12/16/200915Tylenol3,2tablets,every6hoursforincisionalpain.TOJ.Winds,LPN,readback.c.12/16/200915Tylenol3,2tablets,every6hoursforincisionalpain.TODr.Day/J.Winds,LPN,readback.d.12/16/200915Tylenol3,2tablets,every6hoursforincisionalpain.TOJ.Winds,LPN.ANS:CThenursereceivingaTOwritesdownthecompleteorderorentersitintothecomputerasitisbeinggiven.Thenheorshereadstheorderbacktothehealthcareprovider,aprocedurecalledreadback,andthepersonwhogavetheorderconfirmsthatthereadbackiscorrect.10/16/2011:0815,Tylenol3,2tablets,every6hoursforincisionalpain.TODr.Knight/J.Woods,LPN,readbackissuchanexample.VOstandsforverbalorder,nottelephoneorder.Thedoctorsnameandreadbackmustbeincludedinthechartentry.DIF:ApplyREF:246OBJ:Explainhowtoverifytelephoneorders.TOP:ImplementationMSC:CPNRE:Professional,Ethical,andLegalPractice22.Anurserecordsthefollowing:Patientiswheezingandexperiencingsomedyspneaonexertion.Thisrepresentswhichofthefollowing?a.TheSinSOAPdocumentation.b.Focusdocumentation.CanadianFundamentalsofNursing7thEditionPotterTestBankUSNTc.ThePofPIEdocumentation.d.TheRinDARdocumentation.ANS:CThestatementisanexampleofthePofPIEdocumentationbecauseitdescribesthepatientsproblem.TheSinSOAPdocumentationrepresentssubjectivedata(verbalizationsofthepatient).Focuschartingdoesnotconcentrateonlyonproblems.TheRinDARdocumentationistheresponseofthepatient.Thesituationdescribedconcernsthepatientsproblem,notthepatientsresponse.DIF:AnalyzeREF:241,Box15-1OBJ:Describethedifferentmethodsusedinrecordkeeping.TOP:ImplementationMSC:CPNRE:Professional,Ethical,andLegalPractice23.Ahospitalisusingcomputersoftwarethatallowsallhealthcareproviderstouseaprotocolsystemtodocumentthecaretheyprovide.Whichtypeofsystem/designwillthenursebeusing?a.Clinicaldecisionsupportsystem.b.Nursingprocessdesign.c.Criticalpathwaydesign.d.Computerizedproviderorderentrysystem.ANS:COnedesignmodelfornursinginformationsystems(NIS)istheprotocolorcriticalpathwaydesign.Withthisdesign,allhealthcareprovidersuseaprotocolsystemtodocumentthecaretheyprovide,allowingthemtoselectoneormoreappropriateprotocolsforapatient.Aclinicaldecisionsupportsystemisbasedonrulesandif-thenstatements,linkinginformationorproducingaleNrts,RwarIningGs,oBr.otCherMinformationfortheuser.ThenursingprocessdesignisthemosttraditionaldesignforanNIS.Thisdesignorganizesdocumentationwithinwell-establishedformatssuchasadmissionandpostoperativeassessments,problemlists,careplans,dischargeplanninginstructions,andinterventionlistsornotes.Computerizedproviderorderentry(CPOE)isaprocessbywhichthehealthcareproviderdirectlyentersordersforpatientcareintothehospitalinformationsystem.DIF:UnderstandREF:249|250OBJ:Describetheroleofcriticalpathwaysininterdisciplinarydocumentation.TOP:EvaluateMSC:CPNRE:Professional,Ethical,andLegalPractice24.Anursewantstoreducedataentryerrorsonthecomputersystem.Whichbehaviourshouldthenurseimplement?a.Usethesamepasswordallthetime.b.Sharepasswordwithonlyoneotherstaffmember.c.Printoutandreviewcomputernursingnotesathome.d.Chartonthecomputerimmediatelyaftercareisprovided.ANS:DCanadianFundamentalsofNursing7thEditionPotterTestBankUSNTOToincreaseaccuracyanddecreaseunnecessaryduplication,manyhealthcareagencieskeeprecordsorcomputersnearapatientsbedsidetofacilitateimmediatedocumentationofinformationasitiscollectedfromapatient.Agoodsystemrequiresfrequentandrandomchangesinpersonalpasswordstopreventunauthorizedpersonsfromtamperingwithrecords.Whenanurseusesahealthcareagencycomputersystem,itisessentialthathisorhercomputerpasswordnotbesharedwithanyoneunderanycircumstances.Thenursedestroys(e.g.,shreds)anythingthatisprintedwhentheinformationisnolongerneeded.TakingnursingnoteshomeisaviolationoftheHealthInsurancePortabilityandAccountabilityAct(HIPAA)andconfidentiality.DIF:ApplyREF:240|249|250OBJ:Discusstheuseofelectronichealthrecordsindocumentation.TOP:ImplementationMSC:CPNRE:Professional,Ethical,andLegalPractice25.Whichentrynecessitatesfollow-upbythenursemanager?a.0800Patientstates,Felloutofbed.Patientfoundlyingbybedonthefloor.Legsequalinlengthbilaterallywithnodistortion,pedalpulsesstrong,legstrengthequalandstrong,nobruisingorbleeding.Neurocheckswithinnormallimits.States,Didnotpassout.Assistedbacktobed.Callbellwithinreach.Bedmonitoron.JaneMore,LPNb.0810Notifiedprimarycareproviderofpatientsstatus.Newordersreceived.JaneMore,LPNc.0815Portablex-rayofLhiptakeninroom.States,Ifeelfine.JaneMore,LPNd.0830Incidentreportcompletedandplacedonchart.JaneMore,LPNANS:DNRIGB.CMTheincidentreportisnotmentionedinthepatientsmedicalrecord.Insteadthenursedocumentsinthepatientsmedicalrecordanobjectivedescriptionofwhathappened,whatthenurseobserved,andfollow-upactionstaken.Itisimportanttoevaluateanddocumentthepatientsresponsetotheerrororincident.Thepatientshealthcareprovidershouldbecontactedwheneveranincidenthappens.DIF:AnalyzeREF:248|249OBJ:Discusslegalguidelinesfordocumentation.TOP:EvaluateMSC:CPNRE:Professional,Ethical,andLegalPractice26.Theactionthatanursewouldtakewhendocumentingonthepatientsrecordandnotesthatheorshehasmadeanerroriswhichofthefollowing?a.Drawingalinethroughtheerrorandinitiallinganddatingit.b.Erasingtheerrorandwritingoverthematerialinthesamespot.c.Usingadark-colouredmarkertocovertheerrorandcontinuingimmediatelyafterthatpoint.d.Footnotingtheerroratthebottomofthepage,includinginitialsandthedate.ANS:ACanadianFundamentalsofNursing7thEditionPotterTestBankNRIGB.CIfthenursehasmadeanerrorindocumentation,heorsheshoulddrawasinglelinethroughtheerror,writetheworderroraboveit,andsignhisorhernameorinitials.Thenthenurseshouldrecordthenotecorrectly.Thenurseshouldnoterase,applycorrectionfluidto,orscratchouterrorsmadewhilerecordingbecausechartingthenbecomesillegible.Entriesshouldbemadeonlyininksothattheycannotbeerased.Usingadark-colouredmarkertocovertheerrorandcontinuingimmediatelyafterthatpointappearsasifthenursewereattemptingtohidesomethingordefacetherecord.Footnotesarenotusedinnursingdocumentation.DIF:ApplyREF:235,Table15-1OBJ:Discusslegalguidelinesfordocumentation.TOP:ImplementationMSC:CPNRE:Professional,Ethical,andLegalPractice27.Aslighthematomahasdevelopedonthepatientsleftforearm.Thenurselabelstheproblemasaninfiltratedintravenous(IV)line.Thenurseelevatestheforearm.Thepatientstates,Myarmfeelsbetter.WhenusingtheDARnotesoffocuscharting,thenursewoulddocumenttheRaswhichofthefollowing?a.Myarmfeelsbetter.b.Slighthematomaonleftforearm.c.InfiltratedIVline.d.Elevationofleftforearm.ANS:ATheRinthedata-action-response(DAR)documentationoffocuschartingistheresponsebythepatient.Inthiscase,thenursewoulddocument,Patientstates,Myarmfeelsbetter.SlighthematomaonleftforearmandInfiltratedIVlineareexamplesoftheDinaDARnote,referringtodatainfocuscharting.ElevationofleftforearmistheAinaDARnote,describingtheactionornursingUintServNentiToninfoOcuscharting.DIF:ApplyREF:242OBJ:Describethedifferentmethodsusedinrecordkeeping.TOP:ImplementationMSC:CPNRE:Professional,Ethical,andLegalPractice28.Anurseisdiscussingtheadvantagesofstandardizeddocumentationformsinthenursinginformationsystem.Whichadvantageshouldthenursedescribe?a.Variedclinicaldatabases.b.Reducederrorsofomission.c.Increasedhospitalcosts.d.Moretimetoreadcharts.ANS:BAdvantagesassociatedwiththenursinginformationsystemincludeincreasedtimetospendwithpatients(nottoreadcharts);betteraccesstoinformation;enhancedqualityofdocumentation;reductioninerrorsofomission;reduced,notincreased,hospitalcosts;increasednursejobsatisfaction;compliancewithrequirementsofaccreditingagencies(e.g.,TJC);anddevelopmentofacommon,notvaried,clinicaldatabase.DIF:UnderstandREF:250OBJ:Discusstheadvantagesofstandardizeddocumentationforms.TOP:ImplementationMSC:CPNRE:Professional,Ethical,andLegalPracticeCanadianFundamentalsofNursing7thEditionPotterTestBank29.Anurseiscreatingaplantoreducedataentryerrorsandmaintainconfidentiality.Whichguidelinesshouldthenurseinclude?a.Createapasswordwithjustletters.b.Bypassthefirewall.c.Avoiduseofaprogrammedspeed-dialkeywhenfaxing.d.Shredpaperscontainingpersonalhealthinformation.ANS:DAllpaperscontainingprivatehealthinformationmustbedestroyed.Mostagencieshaveshreddersorlockedreceptaclesforshreddingandlaterincineration.Strongpasswordshavecombinationsofletters,numbers,andsymbolsthataredifficulttoguess.Afirewallisacombinationofhardwareandsoftwarethatprotectsprivatenetworkresources(e.g.,theinformationsystemofthehospital)fromoutsidehackers,networkdamage,andtheftormisuseofinformationandshouldnotbebypassed.Whenfaxing,thenurseshoulduseprogrammedspeed-dialkeystoeliminatethechanceofadiallingerrorandmisdirectedinformation.DIF:CreateREF:237|238OBJ:Identifywaystomaintainconfidentialityofelectronicandwrittenrecords.TOP:EvaluateMSC:CPNRE:Professional,Ethical,andLegalPracticeNURSINGTB.COMCanadianFundamentalsofNursing7thEditionPotterTestBankNRIGB.CMChapter16:NursingInformaticsandCanadianNursingPracticePotteretal:CanadianFundamentalsofNursing,7thEditionMULTIPLECHOICE1.Ofthefollowing,whichisacurrenttechnologicalapplicationthatiscriticalforsupportingclinicaljudgement,decisionmaking,andoptimalpatientoutcomes?a.Patientdocumentationsystems.b.Laboratoryreportingsoftware.c.Diagnosticimagingsystems.d.Billingandfinancialmanagementdatabases.ANS:APatientdocumentationsystemsinformnursingpracticethroughsupportingclinicaljudgementanddecisionmaking,aswellassupportingoptimalnursingcare.Inaddition,effectivedocumentationsupportsaggregationwithdocumentationfromothernursesandensuringoptimalpatientoutcomes.Laboratoryreportingdoesnotnecessarilyinformeffectivenursingpracticeorsupportoptimalpatientoutcomes;itisanexampleofacurrenttechnologicalapplication.Diagnosticimagingisacurrenttechnologicalapplicationtool.Billingandfinancialmanagementdonotoptimizenursingoutcomes.DIF:RememberREF:254OBJ:IdentifyandcompareCanadianstrategiesforidentifyinganddocumentingkeynursingdata.TOP:ImplementationMSC:CPNRE:Professional,Ethical,andLegalPractice2.Asnursescontinuetocontextualizetechnologywithinthescopeoftheirprofessionalpractice,whatisthemainnursingissueUwithStecNhnoTlogythOatrequiresconsideration?a.Computers.b.Managementinformationsystems.c.Informationandinformationmanagement.d.Orderentryapplications.ANS:CTheissuesfornursesarenolongercomputersormanagementinformationsystemsbutratherinformationandinformationmanagement.Thecomputeranditsassociatedsoftwarearemerelytoolstosupportnursesastheypractisetheirprofession.Computersandmanagementinformationsystemsarenolongerissuesfornurses.Orderentryapplicationsarecurrenttechnologicalapplications.DIF:UnderstandREF:255OBJ:IdentifyandcompareCanadianstrategiesforidentifyinganddocumentingkeynursingdata.TOP:ImplementationMSC:CPNRE:Professional,Ethical,andLegalPractice3.Nursinginformaticsisaspecialtyareaofnursingpracticededicatedtotheoptimaluseoftechnologytosupportprofessionalpracticeandoptimalpatientoutcomes.Whichofthefollowingisasignificantobstacletothecollectionofnursingdata?a.CanadaHealthInfoway.b.InternationalClassificationforNursingPractice(ICNP),whichlacksunifiedterminologyforrecordingnursingpractice.c.Lackofevidence-informedpracticesforhealthinformation.CanadianFundamentalsofNursing7thEditionPotterTestBankNRIGB.CMd.Absenceofuniversallyacceptedmethodsfordefiningandcodingnursingcontributionstohealthoutcomes.ANS:DDespitetheescalationoftheuseoftechnologyinhealthcareandtherecognitionofnursinginformatics,nomethodsfordefiningandcodingnursingcontributionstohealthoutcomesareuniversallyaccepted,andthispersistentabsenceisasignificantobstacletothecollectionofnursingdata.Theotheroptionsarenotobstaclestocollectingnursingdata.TheCanadaHealthInfowayisanincorporatednationalbodywithmandatestogenerateconsensusonhealthinformationstandards,todriveforwardanationalagendaofcreatinganelectronichealthrecord(EHR),andtoactastheliaisontointernationalstandardsanddevelopmentorganizations.TheICNPwasdevelopedbytheInternationalCouncilofNurses;itcomprisessevenaxeswithassociatedtermsfordescribingnursingpracticeandistheonlyunifiedinternationalterminologyforrecordingnursingpractice.Ashealthcaresystemsrespondtoanincreasinglycomplextechnologicalenvironment,long-standingroutinesandtoolsarebeingsupersededbystrategic,evidence-informedpracticesthatmandatehigh-quality,timelyhealthinformation.DIF:UnderstandREF:255OBJ:DiscusswhyusingstandardizednursingdataisimportantforacknowledgingtheprofessionalcontributionsofnursingtohealthoutcomesofCanadians.TOP:PlanningMSC:CPNRE:Professional,Ethical,andLegalPractice4.AccordingtotheCanadianOrganizationforAdvancementofComputersinHealth(COACH),whatishealthinformatics?a.Theintersectionofclinical,informationmanagement/informationtechnology,andmanagementpracticestoachievebetterhealth.b.ThespecialtythatintegrateUsnuSrsinNgscTience,cOomputerscience,andinformationscience.c.Theapplicationofcomputerscienceandinformationsciencetonursing.d.Aclinicaltermusedtodescribemultidisciplinaryclinicalpractice.ANS:ACOACHdefineshealthinformaticsastheintersectionofclinical,IM/IT[informationmanagement/informationtechnology]andmanagementpracticestoachievebetterhealth(COACH,2009,p.7).Healthinformaticscoversalldisciplines.Role-centred/role-basednursinginformaticswasastepintheevolutionofhealthinformaticsthatintegratesnursingscience,computerscience,andinformationscience,accordingtotheAmericanNursesAssociation.TheapplicationofcomputerscienceandinformationsciencetonursingisthedefinitionofnursinginformaticsbytheCanadianNursesAssociation(CNA).AclinicaltermusedtodescribemultidisciplinaryclinicalpracticeisSystematizedNOmenclatureofMEDicineClinicalTerms(SNOMEDCT);thisisnothowCOACHdefineshealthinformatics.DIF:UnderstandREF:255|256OBJ:Differentiatehownursinginformaticsdiffersfromroutineuseoftechnologiesinnursingpractice.TOP:AssessmentMSC:CPNRE:Professional,Ethical,andLegalPractice5.TheManagementInformationSystem(MIS)GroupwasanimportantorganizationinCanadianhealthcareinformationmanagementbutthisgroupdidnotcollectwhichofthefollowing?CanadianFundamentalsofNursing7thEditionPotterTestBankNURSINGTB.CMa.Demographicdata.b.Clinicalnursingdata.c.Statisticalmedicaldata.d.Resourceutilizationdata.ANS:BClinicalnursingdatawerenotcollectedbytheMISGroupbecausetheinformationwasrestrictedtophysician-drivendata.TheMISGroupdidcollectdemographicdata,statisticalmedicaldata,andresourceutilizationdata.DIF:UnderstandREF:256OBJ:DiscusshowhealthinformationdatastandardsinfluenceCanadiannursingpractice.TOP:AssessmentMSC:CPNRE:Professional,Ethical,andLegalPractice6.WhichinstitutewasdevelopedasaresultoftheWilkReport?a.HospitalMedicalRecordsInstitute(HMRI).b.StatisticsCanadaandHealthandWelfareInstitute.c.CanadianNursingInformaticsAssociation.d.CanadianInstituteforHealthInformation(CIHI).ANS:DTheWilkReport(NationalTaskForceonHealthInformation,1991)hadasignificanteffectonCanadianhealthinformation,triggeringthe1993mergeroftheMISGroup,HMRI,portionsofStatisticsCanada,andHealthandWelfareCanadatocreatetheCIHI.TheCanadianNursingInformaticsAssociationwasnotdevelopedasaresultoftheWilkReport.DIF:UnderstandREF:256OBJ:DiscusshowhealthinformationdatastandardsinfluenceCanadiannursingpractice.TOP:AssessmentMSC:CPNRE:Professional,Ethical,andLegalPractice7.TheCIHIdisseminatesessentialdataandanalysisonCanadashealthcaresystemandthehealthofCanadians.TheCIHIinfluencedissuesdirectlyrelatedtonursingbyincludingissuesrelatedtowhichofthefollowing?a.Nursingscienceandinformationsciencetosupportpatients.b.Nursingworkforcerecruitmentandretention.c.Clinicalpractice,administration,research,andeducation.d.Advocatingforhealthpolicy.ANS:BTheCIHIisthenational,independent,andnot-for-profitbodythatrecords,analyzes,anddisseminatesdataandanalysisonCanadashealthcaresystemandthehealthofCanadians.Althoughnotinitiallyattentivetonursingdata,theCIHIlaterbecamemoreimportanttoseveralissuesdirectlyinfluencingnursing,includingissuesrelatedtonursingworkforcerecruitmentandretention.Nursingscience,informationscience,andsupportingpatientsispartofthedefinitionofrole-centrednursinginformatics.Clinicalpractice,administration,research,andeducationarepartofthedefinitionofnursinginformaticsrelatedtoinformationtechnology.AdvocatingforhealthpolicyisthemandateoftheICN,nottheCIHI.DIF:UnderstandREF:256OBJ:DiscusshowhealthinformationdatastandardsinfluenceCanadiannursingpractice.TOP:AssessmentMSC:CPNRE:Professional,Ethical,andLegalPracticeCanadianFundamentalsofNursing7thEditionPotterTestBank8.CanadaHealthInfowaywasakeyoutcomeofthefederal/provincial/territorialpartnership.Whatisitsmandate?a.Tocreateanelectronichealthrecordsystem.b.Tounifyinternationalterminologyforrecordingnursingpractice.c.Toadvocateforeffectivehealthpolicy.d.Toimplementprovincial/territorialstandards.ANS:AInfowayhasamandatetodriveforwardanationalagendatocreateanelectronichealthrecordsystem.UnifyinginternationalterminologyforrecordingnursingpracticeisassociatedwiththeICNP,notCanadaHealthInfoway.AdvocatingforeffectivehealthpolicyisassociatedwiththeInternationalCouncilofNurses,notCanadaHealthInfoway.CanadaHealthInfowaydoeshaveamandatetogenerateconsensusonhealthinformationstandardsbutnottoimplementprovincial/territorialstandards.DIF:UnderstandREF:256OBJ:IdentifyandcompareCanadianstrategiesforidentifyinganddocumentingkeynursingdata.TOP:ImplementationMSC:CPNRE:Professional,Ethical,andLegalPractice9.Apatienthashadseveraladmissionstohislocalhospitalforasthmaandwasrecentlytransferredtoanotherhospitaltohavehipreplacementsurgery.WhatisthebenefitofastandardizedEHR?a.Timelyaccesstohealthdata.b.Improvedcoordinationofcare.c.Enhancedabilitytoworkcollaborativelywithotherorganizations.d.Enhancedabilitytoextractbestpracticedatafrompublishedsources.ANS:BNURSINGTB.COMThepatientshealthinformationcouldbetransferredfromthelocalhospitaltothehospitalwherehipreplacementsurgerywillbedone.ThepatientwouldbenefitfromastandardizedEHRbyimprovedcoordinationofcare,reducedrepetitionofhealthinformation,andreducedduplicationoftestsandprocedures.Healthcareprovidersbenefitfromtimelyaccesstohealthdatabenefits.Servicedeliveryorganizationsbenefitfromtheenhancedabilitytoworkcollaborativelywithotherorganizations.Educatorsbenefitfromtheenhancedabilitytoextractbestpracticedatafrompublishedsources.DIF:AnalyzeREF:255|256OBJ:Discusstherelationshipbetweennationalprivacylegislationandnursingpracticeinadigitalpracticeenvironment.TOP:ImplementationMSC:CPNRE:Professional,Ethical,andLegalPractice10.WhichofthefollowingHealthInformation:NursingComponent(HI:NC)canbedescribedastheamountandtypeofnursingresourceusedtoprovidecare?a.Patientstatus.b.Nursinginterventions.c.Nursingintensity.d.Patientoutcome.ANS:CNURSINGTB.COMCanadianFundamentalsofNursing7thEditionPotterTestBankNursingintensityistheamountandtypeofnursingresourceusedtoprovidecare.Patientstatusisthehealthstatusofpatients.Nursinginterventionsarethepurposefulanddeliberatehealth-affectinginterventions.Patientoutcomeisthepatientstatusatadefinedpointafterhealthcareintervention.DIF:UnderstandREF:260OBJ:IdentifyandcompareCanadianstrategiesforidentifyinganddocumentingkeynursingdata.TOP:PlanningMSC:CPNRE:Professional,Ethical,andLegalPractice11.WhichofthefollowingisaHealthInformation:NursingComponent(HI:NC)?a.Patientdiagnosis.b.Educationalbackground.c.Primarynurseidentifier.d.Independentnursingjudgement.ANS:COneofthefiveHI:NCsisprimarynurseidentifier.Theremainingfourarepatientstatus,nursingintervention,patientoutcome,andnursingintensity.Patientdiagnosis,educationalbackground,andindependentnursingarenotamongthefiveHI:NCs.DIF:UnderstandREF:259|260OBJ:IdentifyandcompareCanadianstrategiesforidentifyinganddocumentingkeynursingdata.TOP:PlanningMSC:CPNRE:Professional,Ethical,andLegalPractice12.ThesevenaxesoftheICNParewhichofthefollowing?a.Assessment,Analysis,Intervention,Action,Outcome,andEvaluation.b.Focus,Judgement,Action,Means,Location,Client,andTime.c.Status,Intervention,OutcNoUmRe,SInIteNnGsitTyB,I.deCnOtifMier,Client,andTime.d.Focus,Standards,Delivery,Outcomes,Intensity,Evaluation,andTime.ANS:BICNPhasamodelwithsevenaxes:Focus,Judgement,Action,Means,Location,Client,andTime.TheINCPisastandardizedterminologyfornursingpracticeandisbuiltwiththeWebOntologyLanguage(OWL).DIF:RememberREF:260OBJ:Developabeginningunderstandingofthescopeofnursinginformaticsconceptsandthewaysinwhichnursescanbeinvolvedinnursinginformatics.TOP:PlanningMSC:CPNRE:Professional,Ethical,andLegalPractice13.Canadianprivacylegislationindicateswhichofthefollowing?a.Allprivacylegislationisdevelopedattheprovincial/territoriallevel.b.Privacylegislationonlyaddressesprotectionofpersonalhealthinformation.c.Privacylegislationcannotbeviolatedifanurseispractisingwithinhisorherstandardsofpractice.d.AnunderstandingoftheprivacylegislationcanassistnursesinupholdingtheCodeofEthics.ANS:DCanadianFundamentalsofNursing7thEditionPotterTestBankAnunderstandingofboththePrivacyActandthePersonalInformationProtectionandElectronicDocumentsActcanassistnursesinupholdingtheCodeofEthics,aswellasthestandardsfornursingpractice.Someprivacylegislation,butnotall,isdevelopedprovinciallyandterritorially;therearealsofederalprivacylaws.Privacylegislationaddressestheprotectionofpersonalhealthinformationandotherpersonalinformation.Itispossibleforanursetoviolateprivacylegislationeventhoughthenurseisfulfillinghisorherstandardsofpractice.DIF:UnderstandREF:262OBJ:Discusstherelationshipbetweennationalprivacylegislationandnursingpracticeinadigitalpracticeenvironment.TOP:PlanningMSC:CPNRE:Professional,Ethical,andLegalPractice14.WhichofthefollowingisoneofthethreefundamentaldirectionsfortheCNAse-NursingStrategy?a.Assessment.b.Participation.c.Collaborativecare.d.Nursingpracticeintegration.ANS:BParticipationisoneofthethreefundamentaldirectionsfortheCNAse-NursingStrategy.Theothertwodirectionsareaccessandcompetencies.Assessment,collaborativecare,andnursingpracticeintegrationarenotamongthethreefundamentaldirectionsfortheCNAse-NursingStrategy.DIF:UnderstandREF:264-266OBJ:DiscusshowtheCanadiNanUNRurSseIsNAGssTocBia.tioCn'OsnMationale-NursingStrategywillinfluencecurrentandfuturenursingpractice.TOP:ImplementationMSC:CPNRE:Professional,Ethical,andLegalPractice15.Nursescancreatediscussiongroupsonlinewithwhichcurrenttechnology?a.Skype.b.NurseONE.c.NurseConnect.d.COACH.ANS:CNurseConnectisaportalthatenablesnursestocreatediscussiongroupsamongitssubscribers.ItispartofNurseONE.Skypeisnotameansfornursestocreatediscussiongroupsonline.NurseONEistheCanadianNursesPortal,anditprovidesprofessionallinks,professionaldevelopment,Library,andNurseConnect.COACHistheacronymfortheCanadianOrganizationfortheAdvancementofComputersinHealthandisnotameansfornursestocreatediscussiongroupsonline.DIF:RememberREF:265OBJ:DiscusshowtheCanadianNursesAssociation'snationale-NursingStrategywillinfluencecurrentandfuturenursingpractice.TOP:ImplementationMSC:CPNRE:Professional,Ethical,andLegalPracticeCanadianFundamentalsofNursing7thEditionPotterTestBankChapter17:CommunicationandRelationalPracticePotteretal:CanadianFundamentalsofNursing,7thEditionMULTIPLECHOICE1.Whatcharacterizesnurseswhomakethebestcommunicators?a.Developingcriticalthinkingskills.b.Likingdifferentkindsofpeople.c.Learningeffectivepsychomotorskills.d.Maintainingperceptualbiases.ANS:ANurseswhodevelopcriticalthinkingskillsmakethebestcommunicators.Criticalthinkinghelpsthenurseovercomeperceptualbiasesorhumantendenciesthatinterferewithaccuratelyperceivingandinterpretingmessagesfromothers.Justlikingpeopledoesnotmakeforeffectivecommunicationbecauseitisimportanttoapplycriticalthinkingstandardstoensuresoundeffectivecommunication.Justlearningpsychomotorskillsdoesnotensurethatthenursewillusethosetechniques,andcommunicationinvolvesmorethanpsychomotorskills.Nurseswhomaintainperceptualbiasesdonotmakegoodcommunicators.DIF:RememberREF:272|273OBJ:Describeaspectsofcriticalthinkingthatareimportanttothecommunicationprocess.TOP:ImplementationMSC:CPNRE:Professional,Ethical,andLegalPractice2.Anursebelievesthatthenurse-patientrelationshipisapartnershipandthatbothareequalparticipants.WhichtermshoNuldRtheInursGeusBe.toCdeMscribethisbelief?a.Criticalthinking.b.Authentic.c.Mutuality.d.Attending.ANS:CUSNTOEffectiveinterpersonalcommunicationrequiresasenseofmutuality,abeliefthatthenurse-patientrelationshipisapartnershipandthatbothareequalparticipants.Criticalthinkinginnursing,basedonestablishedstandardsofnursingcareandethicalstandards,promoteseffectivecommunicationandusessuchstandardsashumility,self-confidence,independentattitude,andfairness.Tobeauthentic(onesself)andtorespondappropriatelytotheotherpersonareimportantforinterpersonalrelationshipsbutdonotmeanmutuality.Attendingisgivingallofonesattentiontothepatient.DIF:UnderstandREF:272OBJ:Identifysignificantfeaturesandtherapeuticoutcomesofnurse-patienthelpingrelationships.TOP:PlanningMSC:CPNRE:Professional,Ethical,andLegalPractice3.Anursewantstopresentinformationaboutfluimmunizationstoolderpersonsinthecommunity.Whichtypeofcommunicationshouldthenurseuse?a.Interpersonal.b.Public.c.Transpersonal.d.Smallgroup.CanadianFundamentalsofNursing7thEditionPotterTestBankUSNTANS:BPubliccommunicationisinteractionwithanaudience.Nurseshaveopportunitiestospeakwithgroupsofconsumersabouthealth-relatedtopics,presentscholarlyworktocolleaguesatconferences,orleadclassroomdiscussionswithpeersorstudents.Intrapersonalcommunicationisapowerfulformofcommunicationthatoccurswithinanindividual.Transpersonalcommunicationisinteractionthatoccurswithinapersonsspiritualdomain.Whennursesworkoncommittees,leadpatientsupportgroups,formresearchteams,orparticipateinpatientcareconferences,theyuseasmallgroupcommunicationprocess.DIF:ApplyREF:274OBJ:Describethefivelevelsofcommunicationandtheirusesinnursing.TOP:PlanningMSC:CPNRE:Professional,Ethical,andLegalPractice4.Whichcommunicationtechniqueisbeingusedmosteffectivelywithwhichscenario?a.Interpersonalcommunicationtochangenegativeself-talktopositiveself-talk.b.Smallgroupcommunicationtopresentinformationtoanaudience.c.Intrapersonalcommunicationtobuildstrongteams.d.Transpersonalcommunicationtoenhancemeditation.ANS:DTranspersonalcommunicationisinteractionthatoccurswithinapersonsspiritualdomain.Manypeopleuseprayer,meditation,guidedreflection,religiousrituals,orothermeanstocommunicatewiththeirhigherpower.Interpersonalcommunicationisone-on-oneinteractionbetweenthenurseandanotherpersonthatoftenoccursfacetoface.Meaningfulinterpersonalcommunicationresultsinexchangeofideas,problemsolving,expressionoffeelings,decisionmaking,goalaccomplishment,teambuilding,andpersonalgrowth.SmallgroupcommunicationisinteNractiRonIthatGoccBur.sCwheMnasmallnumberofpersonsmeet.Thistypeofcommunicationisusuallygoaldirectedandrequiresanunderstandingofgroupdynamics.Whennursesworkoncommittees,leadpatientsupportgroups,formresearchteams,orparticipateinpatientcareconferences,theyuseasmallgroupcommunicationprocess.Intrapersonalcommunicationisapowerfulformofcommunicationthatoccurswithinanindividual.Forexample,peopleimprovetheirhealthandself-esteemthroughpositiveself-talkbyreplacingnegativethoughtswithpositiveassertions.DIF:EvaluateREF:273|274OBJ:Describethefivelevelsofcommunicationandtheirusesinnursing.TOP:EvaluateMSC:CPNRE:Professional,Ethical,andLegalPractice5.Anurseisstandingbesidethepatientsbed.Thenurseasks,Howareyoudoing?Thepatientresponds,Idontfeelgood.Inthissituation,whichelementisthefeedback?a.Thenurse.b.Thepatient.c.Howareyoudoing?d.Idontfeelgood.ANS:DIdontfeelgoodisthefeedbackbecausethefeedbackisthemessagethereceiverreturnstothesender.Thesenderisthepersonwhoencodesanddeliversthemessage,andthereceiveristhepersonwhoreceivesanddecodesthemessage.Thenurseisthesender.Thepatientisthereceiver.Howareyoudoing?isthemessage.CanadianFundamentalsofNursing7thEditionPotterTestBankDIF:ApplyREF:274OBJ:Describethebasicelementsofthecommunicationprocess.TOP:AssessmentMSC:CPNRE:Professional,Ethical,andLegalPractice6.Anurseissittingatthepatientsbedsidedocumentinganursinghistory.Whichzoneofpersonalspaceisthenurseusing?a.Intimate.b.Personal.c.Social.d.Public.ANS:BPersonalspaceis45cmto1m(~18inchesto~4feet)awayfromapersonandisusedwhenthenurseissittingatapatientsbedside,takingapatientsnursinghistory,orteachinganindividualpatient.Intimatespaceis0to45cm(0to18inches)andisusedinsuchactivitiesasperformingaphysicalassessment,bathing,grooming,dressing,feeding,andtoiletingapatient.Thesocialzoneis1to4m(4to12feet)andisusedinsuchactivitiesasmakingroundswithaphysician,sittingattheheadofaconferencetable,orteachingaclassforpatientswithdiabetes.Thepubliczoneis4m(12feet)andgreaterandisusedinsuchactivitiesasspeakingatacommunityforum,testifyingatalegislativehearing,orlecturing.DIF:RememberREF:276,Box17-2OBJ:Describethebasicelementsofthecommunicationprocess.TOP:ImplementationMSC:CPNRE:Professional,Ethical,andLegalPractice7.Asmilingpatientangrilystates,Iwillnotcoughanddeepbreathe.Howwillthenurseinterpretthisfinding?a.ThepatientspersonalspNacUeRwSasIvNioGlaTteBd..COMb.Thepatientsaffectisinappropriate.c.Thepatientsvocabularyispoor.d.Thepatientsdenotativemeaningiswrong.ANS:BAninappropriateaffectisafacialexpressionthatdoesnotmatchthecontentofaverbalmessage(e.g.,smilingwhendescribingasadsituation).Thepatientissmilingbutisangry,whichindicatesaninappropriateaffect.Thepatientspersonalspacewasnotviolated.Thepatientsvocabularyisnotpoor.Individualswhouseacommonlanguagesharedenotativemeaning:baseballhasthesamemeaningforeveryonewhospeaksEnglish,butcodedenotescardiacarrestprimarilytohealthcareproviders.Thepatientsdenotativemeaningiscorrectforcoughanddeepbreathe.DIF:EvaluateREF:275|276OBJ:Describethebasicelementsofthecommunicationprocess.TOP:EvaluateMSC:CPNRE:Professional,Ethical,andLegalPractice8.Thenurseasksapatientwherethepainis,andthepatientrespondsbypointingtotheareaofpain.Whichformofcommunicationdidthepatientuse?a.Verbal.b.Nonverbal.c.Intonation.d.Vocabulary.CanadianFundamentalsofNursing7thEditionPotterTestBankNRIGB.CMANS:BThepatientgestured(pointed),whichisatypeofnonverbalcommunication.Gesturesemphasize,punctuate,andclarifythespokenword.Pointingtoanareaofpainissometimesmoreaccuratethandescribingitslocation.Verbalisthespokenwordormessage.Intonationortoneofvoicedramaticallyaffectsthemeaningofamessage.Vocabularyconsistsofwordsusedforverbalcommunication.DIF:UnderstandREF:275|276OBJ:Describethebasicelementsofthecommunicationprocess.TOP:AssessmentMSC:CPNRE:Professional,Ethical,andLegalPractice9.Apatienthasbeenadmittedtothehospitalnumeroustimes.Thenurseasksthepatienttoshareapersonalstoryaboutthecarethathasbeenreceived.Whichinteractionisthenurseusing?a.Narrative.b.Socializing.c.Nonjudgemental.d.SBAR.ANS:AInatherapeuticrelationship,nursesoftenencouragepatientstosharepersonalstories.Sharingstoriesiscallednarrativeinteraction.Socializingisanimportantinitialcomponentofinterpersonalcommunication.Ithelpspeoplegettoknowoneanotherandrelax.Itiseasy,superficial,andnotdeeplypersonal.Nonjudgementalacceptanceofthepatient,animportantcharacteristicoftherelationship,conveysawillingnesstohearamessageoracknowledgefeelings;itisnotatechniquethatinvolvespersonalstories.SBAR(situation,background,assessment,andrecommendation)isapopularcommunicationtoolthathelpsstandardizecommunicationamonghealthcUareSproNvideTrs.ODIF:RememberREF:278OBJ:Identifysignificantfeaturesandtherapeuticoutcomesofnurse-patienthelpingrelationships.TOP:AssessmentMSC:CPNRE:Professional,Ethical,andLegalPractice10.Beforemeetingthepatient,anursetalkstoothercaregiversaboutthepatient.Thenurseisinwhichphaseofthehelpingrelationship?a.Preinteraction.b.Orientation.c.Working.d.Termination.ANS:ACanadianFundamentalsofNursing7thEditionPotterTestBankThetimebeforethenursemeetsthepatientiscalledthepreinteractionphase.Thisphasecaninvolvesuchthingsasreviewingavailabledata,includingthemedicalandnursinghistory;talkingtoothercaregiverswhohaveinformationaboutthepatient;andanticipatinghealthconcernsorissuesthatcanarise.Duringtheorientationphase,thenurseandthepatientmeetandgettoknowoneanother.Thisphasecaninvolvesuchthingsassettingthetonefortherelationshipbyadoptingawarm,empathetic,caringmanner;recognizingthattheinitialrelationshipisoftensuperficial,uncertain,andtentative;orexpectingthepatienttotestthenursescompetenceandcommitment.Intheworkingphase,thenurseandthepatientworktogethertosolveproblemsandaccomplishgoals.Thisphasecaninvolvesuchthingsasencouragingandhelpingthepatientexpressfeelingsabouthisorherhealth,encouragingandhelpingthepatientwithself-exploration,orprovidinginformationneededtounderstandandchangebehaviour.Theterminationphaseoccursduringtheendingoftherelationship.Thisphasecaninvolvesuchthingsasremindingthepatientthattherelationshipisabouttoend,evaluatinggoalachievementwiththepatient,orreminiscingabouttherelationshipwiththepatient.DIF:UnderstandREF:277,Box17-3OBJ:Listnursingfocusareaswithinthefourphasesofanurse-patienthelpingrelationship.TOP:AssessmentMSC:CPNRE:Professional,Ethical,andLegalPractice11.Duringtheinitialhomevisit,ahomehealthnurseletsthepatientknowthatthevisitsareexpectedtoendinaboutamonth.Thenurseisinwhichphaseofthehelpingrelationship?a.Preinteraction.b.Orientation.c.Working.d.Termination.ANS:BNURSINGTB.COMLettingthepatientknowwhentoexpecttherelationshiptobeterminatedoccursintheorientationphase.Preinteractionoccursbeforethenursemeetsthepatient.Workingoccurswhenthenurseandthepatientworktogethertosolveproblemsandaccomplishgoals.Terminationoccursduringtheendingoftherelationship.DIF:ApplyREF:277,Box17-3OBJ:Listnursingfocusareaswithinthefourphasesofanurse-patienthelpingrelationship.TOP:AssessmentMSC:CPNRE:Professional,Ethical,andLegalPractice12.Anurseandpatienttakeactiontomeethealth-relatedgoals.Thenurseisinwhichphaseofthehelpingrelationship?a.Preinteraction.b.Orientation.c.Working.d.Termination.ANS:CTheworkingphaseiswhenthenurseandthepatientworktogethertosolveproblemsandaccomplishgoals.Preinteractionoccursbeforethenursemeetsthepatient.Orientationoccurswhenthenurseandthepatientmeetandgettoknoweachother.Terminationoccursduringtheendingoftherelationship.DIF:RememberREF:277,Box17-3CanadianFundamentalsofNursing7thEditionPotterTestBankOBJ:Listnursingfocusareaswithinthefourphasesofanurse-patienthelpingrelationship.TOP:ImplementationMSC:CPNRE:Professional,Ethical,andLegalPractice13.Thenurseisintheprocessofconductinganadmissioninterviewwiththepatient.Atonepointinthediscussion,thepatienthasprovidedinformationthatthenursewouldliketoclarify.Usingthetechniqueofclarification,howdoesthenurserespond?a.ImnotsurethatIunderstandwhatyoumeanbythatstatement.b.Theelectrocardiogramrecordsinformationaboutyourheartselectricalactivity.c.Letslookattheproblemyouhavehadwithyourmedicationathome.d.Whatsyourbiggestconcernatthemoment?ANS:AInclarifying,thenursecheckswhetherunderstandingisaccuratebyrestatinganunclearmessagetoclarifythesendersmeaningorbyaskingtheotherpersontorestatethemessage,explainfurther,orgiveanexampleofwhatthepersonmeans.TheresponseImnotsurethatIunderstandwhatyoumeanbythatstatementindicatesthatthenursewantstoclarifywhatthepatientissayingsothatheorshecanhaveanaccurateunderstandingofwhatthepatientmeans.ThestatementTheelectrocardiogramrecordsinformationaboutyourheartselectricalactivityisanexampleofprovidinginformation,notclarification.ThestatementLetslookattheproblemyouhavehadwithyourmedicationathomeisanexampleoffocusing,notclarification.ThequestionWhatsyourbiggestconcernatthemoment?isanexampleofaskingrelevantquestions,notofclarification.DIF:ApplyREF:284OBJ:Discusseffectiveapproachestocommunicatingwithpatientsatvariousdevelopmentallevels.TOP:PlanningMSC:CPNRE:Professional,Ethical,andLegalPractice14.ThepatientdrawsbackwhenNtUheRnSurIseNrGeaTcBhe.sCovOeMrthesiderailstotakehisbloodpressure.Whatshouldthenursedofirsttopromoteeffectivecommunication?a.Tellthepatientthatthebloodpressurecanbetakenatalatertime.b.Rotatethenurseswhoareassignedtotakethepatientsbloodpressure.c.Continuetoperformtheprocedurequicklyandquietly.d.Apologizeforstartlingthepatientandexplaintheneedforcontact.ANS:DNursesoftenhavetoenterapatientspersonalspacetoprovidecare.Thenurseshouldconveyconfidence,gentleness,andrespectforprivacy.Apologizingforstartlingthepatientandexplainingtheneedforcontactdemonstratesrespectandprovidesinformationsothepatientcanunderstandtheneedforpersonalcontact.Tellingthepatientthatthebloodpressurecanbetakenatalatertimedoesnotpromoteeffectivecommunication.Rotatingthenurseswhoareassignedtotakethepatientsbloodpressureimpedesthenursesabilitytoformatherapeutic,helpingrelationship.Continuingtoperformtheprocedurequicklyandquietlymaysendanegativenonverbalmessagetothepatient.Italsodoesnotpromoteeffectivecommunication.DIF:ApplyREF:282-285OBJ:Identifythepracticesimportantforrelationalinquiry.TOP:ImplementationMSC:CPNRE:Professional,Ethical,andLegalPractice15.Apatienthastroublespeakingwords,andthepatientsspeechisgarbled.Whichnursingdiagnosisismostappropriateforthispatient?a.Hopelessness.CanadianFundamentalsofNursing7thEditionPotterTestBankb.Impairedverbalcommunication.c.Hearingloss.d.Self-caredeficit.ANS:BApatientwithimpairedverbalcommunicationhasdefiningcharacteristicssuchasaninabilitytoarticulatewords,inappropriateverbalization,difficultyformingwords,anddifficultycomprehending.Hopelessnessimpliesthatthepatienthasnohopeforthefuture.Hearinglossisnotanursingdiagnosis.Justbecauseapatienthasgarbledspeechdoesnotmeanthatahearinglosshasoccurred;aphysicalproblemsuchasastrokecouldcausethespeechtobegarbled.Self-caredeficitdoesnotapplyinthissituationbecausethisusuallyrelatestobathingandgrooming.DIF:AnalyzeREF:286OBJ:Identifypatienthealthstatesandconditionsthatcontributetoimpairedcommunication.TOP:DiagnosisMSC:CPNRE:Professional,Ethical,andLegalPractice16.Whichpersonisthebestreferralforapatientwhospeaksaforeignlanguage?a.Afamilymember.b.Aspeechtherapist.c.Aninterpreter.d.Amentalhealthnursespecialist.ANS:CTheservicesofinterpretersareoftennecessaryforpatientswhospeakaforeignlanguage.Useofafamilymembertointerpretcanleadtolegalissues;speechtherapistshelppatientswithaphasia;andmentalhealthnursespecialistshelpangryorhighlyanxiouspatientstocommunicatemoreeffectivelNyU.RSINGTB.COMDIF:UnderstandREF:275OBJ:Discussnursingcaremeasuresforpatientswithspecialcommunicationneeds.TOP:PlanningMSC:CPNRE:Professional,Ethical,andLegalPractice17.AnurseisusingSOLERtofacilitateactivelistening.WhichtechniqueshouldthenurseuseforR?a.Relax.b.Respect.c.Reminisce.d.Reassure.ANS:AInSOLER,theRstandsforrelax.Itisimportanttocommunicateasenseofbeingrelaxedandcomfortablewiththepatient.Activelisteningenhancestrustbecausethenursecommunicatesacceptanceandrespectforthepatient,butitisnottheRinSOLER.Reminiscenceisatherapeuticcommunicationtechnique,especiallywhenusedwiththeelderly.Reassurancecanbetherapeuticifthenursehelpspatientsunderstandthattherearemanykindsofhopeandthatmeaningandpersonalgrowthcancomefromillnessexperiences.However,falsereassurancecanblockcommunication.DIF:UnderstandREF:282OBJ:Describequalities,behaviours,andapproachesthataffectinterprofessionalcommunicationTOP:ImplementationMSC:CPNRE:Professional,Ethical,andLegalPracticeCanadianFundamentalsofNursing7thEditionPotterTestBankUSNTO18.Anolderpatientiswearingahearingaid.Whichtechniqueshouldthenurseusetofacilitatecommunication?a.Speakclearlyandloudly.b.Turnoffthetelevision.c.Chewgum.d.Useatleast14-pointprint.ANS:BPatientswhoarehearingimpairedbenefitwhennursesusethefollowingtechniques:checkingforhearingaidsandglasses,reducingenvironmentalnoise,gettingthepatientsattentionbeforespeaking,notchewinggum,andspeakingatnormalvolume(notshouting).Usingatleast14-pointprintisforpatientswhoaresight/visuallyimpaired,nothearingimpaired.DIF:ApplyREF:281,Box17-6OBJ:Discusseffectiveapproachestocommunicatingwithpatientsatvariousdevelopmentallevels.TOP:ImplementationMSC:CPNRE:Professional,Ethical,andLegalPractice19.Whenmakingrounds,thenursefindsapatientwhoisnotabletosleepbecauseofanticipationofsurgeryinthemorning.Whichtherapeuticresponseismostappropriate?a.Itwillbeokay.Yoursurgeonwilltalktoyouinthemorning.b.Whycantyousleep?Youhavethebestsurgeoninthehospital.c.Dontworry.Thesurgeonorderedasleepingpilltohelpyousleep.d.Itmustbedifficultnottoknowwhatthesurgeonwillfind.WhatcanIdotohelp?ANS:DItmustbedifficultnottoknNowRwhaItthGesuBrg.eConwMillfind.WhatcanIdotohelp?isanexampleoftherapeuticcommunicationtechniquesofempathyandofferingofself.Falsereassurances(ItwillbeokayandDontworry)tendtoblockcommunication.Patientsfrequentlyinterpretwhyquestionsasaccusationsorthinkthenurseknowsthereasonandissimplytestingthem.DIF:ApplyREF:282-285OBJ:Describequalities,behaviours,andapproachesthataffectinterprofessionalcommunicationTOP:ImplementationMSC:CPNRE:Professional,Ethical,andLegalPractice20.Whichsituationwillpromptthenursetointerveneandfollowupontheunregulatedcareprovidersbehaviour?a.Theunregulatedcareprovideriscallingtheolderpatienthoney.b.Theunregulatedcareproviderisfacingtheolderpatientwhentalking.c.Theunregulatedcareprovidercleanstheolderpatientsglasses.d.Theunregulatedcareproviderallowstimefortheolderpatienttorespond.ANS:AHealthcareprovidersshouldcommunicatewitholderpersonsonanadultlevelandavoidpatronizingorspeakinginacondescendingmanner.Termsofendearmentsuchashoney,dear,grandma,orsweetheartshouldbeavoided.Facinganolderpatient,makingsuretheolderpersonhascleanglasses,andallowingtimetorespondfacilitatecommunicationwitholderpatientsandshouldbeencouraged,notstopped.DIF:ApplyREF:279CanadianFundamentalsofNursing7thEditionPotterTestBankUSNTOOBJ:Discusseffectiveapproachestocommunicatingwithpatientsatvariousdevelopmentallevels.TOP:ImplementationMSC:CPNRE:Professional,Ethical,andLegalPractice21.Aconfusedolderpersoniswearingthickglassesandahearingaid.Whichinterventionisaprioritytofacilitatecommunication?a.Focusingontaskstobecompleted.b.Allowingtimeforthepatienttorespond.c.Limitingconversationswiththepatient.d.Usinggesturesandothernonverbalcues.ANS:BAllowingtimeforthepatienttorespondwillfacilitatecommunication,especiallyforanolderconfusedpatient.Focusingontaskstobecompletedandlimitingconversationsdonotfacilitatecommunication;infact,theyblockcommunication.Usinggesturesandothernonverbalcuesisnoteffectiveforvisuallyimpairedorcognitivelyimpairedpatients.DIF:ApplyREF:281,Box17-6OBJ:Discusseffectiveapproachestocommunicatingwithpatientsatvariousdevelopmentallevels.TOP:ImplementationMSC:CPNRE:Professional,Ethical,andLegalPractice22.Thestaffishavingahardtimegettinganolderpersontocommunicate.Whichtechniqueshouldthenursesuggestthestaffuse?a.Allowingthepatienttoreminisce.b.Tryingtochangetopicsoften.c.Involvingonlythepatientinconversations.d.Askingthepatientforexplanations.ANS:ANRIGB.CMEncouragingolderpersonstosharelifestoriesandreminisceaboutthepasthasatherapeuticeffectandincreasestheirsenseofwell-being.Suddenshiftsfromsubjecttosubjectshouldbeavoided.Itishelpfultoincludethepatientsfamilyandfriendsandtobecomefamiliarwiththepatientsfavouritetopicsforconversation.Askingforexplanationsisanontherapeutictechnique.DIF:ApplyREF:278-281OBJ:Discusseffectiveapproachestocommunicatingwithpatientsatvariousdevelopmentallevels.TOP:PlanningMSC:CPNRE:Professional,Ethical,andLegalPractice23.Whichofthefollowingpatientswillcausethegreatestcommunicationconcernsforanurse?a.Apatientwhoisalert,hasstrongself-esteem,andishungry.b.Apatientwhoisoriented,painfree,andblind.c.Apatientwhoiscooperative,depressed,andhardofhearing.d.Apatientwhoisdyspneic,hasatracheostomy,andisanxious.ANS:DFacialtrauma,laryngealcancer,orendotrachealintubationoftenpreventsmovementofairpastvocalcordsormobilityofthetongue,whichresultsininabilitytoarticulatewords.Apatientextremelyshortofbreathneedstouseoxygentobreatheratherthanspeak.Personswithsevereanxietyaresometimesunabletoperceiveenvironmentalstimuliorhearexplanations.Peoplewhoarealert,havestrongself-esteem,andarecooperativeandpainfreedonotcausecommunicationconcerns.Hunger,blindness,anddifficultyhearingindividuallycancausecommunicationconcerns,butdonotnecessarilyaffectcommunication.CanadianFundamentalsofNursing7thEditionPotterTestBankDIF:EvaluateREF:279|280OBJ:Identifypatienthealthstatesandconditionsthatcontributetoimpairedcommunication.TOP:EvaluateMSC:CPNRE:Professional,Ethical,andLegalPractice24.Apatientisaphasic,andthenursenoticesthatthepatientshandsshakeintermittently.Whichnursingactionismostappropriatetofacilitatecommunication?a.Useapictureboard.b.Usepenandpaper.c.Useaninterpreter.d.Useahearingaid.ANS:AUsingapenandpapercanbefrustratingforapatientwhoisnonverbal(aphasic)andwhosehandwritingisshaky;thenursecanrevisethecareplantoincludeuseofapictureboardinstead.Aninterpreterisusedforapatientwhospeaksaforeignlanguage.Ahearingaidisusedforpatientswhoarehardofhearing,notforapatientwithaphasia.DIF:ApplyREF:286OBJ:Discussnursingcaremeasuresforpatientswithspecialcommunicationneeds.TOP:ImplementationMSC:CPNRE:Professional,Ethical,andLegalPractice25.Whatischaracteristicofanurseusingcriticalthinkingtoenhancecommunicationwithpatients?a.Showingsympathyappropriately.b.Usingautomaticresponsesfluently.c.Self-examiningpersonalcommunicationskills.d.DemonstratingpassivereNmUarRksSaIcNcuGraTteBly..COMANS:CNurseswhousecriticalthinkingskillsinterpretmessagesreceivedfromothers,analyzetheircontent,makeinferencesabouttheirmeaning,evaluatetheireffects,explainrationalesforcommunicationtechniquesused,andself-examinepersonalcommunicationskills.Sympathyisconcern,sorrow,orpityfeltforthepatientandisnontherapeutic.Clichsandstereotypedremarksareautomaticphrasesthatcommunicatethatthenurseisnottakingconcernsseriouslyorrespondingthoughtfully.Passiveresponsesservetoavoidconflictortosidestepissues.DIF:UnderstandREF:272OBJ:Describeaspectsofcriticalthinkingthatareimportanttothecommunicationprocess.TOP:ImplementationMSC:CPNRE:Professional,Ethical,andLegalPractice26.Apatientsays,YouaretheworstnurseIhaveeverhad.Whichresponsebythenurseisthemostassertive?a.IfIwereyou,Idfeelgratefulforanurselikeme.b.Ifeeluncomfortablehearingthatstatement.c.HowcanyousaythatwhenIhavebeencheckingonyouregularly?d.Youshouldntsaythingslikethat,itisnotright.ANS:BCanadianFundamentalsofNursing7thEditionPotterTestBankAssertiveresponsescontainImessagessuchasIwant,Ineed,Ithink,orIfeel.Givingpersonalopinions(IfIwereyou),arguing(Howcanyousaythat?),andshowingdisapproval(usingwordslikeshould,good,bad,right)arenotassertiveortherapeutic.DIF:ApplyREF:279OBJ:Describequalities,behaviours,andapproachesthataffectinterprofessionalcommunicationTOP:ImplementationMSC:CPNRE:Professional,Ethical,andLegalPractice27.Whichcriticalthinkingstandardsshouldthenurseusetoensuresoundeffectivecommunicationwithpatients?a.Faith,spiritualexpression,andhumility.b.Supportiveness,independentattitude,andself-confidence.c.Self-confidence,spiritualexpression,andindependentattitude.d.Self-confidence,humility,andindependentattitude.ANS:DAself-confidentattitudeisimportantbecausethenursewhoconveysconfidenceandcomfortwhilecommunicatingmorereadilyestablishesaninterpersonalhelping-trustingrelationship.Inaddition,anindependentattitudeencouragesthenursetocommunicatewithcolleaguesandshareideasaboutnursinginterventions.Anattitudeofhumilityisnecessarytorecognizeandcommunicatetheneedformoreinformationbeforemakingadecision.Faith,supportiveness,andspiritualexpressionareattributesofcaring,notcriticalthinkingstandards.DIF:UnderstandREF:272OBJ:Describeaspectsofcriticalthinkingthatareimportanttothecommunicationprocess.TOP:ImplementationMSC:CPNRE:Professional,Ethical,andLegalPracticeNURSINGTB.COMCanadianFundamentalsofNursing7thEditionPotterTestBankChapter18:Patient-CentredCare:InterprofessionalCollaborativePracticePotteretal:CanadianFundamentalsofNursing,7thEditionMULTIPLECHOICE1.Anurseisdescribingtheantibioticsheisabouttoadministerthroughapatientscentralline.Thepatientacceptswhatthenurseissaying,andisabletorepeatitback.However,thepatientdoesnotinternalizethisinformationoraskquestions.Thisisanexampleofwhichofthefivewaysofknowing?a.Constructedknowing.b.Receivedknowing.c.Subjectiveknowing.d.Perceivedknowing.ANS:BReceivedknowingreferstowhenapatientdeferstothenurseandacceptswithoutdebatewhatthenurseteacheshimorher.Constructiveknowingreferstowhenknowledgeisreceivedandthepatientcomparesthisknowledgeagainsthisorherassumptions,challenginghisorherownassumptionsandthoseofothers.Subjectiveknowingreferstowhenthepatientlistenstowhatthenurseisexplainingandinternalizesthemeaning.Perceivedknowingreferstowhenthepatientreceivestheknowledgeandconsidershowitrelatestowhatheorshealreadyunderstands.DIF:ApplyREF:292|293OBJ:ExploreyourownwaysoflearningandhowthesecanbeintegratedtosupportyourlearningofhowtobeaprofessionalnurseaNndRprovIideGcareBto.pCatienMts.TOP:AssessmentMSC:CPNRE:FoundationsofPUractSiceNTO2.Whichofthefollowingpatternsofknowingrelatestohowanurse,asauniqueindividual,choosestorespondinasituationinvolvingapatient?a.Empiricalknowing.b.Personalknowing.c.Aestheticknowing.d.Ethicalknowing.ANS:CAestheticknowingrelatestohowanurse,asauniqueindividual,choosestorespondinasituationinvolvingapatient.Empiricalknowingisrelatedtotheknowledgethatisappliedtosuchsituations.Personalknowingreflectsthenursingunderstandingaccumulatedfrompreviousexperiences.Ethicalknowingisshapedbythenursesownvalues.DIF:UnderstandREF:293OBJ:Exploreyourownwaysoflearningandhowthesecanbeintegratedtosupportyourlearningofhowtobeaprofessionalnurseandprovidecaretopatients.TOP:AssessmentMSC:CPNRE:FoundationsofPractice3.AnurseisplanningtheircareforapatientbasedonOrlandosnursingprocess.Thenursingprocessoccursinwhichorder?a.Perception,feeling,thought,andaction.b.Feeling,thought,perception,andaction.CanadianFundamentalsofNursing7thEditionPotterTestBankc.Thought,feeling,action,andperception.d.Perception,thought,feeling,andaction.ANS:DThenursingprocessoccursinthefollowingorder:perception,thought,feeling,andaction.DIF:UnderstandREF:295|296OBJ:Gainanunderstandingoftheframeworksthatprovideguidancetowhatnursingprofessionalpracticeentails.TOP:PlanningMSC:CPNRE:FoundationsofPractice4.Anursedeterminesthatapatientisinpainanddecidestogiveananalgesicmedicationthepatienthasbeenordered.Thenursethengoesbacktoassessthepatientspainafter30minutes.Theactofadministeringtheanalgesicmedicationisbestdescribedaswhichstageofthenursingprocess?a.Assessment.b.Planning.c.Intervention.d.Evaluation.ANS:CTheactofadministeringtheanalgesicmedicationisbestdescribedastheinterventionstage.Thenursesdeterminingthatthepatientisinpainwouldbedescribedasassessment;thenursesdecisiontogivetheanalgesicreflectsplanning;andevaluationreferstothenursesreturningtoreassessthepatientspain.DIF:ApplyREF:296OBJ:Gainanunderstandingoftheframeworksthatprovideguidancetowhatnursingprofessionalpracticeentails.TOP:PlNanniRngIGMSBC:.CCPNMRE:FoundationsofPracticeUSNTO5.WhatwouldbethebestquestiontoaskapatientinthenoticingphaseoftheClinicalJudgementModel?a.Whereisthepaintheworst?b.Howareyoufeelingtoday?c.Howwasyournight?d.Whatareyourgoalsfortoday?ANS:DThemostcriticalinformationtoobtainfromapatientiswhathisorhergoalsare.Thisinformationwillhelpthenursefocusfurtherexplorationofthepatientsgoalsandplanaroundthepatientsgoals.Theotherquestionswillelicitimportantinformationbutarenottheconsideredthemostcriticalquestionsinthisphase.DIF:ApplyREF:296OBJ:Gainanunderstandingoftheframeworksthatprovideguidancetowhatnursingprofessionalpracticeentails.TOP:AssessmentMSC:CPNRE:FoundationsofPractice6.AnursegathersinformationthroughthenoticingphaseoftheClinicalJudgementModel.Thenurseisinterpretingthisinformationbyusingexperience,expertise,andknowledge,alongwithpersonalityandenvironment.Thisisbestdescribedaswhichofthefollowing?a.Intuitiveinterpreting.b.Narrativeinterpreting.c.Experientialinterpreting.CanadianFundamentalsofNursing7thEditionPotterTestBankd.Analyticinterpreting.ANS:AIntuitiveinterpretingisdescribedwhenanurseapplieshisorherexperience,expertise,andknowledge,alongwithpersonalityandenvironment,tounderstandinformation.Narrativeinterpretinginvolvestryingtounderstandtheparticularcareandisviewedashumanbeingsprimarywayofmakingsenseofexperience,throughaninterpretationofhumanconcerns,intents,andmotive.Analyticinterpretinginvolvestheintegrationofinformationgatheredthroughthenoticingphasealongwiththepatientsgoals.Experientialinterpretingisnotlistedasatypeofinterpretationinthismodel.DIF:UnderstandREF:297OBJ:Gainanunderstandingoftheframeworksthatprovideguidancetowhatnursingprofessionalpracticeentails.TOP:PlanningMSC:CPNRE:FoundationsofPractice7.Whoistheexpertinthepatientsmanagementofillness?a.Thenurse.b.Thephysician.c.Thepatient.d.Theinterprofessionalteam.ANS:CPatientsaretheexpertsintheirmanagementofillness.Thenurse,physician,andinterprofessionalteamareallimportantpartnersincare.DIF:UnderstandREF:298OBJ:Gainanunderstandingoftheframeworksthatprovideguidancetowhatnursingprofessionalpracticeentails.TOP:ANssessRmenItGMSBC:.CCPNMRE:FoundationsofPracticeUSNTO8.Whatisthecauseofinternalizedmythsthatnursesmayhaveabouttheirownprofessionandthoseofotherhealthcareproviders?a.Roleambiguity.b.Mediaportrayal.c.Familialexperiences.d.Socialization.ANS:DSocializationisthemostencompassingcauseofinternalizedmythsnursesmayhaveoftheirownprofessionandthoseofotherhealthcareproviders.Roleambiguitymaycontributetothesemythsbutisnotacause.Mediaportrayalandfamilialexperiencesarepartsofsocialization,contributingtothemyths.DIF:UnderstandREF:298|299OBJ:Explorehowtointegrateyourgrowingnursingprofessionalidentitywiththatofaninterprofessionalidentity.TOP:EvaluateMSC:CPNRE:Professional,Ethical,andLegalPractice9.Toclarifytheroleofanurseinpatient-centredcare,anurseisresponsibleforwhichofthefollowing?a.Askingotherinterprofessionalteammembersabouttheirroles.b.Shadowingotherinterprofessionalteammemberstoexperiencetheirroles.c.BeingabletoexplainownroleandtheknowledgeandskillsthatthenursebringsCanadianFundamentalsofNursing7thEditionPotterTestBankUSNTtopatient-centredcare.d.Beingabletoexplaintherolesofallinterprofessionalteammembers.ANS:CRoleclarificationrequiresanursetobeabletoexplainwhataprofessionalnursesroleisandwhatknowledgeandskillsthenursebringstopatient-centredcare.Askingotherinterprofessionalteammembersabouttheirroles,shadowingotherinterprofessionalteammembers,andbeingabletoexplaintherolesofallinterprofessionalteammemberscontributetoroleclarificationbutarenotthenursesmainresponsibilitywhenclarifyinghisorherownrole.DIF:UnderstandREF:299OBJ:Explorehowasabeginningnurseprofessionalyoucanworkwithininterprofessionalteams.TOP:ImplementationMSC:CPNRE:CollaborativePractice10.Anurseiscaringforsixpatientsonapostsurgicalunit.Shehearsacodebluebeingcalledononeofherpatients,andsherunstothepatientsroom.Whenthenursearrives,acodeteamleaderhasbeenestablished.Thefirstthingthenurseshoulddoiswhichofthefollowing?a.Introduceherselfasthepatientsnurse,offeringherspecificknowledgeandskills.b.Immediatelyjumpinandassistwiththeairway.c.Standback,observethesituation,andwaittobegivenarolebythecodeleader.d.Acknowledgethatthesituationisundercontrolandgobacktoherotherfivepatients.ANS:AThenurseshouldintroduceherself,providerelevantinformation,andassistinroleclarificationbyexplainingtheskillsshecancontribute,suchasinitiationofintravenous(IV)treatmentormedicationadmNinisRtratiIon.GTofBu.ncCtionMbestasagroup,theteammembersneedtobeawareofeachothersroles.Ifthenurseweretojumpinandassistwiththeairwaywithoutintroducingherself,theteammaynotknowwhosheisorwhatherroleis.Thenurseisnotbeinganactiveteammemberbystandingbackandwaitingforaroleorbyleavingtheroomduringthecode.Itisherresponsibilityasthepatientsprimarynursetoprovidetheinformationandskillsshehastooffertothissituation.DIF:ApplyREF:300OBJ:Explorehowasabeginningnurseprofessionalyoucanworkwithininterprofessionalteams.TOP:ImplementationMSC:CPNRE:Professional,Ethical,andLegalPractice11.Atmorningrounds,anurseexplainsthechangeinstatusherpatienthadovernight.Theinterprofessionalteammembersallrecognizethatthisnursehasbeenworkingintheunitformorethan10yearsandisextremelycompetentatassessmentandinterpretation.Thisrecognitioninfluenceshowtheteamisinterpretingthenursesreport.Whichaspectisbeingdescribed?a.Affinity.b.Immediacy.c.Respect.d.Control.ANS:ACanadianFundamentalsofNursing7thEditionPotterTestBankAffinitydescribeshowthenurseisviewedonthebasisofperceivedcompetence,whichinfluenceshowtheteaminterpretsthenursesreport.Immediacyreferstotheurgencyofthemessagethenurseisrelayingandwasnotalludedtointhequestion.Respectreferstotrustgainedovertimethroughexperienceinteractingwiththeteam.Controlreferstopowerdifferentialsandwasnotalludedtointhequestion.DIF:ApplyREF:301OBJ:Explorehowasabeginningnurseprofessionalyoucanworkwithininterprofessionalteams.TOP:ImplementationMSC:CPNRE:CollaborativePractice12.Whencommunicatingwithothermembersoftheinterprofessionalteam,thenurseshouldexplainwhichofthefollowing?a.Situation,background,assessment,andreassessment.b.Situation,background,assessment,andrecommendations.c.Subjectiveinformation,behaviour,assessment,andrecommendations.d.Socialization,behaviour,action,andreaction.ANS:BTheacronymSBARstandsforsituation,background,assessment,andrecommendations,allofwhichshouldbeexplainedbythenursewheninteractingwiththeinterprofessionalteam.DIF:UnderstandREF:301OBJ:Explorehowasabeginningnurseprofessionalyoucanworkwithininterprofessionalteams.TOP:ImplementationMSC:CPNRE:CollaborativePractice13.Apatientundergoingchemotherapyvisitswithhisinterprofessionalteamonceamonth.Heobservestheoncologistencouragingotherteammembers,suchasthenurse,thepharmacist,orthesocial-worker,totakeNonUtRheSlIeaNdGroTleBd.urCinOgMthemeetings,onthebasisofthepatientsconcernsandgoals.Whichleadershipelementisbeingdemonstratedbytheoncologist?a.Inspiringasharedvision.b.Enablingotherstoact.c.Challengingtheprocess.d.Encouragingtheheart.ANS:BTheoncologistisdemonstratingtheleadershipelementofenablingotherstoactbyencouragingothermemberstotakeontheleadershiproleandsupportpatientsintheirdecisionmakingwiththeteam.Inspiringasharedvisionwouldbedemonstratedbyhavingthemembersfocusonpatient-specificgoalsandhelpingbringtheideastogetherinanagreed-uponplanwiththepatient.Challengingtheprocesswouldbedemonstratedbyreflectingonhowtheteamisworkingtogetherandmakingneededchanges.Encouragingtheheartwouldbedemonstratedbyrecognizingthepositiveworkofallteammembers,includingthepatient,towardmeetingpatient-setgoals.DIF:ApplyREF:303,Box18-4OBJ:Explorehowasabeginningnurseprofessionalyoucanworkwithininterprofessionalteams.TOP:EvaluateMSC:CPNRE:CollaborativePractice14.TheCanadianInterprofessionalHealthCollaborative(CIHC)hasfourkeycompetenciesforinterprofessionalcollaboration.Theyareroleclarification,teamfunctioning,collaborativeleadership,andwhichofthefollowing?CanadianFundamentalsofNursing7thEditionPotterTestBanka.Patient-centredcare.b.Qualityimprovement.c.Dealingwithinterprofessionalconflict.d.Reflection.ANS:CThefourkeycompetenciesfortheCIHCNationalInterprofessionalCompetencyFrameworkareroleclarification,teamfunctioning,collaborativeleadership,anddealingwithinterprofessionalconflict.Patient-centeredcare,qualityimprovement,andreflectionarenotkeycompetenciesinthisframework.DIF:UnderstandREF:300,Fig.18-4OBJ:Explorehowasabeginningnurseprofessionalyoucanworkwithininterprofessionalteams.TOP:AssessmentMSC:CPNRE:CollaborativePractice15.Whichwayofknowingisprimarilyaffectedbytheidealsthataresignificantorimportanttotheperson,thefamily,orthecommunity?a.Empiricalknowing.b.Aestheticknowing.c.Personalknowing.d.Ethicalknowing.ANS:DEthicalknowingisshapedbyonesvalues,whicharetheidealsthathavesignificantmeaningorimportancetotheperson,thefamily,orthecommunity.Aestheticknowingconcernshowtheperson,asauniqueindividual,choosestorespondinasituation.Empiricalknowingisrelatedtotheknowledgegainedthatcanbeappliedtospecificsituations.PersonalknowingreflectstheunderstandingaccNuUmRulSatIedNfGroTmBp.reCvOioMusexperiences.DIF:UnderstandREF:293OBJ:Exploreyourownwaysoflearningandhowthesecanbeintegratedtosupportyourlearningofhowtobeaprofessionalnurseandprovidecaretopatients.TOP:AssessmentMSC:CPNRE:Professional,Ethical,andLegalPractice16.Anursecallsthephysicianandsays,Dr.Green,thepatientLTiscomplainingofincreasedpaintohisleftleg,ratingit8/10.LTisthe8-year-oldboyinroom12whobrokehisfemurinasnowboardingaccidentyesterday.Hispainhasbeenwellcontrolledat2to4/10forthepastday,buthisanalgesicdosewasweanedafterroundsthismorning.Hisfootdoesnotappeartobeswollenbelowthecast,andhisperfusionisokaywithpalpablepedalpulsesandacapillaryrefillof2to3secondstothetoesontheleftfoot.WhichelementsofSBARcommunicationdidthenurseinclude?a.Situation,background,andassessment.b.Subjectiveinformation,assessment,andrecommendation.c.Background,assessment,andreassessment.d.Assessment,recommendation,andreassessment.ANS:ACanadianFundamentalsofNursing7thEditionPotterTestBankThecommunicationelementsofSBARaresituation,background,assessment,andrecommendation.Thenurseexplainedthesituationbysaying,ThepatientLTiscomplainingofincreasedpaintohisleftleg.ThebackgroundwasdescribedbyLTisthe8-year-oldboyinroom12whobrokehisfemurinasnowboardingaccidentyesterday.Hispainhasbeenwellcontrolledat2to4/10forthepastday,buthisanalgesicdosewasweanedafterroundsthismorning.AssessmentwasdescribedbyHisfootdoesnotappeartobeswollenbelowthecast,andhisperfusionisokaywithpalpablepedalpulsesandacapillaryrefillof2to3secondstothetoesontheleftfoot.Thenursedidnotincludearecommendation.SubjectiveinformationandreassessmentarenotelementsofSBAR.DIF:AnalyzeREF:301OBJ:Explorehowasabeginningnurseprofessionalyoucanworkwithininterprofessionalteams.TOP:AssessmentMSC:CPNRE:FoundationsofPracticeNURSINGTB.COMCanadianFundamentalsofNursing7thEditionPotterTestBankUSNTOChapter19:FamilyNursingPotteretal:CanadianFundamentalsofNursing,7thEditionMULTIPLECHOICE1.Whatisanexampleofcircularcommunicationpatternsbetweenfatherandchild?a.Thefatherandchildareengagedinagameofcatch.b.Thefatherusesrewardstoencouragethechildtogotobed.c.Thefathercomfortsthecryingchild.d.Thechilddisobeyshisfather.ANS:CCircularcommunicationreferstocommunicationbetweenfamilymembersinwhicheachpersoninfluencesthebehaviouroftheother.Anexampleiswhenaparentcomfortsachildbecausethechildcries;becausetheparentrespondstothechild,thechildfeelssafeandsecure.Theexampleofthefatherandchildbeingengagedinagameofcatchisnotanexampleofcircularcommunication.Itreflectsasubsystem(structuralassessment)offatherandchild;itreflectsarelationshipwithinthefamily.Theexampleofthefatherusingrewardstoencouragethechildtogotobedisnotanexampleofcircularcommunication.Itillustrateshowinfluence(expressivefunctioning)isusedtoaffectorcontrolanotherpersonsbehaviour.Influencecanbeclassifiedasinstrumental(e.g.,usingprivilegestorewardgoodbehaviour),psychological(e.g.,givingpraiseoradmonishment),orcorporal(e.g.,huggingorhitting).Theexampleofthechilddisobeyinghisfatherisnotanexampleofcircularcommunication.Rather,itisanexampleofaboundary.DIF:AnalyzeREF:31N7RIGOBBJ:.DefCiMnethekeytermslisted.TOP:AssessmentMSC:CPNRE:Professional,Ethical,andLegalPractice2.Balancingemploymentandfamilylifecreatesavarietyofchallengesintermsofchildcareandhouseholdworkforbothparents.Whydoesthishavemajorimplicationsinhealthcare?a.Maternalemploymenthasbeendemonstratedtobeharmfulforchildren.b.Maternalemploymenthasshiftedthemajorityofhouseholdtaskstothemale.c.Fathersnowparticipatemorefullyinday-to-dayparentingresponsibilities.d.Thenumberofsingle-parentfamilieshasdecreasedsince1970.ANS:CThereisnoproofthatmaternalemploymentisdamagingforchildren.However,findingqualitychildcareisamajorissue.Managinghouseholdtasksisanotherchallenge.Althoughequaldivisionoflabourreceivesverbalapproval,mosthouseholdtasksremainwomenswork.Evidencesuggeststhatthefatheringroleischanging.Fathersnowparticipatemorefullyinday-to-dayparentingresponsibilities.Thenumberofsingle-parentfamilies,whichdoubledfromthe1940stothe1990s,seemstobestabilizing.DIF:UnderstandREF:309OBJ:Discusshowfamilymembersinfluenceoneanothershealth.TOP:DiagnosisMSC:CPNRE:FoundationsofPracticeCanadianFundamentalsofNursing7thEditionPotterTestBank3.Ahusbandbringshischildrenintovisittheirmotherinthehospital.Thenurseaskshowthefamilyisgettingalongathomewithouttheirmomaround.Thehusbandstates,Noneofherjobsaregettingdone,andIdontdothosejobs,sothehouseandthekidsarefallingapart.Thenursesuspectsthatthisfamilystructureiswhichofthefollowing?a.Veryflexible.b.Quiterigid.c.Extremelyopen.d.Hardy.ANS:BArigidstructurespecificallydictateswhoisabletoaccomplishataskandmaylimitthenumberofpeopleoutsidetheimmediatefamilywhoassumethesetasks.Acrisis-proof,oreffective,familycanintegratetheneedforstabilitywiththeneedforgrowthandchange;hasaflexiblestructurefortaskperformances;andisreceptivetohelpfromoutsidethefamilysystemwhilemaintainingasenseofstrengthandstability.Aneffectivefamilyexertsinfluenceontheimmediateenvironmentofhome,neighbourhood,andschool,whereasacrisis-pronefamilymaylack,orbelieveitlacks,controlovertheseenvironments.Anextremelyopenorveryflexiblestructurealsopresentsproblemsforthefamilyinthatconsistentpatternsofbehaviourdonotexist,andenactmentofrolesisoverlyflexible.Hardinessistheinternalstrengthanddurabilityofthefamilyunitcharacterizedbyasenseofcontrolovertheoutcomeoflifeandanactiveratherthanpassiveorientationinadaptingtostressfulevents.DIF:ApplyREF:314OBJ:Discusshowfamilymembersinfluenceoneanothershealth.TOP:ImplementationMSC:CPNRE:FoundationsofPractice4.ItisessentialforfamilymemNbUerRstSoIreNalGizTeBth.atCaOfaMmilysbeliefs,values,andpracticesstronglyinfluencethehealth-promotingbehavioursofitsmembers,andtounderstandwhichofthefollowing?a.Canadianfamiliesarepartofthesameculturewiththesamevaluesandbeliefs.b.Economicstatushaslittleeffectonafamilysabilitytoaccessadequatehealthcare.c.Familyenvironmentinearlylifehasastronginfluenceonlaterhealthpractices.d.Allfamiliesplaceahighvalueongoodhealthandhealthpractices.ANS:CFamilyenvironmentiscrucialbecausehealthbehaviourreinforcedearlyinlifehasastronginfluenceonlaterhealthpractices.Somefamiliesdonotplaceahighvalueongoodhealth.Infact,somefamiliesacceptharmfulpractices.AlthoughCanadianfamiliesexistwithinthesameculture,theyliveinverydifferentwaysasaresultofrace,values,socialclass,andethnicity.Economicstabilityincreasesafamilysaccesstoadequatehealthcare.DIF:UnderstandREF:310OBJ:Discusshowfamilymembersinfluenceoneanothershealth.TOP:AssessmentMSC:CPNRE:FoundationsofPractice5.Inanassessmentforsignsofahealthyfamily,whatshouldthenurseexpecttofind?a.Changeisviewedasdetrimentaltofamilyprocesses.b.Theresponsetostressorsispassive.c.Thestructureisflexibleenoughtoadapttocrises.CanadianFundamentalsofNursing7thEditionPotterTestBankd.Minimalinfluenceisexertedontheenvironment.ANS:CAhealthyfamilyhasaflexiblestructurethatallowsadaptableperformanceoftasksandacceptanceofhelpfromoutsidethefamilysystem.Thestructureisflexibleenoughtoallowadaptabilitybutnotsoflexiblethatthefamilylackscohesivenessandasenseofstability.Thehealthyfamilyisabletointegratetheneedforstabilitywiththeneedforgrowthandchange.Itdoesnotviewchangeasdetrimentaltofamilyprocesses.Thehealthyfamilydemonstratescontrolovertheenvironmentanddoesnotpassivelyrespondtostressors.Thehealthyfamilyexertsinfluenceontheimmediateenvironmentofhome,neighbourhood,andschool.DIF:EvaluateREF:310OBJ:Discusshowfamilymembersinfluenceoneanothershealth.TOP:EvaluateMSC:CPNRE:FoundationsofPractice6.An86-year-oldpatientwithdiabeteswhorequiresdailyinsulininjectionsliveswithhisdaughterandherhusband.Toassessinstrumentalfunctioning,whatwouldthenurseask?a.Mr.Casey,howdoyouthinkyourdaughterfeelsaboutyourrefusingtotakeyourinsulin?b.Whatdoyoufeelhasaggravatedyourdifficultyincontrollingthediabetes?c.Mr.Casey,whoisresponsibleforadministeringyourinsulininjections?d.Howwillyoudealwithhypoglycemicreactions?ANS:CInstrumentalfunctioningincludesallnormalactivitiesofdailyliving,suchaspreparingmeals,eating,sleeping,andattendingtohealthneeds.Forfamilieswithhealthproblems,theseactivitiesmayincludeadministrationofmedications.ThequestionHowdoyouthinkyourdaughterfeelsaboutyouNrUreRfuSsIinNgGtoTtaBk.eCyouMrinsulin?exploresexpressivefunctioning,particularlyemotionalcommunication.ThequestionWhatdoyoufeelhasaggravatedyourdifficultyincontrollingthediabetes?exploresthepatientsbeliefswithinthecategoryofexpressivefunctioning.ThequestionHowwillyoudealwithhypoglycemicreactions?evaluatesthefamilysabilitytosolveproblems;problemsolvingisinthecategoryofexpressivefunctioning.DIF:ApplyREF:316OBJ:Askassessmentquestionstolearnrelevantinformationaboutfamilyfunctioninginthecontextofhealthorillness.TOP:ImplementationMSC:CPNRE:FoundationsofPractice7.Whenthenurseisinitiatingthecareoffamilies,whatisonefactorthathelpsorganizethefamilyapproachtothenursingprocess?a.Theviewofallpatientsasuniqueindividuals.b.Therealizationthatfamilieshavelittleeffectonindividuals.c.Therealizationthatindividualshavelittleeffectonfamilies.d.Therealizationthatindividualshaveaneffectonfamilies.ANS:DAchangeinonefamilymember,suchasanillnessorhealthcondition,affectstheotherfamilymembers.Familynursingpromotes,supports,andprovidesforthewell-beingandhealthofthefamilyandindividualfamilymembers.DIF:UnderstandREF:311|312CanadianFundamentalsofNursing7thEditionPotterTestBankOBJ:Comparefamilyascontext,familyaspatientandfamilyincontext,explaininghowthesedifferentperspectivesinfluencenursingpracticewithfamilies.TOP:AssessmentMSC:CPNRE:FoundationsofPractice8.Thenurseisinterviewingapatientwhoisbeingadmittedtothehospital.Thepatientsfamilywenthomebeforethenursesinterview.Thenurseasksthepatient,Whodecideswheretogoonvacation?Inaskingthis,whatisthenursetryingtodo?a.Assessthefamilystructure.b.Assessthefamilyform.c.Assessthefamilyfunction.d.Makeacategoricalgeneralization.ANS:AToassessthefamilystructure,thenurseasksquestionsthatdeterminethepowerstructureandpatterningofrolesandtasks(e.g.,Whodecideswheretogoonvacation?).Whenfocusingonfamilyform,thenurseshouldbeginthefamilyassessmentbydeterminingthepatientsdefinitionoffamily.Familyfunctionistheabilityofthefamilytoprovideemotionalsupportandtocopewithhealthproblemsorsituations.Thequestionaskedabovewillnothelpassessthat.Categoricalgeneralizationsaremisleadingandshouldbeavoided.DIF:ApplyREF:313-315OBJ:Askassessmentquestionstolearnrelevantinformationaboutfamilyfunctioninginthecontextofhealthorillness.TOP:ImplementationMSC:CPNRE:FoundationsofPractice9.Whenfocusingonolderpersons,thenursemustbeawareofwhichofthefollowing?a.Elderabusehappensonlyinlowersocioeconomicclasses.b.OlderpersonshavethesaNmUeRsoScIiaNlnGeTtwBo.rkCsOasMdoyoungerpeople.c.Caregiversmaybespousesormiddle-agedchildren.d.Caregiverstressisminimalwhencaringforaparent.ANS:CCaregiversaretypicallyspouses,whomaybeolderpersonswithdecliningphysicalstamina,ormiddle-agedchildren,whooftenhaveotherresponsibilities.Abuseofolderpersonsinfamiliesoccursacrossallsocialclasses.Later-lifefamilieshaveadifferentsocialnetworkthanyoungerfamiliesbecausemanyfriendsandsame-generationfamilymembershavediedorhavebeenillthemselves.Thenurseshouldassessforcaregiverstresssuchastensioninrelationshipsbetweenfamilyandcarerecipient,changesinlevelofhealth,changesinmood,andanxietyanddepression.DIF:RememberREF:310OBJ:Comparefamilyascontext,familyaspatientandfamilyincontext,explaininghowthesedifferentperspectivesinfluencenursingpracticewithfamilies.TOP:AssessmentMSC:CPNRE:FoundationsofPractice10.Whenthenurseviewsthefamilyascontext,theprimaryfocusisonthehealthanddevelopmentofanindividualmemberexistingwithinaspecificenvironment(i.e.,thepatientsfamily).Althoughthefocusisontheindividualshealthstatus,thenurseshoulddowhichofthefollowing?a.Assesshowmuchthefamilyprovidesthepatientsbasicneeds.b.Assessfamilypatternsversusindividualcharacteristics.CanadianFundamentalsofNursing7thEditionPotterTestBankc.Maintaindistinctionsbetweenfamilyaspatientandfamilyascontext.d.Plancaretomeetnotonlythepatientsneedsbutalsothoseofthepatientsfamily.ANS:AWhenthenurseviewsthefamilyascontext,theprimaryfocusisonthehealthanddevelopmentofanindividualmemberexistingwithinaspecificenvironment(i.e.,thepatientsfamily).Althoughthefocusisontheindividualshealthstatus,thenurseassesseshowmuchthefamilyprovidestheindividualsbasicneeds.Familypatternsareintherealmoffamilyaspatient.Itisimportanttounderstandthatalthoughthenurseisabletomaketheoreticalandpracticaldistinctionsbetweenfamilyascontextandfamilyaspatient,theyarenotnecessarilymutuallyexclusive.Nursesoftenusethetwosimultaneously,aswiththeperspectiveoffamilyassystem.Familyaspatientinvolvesplanningtomeettheneedsofthepatientandthoseofthepatientsfamilyaswell.DIF:UnderstandREF:311OBJ:Comparefamilyascontext,familyaspatientandfamilyincontext,explaininghowthesedifferentperspectivesinfluencenursingpracticewithfamilies.TOP:AssessmentMSC:CPNRE:FoundationsofPractice11.Mrs.Lilyistalkingaboutherrecentchronicdiagnosisandhowithasaffectedheremotionally,intellectually,socially,andspiritually.Thenurseknowsthatthisisreferredtoaswhichofthefollowing?a.Reflection.b.Illnessnarrative.c.Comprehensivehonesty.d.Completelifereview.ANS:BNURSINGTB.COMAnillnessnarrativeisapatientsstoryofhowillnessaffectshisorherwholebeing,includingemotional,intellectual,social,andspiritualcomponents.Reflection,comprehensivehonesty,andacompletelifereviewdonotrefertothesecomponents.DIF:UnderstandREF:320OBJ:Discussfamilynursingasrelationalinquiry.TOP:ImplementationMSC:CPNRE:FoundationsofPractice12.Thenurseiscaringforanolderpatientwhoapparentlyhasnofamily.Whenquestionedabouthisfamilyandhisdefinitionoffamily,thepatientstates,Ihavenofamily.Theyreallgone.Whenasked,Whopreparesyourmeals?hestates,Ido,orIgoout.Giventhethreedifferentapproachestofamilynursingpractice,whichwouldbemostappropriateforthispatient?a.Familyascontext.b.Familyaspatient.c.Familyassystem.d.Combinationoffamilyascontextandfamilyaspatient.ANS:AIfonlyonefamilymemberreceivesnursingcare,itisrealisticandpracticaltoviewthefamilyascontext.Althoughfamilynursingisbasedontheassumptionthatallpeopleregardlessofageareamemberofsometypeoffamilyform,thepatientinsiststhathehasnofamily.Thenurseshouldinvestigatefurther.However,atthistime,familyaspatientorassystem,oracombinationofthese,isnotappropriate.CanadianFundamentalsofNursing7thEditionPotterTestBankUSNTDIF:AnalyzeREF:311OBJ:Comparefamilyascontext,familyaspatientandfamilyincontext,explaininghowthesedifferentperspectivesinfluencenursingpracticewithfamilies.TOP:EvaluateMSC:CPNRE:FoundationsofPractice13.Thenurseiscaringforanolderwomanandnoticesthatsheisnotusinghercaneproperly.Whichofthefollowingstatementsbythenursewouldmostlikelyelicitapositiveresponsefromthepatient?a.Youredoingthatallwrong.Letmeshowyouhowtodoit.b.Idontknowwhoshowedyouhowtousethecanelikethat,butyourenotdoingitright.Letmeshowyouagain.c.YouusethecanethewayIdidbeforeIwasshownawaytokeepfromtrippingoverit;doyoumindifIshowyou?d.Iusedtousethecanethesamewayyouareusingit:thewrongway.Illshowyoutherightwaytodoit.ANS:CWhenthenurseisrespectfulinsteadofcomingacrossasanauthorityonthesubject,thepatientsdefenceswillbedown,makingthepatientmorewillingtolistenwithoutfeelingembarrassed.DIF:UnderstandREF:319OBJ:Discusstherelationalapproachesandpracticesneededtoconductafamilyinterviewandeffectivelyintervenewiththefamilyinnursingpractice.TOP:ImplementationMSC:CPNRE:FoundationsofPractice14.ThenurseisprovidingdischaNrgeRteaIchinGgfoBr.anColdMerwomanwhowillneeddressingchangesathome.Herhusband,whoisalsoanolderperson,isheronlysourceofcare.Thehusbandstatesthathewillnotbeabletoperformthedressingchanges.Whatdoesthenurseneedtoarrangefor?a.Homecareservicereferrals.b.Extradressingsupplies.c.Cancellationofthedischarge.d.Anorderforantibiotics.ANS:ADischargeplanningwithafamilyinvolvesanaccurateassessmentofwhatwillbeneededforcareatthetimeofdischarge,alongwithanyshortcomingsinthehomesetting.Ifnoonecanchangethedressingsproperly,thenursemustarrangeforahomecareservicereferral.Extradressingsupplieswillnothelpthesituationifthehusbandisafraidtousethem.Onlyunderextremesituationsorinanunsafesituationwillthedischargebecancelled.Anorderforantibioticsisnotareplacementforgooddressingchangetechnique.DIF:ApplyREF:311|316OBJ:Discusstherelationalapproachesandpracticesneededtoconductafamilyinterviewandeffectivelyintervenewiththefamilyinnursingpractice.TOP:ImplementationMSC:CPNRE:FoundationsofPractice15.Althoughthefamilyasawholediffersfromindividualmembers,themeasureoffamilyhealthismorethanasummaryofthehealthofallmembers.Ofthefollowing,whatareasareuniquetofamilyassessmentintheCalgaryFamilyAssessmentModel(CFAM)?CanadianFundamentalsofNursing7thEditionPotterTestBanka.Development,familyhealth,andfunctionality.b.Development,structure,andfunctionality.c.Individualhealth,familyhealth,andfunctionality.d.Development,individualhealth,andfamilyhealth.ANS:BAlthoughthefamilyasawholediffersfromindividualmembers,themeasureoffamilyhealthismorethanasummaryofthehealthofallmembers.WiththeCFAM,familyassessmentiscompletedinthedevelopmental,structural,andfunctionalareas.Althoughindividualhealthisimportant,itvariesfromthefamilyfocus.DIF:RememberREF:313OBJ:StatethethreemajorcategoriesoftheCalgaryFamilyAssessmentModel(CFAM)andunderstandsubcategoriesimportanttoconsiderinafamilyassessment.TOP:AssessmentMSC:CPNRE:FoundationsofPracticeNURSINGTB.COMCanadianFundamentalsofNursing7thEditionPotterTestBankChapter20:PatientEducationPotteretal:CanadianFundamentalsofNursing,7thEditionMULTIPLECHOICE1.Anurseisaskedaboutthegoalofpatienteducation.Whatisthenursesbestresponse?a.ThegoalofeducatingothersistohelppeoplemeetstandardsoftheNursePracticeAct.b.Thegoalofeducatingothersistohelppeopleachieveoptimallevelsofhealth.c.Thegoalofeducatingothersistohelppeoplebecomedependentonthehealthcareteam.d.Thegoalofeducatingothersistohelppeopleprovideself-careonlywhiletheyareinthehospital.ANS:BThegoalofeducatingpeopleabouttheirhealthistohelpindividuals,families,andcommunitiesachieveoptimallevelsofhealth.AlthoughallprovincialandterritorialNursePracticeActsacknowledgethatpatientteachingfallswithinthescopeofnursingpractice,thisisthenursesstandard,notthegoalofeducation.Patienteducationhelpspatientsmakeinformeddecisionsabouttheircareandbecomehealthierandmoreindependent,notdependent.Nursesprovidepatientswithinformationneededforself-caretoensurecontinuityofcarefromthehospitaltothehome,notonlyinthehospital.DIF:RememberREF:325OBJ:Describethepurposesofpatienteducation.TOP:ImplementationMSC:CPNRE:FoundationsofPractice2.AnurseisteachingagroupoNfUheRalSthIyNadGuTltBsa.bCouOtMthebenefitsoffluimmunizations.Whichpurposeofpatienteducationisthenursefulfilling?a.Restorationofhealth.b.Copingwithimpairedfunctions.c.Promotionofhealthandillnessprevention.d.Healthanalogies.ANS:CAnurseisavisible,competentresourceforpatientswhowanttoimprovetheirphysicalandpsychologicalwell-being.Intheschool,home,clinic,orworkplace,nursespromotehealthandpreventillnessbyprovidinginformationandskillsthatenablepatientstopractisehealthierbehaviours.Injuredandillpatientsneedinformationandskillstohelpthemregainormaintaintheirlevelofhealth;thisisreferredtoasrestorationofhealth.Notallpatientsrecoverfullyfromillnessorinjury.Manyhavetolearntocopewithpermanenthealthalterations;thisisknownascopingwithimpairedfunctions.Analogiessupplementverbalinstructionwithfamiliarimagesthatmakecomplexinformationmorerealandunderstandable;forexample,whenexplainingarterialbloodpressure,thenursecanuseananalogyoftheflowofwaterthroughahose.DIF:UnderstandREF:325OBJ:Describethepurposesofpatienteducation.TOP:PlanningMSC:CPNRE:FoundationsofPractice3.Anurseprovidesteachingaboutcopingwithlong-termimpairmentoffunctions.Whichsituationservesasthebestexample?CanadianFundamentalsofNursing7thEditionPotterTestBankNRIGB.Ca.Teachingafamilymembertogivemedicationsthroughthepatientspermanentgastrictube.b.Teachingawomanwhorecentlyhadahysterectomyaboutherpathologyreports.c.Teachingexpectantparentsaboutphysicalandpsychologicalchangesinchildbearingwomen.d.Teachingateenagerwithabrokenleghowtousecrutches.ANS:ANotallpatientsrecoverfullyfromillnessorinjury.Manyhavetolearntocopewithpermanenthealthalterations.Newknowledgeandskillsareoftennecessaryforpatientsorfamilymembers,orboth,tocontinueactivitiesofdailyliving.Teachingfamilymemberstohelpthepatientwithhealthcaremanagement(e.g.,givingmedicationsthroughgastrictubes,doingpassiverange-of-motionexercises)isanexampleofteachingthemhowtocopewithlong-termimpairmentoffunctions.Injuredandillpatientsneedinformationandskillstohelpthemregainormaintaintheirlevelsofhealth.Someexamplesofthisincludeteachingawomanwhorecentlyhadahysterectomyaboutherpathologyreportsandexpectedlengthofrecoveryandteachingateenagerwithabrokenleghowtousecrutches.Inchildbearingclasses,expectantparentsaretaughtaboutphysicalandpsychologicalchangesinthewomanandaboutfetaldevelopment;thisispartofhealthmaintenance.DIF:UnderstandREF:326OBJ:Identifyappropriatetopicsthataddressapatientshealtheducationneeds.TOP:EvaluateMSC:CPNRE:FoundationsofPractice4.Whichstatementindicatesthatthenursehasagoodunderstandingofteaching/learning?a.Teachingandlearningcanbeseparated.b.Learningisaninteractiveprocessthatpromotesteaching.c.LearningconsistsofaconUscioSus,NdeliTberatesOetofactionsdesignedtohelptheteacher.d.Teachingismosteffectivewhenitrespondstothelearnersneeds.ANS:DTeachingismosteffectivewhenitrespondstothelearnersneeds.Itisimpossibletoseparateteachingfromlearning.Teachingisaninteractiveprocessthatpromoteslearning.Teachingconsistsofaconscious,deliberatesetofactionsthathelpindividualsgainnewknowledge,changeattitudes,adoptnewbehaviours,orperformnewskills.DIF:UnderstandREF:326OBJ:Describethepurposesofpatienteducation.TOP:EvaluateMSC:CPNRE:FoundationsofPractice5.Whichactionbestindicatesthatlearninghasoccurred?a.Anursepresentsinformationaboutdiabetes.b.Apatientdemonstrateshowtoinjectinsulin.c.Afamilymemberlistenstoalectureondiabetes.d.Aprimarycareproviderhandsadiabetespamphlettothepatient.ANS:BCanadianFundamentalsofNursing7thEditionPotterTestBankUSNTOLearningisthepurposefulacquisitionofnewknowledge,attitudes,behaviours,andskills.Complexpatternsareinvolvedinlearningnewskills,changingexistingattitudes,transferringlearningtonewsituations,andsolvingproblems.Anewmotherexhibitslearningwhenshedemonstrateshowtobathehernewborn.Anursepresentinginformationandaprimarycareproviderhandingapamphlettoapatientareexamplesofteaching.Afamilymemberlisteningtoalecturedoesnotindicatethatlearningoccurred;achangeinknowledge,attitudes,behaviours,orskillsmustbeevident.DIF:UnderstandREF:327OBJ:Useappropriatemethodstoevaluatelearning.TOP:EvaluateMSC:CPNRE:FoundationsofPractice6.Thenurseisdemonstratingtothepatienthowtoputonantiembolismstockings.Inthemiddleofthelesson,thepatientasks,Whyhavemyfeetbeenswelling?Thenursestopsandrespondstothepatient,adheringtowhichteachingprinciple?a.Timing.b.Settingpriorities.c.Buildingonexistingknowledge.d.Organizingteachingmaterials.ANS:AThenursewhostopsademonstrationofapplyingantiembolismstockingstoanswerapatientsquestionisfollowingtheteachingprincipleoftiming.Ifthepatienthasaquestion,itisimportanttoanswerthequestionrightaway,sothatthefocuscanreturntothetaskbeingtaught.Settingprioritiesisimportantforconservingthetimeandenergyofthepatientandnurse.Apatientlearnsbestonthebasisofpreexistingcognitiveabilitiesandknowledge.Thissituationisnotanexampleofbuildingonexistingknowledge.OrganizingteachingmaterialmeansthatthenurseconsideNrsthReorIderGinwBh.icChtoMpresenttheinformation.DIF:ApplyREF:333|334OBJ:Explaintheroleofthenurseinpatienteducation.TOP:ImplementationMSC:CPNRE:FoundationsofPractice7.Anurseteachesapatientwithheartfailureabouthealthyfoodchoices.Thepatientstatesthateatingyogurtisbetterthaneatingcake.Inthissituation,whichelementrepresentsfeedback?a.Thenurse.b.Thepatient.c.Thenursesteachingabouthealthyfoodchoices.d.Thepatientsstatementthateatingyogurtisbetterthaneatingcake.ANS:DFeedbackshouldshowthesuccessofthelearnerinachievingobjectives(i.e.,thelearnerverbalizesinformationorprovidesareturndemonstrationofskillslearned).Thenurseisthesender.Thepatientisthereceiver.Theteachingisthemessage.DIF:ApplyREF:335OBJ:Determineappropriatecommunicationprincipleswhenpatienteducationisprovided.TOP:EvaluateMSC:CPNRE:FoundationsofPractice8.Whilepreparingateachingplan,thenursedescribeswhatthelearnerwillbeabletoaccomplishaftertheteachingsession.Whichactionisthenursecompleting?a.Developinglearningobjectives.b.Providingpositivereinforcement.CanadianFundamentalsofNursing7thEditionPotterTestBankc.Implementinginterpersonalcommunication.d.Presentingfactsandknowledge.ANS:ALearningobjectivesdescribewhatthelearnerwillbeabletodoaftersuccessfulinstruction.Positivereinforcementfollowsfeedbackandinvolvestheuseofpraiseandacknowledgementofnewattitudes,behaviours,orknowledge.Interpersonalcommunicationingeneralisnecessaryfortheteaching/learningprocessandshouldbeusedinteaching.Factsandknowledgewillbepresentedintheteachingsession.DIF:UnderstandREF:333OBJ:Writelearningobjectivesforateachingplan.TOP:PlanningMSC:CPNRE:FoundationsofPractice9.Astudentnurselearnsthatanormaladultheartbeatis60to100beats/minute.Inwhichdomaindidlearningtakeplace?a.Kinesthetic.b.Cognitive.c.Affective.d.Psychomotor.ANS:BCognitivelearningincludesallintellectualbehavioursandrequiresthinking.Inthehierarchyofcognitivebehaviours,thesimplestbehaviourisacquiringknowledge.Thestudentnurseacquiredknowledge,whichiscognitive.Akinestheticlearnerisatypeoflearnerwholearnsbestwithahands-onapproach.Affectivelearningdealswithexpressionoffeelingsandacceptanceofattitudes,opinions,orvalues.Psychomotorlearninginvolvesacquiringskillsthatrequireintegrationofmentalandmuscularactivities,suchastheabilitytowalkortouseaneatingutensil.NURSINGTB.COMDIF:ApplyREF:327|328OBJ:Describethedomainsoflearning.TOP:AssessmentMSC:CPNRE:FoundationsofPractice10.Anursewantsthepatienttobegintoacceptthechronicnatureofdiabetes.Whichteachingtechniqueshouldthenurseusetoenhancelearning?a.Lecture.b.Demonstration.c.Roleplay.d.Questionandanswersession.ANS:CAffectivelearningdealswithexpressionoffeelingsandacceptanceofattitudes,opinions,orvalues.Roleplayanddiscussion(one-on-oneandgroup)areeffectiveteachingmethodsfortheaffectivedomain.Lectureandquestion-and-answersessionsareeffectiveteachingmethodsforthecognitivedomain.Demonstrationisaneffectiveteachingmethodforthepsychomotordomain.DIF:AnalyzeREF:328,Box20-4OBJ:Describethedomainsoflearning.TOP:ImplementationMSC:CPNRE:FoundationsofPractice11.Whenthenursedescribesapatientsperceivedabilitytosuccessfullycompleteatask,whichtermshouldthenurseuse?CanadianFundamentalsofNursing7thEditionPotterTestBanka.Self-efficacy.b.Motivation.c.Attentionalset.d.Activeparticipation.ANS:ASelf-efficacy,aconceptincludedinsociallearningtheory,referstoapersonsperceivedabilitytosuccessfullycompleteatask.Motivationisaforcethatactsonorwithinaperson(e.g.,anidea,anemotion,aphysicalneed)tocausethepersontobehaveinaparticularway.Anattentionalsetisthementalstatethatallowsthelearnertofocusonandcomprehendalearningactivity.Learningoccurswhenthepatientisactivelyinvolvedintheeducationalsession.DIF:RememberREF:330|331OBJ:Identifybasiclearningprinciples.TOP:DiagnosisMSC:CPNRE:FoundationsofPractice12.Atoddlerisgoingtohavesurgeryontherightear.Whichteachingmethodismostappropriateforthisdevelopmentalstage?a.Encourageindependentlearning.b.Usediscussionthroughouttheteachingsession.c.Applyabandagetoadollsear.d.Developaproblem-solvingscenario.ANS:CNursesshoulduseplaytoteachaprocedureoractivity(e.g.,handlingexaminationequipment,applyingabandagetoadoll)totoddlers.Independentlearningisforadults.Useofdiscussionisforolderchildren,adolescents,andadults,notfortoddlers.Problemsolvinghelpsadolescentsmakechoices;itNisUtoRoSaIdvNanGcTedBf.orCaOtoMddler.DIF:AnalyzeREF:329,Box20-5OBJ:Discusshowtointegratehealtheducationintopatient-centredcare.TOP:PlanningMSC:CPNRE:FoundationsofPractice13.Whichfactorsshouldthenurseassesstodetermineapatientsabilitytolearn?a.Developmentalcapabilitiesandphysicalcapabilitiesb.Socioculturalbackgroundandmotivationc.Psychosocialadaptationtoillnessandactiveparticipationd.StageofgrievingandoverallphysicalhealthANS:ADevelopmentalandphysicalcapabilitiesreflectapersonsabilitytolearn.Socioculturalbackground,motivation,psychosocialadaptationtoillness,andactiveparticipationarefactorsinreadinesstolearn.Readinesstolearnisalsorelatedtothestageofgrieving.Overallphysicalhealthdoesreflectabilitytolearn;however,becauseitispairedherewithstageofgrieving(whichisareadinesstolearnfactor),thisisawronganswer.DIF:UnderstandREF:328-330OBJ:Differentiatefactorsthatdeterminereadinesstolearnfromthosethatdeterminetheabilitytolearn.TOP:AssessmentMSC:CPNRE:FoundationsofPractice14.Anurseispreparingtoteachapatientaboutheartfailure.Whichenvironmentisbestforpatientlearning?CanadianFundamentalsofNursing7thEditionPotterTestBanka.Adarkened,quietroomb.Awell-lit,ventilatedroomc.Aprivateroomat30C(85F)temperatured.Agrouproomfor10to12patientswithheartfailureANS:BTheidealenvironmentforlearningisaroomthatiswelllitandhasgoodventilation,appropriatefurniture,andacomfortabletemperature.Althoughquietisappropriate,adarkenedroominterfereswiththepatientsabilitytowatchthenursesactions,especiallywhenthenurseisdemonstratingaskillorusingvisualaidssuchaspostersorpamphlets.Aroomthatiscold,hot,orstuffymakesthepatienttoouncomfortabletofocusontheinformationbeingpresented.Learninginagroupofsixorfewerismoreeffectivethaninlargergroupsandtendstopreventoutburstbehaviours.DIF:ApplyREF:328OBJ:Establishanenvironmentthatpromoteslearning.TOP:PlanningMSC:CPNRE:FoundationsofPractice15.Whichsituationindicatestothenursethatthepatientisreadytolearn?a.Apatienthassufficientupperbodystrengthtomovefromabedtoawheelchair.b.Apatienthastheabilitytograspandapplytheelasticbandage.c.Apatientwithabelow-the-kneeamputationismotivatedabouthowtowalkwithassistivedevices.d.Apatienthasnormaleyesighttoidentifythemarkingsonasyringeandcoordinationtohandleasyringe.ANS:CMotivationorreadinesstolearnsometimesresultsfromsocialtaskmastery,orphysicalmotivesmaybeinvolved.OfNteUnRpaStiIenNtsGTmBot.ivCesOaMrephysical.Somepatientsaremotivatedtoreturntoalevelofself-sufficiency;forexample,apatientwithabelow-the-kneeamputationismotivatedtolearnhowtowalkwithassistivedevices.Readinesstolearnshouldnotbeconfusedwithabilitytolearn.Alltheotheranswersareexamplesofabilitytolearnbecausethecapabilitiesmentionedoftendependonthepatientslevelofphysicaldevelopmentandoverallphysicalhealth.Tolearnpsychomotorskills,apatientneedstopossessacertainlevelofstrength,coordination,andsensoryacuity.Forexample,itisuselesstoteachapatienttotransferfromabedtoawheelchairifheorshehasinsufficientupperbodystrength.Anolderpatientwithpooreyesightoraninabilitytograspobjectstightlycannotlearntoapplyanelasticbandageorhandleasyringe.DIF:EvaluateREF:330OBJ:Differentiatefactorsthatdeterminereadinesstolearnfromthosethatdeterminetheabilitytolearn.TOP:EvaluateMSC:CPNRE:FoundationsofPractice16.Anurseisteachingthestaffaboutnursingandteachingprocesses.Duringtheteachingprocess,whatshouldthenursedo?a.Assessallsourcesofdata.b.Identifyitasthesameasthenursingprocess.c.Performnursingcaretherapies.d.Focusonapatientslearningneeds.ANS:DCanadianFundamentalsofNursing7thEditionPotterTestBankTheteachingprocessfocusesonthepatientslearningneedsandwillingnessandcapabilitytolearn.Nursingandteachingprocessesarenotthesame.Assessingallsourcesofdataandperformingnursingcaretherapiesarecomponentsofthenursingprocess.DIF:RememberREF:326OBJ:Compareandcontrastthenursingandteachingprocesses.TOP:PlanningMSC:CPNRE:FoundationsofPractice17.Whichnursingactionismostappropriateforassessingapatientslearningneeds?a.Assessthepatientstotalhealthcareneeds.b.Assessthepatientshealthliteracy.c.Assessallsourcesofpatientdata.d.Assessthegoalsofpatientcare.ANS:BBecausehealthliteracyinfluenceshowyoudeliverteachingstrategies,thenursemustassessapatientshealthliteracybeforeprovidinginstruction.Thenursingprocessrequiresassessmentofallsourcesofdatatodetermineapatientstotalhealthcareneeds.Evaluationoftheteachingprocessinvolvesdeterminingoutcomesoftheteaching/learningprocessandtheachievementoflearningobjectives,notpatientcare.Assessingthegoalofmeetingpatientcareistheevaluationcomponentofthenursingprocess.DIF:AnalyzeREF:331|338OBJ:Compareandcontrastthenursingandteachingprocesses.TOP:AssessmentMSC:CPNRE:FoundationsofPractice18.Anurseisgoingtoteachapatientabouthypertension.Whichactionshouldthenurseimplementfirst?NURSINGTB.COMa.Setmutualgoalsforknowledgeofhypertension.b.Teachwhatthepatientwantstoknowabouthypertension.c.Assesswhatthepatientalreadyknowsabouthypertension.d.Evaluatetheoutcomesofpatienteducationforhypertension.ANS:CAssessmentisthefirststepofanyteachingsession,followedbydiagnosing,planning,implementation,andevaluation.Aneffectiveassessmentprovidesthebasisforindividualizedpatientteaching.Assessingwhatthepatientcurrentlyknowsimprovestheoutcomesofpatienteducation.DIF:ApplyREF:331,Table20-1OBJ:Identifyappropriatetopicsthataddressapatientshealtheducationneeds.TOP:AssessmentMSC:CPNRE:FoundationsofPractice19.Apatienthadastrokeandmustuseacaneforsupport.Anurseispreparingtoteachthepatientaboutthecane.Whichlearningobjective/outcomeismostappropriate?a.Thepatientwillwalktothebathroomandbacktobedusingacane.b.Thepatientwillunderstandtheimportanceofusingacane.c.Thepatientwilllearnhowtouseacane.d.Thepatientwillknowthecorrectuseofacane.ANS:ACanadianFundamentalsofNursing7thEditionPotterTestBankOutcomesrefertothepatientsabilitytodosomethingoncompletionofteachingsuchaswillemptycolostomybag,orwilladministeraninjection.Understanding,learning,andknowingarenotbehavioursthatcanbeobservedorevaluated.DIF:ApplyREF:333OBJ:Writelearningobjectivesforateachingplan.TOP:PlanningMSC:CPNRE:FoundationsofPractice20.Whichlearningobjective/outcomehasthehighestpriorityforapatientwithlife-threatening,severefoodallergiesthatnecessitateuseofanEpiPen(epinephrine)?a.Thepatientwilldemonstratethecorrectwaytoadministerepinephrine.b.Thepatientwillidentifythemainingredientsinseveralfoods.c.Thepatientwilllistthesideeffectsofepinephrine.d.Thepatientwilllearnaboutfoodlabels.ANS:AOncethenurseassistsinmeetingpatientneedsrelatedtobasicsurvival(howtogiveepinephrine),thenursecandiscussothertopics,suchasnutritionalneedsandsideeffectsofmedications.Forexample,apatientwitharecentdiagnosisofcoronaryarterydiseasemayhavedeficientknowledgerelatedtotheillnessanditsimplications.Thepatientbenefitsmostbyfirstlearningaboutthecorrectwaytotakenitroglycerineandhowlongtowaitbeforecallingforhelpwhenchestpainoccurs.Thusinthissituation,thepatientbenefitsmostbyfirstlearningaboutthecorrectwaytotakeepinephrine.Thepatientwilllearnaboutfoodlabelsisnotobjectiveormeasurableandisnotspecificenough.DIF:EvaluateREF:333OBJ:Writelearningobjectivesforateachingplan.TOP:EvaluateMSC:CPNRE:FoundationsofPractice21.AfterateachingsessionontaNkUinRgSblIooNdGpTreBss.urCesO,Mthenursetellsthepatient,Youtookthatbloodpressurelikeanexperiencednurse.Whattypeofreinforcementdidthenurseuse?a.Material.b.Activity.c.Social.d.Entrusting.ANS:CThreetypesofreinforcersaresocial,material,andactivity.Whenanurseworkswithapatient,mostreinforcersaresocialandareusedtoacknowledgealearnedbehaviour(e.g.,smiles,compliments,wordsofencouragement).Examplesofmaterialreinforcersincludefood,toys,andmusic.Activityreinforcersrelyontheprinciplethatapersonismotivatedtocompleteataskifheorshehastheopportunitytoengageinamoredesirableactivityafterwards.Theentrustingapproachisateachingapproachthatprovidesthepatienttheopportunitytomanageself-care.Itisnotatypeofreinforcement.DIF:UnderstandREF:336OBJ:Determineappropriatecommunicationprincipleswhenpatienteducationisprovided.TOP:ImplementationMSC:CPNRE:FoundationsofPractice22.Apatientwithheartfailureislearningtoreducesaltinthediet.Whenwouldbethebesttimeforthenursetoaddressthistopic?a.Atbedtime,whenthepatientisrelaxed.b.Atlunchtimewhilethenurseispreparingthefoodtray.CanadianFundamentalsofNursing7thEditionPotterTestBankUSNTc.Atbathtime,whenthenurseiscleaningthepatient.d.Atmedicationtime,whenthenurseisadministeringmedication.ANS:BAppropriatetimestotalkaboutfood/dietchangesduringroutinenursingcareareatbreakfast,lunch,anddinnertimesorwhenthepatientisfillingoutthemenu.Manynursesfindthattheyareabletoteachmoreeffectivelywhiledeliveringnursingcare.Forexample,whilehangingblood,youexplaintothepatientwhythebloodisnecessaryandthesymptomsofatransfusionreactionthatneedtobereportedimmediately.Inthissituation,becausetheteachingisaboutfood,coordinatingitwithroutinenursingcarethatinvolvesfoodcanbeeffective.Bedtimewouldbeagoodtimetodiscussroutinesthatenhancesleep.Bathtimewouldbeagoodtimetodescribeskincareandhowtopreventpressureulcers.Medicationtimewouldbeagoodtimetoexplainthepurposesandsideeffectsofthemedication.DIF:ApplyREF:333OBJ:Includepatientteachingwhileperformingroutinenursingcare.TOP:ImplementationMSC:CPNRE:FoundationsofPractice23.Apatienthasbeentaughthowtocoughanddeepbreathe.Whichevaluationmethodismostappropriate?a.Returndemonstration.b.Computerinstruction.c.Verbalizationofsteps.d.Clozetest.ANS:ATodemonstratemasteryoftheskill,thepatientshouldperformareturndemonstrationunderthesameconditionsthatwillNbeeRxpeIrienGcedBa.tChomMeorintheplacewheretheskillistobeperformed.Computerinstructionisaprogrammedinstructionformatinwhichcomputersstoreresponsepatternsforlearnersandselectfurtherlessonsonthebasisofthesepatterns(programscanbeindividualized).Computerinstructionisateachingtoolratherthananevaluationtool.Verbalizationofstepscanbeanevaluationtool,butitisnotaseffectiveforevaluatingapsychomotorskillasareturndemonstrationis.TheClozetestisatestofreadingcomprehensioninwhichpatientsfillintheblanksinawrittenparagraph.DIF:EvaluateREF:336OBJ:Useappropriatemethodstoevaluatelearning.TOP:EvaluateMSC:CPNRE:FoundationsofPractice24.Apatienthasbeentaughthowtochangeacolostomybagbutishavingtroublemeasuringandmanipulatingtheequipmentandhasmanyquestions.Whatisthenursesnextaction?a.Refertoamentalhealthspecialist.b.Refertoanostomyspecialist.c.Refertoadietitian.d.Refertoawoundcarespecialist.ANS:BResourcesthatspecializeinaparticularhealthneed(e.g.,woundcareorostomyspecialists)areintegraltosuccessfulpatienteducation.Amentalhealthspecialistishelpfulforemotionalissuesratherthanforphysicalproblems.Adietitianisaresourcefornutritionalneeds.Awoundcarespecialistprovidescomplexwoundcare.CanadianFundamentalsofNursing7thEditionPotterTestBankUSNTDIF:UnderstandREF:334OBJ:Useappropriatemethodstoevaluatelearning.TOP:ImplementationMSC:CPNRE:FoundationsofPractice25.Anursehastaughtapatientabouthealthyeatinghabits.Whichlearningobjective/outcomeismostappropriatefortheaffectivedomain?a.Thepatientwillstatethreefactsabouthealthyeating.b.Thepatientwillidentifytwofoodsforahealthysnack.c.Thepatientwillverbalizethevalueofeatinghealthy.d.Thepatientwillcookamealwithlow-fatoil.ANS:CAffectivelearningdealswithexpressionoffeelingsandacceptanceofattitudes,opinions,orvalues.Havingthepatientvaluehealthyeatinghabitsfallswithintheaffectivedomain.Statingthreefactsoridentifyingtwofoodsforahealthysnackfallswithinthecognitivedomain.Cookingfallswithinthepsychomotordomain.DIF:AnalyzeREF:327OBJ:Writelearningobjectivesforateachingplan.TOP:PlanningMSC:CPNRE:FoundationsofPractice26.Anurseisassessingtheabilitytolearnofapatientwhohasrecentlysufferedastroke.Whichquestion/statementwillbestassessthepatientsabilitytolearn?a.Whatdoyouwanttoknowaboutstrokes?b.Onascalefrom1to10,tellmewhereyourankyourdesiretolearn.c.DoyoufeelstrongenoughtoperformthetasksIwillteachyou?d.Pleasereadthishandoutandtellmewhatitmeans.ANS:DApatientsreadinglevelaffeNctsRabilIitytGoleBar.n.CReMadinglevelisoftendifficulttoassessbecausepatientswhoarefunctionallyilliterateareoftenabletoconcealitbyusingexcusessuchasnothavingthetimeornotbeingabletosee.Onewaytoassessapatientsreadinglevelandlevelofunderstandingistoaskthepatienttoreadinstructionsfromaneducationalhandoutandthenexplaintheirmeaning.Askingpatientswhattheywanttoknowhelpsidentifypreviouslearningandlearningneedsandpreferences;itdoesnothelpassessabilitytolearn.Motivationisrelatedtoreadinesstolearn,notabilitytolearn.Justaskingapatientwhetherheorshefeelsstrongisnotaseffectiveasactuallyassessingthepatientsstrength.DIF:EvaluateREF:329|338|339OBJ:Differentiatefactorsthatdeterminereadinesstolearnfromthosethatdeterminetheabilitytolearn.TOP:AssessmentMSC:CPNRE:FoundationsofPractice27.Anurseispreparingtoteachakinestheticlearneraboutexercise.Whichtechniqueshouldthenurseuse?a.Letthepatienttouchandusetheexerciseequipment.b.Providethepatientwithpicturesoftheexerciseequipment.c.Letthepatientlistentoapodcastabouttheexerciseequipment.d.Providethepatientwithacasestudyabouttheexerciseequipment.ANS:ACanadianFundamentalsofNursing7thEditionPotterTestBankKinestheticlearnerslearnbestwhiletheyaremovingandparticipatinginhands-onactivities.Demonstrationsandrole-playingworkwellwiththeselearners.Patientswhoarevisuallearnerslearnbestfrompicturesanddiagramsthatexplaininformation.Patientswhopreferauditorylearningaredistractedbypicturesandpreferlisteningtoinformation(e.g.,podcasts).Patientswholearnbestbyreasoninglogicallyandintuitivelylearnbetterifpresentedwithacasestudythatrequirescarefulanalysisanddiscussionwithotherstoarriveatconclusions.DIF:ApplyREF:330OBJ:Identifyappropriatetopicsthataddressapatientshealtheducationneeds.TOP:PlanningMSC:CPNRE:FoundationsofPractice28.Whichstatementsbythenurseindicateagoodunderstandingofpatienteducation/teaching?a.Patienteducationisanessentialcomponentofsafe,patient-centredcare.b.Patienteducationisnoteffectivewithchildren.c.Patientteachingcanincreasehealthcarecosts.d.Patientteachingdoesnotneedtobedocumentedinthechart.ANS:APatienteducationisanessentialcomponentofprovidingsafe,patient-centredcare.Itisimportanttodocumentevidenceofsuccessfulpatienteducationinpatientsmedicalrecords.Patienteducationiseffectiveforchildren.Differenttechniquesmustbeusedwithchildren.Creatingawell-designed,comprehensiveteachingplanthatfitsapatientsuniquelearningneedsreduceshealthcarecosts,improvesthequalityofcare,andultimatelychangesbehaviourstoimprovepatientoutcomes.DIF:UnderstandREF:324-326|340OBJ:Identifytheroleofthenurseinpatienteducation.TOP:EvaluateMSC:CPNRE:FoundationsofNPUraRctiSceINGTB.COM29.Whichfollowingsituationwouldcausethenursetopostponeateachingsession?a.Thepatientismildlyanxious.b.Thepatientisaskingquestions.c.Thepatientisafebrile.d.Thepatientisinthebargainingphase.ANS:DWhenpatientsenterthestageofbargaining,theyarestillunreadytolearn,andtheteachingsessionshouldbepostponed.Thenurseshouldpostponeteachingwhenanillnessbecomesaggravatedbycomplicationssuchasahighfeverorrespiratorydifficulty;however,ifapatientisafebrile,thisshouldnotaffectlearning.Amildlevelofanxietymotivateslearning.Whenpatientsarereadytolearn,theyfrequentlyaskquestions.DIF:ApplyREF:338|339OBJ:Includepatientteachingwhileperformingroutinenursingcare.TOP:ImplementationMSC:CPNRE:FoundationsofPracticeCanadianFundamentalsofNursing7thEditionPotterTestBankChapter21:DevelopmentalTheoriesPotteretal:CanadianFundamentalsofNursing,7thEditionMULTIPLECHOICE1.Achildisassessedasbeingextremelyactive,requiringahighlystructuredenvironment,andirregularinherhabits.AccordingtoChessandThomas(1995),anaccurateinterpretationofthechildscategoryoftemperamentiswhichofthefollowing?a.Easychild.b.Difficultchild.c.Hyperactivechild.d.Slow-to-warmupchild.ANS:BAccordingtoChessandThomas,difficultchildwouldaccuratelydescribethischildsbehaviour.Theeasychildiseven-tempered,regular,andpredictable.ThetemperamentcategoryhyperactivechilddoesnotexistwithinChessandThomasscommonbehaviourcategories.Theslow-to-warmupchildtypicallyreactsnegativelyandwithmildintensitytonewstimuli.DIF:AnalyzeREF:346OBJ:Discussfactorsinfluencinggrowthanddevelopment.TOP:AssessmentMSC:CPNRE:FoundationsofPractice2.Thenursinginstructorneedstoprovidefurtherinstructiontothestudentwhomakeswhichstatement?NRIGB.CMa.IntellectualdevelopmentiUsafSfectNedbTycogniOtiveprocesses.b.Socioemotionalprocessescaninfluenceanindividualsgrowthanddevelopment.c.Breastdevelopmentisanexampleofachangeresultingfrombiologicalprocesses.d.Anindividualsbiologicalprocessesdeterminephysicalcharacteristicsanddonotaffectgrowthanddevelopment.ANS:DHumangrowthanddevelopmentarenowseenasprocessesinwhichsociocultural,biological,andpsychologicalforcesinteractwiththeindividualovertime.Cognitiveprocessescomprisechangesinintelligence,useoflanguage,anddevelopmentofthinking.Socioemotionalprocessesconsistofvariationsinpersonality,emotions,andrelationshipswithothers.Heightandweight,developmentofgrossandfinemotorskills,andsexualmaturationresultingfromhormonalchangesduringpubertyareexamplesofchangesresultingfrombiologicalprocesses.DIF:UnderstandREF:344OBJ:Discussfactorsinfluencinggrowthanddevelopment.TOP:AssessmentMSC:CPNRE:FoundationsofPractice3.Whichofthesestatementswouldbemostappropriateforanursetostatewhenassessinganadultpatientforgrowthanddevelopmentaldelays?a.Howmanytimesperweekdoyouexercise?CanadianFundamentalsofNursing7thEditionPotterTestBankb.Areyouabletostandononefootfor5seconds?c.Wouldyoupleasedescribeyourusualactivitiesduringtheday?d.Howmanyhoursadaydoyouspendwatchingtelevisionorsittinginfrontofacomputer?ANS:CUnderstandingnormalgrowthanddevelopmenthelpsnursespredict,prevent,anddetectdeviationsfrompatientsownexpectedpatterns.Thenursecanthencompareexpectedpatternsofactivityonthebasisofagewiththepatientsstatedactivitypatternstodeterminedeviationsfromthepatientsownexpectedpatterns.Askingthepatienttodescribehisorherusualdailyactivitieswillelicitusefulinformationaboutthepatientsownexpectedpatterns.Howmanyhoursarespentwatchingtelevisionorinfrontofacomputerandhowmanytimesthepatientexercisesinaweekareclosed-endedquestions.Thesequestionswouldnotprovidethenursewithasmuchinformationaboutthepatientsexpectedpatternswhenhisorherstatedpatternsarecomparedwithexpectedpatternsforthepatientsagegrouptodetectdelays.DIF:ApplyREF:343OBJ:Discussfactorsinfluencinggrowthanddevelopment.TOP:AssessmentMSC:CPNRE:FoundationsofPractice4.Whichofthefollowingisapriorityreasonforbeingknowledgeableaboutbiophysicaldevelopmentaltheories?a.Understandinghowthephysicalbodygrows.b.Predictingdefinitepatternsofcognitivedevelopment.c.Anticipatinghowpatientssocialbehavioursdevelop.d.DescribingtheprocessofNpsyRchoIlogGicalBd.evCelopMment.ANS:AUSNTOBiophysicaldevelopmentconcernshowpeoplesphysicalbodiesgrowandchange.Nursesandotherhealthcareprovidersareabletoquantifythechangesthatoccurasanewborngrowsintoadulthoodandcomparethemwithestablishednormstodetectabnormalities.Biophysicaldevelopmentisconcernedwithphysicalgrowth,notcognitivedevelopment,socialbehaviours,orpsychologicaldevelopment.DIF:KnowledgeREF:344|345OBJ:Nameanddescribethemajordevelopmentaltheoriesassociatedwitheachtradition.TOP:AssessmentMSC:CPNRE:FoundationsofPractice5.Whileassessingan18-month-oldtoddler,thenursedistinguishesnormalfromabnormalfindingsbyrememberingthatGesellstheoryofdevelopmentaccountsforwhichofthefollowingstatements?a.Thedevelopmentalstageofthetoddlerisaffectedsolelybyenvironmentalinfluence.b.Developmentalpatternsarenotaffectedbygeneactivity.c.Skilldevelopmentshouldbeidenticaltothatofothertoddlersintheplayroom.d.Environmentalinfluencedoesnotaffectthesequenceofdevelopment.ANS:DCanadianFundamentalsofNursing7thEditionPotterTestBankUSNTOAccordingtoGesellstheoryofdevelopment,environmentplaysapartinchilddevelopment,butitdoesnothaveanypartinthesequenceofdevelopment.Otherfactorsinfluencinggrowthanddevelopmentincludebiological,cognitive,andsocioemotionalprocesses.Environmentalfactorssupport,change,andmodifythepatternofdevelopment,buttheydonotgenerateprogressionsofdevelopment.Eachchildspatternofgrowthanddevelopmentisuniqueandisdirectedbygeneactivity.Noteverychilddevelopscertainskillsatthesametime.Childrengrowaccordingtotheirowngeneticblueprint.DIF:UnderstandREF:345|346OBJ:Nameanddescribethemajordevelopmentaltheoriesassociatedwitheachtradition.TOP:AssessmentMSC:CPNRE:FoundationsofPractice6.WhichstatementisinaccordancewithFreudspsychoanalytical/psychosocialtheory?a.Adultpersonalityistheresultofresolvedconflictsbetweensourcesofsexualpleasureandthemandatesofreality.b.Developmentoccursthroughoutthelifespanandfocusesonpsychosocialstages.c.Thegenitalstageprecedesthephallicstageofdevelopment.d.Problemsevidentinadultlifeareduetoearlysuccessesandresolutionofearlierdevelopmentalstages.ANS:AFreudbelievedthatadultpersonalityistheresultofhowanindividualresolvedconflictsbetweensourcesofsexualpleasureandthemandatesofreality.FreudhadastronginfluenceonErikErikson,butEriksonstheorydifferedfromFreudsinthatitfocusedonpsychosocialstagesratherthanpsychosexualstages.Freudsfivestagesofpsychoanalyticaldevelopmentare,insequentialorder,oral,anal,phallic,latency,andgenital.Thephallicstageprecedesthegenitalstage.Intheory,probNlemRsinIaduGltliBfe.wCoulMdbeduetounresolvedconflictsandfailures.DIF:KnowledgeREF:349|350OBJ:Nameanddescribethemajordevelopmentaltheoriesassociatedwitheachtradition.TOP:AssessmentMSC:CPNRE:FoundationsofPractice7.Thenurseisteachingayoungadultcoupleaboutpromotingthehealthoftheir8-year-oldchild.ThenurseknowsthattheparentsunderstandthedevelopmentalstagetheirchildisinaccordingtoEriksonwhentheystatewhichofthefollowing?a.Weshouldprovidepropersupportforlearningnewskills.b.Weshouldencouragedevotedrelationshipswithothers.c.Weshouldlimitchoicesandprovideharshpunishmentformistakes.d.Weshouldnotleaveourchildatschoolforlongerthan3hoursatatime.ANS:AAn8-year-childwouldbeintheindustryversusinferioritystageofdevelopment.Duringthisstage,thechildneedstobepraisedforaccomplishmentssuchaslearningnewskills.Developingdevotedrelationshipsispartoftheidentityversusroleconfusionstage,usuallyoccurringduringpuberty.Duringtheautonomyversusshameanddoubtstage,limitingchoicesandharshpunishmentleadtofeelingsofshameanddoubt.Separationanxietyisusuallyapartofthetrustversusmistruststage.DIF:UnderstandREF:350-352OBJ:Nameanddescribethemajordevelopmentaltheoriesassociatedwitheachtradition.CanadianFundamentalsofNursing7thEditionPotterTestBankUSNTTOP:EvaluateMSC:CPNRE:FoundationsofPractice8.JeanPiagetscognitivedevelopmentaltheoryfocusesonfourstagesofdevelopment,includingwhichofthefollowing?a.Formaloperations.b.Intimacyversusisolation.c.Latency.d.Thepostconventionallevel.ANS:AJeanPiagetstheoryincludesfourstagesinsequentialorder:sensorimotor,preoperational,concreteoperations,andformaloperations.IntimacyversusisolationispartofErikEriksonspsychosocialtheoryofdevelopment.Latencyisstage4ofFreudsfive-stagepsychosexualtheoryofdevelopment.ThepostconventionallevelofreasoningispartofKohlbergstheoryofmoraldevelopment.DIF:KnowledgeREF:347,Table21-2OBJ:Nameanddescribethemajordevelopmentaltheoriesassociatedwitheachtradition.TOP:AssessmentMSC:CPNRE:FoundationsofPractice9.AccordingtoPiagetsformaloperationslevel,whatisa13-year-oldlikelytodo?a.Hitotherstudentstodealwithenvironmentalchange.b.Useplaytounderstandhersurroundings.c.Questionherparentsaboutanupcomingpresidentialelection.d.Questionwheretheiceishidingwhenicehasmeltedinherdrink.ANS:CIntheformaloperationsperioNd,aRdolIesceGntsBa.ndCyoMungadultsbegintothinkaboutsuchsubjectsasachievingworldpeace,findingjustice,andseekingmeaninginlife.Askingaboutapresidentialelectiondemonstratesthattheadolescentisconcernedaboutpoliticalissuesthataffectothersbesidesher.Hittingwouldbeacommonschemaduringthesensorimotorstageofdevelopment.Usingplaytolearnabouttheenvironmentisindicativeofthepreoperationalstage.Duringtheconcreteoperationsstage(ages6to12years),childrenareabletocoordinatetwoconcreteperspectivesinsocialandscientificthinking,suchasunderstandingthedifferencebetweenhidingandmelting.DIF:UnderstandREF:347,Table21-2OBJ:Nameanddescribethemajordevelopmentaltheoriesassociatedwitheachtradition.TOP:AssessmentMSC:CPNRE:FoundationsofPractice10.AccordingtoPiagetstheoryofcognitivedevelopment,thenurseshouldallowahospitalized4-year-oldpatienttosafelyplaywithwhichitem?a.Thepumpadministeringintravenousfluids.b.Thebloodpressurecuff.c.Abaseballbat.d.Abooktoreadaloneinaquietplace.ANS:BCanadianFundamentalsofNursing7thEditionPotterTestBankNRIGB.CA4-year-oldchildwouldbeinthepreoperationalperiod.Childrenatthisstagearestillegocentric.Playisveryimportantforfosteringcognitivedevelopment.Childrenshouldbeallowedtoplaywithanyequipmentthatissafe,suchasabloodpressurecuff,andshouldbeallowedtocommunicatefeelingsabouttheirhealthcare.Theintravenouspumpisnotasafepieceofequipmentfora4-year-oldchildtoplaywith.Abaseballbatisnottypicallyfoundinahospitalsettingandisapotentiallydangeroustoytoplaywithinthehospital.A4-year-oldchildisofpreschoolageandmaynotbeabletoreadyet.Also,thebookdoesnotallowforanyhumaninteractionandcommunicationifitisreadalone.DIF:ApplyREF:347,Table21-2OBJ:Nameanddescribethemajordevelopmentaltheoriesassociatedwitheachtradition.TOP:PlanningMSC:CPNRE:FoundationsofPractice11.Whichofthesemanifestations,ifidentifiedina6-year-oldpatient,shouldthenurseassociatewithapossibledevelopmentaldelayaccordingtoPiagetstheory?a.Thechildspeaksincompletesentencesbutoftentalksonlyabouthimself.b.Thechildstillplayswithafavouritedollthathehashadsincehewasatoddler.c.Thechildcontinuestosuckhisthumb.d.Thechilddescribesaneventfromhisownperspective,eventhoughtheentirefamilywaspresent.ANS:CThumbsuckingisacharacteristicofthesensorimotorstage(birthto2years),inwhichschemasbecomeself-initiatedactivities.Forexample,theinfantwholearnsthatsuckingachievesapleasingresultgeneralizestheactiontosuckfingers,blanket,orclothing.Successfulachievementleadstogreaterexploration.Byage6,thechildisinthepreoperationalstageofdevelopment.Thechildisexpectedtobeegocentric,eventhoughlanguageabilityisprogressingU.PlaSybNecomTesaprOimarymeansbywhichchildrenfostertheircognitivedevelopment;therefore,playingwithadollisconsiderednormalatthisage.Childrenseeobjectsandpersonsfromonlyonepointofviewtheirownatthisstage.DIF:AnalyzeREF:347,Table21-2OBJ:Nameanddescribethemajordevelopmentaltheoriesassociatedwitheachtradition.TOP:AssessmentMSC:CPNRE:FoundationsofPractice12.An18-month-oldpatientisbroughtintotheclinicforevaluationbecausethemotherisconcerned.The18-month-oldchildhitshersiblingsandsaysonlyNowhencommunicatingverbally.AccordingtoPiagetstheory,whatrecommendationshouldthenursemakeapriority?a.Consultthesocialworkerbecausethechildishittingotherchildren.b.Reassurethemotherthatthechildisdevelopmentallywithinspecifiednorms.c.Encouragethemothertoseekpsychologicalcounsellingforthechild.d.Removealltoysfromthechildsroomuntilthisbehaviourceases.ANS:BCanadianFundamentalsofNursing7thEditionPotterTestBankAt18months,thechildisinthesensorimotorperiodofdevelopment.Piagetdescribedhitting,looking,grasping,andkickingasnormalschemastodealwiththeenvironment.Thesocialworkerdoesnotneedtobeconsultedinthiscase,andpsychologicalcounsellingisnotwarranted,becausethechildisexhibitingnormalbehaviours.Playisanimportantpartofallchildrensdevelopment.Removingthetoysisnotnecessarybecausethischildisexhibitingnormalbehaviours;removingtoysandtheopportunitytoplaywiththemmayactuallyhinderthechildsdevelopment.DIF:EvaluateREF:347,Table21-2OBJ:Nameanddescribethemajordevelopmentaltheoriesassociatedwitheachtradition.TOP:ImplementationMSC:CPNRE:FoundationsofPractice13.Anursingstudentoverhearsa72-year-oldpatientreflectingonwhetherhisorherlifewasmeaningful.ThenursingstudentacknowledgesthatthepatientisinwhichstageofEriksonseightstagesoflife?a.Initiativeversusguilt.b.Industryversusinferiority.c.Integrityversusdespair.d.Intimacyversusisolation.ANS:CDuringtheintegrityversusdespairstage(65yearsandolder),olderpersonsreflectontheirlifeandfeelsatisfactionordisappointment.ThequestionansweredduringthisstageisHasmylifebeenworthwhile?Theolderpersonreflectingonhisorherlifeisnotintheinitiativeversusguiltstage,theindustryversusinferioritystage,ortheintimacyversusisolationstage.DIF:ApplyREF:351,Table21-5OBJ:NameanddescribethemNaUjoRrdSeIveNloGpmTeBnt.alCthOeoMriesassociatedwitheachtradition.TOP:PlanningMSC:CPNRE:FoundationsofPractice14.Theparentsofa14-year-oldboyexpressconcernovertheirchildsrebelliousbehaviour.Thenurseshouldplantorespondtotheparentsconcernbyinformingthemofwhichofthefollowing?a.Theirchildshouldbereferredtoajuvenilecorrectionalfacility.b.Theirchildsbehaviourisnormalbecausetheadolescentistryingtoadjusttohisemergingidentity.c.Theirchildsbehaviourisamatterofconcernbecauseheisprobablyconflictedaboutestablishingcompanionshipwithapartner.d.Theirchildsbehaviourisexpectedbecauseheisexpressinghisneedtosupportfuturegenerations.ANS:BAccordingtoErikson,a14-year-oldadolescentisdevelopinghisidentityinrelationtoroleconfusion.Ateenagerisveryconcernedwithselfandisoftenpreoccupiedwithbodyimage.Frequently,teenagersexpressthemselvesrebelliouslyastheystruggletodiscovertheirownidentities.Rebelliousbehaviourisverycommonandnormalatthisstageofdevelopment.Ajuvenilecorrectionalfacilityusuallyisnotnecessary.Establishingcompanionshipoccursduringtheyoungadultperiod.Feelingtheneedtosupportfuturegenerationsisusuallyexperiencedbymiddle-agedadults.DIF:ApplyREF:351,Table21-5CanadianFundamentalsofNursing7thEditionPotterTestBankOBJ:Nameanddescribethemajordevelopmentaltheoriesassociatedwitheachtradition.TOP:PlanningMSC:CPNRE:FoundationsofPractice15.Theteachingplanfora3-year-oldchildwhoisatriskfordevelopmentaldelayshouldincludewhichoftheseinstructionsfortheparents?a.Encourageplayasyourchildisexploringhisorhersurroundings.b.Insistthatyourchilddiscussvariouspointsofview,notjusthisorherown.c.Discussworldeventswithyourchildtofosterlanguagedevelopment.d.Activelyencourageyourchildtoreadlengthybookstoexpeditereadingandwritingabilities.ANS:AA3-year-oldchildusesplaytolearnanddiscoverthesurroundingenvironment.Childrenatthisageareegocentricandoftenareunabletoseetheworldfromanyperspectiveotherthantheirown.Veryyoungchildrenarenotabletounderstandandcommentonworldeventsbecausetheirthinkinghasnotadvancedtoabstractreasoningyet.A3-year-oldchildisprobablyunabletoread.Askingachildtoperformanactivitythatisbeyondhisorherdevelopmentalabilitieswillprobablyresultinfrustrationatnotbeingabletocompletethetask.DIF:PlanREF:347,Table21-2OBJ:Nameanddescribethemajordevelopmentaltheoriesassociatedwitheachtradition.TOP:ApplicationMSC:CPNRE:FoundationsofPractice16.Anurseshouldinstructtheparentsofa10-year-oldchildtokeepwhichofthefollowingtheoreticalprinciplesinmindwhendealingwithabehaviouralproblemathome?a.Strategiesthatworkedwellwiththefirstchildwillbeequallyaseffectiveforthesecondchild.NURSINGTB.COMb.Encouragethechildtovolunteersometimeatalocalhospitaltoinstillasenseoffulfillment.c.Bargainingaboutchoresinexchangeforprivilegesmaybeaneffectivemethodofencouraginghelpfulactivities.d.Donotofferpraiseforaccomplishmentsandpunishmentforbehaviouralissues.ANS:CIntheconcreteoperationsperiod,childrenbegintocooperateandsharenewinformationabouttheactstheyperform.Parentscanadjusttheirapproachestoguidethechildintohelpfulactivitieswithinthehome,suchasbargainingaboutchoresinexchangeforprivileges.Withthebirthofasecondchild,mostparentsfindthatthestrategiesthatworkedwellwiththefirstchildnolongerworkatall.Afterbirth,childrengrowaccordingtotheirgeneticblueprintandgainskillsinanorderlymanner,butateachindividualsownpace.Theneedforasenseoffulfillmentisusuallyexperiencedbymiddle-agedadults,notchildren.School-agedchildrenneedpraisetodiscourageasenseofinferiority;providingpraiseisthebestchoiceforencouragingpositivebehaviourswhilegrowthanddevelopmentarenurtured.DIF:UnderstandREF:347,Table21-2OBJ:Discussnursingimplicationsassociatedwiththeapplicationofdevelopmentalprinciplestopatientcare.TOP:ImplementationMSC:CPNRE:FoundationsofPracticeCanadianFundamentalsofNursing7thEditionPotterTestBankNRIGB.CM17.Theparentsofa15-month-oldchildexpressconcerntothenurseabouttheirchildsthumb-suckinghabit.Whichoftheseexplanationsrelatedtothechildsageanddevelopmentallevelwouldbemostappropriateforthenursetogivetheparents?a.Thumbsuckingatthisageindicatesadevelopmentaldelayandshouldbefurtherassessed.b.Suckingachievesapleasingresultforinfants,andgeneralizingthatactionbythumbsuckingisnormal.c.Thumbsuckingatthisagedemonstratesatransitionawayfromegocentricthinking.d.Atthisage,thumbsuckingwillenhancelanguagedevelopment.ANS:BActionpatternsareusedbyinfantsandtoddlerstodealwiththeenvironment.Forexample,theinfantwholearnsthatsuckingachievesapleasingresultgeneralizesthatactiontosuckfingers,blankets,orclothing.Childrenremainegocentricintothepreoperationalperiod.Thumbsuckingdoesnotindicatetransitionawayfromegocentricthinking.Nostatementshavesupportedthumbsuckingasenhancinglanguagedevelopment.DIF:ApplyREF:347,Table21-2OBJ:Discussnursingimplicationsassociatedwiththeapplicationofdevelopmentalprinciplestopatientcare.TOP:ImplementationMSC:CPNRE:FoundationsofPractice18.Whichoftheseapproacheswouldbemostappropriateforthenursetousewhenteachinga4-year-oldpatientaboutascheduledsurgery?a.Givetheparentsabooktoreadabouttheprocedureanddonotdiscusstheprocedurewiththechildtodecreaseanxiety.b.SetboundariesbeforeteachUingSbyNtelliTngthecOhildthatshecanaskonlythreequestionsbecausetimeislimited.c.Insistthattheparentswaitoutsidetheroomtoensureprivacyofthechild.d.Allowthechildtotouchandholdmedicalequipmentsuchasthermometersandemptysyringes.ANS:DNursinginterventionsduringthepreoperationalperiod(age2to7years)shouldrecognizetheuseofplay(suchashandlingequipment)tohelpthechildunderstandtheeventstakingplace.Givingtheparentsabookandnotinvolvingthechildisnotthebestoption,becausethenurseshouldexplainallprocedurestochildrenandtheirparents.Childrentendtoaskalotofquestions;therefore,limitingquestionsmayincreaseanxiety.Parentsandthechildallshouldbeinvolvedinpreoperativeteachingbecausetheparentswillbetheprimarycaregiversupondischarge.DIF:ApplyREF:347,Table21-2OBJ:Discussnursingimplicationsassociatedwiththeapplicationofdevelopmentalprinciplestopatientcare.TOP:ImplementationMSC:CPNRE:FoundationsofPractice19.Thenurseisplanningplayroomactivitiesforahospitalized6-year-oldpatient.Theplayroomhaschildrensbooksandbuildingblocks.Whichoneofthefollowingadditionalage-appropriateitemsshouldthenurseensureisavailableforthechild?a.Crayonsandpaper.CanadianFundamentalsofNursing7thEditionPotterTestBankb.500-piecepuzzle.c.Ahockeystick.d.Magazinesandnewspapers.ANS:AAschool-agedchildthrivesonfeelingsofaccomplishment.Drawingpictures,lookingatchildrensbooks,andbuildingblocksareallwaysthatachildthisagecouldplaywhiledevelopingasenseofaccomplishment.A500-piecepuzzlewouldbetoodifficultfora6-year-oldchildtocompletewithoutthepossibilityofgettingfrustrated.Mostmagazinesandnewspaperswouldbewrittenattoohighareadinglevelfora6-year-oldchild.Ahockeysticktypicallyisnotfoundinahospitalsettingandisapotentiallydangeroustoytoplaywithinthehospital.Ifplayitemsofferedtothechildaretoodifficult,thechildmaybecomefrustratedandmayexperienceafeelingofinferiority.DIF:ApplyREF:351OBJ:Discussnursingimplicationsassociatedwiththeapplicationofdevelopmentalprinciplestopatientcare.TOP:PlanningMSC:CPNRE:FoundationsofPracticeNURSINGTB.COMCanadianFundamentalsofNursing7thEditionPotterTestBankChapter22:ConceptionThroughAdolescencePotteretal:CanadianFundamentalsofNursing,7thEditionMULTIPLECHOICE1.Topromoteparent-childattachmentwithahealthynewborn,whatshouldthenursedo?a.Encourageclosephysicalcontactassoonaspossibleafterbirth.b.Donotallowthenewborntoremainwithparentsuntilthesecondhourafterdelivery.c.Neverleavethenewbornalonewiththemotherduringthefirst8hoursafterdelivery.d.Isolatethenewborninthenurseryduringthefirsthourafterdelivery.ANS:AAfterimmediatephysicalevaluationandapplicationofidentificationbracelets,thenursepromotestheparentsandnewbornsneedforclosephysicalcontact.Earlyparent-childinteractionencouragesparent-childattachment.Mosthealthynewbornsareawakeandalertforthefirsthalf-hourafterbirth.Thisisagoodtimeforparent-childinteractiontobegin.Noevidenceinthequestionstemsuggeststhatthebabycannotbeleftalonewiththeparentsduringthefirst8hoursorthatthebabyshouldbeisolatedinthenurseryduringthefirsthour.DIF:KnowledgeREF:362OBJ:Discussphysiologicalandpsychosocialhealthconcernsduringthetransitionofthechildfromintrauterinetoextrauterinelife.TOP:AssessmentMSC:CPNRE:FoundationsofPractice2.ThenurseknowsthatthemoNthUerRoSfIanNeGwTboBrn.uCnOdeMrstandsassociatedhealthriskstoherbabywhenshestateswhichofthefollowing?a.Ineedtomoistentheumbilicalcordeveryhourduringthedayuntilthecordfallsoff.b.Ineedtoremindanyonewhowantstoholdthebabytowashtheirhands.c.Ineedtoleavetheblanketsoffthebabytopreventsmothering.d.Icanthrowawaythebulbsyringenowbecausemybabyisbreathingonherown.ANS:BPreventionofinfectionisamajorconcerninthecareofthenewborn.Goodhandhygienetechniqueisthemostimportantfactorinprotectingthenewbornfrominfection.Theumbilicalstumpshouldbekeptcleananddry.Newbornsaresusceptibletoheatlossandcoldstress.Thenurseshouldplacethenewborndirectlyonthemothersabdomen,andcoverhimorherinwarmblankets,makingsuretokeeptheheadwellcovered,orplacetheinfantunclothedinaninfantwarmerwithatemperatureprobeinplace.Removalofnasopharyngealandoropharyngealsecretionsremainsapriorityofcaretokeeptheairwaypatent.DIF:UnderstandREF:362|363OBJ:Discussphysiologicalandpsychosocialhealthconcernsduringthetransitionofthechildfromintrauterinetoextrauterinelife.TOP:AssessmentMSC:CPNRE:FoundationsofPractice3.Whatisthepriorityassessmentimmediatelyafterandinfantsbirth?CanadianFundamentalsofNursing7thEditionPotterTestBankUSNTa.Assessinfant-parentinteractions.b.Promoteparent-newbornphysicalcontact.c.Opentheinfantsairway.d.Assessgestationalage.ANS:CThemostextremephysiologicalchangeoccurswhenthenewbornleavestheinuteroenvironmentanddevelopsindependentrespiratoryfunctioning.Directnursingcareincludesmaintaininganopenairway,stabilizingandmaintainingthenewbornsbodytemperature,andprotectingthenewbornfrominfection.Afterimmediatephysicalevaluationandapplicationofidentificationbracelets,thenursepromotestheparentsandnewbornsneedforclosephysicalcontact.Afteracomprehensivephysicalassessment,thenurseassessesgestationalageandinteractionsbetweeninfantandparents.DIF:ApplyREF:362|363OBJ:Discussphysiologicalandpsychosocialhealthconcernsduringthetransitionofthechildfromintrauterinetoextrauterinelife.TOP:AssessmentMSC:CPNRE:FoundationsofPractice4.Immediateinterventionisneededwhenthenewbornexhibitswhichofthefollowing?a.Asoft,protuberantabdomen.b.Moulding.c.Lackofreflexes.d.Cyanotichandsandfeet.ANS:CNormalreflexesincludeblinkinginresponsetobrightlights,startlinginresponsetosuddenloudnoises,andsucking,rooNtingR,grIaspiGng,Bya.wCninMg,coughing,sneezing,andhiccupping.Assessmentofthesereflexesisvitalbecausethenewborndependslargelyonreflexesforsurvivalandinresponsetoitsenvironment.Normalphysicalcharacteristicsincludethecontinuedpresenceoflanugoontheskinoftheback;cyanosisofthehandsandfeetforthefirst24hours;andasoft,protuberantabdomen.Moulding,oroverlappingofthesoftskullbones,allowsthefetalheadtoadjusttovariousdiametersofthematernalpelvisandisacommonoccurrencewithvaginalbirths.DIF:ApplyREF:364|365OBJ:Discussphysiologicalandpsychosocialhealthconcernsduringthetransitionofthechildfromintrauterinetoextrauterinelife.TOP:AssessmentMSC:CPNRE:FoundationsofPractice5.Normalphysicalfindingsinahealthynewbornincludewhichofthefollowing?a.Sporadicmotormovements.b.Cyanosisofthefeetandhandsforthefirst48hours.c.Triangle-shapedanteriorfontanel.d.Weightof4800g.ANS:AMovementsinthenewbornaregenerallysporadic,buttheyaresymmetricandinvolveallfourextremities.Cyanosisofthehandsandfeetisnormalforthefirst24hours,not48hours.Theanteriorfontanelisdiamondshaped,andtheposteriorfontanelistriangular;botharefoundbetweentheunfusedbonesoftheskull.Theexpected,normalweightofahealthynewbornisbetween2700and4000g(6to9pounds).CanadianFundamentalsofNursing7thEditionPotterTestBankDIF:KnowledgeREF:364|365OBJ:Describecharacteristicsofphysicalgrowthofthefetusandofthechildfrombirthtoadolescence.TOP:AssessmentMSC:CPNRE:FoundationsofPractice6.Whencomparingphysicalgrowthpatternsbetweenschool-agedchildrenandadolescents,whatdoesthenursenote?a.Physicalgrowthusuallyslowsduringtheadolescentperiod.b.Boysusuallyexceedgirlsinheightandweightbytheendofthemiddle-schoolyears.c.Secondarysexcharacteristicsusuallydevelopduringtheadolescentyears.d.Thedistributionofmuscleandfatremainsconstantduringtheadolescentyears.ANS:CHormonalchangesduringadolescencecontributetothedevelopmentofsecondarysexcharacteristicssuchaspubicandaxillaryhairgrowthandvoicechanges.Physicalgrowthusuallyslowsduringtheschool-agedperiod,andthenagrowthspurtoccursduringadolescence.Girlsusuallyexceedboysinheightandweightbytheendofthemiddleschoolyears.Asheightandweightincreaseduringadolescence,thedistributionofmuscleandfatchanges.DIF:UnderstandREF:381|382|386|387OBJ:Describecharacteristicsofphysicalgrowthofthefetusandofthechildfrombirthtoadolescence.TOP:AssessmentMSC:CPNRE:FoundationsofPractice7.Whichofthefollowingischaracteristicofthecognitivechangesinapreschooler?a.Theabilitytothinkinalogicalmanneraboutthehereandnow.b.TheabilitytothinkabstraNcUtlyRaSnIdNdeGalTeBff.ecCtiOveMlywithhypotheticalproblems.c.Theinabilitytoassumetheviewofanotherpersonandtousesymbolstorepresentothers.d.Theabilitytoclassifyobjectsbysizeorcolour.ANS:DPreschoolersdemonstratetheirabilitytothinkmorecomplexlybyclassifyingobjectsaccordingtosizeorcolour.Cognitivechangesthatprovidetheabilitytothinkinalogicalmanneraboutthehereandnowandtounderstandtherelationshipsbetweenthingsandideasoccurduringtheschool-ageyears.Itisduringtheteenageyearswhentheindividualthinksabstractlyanddealseffectivelywithhypotheticalproblems.Thepreschoolerisunabletoassumetheviewofanotherperson.DIF:KnowledgeREF:377OBJ:Describecognitiveandpsychosocialdevelopmentfrombirthtoadolescence.TOP:AssessmentMSC:CPNRE:FoundationsofPractice8.Thenursinginstructorwillneedtoprovidefurtherinstructiontothestudentwhouseswhichofthesestatementswhendescribingthedifferencesbetweencognitiveandpsychosocialdevelopmentinchildren?a.Thepreschoolerdevelopstheabilitytoplayinsmallgroups.b.Thetoddlermayparticipateinparallelplay.c.Theschool-agedchildstillrequirestotalassistanceinallactivitiesforsafety.d.ThetoddlerperiodisatimeofpotentialfrustrationmanifestedbytemperCanadianFundamentalsofNursing7thEditionPotterTestBanktantrums.ANS:CThecareprovidershouldpromoteindependencewithinsafelimitsfortheschool-agedchild.School-agedchildren,accordingtoErikson,areintheindustryversusinferioritystageofdevelopment.School-agedchildrenliketoperformtasksbythemselveswhenpossibleandneedtobepraisedforthosetasks.Childrencontinuetoengageinsolitaryplayduringtoddlerhoodbutalsobegintoparticipateinparallelplay,whichisplayingbesideratherthanwithanotherchild.Toddlersstrongwillisfrequentlyexhibitedinnegativebehaviourwhencaregiversattempttodirecttheiractions.Tempertantrumsresultwhenparentalrestrictionsfrustratetoddlers.DIF:UnderstandREF:383OBJ:Describecognitiveandpsychosocialdevelopmentfrombirthtoadolescence.TOP:AssessmentMSC:CPNRE:FoundationsofPractice9.Thenurseisobservinghis2-year-oldhospitalizedpatientintheplayroom.Whatisthenursemostlikelytoobservethechilddoing?a.Participatingastheleaderofasmallgroupactivity.b.Sittingbesideanotherchildwhileplayingwithblocks.c.Separatingbuildingblocksintogroupsbysizeandcolour.d.Seekingoutsame-sexchildrentoplaywith.ANS:BThechildbesideanotherchildandplayingisexhibitingparallelplay,characteristicofatoddler.Participatingasagroupleaderdoesnotusuallyoccuruntilapproximatelyage5.Preschoolers(ages3to5)demonstratetheirabilitytothinkmorecomplexlybyclassifyingobjectsaccordingtosizeorcNolUouRrS.AI2N-GyeTarB-o.ldCchMilddoesnothavethisabilityyet.Theplayofpreschoolchildrenbecomesmoresocialafterthethirdbirthdayasitshiftsfromparalleltoassociativeplay.However,genderdoesnotbecomeafactoruntilthechildreachesschoolage,whenheorshepreferssame-sexpeerstoopposite-sexpeers.DIF:ApplyREF:375OBJ:Describecognitiveandpsychosocialdevelopmentfrombirthtoadolescence.TOP:AssessmentMSC:CPNRE:FoundationsofPractice10.Apatientinhersecondtrimesterofpregnancycomestotheprenatalclinicforacheckup.Whatisthemostimportantforthenursetoassessincaringforawomanatthisstageofpregnancy?a.Detectionoffetalmovement.b.Observationthattheuterusisbelowthesymphysispubis.c.Confirmationofthedesiretobreastfeedorbottle-feed.d.Determinationofthepresenceofmorningsickness.ANS:ADuringthesecondtrimester,between16and20weeksgestation,theprospectivemotherbeginstofeelfetalmovement.Duringthesecondtrimester,theuterusshouldbeabovethelevelofthesymphysispubis.Thedesiretobreastfeedorbottle-feedismorelikelytobeconfirmedduringthethirdtrimester.Morningsicknessismostlikelytooccurduringthefirsttrimester.DIF:ApplyREF:362CanadianFundamentalsofNursing7thEditionPotterTestBankOBJ:Discussphysiologicalandpsychosocialhealthconcernsduringthetransitionofthechildfromintrauterinetoextrauterinelife.TOP:AssessmentMSC:CPNRE:FoundationsofPractice11.Duringinfant/childdevelopment,playisbestrecognizedaswhichofthefollowing?a.Ameanstointeractwiththeenvironmentandrelatetoothers.b.Independentofcognitiveandsocialdevelopment.c.Nonexploratoryandsimplyplay.d.Toosoontoachievemilestones.ANS:ADuringinfancy,playisameaningfulsetofactivitiesthroughwhichthechildinteractswiththeenvironmentandrelatestoothers.Playprovidesopportunitiesfordevelopmentofcognitive,social,andmotorskills.Muchofinfantplayisexploratoryasinfantsusetheirsensestoobserveandexaminetheirownbodiesandobjectsofinterestintheirsurroundings.Adultsfacilitateinfantlearningbyplanningactivitiesthatpromotethedevelopmentofmilestonesandbyprovidingtoysthataresafefortheinfanttoexplorewiththemouthandmanipulatewiththehands.DIF:KnowledgeREF:367OBJ:Explaintheroleofplayinthedevelopmentofachild.TOP:AssessmentMSC:CPNRE:FoundationsofPractice12.Whichstatementbythenursebestexplainstheimportanceofplayduringthetoddlerstageofdevelopment?a.Explorationcansuppressthetoddlerscuriositytopromotesafety.b.Parentalcontrolduringplaywilleliminatethefrustrationoflearningself-control.NURSINGTB.COMc.Playcanenhancecognitiveandpsychosocialdevelopment.d.Playwillenhancethetoddlersabilitytoexploretheenvironmentsafelywithoutsupervision.ANS:CPlaycanenhancecognitiveandpsychosocialdevelopment.Thetoddlerscuriosityisevidentinhisorherexplorationoftheenvironment.Childrenstriveforindependence.Theirstrongwillsarefrequentlyexhibitedinnegativebehaviourwhencaregiversattempttodirecttheiractions.Tempertantrumsresultwhenparentalrestrictionsfrustratetoddlers.Parentsneedtoprovidetoddlerswithgradedindependence,allowingthemtodothingsthatdonotresultinharmtothemselvesorothers.DIF:UnderstandREF:375OBJ:Explaintheroleofplayinthedevelopmentofachild.TOP:AssessmentMSC:CPNRE:FoundationsofPractice13.Aftercomparingappropriateplayactivitiesforinfantsandpreschoolchildren,thenurseshouldofferwhichofthefollowingactivitiestoaninfant?a.Setofcardstoorganizeandseparateintogroups.b.Setofplasticstackingrings.c.Paperbackbook.d.Setofsockpuppetswithmovableeyes.ANS:BCanadianFundamentalsofNursing7thEditionPotterTestBankPlaybecomesmanipulativeasthechildlearnscontrolofthehands.Adultsfacilitateinfantlearningbyplanningactivitiesthatpromotethedevelopmentofmilestones,andbyprovidingtoysthataresafefortheinfanttoexplorewiththemouthandmanipulatewiththehands,suchasrattles,woodenblocks,plasticstackingrings,squeezablestuffedanimals,andbusyboxes.Preschoolersdemonstratetheirabilitytothinkmorecomplexlybyclassifyingobjectsaccordingtosizeorcolour,andthusthecardsaremoreappropriateforthem.Neithergroupisreadyforpaperbackbooks.Thesockpuppetwithmovableeyescouldcreateachokinghazardifoneoftheeyescomesoff.DIF:UnderstandREF:367OBJ:Explaintheroleofplayinthedevelopmentofachild.TOP:ImplementationMSC:CPNRE:FoundationsofPractice14.Amotherexpressesconcernbecauseher5-year-oldchildfrequentlytalksaboutfriendswhodontexist.Whatisthenursesbestresponsetothismothersconcern?a.Haveyouconsideredachildpsychologicalevaluation?b.Itsverynormalfora5-year-oldchildtohaveimaginaryplaymates.c.Youshouldstopyourchildfromplayingelectronicgames.d.Pretendplayisasignyourchildwatchestoomuchtelevision.ANS:BAtage5,somechildrenhaveimaginaryplaymates.Imaginaryplaymatesareasignofhealthandallowthechildtodistinguishbetweenrealityandfantasy.Thechilddoesnotneedapsychologicalevaluationonthebasisofthisinformation.Television,videos,electronicgames,andcomputerprogramshelpsupportdevelopmentandthelearningofbasicskills;however,theseshouldbeonlyonepartofthechildstotalplayactivities.DIF:ApplyREF:37N9URSINGTB.COMOBJ:Explaintheroleofplayinthedevelopmentofachild.TOP:ImplementationMSC:CPNRE:FoundationsofPractice15.Encouragingchildrentoplayagameofkickballwouldbebestsuitedforwhichagegroup?a.Infant.b.Toddler.c.Preschool.d.School-aged.ANS:DAgameofkickballwouldbebestsuitedforschool-agedchildrenbecauseinthisagegroup,playinvolvespeersandthepursuitofgroupgoals.Althoughsolitaryactivitiesarenoteliminated,groupplayovershadowsthem.Youngerchildrentypicallyarenotabletoparticipatecooperativelyingroupsyet.Infantsbegintoplaysimplesocialgamessuchaspatty-cakeandpeek-a-boo.Toddlersengageinsolitaryplaybutalsobegintoparticipateinparallelplay.Preschoolersplayingtogetherengageinsimilarifnotidenticalactivities;however,nodivisionoflabour,rigidorganization,orrulesareobserved.Bytheageof5,thegrouphasatemporaryleaderforeachactivity.DIF:ApplyREF:381|383OBJ:Explaintheroleofplayinthedevelopmentofachild.TOP:ImplementationMSC:CPNRE:FoundationsofPracticeCanadianFundamentalsofNursing7thEditionPotterTestBankNRIGB.C16.Whichofthesemanifestations,ifidentifiedinaschool-agedchildduringaroutineassessment,shouldanurseassociatewithapossibledevelopmentaldelayorproblem?a.Withdrawndemeanourandverbalizesthathehasnofriends.b.Absenceofsecondarysexcharacteristics.c.Lackofpeerrelationships.d.Curiosityabouthisorhersexuality.ANS:ASchool-agedchildrenshouldbegintodevelopfriendshipsandtosocializewithothers.Interactionwithpeersallowsthemtodefinetheirownaccomplishmentsinrelationtoothersastheyworktodevelopapositiveself-image.Theabsenceofsecondarysexcharacteristicsisamajorconcernofadolescents,notschool-agedchildren,becausephysicalevidenceofmaturityencouragesthedevelopmentofadultmasculineandfemininebehavioursintheadolescent.Lackofpeerrelationshipsisalsoaconcernofadolescents,notofschool-agedchildren,becauseadolescentsseekagroupidentitytofulfilltheiresteemandacceptanceneeds.Todaymanyresearchersbelievethatschool-agedchildrenhaveagreatdealofcuriosityabouttheirsexuality.Someexperiment,butthisplayisusuallytransitory.DIF:AnalyzeREF:383|384OBJ:Explaintheroleofplayinthedevelopmentofachild.TOP:AssessmentMSC:CPNRE:FoundationsofPractice17.Thenursewhoisteachingaparentaboutdevelopmentalneedsoftheinfantknowsthattheparentunderstandsaninfantsdevelopmentalneedswhenheorshestateswhichofthefollowing?a.Mychildistooyoungtounderstandwords.b.Mychildwillbegintospeakinsentencesby1yearofage.c.MychildwillprobablyenUjoySplayNingTpeek-aO-boo.d.Whilemychildisinthehospital,Ishouldletthenursesprovidemostofthecare.ANS:CBy9monthsofage,infantsplaysimplesocialgamessuchaspatty-cakeandpeek-a-boo.By1yearofage,notonlydoinfantsrecognizetheirownnamesbutmanyareabletosaythreetofivewordsandunderstandalmost100words.Extendedseparationsfromparentscomplicatetheattachmentprocessandincreasethenumberofcaregiverswithwhomtheymustinteract.Ideally,theparentsprovidemostofthecareduringhospitalizations.DIF:ApplyREF:366|367OBJ:Discusswaysinwhichyoucanhelpparentsmeettheirchildren'sdevelopmentalneeds.TOP:AssessmentMSC:CPNRE:FoundationsofPractice18.Duringhospitalization,whatshouldthenurseencouragetheparentsofan8-month-oldinfanttodo?a.Provideasmuchcareaspossible.b.Notworryaboutattachmentsbecausetheinfantistooyoungtodevelopthem.c.Rememberthatinfantscannotdifferentiateastrangerfromafamiliarperson.d.Relaxandallownursingstafftocareforthechildatalltimes.ANS:ACanadianFundamentalsofNursing7thEditionPotterTestBankNRIGB.CExtendedseparationsfromparentscomplicatetheattachmentprocessandincreasethenumberofcaregiverswithwhomtheinfantmustinteract.Ideally,theparentsprovidemostofthecareduringhospitalizations.Closeattachmenttotheprimarycaregivers,mostoftenparents,isusuallyestablishedbytheageof8months.Infantsseekoutthesepersonsforsupportandcomfortduringtimesofstress.Bythisage,mostinfantsareabletodifferentiateastrangerfromafamiliarpersonandresponddifferentlytothetwo.DIF:ApplyREF:367OBJ:Discusswaysinwhichyoucanhelpparentsmeettheirchildren'sdevelopmentalneeds.TOP:ImplementationMSC:CPNRE:FoundationsofPractice19.Thenursingstudentcorrectlyexplainshealthpromotionteachingpointsforparentsoftoddlerswhenshemakeswhichstatement?a.Settingconsistent,firmlimitswillhelpthechildcopewiththefrustrationoflearningself-control.b.Slowerdevelopmentofmotorskillspreventsthechildfromparticipatinginself-careactivities.c.Toddlershaveanaturalsenseofrightandwrongandknowwhentheydosomethingwrong.d.Tempertantrumsshouldneverbetolerated,andtoddlersneedtodowhattheyaretold.ANS:APatience,support,andfirm,consistentlimitsallowtoddlerstodevelopsociallyacceptablebehavioursandtocopewiththefrustrationoflearningself-control.Rapiddevelopmentofmotorskillsallowsthechildtoparticipateinself-careactivitiessuchasfeeding,dressing,andtoileting.Becausechildrensmoraldevelopmentiscloselyassociatedwiththeircognitiveabilities,moraldevelopmentinUtodSdlerNsisTonlybeOginning.Toddlersdonotunderstandconceptsofrightandwrong.Tempertantrumsresultwhenrestrictionsfrustratetoddlers.Parentsneedtoprovidetoddlerswithgradedindependence,allowingthemtodothingsthatdonotresultinharmtothemselvesorothers.DIF:ApplyREF:372OBJ:Discusswaysinwhichyoucanhelpparentsmeettheirchildren'sdevelopmentalneeds.TOP:ImplementationMSC:CPNRE:FoundationsofPractice20.A5-year-oldboyisadmittedforsurgerytohavehistonsilsremoved.Onthebasisofknowledgeaboutchildrenofthisage,whatwouldthenurseplantodo?a.Allowthechildtotakeresponsibilityforhisownpreoperativehygieniccare.b.Leavethechildalonetorelaxbeforetheprocedure.c.Allowthechildtohandleandlookattheequipmentwhenthenursetakeshisbloodpressure.d.Providemagazinesandpuzzlesfordiversion.ANS:CPreschoolchildrenmaycooperateiftheyareallowedtomanipulatetheequipment.Apreschoolchildisunabletotakeresponsibilityforhisorherownpreoperativehygieniccare.Leavingthepreschooleralonemayincreasethechildsanxiety.Magazinesandpuzzleswouldbemoreappropriateactivitiesfortheolderchild.Thepreschoolchildlikestoengageinpretendplaybyusingtheimaginationandimitatingadultbehaviour.CanadianFundamentalsofNursing7thEditionPotterTestBankDIF:ApplyREF:376-379OBJ:Describecognitiveandpsychosocialdevelopmentfrombirthtoadolescence.TOP:ImplementationMSC:CPNRE:FoundationsofPractice21.Whichofthesestatements,ifmadebyaparent,wouldnecessitatefurtherinstruction?a.Ishouldnotbesurprisedthatmyteenagerhassomanyfriends.b.Igetworriedbecausemyteenagerthinkshesindestructible.Hetakesalotofrisks.c.Ishouldcoverformyschool-agedchildwhenhemakesamistakeuntilhelearnstheropes.d.My10-year-oldchildisalwayshungryrightafterschool,soIusuallyfixhimanutritioussnack.ANS:CSchoolandhomeinfluencegrowthanddevelopment,whichrequiresadjustmentbyparentsandbythechild.Thechildlearnstocopewithrulesandexpectationspresentedbytheschoolandbypeers.Parentshavetolearntoallowtheirchildtomakedecisions,acceptresponsibility,andlearnfromlifesexperiences.Teenagerstypicallyareverysocialandhavemanyfriends.Adolescentsseekagroupidentitybecausetheyneedesteemandacceptance.Bymid-adolescence,childrenbelievethattheyareuniqueandtheexceptiontoallrules,whichgivesrisetotheirrisk-takingbehaviours.Obesityoccursbecausechildrenoftenrushintothehomeafterschoolorplayandeatthemosteasilyobtainableandappealingfoods.Providingnutritioussnacksisoftenthebestwaytoensuregoodnutritionalintake.DIF:AnalyzeREF:380,Table22-5OBJ:Discusswaysinwhichyoucanhelpparentsmeettheirchildren'sdevelopmentalneeds.TOP:ImplementationMSC:CPNRE:FoundationsofPracticeNURSINGTB.COM22.Whichofthesetoys,ifselectedbytheparentofa10-month-oldchild,wouldindicatethattheparenthasacorrectunderstandingofinfantgrowthanddevelopment?a.Agamerequiringtwotofourplayers.b.Electronicgames.c.Small,plasticalphabetlettersandmagnets.d.Plasticstackingrings.ANS:DAdultsfacilitateinfantlearningbyplanningactivitiesthatpromotethedevelopmentofmilestonesandbyprovidingtoysthataresafefortheinfanttoexplorewiththemouthandmanipulatewiththehands,suchasrattles,woodenblocks,plasticstackingrings,squeezablestuffedanimals,andbusyboxes.Infantsarenotcapableofparticipatinginsmallgroupactivities.Byage4,childrenplayingroupsoftwoorthree.Forthetoddler(nottheinfant),television,videos,electronicgames,andcomputerprogramshelpsupportdevelopmentandlearningofbasicskills.Adultsshouldprovidetoysthataresafefortheinfanttoexplorewiththemouth.Small,plasticlettersandmagnetscouldbechokinghazardsforaninfant.DIF:EvaluateREF:367OBJ:Discusswaysinwhichyoucanhelpparentsmeettheirchildren'sdevelopmentalneeds.TOP:ImplementationMSC:CPNRE:FoundationsofPracticeCanadianFundamentalsofNursing7thEditionPotterTestBankNRIGB.CMChapter23:YoungtoMiddleAdulthoodPotteretal:CanadianFundamentalsofNursing,7thEditionMULTIPLECHOICE1.Thenurseisperformingaphysicalexaminationina40-year-oldpatient.Thenursewillprobablyfindthatatthisage,thepatientisexperiencingwhichofthefollowingphysiologicalchangesrelatedtonormalaging?a.Decreasedheartrate.b.Decreasedsenseofsmell.c.Decreasedstrengthofabdominalmuscles.d.Decreasedfunctionofthecranialnerves.ANS:CAphysiologicalchangerelatedtonormalaginginthemiddle-agedadultwouldbedecreasedstrengthofabdominalmuscles.Themiddle-agedadultshouldnothaveadecreasedheartrate,shouldhaveanormalsenseofsmell,andshouldhavenormalfunctioningofthecranialnerves.DIF:ApplyREF:404,Table23-3OBJ:Describenormalphysiologicalchangesinyoungandmiddleadulthood,includingpregnancy.TOP:AssessmentMSC:CPNRE:FoundationsofPractice2.Thenurseiscaringforahospitalizedyoungmanwhoisuninsuredeventhoughheworksasadishwasheratalocalrestaurant.Hestatesthathewouldliketogetabetterjob,buthehasnoeducation.Howcanthenursebestassistthispatientpsychosocially?a.ByprovidinginformationaUndSrefeNrralsT.Ob.Bytellingthepatientthatheneedstogobacktoschool.c.Byfocusingonthepatientsmedicaldiagnoses.d.Byexpectingthepatienttobeflexibleinhisdecisionmaking.ANS:ASupportfromthenurse,accesstoinformation,andappropriatereferralsprovideopportunitiesforachievementofapatientspotential.Manyyoungadultslackthenecessaryresourcesorsupportsystemstofacilitatefurthereducationordevelopmentofskillsnecessaryformanypositionsintheworkplace.Asaresult,someyoungadultshavelimitedoccupationalchoices.Healthisnotmerelytheabsenceofdiseasebutinvolveswellnessinallhumandimensions.Insecurepersonstendtobemorerigidinmakingdecisions.DIF:AnalyzeREF:397|398OBJ:Discussmajorlifeeventsanddevelopmentaltasksofyoungandmiddle-agedadults.TOP:ImplementationMSC:CPNRE:FoundationsofPractice3.Anursingstudentisaskedtocomparemajorlifeeventsofyoungadult,middleadult,andchildbearingfamilies.Whichstatementbythestudentdemonstratesunderstanding?a.Youngadultshavegainedsexualexperienceanddonotneedsexualeducation.b.Onceawomanhasherbaby,stresslevelsdecrease,asdoeshealthrisk.c.Thesocialpressuretogetmarriedisgreaternowthaniteverwas.d.Whenmarriedpeoplebothwork,incomeisincreased,butsoisstress.CanadianFundamentalsofNursing7thEditionPotterTestBankNRIGB.CANS:DThetwo-careerfamilyhasbenefitsandliabilities.Stressorsresultfromtransfertoanewcity;increasedexpendituresofphysical,mental,oremotionalenergy;childcaredemands;andhouseholdneeds.Toavoidstress,partnersshouldshareallresponsibilities.Youngadultsareatriskforsexuallytransmittedinfections;therefore,thereisanincreasedneedforeducationregardingmodeoftransmission,prevention,andsymptomrecognitionandmanagementofsexuallytransmittedinfections.Thestressthatmanywomenexperienceafterchildbirthhasasignificanteffectontheirhealth.Socialpressuretogetmarriedisnotasgreatasitoncewas,andmanyyoungadultsdonotmarryuntiltheirlate20s,early30s,orlaterordonotmarryatall.DIF:UnderstandREF:399OBJ:Discussmajorlifeeventsanddevelopmentaltasksofyoungandmiddle-agedadults.TOP:AssessmentMSC:CPNRE:FoundationsofPractice4.Thenurseknowsthattheyoungadultpatientunderstandsthehealthrisksthataffecthisorheragegroupwhenthepatientmakeswhichstatement?a.Itsprobablysafeformetostartsmoking.Atmyage,theresnotenoughtimeforcancertodevelop.b.IamsurethatIamgoingtogetemphysema.Bothmymotherandmyaunthadit.Itsgenetic.c.Controllingtheamountofstressinmylifemaydecreasetheriskofillness.d.Idontdodrugs.Idodrinkcoffee,butcaffeineisnotadrug.Itisperfectlysafeandhasnosideeffects.ANS:CLifestylehabitsthatactivatethestressresponseincreasetheriskofillness.Smokingisawell-documentedriskfactorfoUrpuSlmoNnarTy,cardiOac,andvasculardisease,notonlyinsmokersbutalsoinindividualswhoareexposedtosecond-handsmoke.Thepresenceofcertainchronicillnessesinthefamilyincreasesthefamilymembersriskfordevelopingadisease.Familyriskisdistinctfromhereditarydisease.Caffeineisadrug;itisanaturallyoccurringlegalstimulantthatisreadilyavailable.Caffeinestimulatescatecholaminerelease,which,inturn,stimulatesthecentralnervoussystem;italsoincreasesgastricacidsecretion,heartrate,andbasalmetabolicrate.DIF:UnderstandREF:400|401OBJ:Discussmajorlifeeventsanddevelopmentaltasksofyoungandmiddle-agedadults.TOP:EvaluateMSC:CPNRE:FoundationsofPractice5.Whenchoosinganappropriatetopicforayoungadulthealthfair,thenurserankswhichtopicasleastrelevant?a.Unplannedpregnancies.b.Menopauseandclimactericfactors.c.Smokingcessation.d.Alcoholanddruguse.ANS:BCanadianFundamentalsofNursing7thEditionPotterTestBankTheonsetofmenopauseandtheclimactericaffectthesexualhealthofthemiddle-agedadult,nottheyoungadult.Unplannedpregnanciesareacontinuedsourceofstressthatcanresultinadversehealthoutcomesforthemother(youngadult),infant,andfamily.Smokingisawell-documentedriskfactorforpulmonary,cardiac,andvasculardiseasesinsmokersandinindividualswhoareexposedtosecond-handsmoke,anditconstitutesahealthriskforyoungadults.Substanceabusedirectlyorindirectlycontributestomortalityandmorbidityinyoungadults.DIF:UnderstandREF:401|405OBJ:Discussmajorlifeeventsanddevelopmentaltasksofyoungandmiddle-agedadults.TOP:AssessmentMSC:CPNRE:FoundationsofPractice6.Duringmiddleadulthood,the50-year-oldpatientislikelytoadaptfavourablytoachangingbodyimageifheorshedoeswhat?a.Decreasestheamountofphysicalexercise.b.Eatsadietcomposedof40%fat.c.Getslessthan5hoursofsleeppernight.d.Engagesingoodhygienepractices.ANS:DHighself-esteem,afavourablebodyimage,andapositiveattitudetowardphysiologicalchangesoccurwhenadultsengageinphysicalexercise,balanceddiets,adequatesleep,andgoodhygienepracticesthatpromotevigorandhealth.DIF:KnowledgeREF:404OBJ:Discussmajorlifeeventsanddevelopmentaltasksofyoungandmiddle-agedadults.TOP:AssessmentMSC:CPNRE:FoundationsofPracticeNURSINGTB.COM7.Apatientstatesthatsheispregnant,isconcernedbecauseshedoesnotknowwhattoexpect,andwantsherhusbandtoplayanactivepartinthebirthingprocess.Whatshouldthenursetellthepatient?a.Childbirthclassescanpreparepregnantwomenandtheirpartnersforwhatiscoming.b.Thefrequencyofsexualintercourseiskeytohelpingthehusbandfeelvalued.c.Afterthebirth,thestressofpregnancywilldisappearandwillbereplacedbyrelief.d.Afterthebabyisborn,thewifeshouldaccepttheextraresponsibilitiesofmotherhood.ANS:AChildbirtheducationcanpreparepregnantwomen,theirpartners,andothersupportpersonstoparticipateinthebirthingprocess.Thepsychodynamicaspectofsexualactivityisasimportantasthetypeorfrequencyofsexualintercoursetoyoungadults.Thestressthatmanywomenexperienceafterchildbirthhasasignificanteffectontheirhealth.Toavoidstressinatwo-careerfamily,partnersshouldshareallresponsibilities.DIF:ApplyREF:402-404OBJ:Discussmajorlifeeventsanddevelopmentaltasksofyoungandmiddle-agedadults.TOP:AssessmentMSC:CPNRE:FoundationsofPractice8.WhatdochangingnormsandvaluesaboutfamilylifeinCanadareveal?CanadianFundamentalsofNursing7thEditionPotterTestBankUSNTa.BasicshiftsinattitudesinCanadiansociety.b.Greaterresistancetocohabitationwithoutmarriage.c.Decreasednumbersofinfantsborntounmarriedwomen.d.Greatersupportandacceptancefromthehealthcaresystem.ANS:AChangingnormsandvaluesaboutfamilylifeinCanadarevealbasicshiftsinattitudesinCanadiansociety.Thetrendtowardgreateracceptanceofcohabitationwithoutmarriageisafactorintheincreaseinnumbersofinfantsbeingborntounmarriedwomen.Manyparentsfromfamilystructuresthatdonotconformtothenormfeellackofsupportandevenbiasfromthehealthcaresystem.DIF:KnowledgeREF:399OBJ:Discussthesignificanceoffamilyinthelifeoftheadult.TOP:AssessmentMSC:CPNRE:FoundationsofPractice9.Whendescribingrelevantfamilypsychosocialfactorsinmiddleadulthoodthatcausestress,thenursewouldnotincludewhichofthefollowing?a.Singlehoodandfeelingisolated.b.Choicesstemmingfrommaritalchanges.c.Financialsecurityandcertainty.d.Planningforthefuturewhenchildrenleavehome.ANS:CInthemiddleadultyears,aschildrendepartfromthehousehold,thefamilyentersthepostparentalfamilystage.Timeandfinancialdemandsonparentsdecrease,andthecouplefacesthetaskofredefiningtheirownrelationship.PsychosocialfactorsinvolvingthefamilyincludethestressesofsinglehNoodR,mIaritGalchBa.ngCes,Mtransitionofthefamilyaschildrenleavehome,andthecareofagingparents.DIF:UnderstandREF:405|406OBJ:Discussthesignificanceoffamilyinthelifeoftheadult.TOP:AssessmentMSC:CPNRE:FoundationsofPractice10.Whatshouldthenurserecognizewhencomparingthephysicalchangesinyoungandmiddleadulthood?a.Fertilityissuesdonotoccurinyoungadulthood.b.Youngadultsarequiteactivebutareatriskforillnessinlateryears.c.Youngadultstendtosuffermorefromsevereillness.d.Exerciseislessimportantinyoungadulthoodthaninmiddleadulthood.ANS:BYoungadultsaregenerallyactiveandhaveaminimumofmajorhealthproblems.However,theirlifestylesmayputthematriskforillnessesordisabilitiesduringtheirmiddleorolderyears.Anestimated10%to15%ofreproductivecouplesareinfertile,andmanyareyoungadults.Exerciseinyoungadulthoodisincreasinglyimportanttopreventordecreasethedevelopmentofchronichealthconditionssuchashighbloodpressure,obesity,anddiabetesthatdeveloplaterinlife.DIF:UnderstandREF:404OBJ:Describenormalphysiologicalchangesinyoungandmiddleadulthood,includingpregnancy.TOP:AssessmentMSC:CPNRE:FoundationsofPracticeCanadianFundamentalsofNursing7thEditionPotterTestBank11.Duringaroutinephysicalassessment,thenurseobtainingahealthhistorynotesthata50-year-oldwomanreportspainandrednessintherightbreast.Whatisthenursesbestactioninresponsetothisfinding?a.Explaintothepatientthatbreasttendernessisnormalatherage.b.Tellthepatientthatrednessisnotacauseforconcernandisquitecommon.c.Assessthepatientasthoroughlyaspossible.d.Informherthatrednessistheprecursortonormalunilateralbreastenlargement.ANS:CAcomprehensiveassessmentoffersdirectionforhealthpromotionrecommendations,aswellasforplanningandimplementinganyacutelyneededintervention.Rednessorpaininbreastsandincreasedsizeofonebreastareabnormalphysicalassessmentfindingsinmiddleadulthood.DIF:ApplyREF:401|402OBJ:Describenormalphysiologicalchangesinyoungandmiddleadulthood,includingpregnancy.TOP:AssessmentMSC:CPNRE:FoundationsofPractice12.A55-year-oldwomanpresentstotheoutpatientclinic,describingirregularmenstrualperiodsandhotflashes.Whatshouldthenurseexplain?a.Thosesymptomsarenormalwhenawomanundergoestheclimacteric.b.Anassessmentisnotreallyneededbecausetheseproblemsarenormalforolderwomen.c.Thepatientsageandsymptomspointtowardnormalmenopause.d.Thepatientshouldstopregularexercisebecausethatisprobablycausinghersymptoms.ANS:CNURSINGTB.COMThemostsignificantphysiologicalchangesduringmiddleagearemenopauseinwomenandtheclimactericinmen.Thenurseshouldcontinuewiththeexaminationbecauseacomprehensiveassessmentoffersdirectionforhealthpromotionrecommendations,aswellasforplanningandimplementinganyacutelyneededinterventions.Highself-esteem,afavourablebodyimage,andapositiveattitudetowardphysiologicalchangesoccurwhenadultsengageinphysicalexercise,balanceddiets,adequatesleep,andgoodhygienepracticesthatpromotevigorous,healthybodies.DIF:ApplyREF:405OBJ:Describenormalphysiologicalchangesinyoungandmiddleadulthood,includingpregnancy.TOP:AssessmentMSC:CPNRE:FoundationsofPractice13.Thenurseisteachingaclasstopregnantwomenaboutcommonphysiologicalchangesduringpregnancy.Whichstatementbythenurseaccuratelydescribesthesechanges?a.Pregnancyenhancesyourabilitytocopewithstress.b.Beingnauseatedandfeelingtiredwillnotaffectyourphysicalbodyimage.c.Youandyourpartnermayexperiencefeelingsofuncertaintyaboutassumingtherolesofparents.d.Returninghomeafterdeliverywillrejuvenateyouandfosterindependence.ANS:CCanadianFundamentalsofNursing7thEditionPotterTestBankUSNTOExpectantparentsthinkaboutandhavefeelingsofuncertaintyaboutimpendingrolechanges.Parentsneedreassurancethatchildbirthandchildrearingarenaturalandpositiveexperiencesbutarealsostressful.Parentsoftenareunabletocopewithparticularstressors.Morningsicknessandfatiguecontributetopoorbodyimage.Newmothersoftenreturnhomefromthehospitalfatiguedandunfamiliarwithinfantcare.DIF:UnderstandREF:402-404OBJ:Discusscognitiveandpsychosocialchangesthatoccurduringtheadultyears.TOP:ImplementationMSC:CPNRE:FoundationsofPractice14.Anurseisabouttodiscusstherisksofrepeatedsunexposurewithayoungadultpatient.Whichofthesestatementswouldbemostexpectedfromthispatientbeforethediscussion?a.Illmakeanappointmentwithmydoctorrightawayforafullskincheck.b.Ishouldconsiderparticipatinginahealthfairaboutsafesunpractices.c.Ihaveamolethathasbeenbotheringme.Illcallmyfamilydoctorforanappointmenttogetitchecked.d.Ivehadthismolemywholelife.Sowhatifitchangedcolour?Myskinisfine.ANS:DYoungadultsoftenignorephysicalsymptomsandoftenpostponeseekinghealthcare.Makinganappointmentwiththedoctorandparticipatinginhealthfairsarenottypicalbehavioursofyoungadults.DIF:ApplyREF:398OBJ:Discusscognitiveandpsychosocialchangesthatoccurduringtheadultyears.TOP:ImplementationMSC:CPNRE:FoundationsofPractice15.WhenperformingathoroughNpsyRchoIsocGialaBss.eCssmMentonayoungadult,whatmustthenurserealize?a.Havingajobisthebestwaytorelievestress.b.Althoughpsychologicallydisturbing,stressdoesnotleadtophysicalillness.c.Changeisinevitableandisnotafactorinstress-relatedillness.d.Psychosocialhealthisoftenrelatedtojobandfamilystress.ANS:DThepsychosocialhealthconcernsofyoungadultsareoftenrelatedtojobandfamilystressors.Ifstressisprolongedandthepatientisunabletoadapttothestressor,healthproblemswilldevelop.Jobassessmentalsoincludesconditionsandhours,durationofemployment,changesinsleeporeatinghabits,andevidenceofincreasedirritabilityornervousness.Whenapatientseekshealthcareandpresentsstress-relatedsymptoms,thenurseneedstoassessfortheoccurrenceofalifechangeevent.DIF:ApplyREF:398|399OBJ:Describehealthconcernsofyoungandmiddle-agedadults.TOP:AssessmentMSC:CPNRE:FoundationsofPractice16.A25-year-oldpatientisbroughttothehospitalbypoliceaftercrashinghiscarinahigh-speedchasewhentryingtoavoidarrestforspousalabuse.Whatshouldthenursedo?a.Questionthepatientaboutdruguse.b.Offerthepatientacupofcoffeetocalmhisnerves.c.Beawarethatsubstanceabuseisusuallyobvious.CanadianFundamentalsofNursing7thEditionPotterTestBankUSNTd.Dealwiththeissueathand,andputoffaskingaboutpreviousillnesses.ANS:AReportsofarrestsbecauseofdrivingwhileintoxicated,wifeorchildabuse,ordisorderlyconductarereasonsforthenursetoinvestigatethepossibilityofdrugabusemorecarefully.Caffeineisalegaldrug,naturallyoccurringincoffee,thatstimulatesthecentralnervoussystemandisnotthechoiceforcalmingnerves.Substanceabuseisnotalwaysdiagnosable,particularlyinitsearlystages.Thenursemayobtainimportantinformationbymakingspecificinquiriesaboutpastmedicalproblems,changesinfoodintakeorsleeppatterns,andproblemsofemotionallability.DIF:ApplyREF:401OBJ:Describehealthconcernsofyoungandmiddle-agedadults.TOP:ImplementationMSC:CPNRE:FoundationsofPractice17.A61-year-oldobesepatientreceivesdiagnosesoftype2diabetesandhighbloodpressure.Thepatientstatesthatheisupsetaboutthedietrestrictionsimposedbythetreatmentregimen.Whatisthenursesbestapproach?a.Tellthepatientthathemustdowhatthedoctortellshim.b.Offercounsellingonnutritionandexercise.c.Tellthepatientaboutwhathappenedtootherpatientswhodidnotchangetheirlifestyle.d.Explainthatheneedstoacceptthecareprovidersadvicewithoutquestionifhewantstogetbetter.ANS:BCounsellingrelatedtophysicalactivityandnutritionisanimportantcomponentoftheplanofcareforoverweightandobesNepaRtienIts.TGohBe.lpCtheMpatientsdeveloppositivehealthhabits,thenursebecomesateacherandafacilitator,providinginformationandpositivereinforcement.Ultimately,however,thepatientdecideswhichbehaviourswillbecomehabitsofdailyliving.Scaretacticsdonotusuallywork.Byprovidinginformationabouthowthebodyworksandhowpatientsformandchangehabits,thenurseraisesthepatientslevelofknowledgeregardingthepotentialeffectofbehaviouronhealth.Thenurseshouldencouragepatientstoexpresstheirfeelingstopromoteproblemsolvingandrecognitionofriskfactorsbypatientsthemselves.DIF:ApplyREF:406|407OBJ:Describehealthconcernsofyoungandmiddle-agedadults.TOP:ImplementationMSC:CPNRE:FoundationsofPractice18.Nursesmustbeknowledgeableaboutdevelopmentaltheoriesinordertoprovidecompetentcaretoyoungandmiddle-agedadultpatients.Whichstatementbythestudentnursedemonstratesaneedforfurtherinstructionbythenursinginstructor?a.Thesetheoriesprovidenurseswithabasisforunderstandingthelifeeventsanddevelopmentaltasksofyoungandmiddle-agedadults.b.Itisimportanttounderstandsocietalstructuresandrolesbecausetheyhavenotchangedinthepast20or30years.c.Patientspresentchallengestonurses,manyofwhomarethemselvesyoungormiddle-agedadultscopingwiththedemandsoftheirrespectivedevelopmentalperiod.d.NursesneedtorecognizetheneedsoftheirpatientseveniftheyarenotCanadianFundamentalsofNursing7thEditionPotterTestBankexperiencingthesamechallengesandevents.ANS:BFacedwithasocietalstructurethatdiffersgreatlyfromthenormsof20or30yearsago,bothmenandwomenareassumingdifferentrolesintodayssociety.Developmentaltheoriesprovidenurseswithabasisforunderstandingthelifeeventsanddevelopmentaltasksofyoungandmiddleadults.Patientspresentchallengestonurseswhothemselvesareoftenyoungormiddle-agedadultscopingwiththedemandsoftheirrespectivedevelopmentalperiod.Nursesneedtorecognizetheneedsoftheirpatientseveniftheyarenotexperiencingthesamechallengesandevents.DIF:KnowledgeREF:397|398OBJ:Discussmajorlifeeventsanddevelopmentaltasksofyoungandmiddle-agedadults.TOP:AssessmentMSC:CPNRE:FoundationsofPractice19.Whenprovidingprenatalcare,thenurseprovidesinformationrelatedtoexercisepatternsandproperdiet.Whatadditionalinformationdoesthenurseexpecttoprovide?a.Protectingagainsturinaryinfection.b.Nolongerneedingcondoms.c.Discussingcareofthechildoncetheinfantisborn.d.Physicalassessmentsonlyduringthelasttrimester.ANS:CPregnancyaffectstheentirechild-bearingfamily,andallmembersbenefitfromeducation.Prenatalcareincludesathoroughphysicalassessmentofthepregnantwomanduringregularlyscheduledintervals(notjustthelasttrimester).Informationregardingsexuallytransmitted,othervaginal,andurinaryinfectionsthatwilladverselyaffectthefetusisimportantforapregnantwoman,asiscounsNelUlinRgSaIboNuGteTxBer.ciCseOpMatterns,diet,andchildcare.DIF:KnowledgeREF:402-404OBJ:Describehealthconcernsofyoungandmiddle-agedadults.TOP:ImplementationMSC:CPNRE:FoundationsofPracticeCanadianFundamentalsofNursing7thEditionPotterTestBankNRIGB.CChapter24:OlderPersonsPotteretal:CanadianFundamentalsofNursing,7thEditionMULTIPLECHOICE1.AstheagingpopulationinCanadaincreases,whichofthefollowingistrue?a.Thebabyboomergenerationaccountsforaverysmallpercentageofthisgroup.b.Theaveragelifespanhasalsoincreased.c.Thepopulationsegmentofpeopleolderthan85isdecreasing.d.Diversityofthisagegroupwillcertainlydecrease.ANS:BPartofthatincreaseisaresultoftheextensionoftheaveragelifespan.In2012,theaveragelifeexpectancyatbirthforCanadianswas81.1years,incomparisonwith70.9in1991.Twootherfactorsthatcontributetotheprojectedincreaseinthenumberofolderpersonsaretheagingofthebabyboomgenerationandthegrowthofthepopulationsegmentoverage85.Thebabyboomersarethelargegroupofpersonsbornbetween1946and1964.Thediversityofthegroupolderthan65willalsopossiblyincrease.DIF:RememberREF:411OBJ:DiscussdemographictrendsrelatedtoolderpersonsinCanada.TOP:AssessmentMSC:CPNRE:FoundationsofPractice2.Asapatientages,howshouldthenursingplanofcarechange?a.Itshouldbestandardizedbecauseallgeriatricpatientshavethesameneeds.b.Itneedstobeindividualizedtothepatientsuniqueneeds.c.ItshouldbebasedonchronUoloSgicaNlagTealoneO.d.Itfocusesonthedisabilitiesthatallagingpersonsface.ANS:BNursesmustapproacheveryolderpersonasauniqueindividual.Thenursingcareofolderpersonsposesspecialchallengesbecauseofgreatvariationintheirphysiological,cognitive,andpsychosocialhealth.Nursesneedtotakeintoaccountthecultural,ethnic,andracialdiversityofthispopulation(notjustage)astheycareforolderpersonsfromthesegroups.Agingdoesnotinevitablyleadtodisabilityanddependence.DIF:UnderstandREF:412OBJ:Identifycommonmythsandstereotypesaboutolderpersons.TOP:AssessmentMSC:CPNRE:FoundationsofPractice3.Whichofthesefindings,ifidentifiedinapatientonagerontologicalunit,wouldbemostsurprisingtoaculturallysensitivenurse?a.Theolderpersonsnotbeingfunctionallyindependent.b.Preferencesinfood,music,andreligion.c.Useofconventionsofthehandshake,silence,andeyecontact.d.Personalhealthpracticesandspiritualresources.ANS:ACanadianFundamentalsofNursing7thEditionPotterTestBankNRIGMostolderpeopleremainfunctionallyindependentdespitetheincreasingprevalenceofchronicdisease.Examplesofculturallycompetentnursingapproachestoolderpersonsincluderespectforpreferencesinfood,music,andreligion;appropriateuseofconventionsofthehandshake,silence,andeyecontact;useofinterpreters;useofphysicalassessmentnormsappropriatefortheethnicgroup;andaskingaboutpersonalhealthpractices,familycustoms,lifestylepreferences,andspiritualresources.DIF:AnalyzeREF:412OBJ:Identifycommonmythsandstereotypesaboutolderpersons.TOP:AssessmentMSC:CPNRE:FoundationsofPractice4.Whichofthefollowingstatementsbyanewgraduatenurseshouldbecorrectedbyanexperiencednurse?a.Mostolderpatientsareillanddisabled.Thatswhywecareforsomanyoftheminthehospital.b.Manyolderpersonsarestillinterestedinsexualrelations.c.Patientsolderthan65arestilllifelonglearners.d.Manyolderpatientsremainindependentenoughtolivealone.ANS:AOlderpersonsaresometimesstereotypedasillanddisabled.However,althoughmanyexperiencechronicconditionsorhaveatleastonedisabilitythatlimitsperformanceofactivitiesofdailyliving(ADLs),only23%ofolderpersondescribetheirhealthaspoororfair.Olderpersonsdoreportcontinuedenjoymentofsexualrelationships.Althoughchangesinvisionorhearingandreducedenergyandendurancesometimesaffecttheprocessoflearning,olderpersonsarelifelonglearners.Mostolderpersonsliveinnoninstitutionalsettingswithfamilymembersoralone.B.CMUSNTODIF:RememberREF:412|413OBJ:Identifycommonmythsandstereotypesaboutolderpersons.TOP:AssessmentMSC:CPNRE:FoundationsofPractice5.Whichteachingstrategyisbesttoutilizewitholderpersons?a.Provideseveraltopicsofdiscussionatoncetopromoteindependenceandmakingchoices.b.Avoiduncomfortablesilencesafterquestionsbyhelpingpatientscompletetheirstatements.c.Askpatientstorecallpastexperiencesthatcorrespondwiththeirinterests.d.Speakinahighpitchtohelppatientshearbetter.ANS:CTeachingstrategiesincludetheuseofpastexperiencestoconnectnewlearningwithpreviousknowledge,focusingonasingletopictohelpthepatientconcentrate,givingthepatientenoughtimeinwhichtorespondbecauseolderpersonsreactiontimesarelongerthanthoseofyoungerpersons,andkeepingthetoneofvoicelow;olderpersonsareabletohearlowsoundsbetterthanhigh-frequencysounds.DIF:UnderstandREF:412|413OBJ:Identifynursinginterventionsrelatedtothephysiological,cognitive,andpsychosocialchangesofaging.TOP:ImplementationMSC:CPNRE:FoundationsofPracticeCanadianFundamentalsofNursing7thEditionPotterTestBank6.Anolderpatienthasfallenandbrokenhiship.Asaconsequence,thepatientsfamilyisconcernedabouthisabilitytocareforhimself,especiallyduringhisconvalescence.Whatshouldthenursedo?a.Stressthatolderpatientsusuallyaskforhelpwhenneeded.b.Informthefamilythatplacementinanursingcentreisapermanentsolution.c.Tellthefamilytoenrolthepatientinaceramicsclasstomaintainhisqualityoflife.d.Provideinformationandanswerquestionsasfamilymembersmakechoicesamongcareoptions.ANS:DNursesassistolderpersonsandtheirfamiliesbyprovidinginformationandansweringquestionsastheymakechoicesamongcareoptions.Someolderpersonsdenyfunctionaldeclinesandrefusetoaskforassistancewithtasksthatplacetheirsafetyatgreatrisk.Thedecisiontoenteranursingcentreisneverfinal,andsometimesaresidentofanursingcentreisdischargedtohomeortoanotherresidenceforlessacutecare.Whatdefinesqualityoflifevariesfrompersontoperson.Nursesmustlistentowhattheolderindividualconsiderstobemostimportantratherthanmakingassumptionsaboutthepersonspriorities.DIF:RememberREF:414OBJ:Identifynursinginterventionsrelatedtothephysiological,cognitive,andpsychosocialchangesofaging.TOP:ImplementationMSC:CPNRE:FoundationsofPractice7.Whatisthebestsuggestionanursecouldmaketoafamilyrequestinghelpinselectingalocalnursingcentre?NRIGB.CMa.SuggestchoosinganursingUcenStreNthatTisassaOnitaryaspossible.Thecloserthecentreistohospitalstandards,thebetter.b.Havefamilymembersevaluatenursinghomestaffaccordingtotheirabilitytogettasksdoneefficiently.c.Makesurethatnursinghomestaffmembersgetpatientsoutofbedeverydayfortheentireday.d.Explainthatitisprobablybestforthefamilytovisitthecentreandinspectitpersonally.ANS:DAnimportantstepintheprocessofselectinganursinghomeistovisitthenursinghome.Thenursinghomeshouldnotfeellikeahospital.Itisahome,aplacewherepeoplelive.Membersofthenursinghomestaffshouldfocusontheperson,notthetask.Residentsshouldbeoutofbedanddressedaccordingtotheirpreferences,notstaffpreferences.DIF:ApplyREF:414OBJ:Discusscommondevelopmentaltasksofolderpersons.TOP:ImplementationMSC:CPNRE:FoundationsofPractice8.A70-year-oldpatientwhosuffersfromworseningdementiaisnolongerabletolivealone.Indiscussinghealthcareservicesandpossiblelong-termlivingarrangementswiththepatientsonlyson,whatshouldthenursesuggest?a.Anapartmentsettingwithneighbourscloseby.b.Weeklyhomehealthvisits.CanadianFundamentalsofNursing7thEditionPotterTestBankUSNTOc.Anursingcentrebecausehomecareisnolongersafe.d.Thatplacementisirrelevantbecausethepatientisretreatingtoaplaceofinactivity.ANS:CSomefamilycaregiversconsidernursingcentreplacementwhenin-homecarebecomesincreasinglydifficultorwhenconvalescencefromhospitalizationrequiresmoreassistancethanthefamilyisabletoprovide.Anapartmentsettingandhomehealthvisitsarenotappropriatebecauseolderpersonswhocannottakecareofthemselvesarenotsafelivingaloneatothertimes.Othersareunabletoengageinactivitiesdesignedtobenefitolderpersonssuchasseniorhealthpromotionactivities(suchassomehealthvisits)andthusdonotreceivethebenefitsthattheseprogramsoffer.Worseningdementiadoesnotnecessarilymeanaretreatintoinactivity,butitdoesrequirearealisticreviewofstrengthsandlimitations.DIF:ApplyREF:414OBJ:Listthetypesofcommunity-basedandinstitutionalhealthcareservicesavailabletoolderpersons.TOP:ImplementationMSC:CPNRE:FoundationsofPractice9.Severaltheoriesonaginghavebeenputforth;howshouldthenurseusethesetheories?a.Toguidenursingcare.b.Toexplainthestochasticviewofgeneticallyprogrammedphysiologicalchanges.c.Toselectonetheorytoguidenursingcareforallgeriatricpatients.d.Tounderstandthenonstochasticviewsofagingastheresultofcellulardamage.ANS:AAlthoughtheoriesonagingareinvariousstagesofdevelopmentandhavelimitations,thenurseshouldusethemtoincrNeasReunIderGstanBdi.ngCofMthephenomenaaffectingthehealthandwell-beingofolderpersonsandtoguidenursingcare.Accordingtostochastictheories,agingistheresultofrandomcellulardamageoccurringovertime.Nosingleuniversallyacceptedtheorypredictsandexplainsthecomplexitiesoftheagingprocess.Accordingtononstochastictheories,agingistheresultofgeneticallyprogrammedphysiologicalmechanismswithinthebody.DIF:ApplyREF:413OBJ:Describetheconceptsofagingwellandqualityoflife.TOP:ImplementationMSC:CPNRE:FoundationsofPractice10.Howwouldthenursecorrectlydescribepsychosocialtheoriesonaging?a.Astheoriesthatdescribechangesinrolesandrelationshipsofolderpersons.b.Astheoriesthatemphasizethatalladultsageinsimilarways.c.Astheoriesthatstresstheneedforolderpeopletodiscontinueactivitiesastheyage.d.Astheoriesthatdescribebehaviourpatternsforallagingpersonsasunpredictable.ANS:ACanadianFundamentalsofNursing7thEditionPotterTestBankNRIGB.CMPsychosocialtheoriesofagingexplainchangesinbehaviours,roles,andrelationshipsthatcomewithaging.Althoughsometheoriesgeneralizeaboutaging,eachindividualagesuniquelybothbiologicallyandpsychosocially.Accordingtotheactivitytheory,thecontinuationofactivitiesperformedduringmiddleageisnecessaryforsuccessfulaging.Accordingtothecontinuitytheory,personalityremainsthesameandbehaviourbecomesmorepredictableaspeopleage.DIF:RememberREF:419OBJ:Discussissuesrelatedtopsychosocialchangesconnectedwithaging.TOP:AssessmentMSC:CPNRE:FoundationsofPractice11.Whencomparingdevelopmentaltasksofmiddle-agedpersonsversusolderpersons,whatshouldthenurseinfer?a.Learningtocopewithlossismostcommonduringthemiddleadultyears.b.Afterage65,mostolderpersonsagebothbiologicallyandpsychologicallythesameway.c.Olderpersonswillneednursingassistancetodealwithloss.d.Olderpersonsfearandresentretirementasadisruptionoftheirlifestyle.ANS:CSomeolderpersonsdenytheirownaginginwaysthatarepotentiallyproblematic.Forexample,someolderpersonsdenyfunctionaldeclinesandrefusetoaskforassistancewithtasksthatplacetheirsafetyatgreatrisk.Theneedtocopewithlossismuchgreaterintheolderpopulation.Themajorityofolderpersonscopewiththedeathofaspouse.Somemustcopewiththedeathofadultchildrenandgrandchildren.Allexperiencethedeathoffriends.Thewaysthatolderpersonsadjusttothechangesofagingarehighlyindividualized.Manyolderpersonswelcomeretirementasatimetopursuenewinterestsandhobbies,participateinvolunteeractivities,continuethUeirSeduNcatiTon,orsOtartanewbusinesscareer.DIF:UnderstandREF:415|419OBJ:Discusscommondevelopmentaltasksofolderpersons.TOP:AssessmentMSC:CPNRE:FoundationsofPractice12.An80-year-oldmanisbroughttotheemergencydepartmentwithanexacerbationofchronicobstructivepulmonarydisease(COPD).Hestatesthathequitsmoking30yearsago,soitcannotbeCOPD.Heargues,ItsjustthesecoldsIvebeengetting.Theyrejustgettingworseandworse.Thenurseunderstandswhichofthefollowing?a.Thesesymptomsaremoreassociatedwithnormalagingthanwithdisease.b.Olderpersonsshouldbeencouragedtomaintainphysicalexerciseandactivity.c.Thepatientsagewillrequireadjustmentoflifestyletooneofinactivity.d.Olderpersonsusuallyareawareandacceptingoftheagingprocess.ANS:BOlderpersonsshouldbeencouragedtomaintainphysicalexerciseandactivity,astolerated.Theprimarybenefitsofexerciseincludemaintainingandstrengtheningfunctionalabilityandpromotingasenseofenhancedwell-being.TheCOPDexacerbationisassociatedwiththedisease,notnormalaging.Thepresenceofdiseasesometimesaltersthetimingofthechangesortheireffectondailylife.Acceptanceofpersonalagingdoesnotmeanretreatintoinactivity,butitdoesrequirearealisticreviewofstrengthsandlimitations.Someolderpersonsfinditdifficulttoacceptthattheyareaging.CanadianFundamentalsofNursing7thEditionPotterTestBankDIF:ApplyREF:424OBJ:Describecommonphysiologicalchangesassociatedwithaging.TOP:PlanningMSC:CPNRE:FoundationsofPractice13.Duringassessmentofanolderpersonsskinintegrity,expectedfindingsincludewhichofthefollowing?a.Decreasedelasticity.b.Oilyskin.c.Increasedfacialhairinmen.d.Fasternailgrowth.ANS:ALossofskinelasticityisacommonfindingintheolderperson.Othercommonfindingsincludepigmentationchanges,glandularatrophy(oil,moisture,sweatglands),thinninghair(facialhair:decreasedinmen,increasedinwomen),slowernailgrowth,andatrophyofepidermalarterioles.DIF:RememberREF:416,Table24-1OBJ:Describecommonphysiologicalchangesassociatedwithaging.TOP:AssessmentMSC:CPNRE:FoundationsofPractice14.Anolderpatientinnoacutedistressreportsbeinglessabletotasteandsmell.Whatisthenursesbestresponsetothisinformation?a.Notifythephysicianimmediatelytoruleoutcranialnervedamage.b.Performtestingonthevestibulocochlearnerveandahearingtest.c.Schedulethepatientforanappointmentatasmellandtastedisordersclinic.d.Explaintothepatientthatdiminishedsensesarenormalinolderpersons.ANS:DNURSINGTB.COMDiminishedtasteandsmellsensesarecommonfindingsinolderpersons.Schedulinganappointmentatasmellandtastedisordersclinic,testingthevestibulocochlearnerve,oranattempttoruleoutcranialnervedamageisunnecessaryatthistimepertheinformationprovided.DIF:ApplyREF:416,Table24-1OBJ:Describecommonphysiologicalchangesassociatedwithaging.TOP:AssessmentMSC:CPNRE:FoundationsofPractice15.Whichsymptomisanexpectedcognitivechangeintheolderperson?a.Disorientation.b.Slowerreactiontime.c.Poorjudgement.d.Lossoflanguageskills.ANS:BSlowerreactiontimeisacommonchangeinolderpersonsasaresultofdegenerationofnervecells,decreasednumbersofneurotransmitters,anddecreasedrateofconductionofimpulses.Symptomsofcognitiveimpairment,suchasdisorientation,lossoflanguageskills,lossoftheabilitytocalculate,andpoorjudgementarenotnormalagingchangesandnecessitatefurtherinvestigationofunderlyingcauses.DIF:UnderstandREF:416,Table24-1CanadianFundamentalsofNursing7thEditionPotterTestBankUSNTOOBJ:Describecommonphysiologicalchangesassociatedwithaging.TOP:AssessmentMSC:CPNRE:FoundationsofPractice16.Apatientwithgradual,progressivecognitiveimpairment(dementia)isadmittedtothenursingunitafterhipreplacementsurgery.Whichofthefollowingisanursingcareprincipleforcareofcognitivelyimpairedolderpersons?a.Maintainphysicalhealth.b.Evaluatethepatientsmanifestationsofstandardsymptoms.c.AssistthepatientwithallADLs.d.Isolatethepatienttoprotectothers.ANS:AThenurseworkstomonitorandmaintainphysicalhealth.ThenurseshouldalsoassessthepersonsuniquemanifestationsofthediseaseasitprogresseswhilefacilitatingindependentperformanceofADLs.Socialinteractionbasedonthepatientsabilitiesistobepromoted.DIF:ApplyREF:418|419OBJ:Identifynursinginterventionsrelatedtothephysiological,cognitive,andpsychosocialchangesofaging.TOP:PlanningMSC:CPNRE:FoundationsofPractice17.Topromotephysicalwell-beingandsocializationinanolderperson,whatshouldthenurserealize?a.Socialisolationismisalwaysachosenbehaviour.b.Bodyimageplaysnoroleindecisionmakingbytheolderperson.c.Nocommunityresourcesarefocusedontheolderperson.d.Olderpersonsmayhaveafunctionalpurposeinsocialarenas.ANS:DNRIGB.CMSocialserviceagenciesinmostcommunitieswelcomeolderpersonsasvolunteersandprovidetheopportunityforolderpersonstoservewhilemeetingtheirsocializationorotherneeds.Althoughsomeolderpersonschooseisolationoralifelongpatternofreducedinteractionwithothers,otherolderpersonsdonotchooseisolationbutarevulnerabletoitsconsequences.Someolderpersonswithdrawfromsocialinteractionbecauseoffeelingsofrejection.Theseolderpersonsseethemselvesasunattractiveandrejectedbecauseofchangesintheirpersonalappearanceresultingfromnormalagingorbecauseofbodyimagechanges.Manycommunitieshaveoutreachprogramsdesignedtomakecontactwithisolatedolderpersons.DIF:UnderstandREF:420OBJ:Identifynursinginterventionsrelatedtothephysiological,cognitive,andpsychosocialchangesofaging.TOP:ImplementationMSC:CPNRE:FoundationsofPractice18.Amaleolderpatientexpresseshisconcernandanxietyaboutdecreasedpenilefirmnessduringerection.Whatisthenursesbestresponse?a.Explainingthatovertime,hislibidowilldecrease,aswillthefrequencyofsexualactivity.b.Tellingthepatienttodoublehisantidepressantmedicationtoincreasehislibido.c.Tellingthepatientthatthischangeisexpectedinagingpersons.d.Tellingthepatientthattouchingshouldbeavoidedunlessintercourseisplanned.ANS:CCanadianFundamentalsofNursing7thEditionPotterTestBankDecreasedfirmnessduringerectionisanexpectedchangeinagingpersons.Libidodoesnotnecessarilydecreaseasoneages.Manyolderpersonsuseprescriptionmedicationsthatdepresssexualactivity,suchasantihypertensives,antidepressants,sedatives,andhypnotics.Touchcomplementstraditionalsexualmethodsorservesasanalternativesexualexpressionwhenphysicalintercourseisnotdesiredorpossible.DIF:ApplyREF:420OBJ:Identifynursinginterventionsrelatedtothephysiological,cognitive,andpsychosocialchangesofaging.TOP:ImplementationMSC:CPNRE:FoundationsofPractice19.Apatientasksthenursewhatthetermpolypharmacymeans.Thenursedefinesthistermaswhichofthefollowing?a.Multiplesideeffectsexperiencedwhenamedicationistaken.b.Theconcurrentuseofmanymedications.c.Themanyadversedrugeffectsreportedtothepharmacy.d.Therisksofmedicationeffectsthatareduetoaging.ANS:BPolypharmacyreferstotheconcurrentuseofmanymedications.Itdoesnothaveanythingtodowithsideeffects,adversedrugeffects,orrisksofmedicationusethatareduetoaging.DIF:RememberREF:426OBJ:Describeselectedhealthconcernsofolderpersons.TOP:ImplementationMSC:CPNRE:FoundationsofPractice20.Anoutcomeforanolderpatientlivingaloneistobefreefromfalls.Whichofthesestatementsbyapatientindicatesthatteachingonsafetyconcernshasbeeneffective?a.IllleavemythrowrugsNinUpRlaScIeNsoGthTaBtm.yCfOeeMtwonttouchthecoldtile.b.Illtakemytimegettingupfromthebedorchair.c.Ishouldwearmyfavouritesmoothbottomsockstoprotectmyfeetwhenwalkingaround.d.Iwillhavemysondimthelightingoutsidetodecreasetheglareinmyeyes.ANS:BOlderpersonstakingmedicationswithadverseeffectssuchasposturalhypotension,dizziness,orsedationneedtobeawareofthesepotentialeffectsandtotakeprecautionssuchaschangingpositionslowlyorambulatingwithassistanceifunsteady.Householditemsthatareeasytotripover,suchasthrowrugs,areariskfactorforfalls.Otherriskfactorsincludewearingshoesinpoorrepairorslipperysoles.Impairedvisionandpoorlightingareotherriskfactors.DIF:EvaluateREF:425OBJ:Describeselectedhealthconcernsofolderpersons.TOP:ImplementationMSC:CPNRE:FoundationsofPractice21.Oneofthegreatestchallengesforthenursecaringforolderpersonsisensuringsafemedicationuse.Whatisonewaytoreducetherisksassociatedwithmedicationusage?a.Periodicallyreviewingthepatientslistofmedications.b.Informingthepatientthatpolypharmacyistobeavoidedatallcost.c.Beingawarethatmedicationisabsorbedthesamewayregardlessofpatientage.d.Focusingonlyonprescribedmedications.ANS:ACanadianFundamentalsofNursing7thEditionPotterTestBankNRIGB.CPeriodicandthoroughreviewofallmedicationsisimportant:thenumberofmedicationsusedshouldbethefewestnecessarytoensurethegreatesttherapeuticbenefitwiththeleastamountofharm.Althoughpolypharmacyreflectsinappropriateprescribing,theconcurrentuseofmultiplemedicationsisnecessaryinsituationsinwhichanolderpersonhasmultipleacuteandchronicconditions.Olderpersonsareatriskforadversedrugeffectsbecauseofage-relatedchangesintheabsorption,distribution,metabolism,andexcretionofdrugs.Nursesshouldworkcollaborativelywitholderpersonstoensuresafeandappropriateuseofallmedications,bothprescribedmedicationsandover-the-countermedications.DIF:ApplyREF:426OBJ:Describeselectedhealthconcernsofolderpersons.TOP:AssessmentMSC:CPNRE:FoundationsofPractice22.Anolderpatienthasdevelopedacuteconfusion.Thepatienthasbeentakingtranquilizersforthepastweek.Thepatientsvitalsignsarenormal.Whatshouldthenursedo?a.Takeintoaccountage-relatedchangesinbodysystemsthataffectpharmacokineticactivity.b.Increasethedoseoftranquilizerifthecauseoftheconfusionisaninfection.c.Notewhentheconfusionoccursandmedicatebeforethattime.d.Restricttelephoneusagetopreventfurtherconfusion.ANS:ASedativesandtranquilizerssometimesprescribedforacutelyconfusedolderpersonssometimescauseorexacerbateconfusion.Drugsusedtomanageconfusedbehavioursshouldbeadministeredcarefullyandmustaccountforage-relatedchangesinbodysystemsthataffectpharmacokineticactivity.Whenconfusionhasaphysiologicalcause(suchasaninfection),thenurseshouldspecificallytreatthatcause,ratherthantheconfusedbehaviour.Whenconfusionvariesbytimeofdayorisrelatedtoenvironmentalfactors,nonpharmacologicalmeasures,UsucShasNmaTkingthOeenvironmentmoremeaningfulandprovidingadequatelight,shouldbeused.Makingtelephonecallstofriendsorfamilymembersallowsolderpersonstohearreassuringvoices,whichmaybebeneficial.DIF:ApplyREF:426OBJ:Describeselectedhealthconcernsofolderpersons.TOP:ImplementationMSC:CPNRE:FoundationsofPractice23.Whichoftheseassessmentsofanolderadult,whohasaurinarytractinfection,necessitatesanimmediatenursingintervention?a.Presbycusis.b.Confusion.c.Deathofaspouse3monthsago.d.Temperatureof36.4C(97.6F).ANS:BConfusionisacommonmanifestationinolderpersonswithurinarytractinfection;however,thecauserequiresfurtherassessment.Theremaybeanotherreasonfortheconfusion.Confusionisnotanormalfindinginolderpersons,eventhoughitiscommonwithconcurrentinfections.Difficultyhearing(presbycusis)isanexpectedfindinginolderpersons.Copingwiththedeathofaspouseisapsychosocialconcerntobeaddressedaftertheacutephysiologicalconcerninthiscase.Olderpersonstendtohavelowertemperatures,sothenurseneedstoassessforslightelevations.Atemperatureof36.4C(97.6F)iswithinnormallimits.CanadianFundamentalsofNursing7thEditionPotterTestBankDIF:ApplyREF:415OBJ:Identifynursinginterventionsrelatedtothephysiological,cognitive,andpsychosocialchangesofaging.TOP:PlanningMSC:CPNRE:FoundationsofPractice24.Whichofthesepatientstatementsisthemostreliableindicatorthatanolderpersonhasthecorrectunderstandingofhealthpromotionactivities?a.Ineedtoincreasemyfatintakeandlimitprotein.b.Ishoulddiscontinuemyfitnessclubmembershipforsafetyreasons.c.Imuptodateonmyimmunizations,butatmyage,Idontneedthetetanusvaccine.d.IstillkeepmydentistappointmentseventhoughIhavepartialsnow.ANS:DGeneralpreventivemeasuresforthenursetorecommendtoolderpersonsincludekeepingperiodicdentalappointmentstopromotegoodoralhygiene;eatingalow-fat,well-balanceddiet;exercisingregularly;andmaintainingimmunizationsforinfluenza,pneumococcalpneumonia,andtetanus.DIF:EvaluateREF:422,Box24-8OBJ:Describeselectedhealthconcernsofolderpersons.TOP:EvaluateMSC:CPNRE:FoundationsofPractice25.A72-year-oldwomanwasrecentlywidowed.Sheworkedasatelleratabankfor40yearsandhasbeenretiredforthepast5years.Sheneverlearnedhowtodrive.Shelivesinaruralareathatdoesnothavepublictransportation.Whichofthefollowingpsychosocialchangesdoesthenursefocusonasapriority?a.Sexuality.b.HousingandenvironmenNt.URSINGTB.COMc.Retirement.d.Socialisolation.ANS:DThehighestpriorityatthistimeisthepotentialforsocialisolation.Thiswomandoesnotknowhowtodriveandlivesinaruralcommunitythatdoesnothavepublictransportation.Allofthesefactorscontributetohersocialisolation.Otherpossiblechangesshemaybegoingthroughrightnowincludesexualityrelatedtoheradvancedageandrecentdeathofherspouse;however,thisisnotthepriorityatthistime.Shehasbeenretiredfor5years,sothisisalsonotanimmediateconcern.Shemayeventuallyexperienceneedsrelatedtohousingandenvironment,butthequestiondoesnotindicatethisasanissueatthistime.DIF:AnalyzeREF:419|420OBJ:Describetheconceptsofagingwellandqualityoflife.TOP:AssessmentMSC:CPNRE:FoundationsofPractice26.Arecentlywidowed80-year-oldmanisdehydratedandisadmittedtothehospitalforintravenousfluidreplacement.Duringtheeveningshift,thepatientbecomesacutelyconfused,andthestudentnurseplanstoassessthepatientforareversiblecause.Thenursinginstructorwillneedtoprovidefurtherinstructiontothestudentwhoplanstoassessforwhichofthefollowing?a.Electrolyteimbalance.b.Hypoglycemia.CanadianFundamentalsofNursing7thEditionPotterTestBankc.Drugeffects.d.Dementia.ANS:DDelirium,oracuteconfusionalstate,isapotentiallyreversiblecognitiveimpairmentthatisoftenduetoaphysiologicalevent.Physiologicalcausesofdeliriumcanincludeelectrolyteimbalances,cerebralanoxia,hypoglycemia,medications,drugeffects,tumours,subduralhematomas,andcerebrovascularinfection,infarction,orhemorrhage.Unlikedelirium,dementiaisagradual,progressive,irreversiblecerebraldysfunction.DIF:ApplyREF:418OBJ:Differentiateamongdelirium,dementia,anddepression.TOP:ImplementationMSC:CPNRE:FoundationsofPracticeNURSINGTB.COMCanadianFundamentalsofNursing7thEditionPotterTestBankNRIGB.CChapter25:TheExperienceofLoss,Death,andGriefPotteretal:CanadianFundamentalsofNursing,7thEditionMULTIPLECHOICE1.Anurseencountersafamilywhoseadultchilddiedlastyear.Theparentsaretalkingabouttheupcominganniversaryoftheirchildsdeath.Thenursespendstimewiththemdiscussingtheirchildslifeanddeath.Thenursesactionbestdemonstrateswhichnursingprinciple?a.Painmanagementtechnique.b.Facilitatingnormalmourning.c.Griefevaluation.d.Palliativecare.ANS:BAnniversariescanreopengriefprocesses.Anurseshouldopenlyacknowledgethelossandtalkaboutthecommonrenewalofgriefaroundtheanniversaryoftheindividualsdeath.Thisfacilitatesnormalmourning.Thenurseisnotattemptingtoalleviateaphysicalpain.Theactionsareofopencommunication,notevaluation.Palliativecarereferstocomfortmeasuresforsymptomrelief.DIF:ApplyREF:447OBJ:Identifyyourroleinassistingpatientswhohaveexperiencedloss,death,andgrief.TOP:ImplementationMSC:CPNRE:FoundationsofPractice2.Apatientwithcancerasksthenursewhenheorshewillbeabletoaccesspalliativecare.Onthebasisoftheknowledgeaboutpalliativecare,whatwillthenursesresponsebe?a.ItisonlyavailableforthosUethSathaNveTaterminOalillness.b.Itcanhelppatientsachieveoptimalpainmanagement.c.Itisofferedwhenpatientshavelessthan6to12moremonths.d.Itisavailableifindicatedinanadvancedirective.ANS:BPalliativecarecanhelppatientsachieveoptimalpainmanagement.Itisforanyage,anydiagnosis,andatanytime,notjustduringthelastfewmonthsoflife.Hospicecareismoreappropriatewhenthepatientisexpectedtolivelessthan6to12moremonths.Anadvancedirectivecanincludeinformationaboutpalliativecarebutisnotrequiredforsuchcaretobeinitiated.DIF:RememberREF:447|448OBJ:Discussprinciplesofpalliativecare.TOP:ImplementationMSC:CPNRE:FoundationsofPractice3.Aterminallyillpatientisexperiencingconstipationsecondarytopainmedication.Whatisthebestwayforthenursetoimprovethepatientsconstipationproblem?a.Massagethepatientsabdomen.b.Contacttheprovidertodiscontinuepainmedication.c.Administerenemastwicedailyfor7days.d.Useastimulantlaxativeandincreasefluidintake.ANS:DCanadianFundamentalsofNursing7thEditionPotterTestBankOpioidmedicationisknowntoslowgastrointestinaltransittime,whichplacesthepatientathighriskforconstipation.Stimulantlaxativesareindicatedforopioid-inducedconstipation.Addedwatertothedietwillallowwatertobepulledintothegastrointestinaltract,whichhelpssoftenstool.Massagingthepatientsabdomenmaycausefurtherdiscomfort.Discontinuingpainmedicationisinappropriateforaterminallyillpatient.Enemaadministrationisnotthefirststepinthetreatmentofopioid-inducedconstipation.DIF:ApplyREF:449OBJ:Discussprinciplesofpalliativecare.TOP:ImplementationMSC:CPNRE:FoundationsofPractice4.Aseverelydepressedpatientcannotstateanypositiveattributestohisorherlife.Thenursesitswiththispatientandhelpsidentifyseveralactivitiesthatthepatientisactuallylookingforwardtoinlife.Thenurseishelpingthepatientdemonstratewhichspiritualconcept?a.Timemanagement.b.Hope.c.Charity.d.Faith.ANS:BTheconceptofhopeisvitaltohumanbeings;itenablesapersontoanticipatepositiveexperiences.Beingpatientandfriendlyandcreatingpositiverelationshipsarekeyconceptsinallareasofnursing,butespeciallywithdepressedpatients.Thenursesactionsdonotaddresstimemanagement,charity,orfaith.DIF:UnderstandREF:437OBJ:Developanursingcareplanforapatientorfamilyexperiencinglossandgrief.TOP:ImplementationMSC:CPNRE:FoundationsofPracticeNURSINGTB.COM5.Thenurseisdiscussingfuturetreatmentswithapatientwhohasaterminalillness.Thenursenotesthatthepatienthasnotbeeneatingandrespondstothenursesinformationbystating,Whatdoesitmatter?Whatisthemostappropriatenursingdiagnosisforthispatient?a.Socialisolation.b.Hopelessness.c.Denial.d.Powerlessness.ANS:DAdefiningcharacteristicforthenursingdiagnosisofPowerlessnessmayincludeastatementbythepatientsuchasWhatdoesitmatter?whenofferedchoicesorinformationconcerninghimorher.Thepatientsbehaviourandverbalizationisnotanexampleofsocialisolation.Thepatientisnotavoidingothersorbeingrestrictedfromseeingothers.HopelessnessismorereflectedbythecommentIhavenofuturethanWhatdoesitmatter?Thepatientsbehaviourandverbalizationdonotindicatedenial.DIF:ApplyREF:442,Box25-7OBJ:Developanursingcareplanforapatientorfamilyexperiencinglossandgrief.TOP:DiagnosisMSC:CPNRE:FoundationsofPracticeCanadianFundamentalsofNursing7thEditionPotterTestBankUSNTO6.Familymembersgatherintheemergencydepartmentafterlearningthatafamilymemberwasinvolvedinamotorvehicleaccident.Afterlearningofthefamilymembersunexpecteddeath,thesurvivingfamilymembersbegintocryandscreamindespair.ThenurserecognizesthisaswhichstageoftheBowlbyAttachmentTheory?a.Numbing.b.Disorganizationanddespair.c.Bargaining.d.Yearningandsearching.ANS:DYearningandsearchingcharacterizethesecondbereavementphaseinBowlbysAttachmentTheory.Emotionaloutburstsarecommoninthisphase.Duringthenumbingphase,thefamilymayfeelasenseofunreality.Duringdisorganizationanddespair,thereasonwhythelossoccurredisconstantlyquestioned.BargainingispartoftheKbler-Rossstages,notoftheBowlbyAttachmentTheory.DIF:ApplyREF:434OBJ:DescribeandcomparethephasesofgrievingfromKbler-Ross(1969),Bowlby(1980),andWorden(1991).TOP:ImplementationMSC:CPNRE:FoundationsofPractice7.Aftertheanticipateddemiseofachronicallyillpatient,theunitnurseisfoundcryinginthestafflounge.Whatwouldbethebestresponsetohercrying?a.Itisnormaltofeelthisway.Giveyourselfsometimetomourn.b.Yourotherpatientsstillneedyou,sohurrybacktothem.c.Yourebeingabadrolemodeltotheunitsnursingstudents.d.WhydontyoutakeaseNdatiRvetIocoGpe?B.CMANS:ANursesoftenwitnesssufferingonadailybasis.Nurses,ashumans,alsoexperiencegriefandlosswhentheyhavebeenintenselyinvolvedinthepatientssufferinganddeath.Theircolleaguesshouldoffercomfortandunderstandingandmaintainastablepatientcareenvironment.Itisinappropriatetocreateguiltbytellingagrievingnursetohurrybacktohisorherpatientsorbyindicatingthatheorsheisabadrolemodel.Suggestingthatacolleaguetakesedativeduringashiftisdangerousforthesafetyofpatientsinhisorhercare.DIF:ApplyREF:453OBJ:Discussyourownexperienceoflosswhencaringfordyingpatients.TOP:ImplementationMSC:CPNRE:FoundationsofPractice8.Afamilyisgrievingafterlearningofafamilymembersaccidentaldeath.Thetransplantcoordinatorrequeststotalkwiththefamilyaboutpossibleorganandtissuedonation.Thenurserecognizeswhichofthefollowing?a.Allreligionsallowfororgandonation.b.Lifesupportmustberemovedbeforeorganandtissueretrievaloccurs.c.Thebesttimefororganandtissuedonationisimmediatelyaftertheautopsy.d.Thetransplantcoordinatorwillneedaprivateplacetotalkwiththefamily.ANS:DCanadianFundamentalsofNursing7thEditionPotterTestBankUSNTOThetransplantcoordinatorshouldalwaysmeetwithfamilymembersinaprivate,quietarea.Notallreligionsallowfororgandonation.Apatientmaybeonlifesupportduringorganremovaltopreserveorgantissues.Autopsycompromisesorganintegrity;removalshouldoccurbeforethat.DIF:ApplyREF:452OBJ:Describetheprocedureforcareofthebodyafterdeath.TOP:ImplementationMSC:CPNRE:Professional,Ethical,andLegalPractice9.Thenewlygraduatednurseisassignedtohisorherfirstdyingpatient.Howcanthenursebestpreparetocareforthispatient?a.Completingacoursedealingwithdeathanddying.b.Controllinghisorherownemotionsaboutdeath.c.Drawingontheexperienceofthedeathofalovedone.d.Developinganunderstandingofhisorherownfeelingsaboutdeath.ANS:DWhencaringforpatientsexperiencinggrief,itisimportantforthenursetoassesshisorherownemotionalwell-beingandtounderstandhisorherownfeelingsaboutdeath.Thenursewhoisawareofhisorherownfeelingswillbelesslikelytoplacepersonalsituationsandvaluesbeforethoseofthepatient.Althoughcourseworkondeathanddyingmayaddtothenursesknowledgebase,itdoesnotbestpreparethenurseforcaringforadyingpatient.Thedeathofapatientcanraisemanyemotions.Beingabletocontrolonesownemotionsisimportant;however,itisunlikelythatthenursewouldbeabletodosoifheorshehasnotfirstacknowledgedhisorherownfeelingsaboutdeath.Thedeathofalovedoneisnotaprerequisitetocaringforadyingpatient.TheexperienceofcaringforadyingpatientmayhelpanursematureindealinNgwRithlIoss,GorBit.mCaybMringupmanynegativeemotionsifcomplicatedgriefispresent.DIF:ApplyREF:453OBJ:Discussyourownexperienceoflosswhencaringfordyingpatients.TOP:ImplementationMSC:CPNRE:Professional,Ethical,andLegalPractice10.Thepalliativeteamsprimaryobligationtoapatientinseverepainincludeswhichofthefollowing?a.Supportingthepatientsnurseinhergrief.b.Providingpost-mortemcareforthepatient.c.Teachingthepatientthestagesofgrief.d.Enhancingthepatientsqualityoflife.ANS:DTheprimarygoalofpalliativecareistohelppatientsandfamiliesachievethebestqualityoflife.Providingsupportforthepatientsnurseisnottheprimaryobligationwhenthepatientisexperiencingseverepain.Notallcollaborativeteammemberswouldbeabletoprovidepost-mortemcare;norwouldnutritionists,socialworkers,orpharmacists.Teachingaboutstagesofgriefshouldnotbethefocuswhenapatientisinseverepain.DIF:UnderstandREF:447|448OBJ:Discussprinciplesofpalliativecare.TOP:ImplementationMSC:CPNRE:FoundationsofPracticeCanadianFundamentalsofNursing7thEditionPotterTestBank11.Amanishospitalizedaftersurgeryinwhichbothlowerextremitiesareamputatedbecauseofinjuriessustainedduringmilitaryservice.Thenurseshouldrecognizehisneedtogrieveforwhattypeofloss?a.Maturationalloss.b.Situationalloss.c.Perceivedloss.d.Uncomplicatedloss.ANS:BLossofabodypartfrominjuryisasituationalloss.Maturationallossesoccuraspartofnormallifetransitions.Perceivedlossisnotobvioustootherpeople.Uncomplicatedisnotatypeofloss;itisadescriptionofnormalgrief.DIF:UnderstandREF:433OBJ:Listanddiscussthefivecategoriesofloss.TOP:ImplementationMSC:CPNRE:FoundationsofPractice12.Iknowitseemsstrange,butIfeelguiltybeingpregnantafterthedeathofmysonlastyear,saidawomanduringherroutineobstetricalexamination.Thenursespendsextratimewiththiswoman,helpinghertobetterbondwithherunbornchild.Thisdemonstrateswhichnursingtechnique?a.Facilitatingmourning.b.Providingcurativetherapy.c.Promotingspirituality.d.Eradicatinggrief.ANS:AThenursefacilitatesmourninginfamilymemberswhoarestillsurviving.ByacknowledgingthepregnantwomansemotioNnUs,RthSeInNurGseThBel.psCtOheMmotherbondwithherfetusandrecognizetheemotionsthatstillexistforthedeceasedchild.Thenurseisnotattemptingtohelpthepatienteradicategrief,whichwouldbeunrealistic.Curativetherapyandspiritualpromotionarenotaddressedbythenursesstatement.DIF:UnderstandREF:434OBJ:Listanddiscussthefivecategoriesofloss.TOP:ImplementationMSC:CPNRE:Professional,Ethical,andLegalPractice13.Threeofthenursespatientshavediedduringthepast2days.Whichapproachismostappropriatetomanagethenursessadness?a.Tellingthenextpatientswhythenurseissad.b.Talkingwithacolleagueorwritinginajournal.c.Exercisingvigorouslyratherthansleeping.d.Avoidingfriendsuntilthenursefeelsbetter.ANS:BSelf-carestrategiesfornursesincludetalkingwithaclosecolleagueandreflectingonfeelingsbywritinginajournal.Itisinappropriateforanursetotalkwithpatientstoresolvethenursesgrief.Althoughexerciseisimportantforself-care,sleepisalsoimportant.Shuttingoneselfawayfromfriendsisnotself-care;thenurseshouldspendtimewithpeoplewhoarenurturing.DIF:UnderstandREF:453OBJ:Discussyourownexperienceoflosswhencaringfordyingpatients.TOP:ImplementationMSC:CPNRE:Professional,Ethical,andLegalPracticeCanadianFundamentalsofNursing7thEditionPotterTestBank14.Awomaniscalledintohersupervisorsofficeregardingherdeterioratingworkperformancesincethelossofherhusband2yearsago.Thewomanbeginssobbingandsayingthatsheisfallingapartathomeaswell.Thewomanisescortedtothenursesoffice,wherethenurserecognizesthewomanssymptomsaswhichofthefollowing?a.Normalgrief.b.Complicatedgrief.c.Disenfranchisedgrief.d.Perceivedgrief.ANS:BAnindividualundergoingacomplicatedgrievingprocessthatinterfereswithcommonroutinesoflifeforexcessivelylongperiodsoftimeisexperiencingcomplicated(dysfunctional)grief.Normalgriefisthemostcommonreactiontodeath;itinvolvesacomplexrangeofnormalcopingstrategies.Disenfranchisedgriefinvolvesarelationshipthatisnotsociallysanctioned.Perceivedgriefisnotatypeofgrief;perceivedlossisalossthatisnotobvioustootherpeople.DIF:UnderstandREF:434|435OBJ:Describethetypesofgrief.TOP:AssessmentMSC:CPNRE:Professional,Ethical,andLegalPractice15.Thefatherhasrecentlybeguntoattendhischildrensschoolfunctionssincethedeathofhiswife.ThiswouldbestbedescribedaswhichtaskintheWordensgrieftasksmodel?a.TaskI.b.TaskII.c.TaskIII.d.TaskIV.ANS:CNURSINGTB.COMTheWordengrieftasksmodelconsistsoffourtasks.InTaskIII,thesurvivingfamilymemberbeginstoadjusttolifewithoutthedeceased.TaskIisacceptingtherealityoftheloss,TaskIIisworkingthroughthepainofgrief,andTaskIVisemotionallyrelocatingthedeceasedandmovingonwithlife.DIF:UnderstandREF:434OBJ:DescribeandcomparethephasesofgrievingfromKbler-Ross(1969),Bowlby(1980),andWorden(1991).TOP:AssessmentMSC:CPNRE:FoundationsofPractice16.Anidentifiedoutcomeforthefamilyofthepatientwithaterminalillnessisthatfamilymemberswillbeabletoprovidepsychologicalsupporttothedyingpatient.Tohelpthefamilytomeetthisoutcome,thenursewilldevelopateachingplanthatwillincludeteachingaboutwhichofthefollowing?a.Bathingtechniques.b.Applicationofoxygendevices.c.Recognitionofpatientneedsandfears.d.Hospicecare.ANS:CCanadianFundamentalsofNursing7thEditionPotterTestBankAdyingpatientsfamilyisbetterpreparedtoprovidepsychologicalsupportifthenursediscusseswiththemwaystolistenandrespondtoneedsandfearsofthedyingperson.Demonstrationofbathingtechniquesandapplicationofoxygendevicesmayhelpthefamilymeetthepatientsphysicalneedsbutwouldnotprovidepsychologicalsupportforthepatient.Informationonwhentocontactthehospicenurseisimportantforthefamilytohaveandmayhelpthemfeeltheyarebeingsupportedincaringforthedyingpatient.However,contactinformationdoesnothelpthefamilyprovidepsychologicalsupporttothedyingpatient.DIF:ApplyREF:450,Box25-9OBJ:Describehowtoinvolvefamilymembersinpalliativecare.TOP:PlanningMSC:CPNRE:FoundationsofPractice17.Validationofadyingpersonslifewouldbedemonstratedbywhichnursingaction?a.Takingpicturesofvisitors.b.Callingtheorgandonationcoordinator.c.Listeningtofamilystoriesabouttheperson.d.Providingquietvisitingtime.ANS:CListeningtofamilymembersstoriesvalidatestheimportanceofthedyingpatientslifeandreinforcesthepatientsdignity.Takingpicturesofvisitorsdoesnotaddressthevalueofapersonslife.Callinganorgandonationcoordinatorandprovidingprivatevisitingtimearecomponentsofthedyingprocess,buttheydonotvalidateadyingpersonslife.DIF:ApplyREF:450OBJ:Developanursingcareplanforapatientorfamilyexperiencinglossandgrief.TOP:ImplementationMSC:CPNRE:FoundationsofPracticeNURSINGTB.COM18.Acoupleisinformedthattheirfetussconditionisincompatiblewithlifeafterbirth.Nursescanbesthelpthecouplewiththeirend-of-lifedecisionmakingbyofferingthemwhichofthefollowing?a.Anadvancedirectivetocomplete.b.Briefdiscussionandfuneralguidance.c.Timeandcarefulexplanations.d.Instructionsonhowtoproceed.ANS:CFamiliescanhavelimitedknowledgewhenaskedtomakeimportantethicaldecisions.Nurseshavethetime,patience,andknowledgebasetohelpthefamilyunderstandtheirethicalsituationandtohelpthemmaketheirowneducateddecision,ratherthangivingtheminstructions.Advancedirectivesarecompletedbythepersonwhoisdying.Funeralguidanceisbestprovidedbyachaplainoracaretaker.DIF:ApplyREF:439-441OBJ:Developanursingcareplanforapatientorfamilyexperiencinglossandgrief.TOP:ImplementationMSC:CPNRE:Professional,Ethical,andLegalPractice19.Acorrectionalfacilitynurseiscalledtothesceneofaninmatewhodiedundersuspectcircumstances.Thecorrectionofficerwantstomovethebodytothefuneralhomequicklybecauseheisnotcomfortablewithdeath.Theinmatesbodywillneedtobetransportedwhere?CanadianFundamentalsofNursing7thEditionPotterTestBanka.Coronersofficeforanautopsy.b.Policedepartmentforaninvestigation.c.Directlytotheinmatesfamily.d.Wardenforinspection.ANS:APhysiciansoftenrequestthatanautopsybeperformedifdeathoccurredunderunusualcircumstances;astheresultoffoulplay,homicide,orsuicide;orasanaccidentaldeath,asoccursincaraccidents.Thenursemustunderstandthepoliciesthatareappliedincasesoffoulplaydeathandmustensurethatthedecedentsbodyisproperlycaredforafterdeath,despitetheemotionalfeelingsofindividualsinclosecontactwiththedecedent.DIF:ApplyREF:451,Box25-10OBJ:Describetheprocedureforcareofthebodyafterdeath.TOP:ImplementationMSC:CPNRE:FoundationsofPractice20.Whenteachingagroupofolderpersonsaboutculturalbeliefsanddeath,thenurseindicateswhichofthefollowing?a.Theethicaldecisionssurroundingapatientsdeathshouldbebasedonhospitalpolicyandnotculture.b.Maintainingritualsandpracticesallowsasenseofacceptanceofthedyingprocess.c.Thenursemustdecidewhichculturalpracticeswillbeincorporatedincareofthedying.d.Regardlessofculture,followinghospitalpracticeswillhelpfocuspatientandfamilyonthedyingprocess.ANS:BNURSINGTB.COMMaintainingtheintegrityofritualsandmourningpracticesgivesfamiliesasenseofacceptanceofthepatientsdeathandpromotesinnerpeace.Thenurseshouldbefamiliarwithpoliciesandprocedures,butethicaldecisionsshouldbemadewithanunderstandingandappreciationofthepatientsculture.Thenursemustassesstheterminallyillpatientsandfamilyswishesforend-of-lifecareanddevelopaplanofcarethatintegratespatientcultureandspiritualbeliefswithnursingactions.DIF:ApplyREF:436,Box25-2OBJ:Identifyyourroleinassistingpatientswhohaveexperiencedloss,death,andgrief.TOP:ImplementationMSC:CPNRE:FoundationsofPractice21.Thenurseispreparingtoassistthepatientintheendstageofherlife.Thepatientisshowingsignsoffatigue.Whatshouldthenursedotoprovidecomfortforthispatient?a.Spendmoretimewiththepatient.b.Limittheuseofanalgesics.c.Providelargermealswithmoreseasoning.d.Determinevaluedactivities,andschedulerestperiods.ANS:DCanadianFundamentalsofNursing7thEditionPotterTestBankTopromotecomfortintheterminallyillpatient,thenurseshouldhelpthepatientidentifyvaluesordesiredtasksandthenhelpthepatienttoconserveenergyforthosetasks.Spendingmoretimewiththepatientconveyscaringandallowsverbalization,butitisnotthebestwaytopromotecomfortforafatiguedpatient.Theuseofanalgesicsshouldnotbelimited.Controllingtheterminallyillpatientslevelofpainisaprimaryconcerninpromotingcomfort.Nausea,vomiting,andanorexiamayincreasetheterminallyillpatientslikelihoodofinadequatenutrition.Thenurseshouldservesmallerportionsandblandfoods,whichmaybemorepalatable.DIF:ApplyREF:447|448OBJ:Explainreasonsfortheneedforimprovedend-of-lifecareforpatients.TOP:ImplementationMSC:CPNRE:Professional,Ethical,andLegalPractice22.Duringafollow-upvisit,awomanisdescribingnewonsetofmaritaldiscordwithherterminallyillspouse.UsingtheKbler-Rossbehaviouraltheory,thenurserecognizesthatthespouseisinwhichstageofgrief?a.Denial.b.Bargaining.c.Anger.d.Depression.ANS:CKbler-Rosstraditionaltheoryinvolvesfivestagesofgrief.Theangerstageofadjustmenttoanimpendingdeathcaninvolveresistance,angeratadeity,angeratpeople,andangeratthesituation.Denialinvolvesfailuretoacceptadeath.Bargainingisanactiontodelayacceptanceoftheinevitabilityofdeath.Depressionwouldmanifestaswithdrawalfromothers.DIF:ApplyREF:43N4URSINGTB.COMOBJ:DescribeandcomparethephasesofgrievingfromKbler-Ross(1969),Bowlby(1980),andWorden(1991).TOP:ImplementationMSC:CPNRE:FoundationsofPractice23.Mrs.Harrisonsfatherdiedaweekago.Mr.Harrisonisexperiencingheadachesandfatigueandkeepsshoutingathiswifetoturndownthetelevision,althoughhehasnotdonesointhepast.Mrs.Harrisonishavingtroublesleepingandhasnoappetite.Howshouldthenurseinterprettheseassessmentfindingsasthebasisforafollow-upassessment?a.Mrs.HarrisonisgrievingandMr.Harrisonisangry.b.Mrs.HarrisonisillandMr.Harrisonisgrieving.c.BothMr.andMrs.Harrisonareprobablyindenial.d.BothMr.andMrs.Harrisonareprobablygrieving.ANS:DEachindividualrespondstolossdifferently.Somepeoplemaydemonstrateangerordenialasaresponsetogrief;Mr.Harrisonsangerismostlikelyamanifestationofgrief.Commonphysicalsymptomsofgriefincludetightnessinthechestandthroat,shortnessofbreath,feelingsofweaknessandlethargy,insomnia,andlossofappetite.Denialisthesituationwhenthepersonindicatesthatheorsheisnotacceptingthatthelosshappened.DIF:ApplyREF:433-435OBJ:Describethecharacteristicsofapersonexperiencinggrief.TOP:AssessmentMSC:CPNRE:FoundationsofPracticeCanadianFundamentalsofNursing7thEditionPotterTestBankChapter26:Self-ConceptPotteretal:CanadianFundamentalsofNursing,7thEditionMULTIPLECHOICE1.Thenursingstudentcanhelpgeriatricpatientsself-conceptbyusingwhichtechnique?a.Discussingcurrentweather.b.Reviewingoldphotoswithpatients.c.Encouragingpatientstosing.d.Allowingpatientsextracomputertime.ANS:BNursescanimproveolderpatientsself-imagebyreviewingoldphotographswiththem.Thisformoflifereviewishelpfultoolderpersonsinrememberingpositivelifeeventsandpeople.Discussingweatherdoesnotinvolvepersonalreflection.Singingimprovesglobalcognition,notself-concept.Givingpatientsextracomputertimeisnotapplicabletoimprovingself-concept.DIF:ApplyREF:465,Box26-4OBJ:Applythenursingprocesstopromoteaclientsself-concept.TOP:ImplementationMSC:CPNRE:FoundationsofPractice2.Whiledocumentinganadolescentshealthhistory,thenurserecognizesthatthepatientbegantoactoutbehaviourallyandengageinriskybehaviourwhenherparentsdivorced.InconsideringanursingdiagnosisofAlteredself-concept,thenursewouldgatherwhatinformation?NRIGB.CMa.HowlongtheparentswereUmaSrriedN.TOb.Howthepatientviewsherbehaviours.c.Whytheparentsaredivorcing.d.Whysheisactingoutofcontrol.ANS:BAnursecanidentifysituationallifestressorsthatcanaffectapersonsself-concept.Byopenlyexploringapatientsthoughtsandfeelings,thenursewillbeabletousecommunicationskillsinatherapeuticmanner.Thisfacilitatesthepatientsinsightintobehavioursandenablesthenursetomakereferralsorprovideneededhealthteaching.Thelengthoftimetheparentsweremarriedandthereasonfortheparentsdivorcedonotexplainthepatientsbehaviours.Whythepatientisoutofcontrolisnotasimportantashowthepatientviewsheractionswhenoutofcontrol.DIF:EvaluateREF:461|462OBJ:Applythenursingprocesstopromoteaclientsself-concept.TOP:ImplementationMSC:CPNRE:FoundationsofPractice3.Thedevelopmentalself-concepttaskknownasinitiativeversusguiltwouldoccurinwhichperson?a.A3-week-oldneonate.b.A5-year-oldkindergartenstudent.c.An11-year-oldstudent.d.A15-year-oldhighschoolstudent.CanadianFundamentalsofNursing7thEditionPotterTestBankUSNTOANS:BTheinitiativeversusguiltdevelopmentalstageoccursbetweentheagesof3and6years.Ifachildshowsinitiative,theoutcomeofthisdevelopmentaltaskistodeveloppurpose.Aneonatedevelopmentaltaskistodeveloptrust.An11-year-oldisinthestageofnewskillmastery,anda15-year-oldisstrugglingwithidentityversusroleconfusion.DIF:RememberREF:459,Box26-1OBJ:Describethecomponentsofself-conceptasrelatedtopsychosocialandcognitivedevelopmentalstages.TOP:AssessmentMSC:CPNRE:FoundationsofPractice4.Averballyabusivepartnerhasmademanynegativecommentstohissignificantother,thepatient,overtheyears.Inthecrisiscentre,thenursewouldanticipatethatthepatientmayhavewhichofthefollowingself-conceptdeficits?a.Negativebodyimage.b.Roleconfusion.c.Rigidity.d.Yearning.ANS:AConsistentnegativecommentscancausedevaluationofanindividualsself-concept.Theeffectofnegativeself-esteemcaninvadeallareasofapersonslife,includingbodyimage.Roleconfusionispartofadevelopmentaltask(identityversusroleconfusion).Rigidityandyearningarenotcomponentsofself-concept.DIF:RememberREF:460OBJ:DiscussfactorsthatinfluNencRetheIfolGlowiBng.cCompMonentsofself-concept:identity,bodyimage,androleperformance.TOP:AssessmentMSC:CPNRE:FoundationsofPractice5.Two50-year-oldmenarediscussingtheirSaturdayactivities.Thefirstmandescribestutoringchildrenasavolunteeratacommunitycentre.Theothermansaysthathewouldneverworkwithchildrenandthathepreferstoworkoutatthegymtomeetyoungwomentodate.Thesecondmansstatementreflectswhichdevelopmentalstage?a.Inferiority.b.Roleconfusion.c.Self-absorption.d.Mistrust.ANS:CInthegenerativityversusself-absorptiondevelopmentaltask,aself-absorbedpersonisconcernedabouthisorherownpersonalwantsanddesiresinaself-centredmanner.Mistrustversustrustisencounteredinthefirstyearoflife.Industryversusinferioritycommonlyoccursinschool-agedchildren.Identityversusroleconfusioncommonlyoccursatthestartofadolescenceintoyoungadulthood.DIF:UnderstandREF:459OBJ:Describethecomponentsofself-conceptasrelatedtopsychosocialandcognitivedevelopmentalstages.TOP:AssessmentMSC:CPNRE:FoundationsofPracticeCanadianFundamentalsofNursing7thEditionPotterTestBank6.Anadultisadjustingtotheideathathischronicallyillparentwillmoveintothefamilyhome.Thecommunityhealthnursewouldassesstheadultsonforwhichpotentialstressorsecondarytothenewfamilylivingarrangement?a.Roleconfusion.b.Roleambiguity.c.Roleperformance.d.Roleoverload.ANS:DRoleoverloadinvolveshavingmoreroles,ormoreresponsibilitieswithinarole,thanaremanageable.Roleoverloadiscommoninindividualswhounsuccessfullyattempttomeetthedemandsofworkandfamilywhiletryingtofindsomepersonaltime.Roleconfusionisanaspectofthedevelopmentaltaskofadolescenceandyoungadulthood(identityversusroleconfusion).Roleambiguityinvolvesunclearroleexpectations.Roleperformanceitselfisnotastressorunlessitisjudgedineffective.DIF:UnderstandREF:463OBJ:Identifystressorsthataffectself-conceptandself-esteem.TOP:AssessmentMSC:CPNRE:FoundationsofPractice7.Anursegrimaceswhenseeingapatientscolostomyopeningwhilechangingthecolostomybag.Thisexpressionismostlikelytohavewhateffectonthepatient?a.Assistingrecoverybyusinghonestcommunication.b.Motivatingthepatienttoincreasephysicalactivity.c.Promotingdevelopmentofanegativebodyimage.d.Developingakindnicknameforthecolostomyopening.ANS:CNURSINGTB.COMNegativenonverbalreactionsbyanursetoapatientsscarorsurgicalalterationscontributetothepatientsdevelopinganegativebodyimage.Honestexpressionsofdistastebythenursewillnotfacilitaterecoveryorongoingcommunication.Encouragingphysicalactivityoradoptingapositivenicknamewillnotpromoteacceptanceofthecolostomyopening.DIF:UnderstandREF:465|466OBJ:Explorewaysinwhichanursesself-conceptandnursingactionscanaffectaclientsself-conceptandself-esteem.TOP:ImplementationMSC:CPNRE:FoundationsofPractice8.Imsuchaloser.Ionlyhadthatjobforamonth.Identifyappropriatenursingoutcomecriteriaforthisindividual.a.Thepatientwillverbalizethreelifeareasinwhichheorshefunctionswell.b.Thepatientwillfindnewemploymentbeforethenextclinicvisit.c.Thepatientwillconfronthisorherformerbossaboutworkproblems.d.Thepatientwillidentifywhyheorsheisconsideredabademployee.ANS:ACanadianFundamentalsofNursing7thEditionPotterTestBankVerbalizingthreelifeareasinwhichapersonfunctionswellisanindividualizedmeasurableoutcomethatisrealistic.Confrontingaformerbosscouldhavephysicalandemotionalrepercussionsforthepatient.Ifthepersonisvoicingconcernsthatheorshehasproblemsobtainingemployment,thenputtingextrapressureonthepersontoobtainemploymentwouldbedetrimentaltothepatientanddoesnotreflectasupportiveandcaringnursingoutcome.Anyimplicationthatthepatientisabademployeeisinappropriate.DIF:AnalyzeREF:472,Box26-11OBJ:Applythenursingprocesstopromoteaclientsself-concept.TOP:PlanningMSC:CPNRE:FoundationsofPractice9.Childrenlearntoliveanauthenticlifestylethroughculturallyacceptedbehaviours,values,androlemodelling.Achildwhodoesthisisattemptingtocreatewhat?a.Hisorherownbodyimage.b.Hisorherownself-esteem.c.Hisorherownidentity.d.Hisorherownroleperformance.ANS:CIdentityversusroleconfusionisastagethatoccursbetweentheagesof12and20years.Bodyimageandself-esteemareattitudesrelatedtopersonalreflectionandattitudes.Roleperformanceistheresultofcreatinganidentity.DIF:UnderstandREF:459OBJ:Describethecomponentsofself-conceptasrelatedtopsychosocialandcognitivedevelopmentalstages.TOP:PlanningMSC:CPNRE:FoundationsofPracticeNURSINGTB.COM10.Whichofthefollowingindividualsismostlikelytoneedthenursesassistancebecauseofthepresenceofidentityconfusion?a.A49-year-oldmanwithstableemployment.b.A35-year-oldrecentlydivorcedmotheroftwins.c.A22-year-oldinthethirdyearofcollege.d.A50-year-oldself-employedwoman.ANS:BIdentityconfusioncanoccurwhenpeopledonotmaintainaclear,consistent,andcontinuousconsciousnessofpersonalidentity.Anewlydivorcedwomanwouldbetryingtoadapttoanewlifestyleofbeingsinglewhilebeingasingleparentoftwins.Thissituationcouldleadtoidentityconfusion.Acollegesophomorewouldhavehadatleast2yearstoadjusttothenewlifesetting,andaself-employedwomanwouldprobablybecontentwithcreatingherownemploymentopportunity.Thereisnoindicationthatthemiddle-agedmanwithstableemploymentshouldhaveidentityconfusion.DIF:AnalyzeREF:463OBJ:Incorporateresearchfindingstopromoteevidence-informedpracticeforidentityconfusion,disturbedbodyimage,lowself-esteem,androleconflict.TOP:PlanningMSC:CPNRE:FoundationsofPractice11.Identifytheassessmentssuggestiveofanalteredself-concept.a.Limpinggaitandlargesmile.CanadianFundamentalsofNursing7thEditionPotterTestBankb.Slumpedpostureandpoorpersonalhygiene.c.Verballyrespondswhenaskedaquestion.d.Appropriatelydressedwithcleanclothes.ANS:BAself-conceptiscreatedbyanindividualsidentity,bodyimage,androleperformance.Poorpersonalhygieneandslumpingposturebestdescribeapersonwithanimpairedself-concept.Smiling,appropriateresponses,andappropriateappearanceareallsignsofnormalself-concept.DIF:UnderstandREF:467,Box26-7OBJ:Applythenursingprocesstopromoteaclientsself-concept.TOP:PlanningMSC:CPNRE:FoundationsofPractice12.Aprioritynursinginterventionforapatientwhohasundergoneamastectomyiswhichofthefollowing?a.Usingtherapeuticsilencetoencouragethepatienttotalk.b.Usingcommunicationskillstoclarifyfamilyandpatientexpectations.c.Tellingherthatthenurseknowsshewilldofinebecausemanyotherwomenhave.d.Rotatingnursingpersonnelinthepatientscare,sothepatientcantalktomanypeople.ANS:BThenurserecognizestheneedtousetherapeuticcommunicationskills,allowingthepatienttheopportunitytotalkopenlyaboutissuesthatareimportanttoapersonwhohasundergonebody-alteringsurgery.Whenanursedoesnotallowforthedevelopmentofapatient-nursetherapeuticrelationship,openandhonestconversationisimpossible.Silencecanbeuseful,butbuildingrapportandopenNinUgRthSeIcNonGvTerBsa.tiConOaMrenecessaryfirst.Reassurancethatapersonwilldofinedismissesanypotentialconcernsthepatientmayhave.Rotatingnursingpersonneldoesnotallowtimeforthepatienttobuildrapportwithanyonenurse.DIF:UnderstandREF:469OBJ:Applythenursingprocesstopromoteaclientsself-concept.TOP:PlanningMSC:CPNRE:FoundationsofPractice13.Thenurseinanaddictionsclinicisworkingwithapatientonprioritysettingbeforethepatientsdischargefromresidentialtreatment.Whichofthefollowingwouldbeanappropriatepriorityforapatientatthisclinic?a.Identifyinglocalself-helpgroupsbeforebeingdischargedfromtheprogram.b.Stayingawayfromalltriggersthatcausesubstanceabuse.c.Statingaplantoneverbetemptedbyillicitsubstancesafterdischarge.d.Identifyingpersonalareasofweaknesstogrowstronger.ANS:ACanadianFundamentalsofNursing7thEditionPotterTestBankProvidingthepatientwithresourcessuchaslocalself-helpgroupscanhelptoturnlimitationsintostrengths.Tryingtoavoidalltriggersthatcanresultinaddictivebehavioursisnotrealistic.Itisalsounrealistictobelievethatthepatientwillneverbetemptedbecausetemptationcanarisefrommultiplesources.Ontheotherhand,anappropriateprioritywouldbetorecognizethattriggerswillariseandthatthepatientshouldlearnhowtohandlebeingconfrontedinthepost-dischargesetting.Havingapersontalkabouthisorherweaknesseswithoutrecognizingapersonsstrengthscouldbeatriggertoreturntoanaddictivelifestyle,sothiswouldnotbethemostappropriatepriority.DIF:ApplyREF:467OBJ:Applythenursingprocesstopromoteaclientsself-concept.TOP:PlanningMSC:CPNRE:FoundationsofPractice14.Thenursecanbestassessthepatientsself-conceptbyevaluatingwhichofthefollowing?a.Thepatientsdrugabusehistory.b.Thepatientsnonverbalbehaviour.c.Thepatientspersonaljournal.d.Thepatientssocialnetworkingsite.ANS:BNonverbalbehavioursarekeyindicatorsofapatientsself-concept.Ahistoryofdrugabusedoesnotnecessarilyindicatecurrentself-concept,andpeoplewhodonothaveadrugabusehistorymayhavealowself-concept.Itwouldbeaninvasionofprivacyandtrustforanursetoreadapatientspersonaljournalorsocialnetworkingsite.DIF:ApplyREF:466|467OBJ:Applythenursingprocesstopromoteaclientsself-concept.TOP:AssessmentMSC:CPNNURRES:FIoNunGdaTtiBon.sCofOPMractice15.Anewlyhirednurseisstrugglingwithnightshiftworkandcaringformultiplefamilymembersathome.Thenursemanagercallsthenewnurseintotalkabouthowthenurseisnegativelyaffectingpatientself-conceptbyignoringpatientsconcerns.Whatshouldthenursemanagershouldfocuson?a.Thenewnursesroleoverload.b.Thenewnursesself-esteem.c.Thenewnursesegointegrity.d.Thenewnursesethicsandmorals.ANS:ARoleoverloadinvolveshavingmorerolesorresponsibilitiesthanaremanageable.Self-esteemistheoverallfeelingofself-worth.Thenurseisnotinvolvedinanethicalormoraldilemma.Egointegrityispartofadevelopmentaltaskassociatedwitholderpersons.DIF:ApplyREF:463OBJ:Explorewaysinwhichanursesself-conceptandnursingactionscanaffectaclientsself-conceptandself-esteem.TOP:ImplementationMSC:CPNRE:FoundationsofPractice16.A9-year-oldisproudlytellingeveryoneaboutmasteringtheyellowbeltinhermartialartsclass.Whatistheappropriatedevelopmentaltaskachieved?a.Initiativeversusguilt.CanadianFundamentalsofNursing7thEditionPotterTestBankUSNTb.Industryversusinferiority.c.Identityversusroleconfusion.d.Autonomyversusshameanddoubt.ANS:BIndustryversusinferiorityisastagethatoccursbetweentheagesof6and12years.Itisduringthisdevelopmentaltaskthatapersongainsself-esteemthroughnewskillmastery.Theotherself-conceptdevelopmenttasksoccuratotherstagesoflifeandwouldnotapplytothissituation.DIF:ApplyREF:459,Box26-1OBJ:Describethecomponentsofself-conceptasrelatedtopsychosocialandcognitivedevelopmentalstages.TOP:PlanningMSC:CPNRE:FoundationsofPractice17.Thenursecanassistthepatientinbecomingmoreself-awarebyusingwhichtechnique?a.Settingupanappointmenttoallowthepatienttovent.b.Allowingthepatienttoopenlyexplorethoughtsandfeelings.c.Assistingthepatienttophysicallypunchapillowwhenupset.d.Providingmaterialsforthepatienttowritecomplaintletters.ANS:BIncreasingthepatientsself-awarenessisachievedthroughestablishingatrustingnurse-patientrelationshipthatallowsthepatienttoopenlyexplorethoughtsandfeelings.Aprioritynursinginterventionistheexpertuseofcommunicationskillstoclarifythepatientsandfamilysexpectations.Openexplorationcanmakethesituationlessthreateningandencouragesbehavioursthatexpandself-awareness.Punchingpillowsdoesnotcreateself-awareness.WritingcomNplaiRntleItterGsanBd.veCntinMgcancreatemoreinternalturmoilinapersonanddonotpromoteself-awareness.DIF:ApplyREF:465OBJ:Applythenursingprocesstopromoteaclientsself-concept.TOP:PlanningMSC:CPNRE:FoundationsofPractice18.Whichofthefollowingisabehavioursuggestiveofalteredself-concept?a.Unkemptappearance.b.Interestinwhatishappening.c.Beingindependent.d.Easilymakingdecisions.ANS:ABehavioursthataresuggestiveofalteredself-conceptincludeavoidanceofeyecontact,hesitantspeech,unkemptappearance,beingexcessivelydependent,demonstratingadifficultyinmakingdecisions,andalackofinterestinwhatishappening.DIF:UnderstandREF:467OBJ:Applythenursingprocesstopromoteaclientsself-concept.TOP:AssessmentMSC:CPNRE:FoundationsofPracticeCanadianFundamentalsofNursing7thEditionPotterTestBankDIF:ApplyUSNTOChapter27:SexualityPotteretal:CanadianFundamentalsofNursing,7thEditionMULTIPLECHOICE1.Anurseiscaringfora15-year-oldwhointhepast6monthshashadmultiplemaleandfemalesexualpartners.Thenurseknowsthatwhichtherapeuticstatementwouldbemosteffective?a.Iknowyoufeelinvincible,butSTIs[sexuallytransmittedinfections]andunwantedpregnancyarearealrisk.Letsdiscusswhatyouthinkisthebestmethodofprotectingyourself.b.HavingsexualinteractionwithbothmalesandfemalesplacesyouathigherriskforSTIs.Toprotectyourselfyouneedtodecidewhichorientationyouare.c.Yourcurrentfriendsareleadingyoutomakepoorchoices.Youshouldfindnewfriendstohangoutwith.d.Ithinkitsbesttonotifyyourparents.Theyknowwhatsbestforyouandcanhelpmakesureyoupractisesafesex.ANS:AMostteenagersfeelinvincible,andforthisreason,someparticipateinriskybehaviours.Thenurseshouldacknowledgethisfeelingtothepatientandoffereducationandalternatives,whilegivingthepatienttheautonomytomakehisorherowndecisions.Thenurseshouldnotforcethepatienttomakeachoiceoforientationandshouldnotpassjudgementonapatientssexualorientationorsocialnetwork;thiswouldmakethepatientfeeldefensiveandwouldeliminatethetrustintherelationship.Involvingparentsisnotthefirstlineofaction;parentsshouldbenotifiedonlyifthechildisinalife-or-deathsituation.NRIGB.CMREF:478OBJ:Identifyhigh-riskandsafersexbehaviours.TOP:ImplementationMSC:CPNRE:Professional,Ethical,andLegalPractice2.Anurseiscaringforapatientwhoexpressesadesiretohaveanelectiveabortion.Thenursesreligiousandethicalvaluesarestronglyopposed.Howshouldthenursebesthandlethesituation?a.Continuetocareforthepatient,andlimitconversationasmuchaspossible.b.Referthepatienttoafamilyplanningcentreorhealthcareprovider.c.Attempttoeducatethepatientabouttheconsequencesofabortion.d.Informthepatientthatbecauseofmoralissues,anothernursewillhavetocareforher.ANS:BThenursemustbeawareofpersonalbeliefsandvaluesandisnotrequiredtoparticipateincounsellingorproceduresthatcompromisethosevalues.However,thepatientisentitledtononjudgementalcareandshouldbereferredtosomeonewhocancreateatrustingenvironment.Thenurseshouldnotcareforapatientifthequalityofcarecouldbejeopardized.Thenurseshouldnotattempttoprojectpersonalvaluesontoapatient.Thenursealsoshouldnotcreatetensionbyinformingthepatientthatshedoesnothavethesamemorals;thiscouldcausethepatienttofeelguiltyordefensivewhenreceivingcarefromanyhealthcareprovider.DIF:ApplyREF:483OBJ:Discussthenurse'sroleinmaintainingorenhancingapatient'ssexualhealth.CanadianFundamentalsofNursing7thEditionPotterTestBankTOP:ImplementationMSC:CPNRE:Professional,Ethical,andLegalPractice3.Whenrespondingtoanadolescentgirlsinquiryrelatedtoemergencycontraception,thenursetellsherthatthemosteffectivemethodiswhichofthefollowing?a.Levonorgestrelforemergencycontraception(LNG-EC).b.Ulipristalacetateforemergencycontraception(UPA-EC).c.Hormonalintrauterinedevice.d.Copperintrauterinedevice.ANS:DThemosteffectivemethodforemergencycontraceptionistheuseofacopperintrauterinedevice,whichcanbeinsertedandiseffectivewithin7daysafterunprotectedintercourse.Hormonalintrauterinedevicesarenotusedasemergencycontraception.BothLNG-ECandUPA-ECareusedasemergencycontraceptionbutarenotaseffectiveasthecopperintrauterinedevice.DIF:ApplyREF:482OBJ:Usecriticalthinkingskillstoassistpatientsinmeetingtheirsexualneeds.TOP:ImplementationMSC:CPNRE:FoundationsofPractice4.An18-year-oldmalepatientinformsthenursethatheisntsurewhetherheishomosexualbecauseheisattractedtobothgenders.Withwhichstatementcanthenurseestablishatrustingrelationshipwiththepatient?a.Dontworry.Itsjustaphaseyouwillgrowoutof.b.Thoseareabnormalimpulses.Youshouldseektherapy.c.Atyourage,itisnormaltobecuriousaboutbothgenders.d.Havingquestionsaboutsexualityisnormal.Tellmeaboutyoursexualexperience.ANS:CNURSINGTB.COMYoungadultshavequestionsaboutsexuality.Thepatientwillfeelmostcomfortablediscussinghissexualconcernsfurtherifthenurseestablishesthatitisnormaltoaskquestionsaboutsexuality.Thenursecanthendiscussingreaterdetail.Althoughitisnormalforyoungadultstobecuriousaboutsexuality,thenurseshouldusecautioningivingadviceontakingsexualaction.Thenurseshouldpromotesafesexpractices.Tellingthepatientnottoworrydismisseshisconcern.Tellingthepatientthatheisabnormalmightoffendthepatientandpreventhimfromestablishinganopenrelationship.Askingthepatientabouthissexualexperienceisalsoinappropriateinthissituationandisnotlikelytoassistinbuildingatrustingrelationshipwiththepatient.DIF:UnderstandREF:438OBJ:Describekeyconceptsofsexualdevelopmentacrossthelifespan.TOP:Education|TeachingMSC:CPNRE:FoundationsofPractice5.Anurseiscaringfora35-year-oldfemalepatientwhorecentlystartedtakingantidepressantsafterrepeatedattemptsatfertilitytreatment.Thepatienttellsthenurse,Ifeelhappier,butmysexdriveisgone.Whichnursingdiagnosishasthehighestpriority?a.Sexualdysfunction.b.Ineffectivecoping.c.Deficientknowledgeaboutcontraception.d.Riskforself-directedviolence.CanadianFundamentalsofNursing7thEditionPotterTestBankUSNTANS:AAntidepressantshaveadverseeffectsonsexualdesireandresponse.Thenurseshouldbesuretoeducatethepatientonthepotentialforthesesideeffectsandhowtocorrectforthem(e.g.,usinglubricanttoeasediscomfort).Thepatienthastakenstepstowardeffectivecopingbyseekingtherapy.Thepatienthasnotexpressedareasonforthenursetobeconcernedaboutcontraceptives.Thenurseshouldalwaysassessforconcernsaboutviolenceinapatientslife.Althoughsomeantidepressantshavebeenrelatedtoself-directedviolence,thispatientstatesthatsheisfeelinghappy.DIF:ApplyREF:484OBJ:Defineappropriatenursingdiagnosesforpatientswithalterationsinsexuality.TOP:PlanningMSC:CPNRE:FoundationsofPractice6.Anadolescentfemalestudentwhoissexuallyactivevisitstheofficeoftheschoolnurse.Thenurseknowsthatteachinghasbeeneffectivewhenthestudentstateswhichofthefollowing?a.Myboyfriendisabletowithdrawbeforeejaculation,andthatpreventsmefromgettingpregnant.b.Itakemytemperatureeverymorning,andwhenitgoesdownforatleasttwodays,wehaveunprotectedsex.c.Weusefoambeforeeachtimewehavesex,andIhaventgottenpregnantyet.d.Weuseacondomwithawater-basedlubricant.ANS:DAsamoreeffectivecontraceptivemethod,thewater-basedlubricantreducestheriskofthecondomsbreaking.Thepatientisverbalizingunderstanding.Anyactofunprotectedintercoursecanresultinpregnancy.Withdrawalisnotaneffectivecontraceptivemethod;anyactofunprotectedintercoursNecaRnreIsultGinpBre.gCnanMcy.ThestatementItakemytemperatureeverymorning,andwhenitgoesdownforatleasttwodays,wehaveunprotectedsex,alsodoesnotdemonstrateunderstandingofthebasalbodytemperaturemethodofcontraception.Usingspermicidalfoamaloneisnotrecommended.Thepatientshoulduseacondomandfoamtobemoreeffectiveinpreventingpregnancy.DIF:ApplyREF:482,Table27-1OBJ:Identifyanddescribenursinginterventionstopromotesexualhealth.TOP:Education|TeachingMSC:CPNRE:FoundationsofPractice7.Apatientwhohashadseveralsexualpartnersinthepastmonthexpressesadesiretouseacontraceptive.Whichcontraceptivemethodshouldthenurserecommend?a.Spermicide.b.Condom.c.Diaphragm.d.Oralcontraceptive.ANS:BCondomsarebothacontraceptiveandabarrieragainstSTIsandhumanimmunodeficiencyvirus(HIV)infection;properusegreatlyreducestheriskofinfection.Spermicides,diaphragms,andoralcontraceptivesallprotectagainstpregnancy;however,theydonotpreventbodilyfluidsfromcomingincontactwiththepatientduringsexualintercourse.DIF:UnderstandREF:481OBJ:Usecriticalthinkingskillstoassistpatientsinmeetingtheirsexualneeds.CanadianFundamentalsofNursing7thEditionPotterTestBankTOP:Education|TeachingMSC:CPNRE:FoundationsofPractice8.Awomanwhohasbeeninamonogamousrelationshipforthepast6monthspresentstoclinicwithherpesonherlabia.Thepatientisdistraughtbecauseshebelievesherpartnermusthavecheatedonher.Whichresponsebythenurseismosteffectiveinestablishinganopenrapportwithapatient?a.Sharingananecdote.b.Informingthepatientthatallencountersareconfidential.c.Tellingthepatientthatshemustbehonestabouteverysexualexperienceshehashad.d.Askingthepatientwhatconcernsorfearsshehasrelatedtothevisit.ANS:BIfeffectiveopencommunicationistobeestablishedwiththepatient,thepatientmustknowthatshecantrustherhealthcareprovider.Bytellingthepatientthatalldiscussionswiththenurseareconfidential,thenurseestablishestrust.Afterestablishingthattrust,thenursecanfurtherbuildtherelationshipsbyaskingthepatientopenquestionsaboutherfear.Forcingthepatienttoconfidebysharingeverysexualencountermayhinderthedevelopmentofatrustingrelationship.DIF:ApplyREF:483OBJ:Assessapatientssexuality.TOP:AssessmentMSC:CPNRE:Professional,Ethical,andLegalPractice9.ApatientadmitsthatheknewforseveralmonthsthathehadanSTIbutdidnotreportit.Whydidhebehavethisway?a.ManypatientswithSTIsdonotacknowledgetheimportanceofSTItestingandtreatment.NRIGB.CMb.ManypatientswithSTIsarUeheSsitaNnttoTadmitOtheycontractedanSTI.c.ManypatientswithSTIshavelifestylesthatsubjectthemtorepeatedexposure.d.ManypatientswithSTIsareuncomfortablediscussingsexualhealthissueswithasame-sexhealthcareprovider.ANS:BManypatientsfeelguilt,embarrassment,andanxietyaboutcontractinganSTI;thiscancausethemtodefercareuntiltheproblembecomessevere.AlthoughknowledgeabouttheseverityofSTIsmaybeinsufficient,thisshouldnotdeterseekingcare.Regardlessoflifestyle,STIsshouldbetreatedimmediatelytopreventfurthertransmission.Theroleofthehealthcareprovideristoestablishatrustingrelationship.ApersonmaybeopentodiscussinghealthpromotionbehavioursbutmaystillbehesitanttodiscussSTIs.DIF:UnderstandREF:480OBJ:Identifyanddescribenursinginterventionstopromotesexualhealth.TOP:ImplementationMSC:CPNRE:FoundationsofPractice10.Thenurseisleadingaseminaraboutmenopauseandage-relatedchanges.Thenurseknowsthatapatientdoesnotfullyunderstandthechangesofagingwhenthepatientmakeswhichstatement?a.Iwillnolongerovulateaftermenopause.b.Orgasmsarenolongerachievableaftermenopause.c.Hormonesofsexualregulationsuchasestrogendecreasewithage.d.Asmenage,theirabilitytosexuallyperformmaydecrease.CanadianFundamentalsofNursing7thEditionPotterTestBankUSNTANS:BOrgasmsareachievableatanyage.Estrogenlevelsdecrease,andthismayimpedesexualdesire.Thenurseshouldaskthepatientwhethershehasanyquestionsonactionthatwillassistinhealthysexualpatterns.Allotherstatementsindicatethatthepatientdoeshaveanunderstandingofage-relatedchanges.DIF:UnderstandREF:478|479OBJ:Usecriticalthinkingskillstoassistpatientsinmeetingtheirsexualneeds.TOP:EvaluateMSC:CPNRE:FoundationsofPractice11.Apatientwhohadanostomyplaced1monthagostatesthatheisfeelingdepressedanddoesnotwanttoparticipateinsexualactivitiesanymorebecauseheisafraidthathispartnerisnotphysicallyattractedtohim.Whichnursinginterventionwillbemosteffectiveinhelpingthispatientresumesexualactivity?a.Reassurethepatientthatlotsofpeopleresumesexthesameweektheostomyisplaced.b.Informthepatientaboutasupportgroupforpeoplewithostomies.c.Teachthepatientaboutintimateactivitiesthatcanbedonetoincorporatetheostomy.d.Discusswaystoadapttonewbodyimagesothepatientwillbecomfortableinresumingintimacy.ANS:DThenurseshouldaddressthepatientsneedtobecomfortablewithhisownbodyimage;oncethisisdone,thepatientcanresumesexualactivity.ReassuringthepatientthatothersmanagetohavesexualintercoursewithanostomymayhelptodecreaseanxietybutmayhavetheunintendedeffectofmakingNtheRpatiIentGfeelBas.tChouMghheisabnormalbecausehehasnotyetresumedsexualactivity.Supportgroupsmaybehelpfulforthepatient,butthisisnotthemosteffectiveinterventionanursecanprovide.Thepatientshouldbediscouragedfrommanipulatingtheostomyduringsexualactivity;thiscancauseinfection,trauma,orprolapsetothestoma.DIF:ApplyREF:485OBJ:Usecriticalthinkingskillstoassistpatientsinmeetingtheirsexualneeds.TOP:ImplementationMSC:CPNRE:FoundationsofPractice12.Amotherbringsher10-year-olddaughterintoaclinicandinquiresaboutgettingherahumanpapillomavirus(HPV)vaccinethatday.Whatinformationdoesthenursegivethemother?a.TheHPVvaccineissafeforchildrenovertheageof9.b.TheHPVvaccineisrecommendedonlyafteragirlorwomanbecomessexuallyactive.c.TheHPVvaccinewillpreventagirlorwomanfromevergettingcervicalcancer.d.TheHPVvaccineisnotcurrentlyavailablefor10-year-oldgirls.ANS:ATheHPVvaccineiseffectiveagainstthefourmostcommontypesofHPVthatcancausecervicalcancer.Therecommendationisthatgirlsandwomenbetweentheagesof9and26beofferedthisvaccine;itisimportantthatthevaccinebegivenbeforetheinitiationofsexualactivity.Thevaccineismosteffectiveifadministeredbeforesexualactivityorexposure.DIF:UnderstandREF:480CanadianFundamentalsofNursing7thEditionPotterTestBankOBJ:Identifyanddescribenursinginterventionstopromotesexualhealth.TOP:ImplementationMSC:CPNRE:FoundationsofPractice13.Anursingstudentisprovidingeducationtoagroupofolderpersonswhoareinanindependentlivingretirementvillage.Whichofthefollowingstatementsmadebythenursingstudentpromptsthenursingprofessortointervene?a.Avoidingalcoholusewillenhanceyoursexualfunctioning.b.Youdonotneedtoworryaboutgettingasexuallytransmittedinfectionatthispointinyourlife.c.Youneedtotellyourpartnerhowyoufeelaboutsexandanyfearsyoumayhave.d.Usingpillowsandtakingpainmedicationifneededbeforehavingsexualintercourseoftenhelpsalleviatepainassociatedwithintercourseandimprovessexualfunctioning.ANS:BAnypersonwhohassexualintercoursecandevelopanSTIatanyage.Peoplewithmultiplesexpartnersareatgreaterrisk.Therefore,theinstructorneedstointervenewhenthestudenttellstheolderpersonsthattheyarenotatriskfordevelopinganSTI.Sexualfunctioningisenhancedbyavoidingtheuseofalcohol;usingpillows;takingpainmedicationsbeforeintercourseifneeded;andcommunicatingthoughts,fears,andfeelingsaboutsex.DIF:EvaluateREF:480|481OBJ:Identifyanddescribenursinginterventionstopromotesexualhealth.TOP:ImplementationMSC:CPNRE:FoundationsofPractice14.Whileteachingadolescentsaboutchlamydia,whatdoestheschoolnursetellsthegroup?a.ChlamydiaisaviralinfecNtiUonRtShaItNcaGnTnoBt.beCcOuMred.b.Chlamydiacanbetreatedwithafullcourseofantibiotics.c.Chlamydiacanbecontractedviabloodborneexchange.d.Chlamydiacanbepreventedwiththeuseofaspermicide.ANS:BChlamydiaisthemostcommonofallbacterialSTIsandistreatedwithanantibiotic.Chlamydiaiscausedbybacteria,notbyavirus,andcanbetreatedwithanantibiotic.STIssuchaschlamydiaaretransmittedfrominfectedindividualstopartnersduringintimatesexualcontact.STIsarecontractednotviabloodborneexchangebutratherthroughbodyfluids.Chlamydiaisnotpreventedwiththeuseofaspermicide.DIF:ApplyREF:480OBJ:Identifycommonsexuallytransmittedinfections(STIs).TOP:ImplementationMSC:CPNRE:FoundationsofPractice15.Apatientasksthenursewhatsignsandsymptomsareassociatedwithchlamydia.Howshouldthenurserespond?a.Thefirstsignsthatchlamydiapresentsarefrequencyandburninguponurination.b.Symptomsofchlamydiausuallyaffectonlywomen.c.Smallredblistersappearfirstandthenmultiply.d.Dementiaresultsifchlamydiagoesuntreatedtoolong.ANS:ACanadianFundamentalsofNursing7thEditionPotterTestBankUrinaryproblemsandabnormaldischargeareoftenthefirstsignsofchlamydia.Bothmenandwomencanexperiencethesesymptoms,althoughitisknownasthesilentSTIbecausesymptomsmaynotmanifestforsometimeafterthediseaseiscontracted.Smallredblistersareassociatedwithgenitalwartsandherpes.Chlamydiadoesnotcausedementia.DIF:RememberREF:480OBJ:Identifycommonsexuallytransmittedinfections(STIs).TOP:AssessmentMSC:CPNRE:FoundationsofPractice16.Whatisanexampleofaqualityinthecriticalthinkingmodelforsexualityassessment?a.Displayingcuriosity.b.Applyinganethicofcare.c.Acceptingthesexualorientationofthepatient.d.Determiningthepatientssexualconcerns.ANS:AOneofthethreequalitiesinthecriticalthinkingmodelforsexualityassessmentisdisplayingcuriosity.Theothertwoqualitiesaredisplayingintegrityandtakingrisksifnecessary.Applyinganethicofcareisanexampleofastandardinthemodel.Acceptingapatientssexualorientationanddeterminingthepatientssexualconcernsareexamplesofknowledgeinthemodel.DIF:ApplyREF:486OBJ:Usecriticalthinkingskillstoassistpatientsinmeetingtheirsexualneeds.TOP:ImplementationMSC:CPNRE:FoundationsofPractice17.ApatientstatesthatsheisafraidthatsheandherhusbandwillnotbeabletomaintainahealthysexualrelationshipnNowUtRhSatIthNeyGhTaBve.aCbOabMyinthehouse.Toassistthesepatients,whatshouldthenurseknow?a.Whethertheyhavesimilarparentingbeliefs.b.Howlongtheyhavebeenmarried.c.Thateffectivecommunicationaboutsexualityrequiresanondiscriminatoryattitude.d.Thelevelofknowledgethepatientshaveregardinghealthysexualrelationships.ANS:CInresponsetoidentifiedconcerns,thenursemayinitiatediscussion.Effectivecommunicationaboutsexualityrequirescaring,sensitivity,tact,compassion,theuseofappropriatelanguage,andanondiscriminatoryattitude.Itisimportantnottohavepreconceivednotionsaboutthepatientssexualidentityoractivity.Havingsimilarparentingbeliefswillhavelesseffectontheirsexualrelationshipthantheuseofeffectivecommunication;toassistthepatientsinadjustingtothechangeofbecomingafamily,thenurseshouldexploretheircommunicationpatterns.Howlongtheyhavebeenmarriedwouldbelesssignificant.Thelevelofknowledgethepatientshaveregardinghealthysexualrelationshipswouldnotaffecttheirsexualrelationshipasmuchastheirabilitytodiscusstheirfeelingswithoneanother.DIF:ApplyREF:483|486|487OBJ:Identifyanddescribenursinginterventionstopromotesexualhealth.TOP:ImplementationMSC:CPNRE:FoundationsofPracticeCanadianFundamentalsofNursing7thEditionPotterTestBank18.A68-year-oldwomanasksthenursewhetheracontraceptiveisstillnecessary.Whatisthebestresponsebythenurse?a.AbarriersuchasacondomisrecommendedifyouareunsurewhetheryoursexualpartnershavebeentestedforSTIs.b.No,becauseyouhavegonethroughmenopauseandcannolongerbecomepregnant.c.Letsdiscussthisfurther;whatisyourcurrentlevelofsexualactivity?d.Yes,aslongasusingabarrierdoesnotdecreasesexualperformance.ANS:CThenurseshouldfirstassessthepatientsriskforcontractinganSTI.Ifthepatienthasbeeninamonogamousrelationship,andbothpartiesareSTIfree,thereisnoneedforabarrier.However,eventhoughapatienthasgonethroughmenopause,thereisstillriskforanSTI.Thebestwayforanursetobesensitivetoapatientsneedsistofindoutmoreaboutthepatient.Discussingsexualperformanceinrelationtousingabarriermethoddoesnotanswerthepatientsquestion.DIF:AnalyzeREF:486|487OBJ:Describekeyconceptsofsexualdevelopmentacrossthelifespan.TOP:ImplementationMSC:CPNRE:FoundationsofPractice19.Whenconductinganeducationsessionontheuseofcontraceptives,thenurseinformsthegroupthatwhichmethodhasthelowestinitialrateofeffectiveness?a.Useofamalecondom.b.Tuballigation.c.Useofafemalecondom.d.UseofavaginalcontraceNptivReriIng.GB.CMANS:CUSNTOOftheanswerchoices,thefemalecondomhasthelowestrateofeffectiveness,beginningat79%.Theinitialrateofeffectivenessofthemalecondomis86%.Theinitialrateofeffectivenessofatuballigationis99.5%.Theinitialrateofeffectivenessofthevaginalcontraceptiveringis98%.DIF:ApplyREF:482OBJ:Identifyanddescribenursinginterventionstopromotesexualhealth.TOP:ImplementationMSC:CPNRE:FoundationsofPractice20.Apatientexpressesconcernthatherpartnernolongerfindsherattractiveandisconsideringhavingthree-waysextospiceuptherelationship.Whichresponseisthebestoptionforthenurseinthissituation?a.Pleasehelpmeunderstandhowyouarefeelingaboutyourrelationshiprightnow.b.Ifyourpartnertrulylovesyou,hedoesntneedtohavesexwithanotherperson.c.Nonmonogamoussexisimmoral;hereisthenumberforthelocalchurch.d.Haveyouconsideredtheconsequencesofaddingathirdpartytoasexualrelationship?ANS:ACanadianFundamentalsofNursing7thEditionPotterTestBankThenurseshouldbenonjudgemental,andaskingforclarificationofthepatientsfeelingswillhelpthenursebetterunderstandthesituation.Makingassumptionsaboutthepatientspartnerisnotappropriate.Passingjudgementorimposingthenursesmoralsonthepatientisunethical.Askingthepatienttoconsidertheconsequencesofathree-wayisjudgementalandimpliesthatnontraditionalsexisinappropriate.DIF:ApplyREF:483|486|487OBJ:Identifyanddescribenursinginterventionstopromotesexualhealth.TOP:ImplementationMSC:CPNRE:FoundationsofPracticeNURSINGTB.COMCanadianFundamentalsofNursing7thEditionPotterTestBankNRIGB.CChapter28:SpiritualityinHealthandHealthCarePotteretal:CanadianFundamentalsofNursing,7thEditionMULTIPLECHOICE1.ThewordspiritualityderivesfromtheLatinwordspiritus,whichreferstobreathorwind.Today,spiritualitycanbedescribedaswhichofthefollowing?a.Transcendencebeyondself,everydayliving,andsuffering.b.Lessimportantthancopingwiththepatientsillness.c.Patientcentredandhavingnobearingonthenursesbeliefpatterns.d.Equatedtoformalreligiouspracticeandhavingaminoreffectonhealthcare.ANS:AToday,spiritualityisoftendefinedasaconnectednesswithself,others,ahigherpowerornature,oracombinationofthese;asenseofmeaninginlife;andtranscendencebeyondself,everydayliving,andsuffering.Spiritualityisanimportantfactorthathelpsindividualsachievethebalanceneededtomaintainhealthandwell-beingandtocopewithillness.Itpositivelyaffectsandenhanceshealth,qualityoflife,healthpromotionbehaviours,anddiseasepreventionactivities.Nursesneedanawarenessoftheirownspiritualitytoprovideappropriateandrelevantspiritualcaretoothers.Theconceptsofspiritualityandreligionareoftendiscussedinterchangeably,butspiritualityisamuchbroaderandmoreunifyingconceptthanreligion.Thehumanspiritispowerful,andspiritualityhasdifferentmeaningsfordifferentpeople.DIF:UnderstandREF:494OBJ:Compareandcontrasttheconceptsofreligionandspirituality.TOP:AssessmentMSC:CPNURES:FoNundaTtionsofOPractice2.ThenurseiscaringforapatientwhoclaimsthathedoesnotbelieveinGodanddoesnotbelieveinanultimatereality.Thenurserealizeswhataboutthispatient?a.Thepatientisdevoidofspirituality.b.Thepatientisanatheist/agnostic.c.Thepatientfindsnomeaningthroughrelationshipswithothers.d.Thepatientbelievesthatwhathedoesismeaningless.ANS:BSomeindividualsdonotbelieveintheexistenceofGod(atheist)ordonotknowwhetherGodoranotherultimaterealityexists(agnostic).Thisdoesnotmeanthatspiritualityisnotanimportantconceptfortheatheistortheagnostic.Atheistssearchformeaninginlifethroughtheirworkandtheirrelationshipswithothers.Agnosticsdiscovermeaninginwhattheydoorhowtheylivebecausetheyfindnoultimatemeaningforthewaythingsare.Theybelievethatpeoplebringmeaningtowhattheydo.DIF:RememberREF:496OBJ:Compareandcontrasttheconceptsofreligionandspirituality.TOP:AssessmentMSC:CPNRE:FoundationsofPractice3.Thenurseiscaringforapatientwhoisterminallyillwithverylittletimelefttolive.Thepatientstates,Ialwaysbelievedthattherewaslifeafterdeath.Now,Imnotsosure.Doyouthinkthereis?Thenursestates,Ibelievethereis.Whathasthenurseattemptedtodo?CanadianFundamentalsofNursing7thEditionPotterTestBankUSNTOa.Strengthenthepatientsreligion.b.Providehope.c.Supportthepatientsagnosticbeliefs.d.Supportthehorizontaldimensionofspiritualwell-being.ANS:BWhenapersonhastheattitudeofsomethingtolookforwardto,hopeispresent.Religionisthesystemoforganizedbeliefsandworshipthatapersonpractisestooutwardlyexpressspirituality.Thisisnotevidenthere.AgnosticsdonotknowwhetherGodoranotherultimaterealityexistsandareuncertainwhetherthereislifeafterdeath.Thehorizontaldimensionofspiritualwell-beingdescribespositiverelationshipsandconnectionspeoplehavewithothers.Inthiscase,thepatientismoreconcernedwiththeverticaldimension,whichsupportsthetranscendentrelationshipwithGodorsomeotherhigherpower.DIF:ApplyREF:497|503OBJ:Discussresearchfindingsthatsuggestarelationshipbetweenspiritualpracticesandpatients'healthstatus.TOP:ImplementationMSC:CPNRE:FoundationsofPractice4.Indiscussingspiritualitywithadolescentpatients,ofwhatshouldthenursebeaware?a.Thatmanyadolescentshaveagoodconceptofasupremebeing.b.Thatmanyadolescentsquestionreligiouspracticesandvalues.c.Thatadolescentsfullyacceptthehighermeaningoftheirfaith.d.Thatadolescentsdogooddeedsforothersasaspiritualtask.ANS:BAdolescentsoftenreconsidertheirchildlikeconceptofaspiritualpower,andinthesearchforanidentity,theymayeitherqNuesRtionIpraGcticBes.aCndvMaluesorfindthespiritualpowerasthemotivationtoseekaclearermeaningtolife.Adolescentsdonotnecessarilyhaveagoodconceptofasupremebeing;thisconceptualizationoccursaspeoplemature.Adolescentsdonotnecessarilyfullyacceptthehighermeaningoftheirfaith.Olderpersons,notadolescents,oftenturntoimportantrelationshipsanddoinggooddeedsforothersasspiritualtasks.DIF:ApplyREF:496OBJ:Discusstheroleofthenurseinprovidingspiritualnursingcare.TOP:ImplementationMSC:CPNRE:FoundationsofPractice5.Thenurseisadmittingapatienttothehospital.Thepatientstatesthatheisaveryspiritualpersonbutdoesnotpractiseanyspecificreligion.Whatshouldthenurseunderstandaboutthesestatements?a.Thattheyarecontradictory.b.Thattheyindicateastrongreligiousaffiliation.c.Thattheyindicatealackoffaith.d.Thattheyarereasonable.ANS:DThesestatementsarereasonableandarenotcontradictory.Manypeopletendtousethetermsspiritualityandreligioninterchangeably.Althoughcloselyassociated,thesetermsarenotsynonymous.Religiouspracticesencompassspirituality,butspiritualitydoesnotneedtoincludereligiouspractice.Whenapersonhastheattitudeofsomethingtoliveforandlookforwardto,hopeispresent.CanadianFundamentalsofNursing7thEditionPotterTestBankUSNTODIF:UnderstandREF:496OBJ:Compareandcontrasttheconceptsofreligionandspirituality.TOP:AssessmentMSC:CPNRE:FoundationsofPractice6.Whichofthefollowingisaninterventionthatwillfacilitateconnectedness?a.Restrictingvisitsfrompets.b.Placingmemorabiliainthepatientsview.c.Avoidingphysicaltouchandmassage.d.Implementingrelevantritualsandtraditions.ANS:BAnexampleofaninterventiontofacilitateconnectednessistoplacememorabiliainviewofthepatient.Visitsfrompetsshouldbeencouraged,notrestricted.Physicaltouchandmassageareinterventionstofacilitateconnectednessandthereforeshouldbeimplemented,notavoided.Implementingrelevantritualsandtraditionsisanexampleofaninterventiontofacilitatehope,notconnectedness.DIF:UnderstandREF:497|498OBJ:Discusstheroleofthenurseinprovidingspiritualnursingcare.TOP:PlanningMSC:CPNRE:FoundationsofPractice7.Whichstatementaboutreligionandspiritualityistrue?a.Religionisaunifyingthemeinpeopleslives.b.Spiritualityisuniquetotheindividual.c.Spiritualityencompassesreligion.d.Religionandspiritualityaresynonymous.ANS:BNRIGB.CMSpiritualityisacomplexconceptthatisuniquetoeachindividual.Religionisthesystemoforganizedbeliefsandworshipthatapersonpractisestooutwardlyexpressspirituality.Peoplefromdifferentreligionsviewspiritualitydifferently.Althoughcloselyassociated,spiritualityandreligionarenotsynonymous.Religiouspracticesencompassspirituality,butspiritualitydoesnotneedtoincludereligiouspractice.DIF:RememberREF:495|496OBJ:Compareandcontrasttheconceptsofreligionandspirituality.TOP:AssessmentMSC:CPNRE:FoundationsofPractice8.Whatisthebeststatementbyanursewhoisassessingthespiritualneedsofa76-year-oldpatientwhowasjustadmittedtothenursingunitwithterminalcanceroftheliver?a.InoticeyouhaveaBible.Isthatasourceofspiritualstrengthforyou?b.Whatdoyoubelievehappenstoyourspiritwhenyoudie?c.Wewouldallowmembersofyourchurchtovisityouwheneveryoudesire.d.Hasyourterminalconditionmadeyouloseyourfaithorbeliefs?ANS:ACanadianFundamentalsofNursing7thEditionPotterTestBankNRIGB.CStatingtheobservationofthepatienthavingaBibleopenscommunicationregardingthepatientssourceofstrength.Assessingapatientssourcesofstrengthandfaithcandirectinteractionwithhimorher,includingmedicaltreatmentplans.Whatdoyoubelievehappenstoyourspiritwhenyoudie?isnotthebestresponse,asitdoesnotprovideinformationthatwouldassistthenurseinmeetingthepatientsspiritualneeds.Wewouldallowmembersofyourchurchtovisityouwheneveryoudesireisnotthebestresponse,asitimpliesboththatthepatientgoes,orshouldgo,tochurchandtheassumptionthatchurchmembersareasourceofstrengthforthepatient.Itdoesnotprovideassessmentinformationtodeterminethepatientsspiritualneeds.Hasyourterminalconditionmadeyouloseyourfaithorbeliefs?hasanegativeconnotationanddoesnothelpassessthepatientssourcesofstrengthorbeliefs.DIF:UnderstandREF:499OBJ:Describeaprocessforunderstandingpatients'spirituality.TOP:AssessmentMSC:CPNRE:FoundationsofPractice9.Whatisthenursesinitialactionwhileworkingwithapatienttoassessandsupportthepatientsspirituality?a.Referringthepatienttotheagencychaplain.b.Helpingthepatienttousefaithtogetwell.c.Providingavarietyofreligiousliterature.d.Determiningthepatientsperceptionsandbeliefsystem.ANS:DToassessandsupportthepatientsspirituality,thenurseshouldfirstdeterminethepatientsperceptionsandbeliefsystem.Exploringthepatientsspiritualitymayrevealresponsestohealthproblemsthatnecessitatenursingintervention,oritmayrevealtheexistenceofastrongsetofresourcesthatenablethepatienttocopeeffectively.Althoughtheagencychaplainmaybeasourceforreferral,suchaUrefeSrralNisnTotthefOirstactionthenurseshouldtakeinassessingandsupportingapatientsspirituality.Thenurseneedsfirsttoassessapatientsspiritualitytodeterminethepatientsperceptionsandbeliefsystembeforeattemptingtoassistthepatienttousefaithtogetwell.Providingavarietyofreligiousliteraturemaybeineffectivebecauseitdoesnotaddressthepatientasanindividualanddoesnothelpassessthepatientspersonalspiritualneeds.DIF:ApplyREF:499OBJ:Describeaprocessforunderstandingpatients'spirituality.TOP:ImplementationMSC:CPNRE:FoundationsofPractice10.IfapatientisidentifiedasfollowingthetraditionalhealthcarebeliefsofJudaism,whileplanningpatientcare,whichofthefollowingshouldbeincorporatedinnursingcare?a.ObservanceoftheSabbath.b.Faithhealing.c.Theremovalofreligioussymbols.d.SacramentsofHolyCommunion.ANS:AObservanceoftheSabbathisimportanttoapatientwhofollowsthetraditionalhealthcarebeliefsofJudaism.ThispatientmayrefusetreatmentsscheduledontheSabbath.FollowersoftheIslamicorChristianfaithmayusefaithhealinginresponsetoillness.Religioussymbolsshouldnotberemovedfromindividualswhopractiseanyreligion.SacramentsofHolyCommunionarepractisedbyfollowersoftheChristianfaith.CanadianFundamentalsofNursing7thEditionPotterTestBankDIF:AnalyzeREF:502,Table28-1OBJ:Discusstheroleofthenurseinprovidingspiritualnursingcare.TOP:PlanningMSC:CPNRE:FoundationsofPractice11.Whichofthefollowingattributesofspiritualcareinnursingpracticeisdescribedasadirectiontoplacepatientsneedsfirstandprotectvulnerability?a.Altruism.b.Interpersonalism.c.Intuitiveness.d.Integrativeness.ANS:AAltruismisoneattributeofspiritualcare,meaningdirectiontoplacepatientsneedsfirstandprotectvulnerability.Interpersonalismisthewillingnesstobepresentandengagemattersofspiritualitywithoutfear.Intuitivenessisthediscernmentofspiritualmattersrelevanttothepatient.Integrativenessisanethicofcarethatinfluencesallaspectsofnursing.DIF:UnderstandREF:503,Figure28-2OBJ:Describetherelationalattributesthatfacilitatespiritualnursingcare.TOP:PlanningMSC:CPNRE:FoundationsofPractice12.Thepatientisadmittedwithchronicbackpain.Thenursewhoiscaringforthispatientshoulddowhichofthefollowing?a.Focusonfindingquickremediesforthebackpain.b.Lookathowpaininfluencesthepatientsabilitytofunction.c.Realizethatthepatientsonlygoalisreliefofthebackpain.d.HelpthepatientrealizethNaUttRheSreIiNslGitTtleBh.oCpeOoMfrelieffromchronicpain.ANS:BThenurseshouldnotviewthepatientsbackpainasmerelyaproblemtosolvewithquickremedies;rather,thenurseshouldexaminehowthepaininfluencesthepatientsabilitytofunctionandachievegoalsestablishedinlife(notjustpainrelief).Mobilizingthepatientshopeiscentraltoahealingrelationship.DIF:ApplyREF:497|504OBJ:Describeaprocessforunderstandingpatients'spirituality.TOP:ImplementationMSC:CPNRE:FoundationsofPractice13.Incaringforthepatientsspiritualneeds,whatshouldthenurseunderstand?a.Establishingpresenceispartoftheartofnursing.b.Presenceinvolvesdoingforthepatient.c.Acaringpresenceinvolveslisteningtothepatientswishesonly.d.Thenursemustuseherexpertisetomakedecisionsforthepatient.ANS:AEstablishingpresenceispartoftheartofnursing.Presenceinvolvesbeingwithapatientversusdoingforapatient.Thenurseshoulddemonstrateacaringpresencebylisteningtothepatientsconcernsandwillinglyinvolvingfamilyindiscussionsaboutthepatientshealth.Thenurseshouldalsoshowself-confidencewhenprovidinghealthinstructionandsupportpatientsastheymakedecisionsabouttheirhealth.CanadianFundamentalsofNursing7thEditionPotterTestBankDIF:UnderstandREF:496|499OBJ:Describetherelationalattributesthatfacilitatespiritualnursingcare.TOP:PlanningMSC:CPNRE:FoundationsofPractice14.Whenaskedabouthisreligiousaffiliation,apatientresponds,Thatspersonal;whydoyouwanttoknow?Whichofthefollowingisthemostappropriatenursingresponse?a.Youneednotanswermyquestionifyouprefernottosharethatinformation.b.Byknowingyourreligiouspreferences,Icanbestmeetyourspiritualneeds.c.Allinformationthatyouprovidewillbekeptinstrictconfidence.d.Ididnotmeantooffendyou;weaskthatquestionofallofournewadmissions.ANS:BInformationaboutreligiousandspiritualbeliefsandpracticesshouldbeobtainedfrompatientswhentheyenterhealthcarefacilities.Nursingcareshouldtakeintoaccountthebiological,psychological,social,cultural,andspiritualneedsofpatients.Applyingknowledgeofspiritualconceptsandusingtherapeuticcommunicationskillswillhelpthenurserecognizeandunderstandthepatientsspiritualbeliefs,soYouneednotanswermyquestionifyouprefernottosharethatinformationisnotanappropriateresponse.Althoughitistruethatpatientinformationiskeptconfidential,itisimportanttounderstandthepatientsbeliefsystemtotreatthepatientwithdignityandrespect.Intheassessmentofspiritualcaregiving,itisimportantforthenursetoinformthepatientthatheorsheisobtaininginformationtoensuresensitivitytothepatientsneedsandgivethepatienttheopportunitytocommunicatehisspiritualneeds.DIF:ApplyREF:499|500OBJ:Discusstheroleofthenurseinprovidingspiritualnursingcare.TOP:ImplementationMSC:CPNRE:FoundationsofPracticeNURSINGTB.COM15.Whichofthefollowingcanbeusedtodevelopthenursesownspiritualawarenesswhilefacilitatingthespiritualpracticesofothers?a.Hostingachurchgrouponthemedicalunit.b.Engaginginmindfulness.c.Takingpartinotherreligionspractices.d.Takingauniversity-levelcourseonreligion.ANS:BMindfulnesscanbeanimportantstrategyfordevelopingspiritualpractice,bothforoneselfandothers.Nursesshouldlearnaboutvariousreligiouspracticestobeabletosupporttheirpatientsspiritualhealth,buttheyarenotrequiredtohostachurchgroup,takeauniversity-levelcourseonreligion,ortakepartinotherreligionspractices.DIF:UnderstandREF:497OBJ:Discusstheroleofthenurseinprovidingspiritualnursingcare.TOP:ImplementationMSC:CPNRE:FoundationsofPractice16.Thepatientishavingadifficulttimedealingwithhisdiagnosisofacquiredimmunedeficiencysyndrome(AIDS).Hestates,Itsnotfair.Imtotallyisolatedfrommyfamilybecauseofthis.Evenmyfatherhatesmeforthis.Hewontevenspeaktome.Whatdoesthenurseneedtodo?a.Assurethepatientthathisfatherwillaccepthissituationsoon.b.Usetherapeuticcommunicationtoestablishtrustandcaring.CanadianFundamentalsofNursing7thEditionPotterTestBankc.Pointoutthatthepatienthasnocontrolandthathehastofacetheconsequences.d.Tellthepatient,Ifyourfathercantgetoverit,forgetit.Youhavetomoveon.ANS:BThenurseneedstousetherapeuticcommunicationtoestablishtrustandacaringpresencebecauseprovidingspiritualcarerequirescaring,compassion,andrespect.Thenurseshouldnotofferfalsehope.Thenurseshouldhelpthepatientmaintainfeelingsofcontrol.Thenurseshouldencouragerenewingrelationshipsifpossibleandestablishingconnectionswithself,significantothers,andahigherbeing.DIF:ApplyREF:500|501OBJ:Describetherelationalattributesthatfacilitatespiritualnursingcare.TOP:ImplementationMSC:CPNRE:FoundationsofPractice17.Thenurseiscaringforapatientwhoisinthefinalstagesofaterminaldisease.Thepatientisveryweakbutrefusestouseabedpanandwantstogetuptousethebedsidecommode.Whatshouldthenursedo?a.Explaintothepatientthatheistooweakandneedstousethebedpan.b.Insertarectaltubesothatthepatientnolongerneedstoactivelydefecate.c.Enlistassistancefromfamilymembersifpossibleandassistthepatienttogetup.d.Putthepatientonabedpanandstaywithhimuntilheisfinished.ANS:CEstablishingpresenceispartoftheartofnursing.Presenceinvolvesbeingwithapatientversusdoingforapatient.Thenurseshoulddemonstrateacaringpresencebylisteningtothepatientsconcernsandwillinglyinvolvingfamilyindiscussionsaboutthepatientshealth.Thenurseshouldsupportpatientsastheymakedecisionsabouttheirhealth.Ifatallpossible,thenurseshouldencouragethNeUpRatSieIntNtoGmTaBin.taCinOaMsmuchindependenceaspossible.Insertingarectaltubeinvolvesdoingforinsteadofbeingwith.Placingthepatientonthebedpanisagainstthepatientswishesandisanotherformofdoingfor.DIF:ApplyREF:496|499OBJ:Describetherelationalattributesthatfacilitatespiritualnursingcare.TOP:ImplementationMSC:CPNRE:FoundationsofPractice18.Inassessingthespiritualhealthofherpatients,whatshouldthenurseunderstand?a.Spiritualbeliefschangeaspatientsgrowanddevelop.b.Spiritualhealthinolderpersonsdoesnotleadtopeaceandacceptanceofothers.c.Olderpersonsoftenexpressspiritualitybyfocusingonthemselves.d.Thebasisofbeliefsamongolderpeopleisfocusedononeortwofactors.ANS:ASpiritualbeliefschangeaspatientsgrowanddevelop.Healthspiritualityinolderpersonsleadstopeaceandacceptanceofself.However,olderpersonsoftenexpresstheirspiritualitybyturningtoimportantrelationshipsandgivingofthemselvestoothers.Beliefsamongolderpeoplevaryonthebasisofmanyfactors,suchasgender,pastexperience,religion,economicstatus,andethnicbackground.DIF:UnderstandREF:496OBJ:Discussappropriatewaystofacilitatepatients'spiritualpractices.TOP:AssessmentMSC:CPNRE:FoundationsofPracticeCanadianFundamentalsofNursing7thEditionPotterTestBank19.WhichofthefollowingareincludedinthefiveCsofrelationalpractice?a.Compassion,curiosity,commitment,competence,andcorresponding.b.Compassion,communication,curiosity,candour,andcorresponding.c.Commitment,caring,candour,communication,andcompetence.d.Commitment,communication,curiosity,caring,andcompetence.ANS:AThefiveCsofrelationalpracticearecompassion,curiosity,commitment,competenceandcorresponding.Communication,caring,andcandourarenotincludedinthisframework.DIF:UnderstandREF:503,Box28-7OBJ:Discusstheroleofthenurseinprovidingspiritualnursingcare.TOP:PlanningMSC:CPNRE:FoundationsofPracticeNURSINGTB.COMCanadianFundamentalsofNursing7thEditionPotterTestBankChapter29:StressandAdaptationPotteretal:CanadianFundamentalsofNursing,7thEditionMULTIPLECHOICE1.Inanaturaldisasterrelieffacility,thenurseobservesthatanelderlymanhasarecoveryplan,whereasa25-year-oldmanisstilloverwhelmedbythedisastersituation.Thesedifferentreactionstothesamesituationwouldbeexplainedbestbywhichofthefollowing?a.Restorativecare.b.Strongfinancialresources.c.Maturationalandsocioculturalfactors.d.Immaturityandintelligencefactors.ANS:CMaturationalfactorsandsocioculturalfactorscanaffectpeopledifferently,dependingontheirlifeexperiences.Anolderindividualwouldhavemorelifeexperiencestodrawfromanddeterminewhichstrategiesweresuccessful,whereasayoungerindividualwouldhavehadfewersuch.Nothinginthescenarioimpliesthateithermanisinrestorativecare,hasstrongfinancialresources,orisimmatureorintelligent.DIF:ApplyREF:514OBJ:Discusstheintegrationofstresstheorywithnursingtheories.TOP:PlanningMSC:CPNRE:FoundationsofPractice2.Awomanwhowassexuallyassaultedmorethanamonthagopresentstothehealthclinicwithcomplaintsofrecurrentnightmares,fearofgoingtosleep,repeatedvividmemoriesofthesexualassault,andinabiliNtyUtRoSfeIelNmGuTchBe.mCoOtion.Thenurserecognizesthesignsandsymptomsofwhichmedicalproblem?a.Generaladaptationsyndrome.b.Post-traumaticstressdisorder(PTSD).c.Developmentalcrisis.d.Alarmreaction.ANS:BPTSDischaracterizedbyvividrecollectionsofthetraumaticeventandemotionalnumbingandoftenisaccompaniedbynightmares.SymptomsofPTSDaremorepersistentthanthoseofacutestressdisorder,havingenduredforatleast1month.Generaladaptationsyndromeistheexpectedreactiontoamajorstressor.Developmentalcrisisoccursasapersonmovesthroughlifestagesratherthaninresponsetoatrauma.Alarmreactioninvolvesphysiologicaleventssuchasincreasedactivationofthesympatheticnervoussystemthatwouldhaveoccurredatthetimeofthesexualassault.DIF:ApplyREF:512OBJ:Differentiateacutestressdisorderandpost-traumaticstressdisorder.TOP:AssessmentMSC:CPNRE:FoundationsofPractice3.Thenurseteachesstressreductionandrelaxationtrainingtoahealtheducationgroupofpatientsaftercardiacbypasssurgery.Thenurseisperformingwhichlevelofintervention?a.Primary.b.Secondary.CanadianFundamentalsofNursing7thEditionPotterTestBankUSNTc.Tertiary.d.Quadlevel.ANS:CTertiary-levelinterventionsassistpatientsinadaptingtolifewithanillness.Tertiarypreventionfocusesonthepersonwhoalreadyhasthediseaseandisrecoveringorrehabilitating,andthegoalsaretoslowdownthediseaseprocess,preventfurtherdamageorpainfromthedisease,andpreventthecurrentdiseasefromcreatingotherhealthproblems.Primaryinterventionsincludestressprevention,promotionofwellness,andriskfactorreductionbeforeillnessoccurs.Secondaryinterventionsareimplementedaftersymptomsappearandhelpthepersondevelopresourcestomanageillnessandstress.Quadlevelinterventionsdonotexist.DIF:UnderstandREF:513OBJ:Discusstheintegrationofstresstheorywithnursingtheories.TOP:AssessmentMSC:CPNRE:FoundationsofPractice4.Anurseisteachingguidedimagerytoaprenatalclass.Whichofthefollowingisanexampleofguidedimagery?a.Singing.b.Backmassage.c.Peacefulsensorywords.d.Listeningtomusic.ANS:CGuidedimageryisusedasameanstocreatearelaxedstatethroughthepersonsimagination,oftenwiththeuseofsensorywords.Imaginationallowsthepersontocreateasoothingandpeacefulenvironment.SinginNg,bRackImaGssagBe.,aCndMlisteningtomusicareothertypesofstressmanagementtechniques.DIF:UnderstandREF:520OBJ:Describestressmanagementtechniquesbeneficialforcopingwithstress.TOP:AssessmentMSC:CPNRE:FoundationsofPractice5.Afteranaturaldisasteroccurred,anemergencyworkerreferredafamilyforcrisisinterventionservices.Onefamilymemberrefusedtoattendtheservices,stating,Noway,Imnotcrazy.Thebestresponsethenursecangiveiswhichofthefollowing?a.Manytimes,disasterscancreatementalhealthproblems,soyoureallyshouldparticipatewithyourfamily.b.Crisisinterventionisashort-termproblem-solvingtypeofhelp,andseekingthishelpdoesnotmeanthatyouhaveamentalillness.c.Dontworrynow.Thepsychiatristsarewelltrainedtohelp.d.Crisisinterventionwillhelpyourfamilycommunicatebetter.ANS:BCrisisinterventionisatypeofbrieftherapythatismoredirectivethantypicalpsychotherapyorcounselling.Itfocusesonproblemsolvingandinvolvesonlytheproblemcreatedbythecrisis.Thegoalofcrisisinterventionistocreatestabilityforthepersoninvolvedinthecrisiswhilepromotingself-reliance.Theotheroptionsdonotproperlyreassurethepatientandbuildtrust.DIF:ApplyREF:521OBJ:Discusstheprocessofcrisisintervention.CanadianFundamentalsofNursing7thEditionPotterTestBankUSNTTOP:ImplementationMSC:CPNRE:FoundationsofPractice6.Pediatricstressorsrelatedtoself-esteemandchangesinfamilystructurereflectwhichmaturationalschoolagecategory?a.Elementaryschoolage.b.Preadolescence.c.Adolescence.d.Earlyadulthood.ANS:BChildrenofpreadolescentageexperiencestressrelatedtoself-esteemissues,changingfamilystructureduetodivorceordeathofaparent,orhospitalization.Adolescentstressorsincludeidentityissueswithpeergroupsandseparationfromparents.Elementaryschoolagestressorsincludefriends,family,andschoolrelations.Adultstressorscentreonlifeevents.DIF:ApplyREF:514OBJ:Describehowstressisconceptualized.TOP:ImplementationMSC:CPNRE:FoundationsofPractice7.Duringtheevaluationstageofthecriticalthinkingmodelappliedtoapatientcopingwithstress,whatwillthenursedo?a.Selectnursinginterventionstopromotethepatientsadaptationtostress.b.Establishshort-andlong-termgoalswiththepatientexperiencingstress.c.Identifystressmanagementinterventionsforachievingexpectedoutcomes.d.Reassesspatientsstress-relatedsymptomsandcomparewithexpectedoutcomes.ANS:DDuringtheevaluationstage,thenursecomparescurrentstress-relatedsymptomsagainstestablishedmeasurableoutcoNmesRtoIevaGluatBet.hCeeffMectivenessoftheintervention.Identifyingandselectingappropriateinterventionsandestablishinggoalsarepartoftheplanningprocess.DIF:UnderstandREF:522OBJ:Developacareplanforpatientsexperiencingstress.TOP:ImplementationMSC:CPNRE:FoundationsofPractice8.Thenurseisinvolvedincrisisinterventionwithafamilyinwhichthefatherhasjustlosthisjobandisexperiencingperiodsofdepression.Themotherhasachronicdebilitatingillnessthathasputaddedresponsibilitiesontheadolescentchild,whoishavingbehaviouralproblems.Howdoesthenursehelpthefamilyfocusontheirfeelings?a.Pointingouttheconnectionbetweenthesituationandtheirresponses.b.Encouragingtheuseofthefamilysusualcopingskills.c.Workingontimemanagementskills.d.Discussingpastexperiences.ANS:AWhenusingacrisisinterventionapproach,thenursehelpsthepatientmakethementalconnectionbetweenthestressfuleventandthepatientsreactiontoit.Becauseanindividualsorfamilysusualcopingstrategiesareineffectiveinmanagingthestressoftheprecipitatingeventinacrisissituation,theuseofnewcopingmechanismsisrequired.Timemanagementskillswillnothelpreducethestressoftheprecipitatingeventinacrisissituation.Pastexperiencesmaynotbehelpfulinmanagingthestressoftheprecipitatingeventinacrisissituation.CanadianFundamentalsofNursing7thEditionPotterTestBankDIF:AnalyzeREF:521OBJ:Discusstheprocessofcrisisintervention.TOP:ImplementationMSC:CPNRE:FoundationsofPractice9.Asenioruniversitystudentcontactsthecampushealthclinicaboutafirst-yearstudentlivingonthesamedormitoryfloor.Theseniorstudentreportsthatthefirst-yearstudentiscryingandisnotadjustingtouniversitylife.Theclinicnurserecognizesthisasacombinationofsituationalandmaturationalstressfactors.Whatwouldbethebestcommenttotheseniorstudent?a.Idbettercall911becauseyourfriendissuicidal.b.Giveherthislistofuniversityandcommunityresources.c.Youmustmakeanappointmentforthestudenttoobtainmedications.d.Idrecommendyouhelpthestudentpackherbagstogohome.ANS:BAhealthcareprovidercanhelptoreducesituationalstressfactorsforindividuals.Providingthestudentwithalistofresourcesisonewaytobeginthisprocess,aspartofsecondarypreventionstrategies.Thisisnotamedicalorpsychiatricemergency,socalling911isnotnecessary.Noteveryonewhohassadnessneedsmedications;someneedonlycounselling.Notenoughinformationisgiventoindicatewhetherleavingtheuniversityisthebestsolutionforthestudent.DIF:ApplyREF:513OBJ:Developacareplanforpatientsexperiencingstress.TOP:ImplementationMSC:CPNRE:FoundationsofPractice10.Whenworkinginahighlystressfulnursingunitandacceptingadditionalshifts,anewnursinggraduateshoulddevelopastrategytopreventburnout.Whatwouldthebeststrategyforthenewnursebe?NURSINGTB.COMa.Identifylimitsandscopeofworkresponsibilities.b.Writefor10minutesinajournaleveryday.c.Useprogressivemusclerelaxation.d.Delegatecomplexnursingtaskstolicensedprofessionalnurses.ANS:AAnimportantstepinpreventingburnoutisacknowledgingonesownlimitations,aswellaswhatonesscopeofworkiswhileonthejob.Bydoingthis,thenursewillhelptopreventemotionalexhaustionandwilllimittheeffectsofchronicstress.Journallingandmusclerelaxationaregoodstress-relievingtechniquesbutarenotdirectedatthecauseoftheworkplacestress.Delegating,ifnotapplicable,isaninappropriatecopingmechanism.DIF:ApplyREF:521OBJ:Discusshowstressintheworkplacecanaffecthealthcareproviders.TOP:ImplementationMSC:CPNRE:Professional,Ethical,andLegalPractice11.Ateenagerwithceliacdiseasecontinuestoeatfoodsheknowswillmakeherillseveralhoursafteringestion.Inviewoftheappropriatetertiary-levelinterventions,whatwouldbethenursingintervention?a.TeachthepatientaboutCanadasFoodGuidetoHealthyEating.b.Administerantidiarrhealmedicationswithmeals.c.Assisttheteenagerinmeetingdietaryrestrictionswhileeatingfoodssimilartothoseeatenbyherfriends.CanadianFundamentalsofNursing7thEditionPotterTestBankUSNTOd.Admonishtheteenagerandherparentsregardingherconsistentlypoordietchoices.ANS:CTertiaryinterventionshelpthepatientadapttolifewithanillness.Byadjustingthediettomeetdietaryguidelinesandalsoaddressingadolescentemotionalneeds,thenursewillhelptheteenagertofollowanappropriatedietwithouthealthcomplicationsandseeherselfasatypicalandnormalteenager.TeachingaboutCanadasFoodGuidetoHealthyEatingwillnotaddresstherealissue,whichisthattheteenagerisstilleatingwhatsheknowswillmakeherill.Administeringantidiarrhealmedicationsmayhelpbutisnotatertiaryintervention.Admonishingtheteenagerandparentsisnotatertiaryintervention,andbecausethisapproachisnontherapeutic,itmaycausecommunicationproblems.DIF:ApplyREF:513OBJ:Developacareplanforpatientsexperiencingstress.TOP:ImplementationMSC:CPNRE:FoundationsofPractice12.Atraumasurvivorisrequestingsleepmedicationbecauseofbaddreams.ConcernedaboutPTSD,thenursewouldaskwhichofthefollowing?a.Areyourelivingyourtrauma?b.Areyouhavingchestpain?c.Canyoudescribeyourphobias?d.Canyoutellmewhenyouwakeup?ANS:APeoplewhohavePTSDoftenhaveflashbacks,re-experiencingthetrauma.TheotheranswersinvolveassessmentofproblemsnotspecifictoPTSD.NRIGB.CMDIF:ApplyOBJ:Differentiateacutestressdisorderandpost-traumaticstressdisorder.TOP:ImplementationMSC:CPNRE:FoundationsofPractice13.A23-year-oldpatientwhorecentlysufferedaheadinjuryinamotorvehicleaccidentisunconscious.Whatphysiologicalcomponentisprimarilyresponsibleforthepatientslevelofconsciousness?a.Medullaoblongata.b.Reticularformation.c.Pituitarygland.d.Externalstressresponse.ANS:BThereticularformationisprimarilyresponsibleforanindividualslevelofconsciousness.Themedullaoblongatacontrolsvitalfunctionssuchasheartrate,bloodpressure,andrespiration.Thepituitaryglandsupplieshormonesthatcontrolvitalfunctions.Thepituitaryglandproduceshormonesnecessaryforadaptationtostress.Theexternalstressresponseisnotprimarilyresponsibleforapersonslevelofconsciousness.DIF:AnalyzeREF:510OBJ:Definethekeybiologicalsystemsinvolvedinstressresponses.TOP:AssessmentMSC:CPNRE:FoundationsofPractice14.Anexampleofanassessmentfindingofcaregiverstrainwouldbewhichofthefollowing?REF:512CanadianFundamentalsofNursing7thEditionPotterTestBankUSNTa.Caregiverroutinelycreatesaweeklymenuplan.b.Caregiverhasnotreceivedmedicalcarewhenill.c.Caregivercanidentifyrespitecareprovider.d.Caregiverattendsreligiousservices.ANS:BAnursewillidentifyacaregiverslackofself-careasapotentialexampleofcaregiverrolestrain.Sacrificingtheirownhealthtocarefortheidentifiedpatientplacescaregiversatriskforbecomingillthemselves.Ifcaregiversjeopardizetheirownhealth,theymaynotbeabletocarefortheactualpatient.Inalloftheotheroptions,thecaregiverishandlingcaregiverstressappropriately.DIF:ApplyREF:513,Box29-3OBJ:Developacareplanforpatientsexperiencingstress.TOP:ImplementationMSC:CPNRE:FoundationsofPractice15.NursesinthemedicalcentreareworkingwithpatientsexperiencingPTSDafterlosingfamilymembersfromsevereacuterespiratorysyndrome.Whichofthefollowingapproacheswouldbeappropriatetoincorporateintotheplanofcare?a.Suppressionofanxiety-producingmemories.b.ReinforcementthatthePTSDisshortterm.c.Promotionofrelaxationstrategies.d.Focusingonphysicalneeds.ANS:CTeachingthepatientrelaxationstrategiescanhelpreducethestressofanxiety-provokingthoughtsandevents,asseeninPTSD,andreinforcesanadaptivecopingstrategy.Inthepresenceofanxiety-provokinNgthRougIhtsGandBe.veCnts,Macommonphysiologicalsymptomismuscletension.Physiologicaltensionisdiminishedthroughasystematicapproachtoreleasingtensioninmajormusclegroups.Suppressionwouldbeamaladaptivecopingmechanism.PTSDisnotashort-termproblembutalong-termone;thefocusshouldbeondevelopingadaptivecopingmechanismsandloweringtheindividualsanxietylevel.TheprimaryfocusforthepatientwhoisexperiencingPTSDisnotonphysicalneeds.DIF:ApplyREF:520OBJ:Differentiateacutestressdisorderandpost-traumaticstressdisorder.TOP:ImplementationMSC:CPNRE:FoundationsofPractice16.Thenursingstudentgaveawellnesslectureontheimportanceofaccurateassessmentandinterventionfromapersonal,family,andcommunityperspective.Theothernursingstudentsenjoyedthelectureaboutwhichnursingtheory?a.Egodefencemodel.b.Situationalmodel.c.Evidence-informedpracticemodel.d.Neumanssystemsmodel.ANS:DCanadianFundamentalsofNursing7thEditionPotterTestBankUSNTNeumanssystemsmodelisbasedonanindividuals/familys/communitysrelationshiptostressandthereactiontostress.Thismodelpromoteswellnessonprimary,secondary,andtertiarylevels.Theotheritemslistedasmodelsarenotnursingtheories.Egodefencemechanismsareunconsciouscopingmechanisms.Situationalfactorsincludestressorssuchasrelocationorfamilyjobchanges.Evidence-informedpracticeconsistsofrelyingondataorotherreputableinformationsourcestoguidenursingcare.DIF:ApplyREF:513OBJ:Discusstheintegrationofstresstheorywithnursingtheories.TOP:ImplementationMSC:CPNRE:FoundationsofPractice17.Anadultwhowasinamotorvehicleaccidentisbroughtintotheemergencydepartmentbyparamedics,whoreportthefollowingin-transitvitalsigns:Oraltemperature:37.2C(99.0F)Pulse:102beatsperminuteRespiratoryrate:26breathsperminuteBloodpressure:140/106Thenursecanidentifythatwhichhormonesarethelikelycausesoftheabnormalvitalsigns?a.Antidiuretichormone(ADH)andadrenocorticotropichormone(ACTH).b.ACTHandepinephrine.c.ADHandnorepinephrine.d.Epinephrineandnorepinephrine.ANS:DEpinephrineandnorepinephrinearecatecholaminehormonessecretedbytheadrenalmedullathatrapidlyelevateheartrateandbloodpressure.ACTHoriginatesfromtheanteriorpituitaryglandandstimulatescortisolNreleRaseI;ADGHoBr.igCinatMesfromtheposteriorpituitaryglandandincreasesrenalreabsorptionofwater.ACTH,cortisol,andADHdonotincreaseheartrate.DIF:ApplyREF:510|511OBJ:Discusstheintegrationofstresstheorywithnursingtheories.TOP:ImplementationMSC:CPNRE:FoundationsofPractice18.Thenurseisworkingwithpatientsinanoutpatienthealthcaresetting.Oneofthepatientsisexperiencingjob-relatedstress.Whichofthefollowingisafactorthatmayindicatechronicstress?a.Avoidingdiscussionofjobproblems.b.Sayingnegativethingsaboutothercolleagues.c.Experiencingchronicpainandirritablebowelsyndrome.d.Blamingthebossforbeingunreasonablydemanding.ANS:CChronicpaindisorders,irritablebowelsyndrome,somatizationdisorder,andclinicaldepressionhaveallbeenlinkedtochronicstress.Apatientsavoidingdiscussionoftheproblem,negativecommentsabouthisorhercolleagues,andblamingofthebossmaynotberelatedtochronicstress.DIF:UnderstandREF:510-512OBJ:Describehowstressisconceptualized.TOP:AssessmentMSC:CPNRE:FoundationsofPracticeCanadianFundamentalsofNursing7thEditionPotterTestBank19.A72-year-oldpatientisinalong-termcarefacilityafterhavinghadacerebrovascularaccident.Thepatientisnoncommunicative,enteralfeedingsarenotbeingabsorbed,andrespirationsarebecominglaboured.Whatstageofthegeneraladaptationsyndromeisthispatientexperiencing?a.Resistancestage.b.Exhaustionstage.c.Reflexpainstage.d.Alarmreactionstage.ANS:BTheexhaustionstageoccurswhenthebodycannolongerresisttheeffectsofthestressorandwhentheenergynecessarytomaintainadaptationisdepleted.Duringtheresistanceoradaptationstage,thebodystabilizes.Reflexpainresponseisnotastageofthegeneraladaptationsyndrome.Duringthealarmreaction,increasinghormonelevelsresultinincreasedbloodvolume,epinephrineandnorepinephrineamounts,heartrate,bloodflowtomuscles,oxygenintake,andmentalalertness.DIF:UnderstandREF:509OBJ:Discusstheintegrationofstresstheorywithnursingtheories.TOP:ImplementationMSC:CPNRE:FoundationsofPractice20.Whilegivingalectureonattention-deficit-hyperactivitydisorder,thenurseencourageswhichofthefollowingtoreducechildrensstressregardinghomeworkassignments?a.Timemanagementskills.b.Preventionofirondeficiencyanemia.c.Routinepreventivehealthvisits.d.SpeecharticulationskillsN.ANS:AURSINGTB.COMTimemanagementskillsaremosthelpfulinreducinghomework-relatedstress.Anemiapreventionwillimproveenergylevelsbutnotalleviatestress.Routinehealthvisitsareimportantbutdonotdirectlyaffectabilitytocompletehomework.Speechandotherdevelopmentalaspectsneedtobedevelopedifthechildistobesuccessful,butskilldevelopmentwillnotdirectlyreducehomework-relatedstress.DIF:ApplyREF:520OBJ:Describestressmanagementtechniquesbeneficialforcopingwithstress.TOP:ImplementationMSC:CPNRE:FoundationsofPracticeCanadianFundamentalsofNursing7thEditionPotterTestBankChapter30:VitalSignsPotteretal:CanadianFundamentalsofNursing,7thEditionMULTIPLECHOICE1.Howdoestheposteriorhypothalamushelpcontroltemperature?a.Bycausingvasoconstriction.b.Byshuntingbloodtotheskinandextremities.c.Byincreasingsweatproduction.d.Bycausingvasodilation.ANS:AIftheposteriorhypothalamussensesthatthebodystemperatureislowerthanthesetpoint,thebodyinitiatesheatconservationmechanisms.Vasoconstrictionofbloodvesselsreducesbloodflowtotheskinandextremities.Theanteriorhypothalamuscontrolsheatlossbyinducingsweating,vasodilationofbloodvessels,andinhibitionofheatproduction.DIF:RememberREF:528OBJ:Explainthephysiologyofnormalregulationofbloodpressure,pulse,oxygensaturation,andrespirations.TOP:AssessmentMSC:CPNRE:FoundationsofPractice2.Ofthefollowingmechanismsofheatlossbythebody,whatisthemechanismthattransfersheatawaythroughtheuseofairmovement?a.Radiation.b.Conduction.c.Convection.d.Evaporation.ANS:CNURSINGTB.COMConvectionisthetransferofheatawayfromthebodybyairmovement.Conductionisthetransferofheatfromoneobjecttoanotherwithdirectcontact.Radiationisthetransferofheatfromthesurfaceofoneobjecttothesurfaceofanotherwithoutdirectcontactbetweenthetwo.Evaporationisthetransferofheatenergywhenaliquidischangedtoagas.DIF:UnderstandREF:529OBJ:Explainthephysiologyofnormalregulationofbloodpressure,pulse,oxygensaturation,andrespirations.TOP:AssessmentMSC:CPNRE:FoundationsofPractice3.Thepatienthasatemperatureof40.7C(105.2F).Thenurseisattemptingtolowerhistemperaturebyprovidingtepidspongebathsandplacingcoolcompressesinstrategicbodylocations.Thenurseisattemptingtolowerthepatientstemperaturethroughtheuseofwhichofthefollowing?a.Radiation.b.Conduction.c.Convection.d.Evaporation.ANS:BCanadianFundamentalsofNursing7thEditionPotterTestBankUSNTOApplyinganicepackorbathingapatientwithacoolclothincreasesconductiveheatloss.Radiationisthetransferofheatfromthesurfaceofoneobjecttothesurfaceofanotherwithoutdirectcontactbetweenthetwo.Evaporationisthetransferofheatenergywhenaliquidischangedtoagas.Convectionisthetransferofheatawayfromthebodybyairmovement.DIF:ApplyREF:529OBJ:Explainthephysiologyofnormalregulationofbloodpressure,pulse,oxygensaturation,andrespirations.TOP:ImplementationMSC:CPNRE:FoundationsofPractice4.Infocusingontemperatureregulationofnewbornsandinfants,whatshouldthenurseknow?a.Temperaturesarebasicallythesameforinfantsandolderpersons.b.Infantshavewell-developedtemperature-regulatingmechanisms.c.Thenormaltemperaturerangegraduallyincreasesasthepersonages.d.Newbornsneedtowearacaptopreventheatloss.ANS:DAnewbornlosesupto30%ofbodyheatthroughtheheadandthereforeneedstowearacaptopreventheatloss.Temperaturecontrolmechanismsinnewbornsareimmatureandresponddrasticallytochangesintheenvironment.Thenormaltemperaturerangegraduallydropswithage.DIF:UnderstandREF:529OBJ:Describefactorsthatcausevariationsinbodytemperature,pulse,oxygensaturation,respirations,andbloodpressure.TOP:AssessmentMSC:CPNRE:FoundationsofPracticeNRIGB.CM5.Thenurseisworkingthenightshiftonasurgicalunitandismakingroundsat0400hours.Shenoticesthatthepatientstemperatureis36C(96.8F),whereasat1600hourstheprecedingday,itwas37C(98.6F).Whatshouldthenursedo?a.Callthephysicianimmediatelytoreportapossibleinfection.b.Realizethatthisisanormaltemperaturevariation.c.Provideanotherblankettoconservebodytemperature.d.Providemedicationtolowerthetemperaturefurther.ANS:BBodytemperaturenormallychanges0.5Cto1C(0.9Fto1.8F)duringa24-hourperiod.Unlessthepatientiscomplainingofbeingcold,thereisnophysiologicalneedforanextrablanketorformedicationtolowerthebodytemperaturefurther.Thereisalsononeedtocallaphysiciantoreportanormaltemperaturevariation.DIF:ApplyREF:530OBJ:Describefactorsthatcausevariationsinbodytemperature,pulse,oxygensaturation,respirations,andbloodpressure.TOP:ImplementationMSC:CPNRE:FoundationsofPractice6.Thenurseiscaringforapatientwhohasatemperaturereadingof38C(100.4F).Hislasttwotemperaturereadingswere37C(98.6F)and36C(96.8F).Whatshouldthenursedo?a.Callthephysicianandanticipateanordertotreatthefever.b.Assumethatthepatienthasaninfectionandorderbloodcultures.c.Waitanhourandrecheckthepatientstemperature.CanadianFundamentalsofNursing7thEditionPotterTestBankUSNTd.Beawarethattemperaturesthishighareharmfulandaffectpatientsafety.ANS:CWaitinganhourandrecheckingthepatientstemperaturewouldbethemostappropriateactioninthiscase.Afeverusuallyisnotharmfulifitstaysbelow39C(102.2F),andasingletemperaturereadingdoesnotalwaysindicateafever.Inadditiontophysicalsignsandsymptomsofinfection,afeverdeterminationisbasedoncomparisonbetweenseveraltemperaturereadingsatdifferenttimesofthedayandtheusualvalueforthatpersonatthattime.Mildtemperatureelevationsenhancethebodysimmunesystembystimulatingwhitebloodcellproduction.Staffnursesusuallydonotorderbloodcultures,andnursesshouldbaseactionsonknowledge,notonassumptions.DIF:ApplyREF:530OBJ:Describefactorsthatcausevariationsinbodytemperature,pulse,oxygensaturation,respirations,andbloodpressure.TOP:ImplementationMSC:CPNRE:FoundationsofPractice7.Whenheatlossmechanismsofthebodyareunabletokeeppacewithexcessheatproduction,theresultisknownaswhichofthefollowing?a.Pyrexia.b.Theplateauphase.c.Thesetpoint.d.Becomingafebrile.ANS:APyrexia,orfever,occursbecauseheatlossmechanismsareunabletokeeppacewithexcessheatproduction,resultinginanabnormalriseinbodytemperature.ThesetpointisthetemperaturepointdeterminedNbyRtheIhypGothBal.amCus.MWhenpyrogenstriggerimmunesystemresponses,thehypothalamusreactstoraisethesetpoint,andthebodyproducesandconservesheat.Duringtheplateauphase,chillssubsideandthepersonfeelswarmanddryasheatproductionandlossequilibrateatthenewlevel.Whenthefeverbreaks,thepatientbecomesafebrile.DIF:RememberREF:530OBJ:Identifyrangesofacceptablevitalsignvaluesforaninfant,achild,andanadult.TOP:AssessmentMSC:CPNRE:FoundationsofPractice8.Thenurseiscaringforapatientwhohasanelevatedtemperature.Whatshouldthenurseknow?a.Feverandhyperthermiaarethesamething.b.Hyperthermiaoccurswhenthebodycannotreduceheatloss.c.Hyperthermiaisanupwardshiftinthesetpoint.d.Hyperthermiaoccurswhenthebodycannotreduceheatproduction.ANS:DElevationinbodytemperaturethatisrelatedtothebodysinabilitytopromoteheatlossorreduceheatproductionishyperthermia.Feverandhyperthermiaarenotthesamething.Fever,nothyperthermia,isanupwardshiftinthesetpoint.DIF:UnderstandREF:530|531OBJ:Describefactorsthatcausevariationsinbodytemperature,pulse,oxygensaturation,respirations,andbloodpressure.TOP:AssessmentCanadianFundamentalsofNursing7thEditionPotterTestBankMSC:CPNRE:FoundationsofPractice9.Thepatientisrestlessandhasatemperatureof39C(102.2F).Whatisoneofthefirstthingsthenurseshoulddo?a.Administeroxygentothepatient.b.Restrictthepatientsfluidintake.c.Increasethepatientsactivity.d.Increasethepatientsmetabolicrate.ANS:ADuringafever,cellularmetabolismincreasesandoxygenconsumptionrises.Myocardialhypoxiaproducesangina.Cerebralhypoxiaproducesconfusion.Interventionsduringafeverincludeoxygentherapy.Dehydrationisaseriousproblemresultingfromincreasedrespirationanddiaphoresis,andadehydratedpatientisatriskforfluidvolumedeficit.Fluidsshouldnotberestricted.Increasingactivitywouldincreasethemetabolicratefurther,whichwouldnotbeadvisable.DIF:ApplyREF:531OBJ:Describefactorsthatcausevariationsinbodytemperature,pulse,oxygensaturation,respirations,andbloodpressure.TOP:ImplementationMSC:CPNRE:FoundationsofPractice10.Apatientstemperaturemustbemeasuredevery2hours.Whichofthefollowingtaskscannotbedelegatedtoanunregulatedcareprovider?a.Selectingappropriaterouteanddevice.b.Obtainingtemperaturemeasurementatorderedfrequency.c.Beingawareoftheusualvaluesforthepatient.d.AssessingchangesinbodNyUteRmSpIerNatGurTe.B.COMANS:DThenurseisresponsibleforassessingchangesinbodytemperature.Thenurseinstructsanunregulatedcareprovidertoselecttheappropriaterouteanddevicetomeasuretemperature,toobtaintemperaturemeasurementatorderedfrequency,andtobeawareoftheusualvaluesforthepatient.DIF:ApplyREF:532OBJ:Appropriatelydelegatevitalsignmeasurementtounregulatedcareproviders.TOP:ImplementationMSC:CPNRE:CollaborativePractice11.Thepatientrequiresroutinetemperatureassessmentbutisconfusedandeasilyagitatedandhasahistoryofseizures.Whatwouldbethebestwaytotakehistemperature?a.Orally.b.Tympanically.c.Rectally.d.Bytheaxillarymethod.ANS:BCanadianFundamentalsofNursing7thEditionPotterTestBankThetympanicrouteiseasilyaccessible,necessitatesminimalpatientrepositioning,andoftencanbeusedwithoutdisturbingthepatient.Itsmeasurementtimeisalsoveryrapid.Oraltemperaturemeasurementsrequirepatientcooperationandarenotrecommendedforpatientswithahistoryofepilepsy.Rectaltemperaturemeasurementsrequirepositioningandmayincreasepatientagitation.Axillarytemperaturemeasurementstakealongtimeandcontinuouspositioningbythenurse.Thepatientsagitationstatemaynotallowforlongperiodsofimmobility.DIF:ApplyREF:537,Box30-4OBJ:Explainvariationsintechniqueusedtoassessaninfants,achilds,andanadultsvitalsigns.TOP:ImplementationMSC:CPNRE:FoundationsofPractice12.Thepatientisbeingadmittedtothesurgicalunitafteramotorvehicleaccident.Hisjawisbroken,andhehasseveralbrokenteeth.Hisskiniscoolanddiaphoretic.Toobtainanaccuratetemperature,thenurseuseswhichofthefollowingroutes?a.Oral.b.Axillary.c.Rectal.d.Temporal.ANS:CTherectalrouteisarguedtobemorereliablewhenoraltemperaturecannotbeobtained.Temperaturesarenotmeasuredorallyinpatientswhohavehadoralsurgeryortrauma,ahistoryofepilepsy,orshakingchills.Axillarytemperaturemeasurementisaffectedbyexposuretotheenvironment,includingtimetoplacethethermometer;italsotakesalongtime.Temporalarterytemperatureisaffectedbyskinmoisturesuchasdiaphoresisorsweating.NURSINGTB.COMDIF:ApplyREF:537,Box30-4OBJ:Accuratelyassesspulse,respirations,oxygensaturation,andbloodpressure.TOP:ImplementationMSC:CPNRE:FoundationsofPractice13.Thenurseiscaringforaninfantandismeasuringthepatientsvitalsigns.Thebestsiteforthenursetomeasuretheinfantspulsewouldbewhichartery?a.Radial.b.Brachial.c.Femoral.d.Popliteal.ANS:BThebrachialorapicalpulseisthebestsiteforassessinganinfantsorayoungchildspulsebecauseotherperipheralpulsessuchastheradial,femoral,andpoplitealarteriesaredeepandaredifficulttopalpateaccurately.DIF:ApplyREF:542OBJ:Explainvariationsintechniqueusedtoassessaninfants,achilds,andanadultsvitalsigns.TOP:ImplementationMSC:CPNRE:FoundationsofPractice14.Thepatientisfoundtobeunresponsiveandnotbreathing.Todeterminethepresenceofcentralbloodcirculationandcirculationofbloodtothebrain,thenursecheckswhichpulse?a.Radial.CanadianFundamentalsofNursing7thEditionPotterTestBankUSNTb.Brachial.c.Posteriortibial.d.Carotid.ANS:DTheheartcontinuestodeliverbloodthroughthecarotidarterytothebrainaslongaspossible.Thecarotidpulseiseasilyaccessibleduringphysiologicalshockorcardiacarrest.Theradialpulseisusedtoassessperipheralcirculationortoassessthestatusofcirculationtothehand.Thebrachialsiteisusedtoassessthestatusofcirculationtolowerarm.Theposteriortibialpulseisusedtoassessthestatusofcirculationtothefoot.DIF:ApplyREF:542OBJ:Accuratelyassesspulse,respirations,oxygensaturation,andbloodpressure.TOP:ImplementationMSC:CPNRE:FoundationsofPractice15.Thenurseneedstomeasuretheradialpulsefromapatient.Foraccuracy,whatmustthenursedo?a.Placethetipsofthenursesfirsttwofingersoverthegroovealongthethumbsideofthepatientswrist.b.Placethethumboverthegroovealongthethumbsideofthepatientswrist.c.Applyaverylighttouchsothatthepulseisnotobliterated.d.Applyverystrongpressuretodetectthepulse.ANS:AThenurseplacesthetipsofthefirsttwoormiddlethreefingersoverthegroovealongtheradialorthumbsideofthepatientsinnerwrist.Fingertipsarethemostsensitivepartsofthehandforpalpatingarterialpulsation.Thethumbhasapulsationthatinterfereswithaccuracy.ThepulseismoreaccuratelyNassResseIdwGithmBo.dCeratMepressure.Toomuchpressureoccludesthepulseandimpairsbloodflow.DIF:ApplyREF:544OBJ:Accuratelyassesspulse,respirations,oxygensaturation,andbloodpressure.TOP:ImplementationMSC:CPNRE:FoundationsofPractice16.Whilethenurseisassessingthepatientsrespirations,itisimportantforthepatienttodowhat?a.Beawareoftheprocedurebeingdone.b.Notknowthatrespirationsarebeingassessed.c.Understandthatrespirationsareestimatedtosavetime.d.Notbetoucheduntiltheentireprocessisfinished.ANS:BDonotletapatientknowthatrespirationsarebeingassessed.Apatientwhoisawareoftheassessmentcanaltertherateanddepthofbreathing.Respirationsaretheeasiestofallvitalsignstoassess,buttheyareoftenthemosthaphazardlymeasured.Donotestimaterespirations.Accuratemeasurementrequiresobservationandpalpationofchestwallmovement.DIF:ApplyREF:549OBJ:Accuratelyassesspulse,respirations,oxygensaturation,andbloodpressure.TOP:ImplementationMSC:CPNRE:FoundationsofPracticeCanadianFundamentalsofNursing7thEditionPotterTestBankUSNT17.Thepatientsbloodpressureis140/60.Howwouldthenurserecordthepulsepressure?a.As140.b.As60.c.As80.d.As200.ANS:CThedifferencebetweenthesystolicpressureandthediastolicpressureisthepulsepressure.Forabloodpressureof140/60,thepulsepressureis80(140-60).Thesystolicpressureis140.Thediastolicpressureis60.Thesystolicpressure(140)addedtothediastolicpressure(60)is200,butthishasnoclinicalsignificance.DIF:UnderstandREF:557OBJ:Accuratelyrecordandreportvitalsignmeasurements.TOP:ImplementationMSC:CPNRE:FoundationsofPractice18.Thethicknessorviscosityofthebloodaffectstheeasewithwhichbloodflowsthroughsmallvessels.Examiningwhatvaluemighthelpdeterminetheamountofbloodviscosity?a.Hematocrit.b.Cardiacoutput.c.Arterialsize.d.Bloodvolume.ANS:AThehematocrit,orthepercentageofredbloodcellsintheblood,determinesbloodviscosity.Bloodpressurealsodependsonthecardiacoutputorvolumepumpedbytheheart,butcardiacoutputdoesnotaffectviscosity.Differencesinarterialsizehelpmodifybloodpressure;thesmallerlumenofavesselincNreasResvIascGularBr.esCistanMcebutdoesnotaffectviscosity.Bloodvolumealsoaffectsbloodpressure,butitdoesnotdirectlyaffectviscosity.DIF:UnderstandREF:557OBJ:Explainthephysiologyofnormalregulationofbloodpressure,pulse,oxygensaturation,andrespirations.TOP:AssessmentMSC:CPNRE:FoundationsofPractice19.Thepatientisbeingadmittedtothemedicalunitwithcomplaintsofshortnessofbreath.Thepatienthashadchroniclungdiseaseformanyyearsbutstillsmokes.Whatshouldthenursedo?a.Administerhighlevelsofoxygen.b.Useoxygencautiouslyinthispatient.c.Placeapaperbagoverthepatientsfacetoallowrebreathingofcarbondioxide.d.AdministerCO2viamask.ANS:BBecauselowlevelsofarterialO2providethestimulusthatallowsthepatienttobreathe,administrationofhighoxygenlevelswillbefatalforpatientswithchroniclungdisease.Oxygenmustbeusedcautiouslyinsuchpatients.Patientswithchroniclungdiseasehaveongoinghypercarbia(elevatedCO2levels)anddonotneedtohaveCO2administeredorrebreathed.DIF:ApplyREF:549OBJ:Explainthephysiologyofnormalregulationofbloodpressure,pulse,oxygensaturation,andrespirations.TOP:ImplementationCanadianFundamentalsofNursing7thEditionPotterTestBankMSC:CPNRE:FoundationsofPractice20.Whichstatementistrueoftheovulationphase?a.Progesteronelevelsarebelownormal.b.Bodytemperatureisbelowbaselinelevels.c.Bodytemperatureisatpreviousbaselinelevelsorhigher.d.Intensebodyheatandsweatingoccur.ANS:CProgesteronelevelsriseandfallcyclicallyduringthemenstrualcycle.Whenprogesteronelevelsarelow,thebodytemperatureisafewtenthsofadegreebelowthebaseline.Thelowertemperaturepersistsuntilovulationoccurs.Duringovulation,greateramountsofprogesteroneenterthecirculatorysystemandraisethebodytemperaturetopreviousbaselinelevelsorhigher.Thesetemperaturevariationshelptopredictawomansmostfertiletime,inordertoachievepregnancy.Womenwhoundergomenopause(cessationofmenstruation)oftenexperienceperiodsofintensebodyheatandsweating(hotflashes)lastingfrom30secondsto5minutes.DIF:RememberREF:530OBJ:Describefactorsthatcausevariationsinbodytemperature,pulse,oxygensaturation,respirations,andbloodpressure.TOP:AssessmentMSC:CPNRE:FoundationsofPractice21.Thenurseiscaringforapatientwhohasapulserateof44.Hisbloodpressureiswithinnormallimits.Intryingtodeterminethecauseofthepatientslowheartrate,whatwouldthenursesuspect?a.Thatthepatientwouldhaveafever.b.PossiblehemorrhageorbNleUedRinSgI.NGTB.COMc.Thatthepatientistakingcalciumchannelblockersordigitalismedications.d.Chronicobstructivepulmonarydisease(COPD).ANS:CNegativechronotropicdrugssuchasdigitalis,beta-adrenergicagents,andcalciumchannelblockerscanslowdownpulserate.Fever,bleeding,hemorrhage,andCOPDallincreasethebodysneedforoxygen,whichleadstoanincreasedheartrate.DIF:UnderstandREF:546OBJ:Describefactorsthatcausevariationsinbodytemperature,pulse,oxygensaturation,respirations,andbloodpressure.TOP:AssessmentMSC:CPNRE:FoundationsofPractice22.Thepatientisbeingadmittedtothemedicalunit.Shehasarm,hand,andlegedema;hertemperatureis35.3C(95.6F);andherhandsarecoldsecondarytoperipheralvasculardisease,ofwhichshehasahistory.Itisreportedthatshehasalatexallergy.Toquicklymeasurethepatientsoxygensaturation,whatshouldthenursedo?a.Attachafingerprobetothepatientsindexfinger.b.Placeanonadhesivesensoronthepatientsearlobe.c.Attachadisposableadhesivesensortothebridgeofthepatientsnose.d.Placethesensoronthesamearmthattheelectronicbloodpressurecuffison.ANS:BCanadianFundamentalsofNursing7thEditionPotterTestBankThenurseshouldmeasureoxygensaturationontheearorbridgeofthenoseinanadultpatienthasahistoryofperipheralvasculardisease.Sensorsshouldnotbeattachedtofingers,ears,orthebridgeofthenoseifareaisedematousorskinintegrityiscompromised.Disposableadhesiveprobesshouldbeavoidedifthepatienthaslatexallergy.Theprobeshouldnotbeattachedtofingersthatarehypothermic.Thesensorshouldnotbeplacedonthesameextremityastheelectronicbloodpressurecuffbecausebloodflowtofingerwillbetemporarilyinterruptedwhencuffinflates.DIF:ApplyREF:555OBJ:Describefactorsthatcausevariationsinbodytemperature,pulse,oxygensaturation,respirations,andbloodpressure.TOP:PlanningMSC:CPNRE:FoundationsofPractice23.Thepatientisadmittedwithshortnessofbreathandchestdiscomfort.Whichofthefollowinglaboratoryvaluescouldaccountforthepatientssymptoms?a.Hemoglobinlevelof80g/L.b.Hematocritlevelof45%.c.Redbloodcellcountof5.0million/mm3.d.Pulseoximetryvalueof90%.ANS:ATheconcentrationofhemoglobinreflectsthepatientscapacitytocarryoxygen.Normalhemoglobinlevelsrangefrom10to18g/100mL(135to180g/L)inmenandfrom12to16g/100mL(120to160g/L)inwomen.Ahemoglobinlevelof8.0(80g/L)islowandindicatesadecreasedabilitytodeliveroxygentomeetbodilyneeds.Allothervalueslistedareconsiderednormal.DIF:AnalyzeREF:55N0U|5R5S1INGTB.COMOBJ:Describefactorsthatcausevariationsinbodytemperature,pulse,oxygensaturation,respirations,andbloodpressure.TOP:ImplementationMSC:CPNRE:FoundationsofPractice24.Ofthefollowingbloodpressurevalues,whichwouldbeconsideredasahighnormalreading?a.98/50ina7-year-oldchild.b.115/70inaninfant.c.135/85inanolderperson.d.120/80inamiddle-agedadult.ANS:CAnadultsbloodpressuretendstorisewithadvancingage.Inmostpeople,bloodpressureshouldbelowerthan140/90.Bloodpressuregreaterthan140/90isdefinedashypertension.Bloodpressureof98/50isnormalforachild,and115/70canbenormalforaninfant.DIF:EvaluateREF:557OBJ:Describefactorsthatcausevariationsinbodytemperature,pulse,oxygensaturation,respirations,andbloodpressure.TOP:EvaluateMSC:CPNRE:FoundationsofPractice25.Anurseiscaringforapatientwhosmokesanddrinkscaffeine.Whatisimportantforthenursetounderstandbeforesheassessesthepatientsbloodpressure(BP)?a.Neithercaffeinenorsmokingaffectsbloodpressure.b.Thatthepatientmuststopsmokingforatleast3hours.CanadianFundamentalsofNursing7thEditionPotterTestBankc.Thatthepatientshouldperformmildexercises.d.CaffeineandsmokingcancausefalseBPelevations.ANS:DSmokingimmediatelyincreasesBP,andthisincreaselastsupto15minutes.CaffeineincreasesBPforupto3hours.Bothaffectapatientsbloodpressure.Thepatientshouldrestatleast5minutesbeforeBPismeasured.DIF:UnderstandREF:561OBJ:Describeethnicvariationsinbloodpressure.TOP:ImplementationMSC:CPNRE:FoundationsofPractice26.Whentakingthepulseofaninfant,thenursenoticesthattherateis145beats/minandtherhythmisregular.Thenurserealizesthatthisrateiswhichofthefollowing?a.Normalforaninfant.b.Theproperrateforatoddler.c.Tooslowforaninfant.d.Thesameasthatofanormaladult.ANS:AThenormalrateforaninfantis120to160beats/min.Therateobtained(145beats/min)iswithinthenormalrangeforaninfant.Thenormalrateforatoddlerisbetween90and140beats/min.Thenormalrateforanadultisbetween60and100beats/min.DIF:RememberREF:547,Table30-3OBJ:Identifyrangesofacceptablevitalsignvaluesforaninfant,achild,andanadult.TOP:AssessmentMSC:CPNRE:FoundationsofPractice27.ThenurseiscaringforaneldNerlyRpatIientGandBn.oCtesMthathistemperatureis36C(96.8F).Thispatientisinwhichcondition?USNTOa.Sufferingfromhypothermia.b.Expressinganormaltemperature.c.Hyperthermicinrelationtohisage.d.Demonstratingtheincreasedmetabolismthataccompaniesaging.ANS:BTheaveragebodytemperatureofolderpersonsisapproximately36C(96.8F).Thisisnothypothermiaorhyperthermia.Olderpersonshavepoorvasomotorcontrol,reducedamountsofsubcutaneoustissue,andreducedmetabolism.Theendresultisloweredbodytemperature.DIF:UnderstandREF:529|530OBJ:Identifyrangesofacceptablevitalsignvaluesforaninfant,achild,andanadult.TOP:AssessmentMSC:CPNRE:FoundationsofPractice28.Whenassessingthetemperatureofnewbornsandchildren,thenursedecidestoutilizeatemporalarterythermometer.Whyisthispreferabletomethodsusedforadults?a.Itisaccurateevenwhentheforeheadiscoveredwithhair.b.Itisnotaffectedbyskinmoisture.c.Itreflectsrapidchangesinradianttemperature.d.Thereisnoriskofinjurytopatientornurse.ANS:DCanadianFundamentalsofNursing7thEditionPotterTestBankThetemporalarterythermometerisespeciallybeneficialwhenusedinprematureinfants,newborns,andchildrenbecausethereisnoriskofinjurytothepatientornurse.However,itisinaccuratewhentheheadiscoveredorwhenhairisontheforehead,andmeasurementisaffectedbyskinmoisturesuchasdiaphoresisorsweating.Thetemporalarterythermometerprovidesveryrapidmeasurementandreflectsrapidchangesincoretemperature,notradianttemperature.DIF:UnderstandREF:537,Box30-4OBJ:Explainvariationsintechniqueusedtoassessaninfants,achilds,andanadultsvitalsigns.TOP:AssessmentMSC:CPNRE:FoundationsofPractice29.Whicharteryisthemostappropriateforassessingthepulseofasmallchild?a.Radial.b.Femoral.c.Brachial.d.Ulnar.ANS:CThebrachialorapicalpulseisthebestsiteforassessinganinfantsorayoungchildspulsebecauseotherperipheralpulsesaredeepanddifficulttopalpateaccurately.DIF:ApplyREF:542OBJ:Explainvariationsintechniqueusedtoassessaninfants,achilds,andanadultsvitalsigns.TOP:ImplementationMSC:CPNRE:FoundationsofPractice30.Thenurseiscaringforanewborninthehospitalnursery.Shenoticesthattheinfantisbreathingrapidlybutispink,warm,anddry.ThenurseknowsthatthenormalrespiratoryrateforanewbornishowmanybNreUatRhsSpIeNrmGiTnuBt.e?COMa.30to60.b.25to32.c.16to19.d.12to20.ANS:ATheacceptablerespiratoryraterangeforanewbornis30to60breathsperminute.Aninfant(6months)isexpectedtohavearatebetween30and50breathsperminute.Atoddlersrespiratoryrangeis25to32breathsperminute.Achildshouldbreathe20to30timesaminute.Anadolescentshouldbreathe16to19timesaminute.Anadultshouldbreathe12to20timesaminute.DIF:RememberREF:553OBJ:Explainvariationsintechniqueusedtoassessaninfants,achilds,andanadultsvitalsigns.TOP:AssessmentMSC:CPNRE:FoundationsofPractice31.Inattemptingtoobtainoxygensaturationreadingsinatoddler,whatshouldthenursedo?a.Placethesensorontheearlobe.b.Placethesensoronthebridgeofthenose.c.Determinewhetherthetoddlerhasatapeallergy.d.Ignoreanyvariationbetweentheoximeterpulserateandthepatientsapicalpulserate.ANS:CCanadianFundamentalsofNursing7thEditionPotterTestBankThenurseshoulddeterminewhetherthepatienthaslatexallergybecausedisposableadhesiveprobesshouldnotbeusedonpatientswithlatexallergies.Sensorsshouldnotbeplacedontheearlobeorbridgeofthenoseininfantsandtoddlersbecauseofskinfragility.Oximeterpulserateandthepatientsapicalpulserateshouldbethesame.Anydifferencenecessitatesre-evaluationofoximetersensorprobeplacementandreassessmentofpulserates.DIF:ApplyREF:555OBJ:Explainvariationsintechniqueusedtoassessaninfants,achilds,andanadultsvitalsigns.TOP:ImplementationMSC:CPNRE:FoundationsofPractice32.Thenurseispreparingtoassessthebloodpressureofa3-year-old.Howshouldthenurseproceed?a.ChoosethecuffthatsaysChildinsteadofInfant.b.Obtainthereadingbeforethechildhasachancetosettledown.c.UsethediaphragmportionofthestethoscopetodetectKorotkoffsounds.d.Explaintothechildwhattheprocedurewillbe.ANS:DPreparingthechildforthebloodpressurecuffsunusualsensationincreasescooperation.Mostchildrenwillunderstandtheanalogyofatighthugonyourarm.Differentarmsizesrequirecarefulandappropriatecuffsizeselection.Donotchooseacuffonthebasisofthenameofthecuff.AnInfantcuffistoosmallforsomeinfants.Readingsaredifficulttoobtaininrestlessoranxiousinfantsandchildren.Allowatleast15minutesforchildrentorecoverfromrecentactivitiesandbecomelessapprehensive.Korotkoffsoundsaredifficulttohearinchildrenbecauseoflowfrequencyandamplitude.Apediatricstethoscopebellisoftenhelpful.DIF:ApplyREF:56N6URSINGTB.COMOBJ:Explainvariationsintechniqueusedtoassessaninfants,achilds,andanadultsvitalsigns.TOP:ImplementationMSC:CPNRE:FoundationsofPractice33.Whatisonebenefitofusingastationaryautomaticbloodpressuredevice?a.Itfitsoverclothing.b.Itisextremelyreliable.c.Itisthemethodofchoiceforirregularheartrhythms.d.Itismorereliablewhenpressureislessthan90mmHgsystolic.ANS:AThecufffitsoverclothing.However,thereliabilityofstationarymachinesislimited.Electronicbloodpressuremeasurementisnotrecommendedwithirregularheartratesorwhensystolicbloodpressureislessthan90mmHg.DIF:RememberREF:568OBJ:Describethebenefitsandprecautionsinvolvingself-measurementofbloodpressure.TOP:AssessmentMSC:CPNRE:FoundationsofPractice34.Thenurseiscaringforapatientwhoisbeingdischargedfromthehospitalafterbeingtreatedforhypertension.Thepatientisinstructedtomeasurehisbloodpressurethreetimesadayandtokeeparecordofthereadings.Thenurserecommendsthatthepatientpurchaseaportableelectronicbloodpressuredevice.Whatotherinstructionshouldthenursegivethepatient?a.ThepatientcanapplythecuffinanymannerhechoosesbecausethemachineisCanadianFundamentalsofNursing7thEditionPotterTestBankdesignedtobeusedbynonprofessionals.b.Thepatientmustnotadjusthismedicationdosageswithoutconsultingthehealthcareprovider.c.Thecuffcanbeplacedoverclothingifnecessary.d.Themachineisaccuratewhenbloodpressuresarelow.ANS:BPatientsmustbeadvisedthatbecauseofpossibleinaccuraciesinthebloodpressuredevices,theymustnotadjusttheirmedicationregimenswithoutconsultingtheirhealthcareprovider.Becauseoftheirsensitivity,impropercuffplacementormovementofthearmcauseselectronicdevicestogiveincorrectreadings.Stationarybloodpressuredevicesareoftenfoundinpublicplaces,andthecufffitsoverclothing.Thesameisnottrueforportabledevices.Electronicbloodpressuremeasurementisnotrecommendedwhensystolicbloodpressureislessthan90mmHg.DIF:UnderstandREF:568|569OBJ:Describethebenefitsandprecautionsinvolvingself-measurementofbloodpressure.TOP:AssessmentMSC:CPNRE:FoundationsofPractice35.Thenurseiscaringforapatientwhocomplainsoffeelinglight-headedandwoozy.Thenursechecksthepatientspulseandfindsthatitisirregular.Thepatientsbloodpressureis100/72.Itwas113/80anhourearlier.Whatshouldthenursedo?a.Callthephysicianimmediately.b.Performanapical/radialpulseassessment.c.Applymorepressuretotheradialarterytoassessthepulse.d.Usethethumbtodetectthepatientspulse.ANS:BNURSINGTB.COMIfthepulseisirregular,thenurseshouldassesstheapical/radialpulsetodetectapulsedeficit.Ifpulsecountdiffersbymorethan2,apulsedeficitexists,whichsometimesindicatesalterationsincardiacoutput.Thenurseneedstogatherasmuchinformationaspossiblebeforecallingthephysician.Theradialpulseismoreaccuratelyassessedwithmoderatepressure.Toomuchpressureoccludesthepulseandimpairsbloodflow.Fingertipsarethemostsensitivepartsofthehandtopalpatearterialpulsations;thethumbhasapulsationofitsownthatinterfereswithaccuratemeasurement.DIF:ApplyREF:544|547|548OBJ:Identifywhenvitalsignsshouldbemeasured.TOP:ImplementationMSC:CPNRE:FoundationsofPractice36.Ofthefollowingpatients,whichoneisthebestcandidatetohavehistemperaturemeasuredorally?a.A27-year-oldpostoperativepatientwithanelevatedtemperature.b.Ateenagedboywhohasjustreturnedfromoutsideforasmoke.c.An87-year-oldconfusedmanwithsuspectedhypothermia.d.A20-year-oldmanwithahistoryofepilepsy.ANS:ACanadianFundamentalsofNursing7thEditionPotterTestBankAnelevatedtemperatureneedstobeevaluated,andnocontraindicationisdescribedforthispatient.Ingestionofhot/coldfluidsorfoods,smoking,orreceivingoxygenbymask/cannulacannecessitatedelaysinmeasuringoraltemperature.Temperaturesarenotmeasuredorallyinpatientswhohavejusthadoralsurgeryortrauma,haveahistoryofepilepsy,orhaveshakingchills,andtheyshouldnotbemeasuredorallyininfants,smallchildren,orconfusedpatients.DIF:EvaluateREF:537,Box30-4OBJ:Identifywhenvitalsignsshouldbemeasured.TOP:AssessmentMSC:CPNRE:FoundationsofPractice37.ThephysicianorderreadsLopressor(metoprolol),50mgPOdaily.Donotgiveifsystolicbloodpressureislessthan100mmHg.Thepatientsbloodpressureis92/66.Thenursedoesnotgivethemedication;whatelsedoesthenursedo?a.Doesnottellthepatientwhatthebloodpressureis.b.Documentsonlywhatthebloodpressurewas.c.Documentsthatthemedicationwasnotgivenowingtolowbloodpressure.d.Doesnotneedtoinformthehealthcareproviderthatthemedicationwasheld.ANS:CThenursemustdocumentanyinterventionsinitiatedasaresultofvitalsignmeasurement,suchaswithholdinganantihypertensivedrug.Thenurseshouldinformthepatientofthebloodpressurevalueandtheneedforperiodicreassessmentofthebloodpressure.Documentingthebloodpressureonlyisnotsufficient;anyinterventionmustbedocumentedaswell.Abnormalfindingsmustbereportedtothenurseinchargeortothehealthcareprovider.DIF:ApplyREF:570|571OBJ:AccuratelyrecordandreNpoUrtRvSitaIlNsigGnTmBea.suCreOmMents.TOP:ImplementationMSC:CPNRE:FoundationsofPractice38.Aftertakingthepatientstemperature,thenursedocumentsthevalueandtherouteusedtoobtainthereading.Whyisthisdone?a.Temperaturesarethesameregardlessoftherouteused.b.Temperaturesvarydependingontherouteused.c.Temperaturesarecoolerwhentakenrectallythanwhentakenorally.d.Axillarytemperaturesarehigherthanoraltemperatures.ANS:BTemperaturesobtainedvarydependingonthesiteused.Rectaltemperaturesareusually0.5C(0.9F)higherthanoraltemperatures,andaxillarytemperaturesareusually0.5C(0.9F)lowerthanoraltemperatures.DIF:UnderstandREF:532OBJ:Accuratelyrecordandreportvitalsignmeasurements.TOP:ImplementationMSC:CPNRE:FoundationsofPractice39.Whentemperatureassessmentisrequired,whichofthefollowingcannotbedelegatedtoanunregulatedcareprovider?a.Temperaturemeasurement.b.Assessmentofchangesinbodytemperature.c.Selectionofappropriaterouteanddevice.CanadianFundamentalsofNursing7thEditionPotterTestBankd.Considerationoffactorsthatfalselyraisetemperature.ANS:BThenurseisresponsibleforassessingchangesinbodytemperature.Thetaskoftemperaturemeasurementcanbedelegated.Thenurseinstructsanunregulatedcareprovidertoselecttheappropriaterouteanddevicetomeasuretemperatureandtoconsiderspecificfactorsthatfalselyraiseorlowertemperature.DIF:UnderstandREF:527|532OBJ:Appropriatelydelegatevitalsignmeasurementtounregulatedcareproviders.TOP:ImplementationMSC:CPNRE:CollaborativePractice40.Theunregulatedcareproviderismeasuringvitalsignsandreportsthatapatientsbloodpressureisabnormallylow.Whatshouldthenursedo?a.Havetheunregulatedcareproviderretakethebloodpressure.b.Ignorethereportandhaveitrecheckedatthenextscheduledtime.c.Remeasurethebloodpressureherselfandassessthepatientscondition.d.Havetheunregulatedcareproviderassessthepatientsothervitalsigns.ANS:CTheunregulatedcareprovidershouldreportabnormalitiestothenurse,whoshouldfurtherassessthepatient.Theunregulatedcareprovidershouldnotremeasurethebloodpressureorothervitalsignsbecausethenurseneedstoassessthepatient.Thereportcannotbeignored.DIF:ApplyREF:527OBJ:Appropriatelydelegatevitalsignmeasurementtounregulatedcareproviders.TOP:ImplementationMSC:CPNRE:CollaborativePractice41.Thepatienthasnew-onsetreNstlUesRsnSeIssNaGndTcBo.nfCusOioMn.Hispulserateiselevated,asishisrespiratoryrate.Hisoxygensaturation,however,is94%accordingtotheportablepulseoximeter.Thenurseignorestheoximeterreadingandcallsthephysiciantoobtainanorderforanarterialbloodgas(ABG)measurement.Thenursinginstructorwillprovidefurthereducationtothepracticalnursingstudentwhostatesthatwhichofthefollowingcancauseinaccuratepulseoximetryreadings?a.O2saturations(SaO2)>70%.b.Carbonmonoxideinhalation.c.Nailpolish.d.Hypothermiaattheassessmentsite.ANS:AInaccuratepulseoximetryreadingscanbecausedbyoutsidelightsources,carbonmonoxide(causedbysmokeinhalationorpoisoning),patientmotion,jaundice,intravasculardyes(methyleneblue),nailpolish,artificialnails,metalstuds,ordarkskin.Otherfactorsincludeperipheralvasculardisease(atherosclerosis),hypothermiaattheassessmentsite,pharmacologicalvasoconstrictors(e.g.,epinephrine),lowcardiacoutput,hypotension,peripheraledema,andtightprobes.DIF:UnderstandREF:556,Box30-11OBJ:Accuratelyassesstympanic,oral,rectal,andaxillarytemperatures.TOP:AssessmentMSC:CPNRE:FoundationsofPracticeCanadianFundamentalsofNursing7thEditionPotterTestBank42.Thenurseisassessingthepatientandhisfamilyforprobablefamilialcausesofthepatientshypertension.Thenursebeginsbyanalyzingthepatientspersonalhistory,aswellasfamilyhistoryandcurrentlifestylesituation.Whichofthefollowingissueswouldbeconsideredriskfactors?a.Lowbloodcholesterollevels.b.Europeandescent.c.Recentweightloss.d.Heavyalcoholconsumption.ANS:DObesity,cigarettesmoking,heavyalcoholconsumption,highbloodcholesterolandtriglyceridelevels,andcontinuedexposuretostressareriskfactorslinkedtohypertension.Weightlossandlowbloodcholesterollevelsarenotriskfactorsforhypertension.TheincidenceofhypertensionishigheramongethnicgroupssuchasSouthAsian,FirstNations,Mtis,andInuit,andinpeopleofAfricandescent,notthoseofEuropeandescent.DIF:AnalyzeREF:560OBJ:Describeethnicvariationsinbloodpressure.TOP:EvaluateMSC:CPNRE:FoundationsofPractice43.Whenrecordingthepatientsrespiratorystatus,thenurserecordstherespiratoryrate,characterofrespirations,andwhichofthefollowing?a.Onlynormalfindings.b.Onlyinthegraphicsection.c.Amountofoxygentherapy.d.Korotkoffphase.ANS:CRespiratoryrateandcharacteNrUshRouSldIbNeGreTcBor.deCdOinMnursesnotesoronavitalsignflowsheet.Typeandamountofoxygentherapy,ifusedduringassessment,shouldbenoted.Afteradministrationofspecifictherapies,respiratoryassessmentshouldbedocumentedinnarrativeforminnursesnotes.Thenurseshoulddocumentbothnormalandabnormalfindings.Korotkoffphaseisrelatedtobloodpressureassessment.DIF:RememberREF:552OBJ:Accuratelyrecordandreportvitalsignmeasurements.TOP:ImplementationMSC:CPNRE:Professional,Ethical,andLegalPracticeCanadianFundamentalsofNursing7thEditionPotterTestBankChapter31:PainAssessmentandManagementPotteretal:CanadianFundamentalsofNursing,7thEditionMULTIPLECHOICE1.Whatisthemostappropriatewaytoassessthepainofapatientwhoisorientedandhasrecentlyhadsurgery?a.Assessingthepatientsbodylanguage.b.Observingthecardiacmonitorforincreasedheartrate.c.Askingthepatienttoratethelevelofpain.d.Askingthepatienttodescribetheeffectofpainontheabilitytocope.ANS:CPainisasubjectivemeasure.Therefore,thebestwaytoassessapatientspainistoaskthepatienttoratethepain.Nonverbalcommunication,suchasbodylanguage,isnotasinformativeforassessingpain,especiallywhenthepatientisoriented.Heartratesometimesincreaseswhenapatientisinpain,butthissignisnotspecifictopain.Painsometimesaffectsapatientsabilitytocope,butassessingtheeffectofpainoncopingassessesthepatientsabilitytocope;itdoesnotassessthepatientspain.DIF:UnderstandREF:575|585OBJ:Performanassessmentofapatientexperiencingpain.TOP:AssessmentMSC:CPNRE:FoundationsofPractice2.Anurseiscaringforapatientwhorecentlyhadanabdominalhysterectomyandstatesthatsheisexperiencingseverepain.Thepatientsbloodpressureis110/60,andherheartrateis60.Inaddition,thepatientdoesnotNaUppReaSrItoNbGeTinBa.nCydOistress.Whichresponsebythenurseismosttherapeutic?a.Yourvitalsignsdonotshowthatyouarehavingpain;canyoudescribeyourpain?b.Youdonotlooklikeyouareinpain.c.OK,Iwillgogetyousomenarcoticpainrelieversimmediately.d.Whatwouldyouliketotrytoalleviateyourpain?ANS:DThenursemustbelievethatapatientisinpainwheneverthepatientreportsthatheorsheisinpain,evenifthepatientdoesnotappeartobeinpain.Wheneverthepatientreportspain,thenurseneedstocollaboratewiththepatienttodeterminethebestmethodofpainrelief,whetheritbemedication,meditation,orrepositioning.Thenursemustbecarefultonotjudgethepatientbasedonthebasisofvitalsignsornonverbalcommunicationandmustnotassumethatthepatientisseekingnarcotics.Thepatientisapartnerinpainmanagement,sogoingtogetnarcoticstotreatthepainwithoutconsultingwiththepatientfirstisnotappropriate.DIF:UnderstandREF:585|590|591OBJ:Describeguidelinesforselectingandindividualizingpaininterventions.TOP:ImplementationMSC:CPNRE:FoundationsofPractice3.Whichofthefollowingstatementsmadebyapatientreflectsthatthepatientunderstandstherelationshipbetweenthegatecontroltheoryofpainandtheuseofmeditationtorelievepain?a.MeditationcontrolspainbyblockingpainimpulsesfromcomingthroughtheCanadianFundamentalsofNursing7thEditionPotterTestBankgate.b.Meditationwillhelpmesleepthroughthepainbecauseitopensthegate.c.Meditationstopstheoccurrenceofpainstimuli.d.Meditationaltersthechemicalcompositionofpainneuroregulators,whichclosesthegate.ANS:AAccordingtothegatetheory,painimpulsescausepainwhentheygetthroughgatesthatareopen.Painisblockedwhenthegatesareclosed.Nonpharmacologicalpainreliefmeasures,suchasmeditation,workbyclosingthegates,whichkeepspainimpulsesfromcomingthrough.Meditationdoesnotopenpaingatesorstoppainfromoccurring.Meditationalsodoesnothaveaneffectonpainneuroregulators.DIF:EvaluateREF:578OBJ:Describethephysiologyofpain.TOP:EvaluateMSC:CPNRE:FoundationsofPractice4.Anursingstudentisplanningcareforanolderpatientwhoisexperiencingpain.Whichofthefollowingstatementsmadebythenursingstudentpromptsthenursingprofessortoclarifythenursingstudentsknowledge?a.Olderpatientsoftenhavedifficultydeterminingwhatiscausingtheirpain.b.Itissafetoadministeropioidstoolderpersonsaslongasyoustartwithsmalldosesandfrequentlyassessthepatientsresponsetothemedication.c.Asadultsage,theirabilitytoperceivepaindecreases.d.Patientswhohavedementiaprobablyexperiencepain,andtheirpainisnotalwayswellcontrolled.ANS:CAgingdoesnotaffecttheabiNlitUyRtoSpIerNceGivTeBp.aiCn.OSMometimesolderpersonshavedifficultyinterpretingtheirpainanddeterminingitscausebecausemultiplediseasesandvaguesymptomsaffectsimilarpartsofthebody.Opioidsaresafetouseinolderpersonsaslongastheyareslowlytitratedandthenursefrequentlymonitorsthepatient.Currentevidenceshowsthatpatientswithdementiaprobablyexperienceunrelievedpainbecausetheirpainisdifficulttoassess.DIF:EvaluateREF:581,Box31-4OBJ:Identifybarrierstoeffectivepainmanagement.TOP:PlanningMSC:CPNRE:FoundationsofPractice5.Thenurseiscaringfortwopatients;botharehavingahysterectomy.Thefirstpatientishavingthehysterectomyafteracomplicatedbirth.Thesecondpatienthasuterinecancer.Whatwillmostlikelyinfluencetheexperienceofpainforthesetwopatients?a.Neurologicalfactors.b.Competencyofthesurgeon.c.Meaningofpain.d.Postoperativesupportpersonnel.ANS:CCanadianFundamentalsofNursing7thEditionPotterTestBankThepatientsperceptionofpainisinfluencedbypsychologicalfactors,suchasanxietyandcoping,whichinturninfluencethepatientsexperienceofpain.Eachpatientsexperienceisdifferent.Thedegreeandqualityofpainperceivedbyapatientarerelatedtothemeaningofthepain.Neurologicalfactorscaninterruptorinfluencepainperception,butthequestiondoesnotindicatethateitherofthesepatientsisexperiencingalterationsinneurologicalfunction.Theknowledge,attitudes,andbeliefsofnurses,physicians,andotherhealthcarepersonnelaboutpainaffectpainmanagementbutdonotnecessarilyinfluenceapatientspainperceptions.DIF:UnderstandREF:577OBJ:Identifycomponentsofthepainexperience.TOP:AssessmentMSC:CPNRE:FoundationsofPractice6.Thenurseanticipatesadministeringanopioidfentanylpatchtowhichpatient?a.A15-year-oldadolescentwithabrokenfemur.b.A30-year-oldadultwithcellulitis.c.A50-year-oldpatientwithprostatecancer.d.An80-year-oldpatientwithabrokenhip.ANS:CAfentanylpatchisanextended-reliefopioidthatprovidespainrelieffor24hoursaday.Thisisidealforpatientswhohavechronicseverepain,suchasthosewhohavecancer.Theotherpatientsareexpectedtoexperienceacutepain.Therefore,theywillprobablybenefitmorefromoralorintravenous(IV)opioidsforshort-termpainrelief.DIF:ApplyREF:602OBJ:Explainthevariouspharmacologicalapproachestotreatingpain.TOP:ImplementationMSC:CPNRE:FoundationsofPracticeNURSINGTB.COM7.Whichofthefollowingstatementsmadebythepatientindicatestothenursethatteachingaboutapatient-controlledanalgesia(PCA)devicehasbeeneffective?a.ThisistheonlypainmedicationIwillneedtobeon.b.IcanadministerthepainmedicationasfrequentlyasIneedto.c.Ifeellessanxietyaboutthepossibilityofoverdosing.d.Iwillneedthenursetonotifymewhenitistimeforanotherdose.ANS:CAPCAdeviceallowsthepatienttodeterminethelevelofpainreliefdelivered,whichreducestheriskofoversedation.Itsuseofteneasesanxietybecausethepatientisnotreliantonthenurseforpainrelief.Othermedications,suchasoralanalgesics,canbegiveninadditiontothePCAdevice.ThePCAdevicedoeshaveaminimumtimelimittopreventoverdose,butthepatientcanlengthentheamountoftimebetweendoses.OnebenefitofPCAisthatthepatientdoesnotneedtorelyonthenursetoadministerpainmedication;thepatientdetermineswhentotakethemedication.DIF:EvaluateREF:598|599OBJ:Explainthevariouspharmacologicalapproachestotreatingpain.TOP:ImplementationMSC:CPNRE:FoundationsofPractice8.Anurseiscaringforapatientwhoisexperiencingpainafterabdominalsurgery.Whatinformationisimportantforthenursetotellthepatientwhenprovidingpatienteducationabouteffectivepainmanagement?CanadianFundamentalsofNursing7thEditionPotterTestBankNRIGB.Ca.Topreventoverdose,youneedtowaittoaskforpainmedicationuntilyoubegintoexperiencepain.b.Youshouldtakeyourmedicationafteryouwalktomakesureyoudonotfallwhileyouarewalking.c.Weshouldworktogethertocreatearegularscheduleofmedicationsthatdoesnotallowforbreakthroughpain.d.Youneedtotakeoralpainmedicationswhenyouexperienceseverepain.ANS:CThebestwaytomanagepainistodevelopascheduleofmedicationsthataregivenaroundtheclocktopreventbreakthroughpain.Thenurseshouldnotwaituntilthepatientisinpainbecauseittakesmedications10to30minutestobegintorelievepain.Thenurseadministerspainmedicationsbeforepainfulactivities,suchaswalking,andadministersthemintravenouslywhenpainissevere.DIF:ApplyREF:591OBJ:Discussnursingimplicationsforadministeringanalgesics.TOP:ImplementationMSC:CPNRE:FoundationsofPractice9.Anurseiscaringforapatientwhorecentlyhadspinalsurgery.Thenurseknowsthatpatientsusuallyexperienceacutepainafterthistypeofsurgery.Thepatientrefusestogetupandwalkandisnotmovingaroundinthebed.However,thepatientisstoicanddeniesexperiencingpainatthistime.Whatmostlikelyexplainsthispatientsbehaviourandresponsetosurgery?a.Thesurgerysuccessfullycuredthepatientspain.b.Thepatientscultureispossiblyinfluencingthepatientsexperienceofpain.c.Thepatientisexperiencingurinaryretentionbecauseofmanipulationofthespineduringsurgery;thisispreventingthepatientfromexperiencingpain.d.ThenurseisallowingpersoUnalSbelNiefsTaboutpOaintoinfluencepainmanagementatthistime.ANS:BApatientscultureofteninfluencesthepatientsexpressionofpain.Inthiscase,thepatienthasjusthadsurgery,andthenurseknowsthatthissurgicalprocedureusuallycausespain.Itisimportantatthistimeforthenursetoexamineculturalandethnicfactorsthatarepossiblyaffectingthepatientsdenialofpainatthistime.Evenifsurgerycorrectsneurologicalfactorsthatcreatechronicpain,surgerycausespainintheacuteperiod.Urinaryretentionusuallycreatespainanddoesnotmasksurgicalpain.Thenurseisnotallowingpersonalbeliefstoinfluencepainmanagementbecausethenurseisattemptingtodeterminethereasonwhythepatientisnotverbalizingtheexperienceofpain.DIF:ApplyREF:583|584OBJ:Explainhowculturalfactorsinfluencethepainexperience.TOP:AssessmentMSC:CPNRE:FoundationsofPractice10.Anurseisprovidingdischargeteachingforapatientwithafracturedhumerus.Thepatientisgoinghomewithoxycodone-acetaminophen(Percocet).Whatimportantpatienteducationdoesthenurseprovide?a.Besuretoeatamealhighinfatbeforetakingthemedication,toavoidastomachulcer.b.Narcoticscanbeaddictive,sodonottakethemunlessyouareinseverepain.c.Youneedtodrinkplentyoffluidsandeatadiethighinfibre.CanadianFundamentalsofNursing7thEditionPotterTestBankUSNTd.Asyourpainseveritylessens,youwillbegintogiveyourselfonce-dailyintramuscularinjections.ANS:CAcommonsideeffectofopioidanalgesicsisconstipation.Therefore,thenurseencouragesthepatienttodrinkfluidsandeatfibretopreventconstipation.Althoughmedicationscanbeirritatingtothestomach,adiethighinfatdoesnotpreventgastriculcers.Tobestmanagepain,thepatientneedstotakepainmedicationbeforepainfulproceduresoractivitiesorbeforepainbecomessevere.Asthepatientspaingetsbetter,thestrengthofthemedicationswilldecrease.Intramuscular,IV,andtopicalanalgesicsareusedformoresevereandchronicpain.DIF:AnalyzeREF:592|597|598OBJ:Discussnursingimplicationsforadministeringanalgesics.TOP:ImplementationMSC:CPNRE:FoundationsofPractice11.Apatientarrivesattheemergencydepartmentexperiencingaheadacheandratesthepainas7ona0-to-10painscale.Whatnonpharmacologicalinterventiondoesthenurseimplementforthispatientwhileawaitingordersforpainmedicationfromthehealthcareprovider?a.Frequentlyreassessingthepatientspainscores.b.Reassuringthepatientthattheproviderwillcometotheemergencydepartmentsoon.c.Softlyplayingmusicthatthepatientfindsrelaxing.d.Teachingthepatienthowtodoyoga.ANS:CTheappropriatenonpharmacologicalpainmanagementinterventionistoquietlyplaymusicthatthepatientfindsrelaxingN.MRusicIdivGertsBa.pCersoMnsattentionawayfrompainandcreatesrelaxation.Thepatientspainscoresarereassessedduringevaluation.Buildingthepatientsexpectationoftheprovidersarrivaldoesnotaddressthepatientspain.Althoughyogapromotesrelaxation,nursesteachrelaxationtechniquesonlywhenapatientisnotexperiencingacutepain.Becausethepatientishavingacutepain,thisisnotanappropriatetimetoprovidepatientteaching.DIF:ApplyREF:595OBJ:Describeapplicationsfortheuseofnonpharmacologicalpaininterventions.TOP:ImplementationMSC:CPNRE:FoundationsofPractice12.Apatientwhohashadtype2diabetesfor26yearsisbeginningtoexperienceperipheralneuropathyinthefeetandlowerlegs,whichiscausingthepatienttohaveadecreasedabilitytofeelpaininthelowerextremities.Thenurseisprovidingeducationtothepatienttopreventinjurytothefeet.Thenursetellsthepatienttoalwayswearshoesorslipperswhenwalking.Whichofthefollowingstatementsmadebythenursebestexplainstherationaleforthisinstruction?a.Wearingshoesblockspainperceptionandhelpsyouadapttopain,whichendsupprotectingyourfeet.b.Shoesprovidenonpharmacologicalpainrelieftopeoplewithdiabetesandperipheralneuropathy.c.Sinceyoucannotfeelpainasmuchinyourfeet,youneedtoopenyourneurologicalgatestoallowpainsensationstocomethrough.Wearingshoeshelpstoopenthosegates,whichprotectsyourfeet.CanadianFundamentalsofNursing7thEditionPotterTestBankd.Youhavelosttheabilitytowithdrawfrompainbecauseofyourperipheralneuropathy.Ifyousteponsomethingandarenotwearingshoes,youwillnotfeelit;thiscouldpossiblycauseinjurytoyourfoot.ANS:DThispatientislosingtheabilitytofeelpainbecauseofperipheralneuropathy.Thepatientwillnolongerhaveprotectivereflexestopreventinjurytothefeet.Wearingshoespreventsthepatientfrominjuringthefeetbecausetheyprotectthefeet.Shoesdonotblockpainperceptionorhelppeopleadapttopain.Shoesarenotaformofnonpharmacologicalpainrelief.Wearingshoeswillnothaveaneffectonopeningorclosingthepaingates.DIF:ApplyREF:576-578OBJ:Describethephysiologyofpain.TOP:ImplementationMSC:CPNRE:FoundationsofPractice13.Anurseisassessingapatientwhostartedtohaveseverepain3daysago.Whenthenurseasksthepatienttodescribethepain,thepatientstates,Thepainfeelslikeitisinmystomach.Itisaburningpain,anditspreadsoutinacirclearoundthespotwhereithurtsthemost.Whattypeofpaindoesthenursedocumentthatthepatientishavingatthistime?a.Superficialpain.b.Idiopathicpain.c.Chronicpain.d.Visceralpain.ANS:DVisceralpaincomesfromvisceralorgans,suchasthosefromthegastrointestinaltract.Visceralpainisdiffuseandradiatesinseveraldirections.Superficialpainhasashortdurationandisusuallyasharppain.Painofanunknowncauseisidiopathicpain.Chronicpainlastslongerthan6months.NURSINGTB.COMDIF:AnalyzeREF:587,Table31-5OBJ:Performanassessmentofapatientexperiencingpain.TOP:AssessmentMSC:CPNRE:FoundationsofPractice14.Apatientwhohadamotorvehicleaccident2daysagoisexperiencingpainandisreceivingpatient-controlledanalgesia(PCA).HowdoesthenurseknowthatthepatientisexperiencingeffectivepainmanagementwiththePCA?a.Thepatientissleepingandisdifficulttoarouse.b.Thepatientratespainatanacceptablelevelof3ona0-to-10scale.c.SufficientmedicationisleftinthePCAsyringe.d.Thepatientpressesthecontrolbuttontodeliverpainmedication.ANS:BTheeffectivenessofpainreliefmeasuresisdeterminedbythepatientsgenerallyratingpainatthelevelof3orlessona0-to-10painscale.Ifthepatientissatisfiedwiththeamountofpainrelief,thenpainmeasuresareeffective.Apatientwhoissleepingandisdifficulttoarouseispossiblyoversedated;thenurseneedstoassessthispatientfurther.TheamountofmedicationleftinthePCAsyringedoesnotindicatewhetherpainmanagementiseffective.PressingthebuttonshowsthatthepatientknowshowtousethePCAbutdoesnothelpevaluatepainmanagement.DIF:EvaluateREF:598|599OBJ:Evaluateapatientsresponsetopaininterventions.TOP:EvaluateMSC:CPNRE:FoundationsofPracticeCanadianFundamentalsofNursing7thEditionPotterTestBank15.Thenurserecognizesthatwhichofthefollowingisamodifiablecontributortoapatientsperceptionofpain?a.Ageandgender.b.Anxietyandfear.c.Culture.d.Previouspainexperience.ANS:BThenursecantakemeasurestoeasethepatientsanxietyandfearrelatedtopain.Age,gender,culture,andpreviouspainexperienceareallnonmodifiablefactorsthatthenursecanhelpthepatientunderstand,butthenursecannotalterthem.DIF:UnderstandREF:583OBJ:Identifycomponentsofthepainexperience.TOP:AssessmentMSC:CPNRE:FoundationsofPractice16.Thenurseisevaluatingtheeffectivenessofguidedimageryforpainmanagementasusedforapatientwhohassecond-andthird-degreeburnsandneedsextensivedressingchanges.Whichsituationbestindicatesthatguidedimageryiscontrollingthepatientspaineffectivelyduringdressingchanges?a.Thepatientsneedforanalgesicmedicationdecreasesduringthedressingchanges.b.Thepatientratespainduringthedressingchangeasa6onascaleof0to10.c.Thepatientsfacialexpressionsarestoicduringtheprocedure.d.Thepatientcantoleratemorepain,sodressingchangescanbeperformedmorefrequently.ANS:AThepurposeofguidedimageNryUiRstSoIalNloGwTtBhe.pCatieMnttoaltertheperceptionofpain.Guidedimageryworksinconjunctionwithanalgesicmedications,potentiatingtheireffects.Ifthepatientneedslesspainmedicationduringdressingchanges,thenguidedimageryishelpingtomanagethepatientspain.Aratingof6ona0-to-10painscaleindicatesthatthepatientishavingmoderatepainandisnotexperiencingpainreliefatthistime.Apersonwhoisstoicisnotshowingfeelings,whichmakesitdifficulttoknowwhetherthepatientisexperiencingpain.Theabilitytochangedressingsmorefrequentlyisnotawaytoevaluatetheeffectivenessofguidedimagery.DIF:EvaluateREF:594OBJ:Evaluateapatientsresponsetopaininterventions.TOP:EvaluateMSC:CPNRE:FoundationsofPractice17.Anurseisprovidingmedicationeducationtoapatientwhojuststartedtakingibuprofen,anonselectivenonsteroidalanti-inflammatorydrug(NSAID).Whichstatementmadebythenursebestindicateshowibuprofenworks?a.Ibuprofenhelpstoremovefactorsthatcauseorstimulatepain.b.Ibuprofenreducesanxiety,whichwillhelpyoubettercopewithyourpain.c.Ibuprofenhelpstodecreasetheproductionofprostaglandins.d.Ibuprofenbindswithopiatereceptorstoreduceyourpain.ANS:CCanadianFundamentalsofNursing7thEditionPotterTestBankNRIGB.CNSAIDssuchasibuprofenprobablyworkbydecreasingthesynthesisofprostaglandinstoinhibitcellularresponsestoinflammation.Ibuprofendoesnotremovefactorsthatcausepain,nordoesitenhancecopingwithpain.Opioidsbindwithopiatereceptorstomodifyperceptionsofpain.DIF:UnderstandREF:597OBJ:Explainhowthephysiologyofpainrelatestoselectinginterventionsforpainrelief.TOP:ImplementationMSC:CPNRE:FoundationsofPractice18.Anursehasbroughtthepatienthisscheduledpainmedication.Thepatientasksthenursetowaittogivepainmedicationuntilthetimeforthedressingchange,whichis2hoursaway.Whichresponsebythenurseismosttherapeutic?a.Thismedicationwillstillbeprovidingyoureliefatthetimeofyourdressingchange.b.OK,swallowthispainpill,andIwillreturninaminutetofillyourwound.c.Wouldyoulikemedicationtobegivenfordressingchangesontopofyourregularlyscheduledmedication?d.Yourmedicationisscheduledforthistime,andIcantadjustthetimeforyou.Imsorry,butyoumusttakeyourpillrightnow.ANS:CAs-needed(prn)dosesofmedicationcanbegiventopatientsincertaincircumstances,aswithanextensivedressingchange.Byaskingtoholdoffonthedose,thepatientisindicatingthatthedressingchangesareextremelypainful.Theregularlyscheduleddosemightnotbeaseffectiveforthepatient.Oralmedicationstake30to60minutestotakeeffect.Ifthenursebeganthedressingchangerightthen,themedicationwouldnothavebeenabsorbedyet.Thepatienthastherighttorefusetotakeamedication.ItisthenursesresponsibilitytocommunicatewiththeproviderUandSwiNthtThepatieOntaboutapaincontrolplanthatworksforboth.DIF:EvaluateREF:598OBJ:Explainvariouspharmacologicalapproachestotreatingpain.TOP:ImplementationMSC:CPNRE:FoundationsofPractice19.Anursereceivesanorderfromahealthcareprovidertoadministeracetaminophen,500mg,toapatientwithmoderatearthritispain.Theorderistogive2tabletsevery4hoursbymouthasneededforpain.Thepatienthasahistoryofgastriculcer.Whatisthenursesbestnextaction?a.Givetheacetaminophentothepatientimmediatelybecausethepatientisexperiencingpain.b.Askthehealthcareprovidertoverifythedosageandfrequencyofthemedication.c.Askthehealthcareproviderforanorderforanonsteroidalanti-inflammatorydrug(NSAID).d.Askthehealthcareproviderforanordertoplaymusicforthepatient,inadditiontoprovidingthepainmedication.ANS:BCanadianFundamentalsofNursing7thEditionPotterTestBankNRIGB.CMThemaximumsafe24-hourdosageforacetaminophenis4g.Ifthepatienttook2500-mgtabletsofacetaminophenevery4hours,thepatientwouldbeingesting6gofacetaminophenin24hours.Thisexceedsthesafedosageofacetaminophen,sothebestactionistoquestionthisorder.Givingthemedicationasorderedwouldpossiblyresultinthepatienttakingmoreacetaminophenthanwhatisconsideredasafedose.Acetaminophenoverdosecanresultinliverfailure.NSAIDscancausebleeding,especiallyinthegastrointestinaltract;therefore,NSAIDsareprobablycontraindicatedinthispatient.Implementingmusictherapyisanursinginterventionandisanindependentnursingaction;thusanordertostartmusictherapyisnotneeded.DIF:EvaluateREF:597OBJ:Discussnursingimplicationsforadministeringanalgesics.TOP:ImplementationMSC:CPNRE:FoundationsofPractice20.Thenurseknowsthatwhichtechniqueisbestforassessingpaininachildwhois4yearsofage?a.Askingtheparentswhethertheythinktheirchildisinpain.b.UsingtheFACESscale.c.Askingthechildtoratethelevelofpainona0-to-10painscale.d.Checkingtoseewhatpreviousnurseshavecharted.ANS:BAssessingpainintensityinchildrenrequiresspecialtechniques.Youngchildrenoftenhavedifficultyexpressingtheirpain.TheFACESscaleisusedtoassesspaininchildrenwhoareverbal.Becausemost4-year-oldsareverbal,thisisanappropriatescaletousewiththischild.Parentsstatementofpainisnotaneffectivewaytoassesspaininchildrenbecausechildrensstatementsarethemostimportant.The0-to-10painscaleistoodifficultfora4-year-oldchildtounderstand.PreviousdocumUentaStionNbyTnursesOwillindicatewhatthechildspainhasbeenbutwillnotindicatethechildscurrentpainintensity.DIF:UnderstandREF:586-588OBJ:Describethecomponentsofpainassessment.TOP:AssessmentMSC:CPNRE:FoundationsofPractice21.Whichstatementmadebyanursingeducatorbestexplainswhyitisimportantfornursestodetermineapatientsmedicalhistoryandrecentdruguse?a.Healthcareprovidershavearesponsibilitytopreventdrugseekersfromgainingaccesstodrugs.b.Thisinformationisusefulindeterminingwhattypeofpaininterventionswillmostlikelybeeffectiveinprovidingpainrelief.c.Somerecreationaldrugshavepharmaceuticalcounterpartsthatmaybemoreeffectiveinmanagingpain.d.Gettingthisinformationgivesthenurseanopportunitytoprovidepatientteachingaboutdrugabstinence.ANS:BCanadianFundamentalsofNursing7thEditionPotterTestBankNRIGB.CInprovidingeffectivepainmanagement,itisimportanttounderstandthepatientshistory,whatdrugsthepatienthasalreadytried,andwhatinterventionsworkbestorhavenegativeactions.Itisnotthenursesresponsibilitytojudgeorquestionapatientspainorlabelthepatientasadrugseeker.Nursesneedtoavoidlabellingpatientsasdrugseekersbecausethistermispoorlydefinedandcreatesbiasandprejudiceamongotherhealthcareproviders.Althoughcertainrecreationaldrugsdohavepharmaceuticalcounterparts,thisisnotthesolepurposeofassessingdruguse.Thenurseneedsmoreinformationbeyondapatientsmedicalandmedicationhistorytodeterminewhetherapatientneedsteachingaboutdrugabstinence.DIF:EvaluateREF:585|603|604OBJ:Identifybarrierstoeffectivepainmanagement.TOP:AssessmentMSC:CPNRE:FoundationsofPractice22.Anurseissupervisingastudentwhoiscaringforapatientwithchronicpain.Whichstatementbythestudentindicatesanunderstandingofpainmanagement?a.Thispatientsaysherpainisa5,butsheisnotactinglikeit.Iamnotgoingtogiveheranypainmedication.b.Thepatientissleeping,soIpushedherPCAbuttonforher.c.Ineedtoreassessthepatientspain1hourafteradministeringoralpainmedication.d.Itwasnttimeforthepatientsmedication,sowhensherequestedit,Igaveheraplacebo.ANS:CBecausetheactionoforalmedicationsusuallypeaksinaboutanhour,thenurseneedstoreassessthepatientspainwithinanhourofadministration.Nursesmustbelieveanypatientreportofpain,evenifnonverbalcommunicationisnotconsistentwithpainratings.ThepatientistheonlypersonwhoUshouSldpNushTthePCOAbutton.PushingthePCAwhenapatientissleepingisdangerousandmayleadtonarcoticoverdoseorrespiratorydepression.Givingthepatientaplaceboandtellingheritishermedicationisunethical.DIF:EvaluateREF:598OBJ:Discussnursingimplicationsforadministeringanalgesics.TOP:EvaluateMSC:CPNRE:FoundationsofPractice23.Thenurseisassessinghowapatientspainisaffectingmobility.Whichassessmentquestionismostappropriate?a.Haveyouconsideredworkingwithaphysiotherapist?b.Whatactivities,ifany,hasyourpainpreventedyoufromdoing?c.Wouldyoupleaserateyourpainonascalefrom0to10forme?d.Whateffectdoesyourpainmedicationtypicallyhaveonyourpain?ANS:BBecausethenurseisinterestedinknowingwhetherthepatientspainisaffectingmobility,thepriorityassessmentquestionistoaskthepatienthowthepainaffectshisorherabilitytoparticipateinnormalactivitiesofdailyliving.Althoughaphysicaltherapistisagoodresourcetohave,especiallyifpainisseverelyaffectingmobility,consideringworkingwithaphysicaltherapistdoesnotdescribetheeffectofpainonthepatientsmobility.Assessingqualityofpainandeffectivenessofpainmedicationdoesnothelpthenursetounderstandhowitisaffectingthepatientsmobility.CanadianFundamentalsofNursing7thEditionPotterTestBankDIF:UnderstandREF:584|585OBJ:Performanassessmentofapatientexperiencingpain.TOP:AssessmentMSC:CPNRE:FoundationsofPractice24.Thenurseisteachingastudentnurseaboutpainassessmentscales.Whichstatementbythestudentindicatescorrectunderstanding?a.Youcannotuseapainscaletocomparethepainofmypatientwiththepainofyourpatient.b.Whenpatientssaytheydontneedpainmedication,theyarentinpain.c.Painassessmentscalesdeterminethequalityofapatientspain.d.Apatientsbehaviourismorereliablethanthepatientsreportofpain.ANS:CTogainabetterunderstandingofapatientscurrentpainstatusandtodeterminewhatinterventionsareneeded,thenurseshouldassessbothcurrentandpreviouspainscores.Apatientwhoratespainat4mightfindthepainmanageableif24hoursearlierhehadratedhispainat10.Somepatientsdonotexpresstheirpainordonotwishtotakemedicationstorelievethepain.Thisdoesnotmeantheyarentinpain;thenursecantrynonpharmacologicaltherapiesforthispatient.DIF:EvaluateREF:586OBJ:Performanassessmentofapatientexperiencingpain.TOP:AssessmentMSC:CPNRE:FoundationsofPractice25.Thenurseisadministeringpainmedicationforseveralpatients.Whichpatientdoesthenurseadministermedicationtofirst?a.Thepatientwhoneedstotakeascheduleddoseofmaintenancepainmedication.b.ThepatientwhoneedstoNbUeRprSemIeNdGicaTteBd.bCefOorMewalking.c.ThepatientwithaPCArunningwhoneedstohavethesyringereplaced.d.Thepatientwhoisexperiencingpainrated8outof10andhasaSTATorderforpainmedication.ANS:DSTATmedicationsneedtobegivenassoonaspossible.Inaddition,thispatientistheprioritybecauseofthereportofseverepain.Theotherpatientsneedpainmedication,buttheirsituationsarenotashighapriorityasthatofthepatientwiththeSTATmedicationorder.DIF:AnalyzeREF:591OBJ:Discussnursingimplicationsforadministeringanalgesics.TOP:ImplementationMSC:CPNRE:FoundationsofPractice26.Thenurseisassessingapatientforopioidtolerance.Whichfindingsupportsthesuchafinding?a.Increasinglyhigherdosesofopioidareneededtocontrolpain.b.Thepatientneededasubstantialdoseofnaloxone(Narcan).c.Thepatientasksforpainmedicationclosetothetimeitisduearoundtheclock.d.Thepatientnolongerexperiencessedationfromtheusualdoseofopioid.ANS:ACanadianFundamentalsofNursing7thEditionPotterTestBankInopioidtolerance,increasingdosesofanopioidareneededtocontrolpain.Naloxone(Narcan)isanopioidantagonistthatisgiventoreversetheeffectsofopioidoverdose.Takingpainmedicationsregularlyaroundtheclockisaneffectivewaytocontrolpain.Thepainmedicationforthispatientisprobablymanagingthepatientspaineffectivelybecausethepatientisnotaskingforthemedicationbeforeitisdue.Apatientnolongerexperiencingasideeffectofanopioiddoesnotindicateopioidtolerance.DIF:UnderstandREF:602OBJ:Evaluateapatientsresponsetopaininterventions.TOP:AssessmentMSC:CPNRE:FoundationsofPractice27.Anurseiscaringforapatientwithrheumatoidarthritiswhoisnowgoingtobetaking2acetaminophen(Tylenol)tabletsevery6hourstocontrolpain.Whichpartofthepatientssocialhistoryisthenursemostconcernedabout?a.Patientdrinks1to2glassesofwineeverynight.b.Patientsmokes2packsofcigarettesaday.c.Patientoccasionallysmokesmarijuana.d.Patienttakesantianxietymedications.ANS:AThemajoradverseeffectofacetaminophenishepatotoxicity.Bothalcoholandacetaminophenaremetabolizedbytheliver;whentakentogether,theycancauseliverdamage.Smokingcigarettesandsmokingmarijuanaarenothealthybehaviours,buttheireffectsonhealtharenotaffectedbyacetaminophen.Antianxietymedicationscanbetakenwithacetaminophen.DIF:ApplyREF:597OBJ:Discussnursingimplicationsforadministeringanalgesics.TOP:AssessmentMSC:CPNRE:FoundationsofPracticeNURSINGTB.COM28.Thenurseiscaringforapatientwhosuddenlyexperienceschestpain.Whatisthenursesfirstpriority?a.Calltherapidresponseteam.b.Askthepatienttorateanddescribethepain.c.Raisetheheadofthebed.d.Administerpainreliefmedications.ANS:BThenursesabilitytoestablishanursingdiagnosis,planandimplementcare,andevaluatetheeffectivenessofcaredependsonanaccurateandtimelyassessment.Theotherresponsesareallinterventions;thenursecannotknowwhichinterventionisappropriateuntilthenursecompletestheassessment,makesanursingdiagnosis,andplanscare.DIF:ApplyREF:584|585OBJ:Describeguidelinesforselectingandindividualizingpaininterventions.TOP:AssessmentMSC:CPNRE:FoundationsofPractice29.Thenurseiscaringforapatientwhorecentlyhadsurgerytorepairahernia.Thepatientspainwasrated7onascaleof0to10beforepainmedicationwasadministered.Onehourafterreceivinganoralopioid,thepatientrankshispainat3.Thepatientasksthenursewhyheisntreceivingmorepainmedication.Whichisthenursesbestresponse?a.Thismedicationcanbegivenonlyevery4hours.Itisnottimeforyoutohaveanyotherpainmedicationrightnow.CanadianFundamentalsofNursing7thEditionPotterTestBankNRIGb.Iwillnotifythehealthcareprovidertocomeperformanassessmentifyourpaindoesntimprovein30minutes.c.Ifthepainbecomessevere,wemayneedtotransferyoutoanintensivecareunit.d.Itcantakelongerfororalpainmedicationtowork,andyourpainisgoingdown.Letstryboostingyouupinbedandputtinganicepackontheincisiontoseeifthathelps.ANS:DThepatientisrespondingwelltotheoralpainmedicationanditcantakelongerfororalmedicationstorelievepain.Tryingnonpharmacologicalinterventionsasanadditiontoopioidmedicationsisappropriateatthistime.Ifnonpharmacologicalinterventionscombinedwiththeoralopioidareineffective,thenurseneedstonotifythehealthcareproviderandaskforachangeinthemedicationorforadditionalpainmedication.Sayingthatthepatienthastowait4hoursforadditionalpainmedicationisinaccuratebecausethenurseneedstoprovidefurthernursinginterventionsifpainisnotrelievedatanacceptablelevelforthepatient.Admissiontoanintensivecareunitisnottypicallynecessarytomanagepainaftersurgeryforahernia.DIF:ApplyREF:598OBJ:Describeguidelinesforselectingandindividualizingpaininterventions.TOP:ImplementationMSC:CPNRE:FoundationsofPractice30.Whichofthefollowingisthebestwayforthenursetomanagepainforapatientwithchronicpainfromarthritis?a.Administeringpainmedicationbeforeanyactivity.b.Providingintravascularbolusasneededforbreakthroughpain.c.Givingmedicationsaroundtheclock.B.CMd.AdministeringpainmedicaUtionSonlNywThennonOpharmacologicalmeasureshavefailed.ANS:CWhenapatientwitharthritishaschronicpain,thebestwaytomanagepainistotakemedicationregularlythroughoutthedaytomaintainconstantpainrelief.Beforeactivityisnonspecific,andthemedicationmaynothavetimetoworkbeforeactivity.Ifthepatientwaitsuntilhavingpaintotakethemedication,painrelieftakeslonger.Nonpharmacologicalmeasuresareusedinconjunctionwithmedicationsunlessrequestedotherwisebythepatient.DIF:UnderstandREF:579|598OBJ:Describeguidelinesforselectingandindividualizingpaininterventions.TOP:ImplementationMSC:CPNRE:FoundationsofPractice31.Anurseiscaringforapatientwhofellontheiceandhasconnectivetissuedamageinthewristandhand.Whattypeofpainisthepatientexperiencing?a.Visceralpain.b.Somaticpain.c.Peripherallygeneratedpain.d.Centrallygeneratedpain.ANS:BCanadianFundamentalsofNursing7thEditionPotterTestBankSomaticpaincomesfrombone,joint,ormuscle.Visceralpainarisesfromthevisceralorganssuchasthegastrointestinaltractandpancreas.Peripherallygeneratedpaincanbecausedbypolyneuropathiesormononeuropathies.Centrallygeneratedpainresultsfrominjurytothecentralorperipheralnervoussystem.DIF:RememberREF:579|580OBJ:Performanassessmentofapatientexperiencingpain.TOP:AssessmentMSC:CPNRE:FoundationsofPractice32.Thenurseiscaringforaninfantinthepediatricunit.Whichofthefollowingisthemostaccuratedescriptionoffactorsthatwillinfluencetheperceptionandmanagementofpainforthispatient?a.Infantscannottolerateanalgesicsbecauseofanunderdevelopedmetabolism.b.Infantshaveanincreasedsensitivitytopainincomparisonwitholderchildren.c.Paincannotbeaccuratelyassessedininfants.d.Infantsrespondbehaviourallyandphysiologicallytopainfulstimuli.ANS:DInfantscannotverballyexpresstheirpain,buttheydoexpresspainwithbehaviouralcuesandphysiologicalindicators.Infantscantolerateanalgesics,butproperdosingandclosemonitoringareessential.Infantsandolderchildrenhavethesamesensitivitytopain.Paincanbeassessedeventhoughtheneonatecannotverbalize;thenursecanobservebehaviouralclues.Nursesobservebehaviouralcuesandphysiologicalresponsestoassesspainininfants.DIF:UnderstandREF:581|589OBJ:Identifycomponentsofthepainexperience.TOP:AssessmentMSC:CPNRE:FoundationsofPractice33.ThenurseisadministeringibNupUrRofSenI(NAGdvTilB).toCanOoMlderpatient.Whichofthefollowingassessmentdatawouldcausethenursetowithholdthemedication?a.Patientstatesthatlastbowelmovementwas4daysago.b.Statedallergytoaspirin.c.Patientratesintermittentjointpainas2outof10.d.Patientexperiencedrespiratorydepressionafteradministrationofanopioidmedication.ANS:BPatientswithanallergytoaspirinaresometimesalsoallergictootherNSAIDs.Thenurseneedstoverifythatthehealthcareproviderisawareoftheallergytoaspirinbeforeadministeringibuprofen.NSAIDsdonotinterferewithbowelfunctionandareusedforthetreatmentofmildtomoderateacuteintermittentpain.NSAIDsalsodonotsuppressthecentralnervoussystem.DIF:UnderstandREF:597OBJ:Explainthevariouspharmacologicalapproachestotreatingpain.TOP:AssessmentMSC:CPNRE:FoundationsofPracticeCanadianFundamentalsofNursing7thEditionPotterTestBankUSNTOChapter32:HealthAssessmentandPhysicalExaminationPotteretal:CanadianFundamentalsofNursing,7thEditionMULTIPLECHOICE1.Anurseisapreceptorforanursewhojustgraduatedfromnursingschool.Whencaringforapatient,thenewgraduatenursebeginstoexplaintothepatientthepurposeofcompletingaphysicalassessment.Whichofthefollowingstatementsmadebythenewgraduatenursepromptsthepreceptortointervene?a.Iwillusetheinformationfrommyassessmenttofigureoutifyourantihypertensivemedicationisworkingeffectively.b.Nursingassessmentdataareusedonlytoprovideinformationabouttheeffectivenessofyourmedicalcare.c.Nursesusedatafromtheirpatientsphysicalassessmenttodetermineapatientseducationalneeds.d.Informationgainedfromphysicalassessmenthelpsnursesbetterunderstandtheirpatientsemotionalneeds.ANS:BNursingassessmentdataareusedtoevaluatetheeffectivenessofallaspectsofapatientscare,notjustthepatientsmedicalcare.Assessmentdatahelpthenurseevaluatetheeffectivenessofmedicationsanddetermineapatientshealthcareneeds,includingtheneedforpatienteducation.Nursesalsouseassessmentdatatoidentifypatientspsychosocialandculturalneeds.DIF:EvaluateREF:61N2RIGOBBJ:.DiCscMussthepurposesofphysicalassessment.TOP:CommunicationandDocumentationMSC:CPNRE:FoundationsofPractice2.Foraweakpatientwithbilateralbasilarpneumonia,whichisthebestpositionforacompletegeriatricphysicalexamination?a.Proneposition.b.Simssposition.c.Supineposition.d.Lateralrecumbentposition.ANS:CThesupinepositionisthemostnormallyrelaxedposition.Itwillnotfurthercompromisethepatientsbreathing.Ifthepatientbecomesshortofbreatheasily,theheadofthebedcanberaised.Thispositionwouldbeeasiestforweakolderpersontogetintoforanexamination.Lateralrecumbentandpronepositionscauserespiratorydifficultyforanypatientwithrespiratorydifficulties.Simsspositionisusedforassessmentoftherectumandthevagina.DIF:UnderstandREF:617,Table32-3OBJ:Listtechniquesforpreparingapatientphysicallyandpsychologicallybeforeandduringanexamination.TOP:PlanningMSC:CPNRE:FoundationsofPracticeCanadianFundamentalsofNursing7thEditionPotterTestBank3.Duringanannualgynecologicalexamination,acollegestudentdiscussesherupcomingcollegebreakatatropicallocation.Afterthestudentreceivesanoralcontraceptiveprescription,thenurseidentifiestheimportanceofskincancerpreventioneducationbydiscussingwhichevidence-informedpreventiontechnique?a.Applyingwater-basedsunscreenonlybeforeswimming.b.Usingtanningbeddailyfor7daysbeforecollegebreaktrip.c.Applyingbroad-spectrumsunscreenofSPF5.d.Takingextraprecautionsinthesunsecondarytotheprescription.ANS:DOralcontraceptivescanmaketheskinmoresensitivetothesun.Forthisreason,thepatientshouldbeeducatedabouttheneedforsunprotectionwithsuchtechniquesastheuseofwide-brimmedhats,useofbroad-spectrumsunscreenofSPF15orgreater,nottanningduringmidday,andnotusingtanningbeds.Broad-spectrumsunscreensshouldbeapplied15minutesbeforeapersongoesoutintothesunandafterswimmingorperspiring.DIF:UnderstandREF:628,Box32-9OBJ:Discusswaystoincorporatehealthpromotionandhealthteachingintotheexamination.TOP:PlanningMSC:CPNRE:FoundationsofPractice4.Aheadandneckphysicalexaminationiscompletedona50-year-oldwoman.Allphysicalfindingsarenormalexceptthatshehasfine,brittlehair.Onthebasisofthephysicalfindings,whichofthefollowinglaboratorytestswouldthenurseexpecttobeordered?a.Liverfunctiontest.b.Leadlevel.c.Thyroid-stimulatinghormonetest.d.CompletebloodcellcounNt(CRBCI).GB.CMANS:CUSNTOThyroiddiseasecanmakehairthinandbrittle.Liverfunctiontestingisindicatedforapatientwhohasjaundice.LeadlevelsandaCBCarenotindicatedforthepresenceofbrittlehair.DIF:UnderstandREF:627OBJ:Identifyhownursesusephysicalassessmentskillsduringroutinenursingcare.TOP:PlanningMSC:CPNRE:FoundationsofPractice5.Afebrilepreschool-agedchildpresentstotheafter-hoursclinic.Varicellaisdiagnosedonthebasisoftheillnesshistoryandthepresenceofsmall,circumscribedskinlesionsfilledwithserousfluid.Thenursedocumentsthevaricellalesionsaswhichtypeofskinlesion?a.Vesicle.b.Wheal.c.Papule.d.Pustule.ANS:AVesiclesarecircumscribed,elevatedskinlesionsfilledwithserousfluidthataresmallerthan1cmindiameter.Whealsareirregularlyshaped,elevatedareasofsuperficiallocalizededemathatvaryinsize.Theyarecommonwithbugbitesandhives.Papulesarepalpable,circumscribed,solidelevationsintheskinthataresmallerthan1cmindiameter.Pustulesareelevationsofskinsimilartovesicles,buttheyarefilledwithpus.DIF:UnderstandREF:626,Box32-7CanadianFundamentalsofNursing7thEditionPotterTestBankOBJ:Describephysicalmeasurementsmadeinassessingeachbodysystem.TOP:AssessmentMSC:CPNRE:FoundationsofPractice6.Aschoolnurserecognizesabeltbuckle-shapedecchymosisona7-year-oldstudent.Whenprivatelyaskedabouthowtheinjuryoccurred,thestudentdescribedfallingontheplayground.Uponsuspectingabuse,theschoolnursesbestnextactioniswhichofthefollowing?a.Interviewingthepatientinthepresenceofhis/herteacher.b.Ignoringthefindingsbecausechildabuseisadecliningproblem.c.Realizingthatabusevictimsusuallyreportabusivesituations.d.ContactingSocialServicesandreportingsuspectedabuse.ANS:DMostprovincesandterritoriesmandateareporttoasocialservicecentreifnursessuspectabuseorneglect.Whenabuseissuspected,thenurseinterviewsthepatientinprivate.Abuseofchildren,women,andolderpersonsisagrowinghealthproblem.Itisdifficulttodetectabusebecausevictimsoftenwillnotcomplainorreportthattheyareinanabusivesituation.DIF:ApplyREF:620OBJ:Identifyhownursesusephysicalassessmentskillsduringroutinenursingcare.TOP:ImplementationMSC:CPNRE:FoundationsofPractice7.AnurseidentifiesPediculosishumanuscapitis.Consideringthepossiblecomplicationsoftreatment,thenurseknowstonotusewhichofthefollowingtreatmentproducts?a.Fine-toothedcomb.b.Pediculicide.c.Lindane-basedshampoo.d.Vinegarhairrinse.ANS:CNURSINGTB.COMProductscontaininglindane,atoxicingredient,oftencauseadversereactionsandneurotoxiceffects.Patientswhohaveheadliceareinstructedtoshampoothoroughlywithpediculicide(shampooavailableatdrugstores)incoldwater,combthoroughlywithafine-toothedcomb,anddiscardthecomb.Adilutesolutionofvinegarandwaterhelpsloosennits.DIF:ApplyREF:629,Box32-10OBJ:Describephysicalmeasurementsmadeinassessingeachbodysystem.TOP:ImplementationMSC:CPNRE:FoundationsofPractice8.Aparentcallstheschoolnursewithquestionsregardingtherecentschoolvisionscreening.Snellenchartexaminationrevealed20/60forbotheyesinthechild.Consideringthevisualacuityresults,whatdoesthenurseinformstheparent?a.Thatthechildshouldhaveanoptometricexamination.b.Thatthechildissufferingfromstrabismus.c.Thatthechildmayhavepresbyopia.d.Thatthechildhasvisionissuesprobablybecauseofcataracts.ANS:ACanadianFundamentalsofNursing7thEditionPotterTestBankNRIGB.CNormalvisionis20/20.Thelargerthedenominator,thepoorerthepatientsvisualacuity.Forexample,avalueof20/60meansthatthepatient,whenstanding20feetaway,canreadalinethatapersonwithnormalvisioncanreadfrom60feetaway.Strabismusisa(congenital)conditioninwhichbotheyesdonotfocusonanobjectsimultaneously:theseeyesappearcrossed.Acuitymaynotbeaffected.Presbyopiaisimpairednearvisionthatoccursinmiddle-agedandolderpersonsandiscausedbylossofelasticityofthelens.Cataractsdevelopslowlyandprogressivelyafterage35orsuddenlyaftertrauma.DIF:ApplyREF:634OBJ:Identifypreventivescreeningsandtheappropriateage(s)foreachscreeningtooccur.TOP:ImplementationMSC:CPNRE:FoundationsofPractice9.Duringaroutinepediatrichistorydocumentationandphysicalexamination,theparentsreportthattheirchildwasaprematureinfantandwassosmallthathehadtostayintheneonatalintensivecareunitlongerthanusual.Theystatethattheinfantwasyellowwhenborn,andthathedevelopedaninfectionthatrequiredeveryantibioticunderthesuntocurehim.Consideringtheneonatalhistory,thenursedeterminesthatitisespeciallyimportanttoperformwhichtypeofafocusedexamination?a.Cardiac.b.Respiratory.c.Ophthalmic.d.Hearingacuity.ANS:DRiskfactorsforhearingproblemsincludelowbirthweight,nonbacterialintrauterineinfection,andexcessivelyhighbilirubinlevels.Hearinglosscausedbyototoxicity(injurytoauditorynerves)canresultfromhighmaintenancedosesofantibiotics.Cardiac,respiratory,andeyeexaminationsareimportantassUessmSenNtsbTutarenOotrelevanttothischildscondition.DIF:ApplyREF:636,Table32-13OBJ:Identifydatatocollectfromthenursinghistorybeforeanexamination.TOP:ImplementationMSC:CPNRE:FoundationsofPractice10.Duringapresentationaboutsexuallytransmittedinfectionstohighschoolstudents,thenurserecommendsthehumanpapillomavirus(HPV)vaccineseriestopreventwhichofthefollowing?a.Cervicalcancer.b.Genitallesions.c.Vaginaldischarge.d.Swollenperianaltissues.ANS:AHPVinfectionincreasestheriskforcervicalcancer.HPVvaccineisrecommendedbythePublicHealthAgencyofCanadaforfemalepatientsaged9to26years.Vaginaldischarge,painfulorswollenperianaltissues,andgenitallesionsaresignsandsymptomsthatmayindicateasexuallytransmittedinfection.DIF:UnderstandREF:664,Table32-26OBJ:Identifypreventivescreeningsandtheappropriateage(s)foreachscreeningtooccur.TOP:ImplementationMSC:CPNRE:FoundationsofPracticeCanadianFundamentalsofNursing7thEditionPotterTestBank11.Amalestudentcomestothecollegehealthclinic.Hehesitantlydescribesthathistestishasapea-sizedhardlump.Thenurserecognizesthisasapotentialsignofwhichofthefollowing?a.Inguinalhernia.b.Sexuallytransmittedinfection.c.Testicularcancer.d.Diureticuse.ANS:CIrregularlumpsofthetestesmayindicatetesticularcancer.Testicularcanceriscancerthatbeginsinthetesticles.Testicularcanceristhemostcommonformofcancerinmenbetweentheagesof15and35years.Aherniamanifestswithbulginginthescrotum.Sexuallytransmittedinfectionsoftenmanifestwithgenitallesions.Useofdiuretics,sedatives,orantihypertensivescancausedifficultyinachievingerectionorejaculationbutdoesnotusuallycauselumps.DIF:UnderstandREF:667OBJ:Identifyself-screeningexaminationscommonlyperformedbypatients.TOP:ImplementationMSC:CPNRE:FoundationsofPractice12.Thenurseisurgentlycalledtothegymnasiumregardinganinjuredstudent.Thestudentiscryinginseverepainwithamalformedfracturedlowerleg.Thepropersequenceforthenursesinitialassessmentisa.Deeppalpation,lightpalpation,inspection.b.Lightpalpation,deeppalpation,inspection.c.Inspection,lightpalpation.d.Auscultation,deeppalpation,lightpalpation.ANS:CNURSINGTB.COMInspectionistheuseofvisionandhearingtodistinguishnormalfromabnormalfindings.Lightpalpationdeterminesareasoftendernessandskintemperature,moisture,andtexture.Deeppalpationisusedtoexaminetheconditionoforgans,suchasthoseintheabdomen;itmustbedonewithcautionandisdoneafterlightpalpation.Auscultationisusedtoevaluatesound.DIF:ApplyREF:613|614OBJ:Demonstratethetechniquesusedwitheachphysicalassessmentskill.TOP:ImplementationMSC:CPNRE:FoundationsofPractice13.Onadmission,apatientweighs113.4kg(250pounds).Theweightisrecordedas116.1kg(256pounds)onthesecondinpatientday.Thenurseshouldevaluatethepatientforwhichofthefollowing?a.Fluidretention.b.Fluidloss.c.Decreasednutritionalreserves.d.Anorexia.ANS:AThispatienthasgained2.7kg(6pounds)ina24-hourperiod.Aweightgainof2.3kg(5pounds)ormoreinadayindicatesfluidretentionproblems.Adownwardtrendmayindicateareductioninnutritionalreservesthatmaybecausedbydecreasedintakesuchasanorexiaorbyfluidloss.CanadianFundamentalsofNursing7thEditionPotterTestBankDIF:ApplyREF:620OBJ:Identifyhownursesusephysicalassessmentskillsduringroutinenursingcare.TOP:ImplementationMSC:CPNRE:FoundationsofPractice14.Thepatientisa50-year-oldAfricanCanadianmanwhohascomeinforhisroutineannualphysical.Whichofthefollowingpreventivescreeningsdoesthenurserecommend?a.Digitalrectalexaminationoftheprostate(DRE)annually.b.Bloodtestforcancerantigen125(CA-125)onceayear.c.Completeeyeexaminationeveryyear.d.Colonoscopyevery3years.ANS:AMenneedtohaveadigitalrectalexaminationoftheprostateeveryyearbeginningat50yearsofage.CA-125bloodtestsareindicatedforwomenathighriskforovariancancer.Becausethispatientisaman,theCA-125testisnotneeded.Patientsolderthan65needtohavecompleteeyeexaminationsyearly.Colonoscopyevery10yearsisrecommendedinpatients50yearsofageandolder.DIF:ApplyREF:619,Table32-4OBJ:Discusswaystoincorporatehealthpromotionandhealthteachingintotheexamination.TOP:ImplementationMSC:CPNRE:FoundationsofPractice15.Anolderpatientisbeingseenforachronicentropion.Thenurserealizesthatentropionplacesthepatientatriskforwhichofthefollowing?a.Ectropion.b.Infection.c.Exophthalmos.d.Strabismus.ANS:BNURSINGTB.COMEntropioncancausethelashesofthelidstoirritatetheconjunctivaandcornea,andirritationcanleadtoinfection.Inectropion,eyelidmarginsturnoutwardsothatthelashesdonotirritatetheconjunctiva.Exophthalmosisabulgingoftheeyesandusuallyindicateshyperthyroidism.Strabismus,orcrossingoftheeyes,resultsfromneuromuscularinjuryorinheritedabnormalities.DIF:ApplyREF:632OBJ:Identifyhownursesusephysicalassessmentskillsduringroutinenursingcare.TOP:ImplementationMSC:CPNRE:FoundationsofPractice16.Duringaschoolphysicalexamination,thenursereviewsthepatientscurrentmedicalhistory,whichispositiveforasthma,eczema,andallergicrhinitis.Whichphysicalfindingsshouldthenurseexpectonnasalexamination?a.Polyp.b.Yellowdischarge.c.Palenasalmucosa.d.Puffinessofnasalmucosa.ANS:CCanadianFundamentalsofNursing7thEditionPotterTestBankUSNTOPalenasalmucosawithclearmucoiddischargeindicatesallergicrhinitis.Polypsaretumour-likegrowths.Yellowdischargewouldbeseenwithinfection.Habitualuseofintranasalcocaineandopioidscausespuffinessandincreasedvascularityofthenasalmucosa.DIF:AnalyzeREF:637OBJ:Identifydatatocollectfromthenursinghistorybeforeanexamination.TOP:AssessmentMSC:CPNRE:FoundationsofPractice17.Objectivephysicaldatadescribeairmovingthroughsmallairways,auscultatedoverthelungsperiphery.Theexpectedinspiratory-to-expiratoryphaseofthisnormalvesicularbreathsoundiswhichofthefollowing?a.Theinspiratoryphaselastsexactlyaslongastheexpiratoryphase.b.Theexpirationphaseislongerthantheinspirationphase.c.Theexpirationphaseistwotimeslongerthantheinspirationphase.d.Theinspiratoryphaseisthreetimeslongerthantheexpiratoryphase.ANS:DVesicularbreathsoundsarenormalbreathsoundsheardoverthelungsperiphery,causedbyairmovingthroughsmallerairways;theinspiratoryphaseisthreetimeslongerthantheexpiratoryphase.Inbronchovesicularbreathsounds,theinspiratoryphaseisequallyaslongastheexpiratoryphase.Inbronchialbreathsounds,theexpirationphaselongerthantheinspirationphaseata3:2ratio.DIF:AnalyzeREF:646,Table32-18OBJ:Discussnormalphysicalfindingsinyoung,middle-aged,andolderpersons.TOP:AssessmentMSC:CPNRE:FoundationsofPractice18.AteenagedfemalepatientreNportRsinItermGitteBnt.aCbdoMminalpainthathaslastedfor12hours.Nodysuriaispresent.Whenperforminganabdominalassessment,whatshouldthenursedo?a.Recommendthatthepatienttakemorelaxatives.b.Askthepatientaboutthecolourofherstools.c.Avoidsexualreferencessuchaspossiblepregnancy.d.Palpatefirstthespotsthataremosttender.ANS:BBlackortarrystools(melena)indicategastrointestinalalteration.Thenurseshouldcautionpatientsaboutthedangersofexcessiveuseoflaxativesorenemas.Thenurseshouldalsodeterminewhetherthepatientispregnantandnoteherlastmenstrualperiod.Pregnancycauseschangesinabdominalshapeandcontour.Painfulareasshouldbeassessedlast,tominimizediscomfortandanxiety.DIF:ApplyREF:661,Table32-25OBJ:Discussnormalphysicalfindingsinyoung,middle-aged,andolderpersons.TOP:ImplementationMSC:CPNRE:FoundationsofPractice19.Duringagenitourinaryexaminationofa30-year-oldman,thenurseidentifiesasmallamountofawhite,thicksubstanceonthepatientsuncircumcisedglanspenis.Whatisthenursesnextstep?a.Notifyhisprovideraboutasuspectedsexuallytransmittedinfection(STI).b.Recognizethisasanormalfinding.c.Tellthepatienttoavoiddoingself-examinationsuntilsymptomsclear.CanadianFundamentalsofNursing7thEditionPotterTestBankREF:617,Table32-3USNTOd.Avoidembarrassingquestionsaboutsexualactivity.ANS:BAsmallamountofthick,whitesmegmasometimescollectsundertheforeskininuncircumcisedboysandmen.Penilepainorswelling,genitallesions,andurethraldischargearesignsandsymptomsthatmayindicateSTI.Allmen15yearsandolderneedtoperformamale-genitalself-examinationmonthly.Thenurseneedstoassessapatientssexualhistoryanduseofsafesexhabits.SexualhistoryrevealsrisksforSTIandhumanimmunodeficiencyvirus(HIV)infection.DIF:ApplyREF:666OBJ:Discussnormalphysicalfindingsinyoung,middle-aged,andolderpersons.TOP:ImplementationMSC:CPNRE:FoundationsofPractice20.Inpreparationforarectalexamination,anonambulatorymalepatientisinformedoftheneedtobeplacedinwhichposition?a.Simssposition.b.Forwardbendingwithflexedhips.c.Knee-chest.d.Dorsalrecumbent.ANS:ANonambulatorypatientsarebestexaminedinaside-lyingSimssposition.Forwardbendingwouldrequirethepatienttobeabletostandupright.Kneestochestwouldbedifficulttomaintaininanonambulatorymaleandisembarrassinganduncomfortable.Thedorsalrecumbentpositiondoesnotprovideadequateaccessforarectalexaminationandisusedforabdominalassessmentbecauseitpromotesrelaxationofabdominalmuscles.NRIGB.CMDIF:UnderstandOBJ:Listtechniquesusedtoprepareapatientphysicallyandpsychologicallybeforeandduringanexamination.TOP:PlanningMSC:CPNRE:FoundationsofPractice21.ThepatientisaskedwhatthestatementAstitchintimesavesninemeanstohim(amentalstatusexaminationtechnique);whatisitusedtoassess?a.Knowledge.b.Long-termmemory.c.Abstractthinking.d.Recentmemory.ANS:CForanindividualtoexplaincommonphrasessuchasAstitchintimesavesninerequiresahigherlevelofintellectualfunction.Knowledge-basedassessmentisfactual.Thenurseassessesknowledgebyaskinghowmuchthepatientknowsabouthisillnessorthereasonforseekinghealthcare.Toassessmemory,thepatientisaskedtorecallthemaidennameofthepatientsmother,abirthday,oraspecialdateinhistory.Itisbesttoaskopen-endedquestionsratherthansimpleyes/noquestions.Patientsdemonstrateimmediaterecallbyrepeatingaseriesofnumbersintheorderinwhichtheyarepresentedorinreverseorder.DIF:UnderstandREF:675OBJ:Describephysicalmeasurementsmadeinassessingeachbodysystem.TOP:PlanningMSC:CPNRE:FoundationsofPracticeCanadianFundamentalsofNursing7thEditionPotterTestBankNRIGB.C22.Duringaroutinephysicalexaminationofa70-year-oldpatient,ablowingsoundisauscultatedoverthecarotidartery.Thenursenotifiesthemedicalprovideroftheunexpectedphysicalfinding,whichisknownaswhichofthefollowing?a.Clubbing.b.Bruit.c.Right-sidedheartfailure.d.Phlebitis.ANS:BAbruitisthesoundofturbulenceofbloodpassingthroughanarrowedbloodvessel.Abruitcanreflectcardiovasculardiseaseinthecarotidarteryofmiddle-agedtoolderpersons.Clubbingofthefingersisduetoinsufficientoxygenationattheperipheryasaresultofconditionssuchaschronicemphysemaandcongenitalheartdisease.Jugularvenousdistension,notbruit,isapossiblesignofright-sidedheartfailure.Insomepatientswithheartdisease,thejugularveinsaredistendedwhenthepatientssit.Phlebitisisaninflammationofaveinthatoccurscommonlyaftertraumatothevesselwall,infection,immobilization,andtheneedforprolongedinsertionofintravenouscatheters.Itaffectspredominantlyperipheralveins.DIF:UnderstandREF:652OBJ:Describephysicalmeasurementsmadeinassessingeachbodysystem.TOP:PlanningMSC:CPNRE:FoundationsofPractice23.ThenursebelievesthatseveralnewfemalepatientsshouldreceiveadditionalhealtheducationabouttheneedformorefrequentPapanicolaou(Pap)smearsandgynecologicalexaminations.Whichofthefollowingassessmentfindingsrevealsthepatientathighestriskforcervicalcancerandthushavingthegreatestneedforpatienteducation?a.13yearsold,doesnotsmokUe,iSsnoNtseTxuallyaOctive.b.15yearsold,isasocialsmoker,iscelibate.c.22yearsold,smokes1packofcigarettesperday,hasmultiplesexualpartners.d.50yearsold,stoppedsmoking30yearsago,hashistoryofhysterectomy.ANS:CFemalepatientsconsideredtobeathigherriskforcervicalcancerincludethosewhosmokeandareolderthan21withweakimmunesystems,multiplesexpartners,andahistoryofsexuallytransmittedinfections.Ofalltheassessmentfindingslisted,thoseofthe22-year-oldsmokerwithmultiplesexualpartnersincludethegreatestnumberofriskfactorsforcervicalcancer.Theotherpatientsareatlowerrisk.DIF:ApplyREF:664,Table32-26OBJ:Discusswaystoincorporatehealthpromotionandhealthteachingintotheexamination.TOP:PlanningMSC:CPNRE:FoundationsofPractice24.Apatienthasbeenadmittedtothemedicalunitafterbeinginvolvedinamotorvehicleaccident.Onphysicalexamination,thepatientslevelofconsciousnessisreportedasopeningeyestopainandrespondingwithinappropriatewordsandflexionwithdrawaltopainfulstimuli.ThenursecorrectlyidentifiesthepatientsGlasgowComaScalescoreaswhichofthefollowing?a.5.b.7.c.9.CanadianFundamentalsofNursing7thEditionPotterTestBankd.11.ANS:CAccordingtotheguidelinesoftheGlasgowComaScale,thepatienthasascoreof9.Openingeyestopainis2points;inappropriateworduseis3points;andflexionwithdrawalis4points.Thetotalforthispatientis2+3+4=9.DIF:ApplyREF:674,Table32-33OBJ:Identifyhownursesusephysicalassessmentskillsduringroutinenursingcare.TOP:AssessmentMSC:CPNRE:FoundationsofPractice25.Whileassessingtheskinofan82-year-oldmalepatient,anursediscoversnonpainfulrubyredpapulesonthepatientstrunk.Whatisthenursesnextaction?a.Explainingthatthepatienthasbasalcellcarcinomaandshouldwatchforspread.b.Documentingcherryangiomasasanormalgeriatricskinfinding.c.Tellingthepatientthathehasabenignsquamouscellcarcinoma.d.Documentingthepresenceofedema.ANS:BTheskinisnormallyfreeoflesions,exceptforcommonfrecklesorage-relatedchangessuchasskintags,senilekeratosis(thickeningofskin),cherryangiomas(rubyredpapules),andatrophicwarts.Basalcellcarcinomaismostcommoninsun-exposedareasandfrequentlyoccursinabackgroundofsun-damagedskin;italmostneverspreadstootherpartsofthebody.Squamouscellcarcinomaismoreseriousthanbasalcellanddevelopsontheouterlayersofsun-exposedskin;thesecellsmaytraveltolymphnodesandthroughoutthebody.Thenurseshouldreportabnormallesionstothehealthcareproviderforfurtherexamination.Edemaisanareaofskinthatbecomesswollenoredematousfromabuildupoffluidinthetissues.ThishasnothingtodNoUwRithScIhNerGryTaBng.ioCmOaMs.DIF:ApplyREF:625OBJ:Discussnormalphysicalfindingsinyoung,middle-aged,andolderpersons.TOP:AssessmentMSC:CPNRE:FoundationsofPractice26.Duringapreschoolreadinessexamination,thenursepreparestoperformvisualacuityscreenings.Inviewofthechildrensage,thebestequipmenttotestcentralvisioniswhichofthefollowing?a.Snellentest.b.Echart.c.Readingtest.d.Penlight.ANS:BTheEchartisusedwhenanindividualisunabletoread,aswouldbethecaseforapreschool-agedchild.ASnellenchartandareadingtestaretooadvancedforapreschoolerseducationlevel.Apenlightisusedtochecklightperception;itshinesalightintotheeye,andthenitisturnedoff.Ifthepatientnoteswhenthelightisturnedonoroff,lightperceptionisintact.DIF:ApplyREF:634OBJ:Identifypreventivescreeningsandtheappropriateage(s)foreachscreeningtooccur.TOP:AssessmentMSC:CPNRE:FoundationsofPracticeCanadianFundamentalsofNursing7thEditionPotterTestBankUSNT27.Anursesuspectsanabnormalthyroidshapeduringthephysicalexamination.Whydoesthenurseofferthepatientaglassofwaterandwatchherdrinkingasshedrinks?a.Tovisualizeanenlargedthyroidgland.b.Toevaluateforexostosis.c.Totestthepatientsgagreflex.d.Tovisualizetheuvulaandsoftpalate.ANS:AThistechniqueisusedtovisualanabnormallylargethyroidgland.Normally,thethyroidcannotbevisualized.Anexostosisisabonygrowthbetweenthetwopalatesthatisnotedwhentheoralcavityisexamined.Thepatientsgagreflexistestedbyplacingatonguedepressorontheposteriortongue.Theuvulaandsoftpalatearevisualizedwiththeuseofapenlight.Bothstructuresshouldrisecentrallyasthepatientsays,Ah.DIF:UnderstandREF:642OBJ:Demonstratethetechniquesusedwitheachphysicalassessmentskill.TOP:AssessmentMSC:CPNRE:FoundationsofPractice28.Thepatientisa54-year-oldmanwithamediumframe.Heweighs67.1kg(148pounds)andis173cm(5feet8inches)tall,withabodymassindex(BMI)of22kg/m2.Thenurserealizesthatthispatientiswhichofthefollowing?a.Overweight.b.Underweight.c.Athisdesiredweight.d.Obese.ANS:CAnormalBMIis18.5to24.9NkgR/m2I.ThGispBat.ienCtisMathisdesiredweight.Heisnotoverweight,underweight,orobese.DIF:RememberREF:622,Figure32-1OBJ:Discussnormalphysicalfindingsinyoung,middle-aged,andolderpersons.TOP:AssessmentMSC:CPNRE:FoundationsofPractice29.Apatientintheemergencydepartmentiscomplainingofleftlowerabdominalpain.Thecomprehensiveabdominalexaminationwouldinclude,inproperorder,whichofthefollowing?a.Inspection,palpation,andauscultation.b.Percussion,inspection,andauscultation.c.Inspection,palpation,andpercussion.d.Inspection,auscultation,andpalpation.ANS:DTheorderofanabdominalexaminationdiffersslightlyfromthatofotherassessments.Itbeginswithinspection,followedbyauscultation.Performingauscultationbeforepalpationlessensthechanceofalteringthefrequencyandcharacterofbowelsounds.DIF:ApplyREF:660|661OBJ:Demonstratethetechniquesusedwitheachphysicalassessmentskill.TOP:AssessmentMSC:CPNRE:FoundationsofPractice30.Whatisthebesttermforbreathsoundscreatedbyairmovingthroughlargelungairways?CanadianFundamentalsofNursing7thEditionPotterTestBanka.Bronchovesicular.b.Rhonchi.c.Bronchial.d.Vesicular.ANS:ABronchovesicularbreathsoundsarecreatedbyairmovingthroughlargeairways.Vesicularsoundsarecreatedbyairmovingthroughsmallerairways.Bronchialsoundsarecreatedbyairmovingthroughthetracheaclosetothechestwall.Rhonchiareabnormallungsoundsthatareloud,low-pitched,rumblingcoarsesoundsheardduringinspirationorexpirationthatsometimesclearbycoughing.DIF:RememberREF:646,Table32-18OBJ:Describephysicalmeasurementsmadeinassessingeachbodysystem.TOP:AssessmentMSC:CPNRE:FoundationsofPractice31.Thepatientpresentstotheclinicwithdysuriaandhematuria.Howdoesthenurseproceedtoassessforkidneyinflammation?a.Lightlypalpateseachabdominalquadrant.b.Inspectsabdomenforabnormalmovementorshadowsusingindirectlighting.c.Usesdeeppalpationposteriorly.d.Percussesposteriorlythecostovertebralangleatthescapularline.ANS:DWiththepatientsittingorstandingerect,directorindirectpercussionisusedtoassessforkidneyinflammation.Withtheulnarsurfaceofthepartiallyclosedfist,thenursepercussesposteriorlythepatientscostovertebralangleatthescapularline.Ifthekidneysareinflamed,thepatientfeelstendernessdNurUinRgSpeIrNcuGssTioBn..ACsyMstematicpalpationapproachforeachquadrantoftheabdomenisusedtoassessformuscularresistance,distension,abdominaltenderness,andsuperficialorgansormasses.Lightpalpationwouldnotrevealkidneytendernessbecausethekidneyssitdeepwithintheabdominalcavity.Thelowerribsandheavybackmusclesprotectthekidneys,sothekidneyscannotbepalpatedposteriorly.Kidneyinflammationdoesnotcauseabdominalmovement;however,toinspecttheabdomenforabnormalmovementorshadows,thenurseshouldstandonthepatientsrightsideandinspectfromabovetheabdomen,usingdirectlightovertheabdomen.DIF:ApplyREF:662OBJ:Demonstratethetechniquesusedwitheachphysicalassessmentskill.TOP:AssessmentMSC:CPNRE:FoundationsofPractice32.Theadvancedpracticenurseisconductingacomprehensiveeyeexaminationonan80-year-oldAfricanCanadianwoman.Whichofthefollowingfindingsrequiresthenursetocontactthepatientsphysicianforfurtherexamination?a.Athinwhiteringalongthemarginoftheiris.b.Ablackpupil.c.Dilatedpupils.d.Ablackfundusoftheeye.ANS:CCanadianFundamentalsofNursing7thEditionPotterTestBankDilatationofthepupilsresultfromglaucoma,trauma,neurologicaldisorders,eyemedication,orwithdrawalfromopioids.Shiningabeamoflightthroughthepupilandontotheretinastimulatesthethirdcranialnerveandcausesthemusclesoftheiristoconstrict.Anyabnormalityalongthenervepathwaysfromtheretinatotheirisalterstheabilityofthepupilstoreacttolight.Athinwhiteringalongthemarginoftheiris,calledanarcussenilis,iscommonwithagingbutisabnormalinanyoneyoungerthan40.Thepupilsarenormallyblack,round,regular,andequalinsize.ThefundusofAfricanCanadianpatientscanbeblack.DIF:ApplyREF:633OBJ:Discussculturaldiversity,culturalcompetency,andculturalsafetyastheserelatetotheprovisionofculturallycompetenthealthandphysicalassessmentandimprovedpatienthealthoutcomes.TOP:AssessmentMSC:CPNRE:FoundationsofPractice33.Anelderlypatienthasbeentakinghighdosesofantibioticsandisexperiencingasuddenlossofhearing.Thenurseshouldcontactthehealthcareprovideranddowhatelse?a.Stopantibioticuseuntilthephysicianresponds.b.Tellthepatientthatolderpatientsoftenloselow-frequencyhearing.c.Explainthathearinglossusuallyoccurswiththinningoftheeardrum.d.Assurethepatientthatrapidhearinglossisnormalinolderpeople.ANS:AOlderpersonsareespeciallyatriskforhearinglosscausedbyototoxicity(injurytoauditorynerve)resultingfromhighmaintenancedosesofantibiotics(e.g.,aminoglycosides).Continuationofthemedicationsisaphysicianresponsibility.Olderpersonsexperienceaninabilitytohearhigh-frequencysoundsandconsonants.Deteriorationofthecochleaandthickeningofthetympanicmembranecauseolderpersonstograduallylosehearingacuity.DIF:ApplyREF:63N6URSINGTB.COMOBJ:Identifyhownursesusephysicalassessmentskillsduringroutinenursingcare.TOP:AssessmentMSC:CPNRE:FoundationsofPractice34.Thepatienthashadastrokethathasaffectedherabilitytospeak,andshebecomesextremelyfrustratedwhenshetriestospeak.Sherespondscorrectlytoquestionsandinstructionsbutcannotformwordscoherently.Thispatientisshowingsignsofwhichtypeofaphasia?a.Expressive.b.Receptive.c.Sensory.d.Combination.ANS:AThetwotypesofaphasiaaresensory(orreceptive)andmotor(orexpressive).Thepatientcannotexpressherselfinwordsandisshowingsignsofexpressiveaphasia.Sherespondscorrectlytoquestionsandinstructions,indicatingthatshedoesnothavereceptiveorsensoryaphasia.Patientssometimessufferacombinationofreceptiveandexpressiveaphasia,butthatisnotthecasewiththispatient.DIF:UnderstandREF:675OBJ:Describephysicalmeasurementsmadeinassessingeachbodysystem.TOP:AssessmentMSC:CPNRE:FoundationsofPracticeCanadianFundamentalsofNursing7thEditionPotterTestBank35.Theschoolnurseisassessingthetympanicmembranesofa3-year-old.Whichofthefollowingisanormalassessmentfinding?a.Presenceofayellowwaxysubstance.b.Swollenmeatus.c.Discomfortwithpalpationoftheauricle.d.Tendernessinthemastoidarea.ANS:AAyellow,waxysubstancecalledcerumeniscommonlypresent.Tendernessinthemastoidareaindicatesmastoiditis.Thenurseshouldinspecttheopeningoftheearcanalforsizeandpresenceofdischarge.Ifdischargeispresent,thenurseshouldwearcleanglovesduringtheexamination.Swellingorocclusionofthemeatusisnotnormal.Yelloworgreen,foul-smellingdischargeindicatesthepresenceofinfectionoraforeignbody.DIF:ApplyREF:635|636OBJ:Discussnormalphysicalfindingsinyoung,middle-aged,andolderpersons.TOP:AssessmentMSC:CPNRE:FoundationsofPracticeNURSINGTB.COMCanadianFundamentalsofNursing7thEditionPotterTestBankNRIGB.CChapter33:InfectionControlPotteretal:CanadianFundamentalsofNursing,7thEditionMULTIPLECHOICE1.ThepatientandthenursearediscussingRickettsiarickettsii,thecauseofRockyMountainspottedfever.Whichpatientstatementtothenurseindicatesunderstandingregardingthemodeoftransmissionofthisdisease?a.WhenIgocamping,Iwillbesuretowearsunscreen.b.WhenIgocamping,Iwilldrinkbottledwater.c.WhenIgocamping,Iwillbesuretowearinsectrepellent.d.WhenIgocamping,Iwillbesuretousehandgelonmyhands.ANS:CEachinfectiousdiseasehasaspecificmodeoftransmission:acomponentofthechainofinfection.RockyMountainspottedfeveriscausedbybacteriatransmittedbythebiteofticks.Wearingarepellentthatisdesignedforrepellingticks,mosquitoes,andotherinsectscanhelpinpreventingtransmissionofthisdisease.Drinkingplentyofuncontaminatedwater,wearingsunscreen,andusingalcohol-basedhandgelsforcleaninghandsareallimportanttaskstoperformwhilecamping,buttheydonotcontributetoorpreventtransmissionofthisdisease.DIF:UnderstandREF:685OBJ:Explaintherelationshipbetweenthechainofinfectionandtransmissionofinfection.TOP:EvaluateMSC:CPNRE:FoundationsofPractice2.Thenurseisprovidinganeducationalsessionforagroupofpreschoolworkers.ThenurseremindsthegroupthatthemosUtimSporNtantTthingtoOdotopreventthespreadofinfectioniswhichofthefollowing?a.Encouragepreschoolchildrentoeatanutritiousdiet.b.Encourageparentstoprovideamultivitamintothechildren.c.Cleanthetoyseveryafternoonbeforeputtingthemaway.d.Performhandhygienebetweeneachinteractionwithchildren.ANS:DThesinglemostimportantthingthatindividualscandotopreventthespreadofinfectionistoperformhandhygienebeforeandaftereating,goingtothebathroom,changingadiaper,andwipinganose,aswellasaftercleaningtoysortables,afterpickingupafterthechildren,andbetweentouchingeachindividualchild.Itisimportantforpreschoolchildrentohaveanutritiousdiet;ahealthyindividualcanfightinfectionmoreeffectively.Aphysician,alongwiththeparent,makesdecisionsaboutdietarysupplements.Cleaningthetoyscandecreasethenumberofpathogensbutisnotthemostimportantthingtodointhisscenario.DIF:RememberREF:700OBJ:Giveanexampleofpreventinginfectionforeachelementoftheinfectionchain.TOP:ImplementationMSC:CPNRE:FoundationsofPractice3.Thenurseisadmittingapatientwithaninfectiousdiseaseprocess.Whatquestionwouldbeappropriateforanursetoaskthispatient?a.Doyouhaveachronicdisease,andhowlonghaveyouhadit?b.Doyouhaveanychildrenlivinginthehome?CanadianFundamentalsofNursing7thEditionPotterTestBankUSNTOc.Whatisyourmaritalstatussingle,married,ordivorced?d.Doyouhaveanyculturalorreligiousbeliefsthatwillinfluenceyourcare?ANS:ASomefactorsincreasethesusceptibilityofanindividualtoinfection.Theseincludeage,nutritionalstatus,presenceofchronicdisease,trauma,andsmoking.Theotherquestionsarepartofanadmissionassessmentprocessbutarenotpertinenttotheinfectiousdiseaseprocess.DIF:UnderstandREF:692|693OBJ:Giveanexampleofpreventinginfectionforeachelementoftheinfectionchain.TOP:AssessmentMSC:CPNRE:FoundationsofPractice4.Thepatientunderwentasurgicalprocedure,andpovidone-iodine(Betadine)wasutilizedasthesurgicalpreparation.Twodayspostoperatively,thenursesassessmentindicatesthattheincisionisredandhasasmallamountofpurulentdrainage.Thepatientreportstendernessattheincisionsite.Thepatientstemperatureis38.1C(100.5F),andthewhitebloodcell(WBC)countis10,500/mm3(10.5109/L).Whichnursingactionshouldthenursetake?a.Plantochangethesurgicaldressingduringtheshift.b.Checktoseewhatsolutionwasusedforskinpreparationinsurgery.c.Collectsuppliestoculturethesurgicalincision.d.Communicatethepatientsneedstothehealthcareprovider.ANS:DOrganismsenterthebodyinseveraldifferentways.Properskinpreparationforsurgeryisessentialfordecreasingthechanceofinfection.Thenursingassessmentindicatessignsandsymptomsofinfection,andthehealthcareprovidershouldbenotified.Changingthedressingmaybeaneedduringtheshiftbutisnotafirstpriority.Checkingtheskinpreparationused2daysagomayormaynotrevNealRusefIuliGnforBm.atCionMatthistime.Collectingsuppliesforculturemaybenecessaryafterthenursetalkstothephysician.DIF:ApplyREF:691|712OBJ:Giveanexampleofpreventinginfectionforeachelementoftheinfectionchain.TOP:ImplementationMSC:CPNRE:FoundationsofPractice5.Thenurseisprovidinganeducationsessiontoanadultcommunitygroupabouttheeffectsofsmoking.Whichofthefollowingisthemostimportantpointtobeincludedintheeducationalsession?a.Smokefromtobaccoproductsclingstoyourclothingandhair.b.Smokingaffectsthecilialiningtheupperairwaysinthelungs.c.Smokingtobaccoproductscanbeveryexpensive.d.Smokingcanaffectthecolourofthepatientsfingernails.ANS:BAnormaldefencemechanismagainstinfectionintherespiratorytractisthecilialiningtheupperairwaysofthelungsandnormalmucus.Whenapatientinhalesamicrobe,theciliaandmucustrapthemicrobeandsweepthemupandouttobeexpectoratedorswallowed.Smokingmayalterthisdefencemechanismandincreasethepatientspotentialforinfection.Smokingcanbeexpensive,thesmelldoesclingtohairandclothing,andthetarwithinthesmokecanalterthecolourofapatientsnails.Thesepointscanbeincludedintheeducationbutdonotconstitutethemostimportantinformation.CanadianFundamentalsofNursing7thEditionPotterTestBankDIF:UnderstandREF:688OBJ:Identifythebodysnormaldefencesagainstinfection.TOP:ImplementationMSC:CPNRE:FoundationsofPractice6.Awomanpresentstotheclinicwithreportsofawhitedischargeanditchinginthevaginalarea.Duringthehealthhistory,whichofthesequestionsshouldthenurseprioritize?a.Whenwasthelasttimeyouvisitedthephysician?b.Hasthisconditionaffectedyoureatinghabits?c.Whatmedicationsareyoucurrentlytaking?d.Areyouabletosleepatnight?ANS:CThebodycontainsnormalflora(microorganisms)thatliveonthesurfaceofskin,saliva,oralmucosa,gastrointestinaltract,andgenitourinarytract.ThenormalfloraofthevaginacausesvaginalsecretionstohavealowpH.Thisinhibitsthegrowthofmanymicroorganisms.Antibioticsandoralcontraceptivescandisruptnormalflorainthevagina,whichcanleadtoanovergrowthofCandidaalbicansinthatarea.Itisimportanttoaskthepatientaboutcurrentmedicationstoobtaininformationthatmayassistwithdiagnosis.Visitingthephysicianisimportantforthepatientshealthmaintenance.Learningaboutthepatientseatingandsleepinghabitswillassistintheplanofcare.DIF:ApplyREF:688OBJ:Identifythebodysnormaldefencesagainstinfection.TOP:AssessmentMSC:CPNRE:FoundationsofPractice7.Thenurseiscaringforaschool-agedchildwhohasinjuredhislegafterabicycleaccident.Todeterminewhetherthechildisexperiencingalocalizedinflammatoryresponse,thenurseshouldassessforwhichofthNesUeRsiSgnIsNanGdTsBym.pCtoOmMs?a.Fever,malaise,anorexia,andnauseaandvomiting.b.Chestpain,shortnessofbreath,andnauseaandvomiting.c.Dizzinessanddisorientationtotime,date,andplace.d.Edema,redness,tenderness,andlossoffunction.ANS:DThebodyscellularresponsetoaninjuryisseenasinflammation.Inflammationcanbetriggeredbyphysicalagents,chemicalagents,ormicroorganisms.Signsoflocalizedinflammationincludeswelling,redness,heat,painortenderness,andlossoffunctionintheaffectedbodypart.Systemicsignsofinflammationincludefever,malaise,andanorexia,aswellasnauseaandvomiting.Chestpain,shortnessofbreath,andnauseaandvomitingaresignsandsymptomsofacardiacalteration.Dizzinessanddisorientationtotime,date,andplacemayindicateaneurologicalteration.DIF:RememberREF:688|689OBJ:Discusstheeventsintheinflammatoryresponse.TOP:AssessmentMSC:CPNRE:FoundationsofPractice8.Whichinterventionsutilizedbythenursewouldindicatetheabilitytorecognizetheinflammatoryresponse?a.Rest,ice,compression,andelevation.b.Turn,cough,anddeepbreathe.c.Orienttodate,time,andplace.d.Passiverange-of-motionexercises.CanadianFundamentalsofNursing7thEditionPotterTestBankNRIGB.CANS:AOnesignoftheinflammatoryresponse,particularlyafteraninjury,isswellingoredema.Restingtheaffectedinjuredarea,usingiceasordered,wrappingtheareatoprovidesupportparticularlyifitisanextremityandelevatingtheinjuredareawillhelpdecreaseswellingoredema.Turning,coughing,anddeepbreathingareutilizedforpostoperativepatientsandforimmobilizedpatientstohelppreventaninfectiousprocesssuchaspneumonia.Orientationtodate,time,andplaceisassessedinmanypatientswhomaybeconfused.Passiverangeofmotionisutilizedforindividualswhoneedtoimprovemovementoftheirextremities,includingimmobilizedpatients.DIF:UnderstandREF:689OBJ:Discusstheeventsintheinflammatoryresponse.TOP:ImplementationMSC:CPNRE:FoundationsofPractice9.Thenurseiscaringforagroupofmedical-surgicalpatients.Whichpatientismostatriskfordevelopinganinfection?a.Thepatientwhoisinobservationforchestpain.b.Thepatientwhoisrecoveringfromarighttotalhiparthroplasty.c.Thepatientwhohasbeenadmittedwithdehydration.d.Thepatientwhohasbeenadmittedforstabilizationofatrialfibrillation.ANS:BThepatientwhoisrecoveringfromarighttotalhiparthroplastyhashadasurgicalprocedurewhereinbonewasremovedfromthebodyandanimplantwasplacedwithinthebody.Thepatienthasalargeincisionfromsurgery.Thepatientalsohasanintravenousinfusiontoprovidefluidsandmedication.Allthesebreaksintheskinincreasethelikelihoodofinfection.Thepatienthasbeengivenanaestheticsandmedicationforpain.BothofthesedepresstherespiratorysystemandhavethepotentialtodecreasetheexpansionofalveoliandtoincreasethechanceofinfectioninthereUspiSratoNrysTystem.OTheotherpatientsmayhaveonebreakintheskinwhenanintravenousinfusionisused.DIF:ApplyREF:688|692OBJ:Identifypatientsmostatriskforinfection.TOP:AssessmentMSC:CPNRE:FoundationsofPractice10.Thenurseiscaringforapatientwithleukemiaandispreparingtoprovidefluidsthroughavascularaccessdevice.Whichnursinginterventionispriorityinthisprocedure?a.Positionthepatientcomfortably.b.Maintainaseptictechnique.c.Gatheravailablesupplies.d.Reviewtheprocedurewiththepatient.ANS:BPatientswithdiseaseprocessesoftheimmunesystemareatparticularriskforinfection.Thesediseasesincludeleukemia,acquiredimmunedeficiencysyndrome(AIDS),lymphoma,andaplasticanemia.Thesediseaseprocessesweakenthedefencesagainstaninfectiousorganism.Anytimeanintravenousdeviceisaccessed,aseptictechniquemustbemaintainedwithwearingofappropriatepersonalprotectiveequipment,preparationoftheskin,anduseofsterilegloves,sterilesupplies,appropriateflushing,andappropriatediscontinuation.Reviewingtheprocedurewiththepatient,positioningthepatient,andgatheringthesuppliesareallimportantstepsintheprocedurebutarenotthepriorityintheprocedure.DIF:ApplyREF:692|693OBJ:Identifypatientsmostatriskforinfection.CanadianFundamentalsofNursing7thEditionPotterTestBankNRIGB.CMTOP:ImplementationMSC:CPNRE:FoundationsofPractice11.Thenurseiscaringforanadultpatientintheclinicwhoisavictimoffloodingandwasevacuated.Thepatientpresentswithsignsandsymptomsofaurinarytractinfection.Alongwithneedededucationsurroundingthisdiagnosis,thenurseteachesthepatientaboutrest,exercise,eatingproperly,andhowtoutilizedeepbreathingandvisualization.Whichoftheseexplanationswouldbestsupportthesenursinginterventions?a.Urinarytractinfectionsarepainful,andthesetechniqueswouldhelpwithmanagingthepain.b.Interventionslistedarestandardtopicstaughtduringhealthcarevisits.c.Stressforlongperiodsoftimecanleadtoexhaustionanddecreasedresistancetoinfection.d.Thepatientrequestedthisinformationtoteachtoextendedfamilyathome.ANS:CThebodyrespondstoemotionalorphysicalstressbythegeneraladaptationsyndrome.Ifstressextendsforlongperiodsoftime,thiscanleadtoexhaustion,wherebyenergystoresaredepletedandthebodyhasnodefencesagainstinvadingorganisms.Techniquesofdeepbreathingandvisualizationmaybehelpfulwithpain,buttheinterventionslistedarenotallstandardinterventionstaughtateveryhealthcarevisit.DIF:AnalyzeREF:692OBJ:Identifypatientsmostatriskforinfection.TOP:EvaluateMSC:CPNRE:FoundationsofPractice12.Thenurseiscaringforapatientwhoissusceptibletoinfection.Whichofthefollowingnursinginterventionswillassistindecreasingtheriskofinfection?a.Teachingthepatientaboutfallprevention.b.TeachingthepatienttoseleUctnSutriNtiouTsfoodsO.c.Teachingthepatienttotakeatemperature.d.Teachingthepatientabouttheeffectsofalcohol.ANS:BWhenproteinintakeisinadequateasaresultofpoordiet,therateofproteinbreakdownexceedsthatoftissuesynthesis.Areductionintheintakeofproteinandothernutrientssuchascarbohydratesandfatsreducesthebodysdefencesagainstinfectionandimpairswoundhealing.Teachingthepatientaboutfallprevention,howtomeasuretemperature,orabouttheeffectsofalcoholdoesnotdecreasetheriskofinfection.DIF:ApplyREF:692OBJ:Identifypatientsmostatriskforinfection.TOP:ImplementationMSC:CPNRE:FoundationsofPractice13.Apatientwithdiabetespresentstotheclinicforadressingchange.Thewoundisontherightfootandhaspurulentyellowdrainage.Whichoftheseinterventionswouldbemostappropriateforthenursetoprovide?a.Positionthepatientcomfortablyonthestretcher.b.Explaintheprocedurefordressingchangetothepatient.c.Donglovesandotherappropriatepersonalprotectiveequipment.d.Reviewthemedicationlistthatthepatientbroughtfromhome.ANS:CCanadianFundamentalsofNursing7thEditionPotterTestBankLocalizedinfectionsaremostcommonintheskinorwithmucousmembranebreakdown.Thenurseshouldwearglovesandotherpersonalprotectiveequipmentasappropriatewhenexaminingorprovidingtreatmenttolocalizedinfectedareas.Positioningthepatient,explainingtheprocedure,andreviewingthemedicationlistarealltasksthatneedtobecompleted,butpreventingthespreadofinfectiontakesprecedence.DIF:ApplyREF:687OBJ:Describethesignsandsymptomsofalocalizedandasystemicinfection.TOP:ImplementationMSC:CPNRE:FoundationsofPractice14.Whichoftheseinterventionswouldtakepriorityandshouldbeincludedinaplanofcareforapatientwhopresentswithpneumonia?a.Observethepatientfordecreasedactivitytolerance.b.Assumethatthepatientisinpainandtreataccordingly.c.Maintainthetemperatureat18.3C(65F).d.Providethepatienticechipsasrequested.ANS:ASystemicinfectioncausesmoregeneralizedsymptomsthandoeslocalinfection.Thistypeofinfectioncanresultinfever,fatigue,nauseaandvomiting,andmalaise.Thenurseshouldbealertforchangesinthepatientslevelofactivityandresponsiveness.Respiratoryinfectionmayresultinaproductivecoughwithpurulentsputum,shortnessofbreath,andactivityintolerance.Nursesdonotassumebutassessandcommunicatewiththepatientaboutpain,temperature,andicechips.Askingthesequestionswouldnotbeapriorityasmuchasassessingthepatientanddeterminingtheeffectthatthesystemicinfectionishavingonthepatient.DIF:UnderstandREF:69N4URSINGTB.COMOBJ:Describethesignsandsymptomsofalocalizedandasystemicinfection.TOP:ImplementationMSC:CPNRE:FoundationsofPractice15.Theinfectioncontrolnurseisreviewingdataforthemedical-surgicalunit.Thenursenoticesaspikeinpostoperativeinfectionsonthisunitandcategorizesthesehealthcare-associatedinfectionaswhichtype?a.Iatrogenic.b.Exogenous.c.Endogenous.d.Nosocomial.ANS:BAnexogenousorganismisonethatispresentoutsidethepatient.Apostoperativeinfectionisanexogenousinfectionbecausetheorganismthathascausedtheinfectionoriginatesfromoutsidethebody.AnexampleisStaphylococcusaureus.Anendogenousorganismispartofthenormalfloraofresidingvirulentorganismsthatcouldcauseinfection.Anendogenousinfectioncanoccurwhenpartofthepatientsflorabecomesaltered,andovergrowthresults.Iatrogenicinfectionresultsfromadiagnosticortherapeuticprocedure,suchasacolonoscopy,thatisconductedinahealthcaresetting.Nosocomialinfectionisthetermformerlyusedforhealthcare-acquiredinfection.DIF:RememberREF:689OBJ:Explainconditionsthatpromotethetransmissionofhealthcare-associatedinfection.CanadianFundamentalsofNursing7thEditionPotterTestBankTOP:EvaluateMSC:CPNRE:FoundationsofPractice16.Whichofthefollowingnursingactionswouldmostincreaseapatientsriskfordevelopingahealthcare-associatedinfection?a.Useofsurgicalaseptictechniquetosuctionanairway.b.Urinarycatheterdrainagebagplacedbelowthelevelofthebladder.c.Cleantechniqueforinsertingaurinarycatheter.d.Useofasterilebottledsolutionmorethanoncewithina24-hourperiod.ANS:CUsingcleantechnique(medicalasepsis)toinsertaurinarycatheterwouldplacethepatientatriskforahealthcare-associatedinfection.Urinarycathetersneedtobeinsertedwithsteriletechnique,alsoreferredtoassurgicalasepsis.Thisinvolveseliminatingallmicroorganisms,includingpathogensandspores,fromanobjectorarea.Placingacatheterintoasterilebodycavitysuchasthebladdernecessitatessteriletechnique.Steriletechniqueshouldalsobeusedwhenanairwayissuctionedbecausetheairwayisconsideredasterilebodycavity.Keepingtheurinarycatheterdrainagebagbelowthebladderhelpsdecreasetheriskofdevelopingahealthcare-associatedinfectionbecauseitpreventsrefluxofurinefromthebagbackintothebladder.Bottledsolutionsmaybeusedrepeatedlyduringa24-hourperiod;however,specialcareisneededtoensurethatthesolutioninthebottleremainssterile.After24hours,thesolutionshouldbediscarded.DIF:AnalyzeREF:697|712OBJ:Explainconditionsthatpromotethetransmissionofhealthcare-associatedinfection.TOP:EvaluateMSC:CPNRE:FoundationsofPractice17.Thenurseisdressedandispreparingtocareforapatientintheperioperativearea.ThenursehasscrubbedherhandsandhNasUdRoSnnIeNdGaTsteBri.leCgOowMnandgloves.Whichactionwouldindicateabreakinsteriletechnique?a.Touchingprotectiveeyewear.b.Standingwithhandsfoldedonchest.c.Acceptingsterilesuppliesfromthesurgeon.d.Stayingwiththesteriletableonceitisopen.ANS:AOnceanurseisgownedandglovedwithsterilegownandgloves,touchingnonsterileprotectiveeyewearwouldindicatedabreakinsteriletechnique.Sterileobjectsremainsterileonlywhentouchedbyanothersterileobject.Standingwithhandsfoldedonchestiscommonpracticeandpreventsarmsandhandsfromtouchingunsterileobjects.Acceptingsterilesuppliesfromthesurgeonwhohasopenedthemwiththeappropriatetechniqueisacceptable.Stayingwithasteriletableonceopenedisacommonpracticetoascertainthatnooneornothinghascontaminatedthetable.DIF:UnderstandREF:712|713OBJ:Explainthedifferencebetweenmedicalandsurgicalasepsis.TOP:ImplementationMSC:CPNRE:FoundationsofPractice18.Thenurseiscaringforapatientwithanincision.Whichofthefollowingactionswouldbestindicateanunderstandingofmedicalandsurgicalasepsis?a.Donningsterilegownandglovestoremovethewounddressing.b.UtilizingcleanglovestoremovethedressingandsterilesuppliesforthenewCanadianFundamentalsofNursing7thEditionPotterTestBankUSNTOdressing.c.Donningcleangoggles,gown,andglovestodressthewound.d.Utilizingcleanglovestoremovethedressingandcleansuppliesforthenewdressing.ANS:BCleangloves(medicalasepsis)areusedtoremovecontaminateddressingsandsterilesupplies,includingglovesanddressings(surgicalasepsis-steriletechnique)toreapplysteriledressings.Wearingsterilegownsandglovesisnotnecessarywhenremovingsoileddressings.Donningcleanglovestodressasterilewoundwouldcontaminatethesterilesupplies.Utilizingcleansuppliesforasteriledressingwouldnothelpindecreasingthenumberofmicrobesattheincisionsite.DIF:UnderstandREF:697|712OBJ:Explainthedifferencebetweenmedicalandsurgicalasepsis.TOP:ImplementationMSC:CPNRE:FoundationsofPractice19.Thenurseiscaringforapatientintheendoscopyarea.Thenurseobservesthetechnicianperformingthefollowingtasks.Whichoftheseobservationswouldrequirethenursetointervene?a.Handhygieneafterremovinggloves.b.Placingtheendoscopeinacontainerfortransfer.c.Removingglovestotransfertheendoscope.d.Disinfectingendoscopesintheworkroom.ANS:CRoutinepracticesareusedtopreventandcontrolthespreadofinfection.TransferringcontaminatedequipmentwithNoutRtheIproGtectBio.nCofgMlovescanhelpspreadmicrobestoinanimateobjectsandtothepersondoingthetransfer.Utilizinggloves,washinghands,coveringcontaminatedsuppliesduringtransfer,anddisinfectingequipmentintheappropriatewayintheappropriateplacesreflecttheprinciplesofbasicmedicalasepsisandroutinepracticesandcanbreakthechainofinfection.DIF:ApplyREF:697|712OBJ:Explaintherationaleandcomponentsofroutinepractices.TOP:ImplementationMSC:CPNRE:FoundationsofPractice20.ThenurseiscaringforapatientwithanursingdiagnosisofRiskforinfection.Awareoftheneedforroutinepractices,whatisthenursecarefultodo?a.Teachthepatientaboutgoodnutrition.b.Weareyewearwhenemptyingaurinarydrainagebag.c.Avoidcontactwithintactskinwithoutwearinggloves.d.Dongloveswhenwearingartificialnails.ANS:BRoutinepracticesincludethewearingofeyewearwheneverthereisapossibilityofasplashorsplatter.Teachingthepatientaboutgoodnutritionispositivebutdoesnotapplytoroutinepractices.Thetermroutinepracticesappliestoallbloodandbodyfluidsexceptsweat,evenifbloodisnotpresent.Italsoappliestononintactskinandmucousmembranes.DIF:UnderstandREF:705OBJ:Explaintherationaleandcomponentsofroutinepractices.CanadianFundamentalsofNursing7thEditionPotterTestBankUSNTOTOP:ImplementationMSC:CPNRE:FoundationsofPractice21.Thenurseiscaringforapatientwhohasjustgivenbirth.Thenurseischeckingthepatientforexcessivevaginaldrainage.Itisimportantforthenursetoutilizewhichtypeofprecautions?a.Contactprecautions.b.Protectiveprecautions.c.Dropletprecautions.d.Routinepractices.ANS:DRoutinepracticesapplytocontactwithblood,bodyfluid,nonintactskin,andmucousmembranesofallpatients.Contactprecautionsapplytoindividualswithcolonizationofinfectionsuchasmethicillin-resistantS.aureus(MRSA).Protectiveprecautionsapplytoindividualswhohaveundergonetransplantations.Dropletprecautionsfocusondiseasesthataretransmittedbylargedroplets.DIF:RememberREF:705OBJ:Explaintherationaleandcomponentsofroutinepractices.TOP:ImplementationMSC:CPNRE:FoundationsofPractice22.Thenurseiscaringforapatientinthehospital.Thenurseobservestheunregulatedcareproviderturningoffthehandlefaucetwithhishands.Whatprofessionalpracticesupportstheneedforfollow-upwiththeunregulatedcareprovider?a.Thenurseisresponsibleforprovidingasafeenvironmentforthepatient.b.Thisisakeystepintheprocedureforhandhygiene.c.Allowingthewatertorunisawasteofresourcesandmoney.d.Differentscopesofpracticeallowmodificationofprocedures.NRIGB.CMANS:AThenurseisresponsibleforprovidingasafeenvironmentforthepatient.Theeffectivenessofinfectioncontrolpracticesdependsonconscientiousnessandconsistencyinusingeffectiveaseptictechnique.Itishumannaturetoforgetkeyproceduralstepsortotakeshortcuts.However,failuretocomplywithbasicproceduresplacesthepatientatriskforinfectionthatcanimpairrecoveryorleadtodeath.Afterhandhygiene,thehealthcareprovidershouldturnoffahandlefaucetwithadrypapertowelandavoidtouchingthehandleswithhisorherownhandstoassistinpreventingthetransferofmicroorganisms.Wettowelsandhandsallowthetransferofpathogensfromfaucettohands.Theprinciplesandproceduresforhandhygieneareuniversalandapplytoallmembersofhealthcareteams.Beingresourcefulandawareofthecostofhealthcareisimportant,buttakingshortcutsthatmayendangeranindividualshealthisnotprudent.DIF:AnalyzeREF:701-703OBJ:Performproperproceduresforhandhygiene.TOP:EvaluateMSC:CPNRE:FoundationsofPractice23.Thenurseiscaringforapatientwhobecomesnauseatedandvomitswithoutwarning.Thenursehascontaminatedhands.Whatisthenursesbestnextstep?a.Cleaninghandswithwipesfromthebedsidetable.b.Handhygienewithanantimicrobialsoapandwater.c.Usinganalcohol-basedwaterlesshandgel.d.Instructingthepatienttowashhisfaceandhands.CanadianFundamentalsofNursing7thEditionPotterTestBankNRIGB.CMANS:BTheU.S.CentersforDiseaseControlandPreventionrecommendthatwhenhandsarevisiblysoiled,thehealthcareprovidershouldwashwithaplainsoaporwithantimicrobialsoap.Cleaninghandswithwipesorusingwaterlesshandgeldoesnotmeetthisstandard.Ifhandsarenotvisiblysoiled,analcohol-basedwaterlessantisepticagentshouldbeusedforroutinelydecontaminatinghands.Thepatientmayverywellneedtowashhisfaceandhands,butthisisnotthebestnextstep.DIF:ApplyREF:700OBJ:Performproperproceduresforhandhygiene.TOP:PlanningMSC:CPNRE:FoundationsofPractice24.Thenurseisperforminghandhygienebeforeassistingaphysicianwithinsertionofachesttube.Whilewashinghands,thenursetouchesthesink.Whatisthenextactionthenurseshouldtake?a.Informthephysicianandrecruitanothernursetoassist.b.Rinseanddryhands,andbeginassistingthephysician.c.Repeathandhygienewithantisepticsoap.d.Extendthehandhygieneprocedureto5minutes.ANS:CTheinsideofthesinkandthecounterattheedgesofthesink,faucet,andhandlesareconsideredcontaminatedareas.Ifthehandstouchanyoftheseareasduringhandhygiene,thenurseshouldrepeatthehandhygieneprocedurewithantisepticsoap.Thereisnoneedtoinformthephysicianorberelievedofthisassignment.Ifthehandsarecontaminatedwhentouchingthesink,dryinghandsandproceedingwiththeprocedurecouldpossiblycontaminatematerials,contributetoincreasedmicrobialcountsduringtheprocedure,andresultininfectioninthepatient.Extendingthetimeforwashingthehands(althoughthisiswhatwillhappenwhentheproUcedSureNisreTpeated)Oisnotthefocus.Thefocusistorepeatthewholehandhygieneprocedureutilizingantisepticsoap.DIF:ApplyREF:701-703OBJ:Performproperproceduresforhandhygiene.TOP:ImplementationMSC:CPNRE:FoundationsofPractice25.Thenurseisobservingafamilymemberchangingadressingforapatientinthehomeenvironment.Whichoftheseobservationswouldindicatethatthefamilymemberhasacorrectunderstandingofhowtomanagecontaminateddressings?a.Thefamilymemberremovesglovesandgathersitemsfordisposal.b.Thefamilymemberplacestheuseddressingsinaplasticbag.c.Thefamilymembersavespartofthedressingbecauseitisclean.d.Thefamilymemberwrapstheuseddressingintoilettissuebeforeplacinginthegarbage.ANS:BContaminateddressingsandotherinfectiousitemsshouldbeplacedinimperviousplasticorbrownpaperbagsandthendisposedofproperlyingarbagecontainers.Glovesshouldbewornduringthisprocess.Partsofthedressingshouldnotbesaved,eventhoughtheymayseemclean,becausemicrobesmaybepresent.DIF:EvaluateREF:711,Box33-18OBJ:Explainhowinfection-controlmeasuresinthehomemaydifferfromthoseinthehospital.TOP:EvaluateMSC:CPNRE:FoundationsofPracticeCanadianFundamentalsofNursing7thEditionPotterTestBankUSNT26.Thehomehealthnurseisteachingapatientandfamilyabouthandhygieneinthehome.Thenurseissuretoemphasizehandhygieneatwhattime?a.Beforeandaftershakinghands.b.Beforeandaftertreatments.c.Beforeopeningtherefrigerator.d.Beforeandafterusingacomputer.ANS:BPatientsshouldperformhandhygienebeforeandaftertreatmentsandwhencomingincontactwithbodyfluids.Dependingonthepatient,holdinghandsdoesnotnecessitatewashingofhandsbefore,buthandhygieneafterwardsisgoodpractice,especiallybeforetouchingeyes,nose,ormouth.Handhygienebeforeandafteropeningtherefrigeratorandusingthecomputerisnotrequired,butduringcoldandfluseason,itmightbeadvisable.DIF:ApplyREF:711,Box33-18OBJ:Explainhowinfection-controlmeasuresinthehomemaydifferfromthoseinthehospital.TOP:ImplementationMSC:CPNRE:FoundationsofPractice27.Thenursehasbeencaringforapatientintheperioperativeareaforseveralhours.Thesurgicalmaskthenurseiswearinghasbecomemoist.Thenursesbestnextstepiswhat?a.Changethemaskwhenrelieved.b.Air-drythemaskwhileatlunch,andreapply.c.Askforrelief,stepoutofthesurgicalarea,andapplyanewmask.d.Notchangethemask,ifthenurseiscomfortable.ANS:CAmaskshouldfitsnuglyaroNundRtheIfacGeanBd.noCse.MAfterthemaskiswornforseveralhours,itcanbecomemoist.Themaskshouldbechangedassoonaspossiblebecausemoistureencouragesthegrowthofmicroorganisms.Waitingtochangethemask,air-dryingit,andwearingitbecauseitiscomfortabledonotsupporttheprinciplesofinfectioncontrol.DIF:ApplyREF:709OBJ:Properlydonasurgicalmask,sterilegown,andsterilegloves.TOP:ImplementationMSC:CPNRE:FoundationsofPractice28.Thenurseiscaringforapatientforwhomcontactprecautionsareordered.Whichofthefollowingactionswouldbeappropriatetopreventthespreadofdisease?a.Wearingagown,gloves,facemask,andgogglesforinteractionswiththepatient.b.Usingadedicatedbloodpressurecuffthatstaysintheroomandisusedforthatpatientonly.c.Placingthepatientinaroomwithnegativeairflow.d.Transportingthepatientquicklytotheradiologydepartment.ANS:BCanadianFundamentalsofNursing7thEditionPotterTestBankUSNTOContactprecautionsareatypeofisolationprecautionusedforpatientswithillnessthatcanbetransmittedthroughdirectorindirectcontact.Apatientisplacedoncontactprecautionsifadiseaseispresentthatcanbetransmittedthroughdirectorindirectcontact.Patientswhoareoncontactprecautionsshouldhavededicatedequipmentwhereverpossible.Thiswouldmean,forexample,thatonebloodpressurecuffandonestethoscopewouldstayintheroomwiththepatientandwouldbeusedforthatpatientonly.Agownandglovesmayberequiredforinteractionswithapatientwhoisoncontactprecautions,butafacemaskandgogglesarenotpartofcontactprecautions.Aroomwithnegativeairflowisneededforpatientsplacedonairborneprecautions;itisnotnecessaryforapatientoncontactprecautions.Whenapatientoncontactprecautionsneedstobetransported,heorsheshouldwearcleangowns,andwheelchairsorgurneysshouldbecoveredwithanextralayerofsheets.Anyonewhomightcomeincontactwiththepatientneedstobeprotected,andequipmentmustbecleanedwithanapprovedgermicideafterpatientuseandbeforeanotherpatientusesthesharedequipment.DIF:ApplyREF:697|705OBJ:Explaintherationaleandcomponentsofroutinepractices.TOP:ImplementationMSC:CPNRE:FoundationsofPractice29.ThenurseiscaringforapatientwhoseculturesarepositiveforClostridiumdifficile.Whichofthefollowingnursingactionswouldbeappropriateinviewofthepresenceofthisorganism?a.Instructingassistivepersonneltousesoapandwaterratherthansanitizertocleanhands.b.Placingthepatientondropletprecautions.c.WearinganN95respiratorwhenenteringthepatientroom.d.Teachingthepatientcoughetiquette.ANS:ANRIGB.CMC.difficileisaspore-formingorganismthatcanbetransmittedthroughdirectandindirectpatientcontact.BecauseC.difficileisaspore-formingorganism,handsanitizerisnoteffectiveinpreventingitstransmission.Handsmustbewashedwithsoapandwatertopreventtransmission.Thisorganismisnottransmittedviathedropletroute;therefore,dropletprecautionsarenotneeded.AnN95respiratorisusedprimarilyforprovidingcaretopatientswithairborneillness.Allpatientsshouldbetaughtcoughetiquette;thisactionisnotspecifictopatientswhohaveC.difficileinfection.DIF:ApplyREF:689OBJ:Explaintherationaleandpracticesforadditional(isolation)precautions.TOP:ImplementationMSC:CPNRE:FoundationsofPractice30.Thenurseischanginglinensforapostoperativepatientandfeelsastickinherhand.Anonactivatedsafeneedleisnotedinthelinens.Inthisscenario,thenursemaybeatriskforwhichofthefollowinginfections?a.HepatitisB.b.C.difficile.c.Methicillin-resistantS.aureus(MRSA).d.Diphtheria.ANS:ACanadianFundamentalsofNursing7thEditionPotterTestBankNRIGB.CMBloodbornepathogenssuchasthoseassociatedwithhepatitisBandCaremostcommonlytransmittedbycontaminatedneedles.C.difficileisspreadbycontactwithandingestionofthismicrobe,andMRSAisspreadbycontact.Diphtheriaisspreadbydropletstoanyonewithin1m(3feet)ofthepatient.DIF:RememberREF:700|704OBJ:Explainconditionsthatpromotethetransmissionofhealthcare-associatedinfection.TOP:DiagnosisMSC:CPNRE:FoundationsofPractice31.Thenurseiscaringforapatientwhohasabloodbornepathogen.Thenursesplashesbloodabovethegloveontointactskinwhilediscontinuinganintravenousinfusion.Thenursesbestnextstepiswhichofthefollowing?a.Toobtainanalcoholswab,removethebloodwithanalcoholswab,andcontinuecare.b.Toimmediatelywashthesitewithsoapandrunningwater,andseekguidancefromthemanager.c.Todelaywashingofthesiteuntilthenurseisfinishedprovidingcaretothepatient.d.Todonothing;accidentallygettingsplashedwithbloodhappensfrequentlyandispartofthejob.ANS:BAftergettingsplashedwithbloodfromapatientwhohasaknownbloodbornepathogen,itisimportanttocleansethesiteimmediatelyandthoroughlywithsoapandrunningwaterandnotifythemanagerandemployeehealthforguidanceonnextstepsintheprocess.Removingthebloodwithanalcoholswab,delayingwashing,anddoingnothingbecausethesplashwastointactskincouldpossiblyspreadthebloodwithintheroomandcouldspreadtheinfection.ContaminationshouldbecontaUinedSimNmeTdiatelytOopreventspreadofinfectionthroughcontact.DIF:ApplyREF:706,Table33-7OBJ:Explaintherationaleandcomponentsofroutinepractices.TOP:ImplementationMSC:CPNRE:FoundationsofPractice32.Thenurseiscaringforapatientwithanorderforroutinepractices.Thenurseincludeshandhygieneaspartoftheplanofcaretowhichofthefollowing?a.Provideanuninterruptedchainofinfection.b.Decreasetheincidenceofhealthcare-associatedinfection.c.Maintainasterileenvironment.d.Decreasethedryingeffectsofsoap.ANS:BHandhygieneispartofroutinepracticesandassistsininterruptingthechainofinfection.Handhygienecanassistindecreasingtheincidenceofhealthcare-associatedinfection,protectthenursefromthetransferofmicroorganisms,decreasethetransmissionofmicrobestootherpatients,andpreventcontaminationofcleansupplies.Handsareacommonmeansoftransmissionofbacteriafromoneplacetoanother.Properhandhygienedoesnotdecreasethedryingeffectsofsoapinfact,itincreasesthedryingeffectsofsoap.Properhandhygieneassistsinmaintainingacleanenvironment.DIF:RememberREF:700|705OBJ:Performproperproceduresforhandhygiene.CanadianFundamentalsofNursing7thEditionPotterTestBankTOP:PlanningMSC:CPNRE:FoundationsofPractice33.Thenurseispreparingtoinsertaurinarycatheter.Thenurseisusingopenglovingtodonthesterilegloves.Whichfourstepsbelowwillthenurseincludeinthisprocess?1.Layglovepackageoncleanflatsurfaceabovewaistline.2.Removeouterglovepackagebytearingthepackageopen.3.Glovethedominanthandofthenursefirst.4.Whileputtingonthefirstglove,touchonlytheoutsidesurfaceoftheglove.5.Withgloveddominanthand,slipfingersunderneathsecondglovecuff.6.Aftersecondgloveison,interlockhands.a.2,3,5,6.b.1,2,3,6.c.1,3,5,6.d.3,4,5,6.ANS:CSterileobjectsheldbelowthewaistareconsideredcontaminated.Glovingthedominanthandhelpstoimprovedexterity.Slippingthefingersunderneaththesecondglovecuffhelpstoprotecttheglovedfingers.Steriletouchingsterilepreventsglovecontamination.Interlockingfingersensuresasmoothfitoverthefingers.Toopensterilesupplies,thesidesofthepackagearecarefullyseparatedandpeeledapart;thispresentsthesterilecontentsfromaccidentallyopeningandtouchingcontaminatedobjects.Touchingtheoutsideoftheglovesurfacewillcontaminatethesterileitem;onlytheinsideoftheglovethepiecethatwillbeagainsttheskinshouldbetouched.DIF:ApplyREF:723|724OBJ:ProperlydonasurgicalmNaskR,steIrileGgowBn.,aCndsMterilegloves.TOP:ImplementationUSNMTSC:CPONRE:FoundationsofPractice34.Thenurseandthestudentnursearecaringfortwodifferentpatientsonthemedical-surgicalunit.Onepatientisonairborneprecautions,andoneisoncontactprecautions.Thenurseexplainstothestudentthedifferentinterventionsforcare.Thenursewouldprovideadditionalinstructionifthestudentmakeswhichofthefollowingstatements?a.Beconsistentinnursinginterventions;thereisonlyonedifferenceintheprecautions.b.Washhandsbeforeenteringandleavingbothofthepatientsrooms.c.Applytheknowledgethenursehasofthediseaseprocesstopreventthespreadofmicroorganisms.d.Patientswithanorderofairborneprecautionswearamaskduringtransportationtodepartments.ANS:AHandhygiene,properlydisposingofsupplies,applyingknowledgeofthediseaseprocess,andhavingpatientswithordersofairborneprecautionswearamaskduringtransferareallprinciplestofollowwhencaringforpatientsinisolation.Multipledifferencesareevidentbetweenthesetypesofisolation,includingthetypeofroomusedforthepatientandwhatthenursewearswhilecaringforthepatient.DIF:ApplyREF:705|706OBJ:Explaintherationaleandpracticesforadditional(isolation)precautions.TOP:PlanningMSC:CPNRE:FoundationsofPracticeCanadianFundamentalsofNursing7thEditionPotterTestBankGB.CM35.Thenurseiscaringforapatientwhoneedsaprotectiveenvironment.Thenursehasprovidedthecareneededandisnowleavingtheroom.Whichsequenceofstepsisinthecorrectorderforremovalofthepersonalprotectiveequipmentandassociatedtasks?1.Removeeyewear/faceshieldandgoggles.2.Performhandhygiene.3.Removegloves.4.Untiegown,allowgowntofallfromshoulders,anddonottouchoutsideofgown;disposeofproperly.5.Removemaskbystrings;donottouchoutsideofmask.6.Disposeofallcontaminatedsuppliesandequipmentindesignatedreceptacles.7.Leaveroomandclosethedoor.a.2,1,3,5,2,6,7.b.3,1,4,5,2,7,6.c.3,1,4,5,2,6,7.d.4,2,1,3,5,7,6.ANS:BThecorrectorderforremovingpersonalprotectiveequipmentforapatientinaprotectiveenvironmentandforperformingassociatedtasksistoremovegloves,removeeyewear,removegown,removemask,performhandhygiene,leaveroomandclosedoors,anddisposeofallcontaminatedsuppliesandequipmentinamannerthatpreventsthespreadofmicroorganisms.DIF:RememberREF:706-708OBJ:Explaintherationaleandpracticesforadditional(isolation)precautions.TOP:ImplementationNRIMSC:CPNRE:FoundationsofPracticeUSNTO36.Thenursemanagerisevaluatingcurrentinfectioncontroldataforthemedicalunit.Thenursecomparespastpatientdatawithcurrentdatatolookfortrends.Thenursemanagerexaminesthechainofinfectionforpossiblesolutions.Inwhichsequencearetheseitemsintheproperorder?1.Amodeoftransmission2.Aninfectiousagentorpathogen3.Asusceptiblehost4.Areservoirorsourceforpathogengrowth5.Aportalofentrytoahost6.Aportalofexitfromthereservoira.3,4,2,6,1,5.b.5,4,3,1,2,6.c.1,2,4,6,5,3.d.2,4,6,1,5,3.ANS:DThenursemanagerisevaluatingthechainofinfectiontodetermineactionsthatcouldbeimplementedtoinfluencethespreadofinfectionintheintensivecareunit.Understandingthespreadofinfectionanddirectingactionstowardthosestepshavethepotentialtodecreaseinfectioninthesetting.Forspreadofinfection,thechainhastobeuninterruptedwithaninfectiousagent,areservoirandportalofexit,amodeoftransmission,aportalofentry,andasusceptiblehost.CanadianFundamentalsofNursing7thEditionPotterTestBankDIF:RememberREF:684-687OBJ:Explaintherelationshipbetweenthechainofinfectionandtransmissionofinfection.TOP:EvaluateMSC:CPNRE:FoundationsofPracticeNURSINGTB.COMCanadianFundamentalsofNursing7thEditionPotterTestBankNRIGB.CMChapter34:MedicationAdministrationPotteretal:CanadianFundamentalsofNursing,7thEditionMULTIPLECHOICE1.Anurseknowsthatpatienteducationhasbeeneffectivewhenthepatientmakeswhichstatement?a.Imusttakemyparenteralmedicationwithfood.b.IfIam30minuteslatetakingmymedication,Ishouldskipthatdose.c.IwillrotatethelocationwhereIgivemyselfinjections.d.OnceIstartfeelingbetter,Iwillstoptakingmymedication.ANS:CRotatinginjectionsitesprovidesgreaterconsistencyinabsorptionofmedication.Parenteralmedicationabsorptionisnotaffectedbythetimingofmeals.Takingamedication30minuteslateiswithinthe60-minutewindowofthetimemedicationsshouldbetaken.Medicationsshouldbestoppedinaccordancewiththeprovidersorders.Withsomemedications,suchasantibiotics,itiscrucialthatthefullcourseofmedicationistakentoavoidrelapseofinfection.DIF:ApplyREF:752|791-792OBJ:Examinethenursesroleandresponsibilitiesregardingmedicationadministration.TOP:EvaluateMSC:CPNRE:FoundationsofPractice2.WhichstatementbythepatientisanindicationtousetheZ-trackmethod?a.Imreallyafraidthatabigneedlewillhurt.b.Thelastshotlikethatturnedmyskincolours.c.IamallergictomanymedUicatSionsN.TOd.Mylegsaretooobesefortheneedletogothrough.ANS:BTheZ-trackisindicatedwhenthemedicationbeingadministeredhasthepotentialtoirritatesensitivetissues.TheZ-trackmethodisnotmeanttoreducediscomfortfromtheprocedure.Ifapatientisallergictoamedication,itshouldnotbeadministered.Ifapatienthasadditionalsubcutaneoustissuetogothrough,aneedleofadifferentsizemaybeselected.DIF:UnderstandREF:794OBJ:Describefactorstoconsiderwhenchoosingroutesofmedicationadministration.TOP:PlanningMSC:CPNRE:FoundationsofPractice3.Thephysicianordersthata2-year-oldchildhaveearirrigationperformeddaily.Howdoesthenursecorrectlyperformtheprocedure?a.Pullingtheauricledownandbacktostraightentheearcanal.b.Pullingtheauricleupwardandoutwardtostraightentheearcanal.c.Instillingtheirrigationsolutionbyholdingthesyringejustinsidetheearcanal.d.Holdingthefluidinthecanalfor2to3minuteswithacottonswab.ANS:ACanadianFundamentalsofNursing7thEditionPotterTestBankChildrenupto3yearsofageshouldhavetheauriclepulleddownandback,children4yearsofageandupandadultsshouldhavetheauriclepulledupwardandoutward.Irrigationsolutionshouldbeinstilled1cm(0.4in)abovetheopeningoftheearcanal.Irrigationsolutionshouldbeallowedtodrainfreelyduringinstillation.DIF:UnderstandREF:769,Box34-21OBJ:Prepareandadministersubcutaneous,intramuscular,andintradermalinjections;intravenousmedications;hypodermoclysisinfusions;oralandtopicalskinpreparations;eye,ear,andnosedrops;vaginalinstillations;rectalsuppositories;andinhalants.TOP:PlanningMSC:CPNRE:FoundationsofPractice4.Thepatientistoreceivephenytoin(Dilantin)at0900.Thenurseknowsthattheidealtimetodrawatroughleveliswhen?a.0800hours.b.0830hours.c.0900hours.d.0930hours.ANS:BTroughlevelsaregenerallymeasured30minutesbeforethedrugisadministered.Ifthemedicationistobeadministeredat0900hours,thetroughshouldbemeasuredat0830hours.DIF:UnderstandREF:733OBJ:Discussfactorsthatinfluencemedicationactions.TOP:ImplementationMSC:CPNRE:FoundationsofPractice5.Aphysicianorders1000mLofnormalsalinetobeinfusedatarateof50mL/hr.Thenurseplansonhanginganewbagatwhattime?a.2hours.b.5hours.c.10hours.d.20hours.ANS:DNURSINGTB.COMItwilltake20hoursforalitre(1000mL)offluidtoinfuseatarateof50mL/hr.After2hours,only100mLwouldhaveinfused.After5hours,only250mLwouldhaveinfused.At10hours,500mLwouldhaveinfused.DIF:RememberREF:738OBJ:Calculateaprescribedmedicationdose.TOP:ImplementationMSC:CPNRE:FoundationsofPractice6.Thenurseispreparingtoadministera0.5-mLrabiesvaccineintothedeltoidmuscleofapediatricpatient.Whichneedlesizeisbestfortheprocedure?a.20gauge3.8cm(11/2inch)b.23gauge1.3cm(1/2inch)c.25gauge1.6cm(5/8inch)d.27gauge1cm(3/8inch)ANS:CForanintramuscularinjectionintothedeltoid,a25-gauge,1.6-cm(5/8-inch)needle(dependinguponthesizeofthechild)isrecommended.Theotherchoicesdidnotincludethecorrectgaugeof25.CanadianFundamentalsofNursing7thEditionPotterTestBankDIF:RememberREF:786OBJ:Describefactorstoconsiderwhenchoosingroutesofmedicationadministration.TOP:ImplementationMSC:CPNRE:FoundationsofPractice7.Thenurseisgivinganintramuscular(IM)injection.Thenursenoticesbloodreturninthesyringe.Whatshouldthenursedo?a.Administertheinjectionataslowerrate.b.Withdrawtheneedleandpreparetheinjectionagain.c.Pulltheneedlebackslightlyandinjectthemedication.d.Givetheinjectionandholdpressureoverthesitefor3minutes.ANS:BBloodreturnindicatesimproperplacement,andtheinjectionshouldnotbegiven.Instead,thenurseshouldwithdrawtheneedle,disposeofthesyringeandneedleproperly,andpreparethemedicationagain.AdministeringIMmedicationintoabloodvesselcouldhavedangerousadverseeffects,andthemedicationwillbeabsorbedfasterthanintendedowingtoincreasedbloodflow.Holdingpressureisnotanappropriateintervention.Pullingbacktheneedleslightlydoesnotguaranteeproperplacementoftheneedleandmedicationadministration.DIF:ApplyREF:789OBJ:Describetheimportanceofsafemedicationtechniques.TOP:ImplementationMSC:CPNRE:FoundationsofPractice8.Thenurseisplanningtoadministeratuberculintestwitha27-gauge,1-cm(3/8-inch)needle.Thenurseshouldinserttheneedleatwhatangle?a.15degrees.b.45degrees.c.90degrees.d.180degrees.ANS:ANURSINGTB.COMA27-gauge,1-cm(3/8-inch)needleisusedforintradermalinjectionssuchasatuberculintest,whichshouldbeinsertedata5-to15-degreeangle,justunderthedermisoftheskin,about3mm.Placingtheneedleat45degrees,90degrees,or180degreeswillplacethemedicationtoodeep.DIF:UnderstandREF:794OBJ:Describefactorstoconsiderwhenchoosingroutesofmedicationadministration.TOP:ImplementationMSC:CPNRE:FoundationsofPractice9.Thenurseknowstoassessforsignsofmedicationtoxicitywithinolderpersonsbecauseofwhichphysiologicalchange?a.Reducedbloodalbuminlevel.b.Delayedesophagealclearance.c.Decreasedgastricperistalsis.d.Decreasedcognitivefunction.ANS:ACanadianFundamentalsofNursing7thEditionPotterTestBankThedegreetowhichmedicationsbindtoserumproteins,suchasalbumin,affectsthemedication'sdistribution.Medicationsboundtoalbumincannotexertpharmacologicalactivity.Theunbound,orfree,medicationistheactiveformofthemedication.Olderpersonshaveadecreaseinalbuminintheirbloodstream,whichisprobablytheresultofachangeinliverfunction.Thesameistrueforpatientswhohaveliverdiseaseormalnutrition,who,alongwitholderpersons,havethepotentialformoremedicationtobeunboundandthusmaybeatriskforanincreaseinmedicationactivityortoxicity,orboth.DIF:UnderstandREF:731OBJ:Discussfactorsthatinfluencemedicationactions.TOP:ImplementationMSC:CPNRE:FoundationsofPractice10.Anurseinterpretsthatascribbledmedicationorderreads25mg.Thenurseadministers25mgofthemedicationtoapatient,andthendiscoversthatthedosewasincorrectlyinterpretedandshouldhavebeen15mg.Whoisultimatelyresponsiblefortheerror?a.Physician.b.Pharmacist.c.Nurse.d.Nofault.ANS:CUltimately,thepersonadministeringthemedicationisresponsibleforensuringthatitiscorrect.Thenurseadministeredthemedication,sointhiscaseitisthenurse.ThisistheimportanceofverifyingtheTenRightsofMedicationAdministration.DIF:UnderstandREF:743|744OBJ:Compareandcontrasttherolesofthephysician,thepharmacist,andthenurseinmedicationadministration.TOP:ImplementationMSC:CPNRE:Professional,ENthUicRal,SaIndNLGegTaBlP.raCctOicMe11.Apatientistoreceivemedicationthroughanasogastrictube.Whatisthemostimportantnursingactiontoensureeffectiveabsorption?a.Thoroughlyshakethemedicationbeforeadministering.b.Afterallmedicationsareadministered,flushtubewith15to30mLofwater.c.Positionpatientinthesupinepositionfor30minutes.d.Clampsuctionfor30to60minutesaftermedicationadministration.ANS:DAbsorptiontimeforamedicationadministeredthroughanasogastrictubeisthesameasforanoralmedication:30to60minutes.Therefore,thenursewouldneedtoholdthesuctionforthatamountoftimetoletthemedicationabsorb.Thoroughlyshakingthemedicationmixesthemedicationbeforeadministrationbutdoesnotaffectabsorption.Flushingthemedicationsensuresthatallwereadministered.Patientswithnasogastrictubesshouldneverbepositionedsupinebutinsteadshouldbepositionedata30-to90-degreeangletopreventaspiration,providednocontraindicationtosuchpositioningisknown.DIF:AnalyzeREF:762,Box34-19OBJ:Describetheimportanceofsafemedicationtechniques.TOP:ImplementationMSC:CPNRE:FoundationsofPracticeCanadianFundamentalsofNursing7thEditionPotterTestBank12.Aspirinisananalgesic,antipyretic,antiplatelet,andanti-inflammatoryagent.Aphysicianwritesforaspirin650mgevery4to6hours,prn[asneeded]:febrile.Forwhichpatientwouldthisorderbeappropriate?a.7-year-oldwithhemophilia.b.21-year-oldwithasprainedankle.c.35-year-oldwithasevereheadache.d.62-year-oldfemalewithpneumonia.ANS:DTheproviderwroteforthemedicationtobegivenforafever.Hemophiliaisableedingdisorder;therefore,antiplateletagentswouldbecontraindicated.Althoughitcanbeusedforinflammatoryproblemsandpain,thisisnotwhattheorderwaswrittenfor.DIF:EvaluateREF:732OBJ:Discussfactorstousewhenassessingapatientsneedsforandresponsetomedicationtherapy.TOP:ImplementationMSC:CPNRE:FoundationsofPractice13.Apatientisinneedofimmediatepainreliefforasevereheadache.Thenurseknowsthatwhichmedicationwillbeabsorbedthequickest?a.Tylenol,650mgPO.b.Morphine,4mgSQ.c.Ketorolac(Toradol),8mgIM.d.Hydromorphone(Dilaudid),4mgIV.ANS:DTheintravenous(IV)routeisthefastestrouteforabsorptionbecauseoftheincreaseinbloodflow.Oral(PO),subcutaneous(SQ),andIMareotherwaystodelivermedicationbutwithlessbloodflow.NURSINGTB.COMDIF:UnderstandREF:731OBJ:Discussfactorsthatinfluencemedicationactions.TOP:ImplementationMSC:CPNRE:FoundationsofPractice14.AdrugrequiresalowpHtobemetabolized.Knowingthis,thenurseanticipatesthatthemedicationwillbeadministeredbywhichroute?a.Oral.b.Parenteral.c.Buccal.d.Inhalation.ANS:AAnoralmedicationwouldpassthroughtothestomach,whichisanareaoflowpH.Thenursewouldquestionanorderforamedicationforwhichanacidicenvironmentisneededtobemetabolized.Buccal,inhalation,andparenteralroutesprovideneutraloralkalineenvironments.DIF:AnalyzeREF:731OBJ:Describefactorstoconsiderwhenchoosingroutesofmedicationadministration.TOP:ImplementationMSC:CPNRE:FoundationsofPractice15.Thenurseknowsthatapatientishavinganidiosyncraticreactionwiththestimulantpseudoephedrine(Sudafed)whenwhathappens?a.Thepatientexperiencesblurredvisionwhiledriving.CanadianFundamentalsofNursing7thEditionPotterTestBankb.Thepatientfallsasleepduringdailyactivities.c.Thepatientpresentswithapruriticrash.d.Thepatientdevelopsxerostomia.ANS:BAnidiosyncraticreactionisareactionoppositetowhatthesideeffectsofthemedicationnormallyare,oranoverreactionorunderreactiontothemedication.Blurredvisionisatoxiceffect.Arashcouldindicateanallergicreaction.Drymouthisatypicalresponsetoastimulant.DIF:ApplyREF:732OBJ:Differentiateamongdifferenttypesofmedicationactions.TOP:AssessmentMSC:CPNRE:FoundationsofPractice16.Anorderiswrittenforphenytoin(Dilantin)500mgIMq3-4hprnforpain.Thenurserecognizesthattreatmentofpainisnotastandardtherapeuticindicationforthisdrug.Thenursebelievesthattheprescribermeanttowriteforhydromorphone(Dilaudid).Whatshouldthenursedo?a.GivethepatientDilaudid,asitwasmeanttobewritten.b.Calltheprescribertoclarifyandjustifytheorder.c.Administerthemedicationandmonitorthepatientfrequently.d.Refusetogivethemedicationandnotifythenursesupervisor.ANS:BIfthenurseisapprehensiveaboutthedrug,dose,route,orreasonforamedication,thenurseshouldfirstcalltheprescriberandclarify.Thenurseshouldnotchangetheorderwithouttheprescribersconsent.Ultimately,thenursecanbeheldresponsibleforadministeringanincorrectmedication.IfthepNreUscRriSbeIrNisGuTnwBi.lliCngOtMochangetheorderanddoesnotjustifytheorderinareasonableandevidence-basedmanner,thenursemayrefusetogivethemedicationandnotifyhersupervisor.DIF:ApplyREF:743-746OBJ:Compareandcontrasttherolesofthephysician,thepharmacist,andthenurseinmedicationadministration.TOP:ImplementationMSC:CPNRE:Professional,Ethical,andLegalPractice17.Apatientneedsassistanceexcretingagaseousmedication.Whatisthecorrectnursingaction?a.Encouragethepatienttocoughanddeep-breathe.b.Suctionthepatientsrespiratorysecretions.c.Administertheantidoteviainhalation.d.Administer100%fractionofinspiredoxygen(FiO2)viasimplefacemask.ANS:AGaseousandvolatilemedicationsareexcretedthroughgasexchange.Deepbreathingandcoughingwillassistinclearingthemedicationmorequickly.DIF:UnderstandREF:731OBJ:Describethephysiologicalmechanismsofmedicationaction,includingabsorption,distribution,metabolism,andexcretionofmedications.TOP:ImplementationMSC:CPNRE:FoundationsofPracticeCanadianFundamentalsofNursing7thEditionPotterTestBank18.Thenurseknowsthatpatienteducationaboutabuccalmedicationhasbeeneffectivewhenthepatientstatesa.Ishouldletthemedicationdissolvecompletely.b.Icanonlydrinkwater,notjuice,withthismedication.c.Forfasterdistribution,Ishouldchewmymedicationfirst.d.Ishouldplacethemedicationinthesamelocation.ANS:ABuccalmedicationsshouldbeplacedinthesideofthecheekandallowedtodissolvecompletely.Buccalmedicationsactwiththepatientssalivaandmucosa.Thepatientshouldnotcheworswallowthemedication.Gastricsecretionsmaydestroysomemedications.Thepatientshouldrotatesidesofthechecktoavoidirritatingthemucosallining.DIF:UnderstandREF:734OBJ:Discussmethodsofeducatingapatientaboutprescribedmedications.TOP:EvaluateMSC:CPNRE:FoundationsofPractice19.Whatisthenursespriorityactiontoprotectapatientfrommedicationerror?a.Requestingthattheprescriberwriteoutanorder,ratherthangivingaverbalorderb.Askinganxiousfamilymemberstoleavetheroombeforegivingamedicationc.Checkingthepatientsroomnumberagainstthemedicationadministrationrecordd.AdministeringasmanyofthemedicationsaspossibleatonetimeANS:AVerbalordersshouldbelimitedtourgentsituationswherewrittencommunicationisunavailable.Thenurseshouldexplainthereasonsandlogisticsofaproceduretocalmanxiousfamilymembersandshouldaskfamilymembersnottodistractthepersonadministeringmedication,forthepatientsNsaUfeRtyS.AIfNteGrTprBop.eCredMucation,ifthefamilymembersarecreatinganunsafeenvironment,thenursemayaskthemtostepoutoftheroom.Themedicationadministrationrecordshouldbecheckedagainstthepatientshospitalidentificationband;aroomnumberisnotanacceptableidentifier.Medicationsshouldbegivenwhenscheduled,andmedicationswithspecialassessmentindicationsshouldbeseparated.DIF:AnalyzeREF:740,Box34-5OBJ:Implementnursingactionstopreventmedicationerrors.TOP:ImplementationMSC:CPNRE:Professional,Ethical,andLegalPractice20.Thepatientisinseverepainandisrequestingaprnmedicationbeforetheprntimeintervalhaselapsed.Whatisthenursespriority?a.Givethemedicationearlyforanypainscoregreaterthan8.b.Calltheprescriberandrequestastatorder.c.Explaintothepatientwhyhewillhavetowaitforthemedication.d.Documentthepatientsrequestandpainscore.ANS:BThenurseshoulduseclinicaljudgementtoadvocateforthepatientbyrequestingastatorderforthepatientsbreakthroughpain.ThenursecannotgiveamedicationwithoutanorderbecausethisviolatestheRightTimeportionoftheTenRightsofMedicationAdministration.Ifanursedeterminesthatapatientisinseverepain,shemustuseclinicaljudgementtofindthatpatientameansofpainrelief.Althoughthenurseshoulddocumentthepatientsrequestandpainscore,thisisnotthepriority.CanadianFundamentalsofNursing7thEditionPotterTestBankDIF:AnalyzeREF:747OBJ:Explaintherightsofmedicationadministration.TOP:ImplementationMSC:CPNRE:FoundationsofPractice21.Apatientisatriskforaspiration.Whatnursingactionismostappropriate?a.Holdthepatientscupforhimsohecanconcentrateontakingpills.b.Thinoutliquidssotheyareeasiertoswallow.c.Givethepatientastrawtocontroltheflowofliquids.d.Havethepatientself-administerthemedication.ANS:DAspirationoccurswhenfood,fluid,ormedicationintendedforgastrointestinaladministrationinadvertentlyenterstherespiratorytract.Tominimizeaspirationrisk,allowthepatient,ifcapable,toself-administermedication.Patientsshouldalsoholdtheirowncuptocontrolhowquicklytheytakeinfluid.Liquidsshouldbethickenedtoreducetheriskofaspiration.Patientsatriskforaspirationshouldnotbegivenstrawsbecauseuseofastrawdecreasesthecontrolthepatienthasovervolumeintake.DIF:UnderstandREF:756,Box34-18OBJ:Discussfactorstousewhenassessingapatientsneedsforandresponsetomedicationtherapy.TOP:ImplementationMSC:CPNRE:FoundationsofPractice22.Aconfusedpatientrefuseshismedication.Whatisthenursesfirstresponse?a.Agreewiththepatientsdecisionanddocumentitinhischart.b.Educatethepatientabouttheimportanceofthemedication.c.DiscreetlyhidethemedicationinthepatientsfavouriteJell-O.d.Informthepatientthathemusttakethemedicationwhetherhewantstoornot.ANS:BNURSINGTB.COMMuchofapatientsapprehensionaboutmedicationcomesfromlackofunderstanding,andeducatingthepatientmayleadtobettercompliance.Ultimately,thepatientdoeshavetherighttorefusethemedication;however,thenurseshouldfirsttrytoeducatethepatient.Hiding,deceiving,orforcingapatientintotakingamedicationisunethicalandviolateshisrighttoautonomy.DIF:ApplyREF:748OBJ:Discussmethodsofeducatingapatientaboutprescribedmedications.TOP:PlanningMSC:CPNRE:FoundationsofPractice23.Apatientwhoisbeingdischargedtodayisgoinghomewithaninhaler.Thepatientistoadminister2puffsofhisinhalertwicedaily.Theinhalercontains200puffs.Whenshouldthenurseappropriatelyadvisethepatienttorefillhismedication?a.Assoonasheleavesthehospitalb.Whentheinhalerishalfemptyc.Sixweeksafterthepatientstartsusingtheinhalerd.FiftydaysafterdischargeANS:CTheinhalershouldlastthepatient50days;thenurseshouldadvisethepatienttorefilltheprescriptionwhenhehas7to10daysofmedicationremaining.Refillingitassoonasheleavesthehospitalorwhentheinhalerishalfemptyistooearly.Ifthepatientwaits50days,thepatientwillrunoutofmedicationbeforeitcanberefilled.CanadianFundamentalsofNursing7thEditionPotterTestBankDIF:UnderstandREF:775OBJ:Calculateaprescribedmedicationdose.TOP:ImplementationMSC:CPNRE:FoundationsofPractice24.WhydoesasubcutaneousinjectiontakeslongertoabsorbthananIVinjection?a.Fewerbloodvesselsarefoundunderthesubcutaneouslevel.b.Adiposetissuetakeslongertometabolizemedication.c.Connectivetissueholdsmedicationinplacelonger.d.Somemedicationleaksoutafterinstillation.ANS:AHowquicklyamedicationisabsorbedisdependentonbloodflowtothesite.Locationswithlessbloodsupplytakelongertoabsorb.Absorptionisnotbasedonadiposetissue;however,excessiveadiposetissuemaycausethemedicationtotakelongerbeforereachingthebloodsupply.Theconnectivetissueisnotpartofmedicationabsorption.Ifamedicationisproperlyadministered,noneofitshouldbewasted.DIF:UnderstandREF:785-792OBJ:Discussfactorsthatinfluencemedicationactions.TOP:PlanningMSC:CPNRE:FoundationsofPractice25.Thenurserealizeswhichpatientisatgreatestriskforanunintendedsynergisticeffect?a.A72-year-oldwhoisseeingfourdifferentspecialists.b.A4-year-oldwhohasmistakenlytakentheentirepacketofhismothersbirthcontrolpills.c.A50-year-oldwhowasprescribedasecondbloodpressuremedication.d.A35-year-olddrugaddictwhohasingestedmethmixedwithseveralhouseholdchemicals.ANS:ANURSINGTB.COMAsynergisticeffectoccurswhentwomedicationspotentiateeachother,creatingagreatereffectthanasinglemedicationonitsown.Polypharmacyislikelytooccurwhenthe72-year-oldisseeingfourdifferenthealthcareproviders.Polypharmacyplacesthepatientatriskforunintendedmixingofmedicationsthatpotentiateeachother.Thechildtakingtoomuchofamedicationbymistakecouldexperienceoverdoseortoxicity.The50-year-oldisprescribedtwodifferentbloodpressuremedicationsfortheirsynergisticeffect,butthisisadesiredevent.Adrugaddictmixingchemicalscanbetoxic.DIF:AnalyzeREF:733|754|755OBJ:Differentiateamongdifferenttypesofmedicationactions.TOP:AssessmentMSC:CPNRE:FoundationsofPractice26.Whichpatientusinganinhalerwouldbenefitmostfromusingaspacer?a.A3-year-oldwithacleftpalate.b.A25-year-oldwithmultiplesclerosis.c.A50-year-oldwithhearingimpairment.d.A72-year-oldwithleft-sidedhemiparesis.ANS:BCanadianFundamentalsofNursing7thEditionPotterTestBankAspacerisindicatedforapatientwhohaslimitedcoordinationorfunction.Individualswithmultiplesclerosisoftenlosemotorcontrolandfunctionandhavedifficultyseeing.Childrenoftenhavedifficultyusingaspacer,soasimplefacemaskispreferredforinfantsandchildrenyoungerthan4.Hearingimpairmentmaymaketeachingthepatienttousetheinhalerdifficult,butitdoesnotindicatetheneedforaspacer.Apatientwithone-sidedweaknesswouldhaveadifficulttimeassemblingandadministeringaninhalerbyusingaspacer,butthepatientcouldusetheinhalersingle-handedly.DIF:AnalyzeREF:768-775OBJ:Describefactorstoconsiderwhenchoosingroutesofmedicationadministration.TOP:ImplementationMSC:CPNRE:FoundationsofPractice27.Theprescriberwroteanorderfora40-kgchildtoreceive25mgofmedicationfourtimesaday.Thetherapeuticrangeis5to10mg/kg/day.Whatisthenursespriority?a.Administerthemedicationbecauseitiswithinthetherapeuticrange.b.Notifythephysicianthattheprescribeddoseisinthetoxicrange.c.Notifythephysicianthattheprescribeddoseisbelowthetherapeuticrange.d.Changethedosetoonethatiswithinrange.ANS:CThedosagerangefora40-kgpatientis200to400mgaday.Theprescribeddoseis100mg/day,whichisbelowtherapeuticrange.Thenurseshouldnotifythephysicianfirstandaskforclarificationontheorder.Thedoseisnotabovethetherapeuticrangeandisnotatatoxiclevel.Thenurseshouldneveralteranorderwithouttheprescribersapprovalandconsent.DIF:ApplyREF:737-739OBJ:Calculateaprescribedmedicationdose.TOP:ImplementationMSC:CPNRE:Professional,Ethical,andLegalPracticeNURSINGTB.COM28.ThenurseisadministeringanIVmedicationthatistobeinfusedover10minutes.Whichmethodshouldthenursechoosetoefficientlyadministerthemedication?a.Placethemedicationinalarge-volumecatheter-tippedsyringe.b.Mixthemedicationintothepatientsmaintenancefluids.c.Attachseparatetubingandsetthemedicationsyringeinamini-infusionpump.d.Standatthepatientsbedsideandcarefullywatchtheclockwhilepushingthemedication.ANS:CToadministerthismedicationefficiently,thenurseshoulduseaninfusionpumptorunthemedicationinoveraprolongedtime.Thismethodismoreaccurateandismoretimeefficientthanothermethodsbecausethenursecanleavetheroom.Thenurseshouldnotmixmedicationintothemaintenancebagwithoutpharmacistandphysicianapproval.Pushingthemedicationisnotatime-efficientmethodforthenurse.Acatheter-tippedsyringeisaninappropriatedeviceforadministrationofamedication.DIF:AnalyzeREF:796OBJ:Describefactorstoconsiderwhenchoosingroutesofmedicationadministration.TOP:ImplementationMSC:CPNRE:FoundationsofPracticeCanadianFundamentalsofNursing7thEditionPotterTestBankUSNT29.Thenurseispreparingtoadministermedicationstotwopatientswiththesamelastname.Afterthefirstadministration,thenurserealizesthatshedidnotchecktheidentificationofthepatientbeforeadministeringmedication.Whichofthefollowingactionsshouldthenursecompletefirst?a.Returntotheroomtocheckandassessthepatient.b.Administertheantidotetothepatientimmediately.c.Alertthechargenursethatamedicationerrorhasoccurred.d.Completeproperdocumentationofthemedicationerrorinthepatientschart.ANS:AThenursesfirstpriorityistoestablishthesafetyofthepatientbyassessingthepatient.Second,thenurseshouldnotifythechargenurseandthephysician.Theantidoteshouldbeadministeredifrequired.Finally,thenurseneedstocompleteproperdocumentation.DIF:EvaluateREF:743|747OBJ:Implementnursingactionstopreventmedicationerrors.TOP:ImplementationMSC:CPNRE:FoundationsofPractice30.Thenurseknowsthatcaringfortwopatientswiththesamelastnamecanleadtoamedicationerrorinvolvingwhichrightofmedicationadministration?a.Rightmedication.b.Rightpatient.c.Rightdose.d.Rightroute.ANS:BThenurseshouldaskthepatienttoverifyhisorheridentityandshouldcheckthepatientsIDbraceletagainstthemedicatioNnrRecorIdtoGensBu.reCproMperpatient.Acceptablepatientidentifiersincludethepatientsname,anidentificationnumberassignedbyahealthcareagency,oratelephonenumber.Thepatientsroomnumbershouldnotbeusedasanidentifier.Toidentifyapatientcorrectlyinanacutecaresetting,thenurseshouldcomparethepatientidentifiersonthemedicationadministrationrecordwiththepatientsidentificationbraceletwhileatthepatientsbedside.Rightmedication,rightdose,andrightrouteareequallyasimportant,butthisexampleoutlinesrightpatient.DIF:RememberREF:746-749OBJ:Explaintherightsofmedicationadministration.TOP:ImplementationMSC:CPNRE:FoundationsofPractice31.Apatientstatesthatshewouldprefernottotakeherdailyallergypillthismorningbecauseitmakeshertoodrowsythroughouttheday.Howmaythenurserespondtherapeutically?a.Thephysicianorderedit;therefore,youmusttakeyourmedicationeverymorningatthesametimewhetheryouredrowsyornot.b.Letschangethetimeyoutakeyourpillto9p.m.,sothedrowsinessoccurswhenyouwouldnormallybesleeping.c.Youcanskipthismedicationondayswhenyouneedtobeawakeandalert.d.Trytogetasmuchdoneasyoucanbeforeyoutakeyourpill,soyoucansleepintheafternoon.ANS:BCanadianFundamentalsofNursing7thEditionPotterTestBankThenurseshoulduseknowledgeaboutthemedicationtoeducatethepatientaboutpotentialresponsetomedications.Thenthemedicationschedulecanbealteredbasedonthatknowledge,afterthephysicianhasbeennotified.Itisthepatientsrighttorefusehermedication;however,thenurseshouldeducatethepatientontheimportanceandeffectsofhermedication.Askingapatienttochangeherentirelifeschedulearoundamedicationisunreasonableandwilldecreasecompliance.Thenurseshouldbesupportiveandshouldoffersolutionstomanagemedicationeffects.DIF:ApplyREF:747OBJ:Discussfactorstousewhenassessingapatientsneedsforandresponsetomedicationtherapy.TOP:ImplementationMSC:CPNRE:FoundationsofPractice32.AproviderhasorderedaSTATmedicationtobeadministered.Thenurseknowsthatthebestrouteofadministrationisa.IV.b.IM.c.SQ.d.PO.ANS:AIVmedicationshavethequickesteffectbecausetheyreceivethemostbloodflow.ASTATorderistobecarriedoutasquicklyaspossible,sotheeffectshouldbeasimmediateaspossible.Oral,subcutaneous(SQ),andIMareotherwaystodelivermedicationbutwithlessbloodflow.DIF:UnderstandREF:731OBJ:Describethephysiologicalmechanismsofmedicationaction,includingabsorption,distribution,metabolism,andexNcUretioSnIofNmGeTdicBa.tioCnsO.MMSC:CPNRE:FoundationsofPracticeTOP:Implementation33.Anurseisattemptingtoadministermedicationtoachild,butthechildrefusestotakethemedication.Thenurseasksfortheparentscooperationbysayinga.Pleaseholdyourchildsarmsdownathersides,soIcangetthefulldoseofmedicationintohermouth.b.Iwillpreparethemedicationforyouandobserveifyouwouldliketotrytoadministerthemedication.c.Letsturnthelightsoffandgivethechildamomenttofallasleepbeforeadministeringthemedication.d.Sinceyourchildlovesapplesauce,letsaddthemedicationtoit,soyourchilddoesntresist.ANS:BChildrenoftenhavedifficultiestakingmedication,butitislesstraumaticforthechildiftheparentadministersthemedication.Holdingdownthechildisnotthebestoptionbecauseitmayfurtherupsetthechild.Neveradministeranoralmedicationtoasleepingchild.Dontmixmedicationsintothechildsfavouritefoods,becausethechildmightstarttorefusethefood.DIF:EvaluateREF:754OBJ:Discussfactorsthatinfluencemedicationactions.TOP:ImplementationMSC:CPNRE:FoundationsofPracticeCanadianFundamentalsofNursing7thEditionPotterTestBank34.A64-year-oldquadriplegicpatientneedsanIMinjectionofantibiotic.Whatisthebestsitefortheadministration?a.Deltoid.b.Dorsalgluteal.c.Ventrogluteal.d.Vastuslateralis.ANS:DVastuslateralisisalargemusclethatiseasilyaccessiblefromthesupineposition.Becausethepatientdoesnotwalk,theventroglutealmuscleatrophiesandisnottheideallocation.Thedorsalglutealsiteisalocationforasubcutaneousinjection,andthispatientrequiresanIMinjection.Thedeltoidiseasilyaccessible,butthismuscleisnotwelldevelopedinmanyadults.DIF:ApplyREF:793,Box34-27OBJ:Discussfactorsthatinfluencemedicationactions.TOP:ImplementationMSC:CPNRE:FoundationsofPractice35.Whichnursingactionisthenumberonepriorityforensuringthatmedicationstaysinthetargettherapeuticrange?a.Measuringthepeakandtroughlevelsatthesametimeeachday.b.Administeringadoubledoseafteradosewasmissed.c.Deliveringthesameamountofthedrugatthesametimeeachday.d.Increasingabsorptionbyholdingallothermedications1hourbeforeadministration.ANS:AThequantityanddistributionNoUfRamSeIdNicGatTioBn.inCdifMferentbodycompartmentschangeconstantly.Measuringpeakandtroughlevelsallowshealthcareproviderstoseewhetherthecurrentmedicationdosageiseffectiveforthepatient,orifitneedstobeadjusted.Administeringadoubledoseisdangerousandcouldcausethemedicationlevelstocrossthetoxicthreshold.Deliveringthesameamounteachdaymaynotbetherapeuticormaybetoxicforthepatient.Holdingallothermedicationsshouldnotaffectthepeakorhalf-lifeofthemedications,assumingthattheyarecompatible.DIF:ApplyREF:733OBJ:Discussfactorstousewhenassessingapatientsneedsforandresponsetomedicationtherapy.TOP:ImplementationMSC:CPNRE:FoundationsofPractice36.Whichofthefollowingdemonstratesproperoralmedicationadministration?a.Removingthemedicationfromthewrapperandplacingitinacuplabelledwiththepatientsinformation.b.Usingtheedgeofthemedicinecuptofillwith0.5mLofliquidmedication.c.Placingallofthepatientsmedicationsinthesamecup,exceptmedicationswithassessments.d.Combiningliquidmedicationsfrom2singledosecupsinto1medicinecup.ANS:CCanadianFundamentalsofNursing7thEditionPotterTestBankPlacingmedicationsthatrequirepreadministrationassessmentinaseparatecupservesasaremindertocheckbeforethemedicationisgiven,whichmakesiteasierforthenursetowithholdmedicationifnecessary.Medicationsshouldnotberemovedfromtheirpackageuntiltheyareinthepatientsroombecausethismakesidentificationofthepilleasierandreducescontamination.Whenmeasuringaliquid,thenurseshouldusethemeniscusleveltomeasure,nottheedge.Inaddition,liquidmedicationsmeasuringlessthan10mLshouldbedrawnupinaneedlelesssyringe.Single-dosemedicationsshouldnotbetransferredtomedicinecupstoreduceunnecessarymanipulationofthedose.DIF:UnderstandREF:758OBJ:Describetheimportanceofsafemedicationtechniques.TOP:ImplementationMSC:CPNRE:FoundationsofPractice37.ApatientwhoisreceivingIVfluidsnotifiesthenursethathisarmfeelstight.Uponassessment,thenursenotesthatthearmisswollenandcooltothetouch.Whatshouldthenursesfirstactionbe?a.DiscontinuetheIVsite,andapplyawarmcompress.b.Attachasyringe,andpullbackontheplungertoaspiratetheIVfluid.c.StartanewIVsitedistalfromthesite.d.StoptheIVfluids,andnotifythephysicianimmediately.ANS:AAnIVsitethatispuffy,swollen,andcooltothetouchindicatesinfiltration.TheIVsiteshouldbediscontinuedimmediatelybecauseitisnolongeraviableaccesspoint.Pullingbackonthesyringewillnotresultinfluidreturnbecausethereisnolongervenousaccess.AnewIVsiteshouldbeestablishedintheoppositearmaftertheoldIVlinehasbeenremoved.TheIVlineshouldberemoved;iNtisnRotsIuffGicienBt.toConMlystopthefluids.UDIF:ApplyREF:729SNTOOBJ:Describetheimportanceofsafemedicationtechniques.TOP:ImplementationMSC:CPNRE:FoundationsofPractice38.Thephysicianorders4mgofoxycodonetobedeliveredevery6hours.After4hours,thepatientiscomplainingthatsheisinmorepain.Thenurseadvisesthephysiciantomakewhichmedicationadjustment?a.Addanadditionalnarcoticontopoftheoxycodone.b.Dividethedoseinhalfandadminister2mgevery3hours.c.Giveanother4mgofoxycodoneafter4hours.d.Changethemedicationbeingadministeredforpainrelief.ANS:BThepatientsmetabolismcausesthepeakeffecttooccurwhenthemedicineisatitshighestconcentration.Afterreachingitspeak,theserumconcentrationofthemedicationfallsprogressively.Spreadingoutthedoseensurethatthepatientwillreceiveconstantpainrelief.Changingthemedication,increasingthedose,oraddinganothermedicationisnotthebestcourseofaction.DIF:ApplyREF:804OBJ:Discussfactorstousewhenassessingapatientsneedsforandresponsetomedicationtherapy.TOP:ImplementationMSC:CPNRE:FoundationsofPracticeCanadianFundamentalsofNursing7thEditionPotterTestBank39.Thenursinginstructorasksthestudenttoexplainmethodstoreducetheriskofneedlestickinjury.Thenursinginstructorwouldprovidefurtherinstructiontothestudentwhomakeswhichfollowingstatement?a.Recaptheneedleaftergivinganinjection.b.Useneedlelesssystemswhenavailablec.Neverforceaneedleintothesharpsdisposal.d.Clearlymarksharpsdisposalcontainers.ANS:ATopreventtheriskofneedlesticks,thenurseshouldneverrecapneedles.Needlelesssystemsorsharpswithengineeredsharpsinjuryprotections(SESIP)safetydevicesshouldbeusedwhenavailable.Needlesshouldnotbeforcedintothebox.Receptaclesshouldbemarkedclearlytowarnofdanger.DIF:RememberREF:796,Box34-28OBJ:Describetheimportanceofsafemedicationtechniques.TOP:ImplementationMSC:CPNRE:FoundationsofPracticeNURSINGTB.COMCanadianFundamentalsofNursing7thEditionPotterTestBankNRIGB.CChapter35:ComplementaryandAlternativeApproachesinHealthCarePotteretal:CanadianFundamentalsofNursing,7thEditionMULTIPLECHOICE1.Apatientdescribespractisingacomplementaryandalternativetherapyinvolvingconcentratingandcontrollinghisrespiratoryrateandpattern,recognizingthatbreathworkistoyogaaswhichofthefollowing?a.Thezoneistoacupressure.b.MassagetherapyistoAyurveda.c.Reikitherapyistotherapeutictouch.d.Prayeristotaichi.ANS:CThisisananalogyinwhichdifferenttherapieswithinspecificcategoriesarecompared.Bothyogaandbreathworkaremind-bodytherapies,whereasbothreikiandtherapeutictouchtherapiesareenergyfieldtherapies.Theotheroptionshavedifferentdesignstructures;thustheydonotfittheanalogy.DIF:ApplyREF:816OBJ:Describethevarioustreatmentsassociatedwithcomplementaryandalternativemedicine.TOP:PlanningMSC:CPNRE:FoundationsofPractice2.Ateenagerwithananxietydisorderisreferredforbiofeedbackbecauseherparentsdonotwantheronanxiolytics.Thenurserecognizesthattheteenagerunderstandsherhealtheducationonbiofeedbackwhenshemakeswhichstatement?a.BiofeedbackwillallowmUetoSdireNctmTyenerOgiesinanintentionalwaywhenstressed.b.Biofeedbackwillallowmetomanipulatemystressed-outjoints.c.Biofeedbackwillhelpmewithmythoughts,feelings,andphysiologicalresponsestostress.d.Biofeedbackwillletmeassessandredirectmyenergyfields.ANS:CByusingelectromechanicalinstruments,apersoncanreceiveinformationorfeedbackonhisorherstresslevel.Havingthisknowledgeallowsthepatienttodevelopawarenessandvoluntarycontroloverhisorherphysiologicalsymptoms.Biofeedbackdoesnotaddressenergyfields.Directingenergiesistherapeutictouch.Manipulationofbodyalignmentandjointsisdonebyachiropractor.DIF:ApplyREF:818OBJ:Understandhowcomplementaryandalternativeapproachesassistinhealthpromotionanddiseaseprevention.TOP:PlanningMSC:CPNRE:FoundationsofPractice3.A70-year-oldpatientisnewlyadmittedtoaskillednursingfacilitywiththediagnosesofAlzheimersdementia,lipidemia,andhypertensionandahistoryofpulmonaryembolism.Medicationsbroughtonadmissionincludedlisinopril,hydrochlorothiazide,warfarin,low-doseaspirin,ginkgobiloba,andechinacea.Thenursecontactsthepatientsmedicalprovideroverwhichpotentialdrug-druginteraction?a.LisinoprilandEchinacea.CanadianFundamentalsofNursing7thEditionPotterTestBankUSNTOb.Warfarinandginkgobiloba.c.Echinaceaandwarfarin.d.Lisinoprilandhydrochlorothiazide.ANS:BWarfarinandbloodthinnersinteractwithginkgobilobaasdesignedtoimprovememory.Allherbalsupplementsshouldbeevaluatedwithcurrentpharmacologicalmedications.Theotheroptionsdonothavedruginteractionswitheachother.DIF:AnalyzeREF:826OBJ:Recognizebotanicaltreatmentsasanapproachtocomplementaryandalternativemedicine.TOP:PlanningMSC:CPNRE:FoundationsofPractice4.Anacquaintanceofanurseasksforanonmedicalapproachforexcessiveworryandworkstress.Themostappropriatecomplementaryandalternativemedicine(CAM)therapythatthenursecanrecommendiswhichofthefollowing?a.Meditation.b.Ayurvedicherbs.c.Acupuncture.d.Chiropractictherapy.ANS:AMeditationisindicatedforstress-relatedillness.Apersoncanlearntocalmdownandcopewithstressthroughtheuseofmeditation.Ayurvedicherbshavebeenusedforcenturiestotreatillness.Acupuncturefocusesonredirectingqiviathebodysmeridianenergylinestoinfluencedeeperinternalorgans.Chiropractictherapyinvolvesmanipulationofthespinalcolumnandincludesphysiotherapyanddiettherapy.NRIGB.CMDIF:AnalyzeOBJ:Describethevarioustreatmentsassociatedwithcomplementaryandalternativemedicine.TOP:PlanningMSC:CPNRE:FoundationsofPractice5.Thetherapythatismoreeffectiveintreatingphysicalailmentsthaninpreventingdiseaseormanagingchronicillnessiswhichmedicine?a.Allopathic.b.Complementary.c.Alternative.d.Mind-body.ANS:AAllopathicmedicineissynonymouswithtraditionalWesternmedicine,whichishighlyeffectiveintreatingnumerousphysicalailments,butitisingenerallesseffectiveinpreventingdisease,decreasingstress-inducedillness,managingchronicdisease,andcaringfortheemotionalandspiritualneedsofindividuals.Complementary,alternative,andmind-bodytypesofmedicinecanbeusedintandemwithallopathicmedicinebutaredistinctlydifferent.DIF:UnderstandREF:815OBJ:Identifythedifferencesbetweencomplementaryandalternativeapproachesinhealthcare.TOP:PlanningMSC:CPNRE:FoundationsofPracticeREF:821CanadianFundamentalsofNursing7thEditionPotterTestBankUSNTO6.Whichofthefollowingisconsideredahealingpracticethatpromotesharmonywithinacommunityandinthephysicalandspiritualworldsthroughsweatingandpurging,herbalremedies,andshamanichealing?a.LatinAmericanpractices.b.TraditionalChinesemedicine.c.Ayurveda.d.TraditionalIndigenousmedicine.ANS:DTraditionalIndigenousmedicineisahealingpracticethatpromotesharmonywithinacommunityandinthephysicalandspiritualworldsthroughsweatingandpurging,herbalremedies,andshamanichealing.LatinAmericanpracticeincludesahumoralmodelforclassifyingfood,activity,drugs,illnesses,andaseriesoffolkillnesses.TraditionalChinesemedicinepromoteshealthandtreatsdiseasethroughacupuncture,herbalremedies,massage,acupressure,qigong,andmoxibustion.Ayurvedaincorporatesacombinationofremedies,suchasherbs,purgatives,andoils,totreatdisease.DIF:UnderstandREF:817,Table35-1OBJ:Describethevarioustreatmentsassociatedwithcomplementaryandalternativemedicine.TOP:AssessmentMSC:CPNRE:FoundationsofPractice7.Apatientasksaboutthenewclinicintownthatisstaffedbyallopathicandcomplementarypractitioners.Whattypeofclinicwouldthisbe?a.Integrativemedicalclinic.b.Ayurvedicclinic.c.Naturopathicmedicalclinic.d.Healingintentionclinic.NRIGB.CMANS:AAnintegrativemedicalprogramallowshealthcareconsumerstobetreatedbyateamofprovidersconsistingofbothallopathicandcomplementarypractitioners.Theotheroptionsaresolelycomplementaryclinics.DIF:UnderstandREF:817OBJ:Identifythedifferencesbetweencomplementaryandalternativeapproachesinhealthcare.TOP:PlanningMSC:CPNRE:FoundationsofPractice8.Whichofthefollowingcanbedescribedasarangeofpracticesthatrelaxthebodyandcalmthemind?a.Mindfulness.b.Imagery.c.Meditation.d.Biofeedback.ANS:CMeditationcomprisesarangeofpracticesthatrelaxthebodyandcalmthemind.Mindfulnesshelpsbuildawarenessofthepresentmomentwithanattitudeofopenness.Withimagery,patientstreatpathologicalconditionsbyconcentratingonanimageorseriesofimages.Biofeedbackinvolvestheuseofinstrumentstoprovideapersonwithvisualorauditoryinformationaboutautonomicphysiologicalfunctions.DIF:UnderstandREF:817,Table35-1CanadianFundamentalsofNursing7thEditionPotterTestBankUSNTOOBJ:Describethevarioustreatmentsassociatedwithcomplementaryandalternativemedicine.TOP:PlanningMSC:CPNRE:FoundationsofPractice9.Atherapeutictouchpractitionerscansthepatientsbodytoidentifywhat?a.Blockedchakra.b.Accumulatedtension.c.Theflowofqi.d.Structuralandfunctionalimbalance.ANS:BThetherapeutictouchpractitionerscansthebodytoidentifyareasofaccumulatedtension.Thepractitionerwillthenattempttoredirecttheseaccumulatedenergiesbackintobalance.Chiropractictherapyinvolvesbalancingstructuralandfunctionalimbalancethroughspinalmanipulation.QiisthevitallifeforceintraditionalChinesemedicine.Chakrasarethecentresofspiritualpowerinvolvedinreikitherapy.DIF:UnderstandREF:822OBJ:Describethevarioustreatmentsassociatedwithcomplementaryandalternativemedicine.TOP:PlanningMSC:CPNRE:FoundationsofPractice10.Whichofthefollowingdietsisbelievedtohaveanticancerproperties,andconsistsof40to60%wholecerealgrain,20to30%vegetables,and5to10%beans?a.Macrobioticdiet.b.Gersontherapy.c.Mediterraneandiet.d.Paleodiet.ANS:ANRIGB.CMThemacrobioticdietisapredominantlyvegandiet(butitalsoincludeswhitemeatfish,occasionalfruits,seeds,andnuts)believedtohaveanticancerproperties.Thedietconsistsof40to60%wholecerealgrain,20to30%vegetables,and5to10%beans.TheGersontherapyadvocatesalow-salt,high-potassiumorganicdietoffruitjuices,rawvegetables,andnutritionalsupplementsandisprimarilyusedinthetreatmentofcancer.TheMediterraneandietishighinwholegrains,nuts,fruits,vegetables,andomega-3essentialfattyacids,whichprovideaprotectivebenefitforcardiachealthandvariousinflammatorydiseases.ThePaleodietdoesnotincludegrainsorlegumes.DIF:UnderstandREF:817,Table35-1OBJ:Describethevarioustreatmentsassociatedwithcomplementaryandalternativemedicine.TOP:PlanningMSC:CPNRE:FoundationsofPractice11.Whatisabasicfoundationalprincipleofchiropracticcare?a.Structureandfunctioncoexist.b.Chiropracticcareisriskfree.c.Humanbeingsneedexternalhands-oncaretobehealthiest.d.Subluxationwillcausepermanentlyrestrictedjointmovement.ANS:ACanadianFundamentalsofNursing7thEditionPotterTestBankChiropractorsusetheirhandsasinstrumentstorestorestructuralandfunctionalbalance.Practitionersofchiropracticcarebelievethatgeneralhealthisaffectedviathenervoussystem.Chiropracticcareisnotriskfree,justasallopathicmedicalcareisnotriskfree.Subluxationeventuallycancausepermanentlyrestrictedjointmovement,butthisisnotabasicfoundationalprincipleofchiropracticcare.Althoughhands-oncareisusedinchiropracticcare,anaturaldietandregularexercisearecriticalcomponentsforthebodytofunctionproperly.DIF:UnderstandREF:822OBJ:Understandhowcomplementaryandalternativeapproachesassistinhealthpromotionanddiseaseprevention.TOP:PlanningMSC:CPNRE:CollaborativePractice12.Aholisticnurseisanursewhodoeswhat?a.Recommendsavegandietforallpatients.b.Recognizesthemind-body-spiritconnection.c.Providesspiritualliteraturetopatients.d.Knowsaboutresourcesforfreshherbs.ANS:BThemind-body-spiritconnectionisimportanttoanursewithaholisticstyleofnursing.Nursinginvolvescaringfortheentirepatient.Avegandietisanaspectofdietarytreatment,butitdoesnotallowforalternativeviewpointsorwell-roundedcare.Spiritualliteratureandknowingaboutresourcesareexcellentalternativeaspectsofallopathicmedicine,buttheyarenotspecifictoholisticnurses.DIF:UnderstandREF:819OBJ:Identifythedifferencesbetweencomplementaryandalternativeapproachesinhealthcare.TOP:PlanningMSC:CPNNURRES:FIoNunGdaTtiBon.sCofOPMractice13.Drawbacksofcomplementaryandalternativetherapieswouldbeallofthefollowing,exceptwhichone?a.Lackofevidence-informedguidelines.b.Minimalsupportiveresearchstudies.c.Strongsupportbyallopathicmedicalproviders.d.Lackofalongtraditionoftherapiestaughtinhealthcareeducation.ANS:CAllopathicmedicalprovidershavenotbeentraditionallyeducatedincomplementaryandalternativetherapies;however,thatisbeginningtochangewithcoursesincludedinmedicalandnursingcurricula.TheseprovidersoftenfeeluncomfortablerecommendingCAMbecauseofthatlackofknowledgeandtraining.Inaddition,researchonCAMislimited,whichmakesitdifficulttocreateguidelines;thisisanotherobstacletotheuseofCAM,buttheresearchbaseisbeginningtoexpand.DIF:UnderstandREF:824OBJ:Identifythedifferencesbetweencomplementaryandalternativeapproachesinhealthcare.TOP:PlanningMSC:CPNRE:FoundationsofPractice14.Physiologicalsymptomsofastressresponseincludeallofthefollowingexceptwhichone?a.Constrictedpupils.b.Tachycardia.CanadianFundamentalsofNursing7thEditionPotterTestBankUSNTOc.Tachypnea.d.Elevatedbloodpressure.ANS:APupilsdilateduringstressfulsituationstoincreasevisualcapacityandsight,especiallyindarkenedconditions;thisisasurvivalmechanism.Thephysiologicalcascadeofchangesassociatedwiththestressresponseincludesincreasedheartandrespiratoryrates,elevatedbloodpressure,muscletightening,increasedmetabolicrate,asenseofforeboding,fear,nervousness,irritability,andanegativemood.DIF:UnderstandREF:821OBJ:Explainthescopeofnaturopathicandchiropracticmedicine.TOP:PlanningMSC:CPNRE:FoundationsofPractice15.Whichofthefollowingisalong-termoutcomeforanindividualwhoislearningrelaxationtherapy?a.Identifyingtensioninthebodyandconsciouslyreleasingthetension.b.Havingnotensioninhisorherlife.c.Increasingdeltabrainactivity.d.Increasingthefocusonhimselforherself.ANS:ALong-termrelaxationtherapyfocusesonactiverecognitionandreleaseofstress.Itisnotrealistictoexpectatension-freelife.Deltabrainwavesarehigh-amplitudebrainwavesassociatedwiththedeepeststagesofsleep.Theoutcomeofrelaxationtherapyisnottoputapersontosleeportoincreasethefocusonself.DIF:UnderstandREF:82N1RIGB.CMOBJ:Understandhowcomplementaryandalternativeapproachesassistinhealthpromotionanddiseaseprevention.TOP:PlanningMSC:CPNRE:FoundationsofPractice16.Whatisonebenefitofmeditationoverotherformsofbehaviouraltherapy?a.Meditationimprovescommunicationskills.b.Meditationcureshypertension.c.Meditationdoesnotrequirememorization.d.Meditationbalancesinsulinandotherbodyhormones.ANS:CMeditationinvolvesrelaxingthebodyandstillingthemind,whichanyonecandothroughavarietyofmeasures.Meditationdoesnotimproveapersonscommunicationskills,cureanyillness,orbalanceanybodilyhormones.DIF:UnderstandREF:821OBJ:Understandhowcomplementaryandalternativeapproachesassistinhealthpromotionanddiseaseprevention.TOP:PlanningMSC:CPNRE:FoundationsofPractice17.Whichoneofthefollowingmealswouldbehighinphytochemicals?a.Sandwichwithwholegrainbreadandleanturkey.b.Grilledsalmonandwhole-grainrice.c.Spinachsaladwithroastedbeets.d.Chickenbreastandmashedpotatoes.CanadianFundamentalsofNursing7thEditionPotterTestBankANS:CPhytochemicalscanbefoundinseveralplant-basedfoods,suchasspinach,carrots,oranges,beets,redpeppers,blueberries,andmore.TheCanadianCancerSocietyadviseschoosingavarietyofcolourfulfoodseachday.DIF:ApplyREF:824OBJ:Identifythedifferencesbetweencomplementaryandalternativeapproachesinhealthcare.TOP:PlanningMSC:CPNRE:FoundationsofPractice18.Whichsubstancecouldcauseanabnormaldruginteractioninapatienttakinganantidepressantmedication?a.Digoxin.b.Aspirin.c.Chamomile.d.Ginger.ANS:CChamomileisknowntocausedrowsiness.Otherherbalsupplementscanaffectserotoninlevelsinthebrainandcanaffectantidepressantmedication.Apatientshouldcheckwithaproviderbeforecombiningherbalsupplementswithmedications.Antidepressantsdonotinteractwithdigoxin,aspirin,orginger.DIF:UnderstandREF:825OBJ:Recognizebotanicaltreatmentsasanapproachtocomplementaryandalternativemedicine.TOP:PlanningMSC:CPNRE:FoundationsofPractice19.WhichofthefollowingstatementsistrueconcerningtheregulationofherbaltherapiesinCanada?NURSINGTB.COMa.Herbalremediesareharmlessanddonotcausesideeffectsbecausetheyarenaturalplants.b.AnaturalhealthproductthathasbeenapprovedundertheCanadianFoodandDrugsActwillcarryaDrugIdentificationNumber(DIN)onitslabel.c.Allherbaltherapymanufacturersmustfollowstrictqualitycontrolandmanufacturingguidelines.d.Thereisnoneedtobeconcernedaboutconcurrentuseofherbaltherapiesandprescriptionorover-the-countermedications.ANS:BAccordingtothefederalFoodandDrugsAct,alldrugsmustbeprovensafeandeffectivebeforetheycanbesoldtothepublic.NaturalhealthproductsthathavebeenapprovedforsaleunderthenewregulationshavebeenassignedaDIN(DIN-HMforhomeopathicmedicines)orNaturalProductNumber(NPN).Thesenumberscertifythattheproducthaspassedareviewoftheirformulation,labelling,andinstructionsforuse.HealthCanadaadvisesCanadianstouseonlyhealthproductsthatcarryaDIN,DIN-HM,orNPNonthelabel.Manypeoplebelieve,incorrectly,thatbecauseherbsarenaturalplants,theywillnotcauseharmorsideeffects.Notallcompaniesfollowstrictqualitycontrolandmanufacturingguidelines,whichsetstandardsforacceptablelevelsofpesticides,residualsolvents,bacteriallevels,andheavymetals.Forthisreason,herbalmedicineshouldbepurchasedfromreputablemanufacturers.Concurrentuseofherbalorothernaturalproductswithprescriptionorover-the-countermedicationsshouldbemonitored.Herbscaninhibitorenhanceaparticularmedicationssiteofaction.CanadianFundamentalsofNursing7thEditionPotterTestBankDIF:ApplyREF:825OBJ:Identifythedifferencesbetweencomplementaryandalternativeapproachesinhealthcare.TOP:AssessmentMSC:CPNRE:FoundationsofPractice20.Thecomplementaryandalternativetherapythatisknowntoalterimmunefunctioniswhichofthefollowing?a.Biofeedback.b.Imagery.c.Breathwork.d.Acupuncture.ANS:BImageryandvisualizationtechniquesproduceapowerfulpsychophysiologicalresponse.Imageryiscommonlyusedbypatientswithcancertoimprovetheirimmunesystemdespiteradicaltreatmentssuchaschemotherapy.Biofeedbackteachesthepatienttoanalyzetriggersofstress.Acupunctureinvolvespunctureoftheskin,whichmayincreaseriskofinfectionandshouldbeusedwithcautioninsomeonewhoisimmunocompromised.Breathworkinvolvesusingavarietyofbreathingpatternstorelax,invigorate,oropenemotionalchannels.DIF:UnderstandREF:821OBJ:Describethevarioustreatmentsassociatedwithcomplementaryandalternativemedicine.TOP:PlanningMSC:CPNRE:FoundationsofPracticeNURSINGTB.COMCanadianFundamentalsofNursing7thEditionPotterTestBankChapter36:ActivityandExercisePotteretal:CanadianFundamentalsofNursing,7thEditionMULTIPLECHOICE1.Thecoordinatedeffortsofthemusculoskeletalandnervoussystemmaintainbalance,posture,andbodyalignment.Whatdoesbodyalignmentreferto?a.Alowcentreofgravitybalancedoverawidebaseofsupport.b.Theresultofweight,centreofgravity,andbalance.c.Therelationshipofonebodyparttoanother.d.Theforcethatoccursinadirectiontoopposemovement.ANS:CBodyalignmentreferstotherelationshipofonebodyparttoanotherbodypartalongahorizontalorverticalline.Bodybalanceisthestateinwhicharelativelylowcentreofgravityisbalancedoverawide,stablebaseofsupport.Coordinatedbodymovementisaresultofweight,centreofgravity,andbalance.Frictionisaforcethatoccursinadirectiontoopposemovement.DIF:RememberREF:833OBJ:Describetheroleofthemusculoskeletalandnervoussystemsintheregulationofactivityandexercise.TOP:AssessmentMSC:CPNRE:FoundationsofPractice2.Astructuralcurvatureofthespineassociatedwithvertebralrotationisknownaswhichofthefollowing?a.Scoliosis.b.Osteogenesis.c.Osteomalacia.d.Arthritis.ANS:ANURSINGTB.COMScoliosisisastructuralcurvatureofthespineassociatedwithvertebralrotation.Osteogenesisimperfectaisaninheriteddisorderinwhichbonesareporous,short,bowed,anddeformed.Osteomalaciaisanuncommonmetabolicdiseasecharacterizedbyinadequateanddelayedmineralization;asaresult,boneiscompactandspongy.Arthritisisaninflammatoryjointdiseasecharacterizedbyinflammationordestructionofthesynovialmembraneandarticularcartilageandbysystemicsignsofinflammation.DIF:RememberREF:837OBJ:Discussphysiologicalandpathologicalinfluencesonbodyalignmentandjointmobility.TOP:AssessmentMSC:CPNRE:FoundationsofPractice3.Howisjointdegenerationunlikearthritis?a.Jointdegenerationresultsonlyfromnoninflammatorydisease.b.Jointdegenerationresultsonlyfrominflammatorydisease.c.Jointdegenerationinvolvesovergrowthofboneatthearticularends.d.Jointdegenerationaffectsmostlynon-weight-bearingjoints.ANS:CCanadianFundamentalsofNursing7thEditionPotterTestBankJointdegeneration,whichcanoccurwithinflammatoryandnoninflammatorydisease,ismarkedbychangesinarticularcartilagecombinedwithovergrowthofboneatthearticularends.Degenerativechangescommonlyaffectweight-bearingjoints.DIF:UnderstandREF:837OBJ:Discussphysiologicalandpathologicalinfluencesonbodyalignmentandjointmobility.TOP:AssessmentMSC:CPNRE:FoundationsofPractice4.Thenurseisprovidingcaretoapatientwhoisbedridden.Toavoidbecomingfatigued,thenurseraisestheheightofthepatientsbed.Thenurseunderstandsthatraisingthebedhelpsmaintainbalanceinwhatway?a.Itpreventsashiftinthenursesbaseofsupport.b.Itnarrowsthenursesbaseofsupport.c.Itallowsthenursetobringhisorherfeetclosetogether.d.Itshiftsthecentreofgravityfartherawayfromthenursesbaseofsupport.ANS:AByraisingtheheightofthebedwhenperformingaprocedure,thenurseavoidsbendingtoofaratthewaistandcausingashiftinthebaseofsupport.Balanceismaintainedbymaintainingproperbodyalignmentandposturethroughtwosimpletechniques:First,thebaseofsupportiswidenedbyseparatingthefeettoacomfortabledistance;second,balanceisincreasedbybringingthecentreofgravityclosertothebaseofsupport.DIF:UnderstandREF:841OBJ:Discussphysiologicalandpathologicalinfluencesonbodyalignmentandjointmobility.TOP:AssessmentMSC:CPNRE:FoundationsofPractice5.ApproximatelywhatpercentaNgUeRofSaIllNbaGcTkBpa.inCiOsaMssociatedwithmanualliftingtasks?a.Morethan10%.b.Morethan20%.c.Morethan40%.d.Morethan50%.ANS:DMorethanhalfofallcasesofbackpainareassociatedwithmanualliftingtasks.DIF:RememberREF:859OBJ:Describehowtomaintainanduseproperbodymechanics.TOP:AssessmentMSC:CPNRE:FoundationsofPractice6.Thenurseispreparingtopositionanimmobilepatient.Beforedoingso,thenursemustunderstandwhichofthefollowing?a.Manualliftingistheeasiermethodandshouldbetriedfirst.b.Followingbodymechanicsprinciplesalonewillpreventbackinjury.c.Bodymechanicscanbeignoredwhenpatient-handlingequipmentisused.d.Bodymechanicsalonearenotsufficienttopreventinjuries.ANS:DCanadianFundamentalsofNursing7thEditionPotterTestBankUSNTOBodymechanicsalonearenotsufficienttopreventmusculoskeletalinjurieswhenpositioningortransferringpatients.Theuseofpatient-handlingequipmentincombinationwithproperbodymechanicsismoreeffectivethaneitheroneinisolation.Bodymechanicscannotbeignoredevenwhenpatient-handlingequipmentisbeingused.Manualliftingisthelastresort,anditisusedonlywhenitdoesnotinvolveliftingmostorallofthepatientsweight.DIF:UnderstandREF:859OBJ:Describehowtouseproperbodymechanicsandergonomicstopreventmusculoskeletalinjuries.TOP:AssessmentMSC:CPNRE:FoundationsofPractice7.Thenurseispreparingtorepositionapatient.Beforedoingso,whatmustthenursedo?a.Assesstheweighttobeliftedandtheassistanceneeded.b.Attempttomanuallyliftthepatientalonebeforeaskingforassistance.c.Attemptamanualliftonlywhenliftingmostorallofthepatientsweight.d.Notusetheagencyliftteamifamechanicalliftisavailable.ANS:ABeforelifting,thenurseassessestheweighttobeliftedanddeterminestheassistanceneededandtheresourcesavailable.Manualliftingisthelastresort,anditisusedwhenthetaskathanddoesnotinvolveliftingmostorallofthepatientsweight.Safepatient-handlingequipmentshouldbeusedinconjunctionwithagencyliftteamstoreducetheriskofinjurytothepatientandmembersofthehealthcareteam.DIF:ApplyREF:859OBJ:Describehowtomaintainanduseproperbodymechanics.TOP:ImplementationMSC:CPNRE:FoundationsofPractice8.Isotonic,isometric,andresisNtiveRisomIetrGicaBre.thCreeMcategoriesofexercise.Theyareclassifiedaccordingtothetypeofmusclecontractioninvolved.Ofthefollowingexercises,whichareconsideredisotonic?a.Bicycling,swimming,walking,jogging,dancing.b.Tighteningortensingofmuscleswithoutmovingbodyparts.c.Push-ups,hiplifting,pushingfeetagainstafootboardonthebed.d.Quadricepssetexercisesandcontractionoftheglutealmuscles.ANS:AExamplesofisotonicexercisesarewalking,swimming,danceaerobics,jogging,bicycling,andmovingarmsandlegswithlightresistance.Isometricexercisesinvolvetighteningortensingofmuscleswithoutmovingbodyparts.Examplesincludequadricepssetexercisesandcontractionoftheglutealmuscles.Examplesofresistiveisometricexercisesarepush-upsandhiplifting,aswellaspushingagainstafootboardatthefootofthebedwiththefeet.DIF:RememberREF:834OBJ:Describethebenefitsofimplementinganexerciseprogramforthepurposeofhealthpromotion.TOP:AssessmentMSC:CPNRE:FoundationsofPractice9.Inplanningaphysicalactivityprogramforapatient,whatmustthenurseunderstand?a.Isotonicexercisescausecontractionwithoutchangingmusclelength.b.Thebestprogramincludesacombinationofexercises.c.Isometriccontractioninvolvesthemovementofbodyparts.d.Resistiveisometricexercisescanleadtobonewasting.CanadianFundamentalsofNursing7thEditionPotterTestBankANS:BThebestprogramofphysicalactivityincludesacombinationofexercisesthatproducedifferentphysiologicalandpsychologicalbenefits.Isotonicexercisescausemusclecontractionsandchangesinmusclelength.Isometricexercisesinvolvetighteningortensingofmuscleswithoutmovingbodyparts.Resistiveisometricexerciseshelppromotemusclestrengthandprovidesufficientstressagainstbonetopromoteosteoblasticactivity.DIF:UnderstandREF:834OBJ:Describethebenefitsofimplementinganexerciseprogramforthepurposeofhealthpromotion.TOP:AssessmentMSC:CPNRE:FoundationsofPractice10.Anactivelifestyleisimportantformaintainingandpromotinghealth.Indevelopinganexerciseprogram,whatshouldthenurseknow?a.Physicalexerciseiscontraindicatedforpatientswithchronicillnesses.b.Regularphysicalactivityisbeneficialonlyforthebodypartthatisexercised.c.Physicalexercisehasnoeffectonpsychologicalwell-being.d.Physicalactivityenhancesfunctioningofallbodysystems.ANS:DRegularphysicalactivityandexerciseenhancethefunctioningofallbodysystems,includingcardiopulmonaryfunctioning,musculoskeletalfitness,weightcontrolandmaintenance,andpsychologicalwell-being.Itisalsoessentialintreatmentofchronicillness.DIF:UnderstandREF:834OBJ:Describethebenefitsofimplementinganexerciseprogramforthepurposeofhealthpromotion.TOP:AssessmentMSC:CPNRE:FoundationsofPractice11.ThenurseisdevelopinganeNxeUrcRisSeIprNogGraTmBf.oCroldMerpatientslivinginanursinghome.Todevelopabeneficialhealthpromotionprogram,whatmustthenurseneedtounderstandaboutolderpeople?a.Exerciseisofverylittlebenefitbecausethepatientsareold.b.Itisimportanttodisregardtheircurrentinterestsinfavourofexercise.c.Nophysicalbenefitcanbegainedwithoutaformalexerciseprogram.d.Adjustmentstoexerciseprogramsmayhavetobemadetopreventproblems.ANS:DExerciseisextremelybeneficialforolderpersons,butadjustmentstoanexerciseprogrammayhavetobemadeforthoseofadvancedagetopreventproblems.Whendevelopinganexerciseprogramforanyolderperson,thenurseshouldconsidernotonlythepersonscurrentactivitylevel,rangeofmotion,musclestrengthandtone,andresponsetophysicalactivity,butalsothepersonsinterests,capacities,andlimitations.Olderpersonswhoareunabletoparticipateinaformalexerciseprogramareabletoachievethebenefitsofimprovedjointmobilityandenhancedcirculationbysimplystretchingandexaggeratingmovementsduringperformanceofroutineactivitiesofdailyliving.DIF:UnderstandREF:849|860OBJ:Describeimportantfactorstoconsiderwhenplanninganexerciseprogramforpatientsacrossthelifespanandforthosewithspecificchronicillnesses.TOP:AssessmentMSC:CPNRE:FoundationsofPracticeCanadianFundamentalsofNursing7thEditionPotterTestBankNRIGB.C12.Thenurseisattemptingtostartanexerciseprograminalocalcommunityasahealthpromotionproject.Inexplainingthepurposeoftheproject,whatdoesthenurseexplaintocommunityleaders?a.Asedentarylifestylecontributestothedevelopmentofhealth-relatedproblems.b.Therecommendedfrequencyofworkoutsshouldbetwiceaday.c.Anexerciseprescriptionshouldincorporateaerobicexerciseonly.d.Thepurposeofweighttrainingistobulkupmuscles.ANS:AAsedentarylifestylecontributestothedevelopmentofhealth-relatedproblems.Aholisticapproachistakentodevelopoverallfitnessandincludeswarm-ups,aerobicexercise,resistancetraining,weighttraining,andsoforth.Therecommendedfrequencyofaerobicexerciseisthreetofivetimesperweekoreveryotherdayforapproximately30minutes.Cross-trainingisrecommendedforthepatientwhopreferstoexerciseeveryday.Somepatientsuseweighttrainingtobulkuptheirmuscles.However,thepurposesofweighttrainingfromahealthperspectivearetodeveloptoneandstrengthandtosimulateandmaintainhealthybone.DIF:UnderstandREF:856OBJ:Describethebenefitsofimplementinganexerciseprogramforthepurposeofhealthpromotion.TOP:AssessmentMSC:CPNRE:FoundationsofPractice13.Thepatientiseagertobeginhisexerciseprogramwitha3.2-km(2-mile)jog.Thenurseinstructsthepatienttowarmupwithstretchingexercises.Thepatientstatesthatheisreadyanddoesnotwanttowastetimewithawarm-up.Whatdoesthenurseexplainaboutthewarm-up?a.Itallowsthebodytoreadjustgraduallytobaselinefunctioning.b.ItpreparesthebodyanddeUcreaSsesNtheTpotentiOalforinjury.c.Itshouldnotinvolvestretchingexercisesbecausetheycanleadtoinjury.d.Itshouldbeperformedwithhighintensitytoprepareforthecomingchallenge.ANS:BThewarm-upactivitypreparesthebodyforactivityanddecreasesthepotentialforinjury.Itusuallylastsabout5to10minutesandmayincludestretching,calisthenics,oraerobicactivity,oracombinationofthese,performedatalowintensity.Thecool-downperiodallowsthebodytoreadjustgraduallytobaselinefunctioningandprovidesanopportunitytocombinemovementsuchasstretchingwithrelaxation-enhancingmind-bodyawareness.DIF:UnderstandREF:856OBJ:Describethebenefitsofimplementinganexerciseprogramforthepurposeofhealthpromotion.TOP:AssessmentMSC:CPNRE:FoundationsofPractice14.Manypatientsfinditdifficulttoincorporateanexerciseprogramintotheirdailylivesbecauseoftimeconstraints.Forthesepatients,itisbeneficialtoreinforcethatmanyactivitiesofdailyliving(ADLs)areusedtoaccumulatetherecommended30minutesormoreperdayofmoderate-intensityphysicalactivity.Wheninstructingthesepatients,whatshouldthenurseexplain?a.Houseworkisnotconsideredanaerobicexercise.b.Tostrengthenbackmuscles,thepatientshouldbendusingbackmuscles.c.Dailychoresshouldbeginwithgentlestretches.d.Thepatientshouldsticktoonechoreuntilitisdonebeforebeginninganewone.CanadianFundamentalsofNursing7thEditionPotterTestBankNURSINGTB.CMOANS:CDailychoresshouldbeginwithgentlestretches.Houseworkisconsideredaerobicexercise.Tomakeitmoreaerobic,thepersoncanworkfasterandscrubharder.Topreventbackinjury,peopleshouldbendtheirlegsratherthantheirback.Cleaningactivitiesshouldbealternatedtopreventoverworkingthesamemusclegroups.DIF:UnderstandREF:856OBJ:Describeimportantfactorstoconsiderwhenplanninganexerciseprogramforpatientsacrossthelifespanandforthosewithspecificchronicillnesses.TOP:AssessmentMSC:CPNRE:FoundationsofPractice15.Thenurseisdevelopinganexerciseplanforsomeonewithadiagnosisofheartfailureandexerciseintolerance.Indoingso,whatshouldthenurseinclude?a.Planfor20minutesofcontinuousaerobicactivityandincreaseastolerated.b.Perform5-minutewalksatthepatientspaceatleast2timesaday.c.Instructthepatientthatheshouldnottakehisbetablockermedicationonexercisedays.d.Encourageahigh-caloriediettoplanforextracalorieexpenditure.ANS:BApatientwiththediagnosisofexerciseintoleranceshouldbeginbyperforming5-minutewalksathisownpaceatleasttwiceaday.Suchapatientwouldnotbeabletotolerate20minutesofcontinuousaerobicactivity.Patientsshouldbeinstructedtotakemedicationsasordered.Low-calorie,low-sodium,andhigh-proteindietsarebestforpatientswithexerciseintolerance.DIF:ApplyREF:857OBJ:Describeimportantfactorstoconsiderwhenplanninganexerciseprogramforpatientsacrossthelifespanandforthosewithspecificchronicillnesses.TOP:ImplementationMSC:CPNRE:FoundationsofPractice16.Whichofthefollowingexerciseactivitieswouldprobablyprovidetheopportunityformind-bodyawareness?a.Warm-upactivity.b.Resistancetraining.c.Aerobicexercise.d.Cool-downactivity.ANS:DThecool-downperiodallowsthebodytoreadjustgraduallytobaselinefunctioningandprovidesanopportunitytocombinemovementsuchasstretchingwithrelaxation-enhancingmind-bodyawareness.Thewarm-upactivitypreparesthebodyanddecreasesthepotentialforinjury.Aerobicexerciseincludesrunning,bicycling,andjumpingropeandisthemainportionofexerciseactivity;itprecedesthecool-downperiod.Resistancetrainingincreasesmusclestrengthandenduranceandisassociatedwithimprovedperformanceofdailyactivitiesbutnotwithenhancingmind-bodyawareness.DIF:AnalyzeREF:860OBJ:Describeimportantfactorstoconsiderwhenplanninganexerciseprogramforpatientsacrossthelifespanandforthosewithspecificchronicillnesses.TOP:EvaluateMSC:CPNRE:FoundationsofPracticeCanadianFundamentalsofNursing7thEditionPotterTestBankNRIG17.Thepatientisbroughttotheemergencydepartmentwithpossibleinjurytohisshoulder.Tohelpdeterminethedegreeofinjury,whatshouldthenurseevaluate?a.Thepatientsgait.b.Thepatientsrangeofmotion.c.Finemotorcoordination.d.Activitytolerance.ANS:BEvaluatingrangeofmotionisoneassessmenttechniqueusedtodeterminethedegreeofdamageorinjurytoajoint.Gaitisthemannerorstyleofwalking;itmayhavelittlebearingontheshoulderdamage.Assessingfinemotorcoordinationwouldbebeneficialinhelpingtoassessthepatientsabilitytoperformtasksbutwouldnothelpinevaluatingtheshoulder.Activitytolerancereferstothetypeandamountofexerciseoractivityapersonisabletoperform.Damagetotheshoulderwouldaffectactivitytolerance,butthedegreeofactivityintolerancewouldnothelpassessthedamagedonetotheshoulder.DIF:ApplyREF:854OBJ:Describehowtoassesspatientsforactivityintolerance.TOP:ImplementationMSC:CPNRE:FoundationsofPractice18.Thenurseisexaminingapatientwhoisattheclinicwithsevereelbowpain.Ofthefollowingsituations,whichwouldcausethenursetosuspectaligamenttearorjointfracture?a.Rangeofmotionoftheelbowislimited.b.Jointmotionisgreaterthannormal.c.Thepatienthasarthritis.d.Theelbowcannotbemoved(frozen).B.CMANS:BUSNTOIncreasedmobility(beyondnormal)ofajointmayindicateconnectivetissuedisorders,ligamenttears,orpossiblejointfractures.Limitedrangeofmotionoftenindicatesinflammationsuchasarthritis,fluidinthejoint,alterednervesupply,orcontractures(frozenjoints).DIF:AnalyzeREF:854OBJ:Describehowtoassesspatientsforactivityintolerance.TOP:EvaluateMSC:CPNRE:FoundationsofPractice19.Thepatienthasbeenbedriddenforseveralmonthsowingtosevereheartdisease.Indeterminingaplanofcareforthispatientthatwilladdresshisactivitylevel,thenurseformulateswhichofthefollowingnursingdiagnoses?a.Fatiguerelatedtopoorphysicalcondition.b.Impairedgasexchangerelatedtodecreasedcardiacoutput.c.Decreasedcardiacoutputrelatedtodecreasedmyocardialcontractility.d.Activityintolerancerelatedtophysicaldeconditioning.ANS:DCanadianFundamentalsofNursing7thEditionPotterTestBankNRIGB.CMWhenactivityandexerciseareproblemsforapatient,nursingdiagnosesoftenfocusontheindividualsabilitytomove.Thediagnosticlabeldirectsnursinginterventions.Inthiscase,physicaldeconditioningmustbeaddressedinrelationtoactivitylevel;perhapsanearlygoalis6-minutewalkstwiceaday.Physicaldeconditioningisthecauseoffatigueaswell,soitwouldtakepriorityoverthediagnosisofFatiguerelatedtopoorphysicalcondition.Decreasedcardiacoutputandmyocardialcontractilityareseriousconcernsthatmustbeaddressedbeforeactivityintolerancetokeepthepatientsafeandtohelpdeterminethelevelofexercisethatthepatientcantolerate,butreconditioningofthepatientsbodywillhelpimprovecontractilityandcardiacoutput.DIF:ApplyREF:833|837OBJ:Developanursingcareplanforapatientwithimpairedmobilityandactivityintolerance.TOP:ImplementationMSC:CPNRE:FoundationsofPractice20.Thepatientweighs204.5kg(450pounds)andcomplainsofshortnessofbreathwithanyexertion.Hishealthcareproviderhasrecommendedthathebeginanexerciseprogram.Hestatesthathecanhardlygetoutofbedandjustcannotdoanythingaroundthehouse.Tofocusonthecauseofthepatientsproblems,thenursedeviseswhichofthefollowingnursingdiagnoses?a.Activityintolerancerelatedtoexcessiveweight.b.Activityintolerancerelatedtobedrest.c.Impairedgasexchangerelatedtoshortnessofbreath.d.Imbalancednutrition:lessthanbodyrequirements.ANS:AThediagnosticlabeldirectsnursinginterventions.Thisrequiresthecorrectselectionofrelatedfactors.Forexample,ActivityintolerancerelatedtoexcessweightnecessitatesverydifferentinterventionsthaniftherelatedUfacStorNispTrolongeOdbedrest.Inthiscase,theintoleranceisrelatedtothepatientsexcessiveweight.Heisnotonbedrest,althoughitisdifficultforhimtogetoutofbed.Shortnessofbreathisasymptom,notacause,ofImpairedgasexchange,andsothisnursingdiagnosisisnotapplicable.Thepatientdoeshaveanimbalanceofnutrition,butitismorethanbodyrequirements.DIF:ApplyREF:855OBJ:Developanursingcareplanforapatientwithimpairedmobilityandactivityintolerance.TOP:ImplementationMSC:CPNRE:FoundationsofPractice21.Topromoteresistiveisometricexercise,thenursehelpsthepatientonbedrestbyencouragingwhichoneofthefollowing?a.Quadricepssetting.b.Glutealmusclecontraction.c.Movingthearmsandlegsincircles.d.Pushingagainstafootboard.ANS:DInresistiveisometricexercises,theindividualcontractsthemusclewhilepushingagainstastationaryobjectorresistingthemovementofanobject.Anexampleofaresistiveisometricexerciseispushingagainstafootboard.Quadricepssettingandglutealmusclecontractionareexamplesofisometricexercise.Movingthearmsandlegsinacircleisanexampleofisotonicexercise.CanadianFundamentalsofNursing7thEditionPotterTestBankUSNTODIF:ApplyREF:834OBJ:Developanursingcareplanforapatientwithimpairedmobilityandactivityintolerance.TOP:ImplementationMSC:CPNRE:FoundationsofPractice22.Thepatientisadmittedwithastroke.Theprognosisisuncertain,butthepatientisunabletomovehisrightarmandleg.Whatshouldthenursekeepinmind?a.Activerangeofmotionistheonlythingthatwillpreventcontracturesfromforming.b.Passiverangeofmotionmustbeinstitutedtohelppreventcontractureformation.c.Range-of-motionexercisesshouldbestarted2daysafterthepatientisstable.d.Range-of-motionexercisesshouldbedoneonmajorjointsonly.ANS:BWhenpatientscannotparticipateinactiverangeofmotion,passiverangeofmotionmustbeinstitutedtomaintainjointmobilityandpreventcontractures.Passiverange-of-motionexercisescanbesubstitutedforactiveexerciseswhenneeded.Forthepatientwhodoesnothavevoluntarymotorcontrol,passiverange-of-motionexercisesaretheexercisesofchoice.Unlesscontraindicated,thenursingcareplanincludesexercisingeachjoint(notjustmajorjoints)throughasnearlyafullrangeofmotionaspossible.Thenurseshouldinitiatepassiverange-of-motionexercisesassoonasthepatientlosestheabilitytomovetheextremityorjoint.DIF:UnderstandREF:838|861OBJ:Describetheinterventionsformaintainingactivitytoleranceandmobilityduringtheacute,restorative,andcontinuingcareofpatients.TOP:AssessmentMSC:CPNRE:FoundationsofPractice23.A40-year-oldhealthywomaNnhaRsprIesenGtedBt.oCthecMlinicforaphysicalexamination.Whenthepatientasksthenursetorecommendtheamountoftimesheshouldspendperweekdoingmoderate-intensityphysicalactivity,whatshouldthenurserecommend?a.Onehourperweekor15minutesadayforfourdays.b.Thirtyminutesormoreaday,foraweeklytotalof150minutes.c.Onehourperday,foraweeklytotalofsevenhours.d.Tenminutesaday,foratotalof60minutesperweek.ANS:BAccordingtotheCanadianDiabetesAssociation,adultsshouldaccumulate150minutesormoreperweekofmoderate-intensity(brisk)physicalactivity.Neither1hourperweek,or15minutesadayforfourdays,nor10minutesadayforatotalof1hourperweekisconsideredanadequateamountoftimeforexerciseforadults.Onehourperday,foraweeklytotalof7hoursexceedstherecommendedamountoftimeforexerciseforadults,butthestatementdoesnotspecifytheintensityofthephysicalactivity.DIF:ApplyREF:862,Table36-3OBJ:Describetheinterventionsformaintainingactivitytoleranceandmobilityduringtheacute,restorative,andcontinuingcareofpatients.TOP:ImplementationMSC:CPNRE:FoundationsofPractice24.Thenurseisambulatingapatientinthehallwhenshenoticesthatheisbeginningtofall.Whatshouldthenursedo?a.Grabthepatientandholdhimtighttopreventthefall.CanadianFundamentalsofNursing7thEditionPotterTestBankUSNTb.Gentlylowerthepatienttothefloor.c.Jumpbackandletthepatientfallnaturally.d.Pushthepatientagainstthewallandguidehimtothefloor.ANS:BIfthepatienthasafaintingepisodeorbeginstofall,thenurseshouldassumeawidebaseofsupportwithonefootinfrontoftheother,thussupportingthepatientsbodyweight.Thenthenurseextendsoneleg,letsthepatientslideagainsttheleg,andgentlylowersthepatienttothefloor,protectingthepatientshead.Grabbingthepatientwillshiftthenursescentreofgravityandmayleadtoabackinjury.Allowingthepatienttofallcouldleadtoheadinjuryforthepatient.Pushingthepatientagainstthewallcouldalsocausethepatienttohithisheadandcauseinjury.DIF:ApplyREF:862OBJ:Describehowtouseproperbodymechanicsandergonomicstopreventmusculoskeletalinjuries.TOP:ImplementationMSC:CPNRE:FoundationsofPractice25.Inassistingthepatienttoexercise,whichofthefollowingshouldthenursedo?a.Expectthatpainwilloccurwithexerciseofunusedmusclegroups.b.Setthepacefortheexerciseclass.c.Forcemusclesorjointstogojustbeyondresistance.d.Stoptheexerciseifpainisexperienced.ANS:DThenurseshouldassessforpain,shortnessofbreath,orachangeinvitalsigns.Ifanyoftheseispresent,theexerciseshouldbestopped.Eachpatientshouldbeallowedtoexerciseathisorherownpace.ThenurseasseNssesRforIjoiGntliBm.itCationsandmustnotforceamuscleorajointduringexercise.DIF:ApplyREF:860OBJ:Describetheinterventionsformaintainingactivitytoleranceandmobilityduringtheacute,restorative,andcontinuingcareofpatients.TOP:ImplementationMSC:CPNRE:FoundationsofPractice26.Thenurseisdevelopingaplanofcareforapatientwithadiagnosisofactivityintolerance.Ofthefollowingstrategies,whichhasthebestchanceofmaintainingpatientcompliance?a.Performing20minutesofaerobicexercisedailywith10-minutewarm-upandcool-downperiods.b.Instructingthepatienttouseanexerciselogtorecordday,time,duration,andresponsestoexerciseactivity.c.Instructingthepatientontheevilsofnotexercising,andgettinghertotakeresponsibilityforhercurrenthealthstatus.d.Arrangingforthepatienttojoinagymforwhichshewillhavetopay,sothatshedoesnotneedtodependoninsurance.ANS:BCanadianFundamentalsofNursing7thEditionPotterTestBankKeepingalogmayincreaseadherencetoanexerciseprescription.Cross-training(combinationofexerciseactivities)providesvarietytocombatboredomandincreasesthepotentialfortotalbodyconditioningasopposedtodailyaerobicexercise.Blamingapatientforhisorherhealthstatusisusuallycounterproductive.Instead,thenurseshouldinstructthepatientaboutthephysiologicalbenefitsofaregularexerciseprogram.Developingaplanofexercisethatthepatientmayperformathomemayimprovecompliance.DIF:EvaluateREF:858OBJ:Evaluatethenursingcareplanformaintainingactivityandexerciseforpatientsacrossthelifespanandwithspecificchronicillnesses.TOP:EvaluateMSC:CPNRE:FoundationsofPractice27.Thenurseisworkingwiththepatientindevelopinganexerciseplan.Thepatienttellsthenursethatshejustwillnotparticipateinaformalexerciseprogram.Thenursethensuggeststhatexerciseactivitiescanbeincorporatedintoactivitiesofdailyliving(ADLs).Thepatientseemstobeagreeabletothatconcept.Ofthefollowingactivities,whichwouldbeconsideredaformalresistancetrainingactivity?a.Doinglaundry.b.Makingthebed.c.Ironing.d.Kneadingbread.ANS:DFormalresistancetrainingincludesweighttraining,butthesamebenefitscanbeobtainedbyperformingADLssuchaspushingavacuumcleaner,rakingleaves,shovellingsnow,andkneadingbread.DIF:EvaluateREF:85N6URSINGTB.COMOBJ:Evaluatethenursingcareplanformaintainingactivityandexerciseforpatientsacrossthelifespanandwithspecificchronicillnesses.TOP:EvaluateMSC:CPNRE:FoundationsofPractice28.Bonesperformfivefunctionsinthebody:support,protection,movement,mineralstorage,andhematopoiesis.Inbodymechanics,whichfunctionsarethemostimportant?a.Supportandmovement.b.Protectionandmineralstorage.c.Supportandhematopoiesis.d.Supportandprotection.ANS:ABonesperformfivefunctionsinthebody:support,protection,movement,mineralstorage,andhematopoiesis.Inbodymechanics,twoofthesefunctionssupportandmovementaremostimportant.Insupport,bonesserveastheframeworkandcontributetotheshape,alignment,andpositioningofbodyparts.Inmovement,bones,togetherwiththeirjoints,constituteleversformuscleattachment.Asmusclescontractandshorten,theypullonbones,producingjointmovement.Protectioninvolvesencasingthesofttissueorgansinaprotectivecage.Mineralstoragehelpstostrengthenbonesbutalsohelpsregulatebloodlevelsofcertainnutrients.Hematopoiesisistheformationofbloodcells.DIF:RememberREF:834OBJ:DescribetheroleofthemusculoskeletalandnervoussystemsintheregulationofactivityandCanadianFundamentalsofNursing7thEditionPotterTestBankexercise.TOP:AssessmentMSC:CPNRE:FoundationsofPractice29.Thestudentisplanningtoassesstheactivitytoleranceofapatient.Thenursinginstructorwouldneedtoprovidefurtherinstructiontothestudentwhoplansevaluatewhichoneofthefollowing?a.Emotionalfactors.b.Age.c.Pregnancystatus.d.Race.ANS:DFactorsinfluencingactivitytoleranceincludephysiologicalfactorssuchasskeletalabnormalities,emotionalfactorssuchasanxiety/depression,developmentalfactorssuchasageandgender,andpregnancystatus.Raceisnotafactorbecausepeopleofallracesarefacedwithsimilarfactorsthataffecttheiractivitytolerance.DIF:ApplyREF:854,Box36-7OBJ:Describehowtoassesspatientsforactivityintolerance.TOP:ImplementationMSC:CPNRE:FoundationsofPracticeNURSINGTB.COMCanadianFundamentalsofNursing7thEditionPotterTestBankChapter37:QualityandPatientSafetyPotteretal:CanadianFundamentalsofNursing,7thEditionMULTIPLECHOICE1.Ahomehealthnurseisperformingahomeassessmentforsafety.Whichofthefollowingcommentsbythepatientwouldindicateaneedforfurthereducation?a.Iwillscheduleanappointmentwithachimneyinspectornextweek.b.Daylightsavingsisthetimetochangebatteriesonthecarbonmonoxidedetector.c.IfIfeeldizzywhenusingtheheater,Ineedtohaveitinspected.d.IfImcookingforonlymyself,Idontneedtowashmyhands.ANS:DNursesshouldteachbasictechniquesforsafefoodhandling,suchashandwashingandcheckingspoilage.Handwashingshouldbedonebeforeallfoodpreparation.Checkingthechimneyandheater,changingthebatteriesonthedetector,andfollowinguponsymptomssuchasdizziness,nausea,andfatigueareallstatementsthatwouldindicatethattheindividualhasunderstoodtheeducation.DIF:ApplyREF:875OBJ:Discussmethodstopreventandreducesafetyrisks.TOP:EvaluateMSC:CPNRE:FoundationsofPractice2.Thenurseiscaringforanelderlypatientadmittedwithnausea,vomiting,anddiarrhea.Uponcompletingthehealthhistory,whichpriorityconcernwouldrequirecollaborationwithsocialservicestoaddressthepatienNtUshReSalIthNcGarTeBne.edCsO?a.Theelectricitywasturnedoff2daysago.b.Thewatercomesfromthecountywatersupply.c.Asonandfamilyrecentlymovedintothehome.d.Thehomeisnotfurnishedwithamicrowaveoven.ANS:AElectricityisneededforrefrigerationoffood,andlackofelectricitycouldhavecontributedtothenausea,vomiting,anddiarrheabypotentiallyleadingtofoodpoisoning.Thisdiscussionaboutthepatientselectricalneedscanbereferredtosocialservices.Thewatersupply,theincreasednumberofindividualsinthehome,andnothavingamicrowavemayormaynotbeconcernsbutdonotpertaintothecurrenthealthcareneedsofthispatient.DIF:UnderstandREF:888OBJ:Discussmethodstopreventandreducesafetyrisks.TOP:ImplementationMSC:CPNRE:FoundationsofPractice3.Ahomelessadultpatientpresentstotheemergencydepartment.Thenurseobtainsthefollowingvitalsigns:temperature34.9C(94.8F),bloodpressure100/56,apicalpulse56,respiratoryrate12.Whichofthevitalsignsshouldbeaddressedimmediately?a.Respiratoryrateb.Temperaturec.Apicalpulsed.BloodpressureCanadianFundamentalsofNursing7thEditionPotterTestBankNRIGB.CANS:BHypothermiaisdefinedasacorebodytemperatureof35C(95F)orbelow.Homelessindividualsaremoreatriskforhypothermiaowingtoexposuretotheelements.DIF:ApplyREF:888OBJ:Describeassessmentactivitiesdesignedtoidentifypatientsphysical,psychosocial,andcognitivestatusesastheypertaintohisorhersafety.TOP:AssessmentMSC:CPNRE:FoundationsofPractice4.AnambulatorypatientisadmittedtotheextendedcarefacilitywithadiagnosisofAlzheimersdisease.IntheHendrichIIFallRiskModel,whatisthemostsignificantindicatorofriskforfalls?a.Confusion/disorientation/impulsivityb.Dizziness/vertigoc.Symptomaticdepressiond.AlteredeliminationANS:AAccordingtotheHendrichIIFallRiskModel,themostsignificantindicatorofriskforfallsisconfusion/disorientation/impulsivity.Dizziness/vertigo,symptomaticdepression,andalteredeliminationarealsoriskfactors;however,theyarenotthemostsignificantindicators.DIF:RememberREF:879,Table37-1OBJ:Describenursinginterventionsspecifictopatientsageforreducingsafetyrisks.TOP:ImplementationMSC:CPNRE:FoundationsofPractice5.A1-year-oldchildisscheduledtoreceiveanintravenous(IV)line.ThemostappropriatetypeofrestrainttouseforthispatieUnttoSpreNvenTtremovOaloftheIVlineiswhichofthefollowing?a.Awristrestraint.b.Ajacketrestraint.c.Anelbowrestraint.d.Amummyrestraint.ANS:DAmummyrestraintisusedintheshorttermforasmallchildorinfantforexaminationortreatmentinvolvingtheheadandneck.Thiswouldbethemostappropriatetypeofrestrainttousefora1-year-oldwhoisgoingtoreceiveanIVline.Thewristrestraintmaintainsimmobilityofanextremitytopreventthepatientfromremovingatherapeuticdevice,suchasanIVtube.ItwouldnotbethebestchoiceforstartinganIVona1-year-old.Thejacketrestraintisoftenusedtopreventapatientfromgettingupandfalling.This,too,isnotthebestchoiceforstartinganIVline.Anelbowrestraintiscommonlyusedwithinfantsandchildrentopreventelbowflexion,asincasesinwhichanIVlineisalreadyinplace.DIF:ApplyREF:894OBJ:Describenursinginterventionsspecifictopatientsageforreducingsafetyrisks.TOP:ImplementationMSC:CPNRE:FoundationsofPractice6.AvisitingnursecompletesanassessmentoftheambulatorypatientinthehomeanddeterminesthenursingdiagnosisofRiskforinjuryrelatedtodecreasedvision.Onthebasisofthisassessment,thepatientwillbenefitthemostfromwhichofthefollowingactions?a.InstallingfluorescentlightingthroughoutthehouseCanadianFundamentalsofNursing7thEditionPotterTestBankb.Evaluatingtheneedtorepositionfurniturec.Maintainingcompletebedrestinahospitalbedwithsiderailsd.ApplyingphysicalrestraintsANS:BEvaluatingthepositioningoffurnitureintheroomandstairwaysisthebestinterventiontohelppreventfallsforthepatientwithdecreasedvision.Attemptsshouldbemadetoreduceglare.Lightbulbsthatare60Worlessmaybeincreasedto75Wnonglaretohelpimprovevisibility.Thebestinterventiontopreventfallsisfirsttoorientthepatienttothesurroundings.Maintainingcompletebedrestisnotthebestoption.Completebedrestcancauseotherhealthproblemsbecauseofalackofmobility.Thepatientshouldnotberestrainedforpoorvision.Attemptsshouldbemadetohelpcompensateforthedecreasedvisiontopreventfalls.DIF:AnalyzeREF:879OBJ:Describenursinginterventionsspecifictopatientsageforreducingsafetyrisks.TOP:DiagnosisMSC:CPNRE:FoundationsofPractice7.Whenteachingaparentaboutinterventionsforaccidentalpoisoning,whatinstructionshouldbeincludedregardingflushingachildseye,inrelationtothewatertemperature?a.Coldb.Lukewarmc.Roomtemperatured.AboveroomtemperatureANS:CThenurseshouldteachtheparentthataneyeflushistobedonewithwateratroomtemperature.Thewaterforaneyeflushisnottobecold,lukewarm,oraboveroomtemperature.NURSINGTB.COMDIF:ApplyREF:885,Box37-8OBJ:Describenursinginterventionsspecifictopatientsageforreducingsafetyrisks.TOP:ImplementationMSC:CPNRE:FoundationsofPractice8.Thenurseknowsthatchildreninlateinfancyandtoddlerhoodareatriskforinjuryfromwhichofthefollowing?a.Learningtowalk.b.Tryingtopulluponfurniture.c.Beingdroppedbyacaregiver.d.Growingabilitytoexploreandoralactivity.ANS:DInjuryisaleadingcauseofdeathinchildrenoverage1,whichiscloselyrelatedtonormalgrowthanddevelopmentbecauseofthechildsincreasedoralactivityandgrowingabilitytoexploretheenvironment.DIF:UnderstandREF:883OBJ:Discussmethodstopreventandreducesafetyrisks.TOP:EvaluateMSC:CPNRE:FoundationsofPractice9.Anurseisteachingacommunitygroupofschool-agedparentsaboutsafety.Themostimportantitemtoprioritizeandexplainishowtochecktheproperfitofwhichoneofthefollowing?CanadianFundamentalsofNursing7thEditionPotterTestBanka.Abicyclehelmet.b.Swimminggoggles.c.Soccershinguards.d.Baseballslidingshorts.ANS:ABicycle-relatedinjuriesareamajorcauseofdeathanddisabilityamongchildren.Properfitofthehelmethelpstodecreaseheadinjuriesresultingfrombicycleaccidents.Goggles,shinguards,andslidingshortsareimportantsportssafetyequipmentandshouldfitproperly,buttheydonotprotectfromthisleadingcauseofdeath.DIF:UnderstandREF:886OBJ:Discussmethodstopreventandreducesafetyrisks.TOP:Implementation|Teaching|LearningMSC:CPNRE:FoundationsofPractice10.Thenurseispresentinganeducationalsessiononsafetyforparentsofadolescents.Thenurseshouldincludewhichofthefollowingteachingpoints?a.Adolescentsneedunsupervisedtimewithfriendstwotothreetimesaweek.b.Parentsandfriendsshouldteachadolescentshowtodrive.c.Adolescentsneedinformationabouttheeffectsofbeerontheliver.d.Adolescentsneedtoberemindedtouseseatbeltsonlongtrips.ANS:CProvidinginformationaboutdrugsandalcoholisimportantbecauseadolescentsmaychoosetoparticipateinrisk-takingbehaviours.Adolescentsneedtosocializebutneedsupervision.Parentscanencourageandsupportlearningprocessesassociatedwithdriving,butorganizedclassescanhelptodecreasemNoUtoRrSvIehNicGleTaBcc.idCenOtMs.Seatbeltsshouldbeusedallthetime.DIF:UnderstandREF:877OBJ:Discussmethodstopreventandreducesafetyrisks.TOP:ImplementationMSC:CPNRE:FoundationsofPractice11.Thenursediscussedthreatstoadultsafetywithacollegegroup.Whichofthefollowingstatementswouldindicateunderstandingofthetopic?a.Ourcampusissafe;weleaveourdormsunlockedallthetime.b.AslongasIhaveonlytwodrinks,Icanstillbethedesignateddriver.c.Iamyoung,soIcanworknightsandgotoschoolwith2hourssleep.d.Iguesssmokingevenatpartiesisnotgoodformybody.ANS:DLifestylechoicesfrequentlyaffectadultsafety.Smokingconveysgreatriskforpulmonaryandcardiovasculardisease.Itisprudenttosecurebelongings.Whenanindividualhasbeendeterminedtobethedesignateddriver,thatindividualmustnotconsumealcohol,beer,orwine.Sleepisimportant,regardlessoftheageoftheindividual,forrestandintegrationoflearning.Theaverageyoungadultneeds61/2to8hoursofsleepeachnight.DIF:UnderstandREF:877OBJ:Describenursinginterventionsspecifictopatientsageforreducingsafetyrisks.TOP:EvaluateMSC:CPNRE:FoundationsofPracticeCanadianFundamentalsofNursing7thEditionPotterTestBank12.Thenurseiscaringforahospitalizedpatient.Whichofthefollowingbehavioursalertsthenursetoconsidertheneedforrestraint?a.Thepatientrefusestocallforhelptogotothebathroom.b.Thepatientcontinuestoremovethenasogastrictube.c.Thepatientgetsconfusedregardingthetimeatnight.d.Thepatientdoesnotsleepandcontinuestoaskforitems.ANS:BRestraintsareutilizedonlywhenalternativeshavebeenexhausted,thepatientcontinuesabehaviourthatcanbeharmfultohimselforherselfortoothers,andtherestraintisclinicallyjustified.Inthiscircumstance,continuingtoremoveaneedednasogastrictubewouldmeetthesecriteria.Refusingtocallforhelp,althoughunsafe,isnotareasonforrestraint.Gettingconfusedatnightregardingthetimeisnotareasonforrestraint;norisnotsleepingandbotheringthestafftoaskforitems.DIF:UnderstandREF:888OBJ:Describemethodstoevaluateinterventionsdesignedtomaintainorpromotesafety.TOP:AssessmentMSC:CPNRE:FoundationsofPractice13.Thenurseisdiscussingwithapatientsphysiciantheneedforrestraint.Thenurseindicatesthatalternativeshavebeenutilized.Whatbehaviourswouldindicatethatthealternativesareworking?a.Thepatientcontinuestogetupfromthechairatthenursesstation.b.Thepatientapologizesforbeingsuchabother.c.Thepatientfoldsthreewashclothsoverandover.d.Thesitterleavesthepatientalonetogotolunch.ANS:CNURSINGTB.COMOfferingdiversionaryactivitiessuchassomethingtoholdisawaytokeepthehandsbusyandprovidesanalternativetorestraints.Assigningaroomnearthenursesstationorachairatthedeskcanbeanalternativeforcontinuousmonitoring.Gettingupconstantlycanbecauseforconcern.Apologizingisnotanalternativetorestraints.Havingasittersitwiththepatienttokeephimoccupiedcanbeanalternativetorestraints,butthesitterneedstobewiththepatientcontinuously.DIF:UnderstandREF:890,Box37-11OBJ:Describeassessmentactivitiesdesignedtoidentifypatientsphysical,psychosocial,andcognitivestatusesastheypertaintohisorhersafety.TOP:EvaluateMSC:CPNRE:FoundationsofPractice14.Thenurseiscaringforapatientwhosuddenlybecomesconfusedandtriestoremoveanintravenousinfusion.Thenursebeginstodevelopaplantocareforthepatient.Whichnursinginterventionshouldtakepriority?a.Gatherrestraintsupplies.b.Tryalternativestorestraint.c.Assessthepatient.d.Callthephysicianforarestraintorder.ANS:CCanadianFundamentalsofNursing7thEditionPotterTestBankWhenapatientbecomessuddenlyconfused,thepriorityistoassessthepatient,includingcheckinglaboratorytestandoxygenstatus,andtreatingandeliminatingthecauseofthechangeinmentalstatus.Ifinterventionsandalternativesareexhausted,thenurse,workingwiththephysician,maydeterminetheneedforrestraints.DIF:ApplyREF:892OBJ:Describeassessmentactivitiesdesignedtoidentifypatientsphysical,psychosocial,andcognitivestatusesastheypertaintohisorhersafety.TOP:PlanningMSC:CPNRE:FoundationsofPractice15.Equipment-relatedaccidentsarerisksinthehealthcareagency.Thenurseassessesforthisriskwhenusingwhichofthefollowing?a.Intravenous(IV)pumps.b.Adevicethatmeasuresurine.c.Computer-baseddocumentation.d.Amanualmedication-dispensingdevice.ANS:AAdysfunctionalIVpumpcancauseanequipment-relatedaccident,suchastoo-rapidinfusionofIVfluids.Devicesusedbythenursetomeasureurine,computerdocumentation,andmanualdispensingdevicescanbreakormalfunctionbutarenotuseddirectlyonapatient.DIF:RememberREF:876OBJ:Describethemostcommonsafetyrisksinhealthcare.TOP:AssessmentMSC:CPNRE:FoundationsofPractice16.Thenurseisdiscussingmeasurestominimizetheriskofinjuryfromanautomobileaccidentwithan84-year-oldindependNeUntRfeSmIaNleGpTatBien.tCwhoMlivesaloneandsaysshedrivesonlytochurch,tothedoctorsoffice,andforgroceries.Whatchangehasthegreatestpotentialforaffectingthepatientssafety?a.Takingpublictransportationwheneveritisavailable.b.Planningalltripsaroundchurchanddoctorappointments.c.Planningtodriveforshorttripsandonlyduringdaylighthours.d.Arrangingforfamilyandfriendstodrivethepatientwheneverpossible.ANS:CThenurseshouldeducatethepatientregardingsafedrivingtips(e.g.,drivingshorterdistancesandonlyduringdaylighthours,usingsideandrearviewmirrorscarefully,andlookingtowardtheblindspotbeforechanginglanes).Takingpublictransportationmaynotmeettheneedsofanindependentpatient.Planningalltripsaroundchurchanddoctorappointmentsmaynotberealistic.Arrangingforfamilyandfriendstodrivethepatientmaynotmeetherneeds.DIF:AnalyzeREF:887OBJ:Describenursinginterventionsspecifictopatientsageforreducingsafetyrisks.TOP:ImplementationMSC:CPNRE:FoundationsofPractice17.Apatientwithanintravenousinfusionrequestsanewgownafterbathing.Whichofthefollowingactionsismostappropriate?a.Disconnecttheintravenoustubing,threadtheendthroughthesleeveoftheoldgownandthroughthesleeveofthenewgown,andreconnect.b.ThreadtheintravenousbagandtubingthroughthesleeveoftheoldgownandCanadianFundamentalsofNursing7thEditionPotterTestBankUSNTthroughthesleeveofthenewgownwithoutdisconnecting.c.Informthepatientthatanewgownisnotanoptionwhilereceivinganintravenousinfusioninthehospital.d.Callthechargenurseforassistancebecauselinenuseismonitoredandthisisnotacommonprocedure.ANS:BProcedure-relatedaccidentssuchascontaminationofsterileitemscanoccurinthehealthcaresetting.Keepingtheintravenoustubingintactwithoutbreaksinthesystemisimperativetodecreasetheriskofinfectionwhilechangingapatientsgownandsatisfyingthepatientsrequest.DIF:ApplyREF:877,Box37-3OBJ:Describethemostcommonsafetyrisksinhealthcare.TOP:ImplementationMSC:CPNRE:FoundationsofPractice18.AconfusedpatientneedstohaverestraintsappliedtopreventhimfrompullingouthisFoleycatheter.Whichofthefollowingoptionscanthenursedelegatetoanunregulatedcareprovider(UCP)?a.Applyingrestraints.b.Obtainingaphysiciansordertorestrainthepatient.c.Documentingtheeventsthatledtorestrainingthepatient.d.Evaluatingtheeffectivenessoftherestraints.ANS:AThenurseisalwaysresponsibleforassessmentofpatientssafetyneeds.AlthoughtheUCPcanapplytherestraintsunderthenursesdirection,heorshecannottakephysiciansorders,documenttheeventsthatledNtorRestrIainiGngtBhe.pCatieMnt,orevaluatetheeffectivenessoftherestraints.DIF:ApplyREF:892OBJ:Developanursingcareplanforpatientswhosesafetyisthreatened.TOP:ImplementationMSC:CPNRE:CollaborativePractice19.AccordingtotheHendrichIIFallRiskModel,apatientwithariskscoreof6isconsideredtobeatwhichrisklevel?a.Norisk.b.Lowrisk.c.Mediumrisk.d.Highrisk.ANS:DAccordingtotheHendrichIIFallRiskModel,ascoreof5orgreaterindicatesthatthepatientisathighriskforafall,notnorisk,lowrisk,ormediumrisk.DIF:AnalyzeREF:879,Table37-1OBJ:Describenursinginterventionsspecifictopatientsageforreducingsafetyrisks.TOP:AssessmentMSC:CPNRE:FoundationsofPractice20.Anolderpatientpresentstotheemergencydepartmentaftersteppinginfrontofacaratacrosswalk.Afterthepatienthasbeenexaminedintriage,thenurseinterviewsthepatient.Whichofthefollowingcommentswouldnecessitatefollow-upbythenurse?CanadianFundamentalsofNursing7thEditionPotterTestBankUSNTa.Itrytoexercise,soIwalkthatblockalmosteveryday.b.Iwaitedandsteppedoutwhenthetrafficsignsaidgo.c.Thecarwasgoingtoofast;thespeedlimitis20.d.Iwassosurprised;Ididntseeorhearthecarcoming.ANS:DAspatientsage,sensoryimpairmentcanincreasetheriskforinjury.Thestatementthatthepatientdidnotseeorhearthecarcomingnecessitatesfollow-upbythenurse;thepatientneedshearingandeyeexaminations.Exerciseisimportantateverystageofdevelopment.Thepatientseemedtocomprehendhowtocrossanintersectioncorrectlyandwasabletodeterminethespeedofthecar.DIF:ApplyREF:877,Box37-4OBJ:Describeassessmentactivitiesdesignedtoidentifypatientsphysical,psychosocial,andcognitivestatusesastheypertaintohisorhersafety.TOP:DiagnosisMSC:CPNRE:FoundationsofPractice21.Anage-relatedmusculoskeletalchangethatpredisposestheolderpersontoaccidentsiswhichofthefollowing?a.Increaseinmusclefunction.b.Increaseinjointmobility.c.Increaseinnocturia.d.Decreaseinmusclestrength.ANS:DMusculoskeletalsystemchangesassociatedwithagingthatincreasetheriskofaccidentsintheolderpeopleincludedecreasesinmusclestrengthandfunction,decreasesinjointmobility,increasingbrittleneNssoRfboInesG,poBstu.rCalchManges,andlimitedrangeofmotion.Ratherthanincreasingwithage,musclefunctiondecreases.Jointsbecomelessmobilewithage,notmoremobile.Nocturiaiscommoninolderpersonsandincreasestheirriskforinjury;however,itisagenitourinarychange,notamusculoskeletalsystemchange.DIF:UnderstandREF:877,Box37-4OBJ:Describenursinginterventionsspecifictopatientsageforreducingsafetyrisks.TOP:AssessmentMSC:CPNRE:FoundationsofPractice22.Thepatientisconfused,istryingtogetoutofbed,andispullingattheIVinfusiontubing.Thesedatawouldhelptosupportwhichnursingdiagnosis?a.Riskforpoisoning.b.Knowledgedeficit.c.Impairedhomemaintenance.d.Riskforinjury.ANS:DThepatientsbehaviourssupportthenursingdiagnosisofRiskforinjury.Thepatientisconfused,ispullingattheIVline,andistryingtoclimboutofbed.Injurycouldresultifthepatientfallsoutofbedorbeginstobleedasaresultofapulledline.Nothinginthescenarioindicatesthatthispatientlacksknowledgeorisatriskforpoisoning.Nothinginthescenarioreferstothepatientshomemaintenance.DIF:UnderstandREF:880OBJ:Identifyrelevantnursingdiagnosesassociatedwithriskstosafety.CanadianFundamentalsofNursing7thEditionPotterTestBankUSNTOTOP:DiagnosisMSC:CPNRE:FoundationsofPractice23.Aconfusedpatientisrestlessandcontinuestotrytoremovehisoxygenandurinarycatheter.Whataretheprioritynursingdiagnosisandinterventiontoimplementforthispatient?a.Riskforinjury:Preventharmtopatient,anduserestraintsifalternativesfail.b.Deficientknowledge:Explainthepurposeofoxygentherapyandtheurinarycatheter.c.Disturbedbodyimage:Encouragepatienttoexpressconcernsaboutbody.d.Caregiverrolestrain:Identifyresourcestoassistwithcare.ANS:ATheprioritynursingdiagnosisisRiskforinjury.Thispatientcouldcauseharmtohimselfbyinterruptingtheoxygentherapyorbydamagingtheurethrainpullingtheurinarycatheterout.Beforerestrainingapatient,itisimportanttoimplementandexhaustalternativestorestraint.Alternativescanincludedistractionandprovidingcompanionshiporsupervision.Patientsmaybemovedtoalocationclosertothenursesstation;trainedsittersorfamilymembersmaybeinvolved.Nursesneedtoensurethatpatientsareprovidedadequatefood,liquid,toileting,andrelieffrompain.Iftheseandotherstrategiesfail,thepatientmayneedrestraints;inthiscase,anorderwouldneedtobeobtainedfortherestraint.Thispatientmayhavedeficientknowledge,andeducatingthepatientabouttreatmentscouldbeconsideredasanalternativetorestraints;however,thehighestpriorityispreventinginjury.Thisscenariodoesnotindicatethatthepatienthasadisturbedbodyimageorthatthepatientscaregiverisstrained.DIF:ApplyREF:881|882OBJ:Identifyrelevantnursingdiagnosesassociatedwithriskstosafety.TOP:DiagnosisMSC:CPNNRRE:FIounGdatiBon.sCofPMractice24.Whichofthefollowingassessmentfindingsismostcriticalforapatientwhoiscurrentlybeingrestrainedwithmechanicalwristrestraints?a.Angry,loudcrying.b.Urinaryincontinence.c.Reddenedareasonwrists.d.Handscooltothetouch.ANS:DAlthoughtheuseofanyrestraintmaybeassociatedwithseriouscomplications,includingpressureulcers,constipation,pneumonia,urinaryandfecalincontinence,andurinaryretention,themostseriousconcernsarecontractures,nervedamage,andcirculatoryimpairment.Coolnessofthepatientshandswouldindicatepoorcirculation,whichcanresultinpermanentdamage.Angry,loudcrying,urinaryincontinence,andreddenedareasonthewristareconcerns,buttheyarenotthemostcriticalconcernsforthepatientwithwristrestraints.DIF:AnalyzeREF:890OBJ:Describemethodstoevaluateinterventionsdesignedtomaintainorpromotesafety.TOP:AssessmentMSC:CPNRE:FoundationsofPractice25.Thenurseisprovidinginformationregardingsafetyandaccidentalpoisoningtoagrandmotherwhowillbetakingcustodyofa1-year-oldgrandchild.Whichofthefollowingcommentswouldindicatethatthegrandmotherneedsfurtherinstruction?CanadianFundamentalsofNursing7thEditionPotterTestBanka.IfIthinkmygrandchildhascomeincontactwithapoison,Iwillcallmylocalpoisoncontrolcentre.b.Neverinducevomitingifmygrandchilddrinksbleach.c.Ishouldcall9-1-1ifmygrandchildlosesconsciousness.d.Ifmygrandchildeatsaplant,Ishouldprovidesyrupofipecac.ANS:DSyrupofipecactoinducevomitingafteringestionofapoisonhasnotprovedeffectiveinpreventingpoisoning.Thismedicationshouldnotbeadministeredtothechild.PhonenumbersforpoisoncontrolcentresacrossCanadacanbeaccessedathttp://www.aboutkidshealth.ca/En/HealthAZ/TestsAndTreatments/Resources/Pages/Poison-Information-Centres-in-Canada.aspx.Afteracausticsubstancesuchasbleachhasbeendrunk,vomitingshouldnotbeinduced;vomitingcancausefurtherburningandinjuryasthemedicationiseliminated.Lossofconsciousnessinassociationwithpoisoningnecessitatescalling9-1-1.DIF:UnderstandREF:885,Box37-8OBJ:Describenursinginterventionsspecifictopatientsageforreducingsafetyrisks.TOP:EvaluateMSC:CPNRE:FoundationsofPractice26.Anelderlypatientpresentstothehospitalwithahistoryoffalls,confusion,andstroke.Thenursedeterminesthatthepatientisathighriskforfalls.Whichofthefollowinginterventionsismostappropriateforthenursetotake?a.Placethepatientinrestraints.b.Lockbedsandwheelchairswhentransferring.c.Placeabathmatoutsidethetub.d.SilencefallalertalarmupNonRrequIestGoffBam.iCly.MANS:BUSNTOLockingthebedandwheelchairswhenthepatientistransferredhelpspreventthesepiecesofequipmentfrommovingduringtransferandwillassistinthepreventionoffalls.Patientsarenotautomaticallyplacedinrestraints.Therestraintprocessconsistsofmanysteps,includingthoroughassessmentandexhaustingofalternativestrategies.Allmatsandrugsshouldbesecuredtohelppreventfalls.Silencingalarmsupontherequestoffamilyisnotappropriateandcouldendangerthepatient.DIF:UnderstandREF:888OBJ:Describenursinginterventionsspecifictopatientsageforreducingsafetyrisks.TOP:ImplementationMSC:CPNRE:FoundationsofPractice27.Thenursehasbeencalledtoahospitalroomwhereapatientisusingahairdryerfromhome.Thepatientreceivedanelectricalshockfromthedryerandisnowunconsciousandisnotbreathing.Whatisthebestnextstep?a.Askthefamilytoleavetheroom.b.Checkforapulse.c.Beginchestcompressions.d.Defibrillatethepatient.ANS:BCanadianFundamentalsofNursing7thEditionPotterTestBankInthisscenario,thepatientisinahospitalsetting,andithasbeendeterminedthatthepatientisnotconsciousandisnotbreathing.Thenextstepistocheckthepulse.Anelectricalshockcaninterferewiththeheartsnormalelectricalimpulsesandcancausearrhythmias.Checkingthepulsehelpstodeterminetheneedforcardiopulmonaryresuscitation(CPR)anddefibrillation.DIF:ApplyREF:898OBJ:Describenursinginterventionsspecifictopatientsageforreducingsafetyrisks.TOP:ImplementationMSC:CPNRE:FoundationsofPractice28.Thenursedeterminesthatthepatientmayneedarestraintandrecognizeswhichoneofthefollowing?a.Anorderforarestraintmaybeimplementedindefinitelyuntilitisnolongerrequiredbythepatient.b.Restraintsmaybeorderedonanas-neededbasis.c.Noorderorconsentisnecessaryforrestraintsinlong-termcarefacilities.d.Restraintsaretobeperiodicallyremovedsothatthepatientcanbere-evaluated.ANS:DRestraintsmustbeperiodicallyremoved,andthenursemustreassessthepatienttodeterminewhethertherestraintscontinuetobeneeded.Itisnottruethatanorderforarestraintmaybeimplementedindefinitelyuntilitisnolongerrequiredbythepatient.Aphysiciansorderforrestraintsmusthavealimitedtimeframe.Iftheordersaretoberenewed,thisshouldbedonewithinaspecifiedtimeframeaccordingtotheagencyspolicy.Restraintsarenottobeorderedasneeded.Theuseofrestraintsmustbepartofthepatientsmedicaltreatment,andanorderforrestraintsmustconformtoprovincialorterritoriallegislationandagencypolicy.Insomesettings,physiciansandNnuRrsesImaGyorBde.rCrestMraints.UDIF:EvaluateREF:891SNTOOBJ:Discussmethodstopreventandreducesafetyrisks.TOP:EvaluateMSC:CPNRE:FoundationsofPractice29.Thestudentnurseiscaringforapatientinrestraints.Thenursinginstructorhasaskedthestudenttodocumentinformationabouttherestraintsinthemedicalrecord.Whichfollowingpieceofinformationthatthestudentwishestoincludewouldpromptthenursinginstructortoprovidefurtherdirectiontothestudent?a.Thepatientstatesthathergownissoiledandneedschanging.b.Attemptstodistractthepatientwithtelevisionareunsuccessful.c.Thepatienthasbeenplacedinbilateralwristrestraintsat0815hours.d.Releasedfromrestraints,activerange-of-motionexercisescomplete.ANS:AAttemptsatalternativesaredocumentedinthemedicalrecord,asaretypeofrestraintandtimerestrained.Assessmentsrelatedtooxygenation,orientation,skinintegrity,circulation,andpositionaredocumented,alongwithreleasefromrestraintsandpatientresponse.Commentsabouthygienearenotnecessarilyrequiredinnursingdocumentationofrestraints.DIF:ApplyREF:892,Skill37-1OBJ:Describenursinginterventionsspecifictopatientsageforreducingsafetyrisks.TOP:ImplementationMSC:CPNRE:Professional,Ethical,andLegalPracticeCanadianFundamentalsofNursing7thEditionPotterTestBankChapter38:HygienePotteretal:CanadianFundamentalsofNursing,7thEditionMULTIPLECHOICE1.Anumberoffactorsinfluenceapatientspersonalpreferencesforhygiene.Becauseofthis,itisimportantforthenursetorealizewhichofthefollowing?a.Notwoindividualsperformhygieneinthesamemanner.b.Itisimportanttostandardizeapatientshygienicpractices.c.Hygienecareisalwaysroutineandexpected.d.Hygieneisnotthetimetolearnaboutpatientneeds.ANS:ANotwoindividualsperformhygieneinthesamemanner;itisimportanttoindividualizethepatientscareaccordingtoknowledgeaboutthepatientsuniquehygienepracticesandpreferences.Hygienecarebynursesisneverroutine;thiscarerequiresintimatecontactwiththepatientandcommunicationskillstopromotethetherapeuticrelationship.Inaddition,duringhygiene,thenurseshouldtaketimetolearnaboutthepatientshealthpromotionpracticesandneeds,emotionalneeds,andhealthcareeducationneeds.DIF:RememberREF:904OBJ:Discusscommonfactorsthatinfluencepersonalhygienepractices.TOP:AssessmentMSC:CPNRE:Professional,Ethical,andLegalPractice2.Socialgroupsinfluencehygienepreferencesandpractices,includingthetypeofhygienicproductsusedandthenatureandfrequencyofpersonalcare.WhichofthefollowingdevelopmentalstagesismostNlUikRelSyItoNbGeiTnBflu.eCncOedMbyfamilycustoms?a.Adolescent.b.Toddler.c.Adult.d.Olderperson.ANS:BDuringchildhood,familycustomsinfluencehygiene.Aschildrenentertheiradolescentyears,peergroupbehaviourofteninfluencespersonalhygiene.Duringtheadultyears,involvementwithfriendsandworkgroupsshapestheexpectationspeoplehaveabouttheirpersonalappearance.Someolderpersonshygienepracticeschangebecauseoflivingconditionsandavailableresources.DIF:AnalyzeREF:904OBJ:Discusscommonfactorsthatinfluencepersonalhygienepractices.TOP:AssessmentMSC:CPNRE:FoundationsofPractice3.Thepatientreceivedadiagnosisofdiabetes12yearsago.Whenadmittedtoday,thepatientisunkemptandisinneedofabathandfootcare.Whenquestionedabouthishygienehabits,thepatienttellsthenursethatbathsaretakenonceaweekwherehecomesfrom,althoughhetakesaspongebatheveryotherday.Toprovideultimatecareforthispatient,whatmustthenurseunderstand?a.Personalpreferencesdeterminehygienepracticesandareunchangeable.b.Patientswhoappearunkemptplacelittleimportanceonhygienepractices.CanadianFundamentalsofNursing7thEditionPotterTestBankUSNTc.Thepatientsillnessmaynecessitateteachingofnewhygienepractices.d.Allculturesvaluecleanlinesswiththesamedegreeofimportance.ANS:CEachpatienthasindividualdesiresandpreferencesaboutwhentobathe,shave,andperformhaircare.However,theyarenotunchangeable.Inaddition,thenursemustassistthepatientindevelopingnewhygienepracticeswhenindicatedbyanillnessorcondition.Forexample,thenursemustteachapatientwithdiabetesproperfoothygiene.Patientswhoappearunkemptoftenneedfurtherassessmentregardingtheirabilitytoparticipateindailyhygiene.Patientswithcertaintypesofphysicallimitationsordisabilitiesoftenlackthephysicalenergyanddexterity,orboth,toperformhygieniccare.Culturally,maintainingcleanlinessdoesnotholdthesameimportanceforsomeethnicgroupsasitdoesforothers.DIF:UnderstandREF:904|905OBJ:Discusscommonfactorsthatinfluencepersonalhygienepractices.TOP:AssessmentMSC:CPNRE:FoundationsofPractice4.ThenurseiscaringforapatientwhorefusesA.M.care.Whenaskedwhy,thepatienttellsthenursethatshealwaysbathesintheevening.Whatshouldthenursedo?a.Deferthebathuntileveningandpassontheinformationtothenextshift.b.Tellthepatientthatshemustbatheinthemorningbecausethatisthenormalroutine.c.Explaintothepatienttheimportanceofmaintainingmorninghygienepractices.d.Cancelhygieneforthedayandattemptagaininthemorning.ANS:AEachpatienthasindividualdesiresandpreferencesaboutwhentobathe,shave,andperformhaircare.KnowingthepatienNtsRpersIonaGlprBef.erCencMesassiststhenurseinprovidingindividualizedcareforthepatient.Hygienecareisneverroutine.Maintainingindividualpersonalpreferencesisimportantunlessnewhygienepracticesareindicatedbyanillnessorcondition.Cancellinghygienecareisnotanoption.Practicesmustbeadaptedtomeetindividualneeds.Noevidencedemonstratesgreaterbenefitwithmorningoreveninghygienecare.DIF:ApplyREF:912OBJ:Discusscommonfactorsthatinfluencepersonalhygienepractices.TOP:ImplementationMSC:CPNRE:Professional,Ethical,andLegalPractice5.Successfulcriticalthinkingrequiressynthesisofknowledge,experience,informationgatheredfrompatients,criticalthinkingqualities,andintellectualandprofessionalstandards.Oncetheassessmenthasbeendone,whatisitimportantforthenursetounderstand?a.Thenursingdiagnosesneverchange.b.Thepatientsconditionneverchanges.c.Criticalthinkingisongoing.d.Hygieneneedstobecomeasimpleroutine.ANS:CApatientsconditionisalwayschanging,whichnecessitatesongoingcriticalthinkingandchangingofnursingdiagnoses.Becausehygieniccareissoimportantforapatienttofeelcomfortable,refreshed,andrenewed,thenurseshouldavoidmakinghygienecareasimpleroutine.CanadianFundamentalsofNursing7thEditionPotterTestBankDIF:UnderstandREF:905OBJ:Discusstherolethatthenursingprocessandcriticalthinkingplayintheprovisionofhygienecare.TOP:AssessmentMSC:CPNRE:Professional,Ethical,andLegalPractice6.Whenthenurseprovideshygieneforanolderpatient,whyisitimportantforthenursetocloselyassesstheskin?a.Aspeopleage,skinbecomesmoreresilient.b.Aspeopleage,sweatglandsbecomemoreactive.c.Aspeopleage,skinbecomeslesssubjecttobruising.d.Aspeopleage,lessfrequentbathingmayberequired.ANS:DDailybathing,aswellasbathingwithwaterthatistoohotorsoapthatisharsh,causestheskintobecomeexcessivelydry.Asthepatientages,theskinlosesitsresiliencyandmoisture,andsebaceousandsweatglandsbecomelessactive.Theepitheliumthins,andelasticcollagenfibresshrink,whichmakestheskinfragileandpronetobruisingandbreaking.DIF:UnderstandREF:911OBJ:Describehowhygienecarefortheolderpatientmaydifferfromthatfortheyoungerpatient.TOP:AssessmentMSC:CPNRE:FoundationsofPractice7.Thenurseisbathingapatientandnoticesmovementinthepatientshair.Whatshouldthenursedo?a.Ignorethemovementandcontinue.b.Useglovesoratonguebladetoinspectthehair.c.Examinethehairwithoutglovestomakepickingliceeasier.d.ShavethehairoffofthepNaUtieRnStIshNeGadT.B.COMANS:BIncommunityhealthandhomecaresettings,itisparticularlyimportanttoinspectthehairforlicesothatappropriatehygienictreatmentcanbeprovided.Suspicionscannotbeignored.Ifpediculosiscapitis(headlice)issuspected,thenursemustprotecthimselforherselfagainstself-infestationsbyhandhygieneandbyusingglovesortonguebladestoinspectthepatientshair.Shavinghairoffaffectedareasisthetreatmentforpediculosispubis(crablice)andisrarelyusedforheadlice.DIF:ApplyREF:908OBJ:Conductacomprehensiveassessmentofapatientstotalhygieneneeds.TOP:ImplementationMSC:CPNRE:FoundationsofPractice8.Whenassessingapatientsskin,whatdoesthenurseneedtoknow?a.Restrictedmovementcanincreasebloodcirculation.b.Paralyzedpatientshavenormalsensoryfunction.c.Lossofsubcutaneoustissuemayincreasetherateofwoundhealing.d.Moistureontheskincanleadtoskinmaceration.ANS:DCanadianFundamentalsofNursing7thEditionPotterTestBankMoistureonthesurfaceoftheskinservesasamediumforbacterialgrowthandcausesirritation,softensepidermalcells,andleadstoskinmaceration.Whenrestrictedfrommovingfreely,dependentbodypartsareexposedtopressurethatreducescirculationtoaffectedtissues.Nursesshouldknowwhichpatientsrequirehelptoturnandchangepositions.Patientswithparalysis,circulatoryinsufficiency,orlocalnervedamageareunabletosenseaninjurytotheskin.Inpatientswithlimitedcaloricandproteinintake,theskinbecomesthinnerandlesselastic,withlossofsubcutaneoustissue,whichresultsinimpairmentofordelayinwoundhealing.DIF:RememberREF:908,Box38-2OBJ:Describeconditionsthatplacethepatientatriskforproblemsrelatedtothehair,scalp,integument,feet,nails,eyes,ears,nose,mouth,andthroat,anddiscusstheirrelatedinterventions.TOP:AssessmentMSC:CPNRE:FoundationsofPractice9.Thenurseiscaringforapatientwhoisimmobile.Whyisthenurseawarethatthepatientisatriskforimpairedskinintegrity?a.Pressurereducescirculationtoaffectedtissue.b.Patientswithlimitedcaloricintakedevelopthickerskin.c.Inadequatebloodflowleadstodecreasedtissueischemia.d.Localnervedamageleadstopainsensation.ANS:ABodypartsexposedtopressurehavereducedcirculationtoaffectedtissue.Inpatientswithlimitedcaloricandproteinintake,theskinbecomesthinnerandlesselastic,withlossofsubcutaneoustissue.Inadequatebloodflowcausesischemiaandbreakdown.Patientswithparalysis,circulatoryinsufficiency,orlocalnervedamageareunabletosenseaninjurytoaffectedpartsoftheskin.NURSINGTB.COMDIF:UnderstandREF:908,Box38-2OBJ:Describeconditionsthatplacethepatientatriskforproblemsrelatedtothehair,scalp,integument,feet,nails,eyes,ears,nose,mouth,andthroat,anddiscusstheirrelatedinterventions.TOP:AssessmentMSC:CPNRE:FoundationsofPractice10.Thenurseiscaringforapatientwhohasdiabetesmellitus,circulatoryinsufficiency,peripheralneuropathy,andurinaryincontinence.Whatdoesthenurseknowaboutpatientswiththeseconditions?a.Theyhavedecreasedpainsensationandareatincreasedriskofskinimpairment.b.TheyareatdecreasedriskofdevelopinginfectionbecauseofurinarypHlevel.c.Theyhavedecreasedcaloricintake,whichresultsinacceleratedwoundhealing.d.Theyhaveimpairedvenousreturn,whichallowsforgreatercirculationandlessbreakdown.ANS:APatientswithparalysis,circulatoryinsufficiency,orlocalnervedamageareunabletosenseaninjurytoaffectedpartsoftheskin.Thepresenceofperspiration,urine,wateryfecalmaterial,andwounddrainageontheskinresultsinbreakdownandinfection.Inpatientswithlimitedcaloricandproteinintake,theskinbecomesthinnerandlesselastic,withlossofsubcutaneoustissue.Thisresultsinimpairmentordelayofwoundhealing.Impairedvenousreturndecreasescirculationtotheextremities.Inadequatebloodflowcausesischemiaandbreakdown.CanadianFundamentalsofNursing7thEditionPotterTestBankUSNTDIF:UnderstandREF:908,Box38-2OBJ:Describeconditionsthatplacethepatientatriskforproblemsrelatedtothehair,scalp,integument,feet,nails,eyes,ears,nose,mouth,andthroat,anddiscusstheirrelatedinterventions.TOP:AssessmentMSC:CPNRE:FoundationsofPractice11.Thenurseiscaringforapatientwhohasundergoneexternalfixationofabrokenlegandhasacastinplace.Topreventskinimpairment,whatshouldthenursedo?a.Notallowthepatienttoturninbedbecausethatmayleadtoredislocationoftheleg.b.Restrictthepatientsdietaryintaketoreducethenumberoftimesonthebedpan.c.Assessallsurfacesexposedtothecastforpressureareas.d.Keepthepatientsbloodpressurelowtopreventoverperfusionoftissue.ANS:CAssessallsurfacesexposedtocasts,clothrestraints,bandagesanddressings,tubing,ororthopedicbraces.Anexternaldeviceappliedtooraroundtheskinexertspressureorfrictionontheskin,whichleadstoskinimpairment.Whenrestrictedfrommoving,dependentbodypartsareexposedtopressurethatreducescirculationtoaffectedtissues.Nursesshouldknowwhichpatientsrequireassistancetoturnandchangepositions.Inpatientswithlimitedcaloricandproteinintake,wouldhealingbecomesimpairedordelayed.Keepingthebloodpressureartificiallylowmaydecreasearterialbloodsupply,leadingtoischemiaandbreakdown.DIF:ApplyREF:908,Box38-2OBJ:Describeconditionsthatplacethepatientatriskforproblemsrelatedtothehair,scalp,integument,feet,nails,eyes,ears,nose,mouth,andthroat,anddiscusstheirrelatedinterventions.TOP:ImplementationMSC:CPNRE:FoundationsofPractice12.OfthefollowinginterventionNs,wRhicIhwGouldBb.eCtheMmostimportantforpreventingskinimpairmentinamobilepatientwithlocalnervedamage?a.Turnthepatientevery2hours.b.Limitcaloricandproteinintake.c.Insertanindwellingurinarycatheter.d.Duringabath,assessforpain.ANS:DWhileapatientisbathing,thenurseshouldassessthestatusofsensorynervefunctionbycheckingforpain,tactilesensation,andtemperaturesensation.Whenrestrictedfrommovingfreely,dependentbodypartsareexposedtopressurethatreducescirculation;however,amobilepatientisabletochangepositions.Limitingcaloricandproteinintakemaycausewoundhealingtobecomeimpairedordelayed.Thepresenceofperspiration,urine,wateryfecalmaterial,andwounddrainageontheskinalsocauseswoundhealingtobecomeimpairedordelayed.However,amobilepatientcanusebathroomfacilitiesoraurinal.DIF:AnalyzeREF:908,Box38-2OBJ:Describeconditionsthatplacethepatientatriskforproblemsrelatedtothehair,scalp,integument,feet,nails,eyes,ears,nose,mouth,andthroat,anddiscusstheirrelatedinterventions.TOP:AssessmentMSC:CPNRE:FoundationsofPractice13.Ofthefollowingdisorders,whichiscausedbyavirus?a.Corns.b.Plantarwarts.CanadianFundamentalsofNursing7thEditionPotterTestBankUSNTOc.Athletesfoot.d.Callus.ANS:BPlantarwartsappearonthesoleofthefootandarecausedbythepapillomavirus.Cornsarecausedbyfrictionandpressurefromill-fittingorlooseshoes.Athletesfoot(tineapedis)isafungalinfection.Acallusiscausedbylocalfrictionorpressure.DIF:RememberREF:909,Table38-3OBJ:Describeconditionsthatplacethepatientatriskforproblemsrelatedtothehair,scalp,integument,feet,nails,eyes,ears,nose,mouth,andthroat,anddiscusstheirrelatedinterventions.TOP:AssessmentMSC:CPNRE:FoundationsofPractice14.Thenurseiscaringforapatientwhoiscomplainingofseverefootpaincausedbycorns.Thepatientstatesthatshehasbeenusingovalcornpadstoself-treatthecorns,buttheyseemtobegettingworse.Whatdoesthenurseexplain?a.Cornpadsareanadequatetreatmentandshouldbecontinued.b.Thepatientshouldavoidsoakingherfeetbeforeusingapumicestone.c.Tightershoeswouldhelptocompressthecornsandmakethemsmaller.d.Dependingonseverity,surgerymaybeneededtoremovethecorns.ANS:DDependingonseverityofpainandthesizeofthecorn,surgicalremovalmaybenecessary.Ovalcornpadsshouldbeavoidedbecausetheyincreasepressureonthetoesandreducecirculation.Warmwatersoakshelpsoftencornsbeforegentlerubbingwithacallusfileorpumicestone.Widerandsoftershoes,especiallyshoeswithawidertoebox,arehelpful.DIF:UnderstandREF:90N9,TRableI38-G3B.CMOBJ:Describeconditionsthatplacethepatientatriskforproblemsrelatedtothehair,scalp,integument,feet,nails,eyes,ears,nose,mouth,andthroat,anddiscusstheirrelatedinterventions.TOP:PlanningMSC:CPNRE:FoundationsofPractice15.Thepatientreceivesadiagnosisofathletesfoot(tineapedis).Thepatientsaysthatsheisrelievedbecauseitisonlyathletesfootanditcanbetreatedeasily.Whatdoesthenurseexplainaboutathletesfoot?a.Itisgenerallyisolatedtothefeetandneverrecurs.b.Itiscontagiousandfrequentlyrecurs.c.Itiscausedbythepapillomavirus.d.Itistreatedwithsalicylicacidorelectrodesiccation.ANS:BAthletesfootspreadstootherbodyparts,especiallythehands.Itiscontagiousandfrequentlyrecurs.Itiscausedbyafungus,notthepapillomavirus.Itisnottreatedwithsalicylicacidorelectrodesiccation;thosearetreatmentsforplantarwarts.DIF:UnderstandREF:909,Table38-3OBJ:Describeconditionsthatplacethepatientatriskforproblemsrelatedtothehair,scalp,integument,feet,nails,eyes,ears,nose,mouth,andthroat,anddiscusstheirrelatedinterventions.TOP:PlanningMSC:CPNRE:FoundationsofPractice16.Whenassessingapatientsfeet,thenursenoticesthatthetoenailsarethickandseparatedfromthenailbed.Whatcausesthiscondition?CanadianFundamentalsofNursing7thEditionPotterTestBankUSNTOa.Fungi.b.Nailpolish.c.Friction.d.Nailpolishremover.ANS:AInflammatorylesionsandfungusofthenailbedcausenailstobecomethickenedandhornyandtoseparatefromthenailbed.Ifafemalepatientisaffected,thenurseshouldaskwhethershefrequentlypolisheshernailsandusespolishremoverbecausechemicalsintheseproductscauseexcessivenaildryness,buttheydonotactuallycausethickeningandseparationofnailsfromthenailbed.Frictionandpressurefromill-fittingorlooseshoescauseskeratosis(corns).Itisseenmainlyonorbetweentoes,overbonyprominences.DIF:UnderstandREF:911OBJ:Describeconditionsthatplacethepatientatriskforproblemsrelatedtothehair,scalp,integument,feet,nails,eyes,ears,nose,mouth,andthroat,anddiscusstheirrelatedinterventions.TOP:AssessmentMSC:CPNRE:FoundationsofPractice17.Thenurseisprovidingeducationaboutproperfootcaretoapatientwhohasdiabetesmellitus.Whyisthisimportant?a.Plantarwartscandevelopfromfootfungi.b.Poorfootcareleadstoneuropathy.c.Astrongdorsalispedispulseindicatespoorbloodflow.d.Footulcersarethemostcommonprecursortoamputation.ANS:DFootulcerationisthemostcommonsingleindicationforlowerextremityamputationsamongpersonswithdiabetes.PlantaNrwaRrtsIareGcauBse.dCbytMhepapillomavirus,notafungus.Palpabledorsalispedisandposteriortibialpulsesindicatethatadequatebloodflowisreachingperipheraltissues.Neuropathyisadegenerationoftheperipheralnervesusuallyresultingfrompoorcontrolofbloodglucoselevels;itisnotadirectresultofpoorfootcare.DIF:UnderstandREF:927OBJ:Understandtheimportanceoffootcareforthediabeticpatient.TOP:AssessmentMSC:CPNRE:FoundationsofPractice18.Thenurseisprovidingoralcaretoanunconsciouspatientandnotesthatthepatienthasextremelybadbreath.Whatisthetermforbadbreath?a.Alopecia.b.Halitosis.c.Dentalcaries.d.Neuropathy.ANS:BHalitosisisthetermforbadbreath.Alopeciaishairloss.Dentalcariesistoothdecay.Neuropathyisadegenerationofperipheralnervesthatleadstolossofsensationintheextremities.DIF:RememberREF:908|932OBJ:Describeconditionsthatplacethepatientatriskforproblemsrelatedtothehair,scalp,integument,feet,nails,eyes,ears,nose,mouth,andthroat,anddiscusstheirrelatedinterventions.TOP:AssessmentMSC:CPNRE:FoundationsofPracticeCanadianFundamentalsofNursing7thEditionPotterTestBank19.Thenurseiscaringforanunresponsivepatientwhohasanasogastrictubeinplaceforcontinuoustubefeedings.Whydoesthenurseassessthepatientsoralhygiene?a.Oralhygienehelpspreventgingivitis.b.Oralhygienemaycauseglossitis.c.Oralhygienemayleadtohalitosis.d.Oralhygienecausestonguecoating.ANS:AEarlyidentificationofpoororalhygienepracticesandcommonoralproblemsreducestheriskforgumdiseaseanddentalcaries.Patientsfrequentlydevelopcommonoralproblemsasaresultofinadequateoralcareorasaconsequenceofdisease(e.g.,oralmalignancy)orasasideeffectoftreatmentssuchasradiationandchemotherapy.Theseproblemsincluderecessionofgumtissue,inflammationofgums(gingivitis),coatingofthetongue,glossitis(inflammationofthetongue),discolorationofteeth(particularlyalonggummargins),dentalcaries,lossofteeth,andhalitosis(foul-smellingbreath).DIF:UnderstandREF:908OBJ:Describeconditionsthatplacethepatientatriskforproblemsrelatedtothehair,scalp,integument,feet,nails,eyes,ears,nose,mouth,andthroat,anddiscusstheirrelatedinterventions.TOP:AssessmentMSC:CPNRE:FoundationsofPractice20.Thepatientisbeingtreatedforcancerwithweeklyradiationandchemotherapytreatments.Thenurseisawarethatthepatientsoralmucosaneedstobeassessedbecauseradiationtherapyandchemotherapycanhavewhateffects?a.Increaseinsalivaproduction.b.Decreaseintheriskoforalinflammation.c.DecreaseindryingoforaNlmURucSosIaN.GTB.COMd.Increaseinlikelihoodoforalproblems.ANS:DPatientsfrequentlydevelopcommonoralproblemsasaresultofinadequateoralcare,asaconsequenceofdisease(e.g.,oralmalignancy),orasasideeffectoftreatmentssuchasradiationandchemotherapy.DIF:UnderstandREF:908OBJ:Describeconditionsthatplacethepatientatriskforproblemsrelatedtothehair,scalp,integument,feet,nails,eyes,ears,nose,mouth,andthroat,anddiscusstheirrelatedinterventions.TOP:AssessmentMSC:CPNRE:FoundationsofPractice21.Inprovidingoralcaretoanunconsciouspatient,whatisanimportantactionbythenurse?a.Moisteningthepatientsmouthwithlemon-glycerinesponges.b.Holdingthepatientsmouthopenwithhisorherfingers.c.Rinsingthemouthandimmediatelysuctioningtheoralcavity.d.Usingfoamswabstohelpremoveplaque.ANS:CCanadianFundamentalsofNursing7thEditionPotterTestBankWhenprovidingoralhygienetoanunconsciouspatient,thenurseneedstoprotecthimorherfromchokingandaspiration.Twonursesshouldprovidecare:Onenursedoestheactualcleaning,andtheotherremovessecretionswithsuctionequipment.Thenursecandelegatesometaskstounregulatedcareproviders.Someagenciesuseequipmentthatcombinesamouthswabwiththesuctiondevice.Thisdevicecanbeusedsafelybyonenursetoprovideoralcare.Commerciallymadefoamswabsareineffectiveinremovingplaque.Lemon-glycerinespongesshouldnotbeusedbecausetheydrymucousmembranesanderodetoothenamel.Whilecleansingtheoralcavity,thenurseshoulduseasmalloralairwayorapaddedtonguebladetoholdthepatientsmouthopen.Thenurseshouldneverusehisorherownfingerstoholdthepatientsmouthopen:Ahumanbitecontainsmultiplepathogenicmicroorganisms.DIF:ApplyREF:931OBJ:Describeconditionsthatplacethepatientatriskforproblemsrelatedtothehair,scalp,integument,feet,nails,eyes,ears,nose,mouth,andthroat,anddiscusstheirrelatedinterventions.TOP:ImplementationMSC:CPNRE:FoundationsofPractice22.Thenurseisteachingthepatientaboutflossingandoralhygiene.Whichofthefollowingisthenursesinstruction?a.Flossingneedstobedoneatleastthreetimesaday.b.Topreventbleeding,thepatientshouldusewaxedfloss.c.Flossingremovesplaqueandbacteriafromtheteeth.d.Applyingtoothpastetotheteethbeforeflossingisharmful.ANS:CDentalflossingremovesplaqueandbacteriabetweenteeth.Topreventbleeding,thepatientshoulduseunwaxedfloss.Flossingonceadayissufficient.Iftoothpasteisappliedtotheteethbeforeflossing,fluorideNwUiRllScoImNeGinTdBir.ecCtOcontactwithtoothsurfaces,aidingincavityprevention.DIF:ApplyREF:931OBJ:Describeconditionsthatplacethepatientatriskforproblemsrelatedtothehair,scalp,integument,feet,nails,eyes,ears,nose,mouth,andthroat,anddiscusstheirrelatedinterventions.TOP:ImplementationMSC:CPNRE:FoundationsofPractice23.Thenurseiscaringforapatientwhohasheadlice(pediculosiscapitis).Whatshouldthenurseknowabouttreatingthiscondition?a.Productscontaininglindanearemosteffective.b.Headlicemayspreadtofurnitureandotherpeople.c.Treatmentmustberepeatedin7to10days.d.Manualremovalisnotarealisticoptionastreatment.ANS:BHeadlicearedifficulttoremoveandspreadtofurnitureandotherpeopleifnottreated.Productscontaininglindaneshouldnotbeusedbecausetheingredientistoxicandisknowntocauseadversereactions.Treatmentsneedtoberepeated12to24hoursaftertheinitialtreatment.Manualremovalisthebestoptionwhentreatmenthasfailed.DIF:UnderstandREF:910,Table38-4OBJ:Describeconditionsthatplacethepatientatriskforproblemsrelatedtothehair,scalp,integument,feet,nails,eyes,ears,nose,mouth,andthroat,anddiscusstheirrelatedinterventions.CanadianFundamentalsofNursing7thEditionPotterTestBankUSNTTOP:AssessmentMSC:CPNRE:FoundationsofPractice24.Scalingofthescalpaccompaniedbyitchingisknownaswhichofthefollowing?a.Dandruff.b.Pediculosis.c.Alopecia.d.Ticks.ANS:ADandruffisscalingofthescalpthatisaccompaniedbyitching.Pediculosis(lice)isaninfestationoftiny,greyish-whiteparasiticinsectsinmammals.Alopeciaishairlossorbalding.Ticksaresmall,grey-brownparasitesthatburrowintotheskinandsuckblood.DIF:RememberREF:910,Table38-4OBJ:Describeconditionsthatplacethepatientatriskforproblemsrelatedtothehair,scalp,integument,feet,nails,eyes,ears,nose,mouth,andthroat,anddiscusstheirrelatedinterventions.TOP:AssessmentMSC:CPNRE:FoundationsofPractice25.Infindingpediculosiscapitis(headlice)inapatient,whatwouldthenurseexpecttoobserve?a.Greyish-whiteparasiteswithredlegs.b.Pustulesorbitesbehindearsandatthehairline.c.Baldingpatchesinperipheryofthehairline.d.Brittleandbrokenhair.ANS:BHeadliceareonthescalp,attachedtohairstands.Bitesorpustulesmaybeobservedbehindtheearsandatthehairline.Greyish-whiteparasiteswithredlegsarepediculosispubis(crablice),notheadlice,andarefoNundRinIpubGichBai.r.CAloMpecia(hairloss)isfoundinallethnicitiesandischaracterizedbybrittleandbrokenhairandbaldingpatchinessintheperipheryofthehairline.DIF:RememberREF:910,Table38-4OBJ:Describeconditionsthatplacethepatientatriskforproblemsrelatedtothehair,scalp,integument,feet,nails,eyes,ears,nose,mouth,andthroat,anddiscusstheirrelatedinterventions.TOP:AssessmentMSC:CPNRE:FoundationsofPractice26.Thenurseiscaringforapatientwhohasmultipleticksonherlegsandbody.Toridthepatientofticks,whatshouldthenursedo?a.Burntheticksinanashtrayonceremoved.b.Useblunttweezersandpullupwardwithsteadypressure.c.Allowthetickstodropoffbythemselves.d.Useproductscontaininglindanetokilltheticks.ANS:BUsingblunttweezers,thenursegraspsthetickasclosetoitsheadaspossibleandpullsupwardwitheven,steadypressure.Thenurseholdsthetickuntilitpullsout,usuallyforabout3to4minutes.Thetickshouldbesavedinaplasticbagandputitinthefreezerifnecessaryinordertoidentifythetypeoftick.Becausetickstransmitseveraldiseasestopeople,theymustberemoved.Allowingthemtodropoffbythemselvesisnotanoption.Lindaneisaningredientthatwastraditionallyusedintreatmentforpediculosiscapitis(headlice);itshouldnolongerbeusedbecausetheingredientistoxicandisknowntocauseadversereactions.CanadianFundamentalsofNursing7thEditionPotterTestBankUSNTODIF:ApplyREF:910,Table38-4OBJ:Describeconditionsthatplacethepatientatriskforproblemsrelatedtothehair,scalp,integument,feet,nails,eyes,ears,nose,mouth,andthroat,anddiscusstheirrelatedinterventions.TOP:ImplementationMSC:CPNRE:FoundationsofPractice27.Thepatientreceivedadiagnosisofpediculosiscapitis(headlice),wastreateduponadmission,andwasre-treated24hourslater,andyetthepatientisstillhasaninfestation.Whatshouldbethenursesnextaction?a.Re-treatthepatientwithamedicatedshampooforeliminatinglice.b.Useaproductcontaininglindanetogetridofthelice.c.Manuallyremovetheliceusingafine-toothedcomb.d.Havethepatientbatheorshowerthoroughly.ANS:CManualremovalisthebestoptionwhentreatmenthasfailed.Re-treatingwithamedicatedshampoomayleadtoadversereactionsandshouldnotbedonewithoutconsultationwiththecareprovider.Productscontaininglindaneshouldnotbeusedbecausetheingredientistoxicandisknowntocauseadversereactions.Althoughbathingorshoweringisagoodidea,thisisusuallyconsideredatreatmentforpediculosiscorporis(bodylice),notpediculosiscapitis(headlice).DIF:ApplyREF:910,Table38-4OBJ:Describeconditionsthatplacethepatientatriskforproblemsrelatedtothehair,scalp,integument,feet,nails,eyes,ears,nose,mouth,andthroat,anddiscusstheirrelatedinterventions.TOP:ImplementationMSC:CPNRE:FoundationsofPractice28.ThenurseiscaringforanolderpatientwithAlzheimersdiseasewhoisambulatorybutrequirestotalassistancewithNhisRactiIvitiGesoBfd.aCilylMiving(ADLs).Thenursenoticesthathisskinisdryandwrinkled.Whatshouldthenursedo?a.Makesurethatthepatientisreceivingdailybaths.b.Reducethenumberofbathsperweekifpossible.c.Beawarethatsweatglandsbecomemoreactivewithaging.d.Besurethatthepatientisusingsoapwithhisbath.ANS:BDecreasingthenumberofbathsperweekmayhelppreventfurtherdryingoftheskin.Aspeopleage,theskinlosesitsresiliencyandmoisture,andsebaceousandsweatglandsbecomelessactive.Dailybathing,aswellasbathingwithwaterthatistoohotorsoapthatisharsh,causestheskintobecomeexcessivelydry.DIF:ApplyREF:918,Box38-9OBJ:Describehowhygienecarefortheolderpatientmaydifferfromthatfortheyoungerpatient.TOP:ImplementationMSC:CPNRE:FoundationsofPractice29.Aself-sufficientbedriddenpatientunabletoreachallbodypartsneedswhichtypeofbath?a.Completebedbath.b.Bagbath.c.Spongebath.d.Partialbedbath.ANS:DCanadianFundamentalsofNursing7thEditionPotterTestBankApartialbathconsistsofwashingbodypartsthatthepatientcannotreach,includingtheback,andprovidingabackrub.Dependentpatientsinneedofpartialhygieneorself-sufficientbedriddenpatientswhoareunabletoreachallbodypartsreceiveapartialbedbath.Completebedbathsareadministeredtototallydependentpatientsinbed.Thebagbathcontainsseveralsoft,nonwovencottonclothsthatarepremoistenedinasolutionofno-rinsesurfactantcleanserandemollient.Itcanbeusedforanypatient.Thespongebathinvolvesbathingfromabathbasinorasinkwiththepatientsittinginachair.DIF:RememberREF:918OBJ:Discussthedifferentapproachesusedinmaintainingapatientscomfortandsafetyduringhygienecare.TOP:AssessmentMSC:CPNRE:FoundationsofPractice30.Thenurseispreparingtoprovideacompletebedbathtoanunconsciouspatient.Thenursedecidestouseabagbath.Shedoesthisforwhichofthefollowingreasons?a.WashbasinscanharbourGram-negativeorganisms.b.Bagbathsinvolvetheuseofsoapsthatenhancecleansing.c.Bagbathsdonotcontainemollients.d.Bagbathsincreaseskinflakingandscaling.ANS:AWhenwashbasinsarenotcleanedanddriedcompletelyafteruse,theyaremorelikelytobecontaminatedbyGram-negativeorganisms.SuccessiveusesofthewashbasincausethepatientsskintoharbourmoreGram-negativeorganisms.Bagbathsdonotcontainsoap.Instead,theycontainano-rinsesurfactant,ahumectanttotrapmoisture,andanemollientthatsignificantlyreducesoverallskindryness,especiallyskinflakingandscaling.DIF:UnderstandREF:926OBJ:DiscussthedifferentappNroUacRhSesIuNseGdTinBm.aiCntOainMingapatientscomfortandsafetyduringhygienecare.TOP:AssessmentMSC:CPNRE:FoundationsofPractice31.Thefemalenurseiscaringforamalepatientwhoisuncircumcisedandnotambulatory,althoughhehasfullfunctionofarmsandhands.Thenurseisprovidingthepatientwithapartialbedbath.Whatstatementistrueaboutperinealcareforthispatient?a.Itisnotnecessarybecauseheisnotcircumcised.b.Itshouldbepostponedbecauseitmaycausehimembarrassment.c.Itshouldbedonebythepatient.d.Itshouldbedonebythenurse.ANS:CPatientsmostinneedofperinealcarearethoseatgreatestriskforacquiringaninfection,suchasuncircumcisedboysandmen.Ifapatientisabletoperformperinealself-care,thisindependenceshouldbeencouraged.Embarrassmentshouldnotcausethenursetooverlookthepatientshygieneneeds.Thenurseshouldprovidethiscareonlyifthepatientisunabletodoso.DIF:ApplyREF:926OBJ:Discussthedifferentapproachesusedinmaintainingapatientscomfortandsafetyduringhygienecare.TOP:ImplementationMSC:CPNRE:FoundationsofPractice32.Afterthepatientsbath,whatshouldthenursedo?CanadianFundamentalsofNursing7thEditionPotterTestBankUSNTOa.Notofferabackrubbecauseitisnottherapeutic.b.Routinelygivebackrubsof2minutesorless.c.Assumethatallpatientsneedbackrubsaftertheirbath.d.Notofferabackrubfor48hoursafterthepatientundergoescoronaryarterybypasssurgery.ANS:DThenurseshouldconsultthemedicalrecordforanycontraindicationstoamassage(e.g.,fracturedribs,burns,heartsurgery).Abackrubof3minutesdurationactuallyenhancespatientcomfortandrelaxationandthusisverytherapeutic.Itisimportanttoaskwhetherapatientwouldlikeabackrubbecausesomeindividualsdislikephysicalcontact.DIF:ApplyREF:927,Box38-10OBJ:Discussthedifferentapproachesusedinmaintainingapatientscomfortandsafetyduringhygienecare.TOP:ImplementationMSC:CPNRE:FoundationsofPractice33.Thenurseisprovidingacompletebedbathtoapatient,usingacommercialbathcleansingpack(bagbath).Whatshouldthenursedo?a.Useonetowelfortheentirebath.b.Drytheskinwithatowel.c.Allowtheskintoairdry.d.Notuseabathblanketortowel.ANS:CThenurseshouldallowtheskintoairdryfor30seconds.Dryingtheskinwithatowelremovestheemollientthatisleftbehindafterthewater/cleansersolutionevaporates.ItispermissibletolightlycovertNhepRatieIntwGithBa.baCthbMlanketortoweltopreventchilling.Thecleansingpackcontains8to10premoistenedtowelsforcleansing.Asingletowelisusedforeachgeneralbodypartcleansed.DIF:ApplyREF:926OBJ:Successfullyperformhygieneforcareoftheintegument;perineum;feet,hands,andnails;mouth;andeyes,ears,andnose.TOP:ImplementationMSC:CPNRE:FoundationsofPractice34.Inprovidingperinealcaretoafemalepatient,howshouldthenursewash?a.Upwardfromrectumtopubicarea.b.Frombacktofront.c.Frompubicareatorectum.d.Inacircularmotion.ANS:CCleansingfrompubicareatorectum(fronttoback)reducesthetransferofmicroorganismstotheurinarymeatusanddecreasestheriskofurinarytractinfection.Cleansingfromrectumtopubicareaorbacktofrontincreasestheriskofurinarytractinfection.Circularmotionsareusedinmaleperinealcare.DIF:ApplyREF:923OBJ:Successfullyperformhygieneforcareoftheintegument;perineum;feet,hands,andnails;mouth;andeyes,ears,andnose.TOP:ImplementationMSC:CPNRE:FoundationsofPracticeCanadianFundamentalsofNursing7thEditionPotterTestBankUSNT35.Thenurseisprovidingperinealcaretoanuncircumcisedmalepatient.Whenprovidingsuchcare,howshouldthenursetreattheforeskin?a.Leavetheforeskinalonebecausethereislittlechanceofinfection.b.Retracttheforeskinforcleansingandallowittoreturnonitsown.c.Retracttheforeskinandkeepretracted.d.Retracttheforeskinandreturnittoitsnaturalpositionwhendone.ANS:DReturntheforeskintoitsnaturalposition.Keepingtheforeskinretractedleadstotighteningoftheforeskinaroundtheshaftofthepenis,causinglocaledemaanddiscomfort.Theforeskinmaynotreturntoitsnaturalpositiononitsown.Patientsatgreatestriskforinfectionareuncircumcisedboysandmen.DIF:ApplyREF:923OBJ:Successfullyperformhygieneforcareoftheintegument;perineum;feet,hands,andnails;mouth;andeyes,ears,andnose.TOP:ImplementationMSC:CPNRE:FoundationsofPractice36.Patientswithdiabetesmellitusneedspecialfootcaretopreventthedevelopmentofulcers.Knowingthis,whatisthenursesaction?a.Trimmingthepatientstoenailsdaily.b.Havingthepatientsoakhisorherfeettwiceaday.c.Requestingaconsultwithanailcarespecialist.d.Assessingthebrachialartery.ANS:CPatientswithperipheralvascNularRdisIeaseGorBdi.abCetesMmellitusoftenrequirenailcarefromaspecialisttoreducetheriskofinfection.Someagenciesallowcuttingofnailswithaprovidersorder;however,mostdonot.Patientswithdiabetesdonotsoakhandsandfeet;soakingincreasestheriskofinfectionbecauseofmacerationoftheskin.Whenassessingthepatientsfeet,thenursepalpatesthedorsalispedisofthefoot,notthebrachialartery.DIF:ApplyREF:926|927OBJ:Successfullyperformhygieneforcareoftheintegument;perineum;feet,hands,andnails;mouth;andeyes,ears,andnose.TOP:ImplementationMSC:CPNRE:FoundationsofPractice37.Theuncooperativepatientisresistingattemptsbythenursetoprovideoralhygiene.Toprovidetheneededcare,whatmaythenursedo?a.Useapaddedtongueblade.b.Holdthepatientsmouthopenwithherfingers.c.Positionthepatientonhisback.d.Useundilutedhydrogenperoxideasacleaner.ANS:ACanadianFundamentalsofNursing7thEditionPotterTestBankIfthepatientisunconsciousoruncooperative,orishavingdifficultykeepingthemouthopen,apaddedtonguebladecanhelp.Itisinsertedoverthetonguetokeeptheteethapartwhenthepatientisrelaxed.Thenursemustnotuseforce.Thenursemustneverplacefingersintothemouthofanunconsciousordebilitatedpatient;thenormalresponseofthepatientistobitedown.Thepatientshouldbepositionedonhisside,ortheheadturned,toallowfordrainage.Placingthepatientonhisbackcouldleadtoaspiration.Hydrogenperoxideandsodiumbicarbonateeffectivelyremovedebrisbut,ifnotdilutedcarefully,maycausesuperficialburns.DIF:ApplyREF:934OBJ:Successfullyperformhygieneforcareoftheintegument;perineum;feet,hands,andnails;mouth;andeyes,ears,andnose.TOP:ImplementationMSC:CPNRE:FoundationsofPractice38.Howisbasiceyecareprovided?a.Thenursecleansestheeyewithsoapandwater.b.Thenurseappliespressuredirectlytotheeyeball.c.Thenursecleansesfrominnercanthustooutercanthus.d.Thenurseprovideslessfrequentcaretounconsciouspatients.ANS:CWhencleansingthepatientseyes,thenurseshouldobtainacleanwashclothandcleansefrominnercanthustooutercanthus.Adifferentsectionofthewashclothshouldbeusedforeacheye.Cleansingsimplyinvolveswashingwithacleanwashclothmoistenedinwater.Soapcausesburningandirritation.Directpressuremustneverbeappliedovertheeyeballbecausethiscausesseriousinjury.Unconsciouspatientsoftenrequiremorefrequenteyecarethandoconsciouspatients.NURSINGTB.COMDIF:ApplyREF:939OBJ:Successfullyperformhygieneforcareoftheintegument;perineum;feet,hands,andnails;mouth;andeyes,ears,andnose.TOP:ImplementationMSC:CPNRE:FoundationsofPractice39.Thenurseisteachingapatientaboutcontactlenscare.Thepatienthasplasticlenses,sowhatdoesthenurseinstructthepatienttodo?a.Usetapwatertocleanlenses.b.Keepthelensesisacool,dryplacewhennotbeingused.c.Reusestoragesolutionforuptoaweek.d.Washandrinselensstoragecasedaily.ANS:DThelensstoragecaseshouldbethoroughlywashedandrinsedonadailybasis.Itshouldbecleanedperiodicallywithsoaporliquiddetergent,rinsedthoroughlywithwarmwater,andallowedtoairdry.Tapwatershouldnotbeusedtocleanlensesbecausetapwaterisnotsterileandcanintroducemicroorganisms.Lensesshouldbekeptmoistorwetwhennotworn.Freshsolutionisuseddailywhenlensesarestoredanddisinfected.DIF:ApplyREF:939,Box38-14OBJ:Successfullyperformhygieneforcareoftheintegument;perineum;feet,hands,andnails;mouth;andeyes,ears,andnose.TOP:ImplementationMSC:CPNRE:FoundationsofPracticeCanadianFundamentalsofNursing7thEditionPotterTestBankUSNTO40.Thepatientcomplainstothenurseaboutaperceiveddecreaseinhearing.Whenthenurseexaminesthepatientsear,shenoticesalargeamountofcerumen(earwax)buildupattheentrancetotheearcanal.Whatshouldthenursedo?a.Applygentle,downwardretractionoftheearcanal.b.Tellthepatienttouseabobbypintoextractearwax.c.Teachthepatienthowtousecotton-tippedapplicators.d.Instillhotwaterintotheearcanaltomeltthewax.ANS:AWhencerumenisvisible,gentle,downwardretractionattheentrancetotheearcanalcausesthewaxtoloosenandslipout.Instructthepatientnevertousesharpobjectssuchasbobbypinsorpaperclipstoremoveearwaxbecausetheycantraumatizetheearcanalandrupturethetympanicmembrane.Cotton-tippedapplicatorsshouldbeavoidedaswellbecausetheycauseearwaxtobecomeimpactedwithinthecanal.Instillingcoldorhotwaterintotheearcausesnausea,vomiting,orboth.DIF:ApplyREF:940OBJ:Successfullyperformhygieneforcareoftheintegument;perineum;feet,hands,andnails;mouth;andeyes,ears,andnose.TOP:ImplementationMSC:CPNRE:FoundationsofPractice41.Thepatientisbeingfittedwithahearingaid.Inteachingthepatienthowtocareforthehearingaid,thenurseinstructsthepatienttodowhichofthefollowing?a.Wearthehearingaid24hoursperdayexceptwhensleeping.b.Changethebatteryeverydayorasneeded.c.Avoidtheuseofhairspray,butaerosolperfumesareallowed.d.AdjustthevolumeforatNalkiRngdIistaGnceBo.f1Cm.MANS:DThevolumeisadjustedtoacomfortablelevelfortalkingatadistanceof1m.Initially,thepatientshouldwearahearingaidfor15to20minutes;thenweartimeisgraduallyincreasedto10to12hoursperday.Batterieslast1weekwithdailywearof10to12hours.Peoplewhowearhearingaidsshouldavoidtheuseofhairsprayandperfume;residuefromthespraycancausethehearingaidtobecomeoilyandgreasy.DIF:ApplyREF:941,Box38-15OBJ:Successfullyperformhygieneforcareoftheintegument;perineum;feet,hands,andnails;mouth;andeyes,ears,andnose.TOP:ImplementationMSC:CPNRE:FoundationsofPractice42.Thepatientiscomplainingofaninabilitytoclearhisnasalpassages.Howshouldthenurseinstructthepatient?a.Toblowhisnoseforcefullytoclearthepassage.b.Toinsertacotton-tippedapplicatorasfaraspossible.c.Toapplygentlesuctionwithapediatricbulbsuctiondevice.d.Touseadrywashclothtoabsorbsecretions.ANS:CCanadianFundamentalsofNursing7thEditionPotterTestBankNRIGB.CExcessivenasalsecretionscanberemovedusinggentlesuctioning.However,patientsusuallyremovesecretionsfromthenosebygentleblowingintoasofttissue.Thepatientshouldbecautionedagainstharshblowing,whichcreatespressurecapableofinjuringtheeardrum,thenasalmucosa,andevensensitiveeyestructures.Ifthepatientisunabletoremovenasalsecretions,thenursecanassistbyusingawetwashclothoracotton-tippedapplicatormoistenedinwaterorsaline.Theapplicatormustneverbeinsertedbeyondthelengthofthecottontip.DIF:ApplyREF:934OBJ:Successfullyperformhygieneforcareoftheintegument;perineum;feet,hands,andnails;mouth;andeyes,ears,andnose.TOP:ImplementationMSC:CPNRE:FoundationsofPractice43.Ofthefollowinghearingaids,whichinterferesthemostwithwearingeyeglassesandusingaphone?a.In-the-canalhearingaid.b.In-the-earhearingaid.c.Behind-the-earhearingaid.d.Theyareallequallyuseful.ANS:CThebehind-the-earaidhooksaroundandbehindtheearandisconnectedbyashort,clear,hollowplastictubetoanearmouldinsertedintotheexternalauditorycanal.Itisusefulforpatientswithrapidlyprogressivehearinglossormanualdexteritydifficulties,butitismorevisibleandinterfereswithwearingeyeglassesandusingaphone.Anin-the-canalaidisthenewest,smallest,andleastvisibletypeofhearingaid;itfitsentirelyintheearcanal.Itdoesnotinterferewithwearingeyeglassesorusingthetelephone,butitdoesnotaccommodateprogressivehearingloss,andmUanuSaldNextTerityisOneededtooperate.Anin-the-earaiddoesnotinterferewithwearingofeyeglassesorphoneusage,butitismorenoticeablethanthein-the-canalaidandisnotusefulforpersonswithskinproblemsintheearcanal.DIF:EvaluateREF:940OBJ:Successfullyperformhygieneforcareoftheintegument;perineum;feet,hands,andnails;mouth;andeyes,ears,andnose.TOP:AssessmentMSC:CPNRE:FoundationsofPractice44.Theuseofcriticalthinkingattitudesisnecessarytodesignaplanofcaretomeetthepatientshygieneneeds.Whichofthefollowingisconsideredtobeacriticalthinkingattribute?a.Curiosity.b.Communicationprinciples.c.Priorexperience.d.Knowledgeofculturalvariations.ANS:AUseofcriticalthinkingattitudes,suchascuriosityandhumility,isnecessarytodesignaplanofcaretomeetthepatientshygieneneeds.Communicationprinciplesandknowledgeofculturalvariationsinhygieneareconsideredknowledgeelements,andpriorexperienceispartoftheexperienceelementsofthecriticalthinkingmodelforhygieneassessment.DIF:RememberREF:906OBJ:DiscusstherolethatthenursingprocessandcriticalthinkingplayintheprovisionofhygieneCanadianFundamentalsofNursing7thEditionPotterTestBankcare.TOP:ImplementationMSC:CPNRE:Professional,Ethical,andLegalPractice45.Ofthefollowingpatients,whichonedoesthenurseexpecttoperformperinealcareindependently?a.Apatientwithurinaryandfecalincontinence.b.Acircumcisedmalepatientwhoisambulatory.c.Apatientwithrectalandperinealsurgicaldressings.d.Apatientwithanindwellingcatheter.ANS:BPatientsatgreatestriskforskinbreakdownintheperinealareaarethosewithurinaryorfecalincontinence,rectalandperinealsurgicaldressings,orindwellingurinarycatheters,alongwiththemorbidlyobese.Circumcisedboysandmenarenotathighriskforacquiringinfection,andambulatorypatientscanusuallyprovideself-perinealcare.DIF:EvaluateREF:926OBJ:Successfullyperformhygieneforcareoftheintegument;perineum;feet,hands,andnails;mouth;andeyes,ears,andnose.TOP:AssessmentMSC:CPNRE:FoundationsofPracticeNURSINGTB.COMCanadianFundamentalsofNursing7thEditionPotterTestBankChapter39:CardiopulmonaryFunctioningandOxygenationPotteretal:CanadianFundamentalsofNursing,7thEditionMULTIPLECHOICE1.Whatisthestructurethatisresponsibleforreturningoxygenatedbloodtotheheart?a.Pulmonaryartery.b.Pulmonaryvein.c.Superiorvenacava.d.Inferiorvenacava.ANS:BThepulmonaryveincarriesoxygenatedbloodtotheheart.Thepulmonaryarterycarriesdeoxygenatedbloodfromthehearttothelungs.Bothvenaecavaereturnbloodtotherightatriumoftheheart.DIF:RememberREF:958OBJ:Describethestructureandfunctionofthecardiopulmonarysystem.TOP:PlanningMSC:CPNRE:FoundationsofPractice2.Wherearechemicalreceptorsthatstimulateinspiration?a.Brain.b.Lungs.c.Aorta.d.Heart.ANS:CNURSINGTB.COMChemicalreceptorsintheaortasendsignalstobegintheinspirationprocess.Thebrain,lungs,andheartallareaffectedbythischemicalreaction.DIF:RememberREF:957OBJ:Describetheneuralandchemicalregulationofrespiration.TOP:PlanningMSC:CPNRE:FoundationsofPractice3.Thenurseknowsthattheprimaryfunctionofthealveoliiswhichofthefollowing?a.Carryoutgasexchange.b.Storeoxygen.c.Regulatetidalvolume.d.Producehemoglobin.ANS:AThealveolusisacapillarymembranethatallowsgasexchangeofoxygenandcarbondioxideduringrespiration.Thealveolidonotstoreoxygen,regulatetidalvolume,orproducehemoglobin.DIF:RememberREF:956OBJ:Describethestructureandfunctionofthecardiopulmonarysystem.TOP:KnowledgeMSC:CPNRE:FoundationsofPractice4.Whatwillanemiaresultin?a.Hypoxemia.CanadianFundamentalsofNursing7thEditionPotterTestBankUSNTOb.Impairedventilation.c.Hypovolemia.d.Decreasedlungcompliance.ANS:APatientswhoareanemicdonothavenormaloxygen-carryingcapacity.Asaresult,oxygencannotproperlyperfusethetissues,whichresultsinhypoxemia.Ventilationisimpairedwhenoxygen/carbondioxideexchangeoccursatthealveolarlevel.Hypovolemiaisadecreaseincirculatingbloodvolume.Lungcompliancereferstotheelasticityofthelungtissue.DIF:UnderstandREF:959OBJ:Identifyanddescribeclinicaloutcomesasaresultofdisturbancesinconduction,alteredcardiacoutput,impairedvalvularfunction,myocardialischemia,andimpairedtissueperfusion.TOP:AssessmentMSC:CPNRE:FoundationsofPractice5.Theprocessofexchanginggasesthroughthealveolarcapillarymembraneisknownaswhichofthefollowing?a.Disassociation.b.Diffusion.c.Perfusion.d.Ventilation.ANS:BDiffusionistheprocessofgasesexchangingacrossthealveoliandcapillariesofbodytissues.Disassociationisnotrelatedtooxygenation.Perfusionistheabilityofthecardiovascularsystemtocarryoxygenatedbloodtotissuesandreturndeoxygenatedbloodtotheheart.Ventilationistheprocessofmovinggasesintoandoutofthelungs.NRIGB.CMDIF:RememberOBJ:Identifythephysiologicalprocessesinvolvedinventilation,perfusion,andexchangeofrespiratorygases.TOP:AssessmentMSC:CPNRE:FoundationsofPractice6.IncaringforapatientwhowasinamotorvehicleaccidentthatresultedintraumatoC4,whatwouldthenurseexpecttofind?a.Decreasedtidalvolumes.b.Increasedperfusion.c.Increaseduseofaccessorymuscles.d.Decreasedhemoglobin.ANS:AAC4injuryresultsindamagetothephrenicnerveandcausesadecreaseininspiratorylungexpansion.AccessorymusclesarealsodamagedbyaC4injury.Thepatientmayexhibitdecreasedperfusionandincreasedhemoglobintocompensateforhypoxemia.DIF:UnderstandREF:970,Table39-3OBJ:Describetheneuralandchemicalregulationofrespiration.TOP:AssessmentMSC:CPNRE:FoundationsofPractice7.Inwhichconditionwouldthenurseexpecttoseeincreasedventilations?a.Increasedoxygensaturation.b.Decreasedcarbondioxidelevels.c.DecreasedpH.REF:958CanadianFundamentalsofNursing7thEditionPotterTestBankd.Increasedhemoglobinlevels.ANS:CRetainedCO2createsH+byproductsthatlowerpH.Thissendsachemicalsignaltoincreaserespiratoryrateandwouldresultinincreasedventilation.Allotheroptionswouldcausetheventilationratetonormalizeordecreaseinordertoincreasecarbondioxideretentionorastheresultofdeliveryofhigherlevelsofoxygentotissues.DIF:UnderstandREF:970,Table39-3OBJ:Describetheneuralandchemicalregulationofrespiration.TOP:AssessmentMSC:CPNRE:FoundationsofPractice8.Whydoesthenurserecommendthatapatientinstallacarbonmonoxidedetectorinthehome?a.Itisrequiredbylaw.b.Carbonmonoxidetightlybondstohemoglobin,causinghypoxia.c.Carbonmonoxidesignalsthecerebralcortextoceaseventilations.d.Carbonmonoxidecombineswithoxygeninthebodyandproducesadeadlytoxin.ANS:BCarbonmonoxidehasahighaffinityforhemoglobin;itpreventsoxygenfrombondingtohemoglobin,andthereforeoxygencannotbetransportedtotissues.Acarbonmonoxidedetectorisnotrequiredbylaw;carbonmonoxidedoesnotsignalthecerebralcortextoceaseventilations,anditcombinesnotwithoxygenbutwithhemoglobintoproduceatoxin.DIF:RememberREF:968OBJ:Identifynursingcareinterventionsintheprimarycare,acutecare,andrestorativeandcontinuingcaresettingsthatpromoteoxygenation.TOP:PlanningMSC:CPNRE:FoundationsofNPraRcticeIGB.CMUSNTO9.Whileperforminganassessment,thenursehearscracklesinthepatientslungfields.Thenursealsolearnsthatthepatientissleepingonthreepillows.Whatdothesesymptomsprobablyindicate?a.Left-sidedheartfailure.b.Right-sidedheartfailure.c.Atrialfibrillation.d.Myocardialischemia.ANS:ALeft-sidedheartfailureresultsinpulmonarycongestion,thesignsandsymptomsofwhichincludeshortnessofbreath,crackles,anddiscomfortinthesupineposition.Right-sidedheartfailureissystemicandresultsinperipheraledemaandhepatojugulardistension.Atrialfibrillationisanirregularheartrate.Myocardialischemiamostoftenresultsinchestpain,alongwithshortnessofbreath,nausea,andfatigue.DIF:UnderstandREF:961OBJ:Identifythephysiologicalprocessesinvolvedinventilation,perfusion,andexchangeofrespiratorygases.TOP:AssessmentMSC:CPNRE:FoundationsofPractice10.Thenurseknowsthatamyocardialinfarctionisanocclusionofwhatbloodvessel?a.Pulmonaryartery.b.Ascendingaorta.c.Coronaryartery.CanadianFundamentalsofNursing7thEditionPotterTestBankd.Carotidartery.ANS:CAmyocardialinfarctionisthelackofbloodflowasaresultofobstructiontothecoronaryartery,whichsuppliestheheartwithblood.Theascendingaortaisavesselthatleadsfromthehearttoperfusethebrain.Thepulmonaryarterysuppliesbloodtothelungs.Thecarotidarterysuppliesbloodtothebrain.DIF:RememberREF:963OBJ:Identifythephysiologicalprocessesofcardiacoutput,myocardialbloodflow,andcoronaryarterycirculation.TOP:AssessmentMSC:CPNRE:FoundationsofPractice11.Myocardialbloodflowisunidirectional;thenurseknowsthatthecorrectpathwayiswhichofthefollowing?a.Rightatrium,rightventricle,leftventricle,leftatrium.b.Rightatrium,leftatrium,rightventricle,leftventricle.c.Rightatrium,rightventricle,leftatrium,leftventricle.d.Rightatrium,leftatrium,leftventricle,rightventricle.ANS:CUnoxygenatedbloodflowsthroughthevenaecavaeintotherightatrium,whereitispumpeddowntotherightventricle;thebloodisthenpumpedoutthepulmonaryarteryandisreturnedoxygenatedviathepulmonaryveintotheleftatrium,whereitflowstotheleftventricleandispumpedouttotherestofthebodyviatheaorta.DIF:RememberREF:954OBJ:Describethestructureandfunctionofthecardiopulmonarysystem.TOP:PathologyMSC:CPNNRRE:FIounGdatiBon.sCofPMracticeUSNTO12.Thenursecaringforapatientwithischemiaoftheleftcoronaryarterywouldexpecttofindwhichsign?a.Increasedventriculardiastole.b.Increasedstrokevolume.c.Decreasedpreload.d.Decreasedafterload.ANS:DTheleftcoronaryarterysuppliesthemusclesoftheleftventricle;thestrengthofthemuscleaffectsthecontractilityoftheheart.Theotheroptionsarenotaffectedbythemusclesoftheleftventricle.DIF:UnderstandREF:963OBJ:Identifythephysiologicalprocessesofcardiacoutput,myocardialbloodflow,andcoronaryarterycirculation.TOP:AssessmentMSC:CPNRE:FoundationsofPractice13.Normalcardiacoutputis2.5to4L/minute/m3inahealthyadultatrest.Whichofthefollowingisthecorrectformulatocalculatecardiacoutput?a.Strokevolumeheartrate.b.Strokevolume/bodysurfacearea.c.Bodysurfaceareacardiacindex.d.Heartrate/strokevolume.CanadianFundamentalsofNursing7thEditionPotterTestBankANS:ACardiacoutputcanbecalculatedbymultiplyingthestrokevolumeandtheheartrate.Theotheroptionsarenotmeasuresofcardiacfunctioning.DIF:RememberREF:955OBJ:Identifythephysiologicalprocessesofcardiacoutput,myocardialbloodflow,andcoronaryarterycirculation.TOP:AssessmentMSC:CPNRE:FoundationsofPractice14.Thenurseiscarefultomonitorapatientscardiacoutputbecausethishelpsthenursetodeterminewhichofthefollowing?a.Peripheralextremitycirculation.b.Oxygenationrequirements.c.Cardiacarrhythmias.d.Ventilationstatus.ANS:ACardiacoutputindicateshowmuchbloodisbeingcirculatedsystemically.Oxygenstatuswouldbedeterminedbypulseoximetryandthepresenceofcyanosis.Cardiacarrhythmiasareirregularrhythmswhoseelectricalimpulsemonitoredthroughfive-leadelectrocardiography(ECG).Ventilationstatusisnotdependentsolelyoncardiacoutput.DIF:ApplyREF:955OBJ:Describetherelationshipamongcardiacoutput,preload,afterload,contractility,andheartrate.TOP:AssessmentMSC:CPNRE:FoundationsofPractice15.Anurseisassistingapatientwithambulation.Thepatientbecomesshortofbreathandbeginstocomplainofsharpchestpain.Whichactionbythenurseisthefirstpriority?a.CallfortheemergencyreNspUoRnsSeIteNamGTtoBb.riCngOtMhedefibrillator.b.Havethepatientsitdowninthenearestchair.c.Returnthepatienttotheroomandapply100%oxygen.d.Askaco-workertogettheECGmachineSTAT.ANS:BThepatientisexperiencingcardiacdistressforreasonsunknown.Thenurseshouldfirstsecurethesafetyofthepatientanddecreasetheworkloadonthepatientsheartbyputtinghiminarestingposition;thiswillincreasecardiacoutputbydecreasingafterload.Oncethepatientisstable,thenursecanobtainoxygentoputonthepatient.Next,thenursecanbegintomonitorthepatientsoxygenandcardiacstatus.Ifnecessary,theemergencyteammaybeactivatedtodefibrillate.DIF:ApplyREF:964|967OBJ:Identifynursingcareinterventionsintheprimarycare,acutecare,andrestorativeandcontinuingcaresettingsthatpromoteoxygenation.TOP:ImplementationMSC:CPNRE:FoundationsofPractice16.Apatienthasinadequatestrokevolumeinrelationtodecreasedpreload.Whatactiondoesthenurseanticipate?a.Placingthepatientonoxygenmonitoring.b.Administeringvasodilators.c.Verifyingthatthebloodconsentformhasbeensigned.d.Preparingthepatientfordialysis.CanadianFundamentalsofNursing7thEditionPotterTestBankANS:CPreloadisaffectedbythecirculatingvolume;ifthepatienthasdecreasedfluid,itwillneedtobereplacedwithfluidorbloodtherapy.Beforebloodproductsareadministered,typingandmatchingshouldbeperformed.Monitoringthepatientsoxygenationstatuswillnotaffectpreload.Administeringvasodilatorsaffectsafterload.Dialysiswouldfurtherremovefluidfromthepatient,thusdecreasingpreload.DIF:ApplyREF:955OBJ:Describetherelationshipamongcardiacoutput,preload,afterload,contractility,andheartrate.TOP:PlanningMSC:CPNRE:FoundationsofPractice17.Whencaringforapatientwithatrialfibrillation,thenurseismostconcernedwithwhichvitalsign?a.Heartrate.b.Pain.c.Oxygensaturation.d.Bloodpressure.ANS:CAtrialfibrillationresultsinpoolingofbloodintheatria,formingembolithatcanbepumpedouttotherestofthebody.Themostcommonmanifestationsarestroke,myocardialinfarction,andpulmonaryembolus.Asuddenanddrasticdropinoxygenationandbloodpressurecanindicatebothpulmonaryembolusandmyocardialinfarction.DIF:ApplyREF:960OBJ:Identifyanddescribeclinicaloutcomesasaresultofdisturbancesinconduction,alteredcardiacoutput,impairedvalvularfunction,myocardialischemia,andimpairedtissueperfusion.TOP:AssessmentMSC:CPNNURRES:FIoNunGdaTtiBon.sCofOPMractice18.Thenursewouldexpectapatientwithright-sidedheartfailuretohavewhichofthefollowing?a.Peripheraledema.b.Basilarcrackles.c.Chestpain.d.Cyanosis.ANS:ARight-sidedheartfailureresultsfrominabilityoftherightsideofthehearttopumpeffectively,whichleadstoasystemicbackup.Peripheraledemaandhepatojugulardistensionaresignsofright-sidedfailure.Basilarcracklescanindicatepulmonarycongestionfromleft-sidedheartfailure.Cyanosisandchestpainresultfrominadequatetissueperfusion.DIF:RememberREF:970,Table39-4OBJ:Identifynursingcareinterventionsintheprimarycare,acutecare,andrestorativeandcontinuingcaresettingsthatpromoteoxygenation.TOP:AssessmentMSC:CPNRE:FoundationsofPractice19.Whichstatementbythepatientindicatesanunderstandingofatelectasis?a.Itisimportanttodobreathingexerciseseveryhourtopreventatelectasis.b.IfIdevelopatelectasis,Iwillneedachesttubetodrainexcessfluid.c.Atelectasisaffectsonlythosewithchronicconditionssuchasemphysema.d.Hyperventilationwillopenupmyalveoli,preventingatelectasis.CanadianFundamentalsofNursing7thEditionPotterTestBankANS:AAtelectasisdevelopswhenalveolidonotexpand.Breathingexercisesincreaselungvolumeandopentheairways.DeepbreathingopenstheporesofKohnbetweenthealveolitoallowsharingofoxygenbetweenalveoli.Thispreventsatelectasisfromdeveloping.DIF:AnalyzeREF:957OBJ:Identifyanddescribeclinicaloutcomesofhyperventilation,hypoventilation,andhypoxemia.TOP:EvaluateMSC:CPNRE:FoundationsofPractice20.Anurseiscaringforapatientwhosetemperatureis37.9C(100.2F).Thenurseexpectsthispatienttohyperventilateforwhichreason?a.Increasedmetabolicdemands.b.Anxietyoverillness.c.Decreaseddrivetobreathe.d.Destructionoflungtissuesbyinfection.ANS:AFeverincreasesthemetabolicdemandsofthebody,increasingproductionofcarbondioxide.Thebodyhyperventilatestogetridofexcesscarbondioxide.Anxietycancausehyperventilation,butfeverwouldbetheprimarycause.Hyperventilationdecreasesthedrivetobreathe.Thecauseofthefeverinthisquestionisunknown.DIF:ApplyREF:964OBJ:Identifyanddescribeclinicaloutcomesofhyperventilation,hypoventilation,andhypoxemia.TOP:AssessmentMSC:CPNRE:FoundationsofPractice21.WhatassessmentfindingisthNeeRarlieIstsGignBof.hCypoMxia?a.Restlessness.Ub.Decreasedbloodpressure.c.Cardiacdysrhythmias.d.Cyanosis.ANS:ASNTOHypoxiaresultsfrominadequatetissueoxygenatthecellularlevel.Theearliestsignofhypoxiaisrestlessness;asitprogresses,mentalstatuschanges,cardiacchanges,andcyanosiscanoccur.Earlyhypoxiaresultsinelevatedbloodpressure.Inlaterhypoxia,changesinvitalsignoccur,suchasincreasedheartandrespiratoryrates.Cyanosisisalatesignofhypoxia.DIF:UnderstandREF:964OBJ:Identifyanddescribeclinicaloutcomesofhyperventilation,hypoventilation,andhypoxemia.TOP:AssessmentMSC:CPNRE:FoundationsofPractice22.Anurseiscaringforapatientwhosufferedamyocardialinfarctionintheleftcoronaryartery.Uponassessment,whatwouldthenurseexpecttofind?a.Bloodinthesputum.b.Distendedjugularvein.c.Peripheraledema.d.Cracklesinthelungs.ANS:DCanadianFundamentalsofNursing7thEditionPotterTestBankTheleftcoronaryarterysuppliestheleftventricleoftheheart;damagetothemuscleintheleftventricleleadstopulmonarycongestionandfrothysputum,andcracklesmaybeheard.Adistendedjugularveinandperipheraledemaareassociatedwithdamagetotherightsideoftheheart.Bloodinthesputumisindicativeofaninfectionsuchastuberculosis.DIF:AnalyzeREF:961OBJ:Identifyanddescribeclinicaloutcomesasaresultofdisturbancesinconduction,alteredcardiacoutput,impairedvalvularfunction,myocardialischemia,andimpairedtissueperfusion.TOP:AssessmentMSC:CPNRE:FoundationsofPractice23.Anurseiscaringforapatientwhohaspoortissueperfusionastheresultofhypertension.Whenthepatientaskswhatheshouldeatforbreakfast,whatshouldthenurserecommend?a.Abowlofcerealwithwholemilkandabanana.b.Acupofnonfatyogurtwithgranola,andahandfulofdriedapricots.c.Wholewheattoastwithbutter,asideofcottagecheese.d.Omelettewithsausage,cheese,andonions.ANS:BDietshighinpotassium,fibre,andcalciumandlowinfatarebestforsomeonewhoismanaginghypertension.Nonfatyogurtwithgranolaisagoodsourceofcalcium,fibre,andpotassium;driedapricotsareasecondsourceofpotassium.Althoughcerealandabananaprovidefibreandpotassium,skimmilkshouldbesubstitutedforwholemilktodecreasefat.Anomelettewithsausageandcheeseishighinfat,asisbutter.DIF:ApplyREF:966OBJ:Identifynursingcareinterventionsintheprimarycare,acutecare,andrestorativeandcontinuingcaresettingsthatpromoteoxygenation.TOP:PlanningMSC:CPNRE:FoundationsofNPUraRctiSceINGTB.COM24.Anursecaringforapatientwithchronicobstructivepulmonarydisease(COPD)knowsthatwhichoxygendeliverydeviceismostappropriate?a.Nasalcannula.b.Simplefacemask.c.Partialnon-rebreathingmask.d.Non-rebreathingmask.ANS:ANasalcannulasdeliveroxygenfrom1to6L/min.ApatientwithCOPDshouldneverreceivemorethan3L/minbecausethisdecreasesthedrivetobreathe,whichresultsinhypoventilation.Allotherdevicesareintendedforflowratesgreaterthan6L/min.DIF:AnalyzeREF:979|1002OBJ:Identifynursingcareinterventionsintheprimarycare,acutecare,andrestorativeandcontinuingcaresettingsthatpromoteoxygenation.TOP:PlanningMSC:CPNRE:FoundationsofPractice25.Thenursedeterminesthatanolderpatientisatriskforinfectionbecauseofdecreasedimmunity.Whichplanofcarebestaddressesthepreventionofinfectionforthepatient?a.Encouragethepatienttostayuptodateonallvaccinations.b.Informthepatientoftheimportanceoffinishingtheentiredoseofantibiotics.c.Schedulethepatientforannualtuberculosisskintesting.d.Createanexerciseroutinetorun30minuteseveryday.CanadianFundamentalsofNursing7thEditionPotterTestBankANS:AAnursingcareplanforpreventivehealthmeasuresshouldbereasonableandfeasible.Keepinguptodateonvaccinationsisimportantbecausevaccinereducestheseverityofillnessesandseriouscomplications.Althoughitisimportanttofinishthefullcourseofantibiotics,itisnotapreventivehealthmeasure.Schedulingannualtuberculosisskintestsdoesnotaddressprevention.Theexerciseroutineshouldbereasonabletoincreasecompliance.DIF:ApplyREF:977OBJ:Identifynursingcareinterventionsintheprimarycare,acutecare,andrestorativeandcontinuingcaresettingsthatpromoteoxygenation.TOP:PlanningMSC:CPNRE:FoundationsofPractice26.Thenursewouldexpectwhichchangeincardiacoutputforapatientwithfluidvolumeoverload?a.Increasedpreload.b.Decreasedafterload.c.Decreasedtissueperfusion.d.Increasedheartrate.ANS:APreloadreferstothestretchoftheventricleinrelationtothevolumeofblood;anincreaseincirculatingvolumewouldincreasethepreloadoftheheart.Afterloadreferstoresistance;increasedpressurewouldleadtoincreasedresistance,andafterloadwouldincrease.Adecreaseintissueperfusionwouldbeseenwithhypovolemia.Adecreaseinfluidvolumewouldcauseanincreaseinheartratebecausethebodyisattemptingtoincreasecardiacoutput.NURSINGTB.COMDIF:UnderstandREF:955OBJ:Describetherelationshipamongcardiacoutput,preload,afterload,contractility,andheartrate.TOP:PlanningMSC:CPNRE:FoundationsofPractice27.Thenurseexpectstofindwhichofthefollowinginapatientwithanginapectoris?a.Experiencefeelingsofindigestionaftereatingaheavymeal.b.Havedecreasedoxygensaturationduringrest.c.Hypoventilateduringperiodsofacutestress.d.Complainoftinglingintheleftarmthatlaststhroughoutthemorning.ANS:AAnginapectorisischestpainthatresultsfromlimitedoxygensupply.Oftenpainisprecipitatedbyactivitiessuchasexercise,stress,andeatingaheavymealandlastsfrom1to15minutes.Hyperventilationmayoccurtocompensatefordecreasedoxygenperfusionandduringperiodsofacutestress.Symptomsofanginapectorisarerelievedbyrest,nitroglycerine,orboth.Oxygensaturation,pain,andtinglinginthearmshouldberelievedbyrest.Painorarmtinglingthatpersistscouldbeasignofmyocardialinfarction.DIF:UnderstandREF:963OBJ:Identifyanddescribeclinicaloutcomesasaresultofdisturbancesinconduction,alteredcardiacoutput,impairedvalvularfunction,myocardialischemia,andimpairedtissueperfusion.TOP:PlanningMSC:CPNRE:FoundationsofPracticeCanadianFundamentalsofNursing7thEditionPotterTestBankUSNT28.Whichofthefollowingisanonmodifiableriskfactorforlungdisease?a.Allergies.b.Smoking.c.Stress.d.Asbestosexposure.ANS:AAnonmodifiableriskfactorisoneoverwhichthepatienthasnocontrol.Allergiescanbemanaged,butimmune-mediatedresponsescannotbecontrolled.Smoking,stress,andasbestosexposureareallmodifiableriskfactors.DIF:UnderstandREF:969OBJ:Describetheeffectofapatientslevelofhealth,age,lifestyle,andenvironmentoncardiopulmonaryoxygenation.TOP:AssessmentMSC:CPNRE:FoundationsofPractice29.Thenurseiscreatingaplanofcareforanobesepatientwhoissufferingfromfatiguerelatedtoineffectivebreathing.Whichinterventionbestaddressesashort-termgoalthatthepatientcouldachieve?a.Running30minuteseverymorning.b.Stoppingsmokingimmediately.c.Sleepingontwotothreepillowsatnight.d.Limitingthedietto1500caloriesaday.ANS:CToachieveashort-termgoal,thenurseshouldplanalifestylechangethatthepatientcanmakeimmediatelythatwillhaveaquickeffect.SleepingonseveralpillowsatnightwouldimmediatelyrelieveorthopneNaanRdoIpenGtheBp.atCientMsairway,therebyreducingsleepapneaandreducingfatigue.Running30minutesadaywouldimprovecardiopulmonaryhealth,butapatientneedstobuildupexercisetolerance.Smokingcessationisanotherprocess,butmanypeoplehavedifficultyquittingimmediately;quittingoftenoccursasaslowprogression,beginningwithreductionoffrequency.Amorerealisticshort-termgoalwouldbetograduallyreducethenumberofcigarettessmoked.Limitingcaloricintakecanhelpapatientloseweight,butthisisagradualprocessandisnotreasonableforashort-termgoal.DIF:AnalyzeREF:968OBJ:Identifynursingcareinterventionsintheprimarycare,acutecare,andrestorativeandcontinuingcaresettingsthatpromoteoxygenation.TOP:PlanningMSC:CPNRE:FoundationsofPractice30.Anurseiscaringforapatientwithleft-sidedhemiparesiswhohasdevelopedbronchitisandhasaheartrateof105,bloodpressureof156/90,andarespirationrateof30.Whichnursingdiagnosisisthepriorityforthispatient?a.Activityintolerance.b.Riskforskinbreakdown.c.Impairedgasexchange.d.Riskforinfection.ANS:CCanadianFundamentalsofNursing7thEditionPotterTestBankThemostimportantnursinginterventionistomaintainairwayandcirculationforthispatient;therefore,Impairedgasexchangeisthefirstnursingpriority.Activityintoleranceisaconcernbutisnotthepriorityinthiscase.RiskforskinbreakdownandRiskforinfectionarealsoimportantbutdonotaddressanimmediateimpairmentwithphysiologicalintegrity.DIF:AnalyzeREF:973OBJ:Identifynursingcareinterventionsintheprimarycare,acutecare,andrestorativeandcontinuingcaresettingsthatpromoteoxygenation.TOP:PlanningMSC:CPNRE:FoundationsofPractice31.Whichnursinginterventionismosteffectiveinpreventinghospital-acquiredpneumoniainanolderpatient?a.Assistingthepatienttocough,turn,andbreathedeeplyevery2hours.b.Encouragingpatienttodrinkthroughastrawtopreventaspiration.c.Discontinuinghumidificationdeliverydevicetokeepexcessfluidfromlungs.d.Monitoringoxygensaturationandfrequentlyassessinglungbases.ANS:AThegoalofthenursingactionshouldbethepreventionofpneumonia;theinterventionthatbestaddressesthisisforthepatienttocough,turn,andbreathedeeplytokeepsecretionsfrompoolingatthebaseofthelungs.Drinkingthroughastrawincreasestheriskofaspiration.Humidificationthinsrespiratorysecretions,whichmakesthemeasiertoexpel.Monitoringoxygenstatusisimportantbutisnotamethodofprevention.DIF:AnalyzeREF:978|979OBJ:Identifynursingcareinterventionsintheprimarycare,acutecare,andrestorativeandcontinuingcaresettingsthatpromoteoxygenation.TOP:ImplementationMSC:CPNRE:FoundationsofNPUraRctiSceINGTB.COM32.Thenurseisassessingapatientwithemphysema.Whichassessmentfindingnecessitatesfurtherfollow-upwiththephysician?a.Clubbingofthefingers.b.Increasedanterior-posteriordiameterofthechest.c.Hemoptysis.d.Tachypnea.ANS:CHemoptysis(bloodinthesputum)isanabnormaloccurrenceinemphysema,andfurtherdiagnosticstudiesareneededtodeterminethecause.Clubbingofthefingers,barrelchest,andtachypneaarealltypicalfindingsinapatientwithemphysema.DIF:ApplyREF:968OBJ:Identifynursingcareinterventionsintheprimarycare,acutecare,andrestorativeandcontinuingcaresettingsthatpromoteoxygenation.TOP:AssessmentMSC:CPNRE:FoundationsofPractice33.ApatientwithCOPDasksthenursewhyheishavingincreaseddifficultywithhisfinemotorskills,suchasbuttoninghisshirt.Whichresponsebythenurseismosttherapeutic?a.Yourbodyisntreceivingenoughoxygentosenddowntoyourfingers;thiscausesthemtoclubandmakesdexteritydifficult.b.Yourdiseaseprocessmakeseventhesmallesttasksseemexhausting.Trytakinganapbeforegettingdressed.CanadianFundamentalsofNursing7thEditionPotterTestBankUSNTc.Oftenpatientswithyourdiseaselosementalstatusandforgethowtoperformdailytasks.d.Yourdiseaseaffectsbothyourlungsandyourheart,andnotenoughbloodisbeingpumped,soyouarelosingsensoryfeedbackinyourextremities.ANS:AClubbingofthenailbedisafrequentsymptomofCOPDandcanmakeactivitiesofdailylivingdifficult.Takinganapdecreasesfatiguebutdoesnothelpthepatientperformfinemotorskills.LossofmentalstatusisnotanormalfindingwithCOPD.Lowoxygenlevel,notlowcirculatingbloodvolume,istheprobleminCOPD.DIF:ApplyREF:969OBJ:Describetheeffectofapatientslevelofhealth,age,lifestyle,andenvironmentoncardiopulmonaryoxygenation.TOP:PatientTeachingMSC:CPNRE:FoundationsofPractice34.Thenurseiscaringforapatientwithatracheostomytube.Whichnursinginterventionismosteffectiveinpromotingeffectiveairwayclearance?a.Suctioningrespiratorysecretionsseveraltimeseveryhour.b.Administeringhumidifiedoxygenthroughatracheostomycollar.c.Instillingnormalsalineintothetracheostomytothinsecretionsbeforesuctioning.d.Deflatingthetracheostomycuffbeforeallowingthepatienttocoughupsecretions.ANS:BHumidificationofairwillhelpkeepthemucousmembranesmoistandwillmakesecretionseasiertoexpel.Suctioningshouldbedoneonlyasneeded;toofrequentsuctioningcandamagethemucosallining,whichwouldresultinthickersecretions.NormalsalineshouldneverbeinstilledintoatrachNeosRtomIybeGcauBse.thCiscMouldleadtoinfection.Thepurposeofthetracheostomycuffistokeepsecretionsfromenteringthelungs;thenurseshouldnotdeflatethetracheostomycuffunlessinstructedtodosobythephysician.DIF:ApplyREF:1002OBJ:Identifynursingcareinterventionsintheprimarycare,acutecare,andrestorativeandcontinuingcaresettingsthatpromoteoxygenation.TOP:ImplementationMSC:CPNRE:FoundationsofPractice35.Thenurseiseducatingastudentnurseoncaringforapatientwithachesttube.Thenurseknowsthatteachinghasbeeneffectivewhenthestudentmakeswhichstatement?a.Ishouldstripthedrainsonthechesttubeeveryhourtopromotedrainage.b.Ifthechesttubebecomesdislodged,thefirstthingIshoulddoisnotifythephysician.c.Ishouldclampthechesttubewhengivingthepatientabedbath.d.IshouldreportifIdonotseecontinuousbubblinginthewater-sealchamber.ANS:DCorrectcareofachesttubeinvolvesknowingnormalandabnormalfunctioningofthetube.Bubblinginthewater-sealchamberisexpected.Strippingthedrainrequiresaprescriberorder.Ifthechesttubebecomesdislodged,thenurseshouldimmediatelyapplyocclusivepressureovertheinsertionsite.Thechesttubeshouldnotbeclampedunlessnecessary;ifso,thelengthoftimeclampedmustbeminimaltoreducetheriskofpneumothorax.DIF:AnalyzeREF:998CanadianFundamentalsofNursing7thEditionPotterTestBankOBJ:Identifynursingcareinterventionsintheprimarycare,acutecare,andrestorativeandcontinuingcaresettingsthatpromoteoxygenation.TOP:PlanningMSC:CPNRE:FoundationsofPractice36.Whichnursingdiagnosisistheprioritywhenthenurseiscaringforapatientwithatraumaticbraininjurywhohadatracheostomyplaced?a.Riskforskinbreakdown.b.Impairedgasexchange.c.Ineffectiveairwayclearance.d.Riskforinfection.ANS:CPatientswithtracheotomiesrelyonthetracheostomytoprovideastableopenairway.Thenurseisalsoconcernedthatthepatientwouldnotbeabletocoughuphisownsecretions,whichcouldoccludethetracheostomyandputthepatientatriskforineffectiveairwayclearance.Nursingprioritiesareairway,breathing,andcirculation.NursingdiagnosesofactualconditionsshouldbeaddressedbeforeRiskdiagnoses.Skinbreakdownandinfectionarenotimmediatelylifethreatening.DIF:AnalyzeREF:980|1005OBJ:Identifynursingcareinterventionsintheprimarycare,acutecare,andrestorativeandcontinuingcaresettingsthatpromoteoxygenation.TOP:PlanningMSC:CPNRE:FoundationsofPractice37.Thenurseknowsthatthemosteffectivemethodforsuctioningapatientwithatracheostomytubeiswhichofthefollowing?a.Setsuctionregulatorat150to200mmHg.b.LiberallylubricatetheenNdUofRthSeIsNucGtiTonBc.atCheOteMrwithawater-solublesolution.c.Limitthelengthofsuctioningto10to15seconds.d.Applysuctionwhilegentlyrotatingandinsertingthecatheter.ANS:CSuctioningpassesshouldbelimitedto10to15secondstoavoidoxygendesaturation.Suctionforatracheostomyshouldbesetat100to150mmHg.Excessivelubricationcanclogthecatheteroroccludetheairway.Suctionshouldnotbeapplieduntilafterthecatheterhasbeeninserted.DIF:ApplyREF:983-986OBJ:Identifynursingcareinterventionsintheprimarycare,acutecare,andrestorativeandcontinuingcaresettingsthatpromoteoxygenation.TOP:ImplementationMSC:CPNRE:FoundationsofPractice38.Thenurseisassessingapatientwitharightpneumothorax.Whichfindingwouldthenurseexpect?a.Bilateralexpiratorycrackles.b.Absenceofbreathsoundsontherightside.c.Right-sidedwheezesoninspiration.d.Tracheadeviationtotheright.ANS:BCanadianFundamentalsofNursing7thEditionPotterTestBankArightpneumothoraxisacollectionofairinthepleuralspace,whichcausesthelungtocollapse;therefore,nobreathsoundsshouldbeheardonthatside.Cracklesindicatepneumonia.Wheezesareasthmarelated.Acollapsedrightlungwouldcausethetracheatodeviatetotheleft.DIF:ApplyREF:998OBJ:Identifythephysiologicalprocessesinvolvedinventilation,perfusion,andexchangeofrespiratorygases.TOP:AssessmentMSC:CPNRE:FoundationsofPractice39.Whilethenurseischangingthetiesonatracheostomycollar,thepatientcoughs,dislodgingthetracheostomytube.Whatisthenursesfirstnursingaction?a.Presstheemergencyresponsebutton.b.Placethepatientonafacemaskdelivering100%oxygen.c.Insertasparetracheostomy.d.Manuallyoccludethetracheostomywithsterilegauze.ANS:CThenursesfirstpriorityistoestablishastableairwaybyinsertingasparetracheostomytubeintothepatientsairway.Thenursecouldactivatetheemergencyresponseteamifthepatientisstillunstableafterthetracheostomytubeisplaced.Apatientwithatracheostomyhasanimpairmentthatcauseshimorhernottobeabletobreathenormally;afacemaskwouldnotbeaneffectivemethodofgettingairintothelungs.Manuallyoccludingpressureoverthetracheostomysiteisnotappropriate.DIF:ApplyREF:997OBJ:Identifynursingcareinterventionsintheprimarycare,acutecare,andrestorativeandcontinuingcaresettingsthatpromoteoxygenation.TOP:ImplementationMSC:CPNRE:FoundationsofNPUraRctiSceINGTB.COMCanadianFundamentalsofNursing7thEditionPotterTestBankChapter40:Fluid,Electrolyte,andAcid-BaseBalancesPotteretal:CanadianFundamentalsofNursing,7thEditionMULTIPLECHOICE1.Approximatelytwo-thirdsofthebodystotalwatervolumeexistsinwhichfluid?a.Intracellular.b.Interstitial.c.Intravascular.d.Transcellular.ANS:AIntracellularfluidaccountsforapproximatelytwo-thirdsofthefluidsinthebodyandabout42%oftotalbodyweight.Interstitialfluid,intravascularfluid,andtranscellularfluidconstituteextracellularfluid,whichisthefluidoutsideacell.DIF:RememberREF:1016OBJ:Describethedistribution,composition,movement,andregulationofbodyfluids.TOP:AssessmentMSC:CPNRE:FoundationsofPractice2.Whatistheprocessinwhichwatermovespassivelyfromanareaoflowerparticleconcentrationtoanareaofhigherparticleconcentration?a.Hydrolysis.b.Osmosis.c.Filtration.d.Activetransport.ANS:BNURSINGTB.COMTheprocessinwhichwatermovespassivelyfromanareaoflowparticleconcentrationtoanareaofhigherparticleconcentrationisknownasosmosis.Hydrolysisisatermnotrelatedtofluidandelectrolytebalance.Filtrationismediatedbyfluidpressurefromanareaofhigherpressuretoanareaoflowerpressure.Activetransportrequiresmetabolicactivityandisnotpassive.DIF:RememberREF:1017OBJ:Describethedistribution,composition,movement,andregulationofbodyfluids.TOP:AssessmentMSC:CPNRE:FoundationsofPractice3.Thenurseknowsthatinapatientwhohasvenouscongestionfromright-sidedheartfailure,edemadevelopsasaresultofanimbalancewithregardtowhichpressure?a.Hydrostatic.b.Osmotic.c.Oncotic.d.Concentration.ANS:AVenouscongestionincreasescapillaryhydrostaticpressure.Increasedhydrostaticpressurecausesincreasesinmovementoffluidintotheinterstitialarea,whichresultsinedema.Osmoticandoncoticpressuresinvolvetheconcentrationsofsolutesandcancontributetoedemainothersituations.Concentrationpressureisnotanursingterm.CanadianFundamentalsofNursing7thEditionPotterTestBankDIF:RememberREF:1018OBJ:Describecommonfluid,electrolyte,andacid-baseimbalances,andidentifyrelatedriskfactors.TOP:AssessmentMSC:CPNRE:FoundationsofPractice4.Thenurseunderstandsthatadministeringahypertonicsolutiontoapatientwillshiftwaterfromwhichspacetowhichspace?a.Intracellular;extracellular.b.Extracellular;intracellular.c.Intravascular;intracellular.d.Intravascular;interstitial.ANS:ATheconcentrationofahypertonicsolutionisgreaterthanthoseofnormalbodyfluids,andsowaterwillshiftoutofcellsbecauseoftheosmoticpulloftheextraparticles.Movementofwaterintocellsoccurswhenhypotonicfluidsareadministered.Distributionoffluidbetweenintravascularandinterstitialspacesoccursbyfiltration,thenetsumofhydrostaticandosmoticpressures.DIF:UnderstandREF:1052OBJ:Describethedistribution,composition,movement,andregulationofbodyfluids.TOP:AssessmentMSC:CPNRE:FoundationsofPractice5.Whichpatientismostatriskforsensiblewaterloss?a.A7-year-oldchildwithasthma.b.A24-year-oldadultwithconstipation.c.A56-year-oldpatientwithgastroenteritis.d.An80-year-oldpatientwithpneumonia.ANS:DNURSINGTB.COMSensiblewaterlossisthelossoffluidsfromtheskinthroughvisibleperspiration,suchasthatoccurringwitharesolvingfeverrelatedtopneumonia.Asthmawouldbeinsensiblewaterlossthroughrespiration.Gastroenteritiscausesdiarrheawithitslargevolumeloss.Constipationdoesnotaffectfluidloss.DIF:ApplyREF:1018OBJ:Describecommonfluid,electrolyte,andacid-baseimbalances,andidentifyrelatedriskfactors.TOP:AssessmentMSC:CPNRE:FoundationsofPractice6.Whatisthemostabundantcationintheblood?a.Sodium.b.Potassium.c.Chloride.d.Magnesium.ANS:ASodiumisthemostabundantcationintheblood.Potassiumisthepredominantintracellularcation.Chlorideisananion(negativelycharged)ratherthanacation(positivelycharged).Magnesiumisfoundpredominantlyinsidecellsandinbone.DIF:RememberREF:1016OBJ:Describetheprocessesinvolvedinregulatingacid-basebalance.TOP:AssessmentMSC:CPNRE:FoundationsofPracticeCanadianFundamentalsofNursing7thEditionPotterTestBankUSNT7.Thenursereceivesthepatientsmostrecentbloodworkresults.Whichlaboratoryvalueisofgreatestconcern?a.Sodium,145mmol/L(145mEq/L).b.Calcium,4.5mmol/L(17.5mg/dL).c.Potassium,3.5mmol/L(3.5mEq/L).d.Chloride,100mmol/L(100mEq/L).ANS:BNormalcalciumlevelsrangefrom2.25to2.75mmol/L(8.5mg/dLto10.5mg/dL);therefore,avalueof4.5mmol/L(17.5mg/dL)isabnormallyhighandofconcern.Therestofthelaboratoryvaluesarewithintheirnormalranges:Normalsodiumlevelsrangefrom135to145mmol/L(135to145mEq/L);normalpotassiumlevelsrangefrom3.5to5.0mmol/L(3.5to5.0mEq/L);andnormalchloridelevelsrangefrom97to107mmol/L(98to106mEq/L).DIF:RememberREF:1020OBJ:Chooseappropriateclinicalassessmentsforfluid,electrolyte,andacid-basebalances.TOP:AssessmentMSC:CPNRE:FoundationsofPractice8.Thenursewouldexpectapatientwithincreasedlevelsofserumcalciumtoalsohavewhichabnormallevels?a.Increasedpotassiumlevels.b.Decreasedphosphatelevels.c.Decreasedsodiumlevels.d.Increasedmagnesiumlevels.ANS:BSerumcalciumandphosphatNehaRveaIninGverBse.rCelatMionship.Whenoneleveliselevated,theotherisdecreased,exceptinsomepatientswithend-stagerenaldisease.Increasedlevelofserumcalciumwouldnotnecessarilycausechangesinlevelsofpotassium,sodium,ormagnesium.DIF:RememberREF:1020OBJ:Chooseappropriateclinicalassessmentsforfluid,electrolyte,andacid-basebalances.TOP:AssessmentMSC:CPNRE:FoundationsofPractice9.Thenurseknowsthatanimbalanceofwhichioncausesacid-baseimpairment?a.Hydrogen.b.Calcium.c.Magnesium.d.Sodium.ANS:ATheconcentrationofhydrogenionsdeterminespH.LowpHreflectsanacidicenvironment;highpHreflectsanalkalineenvironment.Calcium,magnesium,andsodiumareions,butimbalancesofthoseionsarenotdirectacid-baseimpairments.DIF:RememberREF:1020OBJ:Chooseappropriateclinicalassessmentsforfluid,electrolyte,andacid-basebalances.TOP:AssessmentMSC:CPNRE:FoundationsofPracticeCanadianFundamentalsofNursing7thEditionPotterTestBankUSNT10.Thenursewouldexpectapatientwithrespiratoryacidosistohaveanexcessiveamountofwhichofthefollowing?a.Carbondioxide.b.Bicarbonate.c.Oxygen.d.Phosphate.ANS:AInrespiratoryacidosis,thelungsarenotabletoexcreteenoughcarbondioxide.Carbondioxideandwatercreatecarbonicacid.Abuildupofcarbonicacidcausestheextracellularfluidtobecomemoreacidic,whichlowersthepH.Bicarbonatelevelsarenormalwithuncompensatedrespiratoryacidosisorelevatedwithcompensatedrespiratoryacidosis.Excessiveoxygenandphosphatelevelsarenotcharacteristicofrespiratoryacidosis.DIF:RememberREF:1021OBJ:Describetheprocessesinvolvedinacid-basebalance.TOP:AssessmentMSC:CPNRE:FoundationsofPractice11.A2-year-oldwasbroughtintotheemergencydepartmentafteringestingseveralmorphinetabletsfromabottleinhismotherspurse.Thenurseknowsthatthechildisatgreatestriskforwhichacid-baseimbalance?a.Respiratoryacidosis.b.Respiratoryalkalosis.c.Metabolicacidosis.d.Metabolicalkalosis.ANS:AMorphineoverdosecancausNeresRpiraItorGydeBpr.eCssioMnandhypoventilation.HypoventilationresultsinretentionofCO2andrespiratoryacidosis.Respiratoryalkalosiswouldresultfromhyperventilation,causingadecreaseinCO2levels.Metabolicacid-baseimbalancewouldbearesultofkidneydysfunction,vomiting,diarrhea,orotherconditionsthataffectmetabolicacids.DIF:AnalyzeREF:1025OBJ:Describecommonfluid,electrolyte,andacid-baseimbalances,andidentifyrelatedriskfactors.TOP:AssessmentMSC:CPNRE:FoundationsofPractice12.Apatientwasadmittedforabowelobstructionandhashadanasogastrictubesettolowintermittentsuctionforthepast3days.Thepatientsrespiratoryratehasdecreasedto12breathsperminute.Thenursewouldexpectthepatienttohavewhichofthefollowingarterialbloodgasvalues?a.pH,7.78;PaCO2,40mmHg;HCO3-,30mmol/L(30mEq/L).b.pH,7.52;PaCO2,48mmHg;HCO3-,28mmol/L(28mEq/L).c.pH,7.35;PaCO2,35mmHg;HCO3-,26mmol/L(26mEq/L).d.pH,7.25;PaCO2,47mmHg;HCO3-,29mmol/L(29mEq/L).ANS:BCanadianFundamentalsofNursing7thEditionPotterTestBankNRIGB.CIncompensatedmetabolicalkalosis,thepHandbicarbonate(HCO3-)values(metabolicvalues)arealkaline,andCO2levelisslightlyacidic(compensatoryrespiratoryacidosis).Inthiscase,thepHof7.52isalkaline(normal=7.35to7.45),partialpressureofarterialcarbondioxide(PaCO2)isacidic(normal=35to45mmHg),andHCO3-leveliselevated(normal=22to26mmol/L[22to26mEq/L]).WhenthepHis7.78,PaCO2is40mmHg,andHCO3-levelis30mmol/L(30mEq/L),theconditionisuncompensatedmetabolicalkalosis.ApHof7.35,aPaCO235mmHg,andaHCO3-levelof26mmol/L(26mEq/L)arewithinnormallimits.WhenthepHis7.25,PaCO2is47mmHg,andHCO3-levelis29mmol/L(29mEq/L),theconditioniscompensatedrespiratoryacidosis.DIF:AnalyzeREF:1025,Table40-5OBJ:Interpretbasicfluid,electrolyte,andacid-baselaboratoryvalues.TOP:AssessmentMSC:CPNRE:FoundationsofPractice13.Thenursewouldnotexpectfullcompensationtooccurforwhichacid-baseimbalance?a.Respiratoryacidosis.b.Respiratoryalkalosis.c.Metabolicacidosis.d.Metabolicalkalosis.ANS:BUsuallythecauseofrespiratoryalkalosisisatemporaryevent(e.g.,anasthmaoranxietyattack).Thekidneystakeabout24hourstocompensateforanevent,soitisunlikelythatmuchifanycompensationforrespiratoryalkalosisisobservable.Respiratoryacidosisusuallyresultsfromlongertermconditionssuchaschroniclungdisease,narcoticoverdose,oranothereventthatcausesrespiratorydepression.Thekidneysstilldonotrespondforabout24hoursoftheevent.Forbothmetabolicimbalances,therespiratorysystemisquicktoattempttocompensate;however,itmayhUaveSdifNficuTltysustaOiningthatcompensation.DIF:UnderstandREF:1025OBJ:Describetheprocessesinvolvedinregulatingacid-basebalance.TOP:AssessmentMSC:CPNRE:FoundationsofPractice14.Anurseiscaringforapatientwhoseelectrocardiogramdisplayschangescharacteristicofhypokalemia.Whichassessmentfindingwouldthenurseexpect?a.Threadyperipheralpulses.b.Abdominaldistension.c.Drymucousmembranes.d.Flushedskin.ANS:BSignsandsymptomsofhypokalemiaaremuscleweaknessandfatigue,abdominaldistension,decreasedbowelsounds,andcardiacdysrhythmias.Threadyperipheralpulsesindicatehypovolemia.Drymucousmembranesandflushedskinareindicativeofdehydrationandhypernatremia.DIF:ApplyREF:1023,Table40-4OBJ:Chooseappropriateclinicalassessmentsforfluid,electrolyte,andacid-basebalances.TOP:AssessmentMSC:CPNRE:FoundationsofPractice15.InwhichpatientwouldthenurseexpecttoseeapositiveChvosteksign?CanadianFundamentalsofNursing7thEditionPotterTestBankREF:1025USNTOa.A7-year-oldchildadmittedforsevereburns.b.A24-year-oldadultadmittedforchronicalcoholabuse.c.A50-year-oldpatientadmittedforanacuteexacerbationofhyperparathyroidism.d.A75-year-oldpatientadmittedforabrokenhipinrelationtoosteoporosis.ANS:BApositiveChvosteksignisrepresentativeofhypocalcemiaorhypomagnesemia.Hypomagnesemiaiscommonwithalcoholabuse.Hypocalcemiacanbebroughtonbyalcoholabuseandpancreatitis(whichalsocanbeaffectedbyalcoholconsumption).Patientswithburnsfrequentlyexperienceextracellularfluidvolume(ECV)deficit.Hyperparathyroidismcauseshypercalcemia.Immobilityisassociatedwithhypercalcemia.DIF:ApplyREF:1023,Table40-4OBJ:Chooseappropriateclinicalassessmentsforfluid,electrolyte,andacid-basebalances.TOP:AssessmentMSC:CPNRE:FoundationsofPractice16.Whichorgansystemisresponsibleforcompensationofrespiratoryacidosis?a.Respiratory.b.Renal.c.Gastrointestinal.d.Endocrine.ANS:BThekidneysareresponsibleforrespiratoryacidosiscompensation.Aproblemwiththerespiratorysystemcausesrespiratoryacidosis,andsoanotherorgansystem(renal)needstocompensate.Problemswiththegastrointestinalandendocrinesystemscancauseacid-baseimbalances,butthesesystemscannotcompensateforanexistingimbalance.NRIGB.CMDIF:UnderstandOBJ:Describetheprocessesinvolvedinregulatingacid-basebalance.TOP:AssessmentMSC:CPNRE:FoundationsofPractice17.Whichlaboratoryvalueshouldthenurseexaminewhenevaluatingapatientwithuncompensatedrespiratoryalkalosis?a.Partialpressureofarterialoxygen(PaO2).b.Aniongap.c.PaCO2.d.HCO3-.ANS:CUncompensatedrespiratoryimbalancesarerevealedbythePaCO2levels.PaO2indicatesoxygenstatus.Highaniongapisindicativeofmetabolicacidosis.HCO3-levelsarestudiedtoevaluatecompensationforrespiratoryimbalancesoruncompensatedmetabolicimbalances.DIF:RememberREF:1026,Table40-6OBJ:Chooseappropriateclinicalassessmentsforfluid,electrolyte,andacid-basebalances.TOP:AssessmentMSC:CPNRE:FoundationsofPractice18.Thenurseiscaringforapatientwhohasdiabetesandisinrenalfailure.Whichlaboratoryfindingswouldthenurseexpect?a.pH,7.3;PaCO2,36mmHg;HCO3-,19mEq/L(19mmol/L).b.pH,7.5;PaCO2,35mmHg;HCO3-,35mEq/L(35mmol/L).CanadianFundamentalsofNursing7thEditionPotterTestBankREF:1023USNTOc.pH,7.3;PaCO2,47mmHg;HCO3-,23mEq/L(23mmol/L).d.pH,7.35;PaCO2,40mmHg;HCO3-,25mEq/L(25mmol/L).ANS:APatientsinrenalfailuredevelopmetabolicacidosis.ThelaboratoryvaluesthatreflectthisarepHof7.3,PaCO2of36mmHg,andHCO3-levelof19mmol/L(19mEq/L).LaboratoryfindingsofpHof7.5,PaCO2of35mmHg,andHCO3-levelof35mmol/L(35mEq/L)reflectmetabolicalkalosis.LaboratoryfindingsofpHof7.3,PaCO2of47mmHg,andHCO3-levelof23mmol/L(23mEq/L)reflectrespiratoryacidosis.LaboratoryfindingsofpHof7.35,PaCO2of40mmHg,andHCO3-levelof25mmol/L(25mEq/L)arewithinnormalranges.DIF:AnalyzeREF:1031OBJ:Chooseappropriateclinicalassessmentsforfluid,electrolyte,andacid-basebalances.TOP:AssessmentMSC:CPNRE:FoundationsofPractice19.Thenurseisassessingapatientandfindscracklesinthelungbasesandneckveindistension.Thenursegivesthepatientadiuretic.Whatelectrolyteimbalanceisthenursemostconcernedabout?a.Potassiumimbalance.b.Sodiumimbalance.c.Calciumimbalance.d.Phosphateimbalance.ANS:AAdiureticcancauseexcessexcretionofpotassium,unlessitisapotassium-sparingdiuretic.Theotherelectrolytesarenotexcretedinthesamewaywithdiuretics.NRIGB.CMDIF:UnderstandOBJ:Describecommonfluid,electrolyte,andacid-baseimbalances,andidentifyrelatedriskfactors.TOP:AssessmentMSC:CPNRE:FoundationsofPractice20.Apatientreceivingchemotherapyhasgained2kg(5pounds)in2days.Whichassessmentquestionbythenurseismostappropriate?a.Areyouhavingdifficultysleepingatnight?b.Howmanycaloriesadaydoyouconsume?c.Doyouhavedrymouthorfeelthirsty?d.Howmanytimesadaydoyouurinate?ANS:DArapidgaininweightusuallyindicatesECVexcessifECVwasinitiallynormal.ThepatientsdescriptionofurinationhabitswillindicatewhetherthebodyistryingtoexcretetheexcessfluidorwhetherrenaldysfunctioniscontributingtoECVexcess.Difficultysleepingatnightcanoccurifthebodybuildsupexcessivefluidinthelungs;however,itcouldalsomeanthatthepatientisgettingupfrequentlytourinate,sothequestionisnotspecificenough.Caloricintakedoesnotaccountforrapidweightchanges.DrymouthandthirstaccompanyECVdeficit,whichwouldbeassociatedwithrapidweightloss.DIF:ApplyREF:1032,Table40-8OBJ:Chooseappropriateclinicalassessmentsforfluid,electrolyte,andacid-basebalances.TOP:ImplementationMSC:CPNRE:FoundationsofPracticeCanadianFundamentalsofNursing7thEditionPotterTestBank21.Whichfluidordershouldthenursequestionforapatientwithatraumaticbraininjury?a.0.45%sodiumchloride.b.0.9%sodiumchloride.c.LactatedRingerssolution.d.Dextrose5%in0.9%sodiumchloride.ANS:AAfluidof0.45%sodiumchlorideisahypotonicsolution,andhypotonicsolutionscausecellstoswell,whichcancauseincreasedintracranialpressure.Thiscanbelife-threateningforapatientwithatraumaticbraininjury.Theothersolutionsarephysiologicallyisotonicsodium-containingsolutionsthatwillexpandECVbutdonotcausecellswelling.Inthefluidcontainer,dextrose5%in0.9%sodiumchlorideishypertonic,butthedextroseenterscellsrapidly,leavingisotonic0.9%sodiumchloride.DIF:AnalyzeREF:1039,Table40-9OBJ:Discussthepurposeof,andprocedurefor,initiating,maintaining,anddiscontinuingintravenoustherapyandperipheralvascularaccessdevices.TOP:ImplementationMSC:CPNRE:FoundationsofPractice22.Thephysicianasksthenursetomonitorthefluidvolumestatusesofapatientwithcongestiveheartfailureandapatientatriskforclinicaldehydration.Whatisthemosteffectivenursinginterventionformonitoringbothofthesepatients?a.Weighthepatientseverymorningbeforebreakfast.b.Askthepatientstorecordtheirintakeandoutput.c.Measurethepatientsbloodpressureevery4hours.d.Assessthepatientsforedemainextremities.ANS:ANURSINGTB.COMAneffectivemeasureoffluidretentionorlossisdailyweights;eachkilogram(2.2pounds)gainedorlostisequivalentto1litreoffluidgainedorlost.Thismeasurementshouldbeperformedatthesametimeeverydayusingthesamescaleandthesameamountofclothing.Althoughintakeandoutputrecordsareimportantassessmentmeasures,somepatientsarenotabletokeeptheirownrecordsthemselves.BloodpressurecandecreasewithECVdeficitbutwillnotnecessarilyincreasewithrecentECVexcess(heartfailurepatient).EdemaoccurswithECVexcessbutnotwithclinicaldehydration.DIF:ApplyREF:1042OBJ:Identifyanddiscussnursinginterventionsforpatientswithfluid,electrolyte,andacid-baseimbalances.TOP:ImplementationMSC:CPNRE:FoundationsofPractice23.Anurseiscaringforacancerpatientwhopresentswithanorexia,bloodpressureof100/60,elevatedwhitebloodcellcount,andoralcandidiasis.Thenurseknowsthatthepurposeofstartingtotalparenteralnutrition(TPN)istoa.Replacefluid,electrolytes,andnutrientsinthepatient.b.Stimulatethepatientsappetitetoeat.c.Providemedicationtoraisethepatientsbloodpressure.d.Deliverantibioticstofightoffinfection.ANS:ACanadianFundamentalsofNursing7thEditionPotterTestBankUSNTOTPNisanintravenous(IV)solutioncomposedofnutrientsandelectrolytestoreplacetheonesthepatientisnoteating.TPNdoesnotstimulatetheappetite,anditdoesnotcontainbloodpressuremedicationorantibiotics.DIF:ApplyREF:1038OBJ:Discussthepurposeof,andprocedurefor,initiating,maintaining,anddiscontinuingintravenoustherapyandperipheralvascularaccessdevices.TOP:ImplementationMSC:CPNRE:FoundationsofPractice24.Apatientpresentstotheemergencydepartmentwiththecomplaintofvomitinganddiarrheaforthepast48hours.Thenurseanticipateswhichfluidtherapyinitially?a.0.9%sodiumchloride.b.Dextrose10%inwater.c.Dextrose5%inwater.d.0.45%sodiumchloride.ANS:APatientswithprolongedvomitinganddiarrheabecomehypovolemic.ThebestsolutiontoreplaceECVis0.9%sodiumchloride,whichisanisotonicsolution.Dextrose10%inwater,dextrose5%inwater,and0.45%sodiumchlorideactashypotonicsolutionsinthebody.ThefirstconsiderationisreplacingECVtooxygenatetissues.DIF:ApplyREF:1039,Table40-9OBJ:Discussthepurposeof,andprocedurefor,initiating,maintaining,anddiscontinuingintravenoustherapyandperipheralvascularaccessdevices.TOP:ImplementationMSC:CPNRE:FoundationsofPractice25.ApatientwithalowerrespirNatorRyinIfectGionBha.sCpHMof7.25,aPaCO2of55mmHg,andaHCO3-levelof20mmol/L(20mEq/L).Thephysicianhasbeennotified.Whichistheprioritynursinginterventionforthispatient?a.Checkthecolourofthepatientsurineoutput.b.PlacethepatientinTrendelenburgposition.c.Encouragethepatienttoincreaserespirations.d.PlacethepatientinhighFowlersposition.ANS:CThepatienthasrespiratoryacidosisfromCO2retention.Increasingrateanddepthofrespirationwillallowthepatienttoblowoffexcesscarbondioxide,andthiswillbegintocorrecttheimbalance.Checkingtheurinecolourisnotanecessaryassessment.TheTrendelenburgpositionwouldprobablymakeitmoredifficultforthepatienttobreatheandshouldbeavoided.HighFowlerspositionmaybemorecomfortableforthepatient,butitisnotnecessary.DIF:ApplyREF:1025OBJ:Identifyanddiscussnursinginterventionsforpatientswithfluid,electrolyte,andacid-baseimbalances.TOP:ImplementationMSC:CPNRE:FoundationsofPractice26.Thenurseknowsthatintravenousfluidtherapyhasbeeneffectiveforapatientwithhypernatremiawhenwhathappens?a.Serumsodiumconcentrationreturnstonormal.b.Systolicanddiastolicbloodpressuredecrease.CanadianFundamentalsofNursing7thEditionPotterTestBankNRIc.Largeamountsofemesisanddiarrheadecrease.d.Urineoutputincreasesto150mL/hr.ANS:AHypernatremiaisdiagnosedbyelevatedserumsodiumconcentration.Bloodpressureisnotanaccurateindicatorofhypernatremia.EmesisanddiarrheawillnotstopbecauseofIVtherapy.Urineoutputisinfluencedbymanyfactors,includingECV.Alargediluteurineoutputcancausefurtherhypernatremia.DIF:ApplyREF:1023OBJ:Identifyanddiscussnursinginterventionsforpatientswithfluid,electrolyte,andacid-baseimbalances.TOP:ImplementationMSC:CPNRE:FoundationsofPractice27.ThenursewouldselectthedorsalvenousplexusofthefootasanIVsiteforwhichpatient?a.A2-year-oldchild.b.A22-year-oldadult.c.A50-year-oldpatient.d.An80-year-oldpatient.ANS:AUseofthefootasanIVsiteiscommoninchildrenbutisavoidedinadultsbecauseoftheriskforthrombophlebitis.DIF:UnderstandREF:1053,Figure40-17OBJ:Discussthepurposeof,andprocedurefor,initiating,maintaining,anddiscontinuingintravenoustherapyandperipheralvascularaccessdevices.TOP:ImplementationMSC:CPNRE:FoundationsofPracticeGB.CMUSNTO28.Whichassessmentfindingshouldcauseanursetoquestionadministeringasodium-containingisotonicIVfluid?a.Bloodpressure102/58.b.Drymucousmembranes.c.Poorskinturgor.d.Pittingedema.ANS:DPittingedemaindicatesthatthepatientmayberetainingexcessextracellularfluid,andthenurseshouldquestiontheorderforasolutionmeanttorehydratethepatient.AllotheroptionsareconsistentwithECVdeficit,andthepatientwouldbenefitfromasodium-containingisotonicsolutionthatexpandsECV.DIF:UnderstandREF:1052OBJ:Discussthepurposeof,andprocedurefor,initiating,maintaining,anddiscontinuingintravenoustherapyandperipheralvascularaccessdevices.TOP:ImplementationMSC:CPNRE:FoundationsofPractice29.Apatientistoreceive1500mLof0.9%sodiumchlorideintravenouslyatarateof125mL/hr.Thenurseisusingmicrodripgravitydriptubing.Whatistheminuteflowrate(dropsperminute)?a.12gtt/min.b.24gtt/min.CanadianFundamentalsofNursing7thEditionPotterTestBankUSNTc.125gtt/min.d.150gtt/min.ANS:CMicrodriptubingdelivers60gtt/mL.Toobtainarateof125mL/hrwithmicrodriptubing,thecalculationis125mL/hr60gtt/mL60min=125gtt/min.DIF:ApplyREF:1054OBJ:Discussthepurposeof,andprocedurefor,initiating,maintaining,anddiscontinuingintravenoustherapyandperipheralvascularaccessdevices.TOP:ImplementationMSC:CPNRE:FoundationsofPractice30.Anursebeginsinfusinga250-mLbagofIVfluidat1845hoursonMondayandprogramsthepumptoinfuseat20mL/hr.Atwhattimeshouldtheinfusionbecompleted?a.0645Tuesday.b.0675Tuesday.c.0715Tuesday.d.0735Tuesday.ANS:CThisanswerwouldbecalculatedasfollows:250mL20mL/hr=12.5hr0.5hr60min=30min1845hours+12hr30min=3115,whichwouldbe0715hoursonTuesday,thefollowingday.DIF:ApplyREF:1055OBJ:Discussthepurposeof,aNndRprocIedurGefoBr,.inCitiatMing,maintaining,anddiscontinuingintravenoustherapyandperipheralvascularaccessdevices.TOP:ImplementationMSC:CPNRE:FoundationsofPractice31.Anurseiscaringforapatientwithdiabeteswhohasabowelobstructionandhasorderstoensurethatthevolumeofintakematchestheoutput.Inthepast4hours,thepatientreceiveddextrose5%with0.9%sodiumchloridethrougha22-gaugecatheter,infusingat150mL/hr,andhaseaten200mLoficechips.Thepatientalsohasanasogastricsuctiontubesettolowcontinuoussuction,whichyieldedanoutputof300mL.Thepatienthasvoided400mLofurine.Afterreportingthesevaluestothephysician,whatordersdoesthenurseanticipate?a.Addapotassiumsupplementtoreplacelossfromoutput.b.Decreasetherateofintravenousfluidsto100mL/hr.c.Discontinuethenasogastricsuctioning.d.Administeradiuretictopreventfluidvolumeexcess.ANS:AThetotalfluidintakeandoutputequals700mL,whichmeetstheprovidergoals.Thenurseshouldrecordhalfthevolumeoficechipswhencalculatingintake.Patientswithnasogastricsuctioningareatriskforpotassiumdeficit,sothenursewouldanticipateapotassiumsupplementtocorrectthiscondition.Theothermeasureswouldbeunnecessarybecausethenetfluidvolumeisequal.DIF:AnalyzeREF:1018OBJ:Identifyanddiscussnursinginterventionsforpatientswithfluid,electrolyte,andacid-baseimbalances.TOP:ImplementationCanadianFundamentalsofNursing7thEditionPotterTestBankMSC:CPNRE:FoundationsofPractice32.ApatientwasadmittedforhypovolemiaandhasIVfluidrunningat250mL/hr.ThepatientcomplainsofburningattheIVinsertionsite.Uponassessment,thenursedoesnotfindredness,swelling,heat,orcoolness.Thenursesuspectswhichofthefollowing?a.IVhasinfiltrated.b.IVhascausedphlebitis.c.Fluidisinfusingtooquickly.d.Patientisallergictothefluid.ANS:CTheinfusionmaybeflowingfasterthantheveincanhandle,whichcausesdiscomfort.Thenurseshouldslowdowntheinfusion.Withinfiltration,theskinaroundtheIVinsertionsitebecomesblanched,cool,andedematous.Pain,warmth,erythema,andapalpablevenouscordareallsymptomsofphlebitis.Allergicresponsetothefluidcouldinvolveacombinationofitching,flushing,hypotension,anddyspnea,dependingontheseverity.DIF:ApplyREF:1041OBJ:Discusscomplicationsassociatedwithintravenoustherapy.TOP:AssessmentMSC:CPNRE:FoundationsofPractice33.Thenurseiscaringforapatientwithsepsis.Theplanofcareforthepatientistoadministerantibioticsthreetimesadayfor4weeks.Whatdevicewillbeusedtoadministertheseantibiotics?a.Acontinuousinfusion.b.Aperipheralcatheterwithaheparinlock.c.Aperipherallyinsertedcentralcatheter(PICC)line.d.AnimplantedportcathetNerU.ANS:CRSINGTB.COMAPICClineisatypeofcentralvenousdevicethatcanbeintroducedintoaperipheralveinforadministrationofIVantibioticsforanextendedperiod,overthecourseofseveralweeks.Acontinuousinfusionwouldnotbeappropriateifthepatientweretoreceiveantibioticsonlythreetimesdaily.Aperipheralcatheterwouldnotbenecessaryorhaveaheparinlock.Animplantedportcatheterisintendedforlong-termuseofvenousaccessovermonths,orevenyears.DIF:ApplyREF:1051OBJ:Discussthepurposeof,andprocedurefor,initiating,maintaining,anddiscontinuingintravenoustherapyandperipheralvascularaccessdevices.TOP:ImplementationMSC:CPNRE:FoundationsofPractice34.Apatienthadanacuteintravascularhemolyticreactionduringabloodtransfusion.Afterdiscontinuingofthebloodtransfusion,whatisthenursesnextaction?a.Runnormalsalinethroughtheexistingtubing.b.Startnormalsalineatto-keep-open(TKO)ratewithnewtubing.c.DiscontinuetheIVcatheter.d.Returnthebloodtothebloodbank.ANS:BCanadianFundamentalsofNursing7thEditionPotterTestBankThenurseshouldfirstattachnewtubingandbeginrunninginnormalsalineataratetokeeptheveinopen,incaseanysortsofmedicationsneedtobedeliveredthroughthatIVsite.Theexistingtubingshouldnotbeusedbecausethatwouldinfusethebloodinthetubingintothepatient.ItisnecessarytopreservetheIVcatheterinplaceforIVaccesstotreatthepatient.Afterthepatienthasbeenassessedandstabilized,thebloodcanbereturnedtothebloodbank.DIF:UnderstandREF:1058OBJ:Discussthepurposeof,andprocedurefor,initiatingabloodtransfusionandinterventionstomanagetransfusionreaction.TOP:ImplementationMSC:CPNRE:FoundationsofPractice35.Anurseisassessingapatientwhoisreceivingabloodtransfusionandfindsthatthepatientisanxiouslyfidgetinginbed.Thepatientisafebrileanddyspneic.Thenurseauscultatescracklesinbothlungbasesandseesjugularveindistension.Thenurserecognizesthatthepatientisexperiencingwhichtransfusioncomplication?a.Anaphylacticshock.b.Septicemia.c.Fluidvolumeoverload.d.Hemolyticreaction.ANS:CThesignsandsymptomsareconcurrentwithfluidvolumeoverload.Anaphylacticshockwouldhavepresentedwithurticaria,dyspnea,andhypotension.Septicemiawouldincludeafever.Ahemolyticreactionwouldconsistofflankpain,chills,andfever.DIF:UnderstandREF:1064|1065OBJ:Discussthepurposeof,andprocedurefor,initiatingabloodtransfusionandinterventionstomanagetransfusionreaction.NURSINGTTOBP:.ICmOplMementationMSC:CPNRE:FoundationsofPractice36.Thenurseselectsappropriatetubingforabloodtransfusionbyensuringthatthetubinghaswhichofthefollowing?a.Two-wayvalvestoallowthepatientsbloodtomixandwarmtheincomingtransfusedblood.b.Aninjectionporttomixadditionalelectrolytesintotheblood.c.Anairventtoletbubblesinthebloodescape.d.Afiltertoensurethatclotsdonotenterthepatient.ANS:DAllbloodtransfusionsmusthaveafiltertopreventmicroembolifrombeingadministeredtothepatient.Thepatientsbloodshouldnotbeaspiratedtomixwiththeinfusionblood.Thebloodshouldnothaveairbubblestovent;ifabagofblooddoeshavebubbles,thenurseshouldpromptlyreturnthebloodtothebloodbank.Theonlysubstancecompatiblewithbloodisnormalsaline;noadditivesshouldbemixedwiththeinfusingblood.DIF:UnderstandREF:1065OBJ:Discussthepurposeof,andprocedurefor,initiatingabloodtransfusionandinterventionstomanagetransfusionreaction.TOP:ImplementationMSC:CPNRE:FoundationsofPractice37.Thenurseiscaringforapatientwithhyperkalemia.Whichbodysystemwouldbemostimportantforthenursetomonitorclosely?CanadianFundamentalsofNursing7thEditionPotterTestBanka.Gastrointestinal.b.Neurological.c.Cardiac.d.Respiratory.ANS:CPotassiumbalanceisnecessaryforcardiacfunction.Hyperkalemiaplacesthepatientatriskforpotentiallyseriousdysrhythmias.Monitoringofgastrointestinal,neurological,andrespiratorysystemswouldbeindicatedforotherelectrolyteimbalances.DIF:ApplyREF:1024OBJ:Identifyanddiscussnursinginterventionsforpatientswithfluid,electrolyte,andacid-baseimbalances.TOP:AssessmentMSC:CPNRE:FoundationsofPractice38.Apatienthasthefollowinglaboratoryvalues:sodiumlevel,145mmol/L(145mEq/L);potassiumlevel,4.5mmol/L(4.5mEq/L);andcalciumlevel,1.05mmol/L(4.5mg/dL).Whatwouldthenurseexpecttofindintheassessment?a.Lightheadednesswhenthepatientstandsup.b.Weakquadricepsmuscles.c.Tinglingoftheextremitiesandtetany.d.Decreaseddeeptendonreflexes.ANS:CThispatienthashypocalcemia;thenormalcalciumrangeis2.25to2.75mmol/L(8.4to10.5mg/dL).Sodiumandpotassiumvaluesarewithintheirnormalranges(sodium,135to145mmol/L[135to145mEq/L];potassium,3.5to5.0mmol/L[3.5to5.0mEq/L]).Hypocalcemiacausesmuscletetany,Trousseaussign,andtinglingoftheextremities.LightheadednesswhenapatiNenUtRstaSnIdsNuGpTisBa.mCaniMfestationofECVdeficitorsometimeshypokalemia.Weakquadricepsmusclesareassociatedwithpotassiumimbalances.Decreaseddeeptendonreflexesarerelatedtohypercalcemiaorhypermagnesemia.DIF:ApplyREF:1026|1027OBJ:Chooseappropriateclinicalassessmentsforfluid,electrolyte,andacid-basebalances.TOP:AssessmentMSC:CPNRE:FoundationsofPractice39.Apatientinformsthenursethathehasthetypeofdiabetesthatdoesnothavetodowithbloodsugar.Thenurseadvisesthepatienttomakewhichdietarychange?a.Drinkplentyoffluidsthroughoutthedaytostayhydrated.b.Avoidfoodhighinacidtoavoidmetabolicacidosis.c.Reducethequantityofcarbohydratesingestedtolowerbloodsugar.d.Includeaservingofdairyineachmealtoelevatecalciumlevels.ANS:AThepatientisindicatingthathehasdiabetesinsipidus,whichplaceshimatriskfordehydrationandhypernatremia.Topreventdehydration,thepatientshoulddrinkplentyoffluidstoreplacetheextrawaterexcretedintheurine.Foodshighinacidshouldbeavoidedbyapatientwithgastroesophagealrefluxdisease.Areductionincarbohydratesappliestopatientswithtype2diabetesmellitus.Calcium-richdairyproductswouldberecommendedforapatientwithhypocalcemia.DIF:AnalyzeREF:1030OBJ:Identifyanddiscussnursinginterventionsforpatientswithfluid,electrolyte,andacid-baseCanadianFundamentalsofNursing7thEditionPotterTestBankUSNTimbalances.TOP:PlanningMSC:CPNRE:FoundationsofPractice40.ThenurseassessesthepatientsIVandnotesthatthereisedemaoftheextremityneartheinsertionsiteandthattheskinisinthisareaisdiscolouredandcooltothetouch.WhichofthefollowingassessmentswouldalsoindicatethatapatientsIVhasinfiltrated?a.Painandwarmthattheinsertionsite.b.Reddishstreakproximaltotheinsertionsite.c.Numbnessorlossofsensation.d.Palpablevenouscord.ANS:CInfiltrationresultsinskinthatisedematousneartheIVinsertionsite.Skiniscooltothetouchandmaybebruisedordiscoloured,andthepatientmayexperiencesomenumbness.Pain,warmth,erythema,areddishstreak,andapalpablevenouscordareallsymptomsofphlebitis.DIF:RememberREF:1049|1051,Table40-11OBJ:Discusscomplicationsassociatedwithintravenoustherapy.TOP:AssessmentMSC:CPNRE:FoundationsofPractice41.WhendiscontinuingaperipheralIVaccess,thenurseshoulddowhichofthefollowing?a.UsescissorstoremovetheIVsitedressingandtape.b.Applyfirmpressurewithsterilegauzeduringremoval.c.Wearsterileglovesandamask.d.Applypressuretothesitefor2to3minutesafterremoval.ANS:DThenurseshouldstoptheinfusionbeforeremovingtheIVcatheter,sothatthefluiddoesnotdriponthepatientsskin;keeNpthRecIatheGterBpa.raCllelMtotheskinwhileremovingit,toreducetraumatothevein;andapplypressuretothesitefor2to3minutesafterremoval,todecreasebleedingfromthesite.Scissorsshouldnotbeusedbecausetheymayaccidentallycutthecatheterortubingormayinjurethepatient.DuringremovaloftheIVcatheter,lightpressure,notfirmpressure,isindicatedtopreventtrauma.CleanglovesareusedfordiscontinuingaperipheralIVaccessbecauseglovedhandswillhandletheexternaldressing,tubing,andtape,whicharenotsterile.DIF:RememberREF:1061OBJ:Discussthepurposeof,andprocedurefor,initiating,maintaining,anddiscontinuingintravenoustherapyandperipheralvascularaccessdevices.TOP:ImplementationMSC:CPNRE:FoundationsofPracticeCanadianFundamentalsofNursing7thEditionPotterTestBankNRIGB.CChapter41:SleepPotteretal:CanadianFundamentalsofNursing,7thEditionMULTIPLECHOICE1.Thephysiologicalprocessesofsleeparecomplex.Whichofthefollowingstatementsisthemostappropriateoneregardingthisprocess?a.Circadianrhythmsoccurinacyclelongerthan24hours.b.Non-rapideyemovement(NREM)referstothecyclethatmostpeopleexperiencewheninahigh-stimulusenvironment.c.Thereticularactivatingsystemispartlyresponsibleforthelevelofconsciousnessofaperson.d.Thebulbarsynchronizingregioncausestherapid-eye-movement(REM)sleepinmostnormaladults.ANS:CTheascendingreticularactivatingsystemlocatedintheupperbrainstemisbelievedtocontainspecialcellsthatmaintainalertnessandwakefulness.Circadianrhythmsarecyclicalrhythmsthatarepartofeverydaylife.Themostfamiliarrhythmisthe24-hourday-nightcycleknownasthediurnalorcircadianrhythm.Itisnotlongerthan24hours.TheNREMstageispartofthesleepcyclethatmostpeopleexperienceinalow-stimulusenvironment.Thebulbarsynchronizingregionistheareaofthebrainwhereserotoninisreleasedtoproducesleep;itisnotresponsibleforREMsleep.DIF:ApplyREF:1073OBJ:Explaintheeffectofthe24-hoursleep-wakecycleonbiologicalfunctions.TOP:AssessmentMSC:CPNURES:FoNundaTtionsofOPractice2.Thenurseisalerttopatientswhomaybepredisposedtoobstructivesleepapnea.Thisincludeswhichofthefollowingindividuals?a.Patientswithheartdisease.b.Patientswithrespiratoryinfections.c.Patientswithnasalpolyps.d.Patientswhoareobese.ANS:CStructuralabnormalitiessuchasnasalpolyps,certainjawconfigurations,enlargedtonsils,oradeviatedseptumpredisposeapatienttoobstructivesleepapnea.Individualswithheartdiseasemayhavesleepdisorders;womenwithheartdiseasehavethemajorityofsleepdisturbances,butnotapneainparticular.Respiratoryinfectionsdonotpredisposeapatienttoobstructivesleepapnea.Obesity,smokingandalcoholuse,andahistoryofobstructivesleepapneagreatlyincreasetheriskofdevelopingsleepapnea,buttheydonotnecessarilypredisposethepersontosleepapnea.DIF:UnderstandREF:1077OBJ:Discussthecharacteristicsofcommonsleepdisorders.TOP:AssessmentMSC:CPNRE:FoundationsofPractice3.Whenapatientisdeprivedofsleep,thenursemightassesswhichofthefollowingsymptoms?a.Elevatedbloodpressure.CanadianFundamentalsofNursing7thEditionPotterTestBankUSNTOb.Confusionandirritability.c.Inappropriatenessandrapidrespirations.d.Decreasedtemperatureandtalkativeness.ANS:BPsychologicalsymptomsofsleepdeprivationincludeconfusionandirritability.Adecreaseincapacityforreasoningandjudgementcouldleadtoinappropriatebehaviour.Elevatedbloodpressure,rapidrespirations,anddecreasedtemperaturearenotsignsofsleepdeprivation.Psychologicalsymptomsofsleepdeprivationincludeconfusionandirritability.Manypatientswithsleepdeprivationiswithdrawn,nottalkative.DIF:UnderstandREF:1079,Box41-7OBJ:Discussthecharacteristicsofcommonsleepdisorders.TOP:AssessmentMSC:CPNRE:FoundationsofPractice4.Theparentsofanewbornwonderwhensheshouldstarttosleepthroughthenight.Thenursesresponseshouldbethatininfants,anighttimepatternofsleepusuallydevelopsbywhichage?a.1month.b.2months.c.3months.d.6months.ANS:DInfantsdonotusuallydevelopanighttimepatternofsleepby1month,2months,or3monthsofage.Infantsdousuallydevelopanighttimepatternofsleepbefore6monthsofage.DIF:UnderstandREF:10N79RIGB.CMOBJ:Comparethesleeprequirementsofdifferentagegroups.TOP:PlanningMSC:CPNRE:FoundationsofPractice5.Themotherofapreschoolertellsthenursethatthechildhasstartedcryingandresistinggoingtosleepatthescheduledbedtime.Whichofthefollowingactionsshouldthenurseadvisetheparenttotake?a.Offerthechildabedtimesnack.b.Eliminateoneofthenapsduringtheday.c.Allowthechildtosleeplongerinthemornings.d.Maintainconsistencyinthesamebedtimeritual.ANS:DItismostimportantthattheparentmaintainaconsistentbedtimeroutine.Ifabedtimesnackisalreadypartofthatroutine,thenthisisallowable.Ifitisnot,thenthechildmightusehavingasnackonlyasameasureofprocrastination.After3yearsofage,thechildmaygiveupdaytimenaps.Abedtimeroutineusedconsistentlywillbemoreeffectiveinhelpingthechildresistgoingtosleepduringtheday.Allowingthechildtosleeplongerinthemorningswillnotaidinestablishingaconsistentsleeppattern.Thesameregularbedtimeandwake-upscheduleshouldbemaintained.DIF:UnderstandREF:1088OBJ:Comparethesleeprequirementsofdifferentagegroups.TOP:ImplementationMSC:CPNRE:FoundationsofPracticeCanadianFundamentalsofNursing7thEditionPotterTestBankb.USNTO6.An11-year-oldchildinmiddleschooliscurrentlyexperiencingfatigueduringclassesinrelationtosleepdeprivation.Whichofthefollowingresponsesbytheschoolnurseisthemostappropriateonewhencounsellingthechildsparentsregardingthisassessment?a.Whatarethechildsusualsleeppatterns?b.Establishbedtimesforthechild,andwithholdhisallowancewheneverhedoesnotadheretothosebedtimes.c.Weneedtoexploreotherhealth-relatedproblems,assleepproblemsareprobablynotthecauseofthechildsfatigue.d.Thebulbarsynchronizingregionofthechildscentralnervoussystem(CNS)iscausingtheseinsomniacproblems.ANS:AAschool-agechildwillbetiredthefollowingdayifallowedtostayuplaterthanusual.Thenurseshouldfirstaskaquestiontoassessthechildsusualsleeppatterns.TheresponseEstablishbedtimesforthechild,andwithholdhisallowancewheneverhedoesnotadheretothosebedtimesisnotappropriatebecausethenurseisassumingthattheboyisnotadheringtoabedtime.Asleepproblem,notahealth-relatedproblem,isoftenthecauseoffatigue.Theresponseaboutthebulbarsynchronizingregionisincorrectbecausethenurseisassumingthechildisexperiencinginsomnia.DIF:ApplyREF:1088OBJ:Comparethesleeprequirementsofdifferentagegroups.TOP:AssessmentMSC:CPNRE:FoundationsofPractice7.Indescribingthesleeppatternsofolderpersons,thenurserecognizesthatwhichofthefollowingstatementsistrue?a.OlderpersonsaremoredNifficRultItoaGrousBe..CMOlderpersonsrequiremoresleepthanmiddle-agedadults.c.Olderpersonstakelesstimetofallasleep.d.Olderpersonshaveadeclineinslow-waveordeepsleep.ANS:DAspeopleage,theydonotbecomemoredifficulttoarouse.Olderpeopledonotrequiremoresleepthandomiddle-agedadults.Olderpeopleawakenmoreoftenduringthenight,anditmaytakemoretimeforanolderpersontofallasleep.Aspeopleage,slow-wave(deep)sleepdeclinesprogressively.DIF:UnderstandREF:1080OBJ:Comparethesleeprequirementsofdifferentagegroups.TOP:AssessmentMSC:CPNRE:FoundationsofPractice8.Apatientwhoiscurrentlytakingadiureticshouldbeinformedbythenursethatheorshemayexperiencewhichofthefollowingeffects?a.Nocturia.b.Nightmares.c.Increaseddaytimesleepiness.d.ReducedREMsleep.ANS:ACanadianFundamentalsofNursing7thEditionPotterTestBankThenurseshouldinformthepatientwhoiscurrentlytakingadiureticthatheorshemightexperiencenighttimeawakeningbecauseofnocturia.Diureticusedoesnotcausenightmares,increasedaytimesleepiness,orreduceREMsleep.DIF:ApplyREF:1080OBJ:Identifyfactorsthatnormallypromotesleepandfactorsthatnormallydisruptsleep.TOP:AssessmentMSC:CPNRE:FoundationsofPractice9.Asaresultofstudiesregardinginfantsafetyduringsleep,whichofthefollowinginstructionsdoesthenursegivetheparents?a.Provideastuffedtoyforcomfort.b.Applyaloose-fittingplasticmattresscover.c.Placetheinfantonhisorherback.d.Usesmallpillowsinthecrib.ANS:CToreducethechanceofsuffocation,pillows,stuffedtoys,ortheendsoflooseblanketsshouldnotbeplacedincribs.Loose-fittingplasticmattresscoverscancausesuffocation.Infantsareusuallyplacedontheirbackstopreventsuffocationorontheirsidestopreventaspirationofstomachcontents.DIF:ApplyREF:1090OBJ:Identifynursinginterventionsdesignedtopromotenormalsleepcyclesforindividualsofallages.TOP:ImplementationMSC:CPNRE:FoundationsofPractice10.A74-year-oldpatientreportshavingsleepingdifficulties.Tohaveabetterideaofthepatientsproblem,howshouldthenurserespond?a.WhatdoyoudojustbefNorUeRgoSinIgNtoGbTeBd?.COMb.Letsmakesurethatyourbedroomiscompletelydarkenedatnight.c.Whydontyoutrynappingmoreduringthedaytime?d.Youshouldalwayseatsomethingjustbeforebedtime.ANS:AToassessthepatientssleepingproblem,thenurseshouldinquireaboutpredisposingfactors,suchasbyasking,Whatdoyoudojustbeforegoingtobed?Assessmentisaimedatunderstandingthecharacteristicsofanysleepproblemandthepatientsusualsleephabitssothatwaysforpromotingsleepcanbeincorporatedintonursingcare.Olderpersonsmayprefertosleepinsoftlylitrooms.Nappingmoreduringthedaytimeisoftennotthebestsolution.Thepatientdoesnotalwayshavetoeatsomethingbeforegoingtobed.DIF:ApplyREF:1080OBJ:Conductasleephistoryforapatient.TOP:AssessmentMSC:CPNRE:FoundationsofPractice11.Whichofthefollowinginformationprovidedbythepatientsbedpartnerismostassociatedwithsleepapnea?a.Restlessness.b.Talkingduringsleep.c.Sleepwalking.d.Excessivesnoring.ANS:DCanadianFundamentalsofNursing7thEditionPotterTestBankPartnersofpatientswithsleepapneaoftencomplainthatthepatientssnoringdisturbstheirsleep.Restlessnessisnotthesymptommostassociatedwithsleepapnea.Sleeptalkingisassociatedwithsleep-waketransitiondisorders,notsleepapnea.Sleepwalkingisassociatedwithparasomnias(specificallyarousaldisordersandsleep-waketransitiondisorders).DIF:ApplyREF:1084,Box41-10OBJ:Discussthecharacteristicsofcommonsleepdisorders.TOP:AssessmentMSC:CPNRE:FoundationsofPractice12.Whichofthefollowinginstructionsdoesthenursegivethepatientinteachingmethodstopromotepositivesleephabitsathome?a.Usethebedroomonlyforsleeporsexualactivity.b.Eatalargemeal1to2hoursbeforebedtime.c.Exercisevigorouslybeforebedtime.d.Stayinbedifsleepdoesnotcomeafter30minutes.ANS:AThenurseshouldexplainthatifpossible,thebedroomshouldnotbeusedforintensivestudying,snacking,TVwatching,orothernonsleepactivity,otherthansexualactivity.Thenurseshouldinstructthepatienttoavoidheavymealsfor3hoursbeforebedtime;alightsnackmayhelp.Thenurseshouldinstructthepatienttotrytoexercisedaily,preferablyinthemorningorafternoon,andtoavoidvigorousexerciseintheeveningwithin2hoursofbedtime.Thepatientwhodoesnotfallasleepwithin30minutesofgoingtobedshouldbeadvisedbythenursetoriseanddosomequietactivityuntilheorshefeelssleepyenoughtoreturntobed.DIF:ApplyREF:1084OBJ:IdentifynursingintervenNtiUonRsSapIprNopGriTatBef.orCpOatMientswithsleepalterations.TOP:ImplementationMSC:CPNRE:FoundationsofPractice13.Thenurseisdiscussingsleephabitswiththepatientinthesleepassessmentclinic.Ofthefollowingactivitiesperformedbeforesleeping,thenurseinformsthepatientthatwhichoneofthefollowingcanpotentiallyinterferewiththepatientssleep?a.Listeningtoclassicalmusic.b.Finishingofficework.c.Readingnovels.d.Drinkingwarmmilk.ANS:BNoiseshouldbekepttoaminimum.Softmusicmaybeusedtomasknoiseifnecessary.Athome,apatientshouldnottrytofinishofficeworkorresolvefamilyproblemsbeforebedtime.Readingalightnovel,watchinganenjoyableTVprogram,orlisteningtomusiccanhelpapersontorelax.Relaxationexercisescanbeusefulatbedtime.Adairyproductsnack,suchaswarmmilk,containsL-tryptophanandmaybehelpfulinpromotingsleep.DIF:UnderstandREF:1084OBJ:Identifynursinginterventionsappropriateforpatientswithsleepalterations.TOP:ImplementationMSC:CPNRE:FoundationsofPracticeCanadianFundamentalsofNursing7thEditionPotterTestBankNRI14.Thepatientneedspharmacologicaltreatmenttoassistwithhissleeppatterns.Thenurseanticipatesthattreatmentwithananxiety-reducing,relaxation-promotingmedicationwillincludetheuseofwhichoneofthefollowing?a.Barbiturates.b.Amphetamines.c.Benzodiazepines.d.Tricyclicantidepressants.ANS:CThebenzodiazepinescauserelaxation,reduceanxiety,andhavehypnoticeffectsbyfacilitatingtheactionofneuronsintheCNSthatsuppressresponsivenesstostimulation,therebydecreasinglevelsofarousal.WithdrawalfromCNSdepressantssuchasbarbituratescancauseinsomniaandmustbemanagedcarefully.Patientscanalsodeveloptoleranceofanddependenceonbarbiturates.CNSstimulants,suchasamphetamines,shouldbeusedsparinglyandonlyundermedicalmanagement.Amphetaminesulphatemaybeusedtotreatnarcolepsy;prolongedusemayleadtodrugdependence.Tricyclicantidepressantscancauseinsomniawhendiscontinuedandshouldbemanagedcarefully.Theyareusedprimarilytotreatdepression.DIF:UnderstandREF:1092OBJ:Identifynursinginterventionsappropriateforpatientswithsleepalterations.TOP:PlanningMSC:CPNRE:FoundationsofPractice15.Thenurseiscompletinganassessmentonthepatientssleeppatterns.Whichofthefollowingisaspecificquestionthatthenurseshouldasktodeterminethepotentialpresenceofsleepapnea?a.Howeasilydoyoufallasleep?GB.CMb.Doyouhavevivid,lifelikUedrSeamNs?TOc.Doyoueverexperiencelossofmusclecontrolorfalling?d.Doyousnoreloudlyorexperienceheadaches?ANS:DToassessforsleepapnea,thenursemayask,Doyousnoreloudly?andDoyouexperienceheadachesafterawakening?Apositiveresponsemayindicatethatthepatientexperiencessleepapnea.ThequestionHoweasilydoyoufallasleep?helpsassessforthepotentialpresenceofinsomnia.ThequestionsDoyouhavevivid,lifelikedreams?andDoyoueverexperiencelossofmusclecontrolorfalling?helpsdeterminethepotentialpresenceofnarcolepsy.DIF:UnderstandREF:1083,Box41-9OBJ:Conductasleephistoryforapatient.TOP:AssessmentMSC:CPNRE:FoundationsofPractice16.Whichofthefollowingisaneffectivebriefmethodforassessingsleepquality?a.Sleephistory.b.Sleepmonitor.c.Visualanaloguescale.d.Sleepquestionnairediary.ANS:CCanadianFundamentalsofNursing7thEditionPotterTestBankOneeffectivebriefmethodforassessingsleepqualityistheuseofavisualanaloguescale.Documentingsleephistoryandkeepingasleepquestionnairediaryarenotbriefandhelpassessmorethanjustsleepquality.Asleepmonitorisnotnecessarilyusedtomeasuresleepquality,anditsuse,too,isnotbrief.DIF:ApplyREF:1083OBJ:Describewaystoevaluatesleeptherapies.TOP:AssessmentMSC:CPNRE:FoundationsofPractice17.Whichsleepstagebeginstheinitialperiodofdeepsleep?a.1.b.2.c.3.d.4.ANS:CStage3isthestagethatbeginstheinitialperiodofdeepsleep.DIF:UnderstandREF:1074OBJ:Describethestagesofanormalsleepcycle.TOP:AssessmentMSC:CPNRE:FoundationsofPractice18.Whichstageofsleepaccountsforthegreatestproportionoftotalsleeptimeinadults?a.1.b.2.c.3.d.4.ANS:BStage2accountsforthegreaNteUstRprSoIpoNrtGioTnB(4.5CtoO5M5%)oftotalsleeptimeinadults.DIF:RememberREF:1074OBJ:Describethestagesofanormalsleepcycle.TOP:AssessmentMSC:CPNRE:FoundationsofPractice19.Whichofthefollowingisadeterminantofdreams?a.Gender.b.Age.c.Height.d.Weight.ANS:BAgeisadeterminantofdreams,alongwithpersonality,physiologicalconditions,psychologicalconditions,pharmacologicaltherapies,andsituationalfactors.Height,weight,andgenderarenotidentifieddeterminantsofdreams.DIF:UnderstandREF:1075OBJ:Comparethecharacteristicsofrestandsleep.TOP:AssessmentMSC:CPNRE:FoundationsofPractice20.Whichofthefollowingsleepdisordersisaparasomniadisorderofarousal?a.Sleepapnea.b.Narcolepsy.c.Sleepwalking.d.Early-morningawakening.CanadianFundamentalsofNursing7thEditionPotterTestBankANS:CSleepwalkingisanexampleofaparasomniadisorderofarousal.Sleepapneaisasleep-relatedbreathingdisorder.Narcolepsyisanexampleofexcessivesleepiness.Early-morningawakeningisanexampleofaninsomniasleepdisorder.DIF:UnderstandREF:1077,Box41-4OBJ:Discussthecharacteristicsofcommonsleepdisorders.TOP:AssessmentMSC:CPNRE:FoundationsofPracticeNURSINGTB.COMCanadianFundamentalsofNursing7thEditionPotterTestBankChapter42:NutritionPotteretal:CanadianFundamentalsofNursing,7thEditionMULTIPLECHOICE1.Theenergyneededtomaintainlife-sustainingactivitiesforaspecificperiodoftimeatrestisknownaswhichofthefollowing?a.Basalmetabolicrate.b.Restingenergyexpenditure.c.Nutrients.d.Nutrientdensity.ANS:AThebasalmetabolicrateistheenergyneededtomaintainlife-sustainingactivitiesforaspecificperiodoftimeatrest.Therestingenergyexpenditure,orrestingmetabolicrate,istheamountofenergythatanindividualneedstoconsumeovera24-hourperiodforthebodytomaintainallofitsinternalworkingactivitieswhileatrest.Nutrientsaretheelementsnecessaryforbodyprocessesandfunction.Nutrientdensityistheproportionofessentialnutrientstothenumberofkilocalories.Foodswithhighnutrientdensityprovidealargenumberofnutrientsinrelationtokilocalories.DIF:RememberREF:1098OBJ:Explaintheimportanceofmaintainingabalancebetweenenergyintakeandexpenditure.TOP:AssessmentMSC:CPNRE:FoundationsofPractice2.Ingeneral,whenenergyrequNiremRentIsarGecoBm.pCleteMlymetbykilocalorieintakeinfood,whathappens?a.Weightincreases.b.Weightdecreases.c.Weightdoesnotchange.USNTOd.Kilocaloriesarenotafactorinenergyrequirements.ANS:CIngeneral,whenenergyrequirementsarecompletelymetbykilocalorieintakeinfood,weightdoesnotchange.Whenkilocaloriesingestedexceedapersonsenergydemands,theindividualgainsweight.Ifkilocaloriesingestedfailtomeetapersonsenergyrequirement,theindividuallosesweight;therefore,kilocaloriesareafactorinenergyrequirements.DIF:UnderstandREF:1099OBJ:Explaintheimportanceofmaintainingabalancebetweenenergyintakeandexpenditure.TOP:AssessmentMSC:CPNRE:FoundationsofPractice3.Indeterminingkilocalorieexpenditure,thenurseknowsthatcarbohydratesandproteinsprovide4kcalofenergypergramingested.Thenursealsoknowsthatfatsprovidehowmanykilocaloriespergram?a.3.b.4.c.6.d.9.CanadianFundamentalsofNursing7thEditionPotterTestBankANS:DFats(lipids)arethemostcalorie-densenutrient,providing9kcalpergram.DIF:RememberREF:1100OBJ:Listtheendproductsofcarbohydrate,protein,andfatmetabolism.TOP:AssessmentMSC:CPNRE:FoundationsofPractice4.Someproteinsaremanufacturedinthebody,butothersarenot.Thosethatmustbeobtainedthroughdietareknownaswhichofthefollowing?a.Aminoacids.b.Dispensableaminoacids.c.Triglycerides.d.Essentialaminoacids.ANS:DThesimplestformofproteinistheaminoacid.Thebodydoesnotsynthesizeessentialaminoacids,sothesemustbeprovidedinthediet.Thebodysynthesizesnonessential(dispensable)aminoacids.Triglyceridesaremadeupofthreefattyacidsattachedtoaglycerol.DIF:RememberREF:1099OBJ:Listtheendproductsofcarbohydrate,protein,andfatmetabolism.TOP:AssessmentMSC:CPNRE:FoundationsofPractice5.Knowingthatproteinisrequiredfortissuegrowth,maintenance,andrepair,thenursemustunderstandthatforoptimaltissuehealingtooccur,thepatientmustbeinwhichstate?a.Negativenitrogenbalance.b.Positivenitrogenbalance.c.TotaldependenceonprotNeiUnRfoSrIkcNalGpTroBd.ucCtionM.d.Neutralnitrogenbalance.ANS:BWhenintakeofnitrogenisgreaterthanoutput,thebodyisinpositivenitrogenbalance.Positivenitrogenbalanceisrequiredforgrowth,normalpregnancy,maintenanceofleanmusclemassandvitalorgans,andwoundhealing.Innegativenitrogenbalance,thebodylosesmorenitrogenthanitgains.Inneutralnitrogenbalance,nitrogengainequalsnitrogenloss;thisstateisnotoptimalfortissuehealing.Proteincanprovideenergy(4kcal/g),butbecauseofitsessentialroleingrowth,maintenance,andrepair,thedietshouldprovideadequatekilocaloriesfromnonproteinsources.Proteinissparedasanenergysourcewhencarbohydrateinthedietissufficienttomeettheenergyneedsofthebody.DIF:UnderstandREF:1100OBJ:Explainthesignificanceofsaturated,unsaturated,polyunsaturatedandtransfats.TOP:AssessmentMSC:CPNRE:FoundationsofPractice6.Inprovidingdieteducationforapatientonalow-fatdiet,itisimportantforthenursetounderstandwhichofthefollowing?a.Saturatedfatsarefoundmostlyinvegetablesources.b.Saturatedfatsarefoundmostlyinanimalsources.c.Unsaturatedfatsarefoundmostlyinanimalsources.d.Linoleicacidisasaturatedfattyacid.ANS:BCanadianFundamentalsofNursing7thEditionPotterTestBankMostanimalfatshavehighproportionsofsaturatedfattyacids,whereasvegetablefatshavehigheramountsofunsaturatedandpolyunsaturatedfattyacids.Linoleicacid,anunsaturatedfattyacid,istheonlyessentialfattyacidinhumans.DIF:UnderstandREF:1100OBJ:Explainthesignificanceofsaturated,unsaturated,polyunsaturatedandtransfats.TOP:AssessmentMSC:CPNRE:FoundationsofPractice7.Fatsarecomposedoftriglyceridesandfattyacids.Whichofthefollowingstatementsistrue?a.Triglyceridesaremadeupofthreefattyacids.b.Triglyceridescanbesaturated.c.Triglyceridescanbemonounsaturated.d.Triglyceridescanbepolyunsaturated.ANS:ATriglyceridescirculateinthebloodandaremadeupofthreefattyacidsattachedtoaglycerol.Fattyacids(nottriglycerides)canbesaturatedorunsaturated(monounsaturatedorpolyunsaturated).DIF:RememberREF:1100OBJ:Explainthesignificanceofsaturated,unsaturated,polyunsaturatedandtransfats.TOP:AssessmentMSC:CPNRE:FoundationsofPractice8.Thepatienthasreceivedadiagnosisofcardiovasculardiseaseandplacedonalow-fatdiet.Thepatientasksthenurse,HowmuchfatshouldIhave?Iguessthelessfat,thebetter.Whatdoesthenurseneedtoexplain?a.Fatshavenosignificanceinhealthandtheincidenceofdisease.b.AllfatscomefromexternNaUlsRouSrIceNs,GaTndBs.oCthOeyMcanbeeasilycontrolled.c.Deficienciesoccurwhenfatintakefallsbelow20%ofdailytotalfatintake.d.Vegetablefatsarethemajorsourceofsaturatedfatsandshouldbeavoided.ANS:CTheacceptablemacronutrientdistributionrange,therangeassociatedwithreducedriskofchronicillnesswhileessentialintakesoftotalfatareprovided,is20to35%foradults.Varioustypesoffattyacidshavesignificanceforhealthandfortheincidenceofdiseaseandarereferredtoindietaryguidelines.Linoleicacidandarachidonicacid,whichareimportantformetabolicprocesses,aremanufacturedbythebodywhenlinoleicacidisavailable.Mostanimalfatshavehighproportionsofsaturatedfattyacids,whereasvegetablefatshavehigheramountsofunsaturatedandpolyunsaturatedfattyacids.DIF:UnderstandREF:1100OBJ:Explainthesignificanceofsaturated,unsaturated,polyunsaturatedandtransfats.TOP:AssessmentMSC:CPNRE:FoundationsofPractice9.Wheninsertinganasoenterictube,thenursewillrotatethetubehowmuch?a.45degrees.b.90degrees.c.180degrees.d.360degrees.ANS:CThetubeistoberotated180degreeswhilebeinginserted.CanadianFundamentalsofNursing7thEditionPotterTestBankDIF:ApplyREF:1138OBJ:Describetheprocedureforinitiatingandmaintainingtubefeedingsandavoidingrelatedcomplications.TOP:ImplementationMSC:CPNRE:FoundationsofPractice10.Thepatientstatesthatsheisanlacto-ovo-vegetarian.Whichofthefollowingtypesoffooddoesanlacto-ovo-vegetarianconsume?a.Fishandpoultry.b.Onlyplantfoods.c.Milkandfish.d.Eggsandmilk.ANS:DOvo-lacto-vegetariansavoidmeat,fish,andpoultrybutconsumeeggsandmilk.Vegansconsumeonlyplant-basedfood.DIF:UnderstandREF:1112OBJ:Identifythepotentialnutritionaldeficitsassociatedwithvegetariandiets,withspecialconsiderationtoveganandovo-lactatediets.TOP:AssessmentMSC:CPNRE:FoundationsofPractice11.ThenurseisprovidingnutritionteachingtoaKoreanpatient.Indoingso,thenursemustunderstandthatthefocusoftheteachingshouldbeonwhichofthefollowing?a.ChangingthepatientsdiettoamoreconventionalCanadiandiet.b.Discouragingthepatientsethnicfoodchoices.c.Foodpreferencesofthepatient,includingracialandethnicchoices.d.ComparingthepatientseNthUnRicSpIreNfeGreTncBe.sCwiOthMCanadiandietarychoices.ANS:CThenurseneedstomakesuretoconsiderthefoodpreferencesofpatientsfromdifferentracialandethnicgroups,vegetarians,andotherswhenplanningdiets.InitiationofabalanceddietismoreimportantthanconversiontowhatmaybeconsideredaCanadiandiet.EthnicfoodchoicesmaybejustasnutritiousasCanadianchoices.FoodsshouldbechosenfortheirnutritivevalueandshouldnotbecomparedwiththeCanadiandiet.DIF:UnderstandREF:1111OBJ:DescribeEatingWellwithCanada'sFoodGuideanditsvalueinplanningnutritiousmeals.TOP:AssessmentMSC:CPNRE:FoundationsofPractice12.Whenteachingapatientaboutcurrentdietaryguidelinesforthegeneralpopulation,thenurseexplainsreferenceddailyintakesanddailyreferencevalues,otherwiseknownasdailyvalues.Inprovidingthisinformation,thenurseunderstandswhataboutdailyvalues?a.Theyhavereplacedrecommendeddailyallowances(RDAs).b.TheyhaveprovidedamoreunderstandablecalculationofRDAsforthepublic.c.Theyarebasedonpercentagesofadietconsistingof1200kcal/day.d.Theyarenotusuallyeasytofind,andcomputerexperienceisrequired.ANS:BCanadianFundamentalsofNursing7thEditionPotterTestBankDailyvaluesdidnotreplaceRDAsbutprovidedaseparate,moreunderstandablecalculationforthepublic.Dailyvaluesarebasedonpercentagesofadietconsistingof2000kcal/day;thesevaluesconstitutethedailyvaluesusedonfoodlabels,whichareeasyforanyonetofind.Computerexperienceisnotrequired.DIF:UnderstandREF:1106OBJ:SpecifyrecommendeddietaryintakeforageandsexgroupsinCanadatoensurethatpatientsmeetthevariedessentialvitamins,minerals,andnutritionalrequirementsthroughouttheirgrowthanddevelopment.TOP:AssessmentMSC:CPNRE:FoundationsofPractice13.Thenurseisteachingthepatientaboutdietaryguidelines.Indiscussingthefourcomponentsofdietaryreferenceintakes(DRIs),itisimportanttounderstandwhichofthefollowing?a.Theestimatedaveragerequirementisappropriatefor100%ofthepopulation.b.Therecommendeddietaryallowance(RDA)meetstheneedsoftheindividual.c.AdequateintakedeterminesthenutrientrequirementsoftheRDA.d.Thetolerableupperintakelevelisnotarecommendedlevelofintake.ANS:DThetolerableupperintakelevelisthehighestlevelthatprobablyposesnoriskofadversehealthevents.Itisnotarecommendedlevelofintake.Theestimatedaveragerequirementistherecommendedamountofanutrientthatappearssufficienttomaintainaspecificbodyfunctionfor50%ofthepopulationbasedonageandgender.TheRDAreflectstheaverageneedsof98%ofthepopulation,nottheexactneedsoftheindividual.AdequateintakeistheintakeforindividualssuggestedonthebasisofobservedorexperimentallydeterminedestimatesofnutrientintakesandisusedwhenevidenceisinsufficientforsettingoftheRDA.DIF:UnderstandREF:1103OBJ:SpecifyrecommendeddNieUtarRySinItaNkeGfoTrBag.eCanOdMsexgroupsinCanadatoensurethatpatientsmeetthevariedessentialvitamins,minerals,andnutritionalrequirementsthroughouttheirgrowthanddevelopment.TOP:AssessmentMSC:CPNRE:FoundationsofPractice14.Inteachingmothers-to-beaboutinfantnutrition,whatdoesthenurseinstructthemtodo?a.Givecowsmilkduringthefirstyearoflife.b.Supplementbreastmilkwithcornsyrup.c.Addhoneytoinfantformulasforincreasedenergy.d.Rememberthatbreastmilkorformulaissufficientforthefirst6months.ANS:DBreastmilkorformulaprovidessufficientnutritionforthefirst6monthsoflife.Infantsshouldnothaveregularcowsmilkduringthefirstyearoflife.Cowsmilkcausesgastrointestinalbleeding,istooconcentratedfortheinfantskidneystomanage,increasestheriskfordevelopingmilkproductallergies,andisapoorsourceofironandvitaminsCandE.Honeyandcornsyruparepotentialsourcesofbotulismtoxinandshouldnotbeusedintheinfantdiet.DIF:RememberREF:1107OBJ:SpecifyrecommendeddietaryintakeforageandsexgroupsinCanadatoensurethatpatientsmeetthevariedessentialvitamins,minerals,andnutritionalrequirementsthroughouttheirgrowthanddevelopment.TOP:AssessmentMSC:CPNRE:FoundationsofPracticeCanadianFundamentalsofNursing7thEditionPotterTestBank15.Tocounterobesityinadolescents,increasingphysicalactivityisoftenmoreimportantthancurbingintake.Sportsandregular,moderatetointenseexercisenecessitatedietarymodificationstomeetincreasedenergyneedsforadolescents.Thenurseunderstandsthatthesemodificationsincludewhichofthefollowing?a.Decreasingcarbohydratesto25to30%oftotalintake.b.Decreasingproteinintaketo0.75g/kg/day.c.Drinkingwaterbeforeandafterexercise.d.Providingvitaminandmineralsupplements.ANS:CAdequatehydrationisveryimportantforallathletes.Theyneedtodrinkwaterbeforeandafterexercisetopreventdehydration,especiallyinhot,humidenvironments.Carbohydrates,bothsimpleandcomplex,arethemainsourceofenergy,providing55to60%oftotaldailykilocalories.Proteinneedsincreaseto1.0to1.5g/kg/day.Vitaminandmineralsupplementsarenotrequired,butintakeofiron-richfoodsisnecessarytopreventanemia.DIF:UnderstandREF:1109OBJ:SpecifyrecommendeddietaryintakeforageandsexgroupsinCanadatoensurethatpatientsmeetthevariedessentialvitamins,minerals,andnutritionalrequirementsthroughouttheirgrowthanddevelopment.TOP:AssessmentMSC:CPNRE:FoundationsofPractice16.Inprovidingprenatalcaretoapatient,whatdoesthenurseteachtheexpectantmother?a.Proteinintakeneedstodecreasetopreservekidneyfunction.b.Calciumintakeisespeciallyimportantinthefirsttrimester.c.Folicacidisneededtohelppreventbirthdefectsandanemia.d.Themothershouldtakeinasmanyextravitaminsandmineralsaspossible.ANS:CNURSINGTB.COMFolicacidintakeisparticularlyimportantforDNAsynthesisandgrowthofredbloodcells.Inadequateintakemayleadtofetalneuraltubedefects(suchasanencephaly)ormaternalmegaloblasticanemia.Proteinintakethroughoutpregnancyneedstoincreaseto60gdaily.Calciumintakeisespeciallycriticalinthethirdtrimester,whenfetalbonesaremineralized.Prenatalcareusuallyincludesvitaminandmineralsupplementationtoensuredailyintakes;however,pregnantwomenshouldnottakeadditionalsupplementsbeyondprescribedamounts.DIF:UnderstandREF:1109OBJ:SpecifyrecommendeddietaryintakeforageandsexgroupsinCanadatoensurethatpatientsmeetthevariedessentialvitamins,minerals,andnutritionalrequirementsthroughouttheirgrowthanddevelopment.TOP:AssessmentMSC:CPNRE:FoundationsofPractice17.Thepatientisan80-year-oldmanwhoisvisitingtheclinictodayforhisroutinephysicalexamination.Thepatientsskinturgorisfair,buthehasbeencomplainingoffatigueandweakness.Theskiniswarmanddry,pulserateis126beatsperminute,andurinarysodiumlevelisslightlyelevated.Afterassessment,thenurseshouldrecommendthatthepatientdowhichofthefollowing?a.Decreasehisintakeofmilkanddairyproductstodecreasetheriskofosteoporosis.b.DrinkmoregrapefruitjuicetoenhancevitaminCintakeandmedicationabsorption.c.Drinkmorewatertopreventfurtherdehydration.d.Eatmoremeatbecausemeatistheonlysourceofusableprotein.CanadianFundamentalsofNursing7thEditionPotterTestBankUSNTANS:CThirstsensationdiminisheswithage,whichleadstoinadequatefluidintakeordehydration.Symptomsofdehydrationinolderpersonsincludeconfusion,weakness,hotdryskin,furrowedtongue,andhighurinarysodium.Milkcontinuestobeanimportantfoodforolderwomenandmen,whoneedadequatecalciumtoprotectagainstosteoporosis.Afterage70,osteoporosisaffectsmenandwomenequally.Olderpersonsshouldbecautionedtoavoidgrapefruitandgrapefruitjuicebecausethesewilldecreaseabsorptionofmanydrugs.Someolderpersonsavoidmeatsbecauseofcostorbecausetheyaredifficulttochew.Creamsoupsandmeat-basedvegetablesoupsarenutrient-densesourcesofprotein.DIF:AnalyzeREF:1111OBJ:SpecifyrecommendeddietaryintakeforageandsexgroupsinCanadatoensurethatpatientsmeetthevariedessentialvitamins,minerals,andnutritionalrequirementsthroughouttheirgrowthanddevelopment.TOP:AssessmentMSC:CPNRE:FoundationsofPractice18.Thenurseisassessingapatientfornutritionalstatus.Indoingso,whatmustthenursedo?a.Chooseasingleobjectivetoolthatfitsthepatientscondition.b.Combinemultipleobjectivemeasureswithsubjectivemeasures.c.Foregotheassessmentinthepresenceofchronicdisease.d.UsetheMiniNutritionalAssessmentforpediatricpatients.ANS:BUsingasingleobjectivemeasureisineffectiveinpredictingriskofnutritionalproblems.Multipleobjectivemeasuresshouldbecombinedwithsubjectivemeasuresrelatedtonutritiontoadequatelyscreenfornutritionalproblems.Chronicdiseaseandincreasedmetabolicrequirementsareriskfactorsforthedevelopmentofnutritionalproblems;affectedpatientsmaybeincriticalneedofthiNsasRsessImenGt.TBhe.MCinMiNutritionalAssessmentwasdevelopedtouseforscreeningolderpersonsinhomecareprograms,nursinghomes,andhospitals.DIF:ApplyREF:1113-1116OBJ:Discussthemajormethodsofnutritionalassessment.TOP:AssessmentMSC:CPNRE:FoundationsofPractice19.Thepatienthasacalculatedbodymassindex(BMI)of34.Thiswouldthepatientbeclassified?a.Asunclassifiable.b.Asbeingofnormalweight.c.Asbeingoverweight.d.Asbeingobese.ANS:DBMIgreaterthan30characterizesobesity.BMIbetween25and30isclassifiedasoverweight.BMIlessthan25isconsiderednormalorunderweight.AllBMIscanbeclassified;theyarecalculatedasweightinkilogramsbytheirheightinmetressquared.DIF:AnalyzeREF:1109,Table42-2OBJ:Discussthemajormethodsofnutritionalassessment.TOP:AssessmentMSC:CPNRE:FoundationsofPracticeCanadianFundamentalsofNursing7thEditionPotterTestBank20.Apatientisseenintheoutpatientclinicforfollow-upofanutritionaldeficiency.Inplanningforthepatientsdietaryintake,thenurseincludesacompleteprotein.Whichoneofthefollowingisanexampleofacompleteprotein?a.Cheese.b.Oats.c.Legumes.d.Vegetables.ANS:AAcompleteproteincontainsallessentialaminoacidsinsufficientquantitytosupportgrowthandmaintainnitrogenbalance.Cheese,chicken,fish,andsoybeansareexamplesofcompleteproteins.Incompleteproteinslackasufficientquantityofoneormoreofthenineessentialaminoacidsandincludecereals,legumes,andvegetables.DIF:RememberREF:1100OBJ:Listtheendproductsofcarbohydrate,protein,andfatmetabolism.TOP:AssessmentMSC:CPNRE:FoundationsofPractice21.ThepatientisanolderwomanandhasbeengivenanursingdiagnosisofImbalancednutrition:lessthanbodyrequirements.Whatroleshouldthenurseplayinhertreatmentregimen?a.Encourageweightgainasrapidlyaspossible.b.Encouragelargemealsthreetimesaday.c.Decreasefluidintaketopreventfeelingfull.d.Encouragefibreintake.ANS:DIncreasingfibreintakedetersNcoUnRstSipIatNioGnTanBd.eCnhOaMncesappetite.Weightgainshouldbeslowandprogressive.Thepatientshouldbeencouragedtoeatfrequentsmallmealsshouldtoincreasedietaryintakeandtohelpoffsetanorexia.Olderpersonsneedeight8-ounceglassesoffluidperdayfrombeverageandfoodsources.DIF:RememberREF:1121-1123OBJ:Identifythreemajornutritionalproblems,thepatientswhoareatrisk,andrelatednutritiontherapy.TOP:AssessmentMSC:CPNRE:FoundationsofPractice22.Indeterminingthenutritionalstatusofapatientanddevelopingaplanofcare,itisimportanttoevaluatethepatientaccordingtowhatdata?a.Publishedstandards.b.Nursingprofessionalstandards.c.Absenceoffamilyinput.d.Patientinputonly.ANS:APublishedstandardsarebasedonscientificfindingsandareimportantreferencestousewhenaplanofcareisdeveloped.Nursingstandardscannotbeusedalone.Otherhealthcareprovidersmustbeconsultedtoadoptinterventionsthatreflectthepatientsneeds.Familyshouldbeinvolvedinevaluationanddesignofinterventions.Althoughpatientinputisimportant,synthesisofpatientinformationfrommultiplesourcesisnecessarytodevisinganindividualizedapproachtocarethatisrelevanttothepatientsneeds.DIF:ApplyREF:1098|1112CanadianFundamentalsofNursing7thEditionPotterTestBankOBJ:Formulateaplanofcaretohelpmeetthespecificnutritionalneedsofinfants,toddlers,preschoolers,school-agedchildren,adolescents,adults,andolderpersons.TOP:ImplementationMSC:CPNRE:FoundationsofPractice23.Increatingaplanofcaretomeetthenutritionalneedsofthepatient,thenurseneedstoexplorethepatientsfeelingsaboutweightandfood.Whymustthenursedothis?a.Todeterminewhichcategoryofplantouse.b.Tosetrealisticgoalsforthepatient.c.Tomutuallyplangoalswithpatientandteam.d.Topreventtheneedforadietitianconsult.ANS:CMutuallyplannedgoalsnegotiatedbypatient,registereddietitian,andnurseensuresuccess.Individualizedplanningcannotbeoveremphasized.Preplannedandcategoricalcareplansarenoteffectiveunlesstheyareindividualizedtomeetpatientneeds.Itisimportanttoexplorepatientsfeelingsaboutweightandfoodtohelpthemsetrealisticandachievablegoals.Thenursedoesnotsetgoalsforthepatient.Theplanshouldreflectthecombinedeffortofpatient,nurse,anddietitian,andsoadietitianconsultisrequired.DIF:ApplyREF:1119OBJ:Formulateaplanofcaretohelpmeetthespecificnutritionalneedsofinfants,toddlers,preschoolers,school-agedchildren,adolescents,adults,andolderpersons.TOP:ImplementationMSC:CPNRE:FoundationsofPractice24.Thepatientisadmittedwithfacialtrauma,includingabrokennose,andhasahistoryofesophagealrefluxandofaspirationpneumonia.Inviewofthisinformation,whichofthefollowingtubesisappropriateforthispatient?a.Nasogastrictube.NURSINGTB.COMb.Percutaneousendoscopicgastrostomy(PEG)tube.c.Nasointestinaltube.d.Jejunostomytube.ANS:DPatientswithgastroparesisoresophagealrefluxorwithahistoryofaspirationpneumoniamayrequireplacementoftubesbeyondthestomachintotheintestine.ThenasogastrictubeandthePEGtubeareplacedinthestomach,andplacementcouldleadtoaspiration.Thenasointestinaltubeandthenasogastrictubemaybecontraindicatedbythefacialtraumaandthebrokennose.Thejejunostomytubeistheonlytubeinthelistthatisplacedbeyondthestomachandisnotcontraindicatedbyfacialtrauma.DIF:UnderstandREF:1135OBJ:Describetheprocedureforinitiatingandmaintainingtubefeedingsandavoidingrelatedcomplications.TOP:AssessmentMSC:CPNRE:FoundationsofPractice25.Thenurseispreparingtoinsertanasogastrictubeinapatientwhoissemiconscious.Todeterminetheneededlengthofthetubetobeinserted,thenursemeasureswhatlength?a.Fromthetipofthenosetothexiphoidprocessofthesternum.b.Fromtheearlobetothexiphoidprocessofthesternum.c.Fromthetipofthenosetotheearlobe.d.Fromthetipofthenosetotheearlobetothexiphoidprocess.ANS:DCanadianFundamentalsofNursing7thEditionPotterTestBankThenursemeasuresthedistancefromthetipofthenosetotheearlobetothexiphoidprocessofthesternum.Thisapproximatesthedistancefromthenosetothestomachin98%ofpatients.Forduodenalorjejunalplacement,anadditional20to30centimetresisrequired.DIF:ApplyREF:1138,Skill42-3OBJ:Describetheprocedureforinitiatingandmaintainingtubefeedingsandavoidingrelatedcomplications.TOP:ImplementationMSC:CPNRE:FoundationsofPractice26.Beforethepatientisgivenanintermittenttubefeeding,whatshouldthenursedo?a.Makesurethatthetubeissecuredtothegownwithasafetypin.b.Havethetubefeedingatroomtemperature.c.Injectairintothestomachviathetubeandauscultate.d.Placethepatientinasupineposition.ANS:BColdformulacausesgastriccrampinganddiscomfortbecausethemouthandtheesophaguscannotwarmtheliquid.Safetypinsshouldnotbeused;theycanbecomeunfastenedandmaycauseharmtothepatient.Auscultationisnolongerconsideredareliablemethodforverificationoftubeplacementbecauseatubeinadvertentlyplacedinthelungs,pharynx,oresophagustransmitssoundsimilartothatofairenteringthestomach.Thepatientshouldbeplacedinhigh-Fowlersposition,ortheheadofthebedshouldbeelevatedatleast30degrees,tohelppreventaspiration.DIF:ApplyREF:1142,Skill42-4OBJ:Describetheprocedureforinitiatingandmaintainingtubefeedingsandavoidingrelatedcomplications.TOP:ImplementationMSC:CPNRE:FoundationsofNPUraRctiSceINGTB.COM27.Atpresent,whatisthemostreliablemethodforverificationofplacementofsmall-borefeedingtubes?a.Auscultation.b.Aspirationofcontents.c.Radiography.d.pHtesting.ANS:CAtpresent,themostreliablemethodforverificationofplacementofsmall-borefeedingtubesisx-rayexamination.AspirationofcontentsandpHtestingarenotinfallible.Thenursewouldneedamorepreciseindicatortohelpdifferentiatethesourceoftubefeedingaspirate.Auscultationisnolongerconsideredareliablemethodforverificationoftubeplacementbecauseatubeinadvertentlyplacedinthelungs,pharynx,oresophagustransmitssoundsimilartothatofairenteringthestomach.DIF:UnderstandREF:1148OBJ:Describetheprocedureforinitiatingandmaintainingtubefeedingsandavoidingrelatedcomplications.TOP:AssessmentMSC:CPNRE:FoundationsofPractice28.Thenurseisconcernedaboutpulmonaryaspirationwhenprovidingherpatientwithtubefeedings.Whatshouldthenursedo?a.Verifytubeplacementbeforefeeding.CanadianFundamentalsofNursing7thEditionPotterTestBankUSNTb.Lowertheheadofthebedtoasupineposition.c.Addbluefoodcolouringtotheenteralformula.d.Runtheformulaover12hourstodecreasevolume.ANS:AAmajorcauseofpulmonaryaspirationisregurgitationofformula.Thenurseneedstoverifytubeplacementandelevatetheheadofthebed30to45degreesduringfeedingsandfor2hoursafterward.Bluefoodcolouringisnolongeraddedtoenteralformulatoassistwithdetectionofaspirate.Theformulashouldnothanglongerthan4to8hours.Afterthatlengthoftime,formulabecomesamediumforbacterialgrowthafterthatlengthoftime.DIF:ApplyREF:1150-1155OBJ:Describetheprocedureforinitiatingandmaintainingtubefeedingsandavoidingrelatedcomplications.TOP:ImplementationMSC:CPNRE:FoundationsofPractice29.Thepatientistoreceivemultiplemedicationsviathenasogastrictube.Thenurseisconcernedthatthetubemaybecomeclogged.Whatcanthenursedotopreventthis?a.Irrigatethetubewith60mLofwaterafterallmedicationsaregiven.b.Checkwiththepharmacytofindoutifliquidformsofthemedicationsareavailable.c.Instillnonliquidmedicationswithoutdiluting.d.Mixallmedicationstogethertodecreasethenumberofadministrations.ANS:BCrushedmedicationshouldbeavoidedifliquidformulationisavailable.Eachtubeisirrigatedwith30mLofwaterbeforeandaftereachmedication.Crushedmedications,ifused,shouldbediluted.ThenurseshouldNreadRphIarmGacoBlo.giCcalMinformationoncompatibilityofdrugsandformulabeforemixingmedications.DIF:ApplyREF:1141,Skill42-3OBJ:Describetheprocedureforinitiatingandmaintainingtubefeedingsandavoidingrelatedcomplications.TOP:ImplementationMSC:CPNRE:FoundationsofPractice30.Thepatienthasjuststartedonenteralfeedingsbutiscomplainingofabdominalcramping.Whatshouldthenursedo?a.Slowtherateoftubefeeding.b.Instillcoldformulatonumbthestomach.c.Placethepatientinasupineposition.d.Changethetubefeedingtoahigh-fatformula.ANS:AOnepossiblecauseofabdominalcrampingisarapidincreaseinrateorvolume.Loweringtherateofdeliverymayincreasetolerance.Anotherpossiblecauseofabdominalcrampingisuseofcoldformula.Thenurseshouldwarmtheformulatoroomtemperature.Thenurseshouldmaintaintheheadofthebedatleast30degrees.High-fatformulasarealsoacauseofabdominalcramping.DIF:ApplyREF:1152,Table42-9OBJ:Describetheprocedureforinitiatingandmaintainingtubefeedingsandavoidingrelatedcomplications.TOP:ImplementationCanadianFundamentalsofNursing7thEditionPotterTestBankUSNTOMSC:CPNRE:FoundationsofPractice31.Thepatienthasjuststartedonanenteralfeedingandhasdevelopeddiarrheaafterbeingonthefeedingfor2hours.Whichisthemostlikelycauseofthediarrhea?a.Clostridiumdifficileinfection.b.Antibiotictherapy.c.Formulaintolerance.d.Bacterialcontamination.ANS:CHyperosmolarformulascancausediarrhea.Ifthatisthecase,thesolutionistolowertherate,dilutetheformula,orchangetoanisotonicformula.Antibioticsdestroynormalintestinalfloraanddisturbtheinternalecology,allowingforC.difficiletoxinbuildup.However,thistakestime,andthedescriptiondoesnotsuggestthatthispatientwastakingantibiotics.Proximitytothestartoftheenteralfeedingsismoresuspect.Bacterialcontaminationofthefeedingusuallyoccurswhenfeedingsarelefthangingforlongerthan8hours.DIF:ApplyREF:1151,Table42-9OBJ:Describetheprocedureforinitiatingandmaintainingtubefeedingsandavoidingrelatedcomplications.TOP:AssessmentMSC:CPNRE:FoundationsofPractice32.Inprovidingdiabeticteachingforapatientwithtype1diabetesmellitus,thenursegivesthepatientwhichinstruction?a.Insulinistheonlyconsiderationthatmustbetakenintoaccount.b.Saturatedfatshouldbelimitedtolessthan30%oftotalcalories.c.Cholesterolintakeshouldbegreaterthan200mg/day.d.Nonnutritivesweetenerscanbeusedwithoutrestriction.NRIGB.CMANS:BThepatientwithdiabetesshouldlimitdailyfattolessthan30%oftotalcaloriesandcholesterolintaketolessthan200mg/day.Patientswithtype1diabetesrequirebothinsulinanddietaryrestrictionsforoptimalcontrol.Nonnutritivesweetenerscanbeeatenaslongastherecommendeddailyintakelevelsarefollowed.DIF:ApplyREF:1127,Box42-9OBJ:Identifythreemajornutritionalproblems,thepatientswhoareatrisk,andrelatednutritiontherapy.TOP:ImplementationMSC:CPNRE:FoundationsofPractice33.Theparentofan8-year-oldasksthenurseaboutanyspecialnutritionalneedsforchildreninthisagegroup.Thenursementionsthatchildreninthisagegroupneedtodowhichofthefollowing?a.IncreasetheirintakeofBvitamins.b.Significantlyincreaseironintake.c.MaintainsufficientintakeofproteinandvitaminsAandC.d.Increasecarbohydratestomeetincreasedenergyneeds.ANS:CCanadianFundamentalsofNursing7thEditionPotterTestBankSchool-agedchildrensdietsshouldbecarefullyassessedforadequateproteinandvitaminsAandC.School-agedchildrenfrequentlyfailtoeataproperbreakfast,andtheirintakeatschoolisunsupervised.AnincreaseinB-complexvitaminsisneededtosupportheightenedmetabolicactivityoftheadolescent,butnottheschool-agedchild.Thepregnantwomanneedstoincreaseironintakesignificantly,buttheschool-agedchilddoesnot.Increasedenergyneedsareexpectedintheadolescentperiod,notintheschool-agedgroup;therefore,an8-year-oldchilddoesnotneedtoincreasecarbohydratestomeetincreasedenergyneeds.DIF:AnalyzeREF:1108OBJ:SpecifyrecommendeddietaryintakeforageandsexgroupsinCanadatoensurethatpatientsmeetthevariedessentialvitamins,minerals,andnutritionalrequirementsthroughouttheirgrowthanddevelopment.TOP:AssessmentMSC:CPNRE:FoundationsofPractice34.Thenurseisprovidinghomecareforapatientwhohasacquiredimmunedeficiencysyndrome(AIDS).Inpreparingmealsforthispatient,whatshouldthenursedo?a.Providesmall,frequentnutrient-densemeals.b.Encourageintakeoffattyfoodstoincreasecaloricintake.c.Preparehotmealsbecausetheyaremoreeasilytolerated.d.Avoidsaltyfoodsandlimitliquidstopreserveelectrolytes.ANS:ASmall,frequent,nutrient-densemealsinwhichfattyfoodsandoverlysweetfoodsarelimitedareeasiertotolerate.Patientsbenefitfromeatingcoldfoodsanddrierorsaltierfoodswithfluidinbetween.DIF:ApplyREF:1128OBJ:Identifythreemajornutritionalproblems,thepatientswhoareatrisk,andrelatednutritiontherapy.TOP:ImNpUlemReSnItatNioGnTB.COMMSC:CPNRE:FoundationsofPractice35.Toprovidesuccessfulnutritionaltherapiestopatients,whatmustthenurseunderstand?a.Patientswillhavetochangedietpreferencesdrasticallytobesuccessful.b.Thepatientwilltellthenursewhentochangetheplanofcare.c.Expectationsofnursesfrequentlydifferfromthoseofthepatient.d.Nursesshouldneveraltertheplanofcareregardlessofoutcome.ANS:CExpectationsandhealthcarevaluesheldbynursesfrequentlydifferfromthoseheldbypatients.Successfulinterventionsandoutcomesdependonrecognitionofthisfact,inadditiontonursingknowledgeandskill.Ifongoingnutritionaltherapiesarenotresultinginsuccessfuloutcomes,patientsexpectnursestorecognizethisfactandaltertheplanofcareaccordingly.Workingcloselywithpatientsenablesthenursetoredefineexpectationsthatarerealisticallymetwithinthelimitsofconditionsandtreatmentsandtoidentifytheirdietarypreferencesandculturalbeliefs.DIF:UnderstandREF:1129OBJ:Discussdietcounsellingandpatientteachinginrelationtopatientexpectations.TOP:ImplementationMSC:CPNRE:FoundationsofPractice36.Inmeasuringtheeffectivenessofnutritionalinterventions,whatmustthenurseremember?a.Toexpectresultstooccurrapidly.CanadianFundamentalsofNursing7thEditionPotterTestBankb.Nottobeconcernedwithphysicalmeasuressuchasweight.c.Toexpecttomaintainacourseofactionregardlessofchangesincondition.d.Toevaluateoutcomesaccordingtothepatientsexpectationsandgoals.ANS:DThenurseshouldmeasuretheeffectivenessofnutritionalinterventionsbyevaluatingthepatientsexpectedoutcomesandgoalsofcare.Nutritiontherapydoesnotalwaysproducerapidresults.Ongoingcomparisonsneedtobemadewithbaselinemeasuresofweight,serumalbuminorprealbumin,andproteinandkilocalorieintake.Changesinthepatientsconditionmayindicateaneedtochangethenutritionalplanofcare.DIF:ApplyREF:1129OBJ:Discussdietcounsellingandpatientteachinginrelationtopatientexpectations.TOP:ImplementationMSC:CPNRE:FoundationsofPractice37.Whatactionshouldthenursetakewhenexpectednutritionaloutcomesarenotbeingmet?a.Revisethenursemeasuresorexpectedoutcomes.b.Altertheoutcomesonthebasisofnursingstandards.c.Ensurethatpatientexpectationsarecongruentwiththenursesexpectations.d.Readjusttheplantoexcludeculturalbeliefs.ANS:AWhenexpectedoutcomesarenotmet,thenurseshouldrevisethenursingmeasuresorexpectedoutcomesaccordingtothepatientsneedsorpreferences,notsolelyonthebasisofnursingstandards.Expectationsandhealthcarevaluesheldbynursesfrequentlydifferfromthoseheldbypatients.WorkingcloselywithpatientsenablesthenursetoredefineexpectationsthatarerealisticallymetwithinthelimitsofconditionsandtreatmentsandtoidentifytheirdietarypreferenNcUesRaSndIcNuGltuTraBl.beCliOefMs.DIF:ApplyREF:1129OBJ:Discussdietcounsellingandpatientteachinginrelationtopatientexpectations.TOP:ImplementationMSC:CPNRE:FoundationsofPractice38.Thepatientisaskingthenurseaboutthebestwaytostayhealthy.Thenursewillprovidefurtherinstructionifthepatientstatesthatheorshewilldowhichofthefollowing?a.Maintainbodyweightinahealthyrange.b.Increasephysicalactivity.c.Increaseintakeofmeatandotherhigh-proteinfoods.d.Chooseandpreparefoodswithlittlesalt.ANS:CCanada'sFoodGuidenotestheimportanceofphysicalactivityinmaintainingenergybalanceandrecommendsthatadultsspend30to60minutesperdaycarryingoutsomephysicalactivityandchildrenandyouthspendatleast90minutesperday.Theguideprovidesadviceontheuseofvitaminandmineralsupplementationwhentherecommendedfoodintakepatterndoesnotensureadequateamountsandtomaintainahealthybodyweight.Althoughrecommendationsforsalt,alcohol,andcaffeinearenotspecifiedintheguide,Canadiansareadvisedbynutritionexpertstolimitsalttohealthylevels,alcoholtonomorethan5%oftotalenergy,andcaffeinetonomorethan400mgforthegeneralpopulation.DIF:ApplyREF:1103-1106OBJ:DescribeEatingWellwithCanada'sFoodGuideanditsvalueinplanningnutritiousmeals.CanadianFundamentalsofNursing7thEditionPotterTestBankTOP:ImplementationMSC:CPNRE:FoundationsofPracticeNURSINGTB.COMCanadianFundamentalsofNursing7thEditionPotterTestBankChapter43:UrinaryEliminationPotteretal:CanadianFundamentalsofNursing,7thEditionMULTIPLECHOICE1.Ifobstructed,whichcomponentoftheurinationsystemwouldcauseperistalticwaves?a.Kidneys.b.Ureters.c.Bladder.d.Urethra.ANS:BUretersdrainurinefromthekidneysintothebladder;iftheybecomeobstructed,peristalticwavesattempttopushtheobstructionintothebladder.Thekidneys,bladder,andurethradonotproduceperistalticwaves.Obstructionofbothbladderandurethratypicallydoesnotoccur.DIF:RememberREF:1167OBJ:Describetheprocessofurination.TOP:EvaluateMSC:CPNRE:FoundationsofPractice2.Whenreviewinglaboratoryresults,thenurseshouldimmediatelynotifythehealthcareprovideraboutwhichfinding?a.Glomerularfiltrationrateof20mL/min.b.Urineoutputof280mL/hr.c.pHof6.4.d.Proteinlevelof2mg/100NmLR.IGB.CMANS:AUSNTONormalglomerularfiltrationrateshouldbeapproximately125mL/min;aseveredecreaseinrenalperfusioncouldindicatealife-threateningproblemsuchasshockordehydration.Normalurineoutputis1000to2000mL/day;anoutputof30mL/hrorlessfor2ormorehourswouldbecauseforconcern.ThenormalpHofurineisbetween4.6and8.0.Proteinlevelsupto8mg/100mLareacceptable;however,valuesinexcessofthiscouldindicaterenaldisease.DIF:ApplyREF:1172OBJ:Describethenursingimplicationsofcommondiagnostictestsoftheurinarysystem.TOP:ImplementationMSC:CPNRE:FoundationsofPractice3.Apatientisexperiencingoliguria.Whichactionshouldthenurseperformfirst?a.Increasethepatientsintravenousfluidrate.b.Encouragethepatienttodrinkcaffeinatedbeverages.c.Assessforbladderdistension.d.Requestanorderfordiuretics.ANS:CCanadianFundamentalsofNursing7thEditionPotterTestBankUSNTOThenursefirstshouldgatherallassessmentdatatodeterminethepotentialcauseofoliguria.Itcouldbethatthepatientdoesnothaveadequateintake,oritcouldbethatthebladdersphincterisnotfunctioningandthepatientisretainingwater.Increasingfluidsiseffectiveifthepatientdoesnothaveadequateintake,orifdehydrationoccurs.Caffeinecanworkasadiureticbutisnothelpfulifanunderlyingpathologicalprocessispresent.Anorderfordiureticscanbeobtainedifthepatientwasretainingwater,butthisshouldnotbethefirstaction.DIF:AnalyzeREF:1174|1175OBJ:Describecharacteristicsofnormalandabnormalurine.TOP:AssessmentMSC:CPNRE:FoundationsofPractice4.Apatientrequeststhenursesassistancetothebedsidecommodeandbecomesfrustratedwhenunabletovoidinfrontofthenurse.Thenurseunderstandsthatthepatientisunabletovoidforwhichreason?a.Anxietycanmakeitdifficultforabdominalandperinealmusclestorelaxenoughtovoid.b.Thepatientdoesnotrecognizethephysiologicalsignalsthatindicateaneedtovoid.c.Thepatientislonely,andcallingthenurseinunderfalsepretensesisawaytogetattention.d.Thepatientisnotdrinkingenoughfluidstoproduceadequateurineoutput.ANS:AAttemptingtovoidinthepresenceofanotherpersoncancauseanxietyandtensioninthemuscles,whichmakesvoidingdifficult.Thenurseshouldgivethepatientprivacyandadequatetimeifappropriate.NNoRevidIencGesuBg.geCstsMthatanunderlyingphysiologicalorpsychologicalconditionexists.DIF:UnderstandREF:1168,Box43-1OBJ:Identifyfactorsthatcommonlyinfluenceurinaryelimination.TOP:ImplementationMSC:CPNRE:FoundationsofPractice5.Thenurseknowsthaturinarytractinfection(UTI)isthemostcommonhealthcare-associatedinfectionforwhichreason?a.Catheterizationproceduresareperformedmorefrequentlythanindicated.b.Escherichiacolipathogensaretransmittedduringsurgicalorcatheterizationprocedures.c.Perinealcareisoftenneglectedbynursingstaff.d.Bedpansandurinalsarenotstoredproperlyandtransmitinfection.ANS:BE.coliistheleadingpathogeniccauseofUTIs;thispathogenentersduringinvasiveprocedures.Steriletechniqueisimperativetopreventthespreadofinfection.FrequentcatheterizationscanplaceapatientathighriskforUTI;however,infectioniscausedbybacteria,notbytheprocedureitself.Perinealcareisimportant,andbuildupofbacteriacanleadtoinfection,butthisisnottheprimarycause.Bedpansandurinalsmaybecomebacteriariddenandshouldbecleanedfrequently;however,bedpansandurinalsarenotinsertedintotheurinarytract,sotheyareunlikelytobetheprimarycauseofUTI.DIF:UnderstandREF:1169CanadianFundamentalsofNursing7thEditionPotterTestBankUSNTOOBJ:Comparecommonalterationsinurinaryelimination.TOP:ImplementationMSC:CPNRE:FoundationsofPractice6.An86-year-oldpatienttellsthenursethatsheisexperiencinguncontrollableleakageofurine.Whichnursingdiagnosisshouldthenurseincludeinthepatientsplanofcare?a.Urinaryretention.b.Hesitancy.c.Urgency.d.Urinaryincontinence.ANS:DAge-relatedchangessuchaslossofpelvicmuscletonecancauseinvoluntarylossofurine,knownasurinaryincontinence.Urinaryretentionistheinabilitytoemptythebladder.Hesitancyoccursasdifficultyinitiatingurination.Urgencyisthefeelingoftheneedtovoidimmediately.DIF:ApplyREF:1169OBJ:Identifynursingdiagnosesappropriateforpatientswithalterationsinurinaryelimination.TOP:PlanningMSC:CPNRE:FoundationsofPractice7.Apatienthasfallenseveraltimesinthepastweekwhenattemptingtogettothebathroom.Thepatientinformsthenursethathegetsupthreeorfourtimesanighttourinate.Whichrecommendationbythenurseismostappropriateincorrectingthisurinaryproblem?a.Clearthepathtothebathroomofallobstaclesbeforebed.b.Leavethebathroomlightontoilluminateapathway.c.Limitfluidandcaffeineintakebeforebed.d.PractiseKegelexercisestostrengthenbladdermuscles.NRIGB.CMANS:CReducingfluids,especiallycaffeineandalcohol,beforebedtimecanreducenocturia.Clearingapathtotherestroomorilluminatingthepath,orshorteningthedistancetotherestroom,mayreducefallsbutwillnotcorrecttheurinationproblem.Kegelexercisesareusefulifapatientisexperiencingincontinence.DIF:ApplyREF:1169OBJ:Discussnursingmeasurestopromotenormalmicturitionandtoreduceepisodesofincontinence.TOP:ImplementationMSC:CPNRE:FoundationsofPractice8.Whencaringforapatientwithurinaryretention,thenursewouldanticipateanorderforwhichofthefollowing?a.Limitedfluidintake.b.Aurinarycatheter.c.Diureticmedication.d.Renalangiography.ANS:BAurinarycatheterwouldrelieveurinaryretention.Reducingfluidswouldreducetheamountofurineproducedbutwouldnotalleviatetheurineretention.Diureticmedicationwouldincreaseurineproductionandmayworsenthediscomfortcausedbyurineretention.Renalangiographyisnotanappropriatediagnostictestforurinaryretention.CanadianFundamentalsofNursing7thEditionPotterTestBankDIF:ApplyREF:1169,Table43-1OBJ:Discussnursingmeasurestopromotenormalmicturitionandtoreduceepisodesofincontinence.TOP:ImplementationMSC:CPNRE:FoundationsofPractice9.Uponpalpation,thenursenoticesthatthebladderisfirmanddistended;thepatientexpressesanurgetourinate.Thenurseshouldfollowupbyaskingwhichquestion?a.Whenwasthelasttimeyouvoided?b.Doyouloseurinewhenyoucoughorsneeze?c.Haveyounoticedanychangeinyoururinationpatterns?d.Doyouhaveafeverorchills?ANS:AToobtainanaccurateassessment,thenurseshouldfirstdeterminethesourceofthediscomfort.Urinaryretentioncausesthebladdertobefirmanddistended.Furtherassessmenttodeterminethepathologicalprocessoftheconditioncanbeperformedlater.Questionsconcerningfeverandchills,changingurinationpatterns,andlosingurineduringcoughingorsneezingfocusonspecificpathologicalconditions.DIF:ApplyREF:1171|1181OBJ:Obtainanursinghistoryforapatientwithurinaryeliminationproblems.TOP:ImplementationMSC:CPNRE:FoundationsofPractice10.Whichofthefollowingistheprimaryfunctionofthekidneys?a.Metabolizingandexcretingmedications.b.Maintainingfluidandelectrolytebalance.c.Storingandexcretingurine.d.FilteringbloodcellsandNprUotReiSnsI.NGTB.COMANS:BThemainpurposeofthekidneyistomaintainfluidandelectrolytebalancebyfilteringwasteproductsandregulatingpressures.Thekidneysfiltertheby-productsofmedicationmetabolism.Thebladderstoresandexcretesurine.Thekidneyshelptomaintainredbloodcellvolumebyproducingerythropoietin.DIF:UnderstandREF:1166OBJ:Describetheprocessofurination.TOP:AssessmentMSC:CPNRE:FoundationsofPractice11.Whilereceivingashiftreportonapatient,thenurseisinformedthatthepatienthasurinaryincontinence.Uponassessment,whatwouldthenurseexpecttofind?a.Anin-dwellingFoleycatheter.b.Reddenedirritatedskinonthebuttocks.c.Tinybloodclotsinthepatientsurine.d.Foul-smellingdischargeindicativeofaUTI.ANS:BUrinaryincontinenceisuncontrolledurinaryelimination;iftheurinehasprolongedcontactwiththeskin,skinbreakdowncanoccur.AnindwellingFoleycatheterisasolutionforurineretention.Bloodclotsandfoul-smellingdischargeareoftensignsofinfection.DIF:ApplyREF:1169|1171OBJ:Comparecommonalterationsinurinaryelimination.TOP:AssessmentCanadianFundamentalsofNursing7thEditionPotterTestBankUSNTOMSC:CPNRE:FoundationsofPractice12.Whichnursingdiagnosisrelatedtoalterationsinurinaryfunctioninanolderpersonshouldbeanursesfirstpriorityforaction?a.Self-caredeficitrelatedtodecreasedmobility.b.Riskofinfection.c.Anxietyrelatedtourinaryfrequency.d.Impairedself-esteemrelatedtolackofindependence.ANS:BInmanyolderpersons,muscletoneispoor,whichleadstoaninabilityofthebladdertoemptycompletely.Residualurinegreatlyincreasestheriskofinfection.AccordingtoMaslowshierarchyofneeds,physicalhealthrisksshouldbeaddressedbeforeemotional/cognitiveriskssuchasanxietyandself-esteem.Decreasedmobilitycanleadtoself-caredeficit;thenursespriorityconcernforthisdiagnosiswouldbeinfectionbecausethispatientmustrelyonothersforbasichygiene.DIF:ApplyREF:1173OBJ:Identifynursingdiagnosesappropriateforpatientswithalterationsinurinaryelimination.TOP:PlanningMSC:CPNRE:FoundationsofPractice13.Apatientasksabouttreatmentforurgeurinaryincontinence.Thenursesbestresponseiswhichadvicetothepatient?a.Performpelvicfloorexercises.b.Drinkcranberryjuice.c.Avoidvoidingfrequently.d.Wearanadultdiaper.NRIGB.CMANS:APoormuscletoneleadstoaninabilitytocontrolurineflow.ThenurseshouldrecommendpelvicmusclestrengtheningexercisessuchasKegelexercises;thissolutionbestaddressesthepatientsproblem.Drinkingcranberryjuiceisapreventivemeasureforurinarytractinfection.Thenurseshouldnotencouragethepatienttoreducevoiding;residualurineinthebladderincreasestheriskofinfection.Wearinganadultdiapercouldbeconsideredifattemptstocorrecttherootoftheproblemfail.DIF:AnalyzeREF:1183OBJ:Identifynursingdiagnosesappropriateforpatientswithalterationsinurinaryelimination.TOP:PlanningMSC:CPNRE:FoundationsofPractice14.Thenursesuspectsthataurinarytractinfectionhasprogressedtocystitiswhenthepatientcomplainsofwhichsymptom?a.Dysuria.b.Flankpain.c.Frequency.d.Feverandchills.ANS:CCystitisisinflammationofthebladder;associatedsymptomsincludehematuriaandurgency/frequency.Dysuriaisacommonsymptomofalowerurinarytractinfection.Flankpain,fever,andchillsareallsignsofpyelonephritis.CanadianFundamentalsofNursing7thEditionPotterTestBankDIF:UnderstandREF:1168|1169OBJ:Comparecommonalterationsinurinaryelimination.TOP:AssessmentMSC:CPNRE:FoundationsofPractice15.Whichassessmentquestionshouldthenurseaskifstressincontinenceissuspected?a.Doesyourbladderfeeldistended?b.Doyouemptyyourbladdercompletelywhenyouvoid?c.Doyouexperienceurineleakagewhenyoucoughorsneeze?d.Doyoursymptomsincreasewithconsumptionofalcoholorcaffeine?ANS:CStressincontinencecanberelatedtointra-abdominalpressurethatcausesurineleakage,aswouldhappenduringcoughingorsneezing.Thepatientsresponseaboutthefullnessofthebladderwouldruleoutretentionandoverflow.Aninabilitytovoidcompletelycanrefertourgeincontinence.Physiologicalcausesandmedicationscanaffectelimination,butthisisnotrelatedtostressincontinence.DIF:ApplyREF:1170,Table43-2OBJ:Comparecommonalterationsinurinaryelimination.TOP:PlanningMSC:CPNRE:FoundationsofPractice16.Toobtainaclean-voidedurinespecimenfromafemalepatient,thenurseshouldteachthepatienttodowhichofthefollowing?a.Cleansetheurethralmeatusfromtheareaofmostcontaminationtoleast.b.Initiatethefirstpartoftheurinestreamdirectlyintothecollectioncup.c.Holdthelabiaapartwhilevoidingintothespecimencup.d.Drinkfluids5minutesbeforecollectingtheurinespecimen.ANS:CNURSINGTB.COMThepatientshouldholdthelabiaaparttoreducebacteriallevelsinthespecimen.Theurethralmeatusshouldbecleansedfromtheareaofleastcontaminationtogreatestcontamination(front-to-back).Theinitialstreamflushesoutmicroorganismsintheurethraandpreventsbacterialtransmissioninthespecimen.Patientsshoulddrinkfluids30to60minutesbeforegivingaspecimen.DIF:UnderstandREF:1178-1180,Skill43-1OBJ:Obtainurinespecimens.TOP:PlanningMSC:CPNRE:FoundationsofPractice17.Whenviewingaurinespecimenunderamicroscope,whatwouldthenurseexpecttoseeifthespecimenisfromapatientwithaurinarytractinfection?a.Bacteria.b.Casts.c.Crystals.d.Protein.ANS:ABacteriaindicateaurinarytractinfection.Crystalswouldbeseenwithrenalstoneformation.Castsindicaterenalalterations.Proteinisnotvisibleunderamicroscope,butitspresenceindicatesrenaldisease.DIF:RememberREF:1180|1181,Table43-5OBJ:Describecharacteristicsofnormalandabnormalurine.TOP:AssessmentCanadianFundamentalsofNursing7thEditionPotterTestBankUSNTMSC:CPNRE:FoundationsofPractice18.Thenursewouldexpecttheurineofapatientwithuncontrolleddiabetesmellitustobewhichofthefollowing?a.Cloudy.b.Discoloured.c.Sweetsmelling.d.Painful.ANS:CIncompletefatmetabolismandbuildupofketonesgiveurineasweetorfruityodour.Cloudyurinemayindicateinfectionorrenalfailure.Discolourationofurinemayresultfromvariousmedications.Painfulurinationindicatesanalterationinurinaryelimination.DIF:UnderstandREF:1177OBJ:Describecharacteristicsofnormalandabnormalurine.TOP:AssessmentMSC:CPNRE:FoundationsofPractice19.Whatsignsandsymptomswouldthenurseexpecttoobserveinapatientwithexcessivenumbersofwhitebloodcellspresentintheurine?a.Feverandchills.b.Difficultywithurinaryelimination.c.Increasedbloodpressure.d.Abnormalbloodsugar.ANS:AThepresenceofwhitebloodcellsinurineindicatesaurinarytractinfection.DifficultywithurinaryeliminationindicatesNbloRckagIeoGrrenBa.ldCamMage.Increaseinbloodpressureisassociatedwithrenaldiseaseordamageandsomemedications.Bloodglucoselevelswouldbeabnormalinsomeonewithketonesintheurine,asthisfindingindicatesdiabetes.DIF:UnderstandREF:1204OBJ:Describecharacteristicsofnormalandabnormalurine.TOP:AssessmentMSC:CPNRE:FoundationsofPractice20.Forapatientwhohassevereflankpainandcalciumphosphatecrystalsrevealedonurinalysis,thenursewouldanticipateanorderforwhichdiagnostictest?a.Renalultrasonography.b.Bladderscan.c.Kidney,ureter,andbladder(KUB)radiography.d.Intravenouspyelography.ANS:DFlankpainandcalciumphosphatecrystalsareassociatedwithrenalcalculi.Intravenouspyelographyallowsthehealthcareprovidertoobservepathologicalproblemssuchasobstructionoftheureter.Renalultrasonographyisperformedtoidentifygrossstructures.Abladderscanhelpsmeasuretheamountofurineinthebladder.AKUBradiographshowssize,shape,symmetry,andlocationofthekidneys.DIF:UnderstandREF:1161|1182,Table43-6OBJ:Describethenursingimplicationsofcommondiagnostictestsoftheurinarysystem.TOP:PlanningMSC:CPNRE:FoundationsofPracticeCanadianFundamentalsofNursing7thEditionPotterTestBankUSNTO21.Anurseiscaringforapatientwhojustunderwentintravenouspyelographythatrevealedarenalcalculusobstructingtheleftureter.Whatisthenursesfirstpriorityincaringforthispatient?a.Turnthepatientontotherightsidetoalleviatepressureontheleftkidney.b.Encouragethepatienttoincreasefluidintaketoflushtheobstruction.c.Administernarcoticmedicationstoalleviatepain.d.Monitorthepatientforfever,rash,anddifficultybreathing.ANS:DToperformintravenouspyelography,iodine-baseddyeisadministeredtorevealfunctionalityoftheurinarysystem.Manyindividualsareallergictoshellfish;therefore,thefirstnursingpriorityistoassessthepatientforanallergicreactionthatcouldbelife-threatening.Thenurseshouldthenencouragethepatienttodrinkfluidstoflushdyeusedintheprocedure.Narcoticscanbeadministeredbutarenotthefirstpriority.Turningthepatientonthesidewillnotaffectpatientsafety.DIF:AnalyzeREF:1182,Table43-6OBJ:Describethenursingimplicationsofcommondiagnostictestsoftheurinarysystem.TOP:PlanningMSC:CPNRE:FoundationsofPractice22.Whichstatementbythepatientaboutupcomingcomputedtomography(CT)indicatesaneedforfurtherteaching?a.Imallergictoshrimp,soIshouldmonitormyselfforanallergicreaction.b.Iwillcompletemybowelprepprogramthenightbeforethescan.c.IwillbeanaesthetizedsothatIlieperfectlystillduringtheprocedure.d.IwillaskthetechnicianNtopRlayImuGsictBo.eaCsemMyanxiety.ANS:CPatientsarenotanaesthetizedforaCTscan;instead,thenurseshouldeducatepatientsabouttheneedtolieperfectlystillandaboutpossiblemethodsofovercomingfeelingsofclaustrophobia.Theotheroptionsarecorrect.PatientsneedtobeassessedforanallergytoshellfishifreceivingcontrastmaterialfortheCTscan.BowelcleansingisoftenperformedbeforeCTscanning.Listeningtomusicwillhelpthepatientrelaxandremainstillduringtheexamination.DIF:ApplyREF:1182,Table43-6OBJ:Describethenursingimplicationsofcommondiagnostictestsoftheurinarysystem.TOP:PlanningMSC:CPNRE:FoundationsofPractice23.ThenurseisvisitingthepatientwhohasanursingdiagnosisofImpairedurinaryelimination:retention.Onassessment,thenurseanticipatesthatthispatientwillexhibitwhichofthefollowing?a.Severeflankpainandhematuria.b.Painandburningonurination.c.Lossoftheurgetovoid.d.Sensationofurgencyandvoidingofsmallamounts.ANS:DCanadianFundamentalsofNursing7thEditionPotterTestBankWithurinaryretention,urinecontinuestocollectinthebladder,stretchingitswallsandcausingfeelingsofpressure,discomfort,tendernessoverthesymphysispubis,restlessness,anddiaphoresis.Thesphinctertemporarilyopenstoallowasmallvolumeofurine(