Contemporary Nursing Issues Trends & Management 6th Edition by Barbara Cherry, Jacob – Test Bank

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INSTANT DOWNLOAD COMPLETE TEST BANK WITH ANSWERS

 

Contemporary Nursing Issues  Trends  & Management 6th Edition by Barbara Cherry – Test Bank

 

 

Sample  Questions

 

Chapter 03: The Influence of Contemporary Trends and Issues on Nursing Education

Test Bank

 

MULTIPLE CHOICE

 

  1. A current trend is for students to be evaluated to determine whether they demonstrate competence in the actual client care environment or with a standardized patient. This process occurs in addition to or instead of traditional pencil-and-paper evaluations. This type of evaluation is referred to as:
a. core practice competencies.
b. continuing competence.
c. distance learning.
d. performance-based assessment.

 

 

ANS:  D

Correct: Performance-based assessment is the evaluation of abilities based on an objective demonstration of specific required competencies. This may include performance in actual or simulated situations.

Incorrect:

  1. Core practice competencies consist of the abilities and skills currently required for program completion and nursing practice.
  2. Continuing competence is required in many states for relicensure and recertification.
  3. Distant learning occurs when courses are delivered through some electronic format such as a web-based course. The course may be presented a great distance from the student, who is never required to attend a class at a physical location.

 

DIF:    Knowledge     REF:   p. 43

 

  1. One of the major trends that currently influences nursing education and practice is:
a. increased technology in the field of critical care.
b. a narrowing scope of practice for nurses.
c. incivility or disregard of others’ rights in social interactions.
d. a decrease in ethnicity due to international programs allowing students to study from a distance.

 

 

ANS:  C

Correct: Incivility has escalated with the use of text-messaging during class and academic dishonesty.

Incorrect:

  1. Critical care is not the only area in which technology is increasing and does not have a major influence on nursing education.
  2. The scope of practice is becoming broader, including community and global settings.
  3. The number of diverse ethnic minorities and illegal immigrants is increasing.

 

DIF:    Application    REF:   p. 45

 

  1. Although the use of technology and the Internet provides nursing faculty and students with unlimited resources and current information, an outcome associated with this trend is that:
a. users of electronic resources spend a disproportionate amount of time looking for pertinent content.
b. additional time is available to study and revise curricula because special skills are not needed to access information via the Internet.
c. immediate results and outcomes are expected from students and faculty, thus enhancing time management.
d. skills that require problem solving and reflective abilities are developed.

 

 

ANS:  A

Correct: Students can easily become distracted by pursuit of the intriguing web of links they encounter while they search websites to complete assignments or find pertinent content.

Incorrect:

  1. Students must learn to become computer literate and competent. Success in nursing courses and practice depends on these skills.
  2. With unlimited information available to them, students may actually take more time to navigate web-based resources than is needed for review of traditional print-based resources.
  3. Learning from the Internet helps students develop skills in analytic thinking, decision making, and reflective judgment.

 

DIF:    Analysis         REF:   pp. 38-39

 

  1. A new trend in nursing education that is consistent with real-world practice is focused on:
a. outcomes.
b. objectives.
c. goals.
d. subjective appraisals.

 

 

ANS:  A

Correct: Outcomes and criteria establish real expectations for clinical practice and have a powerful influence on nursing education and practice at all levels. Outcomes are used in all areas of nursing in the nursing process.

Incorrect:

  1. Objectives refer to knowledge that the student is expected to attain.
  2. Goals are client focused.
  3. Subjective appraisals are not used in real-world practice.

 

DIF:    Knowledge     REF:   p. 43

 

  1. The practice of nurses, nursing students, and faculty is affected by demographic changes due to:
a. the growing percentage of adults ages 50 to 55 years.
b. increasing numbers of obese children and adults.
c. changes by which families are becoming more nuclear.
d. social programs that are essentially eliminating poverty.

 

 

ANS:  B

Correct: The United States is experiencing an epidemic of obesity with major consequences for health and the health care system.

  1. The percentage of adults ages 50 to 65 years is not increasing. The number of very old adults is increasing.
  2. Even the definition of family has changed radically, as evidenced by single individuals living with other single individuals, single-parent households, and same-sex couples (with and without children).
  3. The number of families who remain uninsured, jobless, homeless, and surviving in poverty is increasing.

 

DIF:    Knowledge     REF:   p. 45

 

  1. The first university to offer nursing graduates a baccalaureate degree was:
a. Columbia Teachers College.
b. Yale University.
c. Harvard University.
d. the New York Regents Program.

 

 

ANS:  B

Correct: In 1924, Yale University offered the first separate Department of Nursing, whose graduates earned a baccalaureate degree.

Incorrect:

  1. Columbia Teachers College was the first to offer a doctor of education degree.
  2. Harvard University does not offer a baccalaureate program in nursing.
  3. The New York Regents Program is a distance mobility program.

 

DIF:    Knowledge     REF:   p. 52

 

  1. Which nursing model is referred to as the “class without walls”?
a. Articulation
b. Career ladder (2 + 2)
c. External degree
d. Second degree

 

 

ANS:  C

Correct: An external degree does not require attendance and provides no course classes; it enrolls thousands and is accessible regardless of geographic location.

Incorrect:

  1. Articulation is the format of a program, or refers to what the student must do to complete the program.
  2. The 2 + 2 option is for LPN or RN students to continue their education to RN or BSN, respectively.
  3. A second degree is a degree that is pursued after the first degree has been obtained.

 

DIF:    Knowledge     REF:   p. 54

 

  1. In preparing students for professional nursing practice in the twenty-first century, where should the emphasis be placed?
a. Care coordination, direct care for complex clients, and outcomes evaluation
b. Chemistry, biostatistics, and computer programming
c. Illness care, hospice, and ethics
d. Psychomotor skills, obstetrics, and epidemiology

 

 

ANS:  A

Correct: Caring for complexities in practice, coordinating care, and focusing on outcomes evaluation are the tasks that reflect the direction in which nursing is heading.

Incorrect:

  1. As supplemental courses to nursing, these are essential, but they do not represent an area of emphasis for professional nursing.
  2. Illness care, hospice, and ethics are currently components of programs that are preparing students for professional nursing.
  3. Psychomotor skills, obstetrics, and epidemiology are limited in scope.

 

DIF:    Application    REF:   p. 43 | p. 53 | p. 56

 

  1. A standardized means of determining initial proficiency at the entry level into nursing is:
a. certification in medical-surgical nursing.
b. the National Certification Licensure Examination (NCLEX®).
c. comprehensive instructor-constructed examinations.
d. the ability of the student to answer questions concerning the care provided to a patient during the senior nursing courses.

 

 

ANS:  B

Correct: NCLEX® is the national licensure examination that is based on the minimal level of safety required for a nurse to enter practice.

Incorrect:

  1. Certification in medical-surgical nursing is attained through a specialty examination for AACN certification that can be taken only by registered nurses.
  2. Instructor-constructed examinations are based on instructors’ knowledge and experience and are not used for entry into practice.
  3. The ability of the student to answer questions related to the care provided to a patient during the senior nursing courses describes a nonstandardized means of determining initial proficiency.

 

DIF:    Knowledge     REF:   p. 52

 

  1. Which trend is an effect of the nursing shortage on nursing education?
a. Only devoted qualified nurses are continuing to provide bedside nursing because of the complexity of care required, resulting in excellent preceptorships for students.
b. The number of applicants to nursing programs has risen, but enrollment is limited because of a decrease in the number of available scholarships and grants.
c. With an increase in the number of nurses who are entering graduate school to escape bedside nursing, students will soon enjoy a lower faculty/student ratio.
d. Students may be assigned to preceptors who have not yet developed expertise in the field of interest.

 

 

ANS:  D

Correct: Qualified preceptors are few.

Incorrect:

  1. There is a shortage of nurses qualified at the bedside who are available to serve as preceptors for students.
  2. Nursing enrollments are limited because of a shortage of faculty.
  3. Nurses are not entering graduate school to escape bedside nursing but to pursue advanced practice degrees.

 

DIF:    Analysis         REF:   pp. 48-49

 

  1. The NCLEX® examination is created and administered by the:
a. American Association of Colleges of Nursing (AACN).
b. American Nurses Association (ANA).
c. National Council of State Boards of Nursing (NCSBN).
d. National League for Nursing (NLN).

 

 

ANS:  C

Correct: The NCSBN coordinates licensure activities on a national level and creates and administers the licensure examination (NCLEX®).

Incorrect:

  1. The AACN is an organization of deans and directors of baccalaureate and higher degree nursing programs that establishes standards for programs and is concerned with legislative issues that pertain to professional nursing education.
  2. The ANA is the major national nursing organization concerned with broad scope practice issues, standards of practice, scope of practice, ethics, legal issues, and employment; it consists of a federation of state nurse associations.
  3. The NLN is a national organization of nurse educators that has a long-standing commitment to four types of basic programs: LPN, diploma, ADN, and BSN.

 

DIF:    Knowledge     REF:   p. 55; Box 3-1

 

  1. A potential nursing student is visiting the website of some nursing programs and notes that the school states, “The curriculum is built on the Essentials of Baccalaureate Education to ensure that this nursing program meets the standards set for educating nurses at the baccalaureate level.” Which organization oversees professional nursing programs and establishes these essentials?
a. American Association of Colleges of Nursing (AACN)
b. American Nurses Association (ANA)
c. National Council of State Boards of Nursing (NCSBN)
d. National League for Nursing (NLN)

 

 

ANS:  A

Correct: The AACN publishes the Journal of Professional Nursing, The Essentials of Baccalaureate Education, and other related documents pertaining to the BSN and higher degree education.

Incorrect:

  1. The ANA is a major national organization that is concerned with a broad scope of practice issues.
  2. The NCSBN is the organization of all state boards of nursing that coordinates licensure activities at the national level.
  3. The NLN is the national organization of nurse educators that has a long-standing commitment to four types of basic programs: LPN, diploma, ADN, and BSN.

 

DIF:    Knowledge     REF:   p. 40; Box 3-2 | p. 45

 

  1. A student is planning to enroll in prerequisite courses after graduating from high school and is researching options for nursing programs. During a career fair the student compares different types of nursing education programs and discovers that:
a. diploma programs focus on family and community, with an emphasis on health promotion.
b. most practicing RNs graduated from diploma programs because this was the first type of RN program.
c. baccalaureate programs focus on technical and hands-on nursing skills in diverse community settings.
d. master’s programs such as that for the clinical nurse leader provide entry into practice with a focus on interdisciplinary and bedside nursing care for complex client populations.

 

 

ANS:  D

Correct: A clinical nurse leader oversees the care coordination of groups of clients and actively provides direct client care in complex situations, evaluates client outcomes, and has the decision-making authority to change care plans when necessary.

Incorrect:

  1. Diploma programs do not focus on community, with an emphasis on health promotion, although baccalaureate programs do have this focus.
  2. Most of today’s practicing RNs graduated from ADN programs.
  3. BSN programs focus on the care of clients, with greater emphasis on the family and community and on health promotion and illness prevention.

 

DIF:    Application    REF:   p. 53

 

  1. When preparing to complete a competency exam involving a neurologic assessment in a simulation laboratory, the nurse reviews the critical elements, which consist of:
a. those steps that result in life or death of a client.
b. required criteria that must be incorporated into the assessment for the desired outcome.
c. fundamental strategies unique to complex dynamic care environments.
d. objective data that can be used to determine the likelihood that the client will recover.

 

 

ANS:  B

Correct: Critical elements include the application of mandatory principles that must be used according to established practice standards.

Incorrect:

  1. Critical elements work to achieve desired outcomes for the client.
  2. Critical elements are not strategies.
  3. Critical elements are based on the application of mandatory principles, not on objective data, to determine the likelihood that the client will recover.

 

DIF:    Comprehension                              REF:   p. 39

 

  1. An RN with a diploma preparation wants to participate in decisions about health care and decides the first step is to obtain a BSN. The nurse enrolls in a nursing program offering self-scheduling and a self-paced curriculum. This nurse is taking advantage of:
a. educational mobility.
b. a traditional nursing program.
c. training for advanced practice nursing.
d. credit by examination.

 

 

ANS:  A

Correct: Education mobility is the progressive movement from one level or type of education to another—in this instance, diploma to BSN. Programs are aimed to make the transition possible through creative flexible scheduling.

Incorrect:

  1. Traditional nursing programs have set schedules, often face-to-face lectures offered in a full-time format; although some programs are web-assisted, the majority require the student to be on campus for most learning experiences.
  2. A BSN is not an advanced practice degree.
  3. Although credit by examination may be a part of a nontraditional nursing program, it is only a portion and does not characterize the type of learning.

 

DIF:    Application    REF:   p. 35

 

  1. A nursing student scores 95% on the written examination for the adult health course. To be successful in this course, this same student must then perform an indwelling catheter insertion and wound care in a simulated environment meeting core competencies. The student asks, “What are core competencies?” The nursing instructor replies, “Core competencies are:
a. a trend used in nursing education to reduce attrition in prelicensure students.”
b. those skills necessary for safe, competent nursing practice.”
c. educational opportunities that provide remediation when student is unable to perform psychomotor skills correctly.”
d. critical thinking exercises aimed to improve reading and math skills.”

 

 

ANS:  B

Correct: Core competencies are those skills and elements that are fundamental and essential for safe, competent practice.

Incorrect:

  1. The aim is not to reduce attrition but to ensure students have skills needed to provide safe care in today’s dynamic health care environment.
  2. Critical elements are the components of any skill required to produce safe, competent care.
  3. The aim is not to improve reading and math skills but rather to enhance critical thinking related to the practice of nursing.

 

DIF:    Comprehension                              REF:   p. 35

 

  1. A nurse realizes that a health care concern related to globalization was:
a. the emergence of epidemic hepatitis A.
b. the pandemic of H1N1 “swine flu.”
c. reemergence of polio.
d. an increase in chronic illnesses.

 

 

ANS:  B

Correct: In 2009, there was a pandemic of H1N1 on every continent and a reemergence of Staphylococcus aureus (MRSA).

Incorrect:

  1. Hepatitis A is not related to globalization; rather the most common cause is lack of simple hand washing.
  2. Polio has been almost nonexistent in the United States since the 1960s.
  3. Globalization does not affect chronic illness.

 

DIF:    Knowledge     REF:   p. 46

 

  1. A student nurse is preparing a presentation that requires identification of outcomes for the care of heart failure patients. Which is a correctly written outcome?
a. Develop a teaching program to address physical activities that improve cardiac function.
b. Consider the clinical manifestations associated with Level 4 heart failure.
c. List the most common pharmaceutical approaches to reduce preload in heart failure patients.
d. Consider the economic impact that recidivism has on the patient and health care facility.

 

 

ANS:  A

Correct: Outcomes use action words, actions that nurses actually do, such as develop, plan, implement, integrate, plan, or conduct. Objectives begin with words like describe, discuss, list, or recognize; they are directions for learning, not what nurses do.

 

DIF:    Application    REF:   p. 39

 

  1. A member of a nursing students study group comments, “I wish our instructor would just tell us the important information that we will be tested on in our course and on NCLEX®. Instead, we spend some time early in the class discussing key facts then the most of the time working through case studies, then practicing on the simulator rather than caring for ‘real’ patients.” This teaching-learning style represents:
a. memorization of basic facts presented early in the lecture.
b. Objective Structured Clinical Examinations (OSCE).
c. peer-to-peer learning.
d. practice-based competency.

 

 

ANS:  D

Correct: Practice-bases competency includes active engagement and application in real practice situations and interactive strategies such as case studies and simulation.

Incorrect:

  1. Lectures and readings are passive and promote memorization.
  2. Objective Structured Clinical Exams are examinations or assessment measures rather than a teaching-learning style.
  3. Peer-to-peer learning involves peer teaching to helps students at risk.

 

DIF:    Application    REF:   p. 37; Table 3-1

 

  1. The Southern Poverty Law Center would be consulted in which situation?
a. An elderly patient can’t afford needed medications because his adult child uses the money for gambling.
b. A group of immigrants are paid half the wages as the citizens of the country receive.
c. Single mothers living below poverty level sell their government-subsidized food to purchase items such as make-up and gasoline for their cars.
d. A gang of teenagers target students who participate in alternate lifestyle choices.

 

 

ANS:  D

Correct: The Southern Poverty Law Center is a national organization that promotes tolerance in schools and monitors militant hate groups and initiates law suits against violent offenders.

Incorrect:

  1. Social workers or agencies such as the National Center on Elder Abuse (NCEA) would be involved in representing the needs of this vulnerable population.
  2. The Equal Employment Opportunity Commission would be contacted when unfair wages are paid to minorities or disadvantaged groups.
  3. The Southern Poverty Law Center focuses on hate groups and does not intervene in poverty issues or concerns. Social workers would be involved with the needs of this vulnerable group.

 

DIF:    Comprehension                              REF:   p. 45

 

  1. A person interested in employment in the health care sector has less than 1 year to pursue his/her education and wants to focus on functional aspects of patient care. He/She desires to work in a long-term facility. Which type of nursing program should this person request information about?
a. Bachelor’s degree in nursing (BSN)
b. Licensed practical nurse (LPN)
c. Associate degree in nursing
d. Master’s degree in nursing

 

 

ANS:  B

Correct: LPN programs provide basic technical bedside care and employment opportunities at hospitals, nursing homes, home care, and doctor offices.

Incorrect:

  1. BSN programs require 2 to 4 years of study unless accelerated and focus on broad areas of care such as community, public health, home health, and acute care.
  2. Associate degrees are 2-year degree nursing program in community colleges, with required college courses in arts and sciences and a more integrated approach to nursing content and clinical learning.
  3. MSN programs usually require a BSN to enter, and practice includes education, community, and public health.

 

DIF:    Comprehension                              REF:   p. 50; Table 3-3 | p. 51

 

MULTIPLE RESPONSE

 

  1. A nurse is concerned that the policy of using povidone-iodine (Betadine) to clean foot ulcers may lead to unwarranted allergic reactions and drying of surrounding tissue. A literature review is performed to determine the “best practice” related to care of foot ulcers. This nurse: (Select all that apply.)
a. is applying evidence-based practice to the clinical setting.
b. is using critical thinking to change procedures performed in the care of foot ulcers.
c. is minimally educated at the master’s level and participating in research to provide cost-effective care (soap is less expensive than povidone-iodine).
d. lacks clinical competence in health assessment and in application of theory to the clinical setting.
e. is using information to problem-solve and ensure safe, competent care.

 

 

ANS:  A, B, E

Correct: Critical thinking is an essential part of applying evidence-based practice—that is using research findings to guide actual practice.

Incorrect:

  1. Evidence-based research, not cost, should be used to guide actual practice.
  2. The nurse is demonstrating clinical competence by using assessment skills and by noting the effects of povidone-iodine and applying evidence-based practice to change procedures performed in the care of foot ulcers.

 

DIF:    Analysis         REF:   p. 36

 

COMPLETION

 

  1. The oldest, most traditional type of program that prepares a candidate for RN licensure is the hospital-based _________ program.

 

ANS:

diploma

The earliest training programs for nurses were hospital based and designed to meet the needs of the particular institution; these were referred to as diploma programs.

 

DIF:    Knowledge     REF:   p. 51

 

  1. According to Lenburg, the use of practice-based assessments in nursing education is aimed toward the target of __________.

 

ANS:

competence

The target that students need to meet to practice safely in today’s complex health environment is achieving critical competencies and demonstrating of practice-based skills.

 

DIF:    Comprehension                              REF:   p. 39

 

Chapter 09: Ethical and Bioethical Issues in Nursing and Health Care

Test Bank

 

MULTIPLE CHOICE

 

  1. Ethics applied to nursing can best be defined as:
a. doing what is best for the client.
b. making good decisions about care.
c. care based on what should be done in keeping with the values of the client.
d. rules for providing competent care that is based on scientific principles.

 

 

ANS:  C

Correct: Nursing ethics is a system of principles intended to guide the actions of the nurse in his or her relationships with clients, clients’ family members, other health care providers, policy makers, and society as a whole. A nurse must make an attempt to understand what values are inherent in the situation.

Incorrect:

  1. “Doing what is best for the client” is not a definition of ethics.
  2. “Making good decisions about care” is not a definition of ethics.
  3. “Rules for providing competent care that is based on scientific principles” is not a definition of ethics.

 

DIF:    Knowledge     REF:   p. 168

 

  1. A family requests that no additional heroic measures be instituted for their terminally ill mother who has advance directives in place. The nurse respects this decision in keeping with the principle of:
a. accountability.
b. autonomy.
c. nonmaleficence.
d. veracity.

 

 

ANS:  B

Correct: Autonomy is the principle of respect for the individual person. Within the concept of autonomy, people are free to form their own judgments and perform whatever actions they choose. They are self-determining agents who are entitled to decide their own destiny.

Incorrect:

  1. Accountability is inherent in the nurse’s ethical obligation to uphold the highest standards of practice and care, assume full personal and professional responsibility for every action, and commit to maintaining quality in the skill and knowledge base of the profession.
  2. Nonmaleficence is a principle that implies a duty not to inflict harm. In ethical terms, it means to abstain from injuring others and to help others further their own well-being by removing harm and eliminating threats.
  3. Veracity means telling the truth as a moral and ethical requirement.

 

DIF:    Application    REF:   p. 173; Table 9-1 | p. 174

 

  1. An older adult client is comatose and had one electroencephalogram that indicated no activity. The daughter is very distraught and notices her mother’s hand moves when she is talking to her. The daughter asks the nurse, “Is mother responding to my voice?” The nurse, attempting to console the daughter, knows the movement was involuntary but states, “It does appear she did.” The nurse is violating which principle of ethics?
a. Autonomy
b. Veracity
c. Utilitarianism
d. Deontology

 

 

ANS:  B

Correct: Veracity is the principle of telling the truth in a given situation.

Incorrect:

  1. Autonomy is the principle of respect for the individual person; this concept states that humans have incalculable worth or moral dignity.
  2. Utilitarianism is an approach that is rooted in the assumption that an action or practice is right if it leads to the greatest possible balance of good consequences or to the least possible balance of bad consequences. Giving the daughter false reassurance is not a good consequence.
  3. Deontological theory claims that a decision is right only if it conforms to an overriding moral duty and wrong only if it violates that moral duty. Persons are to be treated as ends in themselves and never as means to the ends of others.

 

DIF:    Application    REF:   p. 175

 

  1. In attempting to decide which services should be offered to a community, the public health nurse decides to implement hypertension screening and treatment because most of the residents are hypertensive. This decision is based on the principle of:
a. veracity.
b. values.
c. utilitarianism.
d. autonomy.

 

 

ANS:  C

Correct: Utilitarianism is an approach that is rooted in the assumption that an action or practice is right if it leads to the greatest possible balance of good consequences or to the least possible balance of bad consequences. On the basis of this principle, an attempt is made to determine which actions will lead to the greatest ratio of benefit to harm for all persons involved in the situation.

Incorrect:

  1. Veracity is defined as the moral and ethical requirement to always tell the truth in personal communication. Although the public health nurse did not lie, she did not use the concept of veracity to decide which health care issue to address with this group.
  2. Values account for our moral decisions and actions. The nurse based the decision on the needs of the group, not on her personal values.
  3. Respecting autonomy means respecting people’s right to make decisions based on their values. The nurse did not base her decision for this group on her respect for them, but on what the needs of the majority were.

 

DIF:    Application    REF:   p. 167 |p. 174

 

  1. A nurse is caring for a client who just consented to an elective abortion. The nurse is unsure of his/her own values as they relate to this issue. The nurse must:
a. know his/her own values and how these values relate to beliefs and the philosophy of nursing.
b. rid the impurities in his/her value system.
c. ignore his/her own values.
d. realize that values do not change and that they cannot be influenced by others.

 

 

ANS:  A

Correct: Nurses must make a deliberate effort to recognize their own values and must learn to consider and respect the values of others. Health care decisions are seldom made independently of other people. Decisions are made with the client, the family, other nurses, and other health care providers.

Incorrect:

  1. There is no need to get rid of impurities in the value system; everyone’s system is unique, and there really are no impurities.
  2. The nurse cannot ignore her own values; these are what shape the nurse’s ethics and morals.
  3. Values can change as a person matures and passes through different life experiences. Values also are often influenced by those around us, especially authority figures.

 

DIF:    Application    REF:   p. 171

 

  1. When assessing an ethical issue, the nurse must first:
a. ask, “What is the issue?”
b. identify all possible alternatives.
c. select the best option from a list of alternatives.
d. justify the choice of action or inaction.

 

 

ANS:  A

Correct: The first step in the situational assessment procedure is to find out the technical and scientific facts and assess the human dimension of the situation—the feelings, emotions, attitudes, and opinions. Assessment can be applied to all areas of patient care, including ethics. Trying to understand the full picture of a situation is time consuming and requires examination from many different perspectives, but it is worth the time and effort.

Incorrect:

  1. Identifying alternatives is the second step in the situation assessment procedure. A set of alternatives cannot be established until an assessment has been completed.
  2. Selecting the best option is actually the third step in the situation assessment procedure. Options cannot be selected until an assessment has been done to define the issue.
  3. Justifying the action or inaction is the final step in the situational assessment procedure. No justification can be made until the assessment and action phases have been completed.

 

DIF:    Comprehension                              REF:   p. 176

 

  1. A researcher calculated the risk-to-benefit ratio and concluded that no harmful effects were associated with a survey of college sophomores. The researcher was applying the principles of:
a. beneficence.
b. human dignity.
c. justice.
d. human rights.

 

 

ANS:  A

Correct: Beneficence is defined as promoting goodness, kindness, and charity. In ethical terms, beneficence means to provide benefit to others by promoting their good.

Incorrect:

  1. Human dignity is the inherent worth and uniqueness of a person.
  2. Justice involves upholding moral and legal principles.
  3. Human rights are the basic rights of each individual.

 

DIF:    Application    REF:   p. 175

 

  1. The physician who insists on providing treatment in spite of the client’s wishes because he “knows best” is reflecting:
a. autonomy.
b. beneficence.
c. justice.
d. paternalism.

 

 

ANS:  D

Correct: Paternalism is an action and an attitude wherein the provider tries to act on behalf of the client and believes that his or her actions are justified because of a commitment to act in the best interest of the client. Paternalism is a reflection of the “father knows best” way of thinking.

Incorrect:

  1. Autonomy is the principle of respect for the individual person.
  2. Beneficence means promoting goodness, kindness, and charity.
  3. Justice states that like cases should be treated alike and equals ought to be treated equally.

 

DIF:    Application    REF:   p. 179

 

  1. The nurse who admits making a medication error and immediately files an incident report is demonstrating:
a. accountability.
b. individuality.
c. an injustice.
d. values clarification.

 

 

ANS:  A

Correct: Accountability is an ethical duty that states that one should be answerable legally, morally, ethically, or socially for one’s actions.

Incorrect:

  1. Individuality is something that distinguishes one person or thing from others.
  2. Injustice is when a person is denied a right or entitlement.
  3. Values clarification is a tool that allows the nurse to examine personal values in terms of ethical situations.

 

DIF:    Application    REF:   p. 166| pp. 180-181

 

  1. Three illegal immigrants with no health insurance or money sustained life-threatening injuries during an automobile accident. Two of these individuals had head trauma and lacerated internal organs. The decision was made to provide extended care in the trauma center after emergency surgery was performed to save their lives. The third individual received only minor injuries, which were treated in the emergency department. The care of the two critical clients was based on the ethical principle of:
a. utilitarianism.
b. deontology.
c. autonomy.
d. veracity.

 

 

ANS:  B

Correct: Deontology is an approach that is rooted in the assumption that humans are rational and act out of principles that are consistent and objective and that compel them to do what is right. Deontological theory claims that a decision is right only if it conforms to an overriding moral duty and wrong only if it violates that moral duty.

Incorrect:

  1. Utilitarianism is an approach that is rooted in the assumption that an action or practice is right if it leads to the greatest possible balance of good consequences or to the least possible balance of bad consequences. An attempt is made to determine which actions will lead to the greatest ratio of benefit to harm for all persons involved in the dilemma.
  2. Autonomy is the principle of respect for the individual person. People are free to form their own judgments and perform whatever actions they choose.
  3. Veracity is defined as telling the truth in personal communication as a moral and ethical requirement.

 

DIF:    Application    REF:   p. 167 |p. 174

 

  1. A 13-year-old female is brought to the family planning clinic by her enraged father, who has just learned that she is pregnant. The pregnant client states, “I want to have this baby and give it up for adoption.” However, the father is adamant that she will disgrace the family and demands that the health care providers tell his daughter that she has a physical condition that would prohibit her from carrying this baby to a viable stage. The nurse realizes that this is a conflict that involves the ethical principle of:
a. deontology.
b. veracity.
c. autonomy.
d. beneficence.

 

 

ANS:  B

Correct: Veracity is telling the truth in personal communication as a moral and ethical requirement.

Incorrect:

  1. Deontology is an approach that is rooted in the assumption that an action or practice is right if it leads to the greatest possible balance of good consequences or to the least possible balance of bad consequences.
  2. Autonomy is the principle of respect for the individual person. All persons have unconditional intrinsic value. People are self-determining agents who are entitled to decide their own destiny.
  3. Beneficence means promoting goodness, kindness, and charity.

 

DIF:    Analysis         REF:   p. 175

 

  1. During a seminar on ethics, the educator realizes that more information is needed when a participant describes which situation as a violation of the ethical principle of autonomy?
a. An older person with advanced stages of Alzheimer’s disease is denied the right to ambulate in the hallway.
b. A mentally competent adult refuses medical treatment for the autoimmune disease lupus erythematosus, stating that this condition reflects the will of a higher power.
c. A mentally competent visitor fell during visiting hours but refused to be examined by the physician on call.
d. A mentally competent adult with a broken wrist refuses to be given a local anesthetic prior to a procedure.

 

 

ANS:  A

Correct: Autonomy is defined as personal freedom, the right to make choices. However, in this case, the patient is not able to be fully informed so they can clearly understand the choices being offered.

Incorrect:

  1. Allowing a mentally competent adult to refuse medical treatment is an example of autonomy. As long as the actions do not infringe on the autonomous actions of others, that person should be free to decide whatever he or she wishes. This freedom should be applied even if the decision creates risk to his or her health and even if the decision seems unwise to others.
  2. The visitor has the right to refuse treatment even if the decision creates a risk to his or her health or seems unwise to others.
  3. A mentally competent adult refusing anesthetic prior to a procedure demonstrates autonomy. The patient has the right to refuse the anesthetic even if it creates a risk to his or her health; in this case, the risk of pain.

 

DIF:    Analysis         REF:   p. 181

 

  1. A nurse who is infected with human immunodeficiency virus (HIV) while working in the operating room seeks revenge by deliberately placing clients at risk by not adhering to universal precautions. This nurse is violating the ethical principle of:
a. veracity.
b. beneficence.
c. nonmaleficence.
d. autonomy.

 

 

ANS:  C

Correct: Nonmaleficence means to abstain from injuring others and to help others further their own well-being by removing harm and eliminating threats. The nurse is definitely violating this principle through her actions.

Incorrect:

  1. Veracity is telling the truth in personal communication.
  2. Beneficence is promoting goodness, kindness, and charity.
  3. Autonomy is the principle of respect for the individual person. This concept maintains that all persons have unconditional intrinsic value.

 

DIF:    Application    REF:   p. 175

 

  1. A client and her husband used in vitro fertilization to become pregnant. The unused sperm was frozen so the couple could have more children later. The husband is killed while in combat, and the client journals her choices and the possible ramifications. She comes to the fertility clinic after looking at the situation from many perspectives and after considering many alternatives. She asks that the sperm be destroyed because her husband’s faith prohibited remarrying, and allowing another person to use the sperm would conflict with her late husband’s beliefs. The nurse realizes that:
a. the client is in the second step of ethical decision making and that the client’s value system is influencing her choices of alternative actions.
b. a logical line of reasoning has led to validation of the decision to destroy the husband’s sperm.
c. the client has not been able to navigate the complicated issues inherent in this situation.
d. a rational decision was reached that was based on reflection and on the value systems of the wife and the husband.

 

 

ANS:  D

Correct: After completing all steps in the situation assessment procedure, the client is now ready to justify her selection. In this phase, the person will specify reasons for the action, will clearly present the ethical basis for these reasons, will understand the shortcomings of the justification, and will anticipate objections to the justification.

Incorrect:

  1. The second step of ethical decision making is identification of hidden issues.
  2. Validation of the decision considers many factors and requires analysis of all possible alternatives.
  3. No situational decision can be made unless an individual begins with the first step of actually identifying and stating the actual issue.

 

DIF:    Analysis         REF:   p. 176

 

  1. A client is in extreme pain after he was involved in a motor vehicle accident, and morphine has been ordered every hour for pain. The nurse injects saline into the client’s IV line and takes the morphine for herself. The nurse is violating which principle of ethics?
a. Autonomy
b. Utilitarianism
c. Beneficence
d. Dilemmas

 

 

ANS:  C

Correct: Beneficence is providing benefit to others by promoting their good. In general terms, to be beneficent is to promote goodness, kindness, and charity. By taking the client’s pain medication and substituting saline, the nurse did harm, not good, for this client.

Incorrect:

  1. Autonomy is the principle of respect for the individual person; the nurse does not respect someone that he or she is inflicting harm upon.
  2. Utilitarianism is the principle that assumes that an action is right if it leads to the greatest possible balance of good consequences or to the least possible balance of bad consequences. Because the client’s pain medication was taken from him, the consequences were all bad.
  3. Dilemmas are not included as a principle of ethics.

 

DIF:    Application    REF:   p. 175

 

  1. The Health Care Reform Act provides insurance for all U.S. citizens and legal residents presenting far reaching ethical considerations related to diverse individual patient health care beliefs for those delivering nursing care. Nurses must consider their civil rights under the Rights of conscience and how new health care agendas such as the Patient Protection and Affordable Care Act (PPACA) could affect their practice in situations that may conflict with their own belief system. Today’s practicing nurse must:
a. remember it is one’s professional duty to render patient-centered care—even when it is in direct conflict with the nurse’s own beliefs—or be held liable for withholding treatment.
b. consider whether the right to act according to one’s inner beliefs will continue to be permissible when federal health insurance becomes fully enacted.
c. discuss with the patient and family different options in hopes they will accept the nurse’s health care beliefs.
d. suggest to the hospital administration that they not accept federal funding to prevent controversial health practices.

 

 

ANS:  B

Correct: With federal funding, many controversial health care services will be covered and provided as part of patient care when desired by the patient; therefore, whether a nurse has autonomy to refuse to provide care may not be as clear even when one might request another patient.

Incorrect:

  1. A nurse must analyze his/her health beliefs to ensure the best care can be rendered without prejudice and under the Right of Conscience (nurses’ civil right allowing them to act according to their conscience).
  2. It is not the role of the nurse to attempt to persuade patients to accept another set of health care beliefs.
  3. Federal health insurance will cover many patients, and refusing funding, even if possible, would place the hospital in financial difficulty.

 

DIF:    Application    REF:   p. 173

 

  1. A nurse is assigned to a unit where 95% of all patients required total care. Most days the assistive personnel are able to complete their assignments and provide high-quality care. A patient returning from a procedure was somehow “skipped” when daily baths were performed and requests that her care now be provided. The nurse discovers the bed is rumpled and damp. The RN joins with some other staff to bathe the patient, change the bed, and help make the patient comfortable. These staff members are demonstrating:
a. altruism.
b. veracity.
c. autonomy.
d. whistle blowing.

 

 

ANS:  A

Correct: Altruism is concern for the welfare of others, including willingness to help others when they are unable to get their assignments completed to ensure that the patient receives high-quality care.

Incorrect:

  1. Veracity is truth telling, in this situation the staff provided care demonstrating altruism and there was no concern that the truth was spoken.
  2. Autonomy is self-determination: the patient was demonstrating autonomy by asking for care, the staff was demonstrating altruism by providing requested care.
  3. The staff did not report unsafe or inappropriate, harmful care.

 

DIF:    Application    REF:   p. 173; Table 9-1

 

  1. In which case does the nurse act as “whistle blower”?
a. One staff member on the unit covers for another nurse, who leaves the premises to purchase illegal substances and signals her friend when she must return.
b. The nurse reports that another nurse is taking medications out of stock medicine for her/himself.
c. A nurse informs respiratory therapy that a patient is now due a treatment.
d. The nurse delegating care to unlicensed assistive personnel makes rounds to ensure all care was rendered properly.

 

 

ANS:  B

Correct: Whistle blowing is the reporting of acts or situations that violate the principle of beneficence such as a chemical impairment, negligence, abusiveness, incompetence, or cruelty.

Incorrect:

  1. The nurse is serving as an ally rather than reporting the violation.
  2. Informing another department that a treatment is due is not considered “whistle blowing.”
  3. Accountability of delegation requires the RN to ensure all assignments were completed effectively.

 

DIF:    Application    REF:   p. 181

 

MULTIPLE RESPONSE

 

  1. Throughout their careers, nurses are in an ongoing state of acculturation, gaining experience from formal nursing school classes, clinical experiences, and the ethical issues they encounter in their clinical practice. The ideal outcomes of these ongoing experiences with cultural decision making include: (Select all that apply.)
a. increased trustworthiness.
b. enhanced ability to take into consideration many aspects of ethical situations.
c. confidence to make decisions based on experience and ethical intelligence.
d. improved clinical decision making and advocacy for patient autonomy.
e. authority to make ethical decisions independently that meet personal moral beliefs.

 

 

ANS:  A, B, C, D

Correct:

  1. The desired outcomes of ethics acculturation across the years are integrity, personal growth, practical wisdom, and effective problem solving on behalf of patients and their families (Weaver et al, 2008). These are the qualities that are characteristic of an ethically sensitive and morally mature person. Trustworthiness is a characteristic of integrity.
  2. The ability to take into consideration many aspects of ethical situations is due in part to personal growth and practical wisdom.
  3. The confidence to make ethically sensitive decisions comes from experience founded on personal growth and personal wisdom.
  4. The ability to be the patient’s advocate in ethical decision making is one test of cultural acculturation.

Incorrect:

  1. Ethical decisions are often the produce of professionals who come together to consider right and wrong choices that affect society or patients as a whole rather than an independent decision based on the nurse’s personal moral beliefs.

 

DIF:    Analysis         REF:   p. 173

 

COMPLETION

 

  1. Practicing nurses participate in employer-sponsored professional development classes that provide case studies related to ethical situations and decision making. Ethical considerations are debated among teams, and an expert helps the class arrive at the “best practices.” The nurses are experiencing ethics ______________.

 

ANS:

acculturation.

Ethics acculturation is the didactic and experiential process of developing ethical reasoning abilities as a part of ongoing professional education.

 

DIF:    Application    REF:   p. 167

 

OTHER

 

  1. When healthy, a patient had requested that all life-sustaining measures be implemented. Now the patient has Alzheimer’s and had a deterioration in health that severely limits quality of life. The patient’s only child is petitioning that the parent not be placed on life support again and be given only palliative care. The nurse assessing this ethical situation following the procedure would place the steps in what order? (Place in order of the Situation Assessment Procedure). Put a comma and space between each answer choice (for example: a, b, c, d).
a. Discuss with the ethics committee possible alternatives that would be acceptable to the family while considering the patient’s wishes.
b. After the family presents two alternatives, work with the committee and family to agree on one alternative.
c. Provide rationale for the selection made.
d. Carefully assess the situation to identify the ethical issue and concerns.

 

 

ANS:

d, a, b, c

The steps to the Situation Assessment Procedure are as follows:

  1. Identify the ethical issues and problems.
  2. Identify and analyze available alternatives for action.
  3. Select one alternative.
  4. Justify the selection.

 

DIF:    Application    REF:   p. 176

 

Chapter 11: Complementary and Alternative Healing

Test Bank

 

MULTIPLE CHOICE

 

  1. A patient observes the practitioner burning a dried herb on the needle during an acupuncture session and asks about this practice. The practitioner responds, “I am inciting the acupuncture points and this is referred to as:
a. doshas.”
b. moxibustion.”
c. yoga.”
d. kapha.”

 

 

ANS:  B

Correct: Applying heat to the acupoints is termed moxibustion.

Incorrect:

  1. Distinct metabolic body types called doshas include vata, pitta, and kapha; signs of illness occur when the delicate balance of the doshas is disturbed.
  2. Yoga is a type of mind-body intervention of complementary alternative medicine.
  3. Kapha is the metabolic body type that is characterized by a relaxed, graceful tendency toward procrastination, affection, forgiveness, compassion, long and deep sleep, coolness, pale and oily skin, slow eating, a tendency toward high cholesterol, obesity, allergies, and sinusitis.

 

DIF:    Comprehension                              REF:   p. 208

 

  1. An older adult has atrial fibrillation, which causes the heart to have an irregular rhythm. The client uses imagery to alter the dysrhythmia. The client is using which type of complementary alternative medicine (CAM)?
a. Ayurveda
b. Dosha
c. Homeopathy
d. Biofeedback

 

 

ANS:  D

Correct: Biofeedback is a type of mind-body intervention that is based on techniques in which the client is taught to alter specific bodily functions such as heart rate, blood pressure, and muscle tension. The client uses various relaxation and imagery exercises to produce desired responses.

Incorrect:

  1. Ayurveda consists of a group of noninvasive approaches that are used to achieve balance; these include yoga, massage, diet, purification regimens, breathing exercises, meditation, and herbs.
  2. Dosha is a distinct body type in which illness occurs with any imbalance.
  3. With homeopathy, the care provider provides small quantities of remedies that produce symptoms similar to those of the illness being treated.

 

DIF:    Application    REF:   p. 208 | p. 210

 

  1. A patient with kyphosis is visiting a practitioner of chiropractic medicine for the first time and asks, “How does this therapy work?” The practitioner replies, “I will use my hands along with heat to correct the misalignment of your spine by placing pressure on the nerves that have produced pain. The misalignment of your spine is referred to as:
a. subluxation.”
b. a sprain.”
c. a fracture.”
d. epicondylitis.”

 

 

ANS:  A

Correct: The chiropractor corrects misalignments of the spine, called subluxations, by putting pressure on the nerves that are causing pain.

Incorrect:

  1. A sprain refers to a tear in a ligament.
  2. A fracture is the separation of a bone or body part into two or more parts.
  3. Epicondylitis is inflammation of the elbow joints leading to “tennis elbow.”

 

DIF:    Comprehension                              REF:   p. 210

 

  1. A young adult on a limited income who is having back pain states, “I want to see a chiropractor, but I don’t have any money. However, I do have health insurance.” The most appropriate response that the nurse can provide is:
a. “Most insurance companies will pay for chiropractic treatment.”
b. “Because chiropractors are not licensed in any state, all services must be paid for by the patient.”
c. “Chiropractic medicine is a new CAM therapy that has not yet been recognized by insurance companies.”
d. “Chiropractic medicine is more than 100 years old, but because it is preventive in nature, it is not covered by most insurance.”

 

 

ANS:  A

Correct: Chiropractic medicine is performed by a licensed professional with reimbursement privileges and is an accepted complementary alternative medicine (CAM) therapy.

Incorrect:

  1. Chiropractors are licensed in the state in which they practice.
  2. Chiropractic medicine is covered by most insurance companies.
  3. Chiropractic medicine has been practiced for longer than 100 years.

 

DIF:    Comprehension                              REF:   p. 210

 

  1. The use of plants in conventional modern medicine is evidenced by the drug atropine, which is derived from which plant?
a. Digitalis purpurea
b. Cephaelis ipecacuanha
c. Rauwolfia serpentina
d. Atropa belladonna

 

 

ANS:  D

Correct: Atropine is derived from the Atropa belladonna plant; it primarily affects the parasympathetic nervous system.

Incorrect:

  1. The drug digitalis (Lanoxin) is derived from the Digitalis purpurea plant; it increases contractility of the heart, making it a popular choice for patients in heart failure.
  2. The drug ipecac is derived from the plant Cephaelis ipecacuanha; it is used to induce vomiting in some cases of poisoning.
  3. The drug reserpine is derived from the plant known as Rauwolfia serpentina and was used in the past to treat patients with depression; currently, it is used in the treatment of those with hypertension.

 

DIF:    Knowledge     REF:   p. 210

 

  1. The massage therapist uses kinesthesia, or thinking about how movement is expressed, to correct habits that cause poor posture and limited movement. This type of massage is called:
a. Alexander technique.
b. Feldenkrais method.
c. healing touch.
d. Reiki.

 

 

ANS:  A

Correct: The Alexander technique teaches improved balance, posture, and coordination through gentle hands-on guidance and verbal instruction.

Incorrect:

  1. The Feldenkrais method teaches movement reeducation through gentle manipulations intended to heighten awareness of the body; it is based on the belief that each person has an individualized optimal style of movement.
  2. Healing touch is a multilevel energy healing program that incorporates aspects of therapeutic touch with other healing measures.
  3. Reiki uses the hands or gestures to channel qi energy from an intangible spirit to bring about healing.

 

DIF:    Application    REF:   p. 214; Box 11-5

 

  1. A nurse practices a relaxing massage technique to stimulate and apply pressure to the feet or hands, increasing blood supply circulation to various parts of the body and relieving pain. The massage technique used by the practitioner is referred to as:
a. reflexology.
b. Feldenkrais method.
c. Reiki.
d. Rolfing.

 

 

ANS:  A

Correct: Reflexology produces pain relief through pressure applied to pressure points on the hands and feet that correspond to various parts of the body.

Incorrect:

  1. The Feldenkrais method is a type of chiropractic medicine in which massage is used to teach movement reeducation through gentle manipulations intended to heighten awareness of the body; it is based on the belief that each person has an individualized optimal style of movement.
  2. Reiki uses energy therapy to direct universal life energy to specific sites.
  3. Rolfing is the use of manual manipulation and stretching of fascial tissues of the body to establish balance and symmetry that cannot be attained by deep massage.

 

DIF:    Application    REF:   p. 214

 

  1. A patient is placed on reserpine (Serpalan) to decrease mild anxiety and treat hypertension. The patient researches the medication on the Internet and finds that this medication comes from which plant?
a. Atropa belladonna
b. Digitalis purpurea
c. Rauwolfia serpentina
d. Cephaelis ipecacuanha

 

 

ANS:  C

Correct: The drug reserpine is derived from the plant known as Rauwolfia serpentina. It was used to treat depression in the past, but currently is used in the treatment of hypertension.

Incorrect:

  1. Atropine is derived from the Atropa belladonna plant; it primarily affects the parasympathetic nervous system.
  2. The drug digitalis (Lanoxin) is derived from the Digitalis purpurea plant; it increases contractility of the heart, making it a popular choice for patients in heart failure.
  3. The drug ipecac is derived from the plant Cephaelis ipecacuanha; it is used to induce vomiting in some cases of poisoning.

 

DIF:    Comprehension                              REF:   p. 210

 

  1. A person who is recovering from a stroke is becoming more forgetful and is unable to recall people’s names. A friend suggests the use of a natural ingredient, ginkgo biloba. The nurse is concerned about the most serious risk associated with this herb, which is:
a. thromboembolism due to increased clotting.
b. seizures due to interaction with anticonvulsants.
c. hypertension due to sodium retention.
d. photosensitivity due to increased melanin production.

 

 

ANS:  B

Correct: Ginkgo reduces the efficacy of anticonvulsants, which may lead to increased seizure activity.

Incorrect:

  1. Ginkgo decreases coagulation of blood by prolonging bleed time.
  2. Ginkgo has no known effect on sodium regulation.
  3. Photosensitivity is due to decreased melanin production, which offers protection.

 

DIF:    Analysis         REF:   p. 211

 

  1. An older adult woman who stops using complementary alternative medicine (CAM) becomes disoriented and is given a diagnosis of dementia. The family is upset with the family physician and the CAM practitioner for not diagnosing the condition earlier. Which CAM may have interfered with early detection of the dementia?
a. Large doses of calcium caused cerebral plaques to form, thereby disguising atrophy of the brain.
b. Excess doses of folic acid masked a vitamin B12 deficiency that led to dementia.
c. Hypnotherapy focused on current pleasant thoughts, eliminating clues to the past.
d. The electrical current from magnetic fields interfered with normal brain waves, resulting in confusion and inability to concentrate.

 

 

ANS:  B

Correct: Individuals with Alzheimer’s often have low levels of vitamin B12; thus, large doses of folic acid may have masked the dementia.

Incorrect:

  1. Calcium results in kidney stones and malabsorption of other essential minerals but would not disguise atrophy of the brain.
  2. Dementia is not associated with unpleasant thoughts of the past; instead, life review and reminiscence may stimulate cognitive function and a sense of well-being.
  3. Magnet therapy is thought to relieve pain by creating a slight electrical current that stimulates the nervous system; it is also thought to speed wound healing by dilating vessels and increasing circulation to an area and is even purported to boost the immune system.

 

DIF:    Application    REF:   p. 210

 

  1. The nurse who presents a class on different methods of complementary alternative medicine (CAM) differentiates between imagery and hypnosis in which of the following ways?
a. Imagery involves the dependent mental construction of a picture, whereas hypnosis requires the patient to recall and verbally describe difficult times in his or her life.
b. Hypnosis requires a trained psychologist, but imagery can be performed by any health care practitioner.
c. Imagery produces a temporary sense of well-being compared with hypnosis, which evokes a permanent positive effect.
d. Although both therapies focus on specific problems and guide the patient into relaxation, imagery requires the patient to formulate the impression, whereas the hypnotist constructs the image for the patient.

 

 

ANS:  D

Correct: Both imagery and relaxation are used to reduce anxiety and stress; however, imagery begins with a goal that is to be achieved and a picture that is formulated by the person under treatment, rather than beginning with the hypnotist, who conjures up a desirable image.

Incorrect:

  1. Imagery is self-constructed, and hypnosis can recall both positive and negative images/memories.
  2. Both hypnosis and imagery can be learned from audiotapes and books.
  3. Neither imagery nor hypnosis can be guaranteed to produce long-term effects.

 

DIF:    Application    REF:   p. 213

 

  1. A pregnant woman reports back pain and wants to try a complementary alternative medicine (CAM) therapy. The nurse knows that which CAM would be contraindicated?
a. Magnet therapy
b. Aromatherapy
c. Imagery
d. Therapeutic touch

 

 

ANS:  A

Correct: The effect of magnets on fetal growth has not been determined.

Incorrect:

  1. Aromatherapy is safe throughout pregnancy, unless the patient is allergic to particular cents.
  2. Imagery is incorrect because it is not contraindicated and can actually be used to reduce stress and discomfort associated with pregnancy.
  3. Therapeutic touch requires only light or no physical contact.

 

DIF:    Comprehension                              REF:   p. 214

 

  1. Despite the presence of safety aids such as handrails in the bathrooms at an assisted living facility, the number of fractures due to unsteady ambulation upon arising from the bed and when attempting to perform activities of daily living has increased. Which complementary alternative medicine (CAM) would be an effective intervention for this population?
a. Yoga
b. Acupuncture
c. Tai chi
d. Magnet therapy

 

 

ANS:  C

Correct: Tai chi improves coordination, thereby reducing the number of falls and improving gait.

Incorrect:

  1. Yoga focuses on breathing and exercises designed to produce harmony within the body.
  2. Acupuncture is used to alleviate pain and to aid smoking cessation or for weight reduction.
  3. Magnet therapy focuses on circulation and wound healing, rather than on posturing and coordination.

 

DIF:    Application    REF:   p. 216

 

  1. A patient informs the nurse, “I burn a lavender-scented candle for an hour before bedtime to help me relax and sleep.” The nurse realizes this patient is using:
a. the mind-body intervention of aromatherapy.
b. an energy technique known as qi gong.
c. the manipulative method using the Alexander technique.
d. conventional medicine, also called allopathic.

 

 

ANS:  A

Correct: Aromatherapy uses scents of essential oils and is a type of mind-body interaction.

Incorrect:

  1. Qi gong is an energy technique that does not require candles.
  2. The Alexander technique is a manipulative method.
  3. Allopathic medicine does not include aromatherapy.

 

DIF:    Application    REF:   p. 205 | p. 207; Box 11-1

 

  1. The nurse caring for a patient who practices Ayurveda would assess for:
a. an increased stool osmolality gap resulting from dehydration.
b. petechiae resulting from fine-needle punctures.
c. use of over-the-counter remedies intended for intended symptom.
d. magnets strategically placed on affected joints.

 

 

ANS:  A

Correct: Individuals practicing Ayurveda may use detoxification and cleansing enemas resulting in dehydration, which increases stool osmolality.

Incorrect:

  1. Acupuncture uses fine needles.
  2. Use of over-the-counter medication is consistent with homeopathic remedies.
  3. Magnet therapy uses magnets in treatment of disease and ailments.

 

DIF:    Application    REF:   p. 208

 

  1. A patient informs the nurse, “I can’t sit in the yard for even 10 minutes without my skin turning red and tender.” The nurse would assess for the use of which complementary alternative medicine (CAM)?
a. St. John’s wort
b. Ginkgo biloba
c. Feverfew
d. Echinacea

 

 

ANS:  A

Correct: St. John’s wort may cause photosensitivity.

Incorrect:

  1. A side effect of ginkgo biloba is risk of bleeding not photosensitivity.
  2. Patients taking feverfew should be observed for altered coagulation and heightened response to environmental allergens.
  3. A side effect of echinacea is heightened sensitivity to ragweed and environmental allergens and is being studied for possible immunosuppressive effects.

 

DIF:    Application    REF:   p. 212

 

  1. A patient states, “My cancer is in remission finally after all that chemotherapy, my friend used the same chemotherapy and wasn’t so lucky. I want to continue participating in spiritual care and ‘mind games’ to keep my memory intact. I am also enrolled in Tai chi, but I just can’t stop thinking about my sick lung.” This patient adheres to which principle underlying alternative healing?
a. A negative alteration in the body produces a parallel effect on the mind and spirit.
b. The body can heal itself with the help of complementary alternative therapies.
c. Approaches to therapy are individualized.
d. There is a focus on the total lifestyle.

 

 

ANS:  A

Correct: Health and healing are related to a harmony of mind, body, and spirit.

Incorrect:

  1. Patients with this belief may have refused the chemotherapy believing the body has the potential to self-heal.
  2. CAM practitioners individualize treatment by exploring underlying causes of the problem.
  3. This principle implies the patient does not focus on the diseased body part.

 

DIF:    Application    REF:   p. 206

 

  1. During an admission history and physical, a female patient states, “I use 5000 mg/day of calcium to prevent osteoporosis and to maintain health.” The nurse should assess for:
a. excessive bleeding.
b. kidney stones.
c. lower blood sugar.
d. jaundice.

 

 

ANS:  B

Correct: Excessive calcium places individuals at risk for renal stone.

Incorrect:

  1. Garlic and chamomile (not calcium) are supplements that increases bleed time.
  2. Ginseng, especially Asian ginseng, places patients at risk for hypoglycemia.
  3. Green tea may cause liver problems resulting in jaundice.

 

DIF:    Application    REF:   p. 210

 

  1. A patient who is pregnant has used the herb feverfew for a history of migraine headaches. The nurse should provide teaching related to a risk for:
a. uterine contractions resulting in possible miscarriage.
b. reduced fetal growth.
c. insomnia.
d. tiredness the following day.

 

 

ANS:  A

Correct: Feverfew has the potential to cause the uterus to contact, increasing the risk for miscarriage or premature delivery.

Incorrect:

  1. Magnets, not feverfew, can reduce fetal growth.
  2. Green tea has the side effect of insomnia
  3. Valerian has the side effect of tiredness the following morning as well as headaches, dizziness, and upset stomach.

 

DIF:    Application    REF:   p. 211

 

  1. A patient who is just beginning to use homeopathy to treat depression is concerned because symptoms are actually becoming worse with increasing sadness, anxiety, and fatigue. The practitioner of homeopathy bases teaching on the Law of Cure and instructs the patient to:
a. discontinue the therapy and seek another alternative therapy.
b. concentrate the preparation to increase its potency in hopes to improve depressive symptoms.
c. increase the dosage of the substance to increase its effectiveness.
d. remain on the current regimen since worsening is a positive sign that healing is occurring.

 

 

ANS:  D

Correct: The Law of Cure states a worsening of symptoms after a remedy is given is considered a positive sign that healing is taking place. The therapy is therapeutic and should be considered.

  1. Worsening of symptoms is a sign that healing is occurring and discontinuation and seeking another therapy would not be recommended.
  2. Diluting the concentration is believed to increase potency according to the law of similar.
  3. Decreasing the dosage of the treatment substance is believed to increase effectiveness according to the law of minimum dose.

 

DIF:    Application    REF:   p. 213; Box 11-4

 

  1. A patient has fallen at home and complains that joints are very painful when trying to climb stairs. The patient desires to use an alternative complementary medicine rather than pain medication. The practitioner begins treatment with touch consisting of rocking, rhythmical motions to loosen tense, sore muscles and joints. The patient is receiving which type of treatment?
a. Swedish massage
b. Rolfing
c. Trager approach
d. Reflexology

 

 

ANS:  C

Correct: Trager approach uses gentle, rhythmic rocking and touch to promote relaxation and energy flow.

Incorrect:

  1. Swedish massage uses long strokes, friction, and kneading of muscles.
  2. Rolfing technique uses manual manipulation and stretching of body’s fascial tissues to establish balance and symmetry.
  3. Reflexology consists of application of pressure to pressure points on the hands and feet that correspond to various parts of the body.

 

DIF:    Application    REF:   p. 214; Box 11-5

 

MULTIPLE RESPONSE

 

  1. Complementary alternative medicine (CAM) is gaining popularity in Western society because: (Select all that apply.)
a. consumers want knowledgeable, trained physicians to control their care.
b. CAM consumers want personalized health care.
c. quantity, rather than quality, of life is most important in Western society.
d. consumers have access to evidence that support CAMs.
e. consumers want to remain indifferent to the health care provider.

 

 

ANS:  B, D

Correct:

Consumers are taking greater responsibility for their own health, which is based on personal preference, and many alternative natural therapies provide evidence of their own efficacy.

Incorrect:

  1. Physicians often offer impersonal care and a long waiting time for patients.
  2. Western medicine focuses on cure rather than on quality of life, and many individuals prefer a better quality of life to a prolonged life of pain.
  3. Consumers are becoming more informed about health care options and providers.

 

DIF:    Application    REF:   p. 206

 

  1. A patient experiences migraine headaches that are not relieved by traditional Western medical practices. The family physician suggests acupuncture, which: (Select all that apply.)
a. is based on the belief that meridians are vital for life, and when they are out of balance, pain occurs.
b. uses strategically placed, slender needles for pain relief.
c. uses breathing exercises and meditation to relieve pain.
d. corrects metabolic imbalance through purification regimens.
e. determines distinct metabolic body types.

 

 

ANS:  A, B

Correct:

  1. Acupuncture is based on the belief that invisible channels are present throughout the body through which energy flows; these are called meridians. This energy, qi, is considered the vital life force, and illness and symptoms occur when the flow of energy becomes blocked or unbalanced. Health is restored when the energy is unblocked; this is achieved by stimulating acupuncture points on affected meridian(s).
  2. Tiny needles are placed on the meridians that are affected and are causing pain.

Incorrect:

  1. Breathing exercises and meditation are associated with yoga.
  2. Ayurveda involves purification regimens, such as cleansing enemas.
  3. Metabolic body types called doshas result in imbalances that may be corrected by a practice called Ayurveda.

 

DIF:    Comprehension                              REF:   pp. 207-208

 

  1. A patient who is interested in herbal medicine attends a seminar to learn more about complementary alternative medicine (CAM). The patient learns that a common belief related to all CAMs includes that: (Select all that apply.)
a. the body is not able to repair itself; thus, natural remedies are used to inhibit the immune system.
b. many different CAMs that focus on specific body parts and the mind are needed.
c. the focus of CAM is on an intervention for the diseased body part.
d. each CAM treatment is unique to the person who is being treated.
e. health promotion is incorporated into CAM.

 

 

ANS:  D, E

Correct:

  1. Healing is individualized, and the uniqueness of each person is considered. Standing protocols that are used to treat everyone with similar conditions in a similar way are not found in CAM.
  2. Health promotion and positive health habits are incorporated into CAM.

Incorrect:

  1. Beliefs of CAMs include that the body is able to heal itself.
  2. Mind, body, and spirit are believed to be inseparable.
  3. CAM focuses on total lifestyle practices, rather than on diseased body parts.

 

DIF:    Application    REF:   p. 206

 

  1. A nurse investigates energy therapies and learns that which therapies would be included? (Select all that apply.)
a. Qi gong
b. Osteopathy
c. Imagery
d. Healing touch
e. Magnet therapy

 

 

ANS:  A, D, E

Correct:

Energy therapies include Qi gong, Reiki, healing touch, healing (therapeutic) touch, and magnet therapy.

Incorrect:

  1. Osteopathy is a manipulative and body-based method.
  2. Imagery is a mind-body intervention.

 

DIF:    Comprehension                              REF:   p. 207; Box 11-1