Maternal & Child Health Nursing Chapter 1

In 2007 the World Factbook published statistics that showed the United States still lagged behind other industrialized nations in the incidence of infant mortality. What is one reason that the United States has a higher infant mortality rate than other countries? A) Low birth weight B) Early prenatal care C) Low adolescent delivery rates D) Home deliveries

A) Low birth weight Many factors may be associated with high infant mortality rates and poor health. Low birth weight and late or nonexistent prenatal care are the main factors in the poor rankings in infant mortality.

To decrease childhood mortality, pediatric nurses need to consistently engage in what activity throughout all age groups? A) Teach injury prevention and proper safety practices. B) Provide guidance regarding proper nutrition. C) Help integrate exercise practices and programs into the lifestyles of individuals and communities. D) Advocate for more research into control of environmental toxins.

A) Teach injury prevention and proper safety practices. The leading cause of death throughout childhood is unintentional injury.

After teaching a group of students about the concept of maternal mortality, the instructor determines that additional teaching is needed when a student makes which statement? A) "The rate includes accidental causes for deaths." B) "It addresses pregnancy-related causes." C) "The duration of the pregnancy is a concern." D) "The time frame is typically for a specified year."

A) "The rate includes accidental causes for deaths." The maternal mortality ratio is the annual number of female deaths from any cause related to or aggravated by pregnancy or its management (excluding accidental or incidental causes) during pregnancy and childbirth or within 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy, per 100,000 live births, for a specified year.

Which nursing intervention would best demonstrate evidence-based practice in maternal-child health care? A) Family-centered pediatric care B) Minimizing parental interaction with preterm infants C) Placing adults and children with similar diseases on the same unit D) Decentralizing care to allow clients to be closer to home

A) Family-centered pediatric care Evidence-based practice has become the standard that nurses are to strive for in caring for their clients. By involving the family in caring for ill children, the child and the family are better served and have improved outcomes. Parental interaction is encouraged for preterm infants to foster bonding. Children and adults need to be separated on inpatient units to ensure that the caregivers have a clear understanding of each client's needs, since children are not small adults. Centralized care has proved to be most beneficial to client's outcomes by providing resources and specialists in one location.

A nurse is reviewing statistics about maternal and child health. Which rate would the nurse identify as reflecting the proportion of women who could have babies that are having them? A) Fertility rate B) Birth rate C) Morbidity rate D) Implantation rate

A) Fertility rate The term fertility rate, the number of pregnancies per 1,000 women of childbearing age, reflects what proportion of women who could have babies are having them. The birth rate is the number of births per 1,000 population.

A nurse is teaching women the importance of good nutrition and taking prenatal vitamins if they are planning pregnancy. Which measure is the nurse performing? A) Health promotion B) Health maintenance C) Health restoration D) Health rehabilitation

A) Health promotion Health promotion means educating clients to be aware of good health through teaching and role modeling. Health maintenance means intervening to maintain health when risk of illness is present. Health restoration is promptly diagnosing and treating illness using interventions that will return clients to wellness most rapidly. Health rehabilitation means preventing further complications from an illness, or bringing an ill client back to an optimal state of wellness or helping a client to accept inevitable death.

The family is the basic unit of society. Which statement correctly illustrates the importance of this concept related to how society functions? A) Healthy, well-functioning families provide members of all ages with fulfilling, supporting relationships. B) The family serves as a place that encourages members to autonomously function in pursuit of personal pleasures. C) Society functions best when families determine how they will interface with others without having to deal with the overall consequences. D) Work is an important part of family function but is not necessary for success if one member can fulfill multiple roles.

A) Healthy, well-functioning families provide members of all ages with fulfilling, supporting relationships. The family is the basic unit of society. In order for this to work well, members of the family must work together. Families make a central contribution to enhance the quality of our society. Families must consider how their actions will impact others, and one member cannot fulfill all roles within the family.

What is the effect of low birth weights in babies born in the United States? A) Increased infant mortality rates B) Higher states of obesity in adulthood C) Higher costs of care D) Fewer deliveries in hospitals

A) Increased infant mortality rates Many factors may be associated with high infant mortality rates and poor health. Low birth weight and late or nonexistent prenatal care are main factors in the poor rankings in infant mortality.

A 16-year-old child is admitted to the hospital for treatment after a motor vehicle crash. Review of the child's record reveals that the child is an emancipated minor. What does this mean? A) The child has the legal right to consent to and make decisions for treatment. B) The nurse needs to check with the child to determine which parent has custody. C) A court-appointed guardian is needed to ensure that the child's rights are maintained. D) The nurse must contact the child's guardian for consent to treatment.

A) The child has the legal right to consent to and make decisions for treatment. Emancipation is the process by which an individual becomes liberated from the authority and control of another person. In pediatric care, this term refers to the emancipation of a child from the authority and control of parents or other guardians. A minor who is recognized as emancipated by state-mandated criteria can consent to medical, dental, or psychiatric care without parental knowledge, consent, or liability.

A nurse educator is conducting a class on abuse and violence for a group of new graduate nurses during orientation. Which statement by the educator best reflects current practice regarding these problems in women's health? A) "Asking every client about abuse and family violence is the best way to elicit accurate information." B) "The nurse should screen for these problems at every client encounter." C) "The nurse is not legally responsible for reporting suspected abuse or violence." D) "Since families are more stable than in the past, nurses are not as concerned about these problems as they used to be."

B) "The nurse should screen for these problems at every client encounter." Both child and intimate partner abuse is increasing in incidence. Families are more mobile than previously. Screening for child or intimate partner abuse should be included in all family contacts. Nurses must be aware of the legal responsibilities for reporting abuse.

Asian American women have the lowest risk of infant mortality of all cultural groups. Which statement best explains this phenomena? A) Asian American women have fewer incidences of hypertension. B) Asian American women have better access to prenatal care. C) Asian American women rarely have preterm infants born to them. D) Asian American women have the lowest incidence of chromosomal anomalies of any cultural group.

B) Asian American women have better access to prenatal care. African, Hispanic, and Native Americans have the highest risk of infant mortality because more than 40% of these populations do not receive any prenatal care. Asian American women are not less likely to have preterm infants, have fewer chromosomal anomalies or develop hypertension during pregnancy.

A 15-year-old client has just given birth and states that she does not want her infant to receive any newborn vaccines. What is the appropriate action for the nurse to take? A) Administer the newborn vaccines. B) Withhold the vaccines. C) Call the primary care provider. D) Ask the grandparents for permission.

B) Withhold the vaccines The client would frequently be considered emancipated and therefore legally able to make legal decisions regarding the health care of the infant. The nurse should withhold the vaccines but inquire to the reason for no vaccination.

When integrating the principles of family-centered care into the birthing process, the nurse would base care upon which belief? A) Birth is viewed as a medical event. B) Families are unable to make informed choices due to stress. C) Birth results in changes in relationships. D) Families require little information to make appropriate decisions for care.

C) Birth results in changes in relationships. Family-centered care is based on the following principles: Birth affects the entire family, and relationships will change; birth is viewed as a normal, healthy event in the life of the family; and families are capable of making decisions about their own care if given adequate information and professional support.

When providing family-centered care for a new mother and infant, which is the appropriate action by the nurse? A) Have the infant stay in the nursery. B) Oversee care provided by the mother. C) Encourage rooming-in to develop bonding. D) Limit interactions by other family members.

C) Encourage rooming-in to develop bonding The nurse should encourage rooming-in of the infant with the mother to develop bonding and provide physical and emotional care. This increases comfort level while nursing staff is available to monitor and provide guidance and assistance; it also promotes a healthy family unit.

Morbidity rates among children are most highly associated with which cause? A) Firearms at home B) School violence C) Environmental factors D) Suicide and homicide

C) Environmental factors The factors most commonly associated with child morbidity are environmental and socioeconomic problems. The more difficult the societal issues and the more marked the environmental poverty, the higher the illness rates and childhood morbidity. Firearms, violence in schools, homicide, and suicide are all factors in morbidity, but they are not strictly related to children.

When integrating the principles of family-centered care, the nurse would include which concept? A) Parents want nurses to make decisions about their child's treatment. B) Families are unable to make informed choices. C) People have taken increased responsibility for their own health. D) Families require little information to make appropriate decisions.

C) People have taken increased responsibility for their own health. Due to the influence of managed care, the focus on prevention, better education, and technological advances, people have taken increased responsibility for their own health. Parents now want information about their child's illness, to participate in making decisions about treatment, and to accompany their children to all health care situations.

When integrating the principles of family-centered care, the nurse would NOT include: A) Parents want to make decisions about their child's treatment. B) Families can make informed choices. C) People have taken less responsibility for their own health. D) Families require more information to make appropriate decisions.

C) People have taken less responsibility for their own health. Due to the influence of managed care, the focus on prevention, better education, and technological advances, people have taken increased responsibility for their own health. Parents now want information about their child's illness, they want to participate in making decisions about treatment, and they want to accompany their children to all health care situations.

After completing an assessment, the nurse examines the information to develop a wellness diagnosis for the client to identify which potential goal? A) Acute health problems B) Potential problems C) The potential for improvement in health D) Chronic health problems

C) The potential for improvement in health Wellness diagnosis identifies the potential for a client to move from one level of wellness to a higher level. The identification of potential, acute, and chronic health problems is part of the diagnostic process.

A young female client is pregnant for the first time and is uncertain who to seek prenatal care from. The nurse should point out which health care provider as the best choice? A) Perinatologist B) Neonatologist C) Family practitioner D) Obstetrician

D) Obstetrician The obstetrician is the physician of choice for prenatal care through labor and delivery. Perinatologists may care for women who have a high-risk pregnancy, and neonatologists provide care to infants. Family practitioner physicians may provide care but are less likely to attend in labor and delivery.

A nurse witnesses a peer tell a client, "You are a mother now and you have to do what is best for you baby. You have to breastfeed her!" Which is the best action by the nurse? A) Approach the client later and provide correct information. B) Immediately interrupt the conversation and reprimand the nurse. C) Fill out an incident report to go in the nurse's personnel file. D) Pull the nurse aside and inquire as to the content of the conversation.

D) Pull the nurse aside and inquire as to the content of the conversation. The nurse overheard just a small portion of the conversation between the client and the peer nurse. The best action would be to inquire as to the content of the conversation and then determine if the peer nurse's comments were appropriate. If the comments were inappropriate, the nurse would then need to fill out an incident report.