CMCA q and a
Lauren Maxwell is aware she's been showing some narcissism since becoming pregnant. How would you describe this phenomenon to an unlicensed care provider?
Her thoughts tend to be mainly about herself
John is 6 years old. You should teach his parents that which of his body systems should be reaching its peak point of development at this time?
His lymphatic system
John, 6 years old, is a school-age child. According to Erikson, health promotion activities should integrate what developmental task of this period?
How to do things well
Chapter 1
A Framework for Maternal and Child Health Nursing
Lauren wasn't totally happy about learning that she was pregnant. What psychological task is important for the woman to complete during the first trimester of her pregnancy?
Accepting the fact that she is pregnant
12.3 Almost all women experience a number of minor discomforts during pregnancy. To investigate whether these symptoms are serious enough to lead to depression, researchers scored 1,507 Australian women during their first pregnancy on a depression inventory questionnaire. The women who were also asked what minor body changes they were experiencing. The most frequent body changes reported were exhaustion (86.9%), morning nausea (64.3%), back pain (45.6%), constipation (43.5%), and severe headache or migraine (29.5%). Women who reported five or more physical health problems were three times more likely to also report depressive (Perlen et al., 2013). Based on the previous study, which statement by Julberry would give you the most concern that she should be assessed at her next prenatal visit as to whether she could be depressed?
"Between the headache, the backache, and the nausea, pregnancy isn't fun."
7.6 Melissa Chung is concerned as to how she will give consent for procedures for her newborn baby because the baby is hospitalized so far away. Which statement would be best to reassure her?
"Consent is required: you can be contacted by telephone or e-mail for a long distance consultation".
Melissa Chung is concerned as to how she will give consent for procedures for her newborn baby because the baby is hospitalized so far away. Which statement would be best to reassure her?
"Consent is required: you can be contacted by telephone or e-mail for a long distance consultation".
16.2 To investigate if listening to music can help women feel less pain and anxiety in labor, researchers assigned 30 primiparas expected to have a normal spontaneous births to either an experimental group that received routine labor care or a control group that received routine care plus music therapy. Both women and their nurses assessed the degree of pain experienced during labor. Results of the study revealed women who listened to music has significantly lowered pain during the latent phase of labor. No significant differences were found between the two groups during the active phase od labor (Liu,Chang, & Chen,2010 ). Based on this study, which statement by Jonny represent the best way to use music therapy in labor?
"I brought some romantic music to play during early labor to help me relax."
9.4 To investigate what the risk factors are that lead to women smoking, researchers surveyed 570 women from Appalachian Ohio as to social, demographic, and psychological factors and whether they smoked. Findings revealed women with low socioeconomic status, those who scored high on a depression assessment score, and those who had their first baby before they were 17 years of age were more likely to smoke. Almost 50% of women with both low socioeconomic status and rated as depressed smoked (Wewers, Salsberry, Ferketich, et al., 2012). Based on the previous study, which statement by Liz Calhorn would make you most worried she might have difficulty quitting smoking during the remainder of her pregnancy?
"I don't have a lot of spare cash, just like everyone else in my family."
To investigate what the risk factors are that lead to women smoking, researchers surveyed 570 women from Appalachian Ohio as to social, demographic, and psychological factors and whether they smoked. Findings revealed women with low socioeconomic status, those who scored high on a depression assessment score, and those who had their first baby before they were 17 years of age were more likely to smoke. Almost 50% of women with both low socioeconomic status and rated as depressed smoked (Wewers, Salsberry, Ferketich, et al., 2012). Based on the previous study, which statement by Liz Calhorn would make you most worried she might have difficulty quitting smoking during the remainder of her pregnancy?
"I don't have a lot of spare cash, just like everyone else in my family."
Which statement by Tori would best suggest she has developed pica?
"I eat the erasers off pencils. It helps relieve my heartburn."
You want to prepare Leana to assess her own health after discharge. Which statement by her would make you worry that she needs added information?
"I know about lochia; I'll use tampons just like I do for my periods."
17.5 Many new mothers are not prepared for how much time newborns spend crying (as many as 16 out of 24 hours); trying to quiet a newborn can lead to extreme fatigue in a postpartal parent. To investigate the effect of newborn crying on new mothers' ability to rest, researchers conducted a systematic review of studies concerned with newborn crying. Results of the literature review revealed that infant crying during the first 3 months postpartum is responsible for disrupting new mothers' circadian rhythms, reducing opportunities to rest, and exacerbating tiredness. Incremental exhaustion from infant crying diminishes a parent's ability to concentrate, raises the fear of harming the children, triggers depressive symptoms, and burdens parent-child interaction (Kurth, Kennedy, Spichiger, et al., 2011). Based on the previous study, which comment by Leana would make you worry that she may have a difficult time getting enough sleep after she returns home?
"I know that the baby will sleep just fine, because I've read everything I can about the subject."
Many new mothers are not prepared for how much time newborns spend crying (as many as 16 out of 24 hours); trying to quiet a newborn can lead to extreme fatigue in a postpartal parent. To investigate the effect of newborn crying on new mothers' ability to rest, researchers conducted a systematic review of studies concerned with newborn crying. Results of the literature review revealed that infant crying during the first 3 months postpartum is responsible for disrupting new mothers' circadian rhythms, reducing opportunities to rest, and exacerbating tiredness. Incremental exhaustion from infant crying diminishes a parent's ability to concentrate, raises the fear of harming the children, triggers depressive symptoms, and burdens parent-child interaction (Kurth, Kennedy, Spichiger, et al., 2011). Based on the previous study, which comment by Leana would make you worry that she may have a difficult time getting enough sleep after she returns home?
"I know that the baby will sleep just fine, because I've read everything I can about the subject."
28.2 Preventing obesity is a major health care goal worldwide. To determine if preschoolers are aware of what an average weight child looks like in contrast to one who is overweight, nurse researchers recruited 17 children between 4 and 5 years of age from preschool settings: each child was weighed and measured for height so their body mass index (BMI) could be calculated, then shown images of children of various body shapes and sizes. All the children were able to correctly identify the body shape that depicted ab overweight child as if they understood the concept of overweight. When asked if they liked their own body shape, however even those who were overweight, answered "yes" or apparently had difficulty applying the concept of overweight to themselves (Burgees & Broome,2012). Based on this study, which statement by John, who is overweight (as his mother), would be typical?
"I like the way I look in my uniform"
Preventing obesity is a major health care goal worldwide. To determine if preschoolers are aware of what an average weight child looks like in contrast to one who is overweight, nurse researchers recruited 17 children between 4 and 5 years of age from preschool settings; each child was weighed and measured for height so their body mass index (BMI) could be calculated, then shown images of children of various body shapes and sizes. All the children were able to correctly identify the body shape that depicted an overweight child as if they understood the concept of overweight. When asked if they liked their own body shape, however, even those who were overweight, answered, "yes" or apparently had diffi culty applying the concept of overweight to themselves (Burgess & Broome, 2012). Based on the study, which statement by John, who is overweight (as is his mother), would be typical?
"I like the way I look in my uniform."
15.3 Labor and birth can be such overwhelming events that between 1% and 6% of women develop PTSD after childbirth. "Hotspots" are moments of extreme distress that strongly influence the development of PTSD. To find what are the hotspots in labor, researchers asked 675 women who experienced a difficult or traumatic birth to complete a questionnaire describing their labor and birth experience. Of the women, 67% reported at least one hotspot during birth and 52.9% had reexperiencing anxiety of these hotspots. Women were more likely to have PTSD if hotspots involved fear and lack of control or if the hotspots concerned interpersonal difficulties or maternal complications compared to complications with the baby (Harris & Ayers, 2012). Based on the previous study, which statement by Celeste would worry you most that labor could be becoming traumatic for her?
"I'm feeling as if I'm losing a grasp on things."
Labor and birth can be such overwhelming events that between 1% and 6% of women develop PTSD after childbirth. "Hotspots" are moments of extreme distress that strongly influence the development of PTSD. To find what are the hotspots in labor, researchers asked 675 women who experienced a difficult or traumatic birth to complete a questionnaire describing their labor and birth experience. Of the women, 67% reported at least one hotspot during birth and 52.9% had reexperiencing anxiety of these hotspots. Women were more likely to have PTSD if hotspots involved fear and lack of control or if the hotspots concerned interpersonal difficulties or maternal complications compared to complications with the baby (Harris & Ayers, 2012). Based on the previous study, which statement by Celeste would worry you most that labor could be becoming traumatic for her?
"I'm feeling as if I'm losing a grasp on things."
10.1 How women feel about being pregnant has a great deal to do with how anxious they are about becoming pregnant. To investigate whether women look forward to a second birth or whether ✔ anxiety about their first birth makes them reluctant to have a second child, researchers interviewed 908 women who had given birth to at least one child, asking them to "please describe your feelings when you think about giving birth in the future." Results showed that two thirds of women who responded had mostly positive feelings; one third of women stated they were frightened of future childbirth. The qualitative analysis resulted in an overall theme of women feeling a mixture of both dread and delight at the thought of a second pregnancy (Rilby, Jansson, Lindblom, et al., 2012). Based on the previous study, which statement by Lauren would make you believe she's having a typical reaction to her second pregnancy?
"I'm feeling good about having a second baby, but a bit worried at the same time."
How women feel about being pregnant has a great deal to do with how anxious they are about becoming pregnant. To investigate whether women look forward to a second birth or whether ✔ anxiety about their first birth makes them reluctant to have a second child, researchers interviewed 908 women who had given birth to at least one child, asking them to "please describe your feelings when you think about giving birth in the future." Results showed that two thirds of women who responded had mostly positive feelings; one third of women stated they were frightened of future childbirth. The qualitative analysis resulted in an overall theme of women feeling a mixture of both dread and delight at the thought of a second pregnancy (Rilby, Jansson, Lindblom, et al., 2012). Based on the previous study, which statement by Lauren would make you believe she's having a typical reaction to her second pregnancy?
"I'm feeling good about having a second baby, but a bit worried at the same time."
14.3 One of the most controversial aspects of childbirth addresses the question of the best birth position for women to use. To evaluate the impact of birth position on maternal and newborn well-being, researchers reviewed 40 studies on birth position published over the past 15 years. The results showed both physical and psychological benefits for women when they are able to adopt positions other than on their back for labor. Women allowed to birth in an upright position had a shorter duration of the first and second stages of labor, experienced less medical intervention, and reported less severe pain; they also had an increased rate of satisfaction with their childbirth experience than women who gave birth in a semi-recumbent or supine/lithotomy position. The only disadvantage identified of an upright position was increased blood loss during the third stage of labor, which may be due to increased perineal edema caused by the upright position (Priddis, Dahlen, & Schmied, 2011). Based on the previous study, what would you like to see included in Elena's birth plan?
"I'm willing to try anything safe that will make my labor shorter."
One of the most controversial aspects of childbirth addresses the question of the best birth position for women to use. To evaluate the impact of birth position on maternal and newborn well-being, researchers reviewed 40 studies on birth position published over the past 15 years. The results showed both physical and psychological benefits for women when they are able to adopt positions other than on their back for labor. Women allowed to birth in an upright position had a shorter duration of the first and second stages of labor, experienced less medical intervention, and reported less severe pain; they also had an increased rate of satisfaction with their childbirth experience than women who gave birth in a semi-recumbent or supine/lithotomy position. The only disadvantage identified of an upright position was increased blood loss during the third stage of labor, which may be due to increased perineal edema caused by the upright position (Priddis, Dahlen, & Schmied, 2011). Based on the previous study, what would you like to see included in Elena's birth plan?
"I'm willing to try anything safe that will make my labor shorter."
Elena, 30 years of age, shows you the birth plan that she has drafted. Which statement by her would help assure you that she has a workable plan?
"I've tried to keep it flexible because I know circumstances can change."
13.3 Gaining too much weight in pregnancy can lead to complications in the mother such as gestational diabetes; in addition, the fetus can gain excess weight with possible long-term weight problems. To see how much weight gain women perceived they needed in pregnancy, nurse researchers surveyed 54 women who were less than 20 weeks pregnant. Results of the questionnaire showed 39% of the women were overweight or obese before pregnancy. Daily caloric intake ranged from 599 to 5,856 calories. Women in all racial/ethnic groups were taking in less than recommended amounts of protein, carbohydrates, calcium, iron, folate, and fi ber. Central American Hispanic women were the group who perceived they needed to gain the most weight for a healthy pregnancy; Caribbean black women, as a group, perceived they needed to gain the least weight (Brooten, Youngblut, Golembeski, et al., 2012). Based on the previous study, which showed the average woman was taking in less nutrients than required during pregnancy, how would you advise Tori about what foods she should eat during pregnancy?
"Make sure that you work plenty of leafy green vegetables into your diet."
Gaining too much weight in pregnancy can lead to complications in the mother such as gestational diabetes; in addition, the fetus can gain excess weight with possible long-term weight problems. To see how much weight gain women perceived they needed in pregnancy, nurse researchers surveyed 54 women who were less than 20 weeks pregnant. Results of the questionnaire showed 39% of the women were overweight or obese before pregnancy. Daily caloric intake ranged from 599 to 5,856 calories. Women in all racial/ethnic groups were taking in less than recommended amounts of protein, carbohydrates, calcium, iron, folate, and fi ber. Central American Hispanic women were the group who perceived they needed to gain the most weight for a healthy pregnancy; Caribbean black women, as a group, perceived they needed to gain the least weight (Brooten, Youngblut, Golembeski, et al., 2012). Based on the previous study, which showed the average woman was taking in less nutrients than required during pregnancy, how would you advise Tori about what foods she should eat during pregnancy?
"Make sure that you work plenty of leafy green vegetables into your diet."
33.5 It has long been theorized there nay be a "gateway" drug or one that, when used first, leads to further and more dangerous substance abuse. To determine whether alcohol, tobacco, or marijuana was the gateway drug, researchers obtained information on the drug use of a nationally representative sample of high school seniors. Results of the study showed alcohol was the gateway drug, leading to tobacco, marijuana, and then other illicit substances. Based on the previous study, which statement by Raul would give you the most concern?
"My parents said I could celebrate my next birthday by drinking my first beer"
Mrs. Chung waited until she was 42 to have her second baby. She asks you if that is the reason her baby was born prematurely. Which of the ff. would be the best reassuring statement for her?
"No one can say for certain. You did all you could to ensure a heathy pregnancy".
11.1 One of the first things a woman who suspects she is pregnant must do is choose a primary health care provider to guide her through her pregnancy. Many women ask, "What type of care provider should I choose?" To investigate whether pregnancy care and outcomes differed when women chose a nurse-midwife rather than a physician as their primary care provider, researchers interviewed a sample of 6,421 Canadian women, all 15 years of age or older, all who had given birth to a singleton baby, and all who were living with their infant. Results of the study showed women whose primary prenatal care provider was a nurse-midwife were more likely to be satisfied with their maternity experience and information provided on pregnancy and birth topics. They were prescribed fewer ultrasounds and were more likely to attend prenatal classes. They were almost half as likely to have labor induced and 7.33 times more likely to experience a medication-free birth. Postpartally, they were more likely to initiate and maintain breastfeeding at 3 and 6 months (O'Brien, Chalmers, Fell, et al., 2011). Based on the previous study, if Sandra asks you if she should choose a nurse-midwife as her primary care provider, what would your best answer be?
"Nurse-midwives tend to use less medication with birth. Is that important to you?"
One of the first things a woman who suspects she is pregnant must do is choose a primary health care provider to guide her through her pregnancy. Many women ask, "What type of care provider should I choose?" To investigate whether pregnancy care and outcomes differed when women chose a nurse-midwife rather than a physician as their primary care provider, researchers interviewed a sample of 6,421 Canadian women, all 15 years of age or older, all who had given birth to a singleton baby, and all who were living with their infant. Results of the study showed women whose primary prenatal care provider was a nurse-midwife were more likely to be satisfied with their maternity experience and information provided on pregnancy and birth topics. They were prescribed fewer ultrasounds and were more likely to attend prenatal classes. They were almost half as likely to have labor induced and 7.33 times more likely to experience a medication-free birth. Postpartally, they were more likely to initiate and maintain breastfeeding at 3 and 6 months (O'Brien, Chalmers, Fell, et al., 2011). Based on the previous study, if Sandra asks you if she should choose a nurse-midwife as her primary care provider, what would your best answer be?
"Nurse-midwives tend to use less medication with birth. Is that important to you?"
You are helping Tori evaluate some of the claims on a Web site that is aimed at pregnant women. Which statement from the Web site is most accurate?
"Orange juice is an acceptable beverage to take with your iron pills."
Celeste Bailey didn't recognize for over an hour that she was in labor. During her prenatal education, Celeste should have been taught to recognize which sign of true labor?
"Show" or release of the cervical mucus plug
Liz Calhorn asks you why her nurse midwife is concerned whether her fetus's lungs are producing surfactant. Your best answer would be:
"Surfactant keeps lungs from collapsing at birth, so it aids newborn breathing."
Beth Ruiz has milia on her nose. What teaching point would constitute a safety risk?
"These will disappear on their own, so you don't need to take any action."
Liz Calhorn is scheduled to have an amniocentesis to test for fetal maturity. To help make sure the procedure is successful, what instruction would be best to give her before this procedure?
"Void (pee) immediately before the procedure to reduce the size of your bladder."
Liz Calhorn is scheduled to have an ultrasound examination and you want to ensure that she understands and is prepared for this procedure to mitigate her anxiety. What instruction would you give her before her examination?
"You will need to drink at least three glasses of water before the procedure."
Lauren Maxwell's doctor told her she had a positive Chadwick's sign. When she asks you what this means, your best answer would be which of the following?
"Your vagina looks dark in color, a typical pregnancy sign."
You document the fact that Suzanne Matthews typically has a menstrual cycle of 34 days. If she had coitus on days 8, 10, 15, and 20 of her last cycle, which is the day on which she most likely conceived?
. Day 20
Tori Alarino has a BMI of 25 so is considered to be slightly overweight. The interprofessional team should recommend what range of weight gain during her pregnancy?
15-25 lb
Sandra reports that the palms of her hands are always itchy, and you notice scratches on them when you perform a physical examination. Your plan of care should specify that this problem is most likely due to what factor in women who are pregnant?
A common reaction to increasing estrogen levels
Suppose Celeste is having long and hard uterine contractions. What length of contraction would you report as indicative of a potential safety risk?
A contraction over 70 seconds in length
Lauren Maxwell did a urine pregnancy test but was surprised to learn a positive result is not a sure sign of pregnancy. As you are recording her result in her electronic health record, she asks you what would be a positive sign. You should cite what finding?
A fetal heartbeat can be seen during an ultrasound exam.
You are reviewing Sandra's electronic health record. While doing so, you ask Sandra to clarify and confirm her surgical history. Why is it important to ask Sandra about past surgery during a pregnancy health history?
Adhesions from surgery could potentially limit uterine growth
30.3 As television sets become larger and thinner, viewing becomes easier. To investigate if television sets can also be a threat to younger children, researchers reviewed a Canadian trauma database over a 15-year period as to how many emergency room visits were caused by a television set falling onto a younger child. They identified a total of 179 injuries (20 to 24) per year. Toddlers were the most frequently injured age group, and head and neck injuries were the most common consequences of a television pulled down onto a young child (Mills, Grushka & Butterworth, 2012). Based on the study and the AAP recommendations on television viewing, how would you advise Jason's parents?
Allow Jason to watch television only when a parent is free to supervise his actions.
A health history document is being modified by an interprofessional group. To obtain the most accurate nutrition history from a pregnant client such as Tori, what should the assessment document specify?
Ask the client to describe what she ate in the last 24 hours
29.5 You review infant safety with Bryan's mother. In light of your knowledge about the most common injuries among infants, it would be most important to teach her about preventing which of the following?
Aspiration and Falls
A growing body of knowledge suggests skin-to-skin contact between mother and baby immediately after birth provides numerous benefits, including regulating heartbeat and temp. for the baby and promoting feelings of calm and well-being in both mother and baby. To see if fathers were interested in participating in this form of care (often called kangaroo care), researchers interviewed seven new fathers who had spent time in skin-to-skin interaction with their newborn. Findings showed kangaroo care allowed fathers to feel more in control and also that they were doing something good for their infant (Blomqvist, Rubertsson, Kyleberg, et al., 2012) Based on the previous study, what action would you take?
Asses whether Mr. Chung is willing to try skin-to-skin care
Suppose Liz Calhorn tells you she is worried her baby will be born with a congenital heart disease. What assessment of the umbilical cord at birth would be most important to help detect congenital heart defects?
Assessing whether the umbilical cord has two arteries and one vein
Chapter 11
Assessment of a Pregnant Family
Celeste is anxious for her placenta to deliver so she can move to a rocking chair and help relieve her back pain. In order to best facilitate Celeste's wishes, which action would be best to do?
Assure her that a placenta loosens quickly so the waiting time will not be long.
Mrs. Ruiz is preparing to take her new daughter home and has asked an unlicensed care provider when Beth's dried umbilical cord will fall off. You should confirm that the care provider has stated what time?
Days 6 to 10
Lauren Maxwell overheard her doctor say insulin is not as effective during pregnancy as usual. How would you explain how decreased insulin effectiveness safeguards the health of her fetus?
Decreased effectiveness of insulin prevents the fetus from having low blood sugar.
18.6 Shaken baby syndrome, or abusive head trauma caused by a parent or caregiver shaking an infant in anger or frustration, creates a potentially lethal situation because forceful shaking can lead to subdural bleeding. To investigate whether a nurse-initiated program could reduce the incidence of abusive head trauma by shaking, nurse researchers offered an educational program including a leaflet explaining abusive head trauma, helpful ways to cope safely with an infant's crying, and an 8-minute video on the subject given to all new mothers at their hospital. Results of the study showed a decrease from 2.8 injuries per year (14 cases in 5 years prior to the intervention) to 0.7 injuries per year (2 cases in 3 years) or a 75% reduction in injuries following the intervention (Altman, Canter, Patrick, et al., 2011). You notice Mrs. Ruiz grows irritated with Beth when Beth doesn't suck readily when she begins to breastfeed. Based on the previous study, what action would be best to take?
Discuss the fact that breastfeeding is a new skill, so infants take time to learn this.
Shaken baby syndrome, or abusive head trauma caused by a parent or caregiver shaking an infant in anger or frustration, creates a potentially lethal situation because forceful shaking can lead to subdural bleeding. To investigate whether a nurse-initiated program could reduce the incidence of abusive head trauma by shaking, nurse researchers offered an educational program including a leaflet explaining abusive head trauma, helpful ways to cope safely with an infant's crying, and an 8-minute video on the subject given to all new mothers at their hospital. Results of the study showed a decrease from 2.8 injuries per year (14 cases in 5 years prior to the intervention) to 0.7 injuries per year (2 cases in 3 years) or a 75% reduction in injuries following the intervention (Altman, Canter, Patrick, et al., 2011). You notice Mrs. Ruiz grows irritated with Beth when Beth doesn't suck readily when she begins to breastfeed. Based on the previous study, what action would be best to take?
Discuss the fact that breastfeeding is a new skill, so infants take time to learn this.
31.2 Many preschoolers have difficulty falling asleep or wake during the night with nightmares. To see if changes in the type of television watched could improve preschooler's sleep, researchers encouraged half of a group of families studied to replace television watching with quality educational and prosocial video content through use of an initial home visit and follow-up telephone calls over 6 months. Among the 565 children studied, the most common sleep problem was delayed sleep onset (38%). Results at the end of 18 months showed that children in the intervention group had significantly lower odds of any sleep problems (Garrison & Christakis,2012) Based on the study, which of the following would be the best advice you could give the Edwards family?
Encourage Cathy to watch specific DVDs that her parents choose for her.
Suppose Elena follows her boyfriend's wishes and decides on a hospital birth. What would be an advantage of hospital birth that can be cited to women considering this birth setting?
Extended high-risk newborn care is available.
John, at 6 years old, is a school-age child. According to Freud, what would you want the members of your interprofessional team to know when caring for school-age children?
Freud saw the school-age period as a largely latent or inactive period.
Liz Calhorn, 18 years of age, asks how much longer her women's nurse practitioner will refer to the baby inside her as an embryo. So your team members will use terms consistently you would want them to know the conceptus is classified as an embryo at what time?
From implantation until 5 to 8 weeks
Mr. Chung's doctor has told her that her baby's most dangerous time will be until the perinatal period ends. When does the perinatal period take place?
From the 20th week of pregnancy to 4 to 6 weeks after birth
John is a school-age child but still has difficulty learning Piaget's concept of conservation. What would this imply?
He feels angry because his sister's piece of pie is long and thin where his is short and fat.
Beth Ruiz had Apgar scores of 6 at 1 minute and 8 at 5minutes after birth. Which of the following are the five areas assessed with Apgar scoring?
Heart rate, respiratory effort, muscle tone, reflex irritability, and color
Leana Cooper has expressed that she is excited to "get to know" her new baby. Which of the following actions will support Leana's transition into a postpartal taking-hold phase?
Help her to give her new baby a bath
8.2 The Carls introduce themselves to you as an "infertile" couple. As a safety measure, you would want them to understand which of the following?
If their relationship is not monogamous, they still need to use safer sex practices.
Sandra Czerinski feels healthy, so she asks you why she needs to bother coming for prenatal care. What benefi t should you cite when responding to Sandra's statement?
It provides time for education about pregnancy and birth.
Tori described what foods she eats daily. What is apt to be her greatest nutritional risk if she is a vegetarian?
Lack of vitamin B12
You are performing massage of Leana's fundus 2 days postpartum. What assessment fi nding should prompt you to contact Leana's primary care provider immediately?
Leana's uterus does not become firm when massaged.
A Moro reflex is the single best assessment of neurologic ability in a newborn. Unit protocols should specify what action for eliciting a Moro reflex in Beth?
Lift her head while she is supine and allow it to fall back 1 in
Suppose John, 6 years old, tells you his broken leg wants to get better. When you are choosing an accurate and empathic response, you should be aware that he is using what form of cognition?
Magical thinking
You observe Leana Cooper holding her newborn. Which position would best reassure you that interventions aimed at promoting bonding have been successful?
She looks directly at her infant's face and talks to him.
You care for Leana Cooper at a 6-week postpartum visit. You read in her electronic health record that her fundal height has been progressing in a healthy and predicted manner. What should her fundal height be during this current visit?
No longer palpable over the symphysis pubis
Chapter 10
Nursing Care Related to Psychological and Physiologic Changes of Pregnancy
Chapter 15
Nursing Care of a Family During Labor and Birth
Chapter 18
Nursing Care of a Family With a Newborn
Chapter 17
Nursing Care of a Postpartal Family
Chapter 9
Nursing Care of the Growing Fetus
Chapter 5
Nursing Role in Reproductive and Sexual Health
Elena's sister-in-law has referred her to a Web site that outlines the Lamaze method for labor and birth. What is the guiding principle of Lamaze childbirth?
Pain can be interrupted before it registers in the brain as pain.
Chapter 14
Preparing a Family for Childbirth and Parenting
Chapter 28
Principles of Growth and Development
You are collaborating with Celeste Bailey's obstetrician and you are planning possible interventions in light of fetal position. Which of the following fetal positions is considered ideal and is most conducive to a birth that requires few interventions by the obstetrician?
Right occipitoanterior with full flexion
You are reviewing danger signs of pregnancy with Sandra. In the interests of safety, which of the following would you tell her to report if it should occur?
She gains more than 3 lb a week beginning at 20 weeks
32.4 Shelly has told you she wants to try out for cheerleading. This is a sport appealing to school-age children and adolescents because of its combinations of dance and gymnastics, the friendships that can develop, and the school status it almost automatically creates. To investigate what type of injuries typically occur with cheerleading, researchers reviewed all cheerleading injuries (over 4,000) presented to U.S. emergency departments during a 5- year period. The types of injuries most often seen were sprains/ strains (44%), fractures (16%) and contusions (16%). The activities resulting in the most injuries were body collisions (29%), stunting (19%), tumbling (11%), and tossing (2.5%) (Jacobson, Morawa, & Bir, 2012). Based on the study, you would advise Shelly of which of the following?
She should be aware that cheerleading may be beneficial to her but does carry some risks
Elena wants to use controlled breathing for early labor and you are reviewing with her doula the actions that Elena will take. What should you review with Elena's doula about controlled breathing early in labor?
She should breathe at a rate of 6 to 12 breaths/min for mild contractions.
Elena asks you which type of exercise is best to strengthen her perineal muscles in anticipation of birth. Which of the following recommendations is safest and most effective?
Squat or tailor sit for 15 minutes out of every day.
You assess Celeste Bailey's uterine contractions and the FHR. Which of the following would you document as a late deceleration?
The FHR decreased in rate 30 seconds after the start of a contraction.
Chapter 13
The Nursing Role in Promoting Nutritional Health During Pregnancy
A nursing assistant informed the nurse that Mr. Chung asked why the hospital where his baby is being cared for is termed a "Magnet Hospital". You would want to know which rationale?
The hospital has met high standards for nursing competency
Suzzane Matthews tells you she's worried she might be subfertile because both breast development and her first menstrual period occurred later than most of her friends. To increase her self-esteem and meet her learning needs, you could assure her of what fact?
The time for development of breast varies a great deal and is termed thelarche
Nurse must always be aware of quality improvement because as society changes with new situations , nursing care must make responding adjustments. Which of the ff. is a trend that will influence the care that the Chung's family's new baby is apt to receive?
The use of multiple technologies can make parents feel overwhelmed unless they receive nursing support
Suppose Kevin Matthews tells you he is planning on having a vasectomy after the birth of his new child, but is worried about having his testes removed this way. You would want your clinic's educational material on vasectomy to clearly state that this procedure involves which of the following structures?
The vas deferens
On physical examination, Suzzane Matthews is found to have a cystocele. You should confirm that the vocational nurse who is contributing to Suzzane's care knows that a cystocele can cause which of the following?
Urinary infection from the pocket caused by pressure against the anterior vaginal wall
Beth Ruiz, like all newborns, is in danger of losing body heat by conduction. You are taking action to ensure that Beth's body temperature is maintained in order to protect her health and comfort. Under which condition is heat loss by conduction most apt to occur?
You place her on a scale that has not been prewarmed.
Sandra has not had a pelvic examination since she was in high school. Consequently, the nurse-midwife has asked you to help make her more at ease during her first prenatal pelvic examination. What nursing action should you take?
d. Teach her to breathe slowly and evenly while being examined.
