Test Bank For Contemporary Nursing Issues Trends And Management 4th Edition By Jacob

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Trends And Management 4th Edition By Jacob
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Contemporary Nursing Issues Trends And Management 4th Edition By Jacob
Cherry: Contemporary Nursing, 4th Edition
Test Bank
Chapter 1: The Evolution of Professional Nursing
MULTIPLE CHOICE
1. Clara Barton is known for
A.
B.
C.
D.
becoming the first African-American public health nurse.
establishing the Henry Street Settlement.
founding the American Red Cross.
publicizing the inadequacies of hospital-based nursing schools.
ANS: C
(C) is correct because the American Red Cross, founded by Clara Barton in 1882,
assisted in efforts to continue public health nursing. (A) is incorrect because Jessie
Sleet Scales was the first African-American public health nurse. (B) is incorrect because
Lillian Wald, a pioneer in public health nursing, is best known for the development and
establishment of the Henry Street Settlement. (D) is incorrect because The Goldmark
Report criticized the inadequacies of hospital-based nursing schools and recommended
enhanced educational standards.
DIF:
Knowledge
REF:
Page 16
2. Which bill provided for construction of hospitals?
A.
B.
C.
D.
Social Security Act
Hill-Burton Act
Sheppard-Towner Act
U.S. Civil Service Act
ANS: B
(B) is correct because the purpose of the Hill-Burton Act was to provide funding to
construct hospitals and to assist states in planning for other health care facilities in
accordance with the needs of communities. (A) is incorrect because the main purposes
of the 1935 Social Security Act were to provide (1) a national insurance system for the
elderly; (2) monies to states for maternal and child welfare services; (3) vocational
rehabilitation services for the physically and mentally challenged; (4) medical care for
crippled children and blind people; (5) a plan to boost public health services; and (6) a
federal/state unemployment system. (C) is incorrect because the Sheppard-Towner Act
provided federal aid for maternal and child health care. (D) is incorrect because the U.S.
Civil Service Act is landmark U.S. legislation establishing the tradition and mechanism
of permanent federal employment based on merit rather than on political party affiliation
(the spoils system).
DIF:
Knowledge
REF:
Page 18
3. The practice of public health nursing and the Henry Street Settlement are
A.
B.
C.
D.
credited to
Mary Breckenridge.
Mary Seacole.
Clara Barton.
Lillian Wald.
ANS: D
(D) is correct because Lillian Wald was a pioneer in public health nursing who is best
known for the development and establishment of the Henry Street Settlement. (A) is
incorrect because Mary Breckenridge of Kentucky established the Frontier Nursing
Service in 1925. (B) is incorrect because Mary Seacole was a black nurse who provided
care during the Crimean War. (C) is incorrect because Clara Barton founded the
American Red Cross in 1882.
DIF:
Knowledge
REF:
Page 15
4. Occupational health nursing features beliefs similar to those of which early
A.
B.
C.
D.
nursing pioneer?
Lillian Wald
Florence Nightingale
Clara Barton
Mary Seacole
ANS: A
(A) is correct because Lillian Wald developed the first nursing service for occupational
health. (B) is incorrect because Florence Nightingale is best known for contributions
made during the Crimean War, efforts to improve sanitation and public health, use of
statistics to provide support for health outcomes, and organization of nurse training. (C)
is incorrect because Clara Barton founded the American Red Cross. (D) is incorrect
because Mary Seacole was a black nurse who served during the Crimean War.
DIF:
Comprehension
REF:
Page 14
5. What historical event first led to the realization of the contribution of African-
A.
B.
C.
D.
Americans to nursing?
Florence Nightingale’s acceptance of African-American nurses into the first
nursing school
The contributions of African-American nurses at the Pennsylvania Hospital,
the first hospital in America
Mary Seacole’s efforts to care for soldiers during the Crimean War
The wives of wealthy African-American nobles who carried food and
medicine from house to house during the Middle Ages
ANS: C
(C) is correct because although Nightingale’s school refused Seacole, she was able to
make a difference in the Crimean War and later was recognized for her efforts. (A) is
incorrect because Florence Nightingale’s efforts during the Crimean War were valuable
and recognized, but she would not allow Seacole to join her in her efforts. (B) is
incorrect because Pennsylvania Hospital was the first hospital in America and was
founded in 1751, but Seacole’s efforts in the Crimean War did not occur until 100 years
later. (D) is incorrect because the wives of noblemen who carried food and medicine
were not uniquely African-Americans.
DIF:
Application
REF:
Page 12
6. World War I contributed to the advancement of health care by
increasing the number of private care hospitals and decreasing the role of
public health services.
employing a large number of civilians to provide care to returning soldiers
B.
through the Red Cross.
C. introducing specialists in nursing such as nurse anesthetists.
D. increasing the number of community health nurses.
A.
ANS: C
(C) is correct because World War I offered nurses a chance to enter into new fields of
specialization, as is seen in the example of nurse anesthetists who became part of
surgical teams at the front lines. (A) is incorrect because advancements in public health
were being made and the primary site for medical care was moved from the home to the
hospital. (B) is incorrect because the Red Cross provided care to communities in which
access was limited and eventually moved to urban areas. (D) is incorrect because many
nurses were needed in the war effort, which caused the growth in community health
nursing to halt.
DIF:
Application
REF:
Page 15
7. The primary purpose of the Social Security Act of 1935 was to
A. increase research that focused on minority groups.
B. provide medical care for chemically impaired persons.
C. ensure health care for older adults through a national insurance system.
decrease the public’s financial burden by limiting services offered by local
D.
health departments.
ANS: C
(C) is correct because the Social Security Act of 1935 set the precedent for the passage
of the Medicare and Medicaid acts that followed in 1965 to provide health insurance for
the elderly, but it also provided maternal and child welfare services, along with
rehabilitation for the mentally and physically challenged, medical care for blind
individuals and crippled children, and unemployment benefits. (A) is incorrect because
increasing research for minorities was not one of the purposes of the Social Security Act
of 1935. (B) is incorrect because the care of persons with substance abuse problems
was not one of the first purposes addressed by the Social Security Act. (D) is incorrect
because the Social Security Act provided a means by which women and children could
receive care, thus increasing the numbers of public health nurses and services offered.
DIF:
Comprehension
REF:
Page 19
8. A patient asks the nurse, “I received information on getting help paying for my
A.
B.
C.
D.
hospitalization. Can you explain Medicare, an amendment to the Social Security
Act?” The nurse responds that Medicare
led to many hospital closings, along with a decrease in acute care hospital–
based nursing care.
provided medical insurance to those younger adults or children who were
not eligible for private insurance because of catastrophic illnesses such as
cancer.
provided preventive care for women, infants, and children.
ensured that individuals with end-stage renal disease had health care
insurance.
ANS: D
(D) is correct because the Medicare program provides hospital insurance, Part A, and
medical insurance, Part B, to all people age 65 and older who are eligible to receive
Social Security benefits; people with total, permanent disabilities; and people with endstage renal disease. (A) is incorrect because Medicare provides insurance for many
who previously have not sought health care, resulting in an increase, not a decrease, in
hospital care. (B) is incorrect because medical insurance for young adults and children
who were not eligible for private insurance is part of Medicaid. (C) is incorrect because
Medicaid was the medical insurance for those families, primarily women and children,
with an income at or below the federal poverty level.
DIF:
Comprehension
REF:
Page 19
9. A comparison of nursing in the 1980s versus nursing in the 1990s reveals that
the 1990s influenced nursing in that a reduction occurred in preventable
diseases caused by unsafe/unhealthy lifestyles.
tuberculosis was the primary concern for nursing in the 1980s, whereas the
B.
AIDS epidemic emerged and was its focus during the 1990s.
a decrease in ambulatory services in the 1980s prompted an increase in
C.
public health nurses in the 1990s.
the demand for advanced practice nurses increased in the 1980s and the
D. 1990s as a result of the economy and concern about the health of the
nation.
A.
ANS: D
(D) is correct because the numbers of advanced nurse practitioners increased as
evidence of their cost-effectiveness as providers of primary and preventive health care
became established. (A) is incorrect because in the 1990s, many diseases associated
with preventable causes led to mortality in the United States. (B) is incorrect because
the AIDS epidemic appeared in the 1980s and tuberculosis became more of a concern
in the 1990s. (C) is incorrect because the 1980s saw an increase in technology that
allowed more outpatient procedures, increased use of ambulatory services, and
increased demand for community health nurses.in the 1990s.
DIF:
Application
REF:
Page 23
10. Which of the following statements accurately describes the historical perspective
of nursing practice?
Nursing has existed to meet the needs of populations, individuals, and
A. aggregates by providing care that is influenced by the needs and beliefs of
society in different historical contexts.
When men became interested in nursing, this provided the impetus to
B. change nursing into a respected profession based on scientific fact rather
than superstition.
Nursing has historically accepted individuals from all social and ethnic
C.
backgrounds.
The United States has led the way throughout history to advance nursing
D.
and health care by providing the first hospital and medical school.
ANS: A
(A) is correct because nursing has existed since biblical times to address needs ranging
from contagious diseases in early times to health prevention in the present time, with
care based on health beliefs of the time. (B) is incorrect because in the beginning, men
were recognized as health healers, but women changed nursing from a mystical
phenomenon to a respected profession. (C) is incorrect because nursing, has had
periods where criminals and prostitutes practiced and discrimination was evidenced by
Nightingale’s refusal of Seacole. (D) is incorrect because the first hospital and the first
medical school in North America were founded in Mexico—the Hospital of the
Immaculate Conception in Mexico City and the University of Mexico Medical School.
DIF:
Application
REF:
Pages 10-25
11. The use of herbs has become a popular alternative to prescription drugs in
A.
B.
C.
D.
today’s health care milieu. During which other historical periods did health
practices focus on the use of herbs?
Prehistoric times and the Middle Ages
Civil War period and World War I
Renaissance and Reformation periods and the Colonial American period
Crimean War and Civil War periods
ANS: A
(A) is correct because during prehistoric times, tribes used herbs to rid themselves of
the curse of disease, and in the Middle Ages, women used herbs. (B) is incorrect
because during the Civil War, health care was similar to that provided in Colonial times,
when epidemics were rampant, and World War I saw an increase in the advancement of
nursing specialties and public health nursing. (C) is incorrect because during the
Renaissance and Reformation periods, major advancements were made in
pharmacology, chemistry, and medical knowledge, including anatomy, physiology, and
surgery, and the Colonial American period focused on transmissible diseases. (D) is
incorrect because the Crimean War era found nursing care that was focused on
sanitation and environmental improvements, and with the Civil War, the nursing focus
reverted to communicable diseases.
DIF:
Application
REF:
Page 7
12. An individual is unable to participate in war because of painful joints and chest
A.
B.
C.
D.
pain with exertion. The care provider sacrifices an animal and waves a smokefilled sack over the patient. This represents health care during
the prehistoric period.
early civilization in Egypt.
the Renaissance.
the Middle Ages.
ANS: A
(A) is correct because during prehistoric times, illness was thought to be caused by evil
spirits that providers attempted to scare away through rituals and dances. (B) is
incorrect because the Egyptians were very advanced at an early time in the use of
suturing and preventive measures such as public health. (C) is incorrect because
although major advancements were made during the Renaissance in pharmacology,
chemistry, and medical knowledge, this was the dark period for nursing because those
who entered the profession were most often unsavory. (D) is incorrect because during
the Middle Ages, health care providers who were women used herbs; however, men
used purging and surgeries that were performed by unskilled individuals.
DIF:
Application
REF:
Page 7
MULTIPLE RESPONSE
1. The clinical nurse leader (Select all that apply.)
A. requires certification as an advanced practice nurse.
provides care at the bedside while collaborating with other members of the
B.
health care team.
focuses on clinical practice rather than fulfilling the role of administrator or
C.
educator.
is an advanced practice nurse whose practice is limited to the acute care
D.
setting.
has a clinically focused doctoral degree in nursing, which provides
E.
prescriptive authority.
ANS: B, C
(B) is correct because the clinical nurse leader (CNL) manages care at the bedside or
point of care through an interdisciplinary approach. (C) is correct because the CNL is a
provider of care and does not assume the role of manager. (A) is incorrect because the
CNL is not an advanced practice nurse but rather a generalist. (D) is incorrect because
the CNL is a generalist and is not an advanced practice nurse. (E) is incorrect because
the CNL is educated at the master’s level and does not have prescriptive authority.
DIF:
Comprehension
REF:
Page 2
OTHER
1. Contrast the role of nursing during the wars that occurred from the time of the
A.
B.
C.
D.
Civil War to World War II. Place the following in correct chronological order.
Nurses who served during war were given rank as officers.
No nurses were formally trained.
Public health nursing and occupational nursing were begun.
The nurse anesthetist was introduced.
ANS:
B, C, D, A
(B) It was not until 1860 that Nightingale established the first nursing school in England.
Nurses were not formally trained until Nightingale’s time. (C) During the 1900s, prior to
World War I, Lillian Wald instituted public health nursing and occupational nursing. (D)
In 1914, with the beginning of World War I, the nurse anesthetist joined the surgical
team. (A) Nurses were seen as a valuable part of the military and attained the ranks of
officers in the Army and the Navy for their participation in World War II.
DIF:
Application
REF:
Pages 13-18
COMPLETION
1. Which group in early civilization is credited with developing a pharmocopoeia to
classify more than 700 drugs used in caring for the sick?
____________________
ANS:
Egyptians
A pharmocopoeia that classified more than 700 drugs was written by the Egyptians to
assist in the care and management of disease.
DIF:
Comprehension
REF:
Cherry: Contemporary Nursing, 4th Edition
Page 7
Test Bank
Chapter 3: The Influence of Contemporary Trends and Issues on Nursing
Education
MULTIPLE CHOICE
1. A current trend is for students to be evaluated to discern whether they
A.
B.
C.
D.
demonstrate competence in the actual patient 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
core practice competencies.
continuing competence.
distance learning.
performance-based assessment.
ANS: D
(D) is 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. (A) is incorrect because core practice
competencies consist of the abilities and skills currently required for program completion
and nursing practice. (B) is incorrect because continuing competence is required in
many states for relicensure and recertification. (C) is incorrect because distant learning
occurs when courses are delivered through some electronic format such as a Webbased 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:
Page 52
2. One of the major trends that currently influences nursing education and practice
is
A.
B.
C.
D.
increased technology in the field of critical care.
the influence of research in the field of genetics.
escalating communication and informatics technologies.
international programs designed to standardize health care.
ANS: C
(C) is correct because with ever-expanding developments in electronic information
technology, the volume of information is growing exponentially on a global level.
Informatics has become a major part of education and practice that facilitates
communication. (A) is incorrect because critical care is not the only area in which
technology is increasing, and this has no direct impact as a major trend influencing
nursing education. (B) is incorrect because research in the field of genetics is a
component of ethics and is a bioethical concern that has not been identified as an
influence on nursing education. (D) is incorrect because international programs
designed to standardize health care have not been identified as a trend in nursing
education.
DIF:
Application
REF:
Page 46
3. Although the use of technology and the Internet provides nursing faculty and
A.
B.
C.
D.
students with unlimited resources and current information, an outcome
associated with this trend is that
users of electronic resources spend a disproportionate amount of time
looking for pertinent content.
additional time is available to study and revise curricula because special
skills are not needed to access information via the Internet.
immediate results and outcomes are expected from both students and
faculty, thus enhancing time management.
skills that require problem solving and reflective abilities are developed.
ANS: A
(A) is correct because students can easily become distracted by pursuit of the intriguing
web of links they encounter while they search Web sites to complete assignments or
find pertinent content. (B) is incorrect because students must learn to become computer
literate and competent. Success in nursing courses and practice depends on these
skills. (C) is incorrect because 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. (D) is incorrect because learning from the
Internet helps students develop skills in analytic thinking, decision making, and
reflective judgment.
DIF:
Synthesis
REF:
Page 47
4. The new trend in nursing education that is consistent with real-world practice is
A.
B.
C.
D.
focused on
outcomes.
objectives.
goals.
subjective appraisals.
ANS: A
(A) is correct because 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. (B) is incorrect
because objectives refer to knowledge that the student is expected to attain. (C) is
incorrect because goals are patient focused. (D) is incorrect because subjective
appraisals are not used in real-world practice.
DIF:
Knowledge
REF:
Page 48
5. The practice of nurses, nursing students, and faculty is affected by demographic
changes due to
A. the growing percentage of adults aged 50 to 65 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
(B) is correct because the United States is experiencing an epidemic of obesity with
major consequences for health and the health care system. (A) is incorrect because the
percentage of adults aged 50 to 65 years is not increasing. The number of very elderly
is increasing. (C) is incorrect because even the definition of family has changed
radically, as evidenced by single individuals living with other single individuals, singleparent households, and same-sex couples (with and without children). (D) is incorrect
because the number of families who remain uninsured, jobless, homeless, and surviving
in poverty is increasing.
DIF:
Knowledge
REF:
Page 54
6. The first university to offer nursing graduates the baccalaureate degree was
A.
B.
C.
D.
Columbia Teachers College.
Yale University.
Harvard University.
the New York Regents Program.
ANS: B
(B) is correct because in 1924, Yale University offered the first separate Department of
Nursing, whose graduates earned a baccalaureate degree. (A) is incorrect because
Columbia Teachers College was the first to offer a Doctor of Education degree. (C) is
incorrect because Harvard University does not offer a baccalaureate program in
nursing. (D) is incorrect because the New York Regents Program is a distance mobility
program.
DIF:
Knowledge
REF:
Page 62
7. The nursing model that is referred to as the “class without walls” is which model?
A.
B.
C.
D.
Articulation
Career ladder (2 + 2)
External degree
Second degree
ANS: C
(C) is correct because an external degree does not require attendance and provides no
course classes; it enrolls thousands and is accessible regardless of geographic location.
(A) is incorrect because articulation is the format of a program, or refers to what the
student must do to complete the program. (B) is incorrect because the 2 + 2 option is for
LPN or RN students to continue their education to RN or BSN, respectively. (D) is
incorrect because a second degree is a degree that is pursued after the first degree has
been obtained.
DIF:
Knowledge
REF:
Page 65
8. In preparing students for professional nursing practice in the 21st century, where
A.
B.
C.
D.
should the emphasis be placed?
Care coordination, direct care for complex patients, and outcomes
evaluation
Chemistry, biostatistics, and computer programming
Illness care, hospice, and ethics
Psychomotor skills, obstetrics, and epidemiology
ANS: A
(A) is the correct answer because caring for complexities in practice, coordinating care,
and focusing on outcomes evaluation are the tasks that reflect the direction in which
nursing is heading. (B) is incorrect because as supplemental courses to nursing, these
are essential, but they do not represent an area of emphasis for professional nursing.
(C) is incorrect because illness care, hospice, and ethics are currently components in
programs that are preparing students for professional nursing. (D) is incorrect because
psychomotor skills, obstetrics, and epidemiology are limited in scope.
DIF:
Application
REF:
Pages 45-46
9. A standardized means of determining initial proficiency at the entry level into
A.
B.
C.
D.
nursing is
certification in medical-surgical nursing.
the National Certification Licensure Examination (NCLEX).
instructor-constructed examinations that are comprehensive in nature.
the ability of the student to answer questions related to the care provided to
a patient during the senior nursing courses.
ANS: B
(B) is correct because NCLEX is the National Licensure examination that is based on
the minimal level of safety required for a nurse to enter practice. (A) is incorrect
because certification in medical-surgical nursing is attained through a specialty
examination for AACN certification that can be taken only by registered nurses. (C) is
incorrect because instructor-constructed examinations are based on instructors’
knowledge and experience and are not used for entry into practice. (D) is incorrect
because it describes a nonstandardized means of determining initial proficiency.
DIF:
Knowledge
REF:
Page 63
10. Which of the following trends is an effect of the nursing shortage on nursing
education?
Only devoted qualified nurses are continuing to provide bedside nursing
A. because of the complexity of care required, resulting in excellent
preceptorships for students.
The number of applicants to nursing programs has risen but enrollment is
B. limited because of a decrease in the number of available scholarships and
grants.
With an increase in the number of nurses who are entering graduate school
C. to escape bedside nursing, students can soon enjoy a lower faculty/student
ratio.
Students may be assigned to preceptors who have not yet developed
D.
expertise in the field of interest.
ANS: D
(D) is correct because qualified preceptors are few in number. (A) is incorrect because
there is a shortage of nurses qualified at the bedside who are available to serve as
preceptors for students. (B) is incorrect because nursing enrollments are limited
because of a shortage of faculty. (C) is incorrect because nurses are not entering
graduate school to escape bedside nursing, but to pursue advanced practice degrees.
DIF:
Analysis
REF:
Page 57
11. Nurses who take the national licensure examination are all expected to meet the
A.
B.
C.
D.
same minimum competencies. This examination is created and administered by
the
American Association of Colleges of Nursing (AACN).
American Nurses Association (ANA).
National Council of State Boards of Nursing (NCSBN).
National League for Nursing (NLN).
ANS: C
(C) is the correct answer because the NCSBN coordinates licensure activities on a
national level and creates and administers the licensure examination (NCLEX). (A) is
incorrect because 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. (B) is
incorrect because ANA is the major national nursing organization concerned with broad
scope practice issues, standard of practice, scope of practice, ethics, legal issues, and
employment; it consists of a federation of state nurse associations. (D) is incorrect
because 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:
Page 66
12. A potential nursing student is visiting the Web site of some programs and notes
A.
B.
C.
D.
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 and higher degrees. Which organization
oversees professional nursing programs and establishes these “essentials”?
American Association of Colleges of Nursing (AACN)
American Nurses Association (ANA)
National Council of State Boards of Nursing (NCSBN)
National League for Nursing (NLN)
ANS: A
(A) is correct because 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. (B) is incorrect because the ANA is the major
national organization that is concerned with a broad scope of practice issues. (C) is
incorrect because the NCSBN is the organization of all state boards of nursing that
coordinates licensure activities at the national level. (D) is incorrect because 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:
Page 66
13. 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
diploma programs focus on family and community with an emphasis on
A.
health promotion.
most practicing RNs graduated from diploma programs because this was
the first type of RN program.
baccalaureate programs focus on technical and hands-on nursing skills in
C.
diverse community settings.
master’s programs such as that for the clinical nurse leader provide entry
D. into practice with a focus on interdisciplinary and bedside nursing care for
complex patient populations.
B.
ANS: D
(D) is correct because a clinical nurse leader oversees the care coordination of groups
of patients and actively provides direct patient care in complex situations, evaluates
patient outcomes, and has the decision-making authority to change care plans when
necessary. (A) is incorrect because diploma programs do not focus on community with
an emphasis on health promotion, although baccalaureate programs do have this focus.
(B) is incorrect because most of today’s practicing RNs graduated from ADN programs.
(C) is incorrect because BSN programs focus on the care of patients, with greater
emphasis on the family and community and on health promotion and illness prevention.
DIF:
Application
REF:
Page 64
14. When preparing to complete a neurologic assessment of competency in a
A.
B.
C.
D.
simulation laboratory, the nurse reviews the critical elements, which consist of
those steps that result in life or death of a patient.
required criteria that must be incorporated into the assessment for the
desired outcome.
fundamental strategies unique to complex dynamic care environments.
objective data that can be used to determine the likelihood that the patient
will recover.
ANS: B
(B) is correct because critical elements include the application of mandatory principles
that must be used according to established practice standards. (A) is incorrect because
critical elements work to achieve desired outcomes for the patient. (C) is incorrect
because critical elements are not strategies. (D) is incorrect because critical elements
are based on the application of mandatory principles, not on objective data, to
determine the likelihood that the patient will recover.
DIF:
Application
REF:
Page 53
MULTIPLE RESPONSE
1. A nurse is concerned that the policy of using povidone-iodine (Betadine) to clean
A.
B.
C.
D.
E.
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.)
is applying evidence-based practice to the clinical setting.
is using critical thinking to change procedures performed in the care of foot
ulcers.
is minimally educated at the master’s level and is interested in providing
cost-effective care (soap is less expensive than povidone-iodine).
lacks clinical competence in health assessment and in application of theory
to the clinical setting.
is using information to problem-solve and ensure safe, competent care.
ANS: A, B, E
(A), (B), and (E) are correct because critical thinking is an essential part of applying
evidence-based practice, that is, using research findings to guide actual practice. (C) is
incorrect because evidence-based research, not cost, should be used to guide actual
practice. (D) is incorrect because 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:
Synthesis
REF:
Page 53
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 were designed to
meet the needs of the particular institution; these were referred to as diploma programs.
DIF:
Knowledge
REF:
Page 61
Cherry: Contemporary Nursing, 4th Edition
Test Bank
Chapter 11: Complementary and Alternative Healing
MULTIPLE CHOICE
1. A patient observes the practitioner burning a dried herb on the needle during an
A.
B.
C.
D.
acupuncture session and asks about this practice. The practitioner responds, “I
am inciting the acupuncture points and this is referred to as
doshas.”
moxibustion.”
yoga.”
kapha.”
ANS: B
(B) is correct because applying heat to the acupoints is termed moxibustion. (A) is
incorrect because distinct metabolic body types called doshas include vata, pitta, and
kapha; signs of illness occur when the delicate balance of the doshas is disturbed. (C) is
incorrect because yoga is a type of mind/body intervention of complementary alternative
medicine. (D) is incorrect because 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:
Page 238
2. An older adult has atrial fibrillation that causes the heart to have an irregular
A.
B.
C.
D.
rhythm. The client uses imagery to alter the arrhythmia. The client is using which
type of complementary alternative medicine (CAM)?
Ayurveda
Dosha
Homeopathy
Biofeedback
ANS: D
(D) is correct because 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. (A) is incorrect because 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. (B) is incorrect because dosha is a distinct body type in which illness occurs with
any imbalance. (C) is incorrect because with homeopathy, the care provider provides
small quantities of remedies that produce symptoms similar to those of the illness being
treated.
DIF:
Application
REF:
Page 244
3. A patient with kyphosis is visiting a practitioner of chiropractic medicine for the
A.
B.
C.
D.
first time and asks, “How does this therapy work?” The practitioner replies, “I will
use my hands and 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
subluxation.”
a sprain.”
a fracture.”
epicondylitis.”
ANS: A
(A) is correct because the chiropractor corrects misalignments of the spine,
called subluxations, by putting pressure on the nerves that are causing pain. (B) is
incorrect because a sprain refers to a tear in a ligament. (C) is incorrect because a
fracture is the separation of a bone or body part into two or more parts. (D) is incorrect
because epicondylitis is inflammation of the elbow joints leading to “tennis elbow.”
DIF:
Comprehension
REF:
Page 241
4. A young adult on a limited income who is having back pain states, “I want to see
A.
B.
C.
D.
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 as
follows:
“Most insurance companies will pay for chiropractic treatment.”
“Because chiropractors are not licensed in any state, all services must be
paid for by the patient.”
“Chiropractic medicine is a new CAM therapy that has not yet been
recognized by insurance companies.”
“Chiropractic medicine is more than 100 years old, but because it is
preventive in nature, it is not covered by most insurance.”
ANS: A
(A) is correct because chiropractic medicine is performed by a licensed professional
with reimbursement privileges and is an accepted complementary alternative therapy.
(B) is incorrect because chiropractors are licensed in the state in which they practice.
(C) is incorrect because chiropractic medicine has been practiced for longer than 100
years. (D) is incorrect because chiropractic medicine is covered by most insurance
companies.
DIF:
Comprehension
REF:
Page 239
5. The use of plants in conventional modern medicine is evidenced by the drug
A.
B.
C.
D.
atropine, which is derived from which plant?
Digitalis purpurea
Cephaelis ipecacuanha
Rauwolfia serpentina
Atropa belladonna
ANS: D
(D) is correct because atropine is derived from the Atropa belladonna plant, which
primarily affects the parasympathetic nervous system. (A) is incorrect because 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. (B) is incorrect
because the drug ipecac is derived from the plant Cephaelis ipecacuanha, which is
used to induce vomiting in some cases of poisoning. (C) is incorrect because 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:
Page 241
6. The massage therapist uses kinesthesia, or thinking about how movement is
A.
B.
C.
D.
expressed, to correct habits that cause poor posture and limited movement. This
type of massage is called
Alexander technique.
Feldenkrais method.
healing touch.
reiki.
ANS: A
(A) is correct because the Alexander technique teaches improved balance, posture, and
coordination through gentle hands-on guidance and verbal instruction. (B) is incorrect
because 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. (C) is incorrect because
healing touch is a multilevel energy healing program that incorporates aspects of
therapeutic touch with other healing measures. (D) is incorrect because reiki uses the
hands or gestures to channel ki energy from an intangible spirit to bring about healing.
DIF:
Application
REF:
Page 245
7. A nurse practices a relaxing massage technique to stimulate and apply pressure
A.
B.
C.
D.
to the feet or hands that increases blood supply, thus improving circulation to
various parts of the body and relieving pain. The massage technique used by the
practitioner is referred to as
reflexology.
Feldenkrais method.
Reiki.
Rolfing.
ANS: A
(A) is correct because reflexology produces pain relief through pressure applied to
pressure points on the hands and feet that correspond to various parts of the body. (B)
is incorrect because 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. (C) is incorrect because Reiki uses
energy therapy to direct universal life energy to specific sites. (D) is incorrect because
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:
Page 245
8. A patient is placed on reserpine (Serpalan) to decrease mild anxiety and treat
A.
B.
C.
D.
hypertension. The patient researches the medication on the Internet and finds
that this medication comes from which plant?
Atropa belladonna
Digitalis purpurea
Rauwolfia serpentina
Ipecac
ANS: C
(C) is correct because 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. (A) is incorrect because atropine is derived from the Atropa
belladonna plant, which primarily affects the parasympathetic nervous system. (B) is
incorrect because the drug digitalis (Lanoxin) is derived from the Digitalis purpureaplant;
it increases contractility of the heart, making it a popular choice for patients in heart
failure. (D) is incorrect because the drug ipecac is derived from the plant Cephaelis
ipecacuanha, which is used to induce vomiting in some cases of poisoning.
DIF:
Comprehension
REF:
Page 241
9. 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
A.
B.
C.
D.
ingredient, Ginkgo biloba.Which risk associated with this herb is the most
serious?
Thromboembolism due to increased clotting
Seizures due to interaction with anticonvulsants
Hypertension due to sodium retention
Photosensitivity due to increased melanin production
ANS: B
(B) is correct because this herb reduces the efficacy of anticonvulsants, which may lead
to increased seizure activity. (A) is incorrect because this herb decreases coagulation of
blood by prolonging bleed time. (C) is incorrect because Ginkgo biloba has no known
effect on sodium regulation. (D) is incorrect because photosensitivity is due to
decreased melanin production, which offers protection.
DIF:
Analysis
REF:
Page 242
10. An elderly woman stops using complementary alternative medicine (CAM),
A.
B.
C.
D.
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 of the following CAMs may have interfered with early
detection of the dementia?
Large doses of calcium caused cerebral plaques to form, thereby disguising
atrophy of the brain.
Excess doses of folic acid masked a vitamin B12 deficiency that led to
dementia.
Hypnotherapy focused on current pleasant thoughts, eliminating clues to the
past.
The electrical current from magnetic fields interfered with normal brain
waves, resulting in confusion and inability to concentrate.
ANS: B
(B) is correct because individuals with Alzheimer’s often have low levels of vitamin B12;
thus, large doses of folic acid may have masked the dementia. (A) is incorrect because
calcium results in kidney stones and malabsorption of other essential minerals but
would not disguise atrophy of the brain. (C) is incorrect because 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. (D) is incorrect because
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:
Page 241
11. The nurse who presents a class on different complementary alternative
A.
B.
C.
D.
medicines (CAMs) differentiates between imagery and hypnosis as follows:
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.
Hypnosis requires a trained psychologist, but imagery can be performed by
any health care practitioner.
Imagery produces a temporary sense of well-being compared with hypnosis,
which evokes a permanent positive effect.
Although both therapies focus on specific problems and guide the patient
into relaxation, imagery requires the patient to formulate the impression, and
the hypnotist constructs the image for the patient.
ANS: D
(D) is correct because 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. (A) is incorrect because imagery is self-constructed, and
hypnosis can recall both positive and negative images/memories. (B) is incorrect
because both can be learned from audiotapes and books. (C) is incorrect because
neither imagery nor hypnosis can be guaranteed to produce long-term effects.
DIF:
Application
REF:
Page 244
12. A pregnant woman reports back pain and wants to try a complementary
A.
B.
C.
D.
alternative medicine (CAM). Which of the following would be contraindicated?
Magnet therapy
Aromatherapy
Imagery
Therapeutic touch
ANS: A
(A) is correct because the effect of magnets on fetal growth has not been determined.
(B) is incorrect because aromatherapy is safe throughout pregnancy, unless the patient
is allergic to particular scents. (C) Imagery is incorrect because it is not contraindicated
and can actually be used to reduce stress and discomfort associated with pregnancy.
(D) is incorrect because therapeutic touch requires only light or no physical contact.
DIF:
Comprehension
REF:
Page 244
13. Despite the presence of safety aids such as handrails in the bathrooms at an
A.
B.
C.
D.
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?
Yoga
Acupuncture
Tai chi
Magnet therapy
ANS: C
(C) is correct because tai chi improves coordination, thereby reducing the number of
falls and improving gait. (A) is incorrect because yoga focuses on breathing and
exercises designed to produce harmony within the body. (B) is incorrect because
acupuncture is used to produce a sense of well-being and to reduce pain but is not used
to improve coordination. (D) is incorrect because magnet therapy focuses on circulation
and wound healing, rather than on posturing and coordination.
DIF:
Application
REF:
Page 247
MULTIPLE RESPONSE
1. Complementary alternative medicine (CAM) is gaining popularity in Western
A.
B.
C.
D.
E.
society because (Select all that apply.)
consumers want knowledgeable, trained physicians to control their care.
CAM consumers make more informed decisions about their own care.
quantity, rather than quality, of life is most important in Western society.
consumers prefer natural products, rather than synthetic medications.
consumers want to remain indifferent to the health care provider.
ANS: B, D
(B) and (D) are correct because consumers are taking greater responsibility for their
own health, and many alternative natural therapies provide evidence of their own
efficacy. (A) is incorrect because physicians often offer impersonal care and a long
waiting time for patients. (C) is incorrect because 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. (E) is incorrect because consumers are becoming more informed
about health care options and providers.
DIF:
Application
REF:
Page 236
2. A patient experiences migraine headaches that are not relieved by traditional
A.
B.
C.
D.
E.
Western medical practices. The family physician suggests acupuncture,
which (Select all that apply.)
is based on the belief that meridians are vital for life, and when they are out
of balance, pain occurs.
uses strategically placed, slender needles for pain relief.
uses breathing exercises and meditation to relieve pain.
corrects metabolic imbalance through purification regimens.
determines distinct metabolic body types.
ANS: A, B
(A) is correct because 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). (B) is correct because tiny needles are placed on the
meridians that are affected and are causing pain. (C) is incorrect because breathing
exercises and meditation are associated with yoga. (D) is incorrect because Ayurveda
involves purification regimens, such as cleansing enemas. (E) is incorrect because
metabolic body types called doshas result in imbalances that may be corrected by a
practice called Ayurveda.
DIF:
Comprehension
REF:
Page 238
3. A patient who is interested in herbal medicine attends a seminar to learn more
A.
B.
C.
D.
E.
about complementary alternative medicine (CAM). The patient learns that a
common belief related to all CAMs includes the following: (Select all that apply.)
The body is not able to repair itself; thus, natural remedies are used to
inhibit the immune system.
Many different CAMs that focus on specific body parts are needed.
The focus of CAM is the diseased body part, rather than a sense of holism.
Each CAM treatment is unique to the person who is being treated.
Health promotion is incorporated into CAM.
ANS: D, E
(D) is correct because healing is individualized, and the uniqueness of each person is
considered. Standing protocols that are used to treat all persons with similar conditions
in a similar way are not found in CAM. (E) is correct because health promotion and
positive health habits are incorporated into CAM. (A) is not correct because beliefs of
CAMs include that the body is able to heal itself. (B) is incorrect because mind, body,
and spirit are believed to be inseparable. (C) is incorrect because CAM focuses on total
lifestyle practices, rather than on diseased body parts.
DIF:
Application
REF:
Page 248
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