REFLECTIVE PRACTICE USING CRITICAL
THINKING SKILLS
Sample Answers
1.What should be the focus of the nursing care plan
developed for Ms. Leming?
The immediate focus should be the health habits of
the mother and their effect on the fetus. Ms. Lem-
ing’s nursing care plan should include patient
teaching regarding the detrimental effects of smok-
ing and drinking alcohol on the fetus, and the
necessity to control nausea and eat a proper diet.
Ms. Leming could benefit from a referral to counsel-
ing and/or social services.
2.What would be a successful outcome for this
patient?
By end of visit, Ms. Leming states that she values
her health and the health of her fetus enough to
stop smoking and drinking alcohol.
By next visit, Ms. Leming reports that her nausea is
under control and she is able to eat three healthy
meals a day.
3.What intellectual, technical, interpersonal, and/or
ethical/legal competencies are most likely to bring
about the desired outcome?
Intellectual: knowledge of the developmental needs
of fetuses and the effects of maternal behaviors,
such as smoking and alcohol consumption on the
fetus
Technical: ability to provide the technical nursing
assistance necessary to assess and meet the needs
of a pregnant woman and her fetus
Interpersonal: ability to demonstrate nonjudgmen-
tal attitude when interacting in potentially
emotionally charged situations, such as a high-risk
pregnancy
Ethical/Legal: knowledge of the nurse’s legal and
ethical obligations in cases of maternal–fetal
conflict
4.What resources might be helpful for Ms. Leming?
Counseling services, social services, community
services, support groups, printed materials on
healthy pregnancy behaviors
CHAPTER 20
PRACTICING FOR NCLEX
MULTIPLE CHOICE QUESTIONS
1.c 2.a 3.d 4.b 5.c
6.a 7.d 8.b 9.b
ALTERNATE-FORMAT QUESTIONS
Multiple Response Questions
1.c, e, f
2.a, c, d, e
3.a, b, e, f
4.c, d, e
5.a, c, f
DEVELOPING YOUR KNOWLEDGE BASE
FILL-IN-THE-BLANKS
1.Cross-linkage
2.40 to 65 years
3.Sandwich generation
4.60 to 74, 75 to 84, 85 and older
5.Ageism
6.Identity-continuity
7.Life review, reminiscence
8.Alzheimer’s disease
9.Reality orientation
10.Gerontology
SHORT ANSWER
- a.Middle adulthood:
Physiologic development: The early years are
marked by maximum physical development and
functioning. As time passes, gradual internal and
external changes occur.
Psychosocial development: Usually a time of
increased personal freedom, economic stability,
social relationships, increased responsibility, and
awareness of one’s own mortality
Cognitive, moral, and spiritual development:
Intellectual abilities change from those of the
young adult. There is increased motivation to
learn. Problem-solving abilities remain, although
response time may be slightly longer.
b.Older adulthood:
Physiologic development: The process of aging
becomes more rapid. All organ systems undergo
some degree of decline, and the body becomes
less efficient.
Psychosocial development: Most continue their
activities from middle adulthood and adapt intu-
itively to gradual limitations of aging.
Cognitive, moral, and spiritual development: Cog-
nition does not change appreciably with aging; an
older adult continues to learn and solve problems,
and intelligence and personality remain consistent.
2.Sample answers:
a.Complete physical examination every 2 years
b.Annual dental examination
c. Eye examination every 1 to 2 years
d.Maintenance of current immunizations
e.Cancer screening for women - a.Genetic theory: Explains that life span depends
to a great extent on genetic factors
b.Immunity theory: Focuses on the functions of
the immune system, which declines steadily
after young adulthood
c. Cross-linkage theory: As one ages, cross-links
accumulate, leading to essential molecules in the
cell binding together and interfering with
normal cell function.
d.Free radical theory: Free radicals formed during
cellular metabolism are molecules with separated
high-energy electrons that can have adverse
effects on and attack adjacent molecules.
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ANSWER KEY 357
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