Old's Maternal-Newborn Nursing and Women's Health, 11e (Davidson/London/Ladewig)

Chapter 7 Social Issues

1. There have been a number of historical trends that have contributed to the existing wage gap, including which of the following?
2. There was a perception that men were the sole breadwinners.
3. Women who were competitive in the work environment were viewed positively.
4. Women in past generations generally were not limited to certain occupations.
5. Increase in societal importance of women's intellectual traits.

Page Ref: 124

Cognitive Level: Understanding

Client Need/Sub: Safe and Effective Care Environment: Management of Care

Standards: Q S E N Competencies: Ⅰ. C. 13. Acknowledge the tension that may exist between patient rights and the organizational responsibility for professional, ethical care. | A A C N Essentials Competencies: Ⅴ. 8. Discuss the implications of healthcare policy on issues of access, equity, affordability, and social justice in healthcare delivery. | N L N Competencies: Context and Environment: Appreciate the influence of systems of healthcare outcomes. | Nursing/Integrated Concepts: Nursing Process: Planning.

Learning Outcome: 2 Identify contributing factors that perpetuate the gender wage gap and economic inequality for women.

M N L L O: Demonstrate understanding of social issues affecting women.

1. The nurse is planning a community educational presentation for people living below the poverty level. The nurse knows that which of the following is the largest population in this socioeconomic category?
2. Adults in communal living situations
3. Young married couples under the age of 20
4. Single women with children
5. Single adults

Page Ref: 121

Cognitive Level: Understanding

Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: Q S E N Competencies: Ⅰ. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | A A C N Essentials Competencies: Ⅴ. 8. Discuss the implications of healthcare policy on issues of access, equity, affordability, and social justice in healthcare delivery. | N L N Competencies: Context and Environment: Appreciate the influences of systems on healthcare outcomes. | Nursing/Integrated Concepts: Nursing Process: Planning.

Learning Outcome: 1 Discuss the meaning of the phrase feminization of poverty and its impact on women and their families.

M N L L O: Demonstrate understanding of social issues affecting women.

1. The community clinic nurse manager is working on a long-term budget. The manager understands that in the next few years, Medicaid is expected to pay for fewer births. This is, in part, because of which of the following?
2. The U.S. economy is becoming stronger.
3. More women are able to pay for private insurance.
4. New public policies are providing other forms of payment.
5. Rules for Medicaid have been changed.

Page Ref: 124

Cognitive Level: Understanding

Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: Q S E N Competencies: Ⅰ. C. 13. Acknowledge the tension that may exist between patient rights, and the organizational responsibility for professional, ethical care. | A A C N Essentials Competencies: Ⅴ. 3. Compare the benefits and limitations of the major forms of reimbursement on the delivery of healthcare services. | N L N Competencies: Context and Environment: Appreciate the influence of systems on healthcare outcomes. | Nursing/Integrated Concepts: Nursing Process: Planning.

Learning Outcome: 3 Discuss the impact of poverty on women's access to healthcare.

M N L L O: Demonstrate understanding of social issues affecting women.

1. The nurse working at a homeless shelter is studying case statistics. Of the total homeless population served at the shelter, which group would the nurse's statistics likely uncover as the fastest-growing group?
2. Unemployed women
3. Families with children
4. The mentally ill
5. The elderly

Page Ref: 123

Cognitive Level: Understanding

Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: Q S E N Competencies: Ⅱ. B. 6. Participate in structuring the work environment to facilitate integration of new evidence into standards of practice. | A A C N Essentials Competencies: Ⅴ. 6. Explore the impact of socio-cultural, economic, legal, and political factors influencing healthcare delivery and practice. | N L N Competencies: Context and Environment: Read and interpret data; apply health promotion/disease prevention strategies; apply health policy; conduct population-based transcultural health assessments and interventions. | Nursing/Integrated Concepts: Nursing Process: Assessment.

Learning Outcome: 3 Discuss the impact of poverty on women's access to healthcare.

M N L L O: Demonstrate understanding of social issues affecting women.

1. The nurse working with a client who is seeking a family and medical leave knows that the employee must meet which eligibility requirement of the Family and Medical Leave Act (F M L A) of 1993?
2. Work at least 40 hours per week
3. Have been employed for at least 1 month
4. Work for a company with fewer than 50 employees
5. Parental leave for childbirth or adoption by her employer

Page Ref: 125

Cognitive Level: Understanding

Client Need/Sub: Safe and Effective Care Environment: Management of Care

Standards: Q S E N Competencies: Ⅰ. A. 6. Describe strategies to empower patients or families in all aspects of the healthcare process. | A A C N Essentials Competencies: Ⅴ. 4. Examine legislative and regulatory processes relevant to the provision of healthcare. | N L N Competencies: Context and Environment: Healthcare economic policy; reimbursement structures; accreditation standards; staffing models and productivity; supply chain models. | Nursing/Integrated Concepts: Nursing Process: Assessment.

Learning Outcome: 4 Describe the implications of the Family and Medical Leave Act (F M L A) of 1993 on maternity and paternity leave and how this has impacted families.

M N L L O: Demonstrate understanding of social issues affecting women.

1. The pregnant client employed at a factory asks the nurse whether exposure to chemicals can cause harm to her fetus. The nurse should advise the client that exposure to which substance can lead to neurological damage?
2. Lead
3. Latex
4. Formaldehyde
5. Benzene

Page Ref: 127

Cognitive Level: Understanding

Client Need/Sub: Health Promotion and Maintenance: Ante/Intra/Postpartum and Newborn Care

Standards: Q S E N Competencies: Ⅰ. A. 1. Elicit patient values, preferences and expressed needs as part of clinical interview, implementation of care plan and evaluation of care. | A A C N Essentials Competencies: Ⅶ. 2. Conduct a health history, including environmental exposure and a family history that recognizes genetic risks, to identify current and future health problems. | N L N Competencies: Context and Environment: Read and interpret data; apply health promotion/disease prevention strategies; apply health policy; conduct population-based transcultural health assessments and interventions. | Nursing/Integrated Concepts: Nursing Process: Assessment.

Learning Outcome: 5 Identify potential adverse outcomes associated with environmental hazards in the workplace or the home of a woman of childbearing age.

M N L L O: Demonstrate understanding of social issues affecting women.

1. Pesticide exposure can be linked to a variety of adverse health outcomes, including which of the following?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Select all that apply.

1. Increased risk of cancer
2. Endocrine abnormalities
3. Liver damage
4. Birth defects
5. Cardiovascular diseases

Page Ref: 127—128

Cognitive Level: Understanding

Client Need/Sub: Health Promotion and Maintenance: Ante/Intra/Postpartum and Newborn Care

Standards: Q S E N Competencies: Ⅰ. C. 10. Value active partnership with patients or designated surrogates in planning, implementation, and evaluation of care. | A A C N Essentials Competencies: Ⅶ. 2. Conduct a health history, including environmental exposure and family history that recognizes genetic risks, to identify current and future health problems. | N L N Competencies: Context and Environment: Read and interpret data; apply health promotion/disease prevention strategies; apply health policy; conduct population-based transcultural health assessments and interventions. | Nursing/Integrated Concepts: Nursing Process: Planning.

Learning Outcome: 5 Identify potential adverse outcomes associated with environmental hazards in the workplace or the home of a woman of childbearing age.

M N L L O: Demonstrate understanding of social issues affecting women.

1. Which of the following federal departments actively investigates and prosecutes individuals who cross state lines to avoid paying child support, and now intercepts delinquent parents' income tax refunds?
2. U.S. Department of Health and Human Services
3. U.S. Department of Labor
4. U.S. Department of Justice
5. U.S. Equal Employment Opportunity Commission

Page Ref: 122

Cognitive Level: Remembering

Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: Q S E N Competencies: Ⅰ. A. 4. Examine how the safety, quality, and cost effectiveness of healthcare can be improved through the active involvement of patients and families. | A A C N Essentials Competencies: Ⅴ. 1. Demonstrate basic knowledge of healthcare policy, finance, and regulatory environments; including local, state, national, and global healthcare trends. | N L N Competencies: Context and Environment: Healthcare economic policy; reimbursement structures; accreditation standards; staffing models and productivity; supply chain models. | Nursing/Integrated Concepts: Nursing Process: Evaluation.

Learning Outcome: 1 Discuss the meaning of the phrase feminization of poverty and its impact on women and their families.

M N L L O: Demonstrate understanding of social issues affecting women.

1. The nurse manager is preparing an educational in-service for staff nurses about elder abuse. The nurse manager develops a hypothetical situation: A wheelchair-bound client who lives with her daughter has experienced hunger because she cannot reach the cupboards to make lunch. Which category of elder abuse does this example describe?
2. Psychologic abuse
3. Physical abuse
4. Neglect
5. Financial abuse

Page Ref: 130

Cognitive Level: Understanding

Client Need/Sub: Health Promotion and Maintenance: Aging Process

Standards: Q S E N Competencies: Ⅰ. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | A A C N Essentials Competencies: Ⅸ. 7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care. | N L N Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Planning.

Learning Outcome: 7 Identify the four different types of elder abuse and the detrimental impact they have on older women.

M N L L O: Demonstrate understanding of social issues affecting women.

1. Psychologic elder abuse includes, but is not limited to, which of the following?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Select all that apply.

1. Verbal assaults
2. Humiliation
3. Desertion
4. Intimidation
5. Failure to provide reasonable care

Page Ref: 130

Cognitive Level: Understanding

Client Need/Sub: Safe and Effective Care Environment: Management of Care

Standards: Q S E N Competencies: Ⅴ. B. 2. Demonstrate effective use of strategies to reduce risk of harm to self or others. | A A C N Essentials Competencies: Ⅸ. 12. Create a safe environment that results in high-quality patient outcomes. | N L N Competencies: Quality and Safety: Communicate potential risk factors and actual errors. | Nursing/Integrated Concepts: Nursing Process: Implementation.

Learning Outcome: 7 Identify the four different types of elder abuse and the detrimental impact they have on older women.

M N L L O: Demonstrate understanding of social issues affecting women.

1. The community health nurse manager is reviewing the charts of female elderly clients. Which issue are these clients most likely to experience?
2. Adequate financial resources to purchase medications
3. Senior services that provide transportation to healthcare appointments
4. Multiple medications prescribed by different physicians
5. Medicare that covers healthcare costs so no out-of-pocket expenses occur

Page Ref: 131

Cognitive Level: Understanding

Client Need/Sub: Health Promotion and Maintenance: Aging Process

Standards: Q S E N Competencies: Ⅴ. B. 6. Demonstrate effective use of strategies to reduce risk of harm to self or others. | A A C N Essentials Competencies: Ⅸ. 12. Create a safe environment that results in high-quality patient outcomes. | N L N Competencies: Quality and Safety: Communicate potential risk factors and actual errors. | Nursing/Integrated Concepts: Nursing Process: Assessment.

Learning Outcome: 8 Discuss possible adverse outcomes that may occur as a result of aging on a woman's health and healthcare.

M N L L O: Demonstrate understanding of social issues affecting women.

1. The nurse recognizes that what are the most common disabilities in women?
2. Asthma and headaches
3. Arthritis or rheumatism
4. Adverse kidney and nervous system functioning
5. Cardiovascular diseases

Page Ref: 131

Cognitive Level: Understanding

Client Need/Sub: Health Promotion and Maintenance: Aging Process

Standards: Q S E N Competencies: Ⅴ. B. 6. Demonstrate effective use of strategies to reduce risk of harm to self or others. | A A C N Essentials Competencies: Ⅸ. 12. Create a safe environment that results in high-quality patient outcomes. | N L N Competencies: Quality and Safety: Communicate potential risk factors and actual errors. | Nursing/Integrated Concepts: Nursing Process: Assessment.

Learning Outcome: 9 Identify the five types of disability and their impact on quality of life for disabled women.

M N L L O: Demonstrate understanding of social issues affecting women.

1. A home care nurse is looking over the charts of four elderly female clients. The nurse knows that which client has the highest risk for developing diabetes and heart disease?
2. A woman who is 55 and white
3. A woman who is 60 and from a middle-class background
4. All women over 55
5. A woman over 65 who is African American

Page Ref: 131

Cognitive Level: Applying

Client Need/Sub: Safe and Effective Care Environment: Management of Care

Standards: Q S E N Competencies: Ⅰ. B. 1. Elicit patient values, preferences, and expressed needs as part of clinical interview, implementation of care plan and evaluation of care. | A A C N Essentials Competencies: Ⅸ. 5. Deliver compassionate, patient-centered, evidence-based care that respects patient and family preferences. | N L N Competencies: Quality and Safety: Communicate effectively with different individuals (team members, other care providers, patients, families, etc.) so as to minimize risks associated with handoffs among providers and across transitions in care. | Nursing/Integrated Concepts: Nursing Process: Implementation.

Learning Outcome: 8 Discuss possible adverse outcomes that may occur as a result of aging on a woman's health and healthcare.

M N L L O: Demonstrate understanding of social issues affecting women.

1. The nurse at a women's clinic is reviewing a new client health information questionnaire. Which question does she find to be insulting and discriminatory toward lesbian clients?
2. Who should be contacted in case of emergency?
3. What method of birth control do you use?
4. How often do you drink alcohol?
5. Do you feel safe in your relationship?

Page Ref: 135

Cognitive Level: Applying

Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: Q S E N Competencies: Ⅰ. B. 1. Elicit patient values, preferences, and expressed needs as part of clinical interview, implementation of care plan and evaluation of care. | A A C N Essentials Competencies: Ⅸ. 1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches. | N L N Competencies: Relationship-Centered Care: Appreciate the patient as a whole person, with his or her own life story and ideas about the meaning of health or illness. | Nursing/Integrated Concepts: Nursing Process: Assessment.

Learning Outcome: 10 Explain the implications of various barriers that lesbian, bisexual, and transgender women face and how they can negatively impact healthcare access and outcomes.

M N L L O: Demonstrate understanding of social issues affecting women.

1. Lesbian, transgendered, and bisexual women are at greater risk for health and social disparities, including which of the following?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Select all that apply.

1. Increased suicide risk
2. Increased risk of homelessness
3. Lack of screening for female-related cancers
4. Lack of screening for lung cancers
5. Increased divorce rates

Page Ref: 133—134

Cognitive Level: Understanding

Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: Q S E N Competencies: Ⅰ. B. 3. Provide patient-centered care with sensitivity and respect for the diversity of human experience. | A A C N Essentials Competencies: Ⅸ. 5. Deliver compassionate, patient-centered, evidence-based care that respects patient and family preferences. | N L N Competencies: Relationship-Centered Care: Appreciate the patient as a whole person, with his or her own life story and ideas about the meaning of health or illness. | Nursing/Integrated Concepts: Nursing Process: Evaluation.

Learning Outcome: 10 Explain the implications of various barriers that lesbian, bisexual, and transgender women face and how they can negatively impact healthcare access and outcomes.

M N L L O: Demonstrate understanding of social issues affecting women.

1. The nurse is working with a group of recent immigrants from a country in which female genital mutilation (F G M) is practiced. In order to be effective in teaching about gynecologic care in the U.S., the nurse must keep which issues in mind?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Select all that apply.

1. Women might undergo F G M willingly to support the status quo of society.
2. Women might undergo the procedure to be considered for marriage.
3. Women who immigrate to other countries feel a sense pride once the procedure has been performed.
4. Women might undergo the procedure to gain greater sexual pleasure.
5. Women might undergo the procedure to lose their virginity.

Page Ref: 135

Cognitive Level: Applying

Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: Q S E N Competencies: Ⅰ. B. 1. Elicit patient values, preferences, and expressed needs as part of clinical interview, implementation of care plan and evaluation of care. | A A C N Essentials Competencies: Ⅸ. 1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches. | N L N Competencies: Relationship-Centered Care: Appreciate the patient as a whole person, with his or her own life story and ideas about the meaning of health or illness. | Nursing/Integrated Concepts: Nursing Process: Planning.

Learning Outcome: 11 Discuss the cultural and healthcare implications of female genital mutilation.

M N L L O: Demonstrate understanding of social issues affecting women.

1. The community nurse is conducting health assessments at the homeless shelter and notes that the majority of clients are female. What should the nurse identify as reasons for the percentage of women who are homeless?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Select all that apply.

1. Unemployment
2. Substance abuse
3. Recent prison release
4. Lack of family support
5. Inadequate child support

Page Ref: 123

Cognitive Level: Analyzing

Client Need/Sub: Psychosocial Integrity

Standards: Q S E N Competencies: Ⅰ. A. 1. Integrate understanding of multiple dimensions of patient-centered care. | A A C N Essentials Competencies: Ⅸ. 5. Deliver compassionate, patient-centered, evidence-based care that respects patient and family preferences. | N L N Competencies: Context and Environment: Practice: conduct population-based transcultural health assessments and interventions. | Nursing/Integrated Concepts: Assessment: Nursing Process.

Learning Outcome: 6 Specify the factors that commonly contribute to many older women's economic vulnerability.

M N L L O: Demonstrate understanding of social issues affecting women.

1. While visiting the home of a single patient who is raising school-age children, the nurse becomes concerned that the quality of care for the children after school is less than adequate. What did the nurse observe that led to this conclusion?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Select all that apply.

1. Children fighting in the front yard
2. Youngest child failing spelling and arithmetic
3. Middle child received an A on a writing assignment
4. Youngest child received a black eye from a child in school
5. Oldest child riding the bicycle in the street without a helmet

Page Ref: 122

Cognitive Level: Analyzing

Client Need/Sub: Psychosocial Integrity

Standards: Q S E N Competencies: Ⅰ. A. 1. Integrate understanding of multiple dimensions of patient-centered care. | A A C N Essentials Competencies: Ⅸ. 5. Deliver compassionate, patient-centered, evidence-based care that respects patient and family preferences. | N L N Competencies: Context and Environment: Practice; conduct population-based transcultural health assessments and interventions. | Nursing/Integrated Concepts: Evaluation: Nursing Process.

Learning Outcome: 3 Discuss the impact of poverty on women's access to healthcare.

M N L L O: Demonstrate understanding of social issues affecting women.

1. At the end of a routine examination, a 68-year-old female asks the nurse what she should observe to determine if she should obtain custody of her two preschool-age grandchildren. What factors should the nurse tell this patient to look for?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Select all that apply.

1. Parental divorce
2. Long work hours
3. Drug or alcohol abuse
4. Intimate partner violence
5. Use of public transportation

Page Ref: 127

Cognitive Level: Analyzing

Client Need/Sub: Psychosocial Integrity

Standards: Q S E N Competencies: Ⅰ. A. 1. Integrate understanding of multiple dimensions of patient-centered care. | A A C N Essentials Competencies: Ⅸ. 5. Deliver compassionate, patient-centered, evidence-based care that respects patient and family preferences. | N L N Competencies: Context and Environment: Practice; conduct population-based transcultural health assessments and interventions. | Nursing/Integrated Concepts: Implementation: Nursing Process.

Learning Outcome: 6 Specify the factors that commonly contribute to many older women's economic vulnerability.

M N L L O: Demonstrate understanding of social issues affecting women.

1. An older patient is demonstrating a new onset of confusion and forgetfulness. While reviewing the patient's medical records, the nurse suspects these new manifestations are drug-induced. Which medications did the nurse identify as causing changes in cognitive functioning in this patient?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Select all that apply.

1. Antihistamine for allergies
2. Antidepressant for nerve pain
3. Antibiotic for bronchial infection
4. Anticoagulant for atrial fibrillation
5. Antihypertensive for high blood pressure

Page Ref: 131

Cognitive Level: Analyzing

Client Need/Sub: Physiological Integrity: Pharmacological and Parenteral Therapies

Standards: Q S E N Competencies: Ⅰ. A. 1. Integrate understanding of multiple dimensions of patient-centered care. | A A C N Essentials Competencies: Ⅸ. 3. Implement holistic, patient-centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management and nursing management across the health-illness continuum, across the lifespan, and in all healthcare settings. | N L N Competencies: Context and Environment: Practice: conduct population-based transcultural health assessments and interventions. | Nursing/Integrated Concepts: Assessment: Nursing Process.

Learning Outcome: 8 Discuss possible adverse outcomes that may occur as a result of aging on a woman's health and healthcare.

M N L L O: Demonstrate understanding of social issues affecting women.

1. While conducting a health interview, the nurse suspects that a middle-aged female client has undiagnosed learning disabilities. What did the nurse observe to make this clinical determination?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Select all that apply.

1. Difficulty reading instructions
2. Illegible signature on treatment forms
3. Difficulty tying shoes when eyeglasses are not being worn
4. Inability to hear normal conversation through the right ear
5. Inability to select correct paper money to pay the insurance co-pay

Page Ref: 132

Cognitive Level: Analyzing

Client Need/Sub: Psychosocial Integrity

Standards: Q S E N Competencies: Ⅰ. A. 1. Integrate understanding of multiple dimensions of patient-centered care. | A A C N Essentials Competencies: Ⅸ. 3. Implement holistic, patient-centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management and nursing management across the health-illness continuum, across the lifespan, and in all healthcare settings. | N L N Competencies: Context and Environment: Practice; conduct population-based transcultural health assessments and interventions. | Nursing/Integrated Concepts: Evaluation: Nursing Process.

Learning Outcome: 9 Identify the five types of disability and their impact on quality of life for disabled women.

M N L L O: Demonstrate understanding of social issues affecting women.

1. The nurse is concerned that a clinic patient is at risk for experiencing poverty. Which information did the nurse use to make this clinical determination?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Select all that apply.

1. Of African-American descent
2. Attends church on Sunday mornings
3. Completed only up to 10th grade
4. Raising 2 children under the age of 10 alone
5. Works as a clothing assistant in a retail store

Page Ref: 121

Cognitive Level: Analyzing

Client Need/Sub: Psychosocial Integrity

Standards: Q S E N Competencies: Ⅰ. A. 1. Integrate understanding of multiple dimensions of patient-centered care. | A A C N Essentials Competencies: Ⅸ 1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches. | N L N Competencies: Context and Environment: Practice; conduct population-based transcultural health assessments and interventions. | Nursing/Integrated Concepts: Assessment.

Learning Outcome: 1 Discuss the meaning of the phrase feminization of poverty and its impact on women and their families.

M N L L O: Demonstrate understanding of social issues affecting women.

1. While attending a community fair the nurse is surprised to learn the number of women who are homemakers, teachers, and nurses. What impact should the nurse recognize that this has on these individuals' income?
2. Potential for longer lifespan
3. Overall lower income than men
4. Reduced risk for chronic illnesses
5. Increased risk for health problems

Page Ref: 124—125

Cognitive Level: Analyzing

Client Need/Sub: Psychosocial Integrity

Standards: Q S E N Competencies: Ⅰ. A. 1. Integrate understanding of multiple dimensions of patient-centered care. | A A C N Essentials Competencies: Ⅸ 1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches. | N L N Competencies: Context and Environment: Practice; conduct population-based transcultural health assessments and interventions. | Nursing/Integrated Concepts: Assessment.

Learning Outcome: 2 Identify contributing factors that perpetuate the gender wage gap and economic inequality for women.

M N L L O: Demonstrate understanding of social issues affecting women.

1. A female is offered a position as a manager with a major city hotel that offers flexibility with childcare and family issues. What should this individual also investigate financially before accepting this position?
2. Number of sick days
3. Expectations to work holidays
4. Number of overtime hours expected to work every month
5. Wages that are commensurate with those of male employee managers

Page Ref: 124—125

Cognitive Level: Analyzing

Client Need/Sub: Psychosocial Integrity

Standards: Q S E N Competencies: Ⅰ. A. 1. Integrate understanding of multiple dimensions of patient-centered care. | A A C N Essentials Competencies: Ⅸ 1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches. | N L N Competencies: Context and Environment: Practice; conduct population-based transcultural health assessments and interventions. | Nursing/Integrated Concepts: Assessment.

Learning Outcome: 2 Identify contributing factors that perpetuate the gender wage gap and economic inequality for women.

M N L L O: Demonstrate understanding of social issues affecting women.

1. A patient requiring back surgery wants to take family/medical leave to recover but is not sure if she is eligible. What should the nurse review as eligibility requirements for this coverage?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Select all that apply.

1. Work more than 25 hours per week
2. Have been in the job for at least 1 year
3. Be expected to return to work within 4 weeks
4. Be willing to accept a lower-paying position upon return
5. Have provisions to self-pay for health insurance while off from work

Page Ref: 125

Cognitive Level: Applying

Client Need/Sub: Psychosocial Integrity

Standards: Q S E N Competencies: Ⅰ. A. 1. Integrate understanding of multiple dimensions of patient-centered care. | A A C N Essentials Competencies: Ⅸ 3. Implement holistic, patient-centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management and nursing management across the health-illness continuum, across the lifespan, and in all healthcare settings. | N L N Competencies: Context and Environment: Practice; conduct population-based transcultural health assessments and interventions. | Nursing/Integrated Concepts: Implementation.

Learning Outcome: 4 Describe the implications of the Family and Medical Leave Act (F M L A) of 1993 on maternity and paternity leave and how this has impacted families.

M N L L O: Demonstrate understanding of social issues affecting women.

1. The elderly parent of an employee at an insurance company sustains a myocardial infarction and needs assistance for several weeks after returning home from the hospital. What option should the employee consider to cover her absence while caring for her parent?
2. Sick days
3. Personal days
4. Vacation days
5. Family medical leave

Page Ref: 125

Cognitive Level: Analyzing

Client Need/Sub: Psychosocial Integrity

Standards: Q S E N Competencies: Ⅰ. A. 1. Integrate understanding of multiple dimensions of patient-centered care. | A A C N Essentials Competencies: Ⅸ 1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches. | N L N Competencies: Context and Environment: Practice; conduct population-based transcultural health assessments and interventions. | Nursing/Integrated Concepts: Assessment.

Learning Outcome: 4 Describe the implications of the Family and Medical Leave Act (F M L A) of 1993 on maternity and paternity leave and how this has impacted families.

M N L L O: Demonstrate understanding of social issues affecting women.

1. During a routine prenatal visit the nurse suspects that a patient in the 14th week of gestation is affected by environmental pollution. What assessment findings caused the nurse to come to this conclusion?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Select all that apply.

1. Headache
2. Scratchy throat
3. Chest wheezing
4. Abdominal pain
5. Itchy burning eyes

Page Ref: 128

Cognitive Level: Analyzing

Client Need/Sub: Psychosocial Integrity

Standards: Q S E N Competencies: Ⅰ. A. 1. Integrate understanding of multiple dimensions of patient-centered care. | A A C N Essentials Competencies: Ⅸ 1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches. | N L N Competencies: Context and Environment: Practice; conduct population-based transcultural health assessments and interventions. | Nursing/Integrated Concepts: Assessment.

Learning Outcome: 5 Identify potential adverse outcomes associated with environmental hazards in the workplace or the home of a woman of childbearing age.

M N L L O: Demonstrate understanding of social issues affecting women.

1. An older female patient is concerned about the finances needed to run her home. What event in this person's life should the nurse realize is causing her financial concern?
2. Change in the number of prescribed medications
3. Recent death of spouse after a long and costly illness
4. Participation in activities at the community center
5. Relocation of older children to another city

Page Ref: 129—130

Cognitive Level: Analyzing

Client Need/Sub: Psychosocial Integrity

Standards: Q S E N Competencies: Ⅰ. A. 1. Integrate understanding of multiple dimensions of patient-centered care. | A A C N Essentials Competencies: Ⅸ 1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches. | N L N Competencies: Context and Environment: Practice; conduct population-based transcultural health assessments and interventions. | Nursing/Integrated Concepts: Assessment.

Learning Outcome: 6 Specify the factors that commonly contribute to many older women's economic vulnerability.

M N L L O: Demonstrate understanding of social issues affecting women.

1. An older person contacts the emergency medical service at 11 P M to report that she has been left sitting in her wheelchair all day after her caregiver left in the morning to buy groceries. What type of elder abuse is this person experiencing?
2. Abandonment
3. Physical abuse
4. Financial abuse
5. Psychological abuse

Page Ref: 130

Cognitive Level: Analyzing

Client Need/Sub: Psychosocial Integrity

Standards: Q S E N Competencies: Ⅰ. A. 1. Integrate understanding of multiple dimensions of patient-centered care. | A A C N Essentials Competencies: Ⅸ 1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches. | N L N Competencies: Context and Environment: Practice; conduct population-based transcultural health assessments and interventions. | Nursing/Integrated Concepts: Assessment.

Learning Outcome: 7 Identify the four different types of elder abuse and the detrimental impact they have on older women.

M N L L O: Demonstrate understanding of social issues affecting women.

1. The nurse determines that a patient in the clinic has a learning disability. What did the nurse assess to make this clinical determination?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Select all that apply.

1. Dyslexia
2. Dysgraphia
3. Hearing loss
4. Osteoarthritis
5. Bilateral cataracts

Page Ref: 132

Cognitive Level: Analyzing

Client Need/Sub: Psychosocial Integrity

Standards: Q S E N Competencies: Ⅰ. A. 1. Integrate understanding of multiple dimensions of patient-centered care. | A A C N Essentials Competencies: Ⅸ 1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches. | N L N Competencies: Context and Environment: Practice; conduct population-based transcultural health assessments and interventions. | Nursing/Integrated Concepts: Assessment.

Learning Outcome: 9 Identify the five types of disability and their impact on quality of life for disabled women.

M N L L O: Demonstrate understanding of social issues affecting women.

1. A 24-year-old patient with an intellectual disability at 30 weeks' gestation asks when it is safe to have an abortion. How should the nurse respond to this patient?
2. "Have you been hiding your pregnancy?"
3. "The safe time to end a pregnancy has passed."
4. "Is it safe for me to assume that you don't want to have this baby?"
5. "I guess you didn't realize that an abortion should have occurred months ago."

Page Ref: 131—132

Cognitive Level: Applying

Client Need/Sub: Psychosocial Integrity

Standards: Q S E N Competencies: Ⅰ. A. 1. Integrate understanding of multiple dimensions of patient-centered care. | A A C N Essentials Competencies: Ⅸ 5. Deliver compassionate, patient-centered, evidence-based care that respects patient and family preferences. | N L N Competencies: Context and Environment: Practice; conduct population-based transcultural health assessments and interventions. | Nursing/Integrated Concepts: Implementation.

Learning Outcome: 9 Identify the five types of disability and their impact on quality of life for disabled women.

M N L L O: Demonstrate understanding of social issues affecting women.

1. An older female patient with a known intellectual disability is newly diagnosed with osteoporosis and admitted with a fractured hip after falling in the home. What should the nurse realize could have contributed to this patient's health problem?
2. Importance of resting during the day
3. Need to reduce the amount of physical activity
4. Understanding home environmental safety needs
5. Reducing the oral intake of protein and carbohydrates

Page Ref: 133

Cognitive Level: Analyzing

Client Need/Sub: Psychosocial Integrity

Standards: Q S E N Competencies: Ⅰ. A. 1. Integrate understanding of multiple dimensions of patient-centered care. | A A C N Essentials Competencies: Ⅸ 1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches. | N L N Competencies: Context and Environment: Practice; conduct population-based transcultural health assessments and interventions. | Nursing/Integrated Concepts: Assessment.

Learning Outcome: 9 Identify the five types of disability and their impact on quality of life for disabled women.

M N L L O: Demonstrate understanding of social issues affecting women.

1. The nurse notes that a lesbian client who recently found a breast lump on self-examination has not had a mammogram for 10 years. When asked about this delay the client states that she was not made to feel comfortable during the last mammogram. What should the nurse recognize is the underlying problem that this client is describing?
2. Social barrier
3. Emotional barrier
4. Fear of finding a health problem
5. Discomfort with the examination

Page Ref: 134

Cognitive Level: Analyzing

Client Need/Sub: Psychosocial Integrity

Standards: Q S E N Competencies: Ⅰ. A. 1. Integrate understanding of multiple dimensions of patient-centered care. | A A C N Essentials Competencies: Ⅸ 1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches. | N L N Competencies: Context and Environment: Practice; conduct population-based transcultural health assessments and interventions. | Nursing/Integrated Concepts: Assessment.

Learning Outcome: 10 Explain the negative implications of homophobia for lesbian and bisexual women and how it can negatively impact healthcare access and outcomes.

M N L L O: Demonstrate understanding of social issues affecting women.

1. A lesbian female is surprised to learn of contracting the human papillomavirus. What should the nurse explain to this patient?
2. "Are you telling me everything about your sexual orientation?"
3. "It is rare for this infection to occur in women such as yourself."
4. "Is it possible that your partner has been having intercourse with a man?"
5. "Exposure to vaginal secretions can increase the risk of sexually transmitted infections."

Page Ref: 135

Cognitive Level: Applying

Client Need/Sub: Psychosocial Integrity

Standards: Q S E N Competencies: Ⅰ. A. 1. Integrate understanding of multiple dimensions of patient-centered care. | A A C N Essentials Competencies: Ⅸ 5. Deliver compassionate, patient-centered, evidence-based care that respects patient and family preferences. | N L N Competencies: Context and Environment: Practice; conduct population-based transcultural health assessments and interventions. | Nursing/Integrated Concepts: Implementation.

Learning Outcome: 10 Explain the negative implications of homophobia for lesbian and bisexual women and how it can negatively impact healthcare access and outcomes.

M N L L O: Demonstrate understanding of social issues affecting women.

1. A patient with female genital mutilation is being prepared for a gynecologic examination. What cultural implications should the nurse keep in mind when assisting with this examination?
2. Maintain a nonjudgmental attitude
3. The procedure was performed by choice
4. The patient is at increased risk for genital infection
5. The procedure was performed to increase sexual satisfaction

Page Ref: 135

Cognitive Level: Applying

Client Need/Sub: Psychosocial Integrity

Standards: Q S E N Competencies: Ⅰ. A. 1. Integrate understanding of multiple dimensions of patient-centered care. | A A C N Essentials Competencies: Ⅸ 5. Deliver compassionate, patient-centered, evidence-based care that respects patient and family preferences. | N L N Competencies: Context and Environment: Practice; conduct population-based transcultural health assessments and interventions. | Nursing/Integrated Concepts: Implementation.

Learning Outcome: 11 Discuss the cultural and healthcare implications of female genital mutilation.

M N L L O: Demonstrate understanding of social issues affecting women.